It was a great honor to be selected as the Nizar N. Oweida, MD, FACS, Scholar for 2014. This award funded my attendance at the October 2014 Clinical Congress of the American College of Surgeons (ACS) in San Francisco, CA. The meeting was a fantastic experience and provided clarity of purpose to me as a rural general surgeon in Pendleton, OR. In addition to attending excellent Panel Sessions and Postgraduate Skills-Oriented Courses, I spoke with numerous other surgeons and clinical experts about special challenges we face as general surgeons in the rural setting. Having the opportunity to interact with other surgeons was as important to me as the informative courses.
Funding from the Oweida Scholarship afforded me the opportunity to register in advance for four Postgraduate Courses. On October 25, for example, I attended the Rural Surgeons Skills Course, during which the speakers provided an excellent review of upper gastrointestinal (GI) bleeding control, esophageal and pediatric airway obstruction, and other topics. This Skills Course provided me with the opportunity to become more familiar with the use of enteric stents, argon plasma coagulators, and several new devices for treating hemorrhoids, polyps, and mucosal defects.
On October 26, I attended the Emergency General Surgery Update, a Didactic Postgraduate Course. The thorough and up-to-date review of difficult conditions, including perforated esophagus, diverticulitis, necrotizing pancreatitis, acute hernia, and C. difficile colitis, was very valuable. These problems do occur in my rural practice, so this review and additional information was extremely helpful.
Interaction with ACS leadership
On October 27, I was honored to be a participant in the Opening Ceremony of the Clinical Congress. Beforehand, I had the opportunity to meet some of the ACS leadership, including ACS Executive Director David B. Hoyt; Immediate Past-President Carlos A. Pellegrini, MD, FACS, FRCSI(Hon); Second Vice-President Kenneth L. Mattox, MD, FACS—a distinct privilege in itself. I also enjoyed visiting with several residents who had received basic science research scholarships. It was interesting to hear about their research and intended career paths in academic surgery. After the Opening Ceremony, I visited with Edgar Rodas, MD, FACS, a general surgeon who was accorded Honorary ACS Fellowship at the Clinical Congress Convocation, and learned about the mobile hospital he has developed to deliver surgical care to patients in rural Ecuador.
I then attended a variety of Panel Sessions throughout the day, including Desperate Situations in Rural Surgery, which provided perspective on my approach to such problems as ruptured aortic aneurisms and other serious conditions. The Optimal Fluid Resuscitation session was another valuable session, particularly because it included a discussion on endpoints of resuscitation.
In the afternoon, I attended the Scholarships Committee meeting and listened to the excellent advanced basic science presentations delivered by surgical residents and faculty in academic programs. It was humbling to learn about the time and effort these surgeons and trainees have dedicated to scientific research. I felt especially privileged to present an overview of my clinical practice and community to this academic group. I emphasized that I am an eventual end user of their research findings and will benefit immensely from their research efforts. My presentation was warmly received, and I much appreciated their respect for rural surgical practice.
That evening, my wife and I attended the Rural Surgeons dinner at a local Italian restaurant. It was truly inspiring to meet so many rural surgeons and to be able to match the faces to the names of those surgeons who post on the ACS rural listserv and the online Rural Community. It was a great privilege to meet ACS Governor Tyler G. Hughes, MD, FACS, and Philip R. Caropreso, MD, FACS, Chair and Vice-Chair, respectively, of the Advisory Council for Rural Surgery, both of whom have such dedication to the cause of rural surgery. The evening was enlightening and enjoyable.
Further educational opportunities
On October 28, I spent most of the day in the Didactic portion of the Laparoscopic Colectomy Postgraduate Course. I also attended the Panel Session titled Is Private Practice Dead? I was relieved to learn that I wasn’t extinct after all!
I left the cadaver skills lab at the impressive University of California, San Francisco, facility a bit early to attend the Rural Surgeons Open Forum, where I was presented the Oweida Scholarship and certificate by Dr. Pellegrini. The Open Forum discussion and audience participation provided enlightening information relevant to several rural surgery issues of concern, including the training of rural surgeons. This session clarified that the ACS values rural surgeons and is working to help solve some of the problems unique to practicing rural general surgeons.
On October 29, I attended a comprehensive Postgraduate Course on Surgical Critical Care. The instructors provided an extensive review of newer concepts for every organ system; much of the information presented was new to me. This experience is particularly useful to me, as I am without formal intensivist support.
The final half-day of the Clinical Congress, I attended Ten Hot Topics in General Surgery—a fast-paced interactive session covering many interesting topics, all relevant to my practice. In particular, blood component therapy in resuscitation and neoadjuvant therapy in breast cancer were both very helpful. The discussion at a Panel Session, Gastroesophogeal Junction Surgery, also was pertinent to my practice.
The ACS Clinical Congress was a superior educational and interactive event. I am extremely grateful to the Scholarships Committee for awarding me this high honor and am indebted to the late Dr. Oweida and his family for funding this great experience for rural surgeons such as myself. I have already implemented some of what I learned at the Clinical Congress in my own practice, including use of the suction cap for endoscopic explantation of impacted food from the esophagus and restraint in fluid resuscitation of seriously injured trauma patients. This experience has given me a renewed enthusiasm and higher level of expertise in patient care as I continue to practice rural surgery in Pendleton.