Cold Steel: Canadian Journal of Surgery Podcast

We sat down with arguably the world expert on low anterior resection syndrome. Dr. Marylise Boutros (https://twitter.com/BoutrosMarylise) is an academic colorectal surgeon at Cleveland Clinic Florida.. Dr. Boutros talks about her pioneering research to understand and treat the challenging functional issues that patients must content with. We also talk about her move to Cleveland Clinic and her advice for an academic surgical career. Links: 1. Low Anterior Resection Syndrome: Predisposing Factors and Treatment. https://pubmed.ncbi.nlm.nih.gov/34863592/ 2. Low Anterior Resection Syndrome in a Reference North American Sample: Prevalence and Associated Factors. https://pubmed.ncbi.nlm.nih.gov/37466264/ 3. Financial and occupational impact of low anterior resection syndrome in rectal cancer survivors. https://pubmed.ncbi.nlm.nih.gov/33724620/ 4. Assessing the readability, quality and accuracy of online health information for patients with low anterior resection syndrome following surgery for rectal cancer. https://pubmed.ncbi.nlm.nih.gov/30609222/ 5. Comparison of the Colonic J-Pouch Versus Side-To-End Anastomosis Following Low Anterior Resection: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/37507144/ Bio (from Cleveland Clinic website): Marylise Boutros is a Staff Colorectal Surgeon at the Cleveland Clinic Florida and the Regional Digestive Disease InstituteDirector of Research. Previously, Dr. Boutros was a Colorectal Surgeon at the Jewish General Hospital, Professor of Surgery at McGill University, and Colorectal Surgery Program Director. Having completed General Surgery residency at McGill University and Colorectal Surgery residency at Cleveland Clinic Florida, her clinical interests are advanced minimally invasive approaches to benign and malignant colorectal and anorectal diseases. She treats colon and rectal cancer, inflammatory bowel disease, diverticular disease, fecal incontinence and all anorectal disorders. Dr Boutros is a federally funded researcher who currently leads an internationally renowned research program focused on assessing innovations to improve recovery and functional outcomes after colorectal surgery using multicentre prospective trials, patient-centred interventions and patient-reported outcome measures. Within her research program, Dr Boutros has mentored over forty trainees and graduate students. Dr Boutros also has leadership roles in multiple international societies including Society of American Gastrointestinal and Endoscopic Surgeons, American Society of Colon and Rectal Surgeons, Canadian Society of Colon and Rectal Surgeons and the Canadian Association of General.

This is a re-broadcast to honour the memory of the "Boss" Dr. Feliciano. Original shownotes: It's not an understatement to say that Dr. David Feliciano is a true giant in trauma surgery. Dr. David V. Feliciano received his medical degree in 1970 from Georgetown University in Washington, D.C. He completed his general surgery training at Mayo Clinic, in trauma at Wayne State University, and vascular surgery at Baylor College of Medicine (where he trained under Dr. DeBakey). He was Professor of Surgery at Emory University and Surgeon-in-Chief at Grady Memorial Hospital in Atlanta, Georgia from 1991 to 2011. He is now a Clinical Professor of Surgery at the University of Maryland and an attending surgeon at Shock Trauma. We discuss with him how he recruited such amazing faculty, developing one's technical skills, research, and the future of trauma. 1.Trauma textbook: www.amazon.ca/Trauma-Eighth-Erne…oore/dp/1259860671 2.“Everything You Ever Wanted to Know about Trauma” public lecture: www.youtube.com/watch?v=99yddsDe6oU 3.“Leftovers” by Dr. Feliciano has one of the best lines in a paper ever: At this point, the chief surgical resident on the trauma service met with the attending surgeon for violating his own well-known rule—“wounds that don't heal contain dead tissue, infected tissue, cancer, or a foreign body.” www.ncbi.nlm.nih.gov/pmc/articles/PMC6263419/ 4.Pitfalls in the management of peripheral vascular injuries. www.ncbi.nlm.nih.gov/pmc/articles/PMC5877918/

We are re-broadcasting this episode in honour of the memory of the late Dr. David Feliciano. Original shownotes: In this episode, we were lucky enough again to be joined by Dr. David Feliciano. Dr. Feliciano is a world-renowned trauma surgeon and a passionate surgical historian. Today he joins us to talk about surgeons who won the Nobel Prize and the complex and rich history that surrounds them. Email us at podcast.cjs@gmail.com or send us a tweet @CanJSurg with your thoughts about this and all our previous episodes. Dr. David V. Feliciano received his medical degree in 1970 from Georgetown University in Washington, D.C. He completed his general surgery training at Mayo Clinic, in trauma at Wayne State University, and vascular surgery at Baylor College of Medicine (where he trained under Dr. DeBakey). He was Professor of Surgery at Emory University and Surgeon-in-Chief at Grady Memorial Hospital in Atlanta, Georgia from 1991 to 2011. He is now a Clinical Professor of Surgery at the University of Maryland and an attending surgeon at Shock Trauma. Links: 1. Nobel Prize winners who were trained as surgeons. Feliciano DV.Am Surg. 2009 Jan;75(1):15-9; quiz 97.PMID: 19213390 No abstract available. journals.sagepub.com/doi/abs/10.117…urnalCode=asua 2. Alexis Carrel (1873-1944): Nobel Laureate, 1912. Dente CJ, Feliciano DV.Arch Surg. 2005 Jun;140(6):609-10. doi: 10.1001/archsurg.140.6.609. jamanetwork.com/journals/jamasurg…ullarticle/508657 3. Joseph E. Murray (1919- ): Nobel Laureate, 1990. Cash MP, Dente CJ, Feliciano DV.Arch Surg. 2005 Mar;140(3):270-2. doi: 10.1001/archsurg.140.3.270.PMID: 15781791 No abstract available. jamanetwork.com/journals/jamasurg…ullarticle/508445 4. Michael Houghton, Winner of 2020 Nobel Prize. www.ualberta.ca/michael-houghton-…l-prize-2020.html

It is with sadness but also profound gratitude that we commemorate the passing of David V Feliciano on January 4, 2024. We invited our friend Neil Parry on the podcast to talk about our memories and the legacy of this amazing surgeon, researcher, and mentor. Links: 1. E27 David Feliciano On Trauma And Culture Building. https://soundcloud.com/cjs-podcast/e27-david-feliciano-on-trauma-and-culture-building 2. E46 Nobel Prize Winners In Surgery With David Feliciano. https://soundcloud.com/cjs-podcast/e46-nobel-prize-winners-in-surgery-with-david-feliciano 3. Feliciano Favorites with Trauma and Acute Care Surgery Open! https://twitter.com/hashtag/FelicianoFavorites?src=hashtag_click' 4. Southeast Surgical Congress tribute: https://www.youtube.com/watch?v=YRaipv7hG9Y 4. E31 Grace Rozycki On Trauma Ultrasound, Gender Equity, And Mentorship. https://soundcloud.com/cjs-podcast/e31-grace-rozycki-on-trauma-ultrasound-gender-equity-and-mentorship/s-cIzPNd8HDtX

We still got more in the vault from CSF 2023! In this episode, Dr. Spoyalo talked about her work on perioperative warming at Vancouver General Hospital. Listen to the work she's done to understand what goes on for warming (most patients have 11 blankets!) and the modeling she's done to figure out the most effective techniques for warming. Another example of the amazing work being done through Dr. Andrea MacNeill's Planetary Health Lab! Links: 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718225/ 2. UBC Planetary Healthcare Lab: https://www.med.ubc.ca/news/planetary-healthcare-lab/ 3. https://soundcloud.com/cjs-podcast/e62-andrea-macneill-on-planetary-health-in-the-operating-room

