Recipient of the 2012 ACS International Guest Scholarship reports on experience

Dr. Sanabria at the ACS Centennial reception during the 2012 Clinical Congress.

As the recipient of the 2012 International Guest Scholarship of the American College of Surgeons (ACS), I visited three places in the U.S. that provide services and procedures related to my practice as a head and neck surgeon.

MD Anderson Cancer Center

First, I went to the University of Texas MD Anderson Cancer Center in Houston where I worked with Randal S. Weber, MD, FACS, professor of surgery and chairman of the department of head and neck surgery. This enormous patient-focused medical center offers numerous treatment alternatives to cancer patients. My visit there inspired me not only to develop and institute a standardized treatment plan, but also to open my mind to integration of other therapies that may improve the patient’s quality of life.

Other surgeons whom I had the pleasure of meeting at MD Anderson Cancer Center include: Ehab Hanna, MB, BCH, FACS, professor of surgery; Mark Chambers, DMD, MS, professor and chief, section of oral oncology and maxillofacial prosthodontics; and Ann Gillenwater, MD, professor, department of head and neck surgery. All three surgeons were very kind people and exceptional teachers who generously explained to me their clinical and surgical decisions. I also met Mariann Crapanzano, managing editor of Head and Neck Journal, whose advice enlightened me about the possibilities of writing for surgeons from developing countries. As a consequence of my stay, I am developing a protocol to validate an MD Anderson symptom inventory for head and neck cancer patients.

Georgia Health Sciences University

Next, I visited the Georgia Health Sciences University in Augusta, to work under the supervision of David Terris, MD, FACS, professor and chair, department of otorhinolaryngology. There, I met my personal objective of assisting in the performance of robotic thyroidectomy. Dr. Terris was a gracious host with incredible technical skills who leads a very strong program on robotic thyroid surgery. Although robotic surgery requires resources that are far from the capabilities of most Colombian medical centers, the opportunity to observe and understand the advantages and disadvantages of this new technology is very useful in order to decide on immersion in this field. I also met Clementino Arturo Solares Rivera, MD, FACS, an extraordinary skull-base surgeon who showed me the most advanced surgical procedures in this field.

Memorial Sloan-Kettering Cancer Center

I went to Memorial Sloan-Kettering Cancer Center in New York, NY, under the supervision of otolaryngologist Bhuvanesh Singh, MD, FACS. At Memorial Sloan-Kettering, I had the privilege of meeting two world leaders in head and neck surgery—
Jatin Shah, MD, FACS, chairman of the head and neck service, and Ashok Shaha, MD, FACS, a general surgeon and associate professor of surgery at Cornell University Medical School and adjunct professor of surgery at State University of New York-New York City.

I enjoyed my stay at Sloan-Kettering not only because of the educational service meetings, but also because it provided the opportunity to observe a successful model that combines demanding clinical activities with basic science and clinical research. The charisma of physicians who treat patients and their commitment to each patient, combined with the rational use of technological resources, was very impressive and gave me a clear indication that good oncological care is possible with an interdisciplinary and coordinated approach and not exclusively dependent on technology.

On the last day of my stay, I also had the pleasure of meeting Snehal G. Patel, MD, FRCS, a head and neck cancer surgeon, who generously offered me the opportunity to use wonderful Caisis software, which will help me compare local practices and results to leaders in the head and neck oncology field.

I observed surgical procedures and clinical visits in all the hospitals, and this experience allowed me to understand that the differences between Colombian cancer centers and the most important oncological centers in America are not the physical resources or money, but the discipline in following established protocols and the ability to work as a team.

Dr. Sanabria (fifth from right) with the other International Guest Scholars at Giordano’s restaurant in Chicago.

ACS Clinical Congress

Finally, I attended the ACS Clinical Congress in Chicago, IL. It was my first time attending this event, and it was extraordinary to see surgeons from the entire world sharing experiences and talking about the most diverse areas of surgical knowledge. I really enjoyed the lectures that I attended on education, professionalism, and leadership. Although they were not the most crowded sessions, for me, as a Colombian academic surgeon, they were informative and exciting. It was encouraging to observe American surgeons who are worried about the present and future of the profession demonstrate a commitment to developing alternatives to maintain the integrity of surgical practice.

The organization of the Clinical Congress was impeccable, and all the activities were designed to offer a highly educational experience. I attended the International Relations Committee meeting, which helped me to recognize the importance of networks for surgeons outside the U.S. I appreciate the opportunity the College provides to foreign surgeons to participate with the ACS International Relations Committee. I would like to thank Kate Early, ACS International Liaison, who made this experience enriching and successful. Her dedication to us was remarkable; she always had a smile and was always available to help us.

I met interesting colleagues from around the world. The interchange of experiences was motivating, and I can say I made some friends. I can also say that I learned a lot from them—most importantly, novel ways to approach surgical problems.
As a practicing surgeon, at this point of my professional life, the most important lesson was to learn that the differences in clinical results between my country’s hospitals and American hospitals are the consequence of personal attitudes and actions. The barriers we usually use to explain these differences, such as economic or social issues, do not exist. The success of American surgery is the result of surgical professionals’ hard work, discipline, and commitment to excellence—
elements difficult to measure and assess, but that can be perceived while visiting American surgical institutions and attending the Clinical Congress. These experiences change the way we view the world. As one colleague told me at the Clinical Congress Convocation, the International Guest Scholarship changes the way you approach your responsibilities, slowly but constantly. The results are generally observed decades after completing the scholarship.

Thanks to the College and all the individuals who made my participation possible. It will be a pleasure to return the favors to the College and other colleagues.

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