It was my distinct privilege to be selected as the 2014 American College of Surgeons (ACS) Traveling Fellow to Australia and New Zealand (ANZ). I had a wonderful experience on my trip to Singapore and Australia. I made many new friends and reconnected with old ones in those busy two weeks. I met many experienced clinical surgeons, accomplished academicians, and motivated trainees, with whom I discussed clinical experiences and research interests, as well as training paradigms and practice patterns. The traveling scholarship afforded me the opportunity to present my work and to learn from surgical colleagues in Australia.
RACS meeting in Singapore
The Royal Australasian College of Surgeons (RACS) and the Australian and New Zealand College of Anaesthetists (ANZCA) held their first combined meeting this year in Singapore, which made travel arrangements a little challenging. To maximize the experience in Australia, I had to make strategic decisions and plan my travel schedule in advance. I worked with Matthew Claydon, MB, BS(Hon), BMedSci(Hon), FRACS(Gen Surg), FRACS(Vasc), the vascular surgery convener, to accommodate my travel arrangements. Richard Hanney, MB, BS, a general surgeon from Sydney and a close friend of the Association for Academic Surgery (AAS), helped me to identify hospitals to visit. Michael Findlay, MB, BS, PhD, a visiting plastic surgeon from Australia, connected me to Prof. John Quinn, MB, BS, FACS, FRACS, president of the ANZ Society for Vascular Surgery. Professor Quinn recommended that I contact John Harris, MS, FACS, FRACS, FRCS, in Sydney and Prof. Michael Grigg, MB, BS, FRACS, in Melbourne. I also reached out to industry partners for suggestions. Jackie Ho Pei, MB, BS, FRCSEdin, FCSHK, an academic vascular surgeon from Singapore National Hospital, graciously hosted me during my weeklong stay in Singapore.
I arrived in Singapore on May 4 and attended the faculty dinner for Developing a Career in Academic Surgery (DCAS) a few hours later. The jetlag passed quickly when I saw many familiar faces from the AAS. It was a busy few days afterward. I met many residents, fellows, and students at the DCAS course the next day. At the vascular specialty dinner, I was welcomed like an old friend and seated with Professor Quinn, Professor Harris, Dr. Claydon, and two other college visitors from the U.K., Peter Taylor, BM, BCh, PhD, FRCP, and Matthew Thompson, MD, FRCS.
At the congress, I presented my research work on cognition and carotid disease at the dedicated 30-minute ACS lecture, where I was introduced by Geoff Cox, MB, BS, FRACS, from Melbourne. Current ACS President Carlos Pellegrini, MD, FACS, FRCSI(Hon), was in attendance. I also gave two talks at the vascular and anesthesia sessions: Radiation Exposure beyond Endovascular Interventions, and Embolic Protection Device in Lower Extremity Interventions.
Dr. Ho Pei also arranged several meetings for me to interact with local physicians, in addition to the activities in RACS. I presented my work on endovascular aortic aneurysm repair-related endoleak to local Singapore vascular surgeons and interventional radiologists. I had an opportunity to visit National University Hospital, and to speak to neurology and surgical groups on the clinical and translational research projects related to carotid disease. The week passed by quickly. I left Singapore one day before the conclusion of RACS and bundled up for Melbourne, where temperatures were 50 degrees cooler than in Singapore.
My husband Van and daughter Madison Chiem met me in Melbourne. My first stop in that city involved reconnecting with Ann Abbott, PhD, MB, BS, FRACP, a stroke neurologist whose primary interest is carotid disease. Although Ann and I have many differences with regard to how to manage carotid disease, our common research interest connected us. With Ann’s family, we rode the Puffy Billy train on Mother’s Day. Puffy Billy is one of the finest preserved steam railways in the world and runs along the Dandenong Ranges east of Melbourne. The scenery was spectacular, and we had an incredible time, dangling both feet outside the window, and enjoying the beautiful mountain ranges.
Box Hill Hospital
My next stop was Box Hill Hospital to meet with Dr. Grigg, the newly elected president of the Royal Australasian College of Surgeons and the head of surgery at Box Hill Hospital. We started the day with an overview of the hospital system in Melbourne, and Dr. Grigg explained the health care system and practice patterns in Australia. He also explained the difference between public and private hospitals and showed me Epworth Eastern Medical Center, the private hospital where he works.
I observed a percutaneous endovascular aortic aneurysm repair (PEVAR) case with Jason Chuen, MB, BS, FRACS, a young academic vascular surgeon. These interactions gave me a better appreciation of the training systems in Australia and New Zealand.
The next day, I met with Terry Devine, MB, BS, at Dandenong Hospital, another large public hospital in Melbourne. Dr. Devine is the head of vascular surgery at the hospital. I was fortunate to observe Dr. Devine treating two cases of type II endoleak embolization and a PEVAR. I have an interest in long-term outcome and management of type II endoleaks and have been performing computed tomography-guided trans-lumbar embolization in a suite equipped with both CT scan and fixed C-arm. It was a great learning experience to see Dr. Devine and his radiology colleague skillfully embolizing type II endoleaks through a translumbar approach without using CT-guidance and using a glue agent that was probably one-tenth of the cost of the agent that I typically use. We went through technical details and the options for endoleak treatment.
Despite a packed schedule each day, I had some opportunities to spend time with my family, enjoying relaxing walks and wonderful restaurants along the Yarra River. Soon, it was time to go to Sydney.
Sydney was, surprisingly, warmer than Melbourne. After our arrival in Sydney, we spent an afternoon at the beautiful Bondi Beach. The following day, I visited Mauro Vicaretti, PhD, FRACS, and his vascular surgery group at Westmead Hospital—one of the largest public hospitals in Sydney. I attended a morning conference, observed operations, and toured the hospital. Westmead places a strong emphasis on teaching vascular trainees, including international trainees. I also presented my research work on carotid artery disease and cognition and candidly discussed the treatment of carotid disease with the vascular surgery group at the Westmead Hospital.
The last stop in Australia was Royal Prince Alfred Hospital (RPAH) in Sydney. On Friday morning, Prof. John Harris, MS, FRACS, FACS, showed me around the campus of the University of Sydney. I enjoyed learning about the university’s rich heritage from the highly knowledgeable Professor Harris, who is the chief of surgery at the University of Sydney Royal Prince Alfred Hospital and editor of the ANZ Journal of Surgery. I had a welcoming breakfast with Professor Harris, legendary Prof. Jim May, MD, MB, BS, and Isuru Nammuni, BSci(Med), MB, BS(Hons), FRACS(Vasc), as well as the vascular fellow Jack Lao, MD. After breakfast, Drs. Nammuni and Lao showed me around the Royal Prince Alfred Hospital. It was a relatively short but, nonetheless, informative day.
During these two weeks, I got to know many surgeons from Australia and New Zealand, and I learned a great deal from our colleagues on the other side of the world. I also got a glimpse of local practice patterns and health care systems in Singapore, Melbourne, and Sydney. I will always treasure the friendships I made during the trip.