In this special episode, we had the opportunity to do our first live Cold Steel episode! We were lucky enough to be able to have Dr. Justin Dimick join us at Queen's University in Kingston, Ontario as part of our William Ersil research day. During this interview we really delved into Dr. Dimick's life story and his vision for how we can continue to improve the science and craft of surgery. Links: 1. https://surgery.queensu.ca/research/2022-william-ersil-resident-research-day#:~:text=The%20William%20Ersil%20Resident%20Research,the%20supervision%20of%20Attending%20Staff. 2. How I Built This: https://www.npr.org/series/490248027/how-i-built-this 3. https://www.ourherald.com/articles/randolph-nationals-dimick-is-banker-of-the-year/ 4. https://www.ourherald.com/articles/justin-dimick-wins-medical-research-award/ 5. Variation in Hospital Mortality Associated with Inpatient Surgery. https://www-nejm-org.proxy.queensu.ca/doi/full/10.1056/nejmsa0903048 6. Complications, failure to rescue, and mortality with major inpatient surgery in medicare patients. https://pubmed.ncbi.nlm.nih.gov/19953723/ 7. https://www.canjsurg.ca/e60-andrew-ibrahim-on-architecture-visual-abstracts-and-design-in-surgery. 8. Wired article on Andrew Ibrahim. https://www.wired.com/story/lets-save-some-lives-doctors-journey-into-pandemic/ 9. Michigan Mentorship Academy. https://www.youtube.com/playlist?list=PLNxqP-XbH8BLhAqx9o_sTLCV2dpGebFM9 10. Chelsea Harris, Justin Dimick, Lesly Dossett. Cultural Complications: A Novel Strategy to Build a More Inclusive Culture. https://pubmed.ncbi.nlm.nih.gov/32740257/

Dr. Haytham Kaafarani is a trauma surgeon at Massachusetts General Hospital. We caught up with him after he recently gave a phenomenal talk at the Canadian Surgical Forum in Vancouver earlier this year. Dr. Kaafarani talked about his work in Lebanon after the explosion in 2020, his research on intra operative adverse events, and ultimately on his work as surgeons as second victims. This episode is a clarion call for surgeons everywhere to develop these support systems for each other. Links: 1. Intraoperative Adverse Events in Abdominal Surgery: What Happens in the Operating Room Does Not Stay in the Operating Room. https://pubmed.ncbi.nlm.nih.gov/27805961/ 2. Derivation and validation of a novel severity classification for intraoperative adverse events. https://pubmed.ncbi.nlm.nih.gov/24702887/ 3. The Surgeon as the Second Victim? Results of the Boston Intraoperative Adverse Events Surgeons' Attitude (BISA) Study. https://pubmed.ncbi.nlm.nih.gov/28093300/ 4. Design and Impact of a Novel Surgery-Specific Second Victim Peer Support Program. https://journals.lww.com/journalacs/abstract/2020/06000/design_and_impact_of_a_novel_surgery_specific.16.aspx

Do you really have to do that appendectomy for acute uncomplicated appendicitis at 2 am??? Now you have level 1 evidence to tell you! Continuing on with our best of Canadian Surgical Forum 2023 series, we interviewed Dr. Zuhaib Mir (current HPB and transplant fellow at Dalhousie University). He spoke on behalf of his coinvestigators on their amazing work on the role of delayed appendectomy for acute appendicitis. YouTube version with video review of the paper: https://www.youtube.com/watch?v=rtOX7kKxe7o Disclaimer: We are not part of the organizing committee of CSF or CAGS. The best way to get all the content is to attend the meeting live in person! See you in Winnipeg in 2024! 1. DELAY trial: https://pubmed.ncbi.nlm.nih.gov/37436871/ 2. www.canadiansurgeryforum.com/

This year we've had the pleasure of introducing a new segment where we highlight some of our favourite sessions from our national general surgery conference, the Canadian Surgical Forum (CSF). In this episode, hepatopancreaticobiliary (HPB) surgeon Dr. Katrina Duncan (@dockcduncan) and HPB fellow Dr. Richard Gilbert (@RichWDGilbert) update us on the best HPB content from this year's conference. Disclaimer: We are not part of the organizing committee of CSF or CAGS. The best way to get all the content is to attend the meeting live in person! See you in Winnipeg in 2024! Links: 1. Tweetorial from Dr. Duncan and Dr. Gilbert: https://twitter.com/CHPBAsurg/status/1705620586263666971 2. https://www.canadiansurgeryforum.com/

How do surgeons incorporate new techniques, tools and approaches while in practice? Dr. Hugh MacDonald is a colorectal surgeon at Queen's University. He has been in practice for nearly 30 years and has been at the forefront of adopting new techniques into his practice, including laparoscopy and most recently robotic surgery. We talk to Hugh about how he approaches innovation and what drives him to constantly look for better ways to take care of patients. YouTube link: https://youtu.be/FAb2_gsXzAQ Links: 1. https://pubmed.ncbi.nlm.nih.gov/35212820/ 2. IDEAL collaborative: https://www.ideal-collaboration.net/ 3. Interview with Sunil Patel: https://soundcloud.com/cjs-podcast/sunil-patel-on-robotic-colorectal-surgery-and-spin-in-surgical-research 4. Interview with Antonio Caycedo-Marulanda: https://soundcloud.com/cjs-podcast/e143-masterclass-with-antonio-caycedo-marulanda-on-transanal-excision-of-rectal-lesions

Dr. Amin Madani is the director of the Surgical AI Research Academy (SARA) at the University Health Network (UHN). He is an endocrine and acute care surgeon at UHN and assistant professor of surgery at the University of Toronto. Dr. Madani talked to us and showed us some of the work he is doing on AI in surgery and in particular on computer vision. He really breaks down for us the terms AI, machine learning, and data science, and highlighted some of the promise and challenges for AI in surgery. Email Dr. Madani: amin.madani@uhn.ca Watch full unedited interview on YouTube: https://youtu.be/aawdQy90v2Q Links: 1. https://temertysimcentre.com/surgical-artificial-intelligence-research-academy-sara/ 2. Video of Go No Go: https://www.youtube.com/watch?v=MmcW8JK1Qv4 3. Surgical Data Science: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135051/ 4. Artificial Intelligence for Intraoperative Guidance: Using Semantic Segmentation to Identify Surgical Anatomy During Laparoscopic Cholecystectomy. https://pubmed.ncbi.nlm.nih.gov/33196488/

On this episode we were joined by the Twitter (X???) legend Dr. Ron Barbosa. Dr. Barbosa is a trauma surgeon at Legacy Health in Portland, Oregon. He's gained popularity for his fantastic threads on Twitter discussing topics in surgery everyone always wondered about but are too afraid to ask. We also discuss the future of surgery, social media, and surgical education. Links: 1. Ron Barbosa Twitter: https://twitter.com/rbarbosa91 2. Gold handled needle driver: https://twitter.com/rbarbosa91/status/1535125990766268416?lang=en 3. Traction/Countertraction: https://twitter.com/rbarbosa91/status/1587495330639400960?lang=en 4. French scale: https://twitter.com/rbarbosa91/status/1532622531558903808

In this episode, we were joined by colorectal surgeon Dr. Nathan Ginther. Dr. Ginther is based out of the University of Saskatchewan, and is the principle author of the CJS article published in January of 2023, entitled, "A comparison of perineal stapled prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals". https://www.canjsurg.ca/content/66/1/E8 We discuss this paper in detail and rectal prolapse more generally. Email comments/thoughts to podcast.cjs@gmail.com or tweet @CanJSurg

