Editor’s note: Following is a brief report on the Presidential Address that A. Brent Eastman, MD, FACS, President of the American College of Surgeons (pictured above), delivered to the 1,377 Initiates of the American College of Surgeons during Convocation ceremonies at the 2012 Clinical Congress. This year’s Clinical Congress took place September 30 to October 4 in Chicago, IL. For the full text of Dr. Eastman’s Presidential Address, see the February 2013 issue of the Journal of the American College of Surgeons.
“There are serious challenges ahead in this new century and the American College of Surgeons (ACS) needs its young, diverse leadership at every level,” Dr. Eastman said in his Presidential Address. “It can be a wonderful two-way street, with you contributing your energy and fresh vision, and the more senior among us offering support and crucial leads as to how things get done,” said Dr. Eastman, a general, vascular, and trauma surgeon from San Diego, CA.
Figure 1: Call to action
After acknowledging the important accomplishments of the College’s founders as the organization enters its Centennial year, Dr. Eastman outlined four key issues that present challenges for the future—access to quality health care, rural surgery workforce shortages, surgical education, and international outreach (see Figure 1).
“The American College of Surgeons is committed to a policy of high-quality, safe, appropriate, and affordable surgical care. But as [ACS] Past-President L.D. Britt [MD, FACS] has said, ‘There is no quality without access,’” noted Dr. Eastman. He urged surgeons at all levels to “speak wisely and forcefully” as advocates for expanded access to optimal care and to get involved in shaping public policy.
Figure 2: ACS total 2012 membership, top 10 countries
With regard to surgeon workforce shortages and maldistribution, particularly in rural areas, Dr. Eastman called for training that is “broad and emphasizes self-reliance,” and he cited the Rural Trauma Team Development Course (RTTDC) created by the ACS Committee on Trauma as an example of the kind of training necessary for surgeons working in this environment. (For more information on the RTTDC, go to www.facs.org/trauma/rttdc/index.html.)
Changes in surgical education pose another significant challenge to current and future surgical leaders, according to Dr. Eastman. “As wonderfully as the Halsted model worked for training 20th century surgeons—including my generation of the 1960s and 1970s—it does not fit the 21st century reality,” observed Dr. Eastman.
Figure 3: ACS total 2012 international membership
Another challenge that surgeons must contend with in the 21st century is the global disease burden. Both Initiates and senior surgeons need to be cognizant of the access, workforce shortages, and other surgical issues that affect surgical patients throughout the world. “I believe that international collaboration is essential to the future of our profession on this planet,” asserted Dr. Eastman. He noted that during the Clinical Congress he would be participating in the ACS International Relations Committee meeting, where he would be able to confer with the presidents of international surgical colleges and societies. “We have much to do together,” he said.
Dr. Eastman also underscored the importance of international collaboration by offering Initiates a look at what he termed “the hundred-year class of Fellows of the American College of Surgeons,” a multicultural group of many different backgrounds and origins.
“So, let me introduce you further to one another and tell you what you told me in our survey of your Fellowship class this summer,” said Dr. Eastman. “You are 1,377 strong. A little over 1,000 of you are men and 300 women. Your average age is 41 and you have been in practice typically four years or more. [A total of] 83 percent of you are residents of the U.S. and Canada, but a full 17 percent—232 of you—are our new international Fellows from 49 different countries and every continent in the world. And, not to be outdone in internationality, one-third of the North Americans here have parents born elsewhere, including all parts of Asia, the Middle East, Africa, Europe, and Latin America.” (See Figures 2 and 3.)
Figure 4: Dr. Franklin Martin
“What reverberates here is the fact that although the American College of Surgeons was established first of all for the reform of surgery in the United States and Canada—Franklin H. Martin always envisioned a world fellowship of surgeons,” continued Dr. Eastman (see Figure 4). “He had been inspired by the Royal College of Surgeons of England, after which he modeled the robes and ceremony you see tonight, and he spent much of his long tenure as Secretary traveling and establishing friendships with leading surgeons of Central and South America and of Australia and New Zealand.”
Dr. Eastman urged Initiates to never forget “the great privilege you have as a fully-qualified surgeon wherever you are in the world.
“I suspect nearly all of you new Fellows have stories about how you chose medicine, and then surgery as a career, and about your mentors,” said Dr. Eastman. “And I hope—when things get tough—that you can find a way to dip into that early well of inspiration and admiration and feel refreshed for the work ahead.
“My greatest wish for you, the newest Fellows of the American College of Surgeons, is the joy of a life in surgery that has been mine,” Dr. Eastman said as the final slide (Figure 5) was displayed to the accompaniment of Beethoven’s “Ode to Joy.”
Figure 5.
