2014 IGS reports on experience from the perspective of a woman surgeon

Dr. Raymundo (left) at the Scholars and Travelers Luncheon with Dr. Liquete.

Dr. Raymundo (left) at the Scholars and Travelers Luncheon with Dr. Liquete.

The following is a summary of my experience as the American College of Surgeons (ACS) International Guest Scholar (IGS) in 2014. Specific topics discussed include my rotations at U.S. medical centers and at the ACS Clinical Congress. This report also provides some insights into the challenges women surgeons continue to face in balancing their work and personal lives.

Rotation at UCSF Medical Center

I began my adventure as an ACS IGS at the University of California, San Francisco (UCSF) Medical Center under the mentorship of Maxwell V. Meng, MD, FACS, professor and chief of uro-oncology. I was able to observe multiple uro-oncologic procedures at the hospital in Mount Zion and the Moffitt Long Hospital, allowing me good exposure to rare and common cases managed both with traditional open surgery and laparoscopic and robotic surgery.

Unexpectedly, the key lesson I took away from this rotation pertained to the format of informed consent forms (ICFs). The UCSF ICF included not only the customary consent for the procedure, but also a section detailing and/or defining each patient’s willingness to have his or her removed tissue used for research. Although this type of document may already be widely used in U.S. hospitals, it was my first exposure to this type of ICF.

Coming from my own country’s national referral center and teaching hospital, I thought adapting such a format would greatly advance research for academic purposes and save time and resources in securing ethics clearance for retrospective studies. At the same time, each patient can discuss directly with his or her physician what most research activities entail, thus placing the power of the informed decision directly in the patients’ hands.

This experience demonstrated that the International Guest Scholarship has the potential not only to enrich the clinical skills and knowledge of its recipients, but also their abilities as researchers and academicians.

Rotation at Stanford

At Stanford University Medical Center (SUMC), CA, I had the privilege of observing my mentor, Benjamin I. Chung, MD, FACS, assistant professor of surgery and chief, robotic surgery. Working with Dr. Chung, I directly observed the superb surgical skills of a colleague who was young, yet was adept at managing even the most complex cases through robotic surgery.

I also collaborated with James D. Brooks, MD, FACS, professor and vice-chair, department of urology, on a research project. This experience was invaluable in completing a research paper on prostate cancer screening while I was at SUMC. Dr. Brooks’ alternate view on the controversial subject provided a broader perspective on the matter, leading to a more well-rounded and robust manuscript. We are proud that our review paper, “Prostate cancer and the Filipino: An updated review of publications,” has been accepted for publication in the Journal of Urology and Research. At press time, a final publication had not yet been set.

This rotation reinforced my growth both as a clinician and as a researcher through my interactions with leaders in the field of uro-oncology. It also has provided me and my home university with a valuable network for future collaboration.

2014 Clinical Congress

Dr. Raymundo (second from left) with other urologic surgeon scholars, left to right: Benjamin Turney, DPhil, MSc, MA, FRCS, Oxford, U.K.; Rajeev Kumar, MB, BS, MS, MCh, New Delhi, India; and Luke Harper, MD, Réunion, France.

Dr. Raymundo (second from left) with other urologic surgeon scholars, left to right: Benjamin Turney, DPhil, MSc, MA, FRCS, Oxford, U.K.; Rajeev Kumar, MB, BS, MS, MCh, New Delhi, India; and Luke Harper, MD, Réunion, France.

The 2014 Clinical Congress of the ACS took place October 26–30 in San Francisco, CA. My experience at the Clinical Congress began with the Opening Ceremony, where each of the scholars was introduced to the attendees. I was pleased that officers from the Philippine College of Surgeons were on stage, as well. It added meaning to see these leaders from my country beaming with pride that one of their junior colleagues had been chosen as a scholar for this year.

After the ceremony, Jesus V. Valencia, MD, MHPEd, and Arturo E. Mendoza, Jr., MD, FACS, president and vice-president, respectively, of the Philippine College of Surgeons, approached me. They offered their congratulations and encouraged me to share my experiences with other young surgeons when I returned home to encourage more Filipinos to apply for this scholarship in the future. It was likewise inspiring to meet Rose Marie Liquete, MD, a Philippine College of Surgeons regent, during the International Scholars and Travelers dinner, as she was the first Filipino woman surgeon to serve as an ACS IGS.

Although a limited number of sessions were specific to urology, I learned a great deal at the Clinical Congress, and several sessions will be important in my research work on prostate and other urologic cancers. I also attended other sessions that would aid me in my role as an educator to residents and medical students at my university.

Perhaps the best experience of the entire Clinical Congress was having the opportunity to meet the other scholars, as well as the Officers and Staff Liaison of the ACS International Relations Committee. The reception and luncheon provided us with a more relaxed environment where we could discuss our experience with fellow scholars and share our thoughts with committee members. This aspect of the meeting allowed me to compare and contrast my work and practice in the Philippines with theirs.

All scholars at the 2014 Clinical Congress had a chance to showcase their chosen research work, providing a rich learning environment for all of us. It was a more formal and organized setting, in which we learned from contemporaries how surgeons in their respective countries practice and hone their craft. From more developed countries, I learned details on research involving new technology and its practical applications in developing countries, such as the Philippines. Presentations by surgeons from other developing nations helped me see how other young surgeons deal with challenges and problems that are similar to those situations that I encounter, and how they have been able to achieve lasting progress in resource-poor academic scenarios.

Indeed, after the Congress, I felt I had grown immensely as a surgeon, educator, and researcher, confidently able to take on the role of a leader when I returned to my home country.

Challenges

I was originally granted the scholarship for use in 2013, but complications in my pregnancy precluded me from traveling to the U.S. that year. Fortunately, the ACS graciously allowed me to postpone my rotations and attendance at the Clinical Congress until the following year.

The challenges of starting a family greatly affected my 2014 experience, as well. Decisions had to be made regarding whether to bring my baby with me or leave him with my family in the Philippines, as my husband lives and works abroad. Once I decided to bring my son with me, finding adequate child care became an obstacle. It created time limitations, hindering my ability to participate in early morning or evening conferences and lectures at my host institutions, as I had to work around the hours that day care was available.

Lessons learned

My five months of rotations at two top-notch U.S. hospitals and my attendance at the 2014 Clinical Congress were instrumental in my enrichment as a surgeon and clinician, as a researcher and academician, and as a teacher and mentor to my junior colleagues.

My personal difficulties as a new mother also made me realize the unique challenges that still exist for women in most surgical fields, especially in the corridors of academic institutions. I was fortunate to have met Dr. Liquete at the Clinical Congress luncheon, allowing us to establish an informal mentor-mentee relationship between a leading surgeon from my own country who has successfully raised children while fostering a thriving career, and a junior physician just beginning her family and surgical career. Strong mentorship from a female colleague and family support were enumerated by multiple published studies as key in breaking through the glass ceiling for many women in surgery. Many successful female surgeons have also relayed how heightened visibility through public speaking and conference presentations are important to recruit more women into our ranks. With more women in surgery, the possibility of women advancing into leadership positions likewise increases. I would like to use this experience as an impetus to be more visible, beginning with sharing my experience as an ACS IGS through this report.

Because of the role that mentorship plays in the success of a woman surgeon, I would encourage the IRC to provide more women role models as mentors to future scholars. I also would encourage scholars to seek out women leaders in their host institutions to enrich their experience and provide a fertile learning environment for their professional growth as surgeons and academicians, as well as their personal growth not only as wives and mothers but as women in general.

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