We caught up with Dr. Justin Rivard, new program director at University of Manitoba general surgery residency program! Links: 1. https://umanitoba.ca/medicine/department-surgery/general-surgery-residency 2. https://www.instagram.com/uofmgeneralsurgery/?hl=en

We were joined on this episode by Dr. Jonathan White. Dr. White is a colorectal surgeon at Royal Alexandra Hospital in Edmonton, Alberta, and is the co-creator of @Surgery101 , the wildly successful surgical podcast aimed at medical students. Dr. White talked about his early career, the impetus behind Surgery101, as well as his recent sabbatical in Ireland. Links: 1. Surgery101: https://surgery101.org/ 2. Surgery 101: evaluating the use of podcasting in a general surgery clerkship. https://pubmed.ncbi.nlm.nih.gov/22022905/ 3. Paul Duffy on Sabbaticals: https://soundcloud.com/cjs-podcast/e67-paul-duffy-on-sabbaticals

On this episode we were joined by the master of optical evaluation of polyps, Dr. Rob Bechara. Dr. Bechara is an advanced therapeutic endoscopist at Queen's University, and he gave us a masterclass on how to look at polyps and assess what kind of polyp it is. This is an essential primer on important macroscopic and microscopic polyp characteristics and really a must-listen for anyone who does endoscopy, surgeon or gastroenterologist. Also don't miss his really unique experience training in Japan and what we might learn about our own training models in the process. You can watch the full video at our YouTube channel @coldsteelsurgery. Link to YouTube video: https://youtu.be/XmAI-OyCCd0 Rob Bechara on Twitter: www.twitter.com/robertbechara Rob's YouTube channel: www.youtube.com/@RBEndoscopy Links: 1. Dr. Haruhiro Inoue - https://endoscopyonair.com/members/haruhiro-inoue/ 2. Clinical Importance of Magnification in the Assessment of Colorectal Lesions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489521/

All of us at some point in our career experience physical pain while operating. We were lucky to be joined by Dr. Geeta Lal (@geetalalmd on twitter) on the show today to talk about the concept of surgical ergonomics. Make sure you check out the YouTube version of this episode, for a special segment where Dr. Lal looks at some actual footage of us operating and makes some recommendations on what we might do differently. This is such an important conversation on how we can take care of ourselves so we can better care for our patients. Links: 1) https://surgicalergonomics.com/ 2) The Society of Surgical Ergonomics has a variety of information and education materials (including articles): https://www.societyofsurgicalergonomics.org/ 3) https://www.facs.org/for-medical-professionals/education/programs/surgical-ergonomics/recommendations/ 4) Susan Hallbeck OR stretch videos: https://www.mayo.edu/research/labs/human-factors-engineering/or-stretch/or-stretch-videos Bio: Dr. Geeta Lal is a board-certified General Surgeon (both USA and Canada) with advanced Fellowship training in Endocrine Surgical Oncology. She is also a tenured Associate Professor of Surgery with a cross-appointment in Pediatrics at a major academic medical center. Dr. Lal has spent the last 17 years practicing Endocrine surgery and has extensive experience in thyroid and parathyroid surgery, including re-operative surgery and pediatric thyroid cancer. She is also involved in teaching surgical residents and medical students, both in the operating room and clinics. Dr. Lal has served in many different roles throughout her career, including being the Co-Leader of her cancer center's Endocrine Multidisciplinary Oncology Group and heading an NIH-funded basic science laboratory focused on the role of the Extracellular Matrix 1 (ECM1) gene for many years. She has since transitioned from the lab into an administrative role as the Associate Chief Quality Officer for the Adult Inpatient Services at her hospital. Dr. Lal continues to perform both clinical and quality and safety research and has presented and published her work extensively.

This is a rebroadcast of our conversation with Dr. Tracy Scott, co-program director of the UBC general surgery residency program! Links: 1. https://twitter.com/ubcgensurg?lang=en 2. https://surgery.med.ubc.ca/divisions/general-surgery/ 3. https://gsresidency.surgery.med.ubc.ca/

This is a rebroadcast of our conversation with Dr. Ryan Rochon, program director for the Calgary general surgery residency program! Links: 1. https://twitter.com/calgarygensurg 2. https://www.instagram.com/calgarygensurg/?hl=en 3. https://cumming.ucalgary.ca/departments/surgery/sections/general-surgery

This is a rebroadcast from last year's conversation with former program director Dr. Mike Ott! Please check out new program director Dr. Julie Ann Van Koughnett's twitter handle: https://twitter.com/javankoughnett Links: 1. https://twitter.com/western_gensurg 2. https://www.schulich.uwo.ca/generalsurgery/

This is a rebroadcast of our conversation with Dr. Sender Liberman about the McGill general surgery residency program! Links: 1. https://www.mcgill.ca/generalsurgery/current-residents 2. https://twitter.com/McGillGenSurg

This is a rebroadcast of last year's conversation with Dr. Lucy Helyer on the Dalhousie general surgery residency program! Links: 1. https://medicine.dal.ca/departments/department-sites/surgery/divisions/general-surgery.html 2. https://www.instagram.com/dalhousiegensurg/?hl=en

We had the pleasure of speaking to Dr. Ilun Yang, new program director of the general surgery residency program at McMaster University! Links: 1. https://twitter.com/mcmastersurgery 2. https://surgery.mcmaster.ca/divisions/general-surgery 3. https://www.instagram.com/macgensurg/?hl=en

We had the pleasure of catching up with Dr. Alex Mathieson for the 2nd year in a row to talk about the MUN general surgery residency program! YouTube: https://youtu.be/8Xn8KnamcQ0 Links: 1. https://www.mun.ca/medicine/surgery/ 2. https://www.instagram.com/mungensx/?hl=en

We had the pleasure of speaking to new program director Dr. Michael McCall about the U of A general surgery residency program! YouTube version: https://youtu.be/iD40jZgXcvs Links: 1. Slides: https://docs.google.com/presentation/... 2. Program Website: https://www.ualberta.ca/surgery/divis... 3. Instagram: https://www.instagram.com/uofagensurg/

We had the pleasure of speaking with program director and pediatric surgeon Dr. Sarah Jones about the Queen's University General Surgery Program! YouTube: https://youtu.be/RdoEpu_wGjM Links: 1. Queen's General Surgery Department: https://surgery.queensu.ca/postgraduate/general-surgery 2. Twitter: https://twitter.com/QueensGenSurg 3. Queen's Colorectal Surgery: https://twitter.com/QueensCRS

It's that time of year again, when we have the pleasure of interviewing and selecting our future colleagues. We are, of course, talking about the CaRMS interview process. Most of our listeners will know that CaRMS stands for Canadian Resident Matching Service. Interviews are well underway for final year medical students across the country. Like last year, we felt it would be helpful for prospective applicants to hear from various general surgery programs across the country about what their residency training programmes have to offer. We have a few new programs and a few repeats from our episode from last year. This year we've broken it up into separate individual episodes from each program, and you can also find the video version on YouTube channel. Of note, we do not have any affiliation with CaRMS. Please check the CaRMS website for the full list of general surgery residency training programs. Last year, Dr. Ball and I talked a bit about our thoughts surrounding interviews and some general advice to applicants. Stay tuned for a re-broadcast of that conversation. If you have questions or comments, we'd love to hear from you, so email us at podcast.cjs@gmail.com or tweet at us @CanJSurg.

Stay tuned till the end of the video where Dr. Caycedo shows us some clips of his own operations and shares his tips and tricks. If you like the podcast, give us a review on iTunes and subscribe to us on our YouTube channel @coldsteelsurgery. Links: 1. Transanal endoscopic microsurgery: a review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968206/ 2. Transanal minimally invasive surgery for benign large rectal polyps and early malignant rectal cancers: experience and outcomes from the first Canadian centre to adopt the technique. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726971/ 3. The surgical defect after transanal endoscopic microsurgery: open versus closed management. https://pubmed.ncbi.nlm.nih.gov/27387173/ 4. E119 Patricia Sylla on taTME, surgical innovation, and SAGES presidency. https://soundcloud.com/cjs-podcast/e119-patricia-sylla-on-tatme-surgical-innovation-and-sages-presidency Bio: Twitter: https://twitter.com/caycedomarula?s=20&t=wmNjxXb_fhNHbz2eVzDoHQ Dr. Antonio Caycedo is a colorectal surgeon who was named an associate professor at Queen's University in May 2020, after having worked in Northern Ontario for more than nine years. Dr. Caycedo completed medical school and his initial general surgery residency in his native Colombia. Dr. Caycedo moved to Canada in 2004 to complete his second general surgery residency at the University of Ottawa, followed by a clinical fellowship in colorectal surgery at Western University in London, Ontario. In addition, he received a master's degree in clinical research from Liverpool University (UK). Dr. Caycedo has extensive knowledge in the least invasive treatment of rectal cancer and is always on the hunt for new treatments. He is credited with introducing transanal minimally invasive surgery (TAMIS) to Canada and is a national pioneer of transanal Total Mesorectal Excision (taTME). The Royal College of Surgeons of Canada has awarded him board certification in both general and colorectal surgery. Dr. Caycedo pays special attention to clinical research and education; as a result, he has established a number of collaborations with surgeons in Canada and abroad, which has led him to participate in a number of clinical trials. Dr. Caycedo was recently recruited as the head of the division of colorectal surgery at OrlandoHealth.

This week we were joined by trauma surgeon and podcaster Dr. Dennis Kim. Dr. Kim, among many other things, hosts the very successful and highly educational @TraumaICURounds podcast. We in Canada are lucky enough to have him back on Canadian soil, and so on this episode talked to him about his experience moving back to Canada and collaborating to develop a trauma system in Victoria, BC. We then delved into a masterclass on fascial dehiscences, ranging from closure techniques to prevent dehiscences in the first place to strategies for dealing with them when they happen. Links: 1. https://www.traumaicurounds.ca/ 2. STITCH trial: https://pubmed.ncbi.nlm.nih.gov/26188742/ 3. Wittman Patch: https://medizzy.com/feed/46410 4. Abra Closure Device: https://www.cjmedical.com/products/specialties/dynamic-tissue-systems/abra-abdominal-wall-closure Bio (from https://medicalstaff.islandhealth.ca/news-events/dr-dennis-kim): Originally from Toronto, Dr. Kim completed medical school at McMaster University followed by General Surgery residency and a Critical Care Medicine fellowship at the University of Ottawa. He subsequently underwent a 2-year fellowship in Trauma & Surgical Critical Care at UC San Diego. Dr. Kim is quadruple board certified in Canada and the US. Dennis has been an attending surgeon in the Division of Trauma/Acute Care Surgery/Surgical Critical Care at Harbor-UCLA Medical Center in South Los Angeles since 2012, where he served as the Medical Director of the Trauma SICU and Chair of the Hospital Critical Care Committee. An avid educator and recipient of several teaching awards, Dr. Kim is an Associate Professor of Clinical Surgery and the former Co-Chair of the College of Applied Anatomy at the David Geffen School of Medicine at UCLA. Dr. Kim is actively involved in and holds numerous leadership roles in several key national trauma organizations including EAST, AAST, and the American College of Surgeons Committee on Trauma. He has published over 140 peer-reviewed publications, 25 book chapters, and several Practice Management Guidelines focused on the optimal care of critically injured and ill patients. Dr. Kim hosts the very popular Trauma ICU Rounds Podcast and is active across several social media platforms. Dr. Kim joins us with his wife, Alexis, their four children, and dog. Traveling, cooking, and spending time in the outdoors are but a few of the activities that help bring balance and joy to the de Rosenroll-Kim family. Dr. Kim brings with him a wealth of experience regarding trauma program development, performance improvement, and patient safety initiatives.

In this “journal club” edition of the podcast, we are joined by the thoughtful trauma guru Dr. Hameed to talk about his paper in the Canadian Journal of Surgery (CJS). This paper, authored by Drs. Ball, Lee, Kaminsky, and Hameed gets at the “heart” of both the decision-making and technical aspects of treating penetrating cardiac injuries. YouTube version: https://youtu.be/_g6Nu66Q3AM YouTube channel: https://www.youtube.com/@coldsteelsurgery Links: 1. Technical considerations in the management of penetrating cardiac injury: https://www.canjsurg.ca/content/65/5/E580 2. Sternotomy or drainage for a hemopericardium after penetrating trauma: a randomized controlled trial. https://pubmed.ncbi.nlm.nih.gov/23604058/ 3. A caveat to the Performance of Pericardial Ultrasound in Patients with penetrating Cardiac Wounds. https://pubmed.ncbi.nlm.nih.gov/19901678/ Morad Hameed Bio: Dr. Morad Hameed is a trauma surgeon and intensivist at the Vancouver General Hospital (VGH) and an Assistant Professor of Surgery at the University of British Columbia (UBC). He completed medical school and surgical residency at the University of Alberta, graduate studies in public health at Harvard University, and fellowships in Trauma Surgery and Surgical Critical Care at the University of Miami. He spent 3 years on the surgical faculty at the University of Calgary, before moving to Vancouver. He is the Head of the UBC and VGH Division of General Surgery and is a Service Chief for Acute Care Surgery at VGH. He also chairs the Research Committee of the Trauma Association of Canada, and is the immediate past chair of the Canadian Association of General Surgeons Committee on Acute Care Surgery. His research focuses on systems of trauma care and acute care surgery. Dr. Hameed's research teams have received grants from the Canadian Institutes for Health Research, the Michael Smith Foundation for Health Research, and other funding agencies for their work on disparities in injury risk and access to trauma systems in Canada. The development of promising partnerships with trauma investigators at the University of Cape Town has recently extended this work to South Africa.

We are absolutely delighted to be back with you all, and starting up our new season of Cold Steel! After a few months hiatus, we are excited to bring you lots of fresh new content, and especially more video content to accompany the podcast. For this episode, we had the opportunity to bring back Dr. Mark Soliman, chief of colorectal surgery at AdventHealth Orlando, to talk about his exciting new venture to develop a social media app for surgeons. The app is called SurgeON. Dr. Soliman talks to us about entrepreneurship and what it takes to build a new social media platform. As always, we'd love to hear your feedback at podcast.cjs@gmail.com or tweet at us @CanJSurg. YouTube version: https://www.youtube.com/watch?v=LqiaSkXTH0I Links: 1. Cold Steel YouTube Channel: https://www.youtube.com/@coldsteelpodcast 2. Mark Soliman on Robotic Colorectal Surgery and Videos in Surgical Education: https://soundcloud.com/cjs-podcast/e71-mark-soliman-on-robotics-and-videos-in-surgery 3. SurgeON App: https://surgeonapp.com/ 4. Lean Product Playbook: https://leanproductplaybook.com/ Mark Soliman Twitter: @marksoliman Mark Soliman YouTube: www.youtube.com/marksoliman Bio (from https://www.adventhealthcancerinstitute.com/meet-our-cancer-team/mark-soliman): Mark Soliman, MD, FACS, FASCRS is a board-certified colon and rectal surgeon. He is the Medical Director of Colorectal Surgery for the AdventHealth Digestive Health and Surgery Institute and also the Department Chairman for Colorectal Surgery. A Florida native and a proud graduate of the University of Florida, he was part of an elite junior medical program through which he earned both his undergraduate and medical degrees with honors by age 23. After serving as Chief Resident at Baptist Health System in Birmingham, AL, he obtained his advanced subspecialty training in Colorectal Surgery at the Colon and Rectal Clinic of Orlando. Dr. Soliman is one of the most recognized colorectal surgeons nationwide in robotic colorectal surgical operations and has written nearly 50 book chapters, scientific abstracts, and manuscripts on this and its related fields. He is proficient in the Arabic language.

We recorded this episode live at the 2022 Canadian Surgical Forum in Toronto, Canada. We managed to catch up with the globetrotting colorectal surgeon, Dr. Neil Smart, right after his in-depth session at CSF on parastomal hernias. Dr. Smart is based out of Exeter, UK and is the current Editor-in-Chief of the journal Colorectal Disease. In this masterclass episode we delved deep into the management of parastomal hernias, covering stoma formation itself to the surgical management of this complex disease. Be sure to check out the links to Dr. Smart's study in the show notes. Neil Smart Twitter handle: @Neil_J_Smart Links: 1. Cohort study to Investigate the prevention of Parastomal Hernia (CIPHER) study: Cohort study to Investigate the prevention of Parastomal Hernia (CIPHER) 2. Twitter link to CIPHER study: https://twitter.com/TheCIPHERStudy?s=20&t=ECwhYqAUrf43WN9h0SuFzw 3. PROPHER study: https://www.escp.eu.com/research/cohort-studies/2019-patient-reported-outcomes-after-parastomal-hernia-treatment 4. Twitter link to PROPHER study: https://www.escp.eu.com/research/cohort-studies/2019-patient-reported-outcomes-after-parastomal-hernia-treatment Bio (from https://www.europeanherniasociety.eu/new-ehs-wing-members): Neil Smart is an academic surgeon at the Royal Devon & Exeter hospital & Honorary Associate Professor at the University of Exeter Medical School. His clinical practice includes subspecialty interests in rectal cancer, hernia prophylaxis, incisional hernia repair / complex abdominal wall reconstruction and parastomal & perineal hernias. Neil has been involved in hernia research for over 15 years, leading a range of study designs from clinical to translational studies, and participating in RCTs and qualitative research. Most notably: • generated over £1.3 million total in research funds directed primarily at hernia research. • Chief Investigator of the NIHR funded CIPHER study on parastomal hernia. • translational work into mesh characteristics. • co-applicant of research onto parastomal hernia repair, incisional hernia outcomes reporting and the impact of Covid on hernia surgery. Neil has published extensively in the field of hernia surgery and mesh, including 3 hernia related guidelines for EHS & ACPGBI on parastomal & perineal hernias. He has been a specialty advisor to NICE for mesh & stomas since 2018. Neil is Editor in Chief of the journal Colorectal Disease and has provided peer review for over 20 other journals. He has provided peer review for grant awarding bodies including NIHR / MRC / RCUK / AMRC.

Sometimes it's hard to process what we've all been through collectively over the last 2 years since the start of COVID19. We are facing tremendous strains on health care system in Canada and it's probably fair to say that many health care workers are facing burnout. Our guest for this week's episode had a really inspiring response to her own feelings of burnout and frustration. Dr. Heather Patterson is an adult and pediatric emergency physician in Calgary. She just released her book, Shadows and Light, a book of photographs that document the experience of dealing with the pandemic. We caught up with her to ask her about the motivation for the book and what's she's learned along the way. Check out some pictures from her book at the links below! Buy Dr. Patterson's book here: https://gooselane.com/products/shadows-and-light 1. Dr. Patterson's website: https://www.heatherpattersonphotography.com/ 2. Dr. Patterson's instagram: https://www.instagram.com/heather.l.patterson/?hl=en 3. Pictures of Sam and Jim: https://drive.google.com/drive/folders/1LhFPORGlkhUdqjgExu8XrP4NxETG08V6?usp=sharing Bio: (from https://www.heatherpattersonphotography.com/about) I am an emergency physician, photographer and mom of 2 who specializes in lifestyle and medical photography. My images capture the raw emotions and realities of daily life and celebrate the unique personalities and stories of our lives. My current project shares the authentic story of patient experiences and the healthcare team collaboration in Calgary, Alberta during the COVID-19 pandemic. I hope that this celebration of our shared humanity generates empathy and inspires others to see what we can accomplish when we work together.

This week we caught up with Dr. Elijah Dixon, a liver and pancreas surgeon at the University of Calgary, to talk about mindfulness and meditation. Dr. Dixon really opened our eyes to how those practices might help us both inside and outside the operating room. We also asked Dr. Dixon about what it was like to be the president of the Americas Hepato-Pancreatico-Biliary Association as well as the Canadian Association of General Surgeons. Links: 1. Eckhart Tolle: https://eckharttolle.com/ 2. Waking Up app: https://www.wakingup.com/ 3. One Blade of Grass: Finding the Old Road of the Heart, a Zen Memoir by Henry Shukman. https://www.amazon.ca/One-Blade-Grass-Finding-Memoir/dp/1640092625 4. Jillian Horton interview: https://soundcloud.com/cjs-podcast/e83-jillian-horton-on-writing-burnout-and-the-quest-for-a-better-culture-in-medicine 5. Stroke of Insight TED talk: https://www.ted.com/talks/jill_bolte_taylor_my_stroke_of_insight?language=en Bio (taken from https://cumming.ucalgary.ca/sites/default/files/teams/236/april-2016-newsletter.pdf): Dr. Dixon is a Professor of Surgery, Oncology and Community Health Sciences with the University of Calgary. He is a practicing General Surgeon at Foothills Hospital with a focus in Hepatobiliary/Pancreatic Surgery. Dr. Dixon completed his Undergrad in General Science and Medical School at the University of Manitoba, and then Surgical Residency at the University of Calgary. From there he went to the University of Toronto and did a Fellowship in Hepatobiliary/Pancreatic Surgery and GI Transplantation at the Toronto General Hospital. He then proceeded to the Harvard School ofPublic Health and did a Masters in Epidemiology. Dr. Dixon's research interests include the development of quality indicators of care for patients undergoing hepatic resection for metastatic colorectal cancer. He conducts clinical research, particularly in the area of hepato-pancreatico-biliary surgery.

This week on the podcast we invited Corrie White, an absolutely fabulous and experienced Medical Office Assistant to talk about what it takes to set up a well functioning office. Corrie breaks down how to find a good assistant and what goes into setting up an efficient system. We'd love to hear from listeners: what do you wish you had known when you were first setting up your practice? Email us a podcast.cjs@gmail.com or tweet at us @CanJSurg. We'd like to make a plug for the upcoming Canadian Surgical Forum or CSF. This year the conference is happening in Toronto from September 15th to the 17th. There is a fantastic program this year, so be sure to register and attend. At the very least follow the session highlights on twitter with the hashtag #CSF2022. Links: 1. Canadian Surgery Forum: https://www.canadiansurgeryforum.com/ 2. https://www.lx.com/social-justice/a-gynecologist-asked-women-how-to-design-his-new-office-the-answers-are-so-on-point/45960/#:~:text=Ryan%20Stewart%2C%20has%20gone%20viral,in%20Indianapolis%20in%20early%202022.&text=I%20have%20the%20opportunity%20to%20design%20my%20office%20from%20scratch.

This week we got to peek behind the curtains of academic publishing with Wendy Carroll. Wendy is the Managing Editor of the Canadian Medical Association Journal group. Wendy had some amazing insights into the whole process of what goes on with the submission process as well as the overall landscape for journals in 2022. Perhaps our favorite part of our conversation with Wendy was her tips about what makes for good writing! Links: 1. Eight Step editing: https://www.editors.ca/eight-step-editing-jim-taylor-0 2. Predatory publishing solicitation: a review of a single surgeon's inbox and implications for information technology resources at an organizational level. https://pubmed.ncbi.nlm.nih.gov/34105930/

Dr. Charles Vollmer is the Chief of GI surgery at the University of Pennsylvania and is a passionate pancreatic surgeon. This is the second part of our masterclass series with Dr. Vollmer on cystic lesions of the pancreas. In part II, Dr. Vollmer dives deep specifically on IPMNs, giving us an in-depth discussion of types of IPMNs, the various guidelines for IPMN management, as well as an overview of operative principles for resecting IPMNs.

Dr. Charles Vollmer is the Chief of GI surgery at the University of Pennsylvania and Director of Pancreatic Surgery. He is a repeat guest of the show. We were lucky enough to have him do another masterclass for Cold Steel, this time on cystic neoplams of the pancreas. In part 1 of this masterclass, Dr. Vollmer gives us an overview of cystic lesions of the pancreas, as well as their diagnosis and management. Make sure to check out part II as well, where Dr. Vollmer specifically focuses on IPMNs. Links: 1. https://soundcloud.com/cjs-podcast/e33-chuck-vollmer-on-peer-review-and-productivity 2. https://soundcloud.com/cjs-podcast/e82-charles-vollmer-on-pancreatic-fistulas Bio: Dr. Charles Vollmer is the Chief of GI Surgery and Director of Pancreatic Surgery at the University of Pennsylvania where he holds the rank of Professor of Surgery. Dr. Vollmer began his career at the Beth Israel Deaconess Medical Center in Boston where he served as an Assistant Professor of Surgery at Harvard Medical School before moving to Penn in 2011. He specializes in Pancreaticobiliary and other complex gastrointestinal surgery with a clinical research focus in outcomes assessment of high-acuity surgery. He has authored over 100 manuscripts and numerous book chapters. He is active in multiple national and international surgical societies where he has served in various leadership positions, including being a past President of the AHPBA. He is the current Scientific Program Chair for the IHPBA, and sits on their Executive Committee and Council. He is currently a reviewer for over 20 medical specialty journals and is on the Editorial Boards of Annals of Surgery, Surgery, HPB, JOGS, and the Journal of Surgical Oncology.

On this episode we had the privilege of speaking with Dr. Donna Kimmaliardjuk (@DKimmaliardjuk on Twitter). Dr. Kimmaliardjuk is the first Inuk cardiac surgeon in Canada and has won numerous awards for her trailblazing work. We were lucky enough to catch up with her to ask her about her career and get her thoughts on how we can both make surgery a more inclusive profession as well as how we can better serve our Indigenous patients. Links: Twitter: https://twitter.com/DKimmaliardjuk?s=20&t=DnmhGW0RRouo2ojP9oPEDQ 1. I had to open his chest to save his life. That's the day I felt, this is badass. https://www.thestar.com/news/canada/2020/03/08/i-had-to-open-his-chest-to-save-his-life-thats-the-day-i-felt-this-is-badass.html 2. Postoperative outcomes for Nunavut Inuit at a Canadian quaternary care centre: a retrospective cohort study. https://www.cmajopen.ca/content/10/2/E304 3. Canada's first Inuk heart surgeon returns from U.S. to take job in St. John's. https://www.cbc.ca/news/canada/newfoundland-labrador/donna-may-kimmaliardjuk-cardiac-surgeon-1.6166828 4. Canada's first Inuk cardiac surgeon gets to the heart of the matter. https://www.theglobeandmail.com/business/adv/article-canadas-first-inuk-cardiac-surgeon-gets-to-the-heart-of-the-matter/ 5. If Joyce Echaquan were white, she would still be alive, Quebec coroner says. https://www.cbc.ca/news/canada/montreal/echaquan-coroner-report-health-care-system-racism-1.6199964 Bio: Dr. Donna May Kimmaliardjuk is Canada's first Inuk cardiac surgeon. She attended medical school at the University of Calgary and then was matched to the University of Ottawa for her cardiac surgery residency. She went on to train at the prestigious Cleveland Clinic for her fellowship. She has won numerous awards, including the 2018 Indspire award. She is currently a staff cardiac surgeon at Eastern Health in St. John's, Newfoundland.

We touched some “taboo” subjects today on the podcast – money and religion! Dr. Jeff Way is a trauma and general surgeon in Calgary. Today we asked Dr. Way about his interest in spirituality and how that has affected his career, inside and outside the operating room. We got his thoughts on managing a busy practice as well as his work on a provincial and national level with the government on healthcare and billing. Links: 1. Establishment and cost analysis of an office surgical suite. https://www.nlc-bnc.ca/eppp-archive/100/201/300/cdn_medical_association/cjs/vol-39/issue-5/0379.htm

Dr. Homer Tien is a trauma surgeon at Sunnybrook Hospital in Toronto. We were so excited to have him on the show because of the incredible work that he has done in multiple leadership roles, more recently as the president and CEO of ornge, Ontario's air ambulance and transport service. Largely because of the amazing work he had done with ornge, Dr. Tien was also made in charge of the COVID19 vaccine distribution task force back in April 2021. This was a conversation about trauma care, paramedic services, and air ambulances, but even more importantly, we got to hear Dr. Tien's insights on leadership. Links: 1. Preventable Deaths From Hemorrhage at a Level I Canadian Trauma Center. https://www.researchgate.net/profile/Fernando-Spencer-Netto/publication/6585292_Preventable_Death_From_Hemorrhage_at_a_Level_I_Canadian_Trauma_Center/links/5a1d4cd50f7e9b2a5317123c/Preventable-Death-From-Hemorrhage-at-a-Level-I-Canadian-Trauma-Center.pdf 2. Ornge. https://www.ornge.ca/home 3. Amid third wave, U of T's Homer Tien takes over province's COVID-19 vaccine task force: CBC. https://www.utoronto.ca/news/amid-third-wave-u-t-s-homer-tien-takes-over-province-s-covid-19-vaccine-task-force-cbc 4. Clinical handover from emergency medical services to the trauma team: A gap analysis. https://pubmed.ncbi.nlm.nih.gov/33084560/ 5. Operation Remote Immunity 3.0 wraps up after coordinating nearly 200 vaccine clinics in 29 remote and isolated communities. https://www.canada.ca/en/indigenous-services-canada/news/2022/02/operation-remote-immunity-30-wraps-up-after-coordinating-nearly-200-vaccine-clinics-in-29-remote-and-isolated-communities.html Bio: Tien earned a bachelor's degree in biochemistry from Queen's University in 1989.In 1992, he graduated with a Doctor of Medicine from McMaster University. He then pursued residency training in family medicine before obtaining his Independent Practice Certificate in 1993. His training was sponsored by the Canadian Forces. After training, he was then posted with the Field Ambulance at CFB Petawawa, and served as the unit medical officer for the 1st Battalion of the Royal Canadian Regiment. While at RCR, he deployed to Croatia on Operation Harmony. He then deployed to Bosnia with IFOR on Operation Alliance. He then served with Canadian special forces at Dwyer Hill Training Centre as their first unit medical officer. He has also deployed to the Golan Heights, and has worked with Veterans Affairs in the recovery of RCAF airmen missing from World War II, in the Burma recovery mission. He later underwent four years of further residency training in general surgery via the Canadian Forces and the University of Toronto from 1998 to 2002. As a Canadian Forces surgeon, he also deployed to the NATO-led multinational stabilization force in Bosnia in 2003, to Kabul with ISAF in 2004, and multiple times to the Role 3 Multinational Medical Unit in Kandahar. In 2007, he earned a Master of Science in clinical epidemiology from the University of Toronto. He is currently the president and CEO of Ornge, an air ambulance non-profit based on Ontario. He also holds the rank of colonel in the Canadian Forces Health Services, associate professorship at the University of Toronto,and was the former director of Trauma Services at Sunnybrook's Tory Regional Trauma Centre. He is the first to hold the Canadian Forces Major Sir Frederick Banting Term Chair in Military Trauma Research. In April 2021, Tien was appointed to head Ontario's COVID-19 Vaccine Distribution Task Force for Phase 2 of the rollout

This week we heard from Dr. Paul McBeth, intensivist and trauma surgeon at the University of Calgary. Dr. McBeth combines his unique engineering background with surgery, and shared his insights on how we all might use an engineering mindset to discover new ways of looking at old problems. Links: 1. Robotics in neurosurgery. https://pubmed.ncbi.nlm.nih.gov/15476655/ 2. Cost-effective remote iPhone-teathered telementored trauma telesonography. https://pubmed.ncbi.nlm.nih.gov/21150536/ Bio: Dr. Paul McBeth is a Clinical Associate Professor in the Departments of Surgery and Critical Care Medicine at the University of Calgary. He began his career as an engineer with post graduate training in surgical robotics and human performance evaluation. He participated in the design and development of Project neuroArm: an image-guided neurosurgical robot system. During his medical training he continued to develop his research interests in robotics and remote ultrasound. Dr. McBeth completed post graduate training in General Surgery at the University of Calgary with sub-specialty training in Critical Care Medicine at the University of British Columbia and Trauma Surgery at the Elvis Presley Memorial Trauma Centre in Memphis, Tennessee. Dr. McBeth also holds an Adjunct position at the Schulich School of Engineering, University of Calgary where he is involved the a number of technology development projects. He has over 75 peer-reviewed publications and is currently leading a research program supporting intelligent systems monitoring for pre-hospital transport of critically ill patients.

A big welcome to all the new resident starting this week on their journeys to become physicians and surgeons. To help you on the journey, we caught up with Dr. Helen Pham. Dr. Pham is a clinical associate lecturer at the University of Sydney and is the current HPB fellow at the University of Calgary. Dr. Pham shared with us some of the differences in training paradigms for surgical programs between Canada and Australia, and also gave us her invaluable advice for new trainees. We would love to hear your tips – what do you wish you knew when you were starting out as a PGY1? Email us at podcast.cjs@gmail.com or tweet at us @CanJSurg. Links: 1. Dr. Pham's notes, textbook recommendations: https://drive.google.com/drive/folders/1x-QJxNi6T-p5EgNy4ChwImmn2KtzlSAN?usp=sharing 2. QxMD: https://read.qxmd.com/ 3. 100 years of surgical education: the past, present, and future. https://bulletin.facs.org/2013/07/100-years-of-surgical-education/ 4. Five things they don't teach you in medical school. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042714/ Bio: Dr. Helen Pham is an HPB fellow at the University of Calgary. She was previously the Clinical Superintendent of Surgery at Westmead Hospital. She has a number of publications in liver and pancreatic surgery.

Dr. Rob Leeper is a trauma surgeon at Western University in London, Ontario. We spoke with Dr. Leeper about his work on trauma simulation and particularly on his work on data drive competitive motivation strategies. Finally, Dr. Leeper shared with us the tips that he wished he had when started out in practice. Links: 1. Data Driven Competitive Motivation Strategies in a Longitudinal Simulation Curriculum for Trauma Team Training. https://pubmed.ncbi.nlm.nih.gov/30833203/ 2. Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program. https://pubmed.ncbi.nlm.nih.gov/29628333/ 3. The role of trauma team leaders in missed injuries: does specialty matter? https://pubmed.ncbi.nlm.nih.gov/24089109/ Bio: Dr. Rob Leeper is an Assistant Professor in the Department of Surgery at Western University. He is an acute care and trauma surgeon with an interest in resuscitation, both inside and outside the operating room. He did residency in Western and went on to do a prestigious trauma fellowship at Johns Hopkins University. He is the father of 3 and a former college football player.

Lauren Kirwan is the nurse clinician for general surgery at the Foothills Medical Centre. She is currently finishing up her nurse practitioner degree. We wanted to ask Lauren her thoughts about what it means to be an OR nurse and what she wishes surgeons would do to make the OR environment better. We also hear about the impact of COVID19 on our nursing colleagues. We'd love to hear from our nurse listeners – what are some things that make your day or make you mad in the operating room? Email us at podcast.cjs@gmail.com with your thoughts and comments. Links: 1. Melinda Davis on the Anesthetist - Surgeon relationship: https://soundcloud.com/cjs-podcast/e40-melinda-davis-on-career-counseling-and-the-anesthetist-surgeon-relationship 2. Atul Gawande paper on Safe Surgery Checklist implementation in South Carolina. Perception of Safety of Surgical Practice Among Operating Room Personnel From Survey Data Is Associated With All-cause 30-day Postoperative Death Rate in South Carolina. https://journals.lww.com/annalsofsurgery/Abstract/2017/10000/Perception_of_Safety_of_Surgical_Practice_Among.14.aspx

We had the unique opportunity on this episode to speak with the Honourable Minister John Haggie. Dr. Haggie is a general surgeon who spent his career in Newfoundland and Labrador, and went on to become a Member of the House of Assembly in 2015. He was appointed to be the Minister of Health at that time and has continued to serve in that porfolio ever since. We spoke to him about his fascinating life story, his thoughts on leadership and the role of physicians in politics, and about his favourite book Shogun! Bio (fromhttps://www.gov.nl.ca/hcs/department/minister/): The Honourable John Haggie Minister of Health and Community Services Born in England, the Honourable John Haggie completed his medical studies at Victoria University in Manchester. He held several positions as physician, surgeon, tutor and registrar in the North West region of England and after a two-year fellowship, he received a doctorate in cancer research. Since moving to Canada in the early nineties, Minister Haggie has had a long and distinguished career in medicine in Newfoundland and Labrador. He practiced initially as a general surgeon in St. Anthony with the Grenfell Region Health Services. In 1997, he was appointed attending surgeon of general and vascular surgery at James Paton Memorial Hospital in Gander. In 2008, he was appointed Chief of Staff at James Paton Memorial Hospital. Dr. Haggie served as President of the Newfoundland and Labrador Medical Association and the Canadian Medical Association. In Newfoundland and Labrador's 2015 general election, he was elected MHA for the District of Gander and appointed to Cabinet to serve as the Minister of Health and Community Services, and continues to serve in that portfolio. Dr. Haggie resides in Gander with his wife Jeanette and two Westies, Chloe and Gracie.

This week on the podcast we spoke with Dr. Paul Engels, a trauma surgeon from McMaster University in Hamilton, Ontario. We got into some pretty detailed discussions around trauma training specifically, but more broadly about how we define what a resident should be able to perform at the end of training. Links: 1. The current state of resident trauma training: Are we losing a generation? https://pubmed.ncbi.nlm.nih.gov/29806811/ 2. Canadian Collaborative on Urgent Care Surgery (CANUCS): https://canucs.ca/ 3. Cause for concern: Resident experience in operative trauma during general surgery residency at a Canadian centre. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/69323/54233 4. Toward an all-inclusive trauma system in Central South Ontario: development of the Trauma-System Performance Improvement and Knowledge Exchange (T-SPIKE) project. https://pubmed.ncbi.nlm.nih.gov/33720676/ 5. ASSET course: https://www.facs.org/quality-programs/trauma/education/asset/ 6. Treatment of Ongoing Hemorrhage: The Art and Craft of Stopping Severe Bleeding. https://www.amazon.ca/Treatment-Ongoing-Hemorrhage-Stopping-Bleeding/dp/3319634941. 7. Simulated Trauma and Resuscitation Team Training (S.T.A.R.T.T) course: https://caep.ca/cpd-courses/simulated-trauma-and-resuscitation-team-training-s-t-a-r-t-t/ 8. Definitive Surgical Trauma Care (DSTC™) Courses. https://iatsic.org/DSTC/ 9. Advanced Trauma Operative Management (ATOM) course. https://atomcourse.com/#:~:text=The%20Advanced%20Trauma%20Operative%20Management,post%2Dcourse%20exams%20and%20evaluations. 10. BEST - Basic Endovascular Skills for Trauma. https://medschool.ucsd.edu/som/surgery/divisions/trauma-burn/training/courses/Pages/REBOA-Course.aspx. Bio: Paul Engels is a Trauma/General Surgeon and Intensivist at McMaster University in Hamilton, Ontario. He completed his residency in General Surgery and fellowship in Critical Care at the University of Alberta. He completed a fellowship in Trauma & Acute Care Surgery at Sunnybrook Health Sciences Centre in Toronto. He is a Fellow of the Royal College of Surgeons of Canada and the American College of Surgeons, as well as a member of the Eastern Association for the Surgery of Trauma and the American Association for the Surgery of Trauma.

This week we were joined by Dr. Pasieka once again to talk about strategies to find stress and burnout as surgeons, especially in the context of COVID19. Check out her paper below! Links: 1. Shinrin-yoku, yoga and other strategies in the fight against COVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405594/ Bio: Dr. Janice L Pasieka graduated from the University of Western Medical School and did her General Surgery Training at the University of Calgary. She then did two and a half years of Endocrine Surgical Training. The first year was spent in Dr David Hanley's lab at the University of Calgary, then a year at the University of Michigan, under the mentorship of Dr. Norman Thompson followed by time at the Karolinska Institute in Stockholm, Sweden. She then returned to Calgary and has devoted her clinical practice solely to endocrine surgical diseases. At the Tom Baker Clinic Center, Dr Pasieka was the driving force behind the development of a multidisciplinary clinic for Neuroendocrine Tumors as well as the Multidisciplinary Hereditary Endocrine Clinic. She is responsible for the development of the only Canadian AAES accredited fellowship program in Endocrine Surgery. Dr Pasieka has been Secretary-Treasurer of the American Association of Endocrine Surgeons (AAES) and in 2010 she became the first Canadian and second woman to become President. She has served on the Council of the International Association of Endocrine Surgeons (IAES), and in 2016 became the Secretary-Treasurer - a position she holds at the present time. Dr Pasieka was the Canadian James IV Traveling Surgical Fellow 2006 and recently was appointed to the James VI Board of Directors. In 2007, the Women's Executive Network named her as one of Canada's 100 Most Powerful Women. Dr Pasieka recently completed her six year term as a Governor of the American College of Surgeons. Her areas of interests (besides running, mountain biking, cycling and hiking & snowshoeing with her dog Kocher) evolve around neuroendocrine tumors, adrenal disease, thyroid cancer and the study of surgical outcomes in patients with hyperparathyroidism. To date she has over 140 peer-review publications, has edited 3 Endocrine Surgical textbooks and written over 24 book chapters.

Dr. Bill Wall is one of the pioneers of liver transplantation, especially in Canada. We spoke to him on this episode about his training, the early days of transplantation and about his new children's book! Links: 1. Member of the Order of Canada: https://www.gg.ca/en/honours/recipients/146-9121 Bio (from https://www.gg.ca/en/honours/recipients/146-9121) William Wall is a dedicated and compassionate physician whose surgical and clinical proficiency have benefited many Canadians with end-stage organ disease. Professor of surgery at the University of Western Ontario, he established Canada's first liver transplant program at the London Health Sciences Centre, where he is director of the Multi-Organ Transplant Program. In this role, he has promoted excellence in research and patient care, as well as public awareness and support for organ donation. Widely respected by his peers, he served as president of the International Liver Transplantation Society.

This week we had the pleasure of interviewing Dr. Peter Brennan (https://twitter.com/BrennanSurgeon?s=20&t=VZQWDi0op02x9_8qdn3Avg). Dr. Brennan is an oral maxillofacial surgeon in Portsmouth, England. A tremendously accomplished academic, Dr. Brennan has a keen interest in human factors in surgery. In addition, he is the co-editor of the Gray's Surgical Anatomy. Links: 1. Dr. Brennan's PhD on human factors: https://researchportal.port.ac.uk/portal/files/18357979/Peter_A_Brennan_PhD_thesis.pdf 2. We need to reduce hierarchy and empower junior doctors to speak up (BMJ): https://blogs.bmj.com/bmj/2019/05/03/improving-patient-safety-we-need-to-reduce-hierarchy-and-empower-junior-doctors-to-speak-up/ 3. MDT meetings: https://onlinelibrary.wiley.com/doi/full/10.1111/jop.12853 4. Gray's Surgical Anatomy: https://www.elsevier.com/books/grays-surgical-anatomy/brennan/978-0-7020-7386-1 Bio (from https://solentmaxillofacialclinic.com/professor-peter-brennan/) Peter has been a consultant Oral and Maxillofacial Surgeon at Portsmouth Hospitals NHS Trust since 2002. He is also honorary Professor of Surgery and Head of the Academic Department of Surgery, at the University of Portsmouth. He qualified with honours in both medicine (1994) and dentistry (1987) gaining distinctions and winning many prizes in subjects including anatomy, pharmacology, anaesthetics, surgery, obstetrics and gynaecology and ophthalmology. Last year, the Royal College of Physicians and Surgeons of Glasgow elected Peter as an Honorary Fellow, the first Maxillofacial Surgeon to receive this accolade. Peter's main clinical interests are head and neck malignancy, reconstructive free flap surgery and neck lumps. He is a research supervisor, an examiner for higher research degrees and has published over 500 papers to date covering many aspects of oral and maxillofacial surgery including cancer. Peter's research has been awarded both National and International research prizes, and he has lectured extensively in the UK and abroad. Peter has edited a number of books including the definitive 2 volume reference textbook of the speciality, Maxillofacial Surgery, which is used worldwide. He is the lead editor of the forthcoming Gray's Surgical Anatomy, sister publication to the famous Gray's Anatomy.

Welcome to all our Cold Steel listeners! We are excited to be collaborating with the Society of American Gastrointestinal and Endoscopic Surgeons or SAGES. SAGES produces an excellent podcast called the SAGES stories podcast, where they highlight some of the amazing work SAGES members have been doing. In this episode, SAGES stories hosts Shireen Towfigh and Kevin Elhayek interview one of our favourite former guests Dr. Liane Feldman, the outgoing presidents of SAGES. Links: 1. SAGES Stories: https://www.sages.org/category/sages-stories/ 2. Cold Steel interview https://soundcloud.com/cjs-podcast/e89-liane-feldman-on-sages-presidency-future-of-mis-and-fuse-program?in_system_playlist=artist-stations%3A636175068