RAS-ACS Symposium essays: Residents debate the future of leadership in surgery

Each year, the Advocacy and Issues Committee of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) hosts a symposium at the Clinical Congress that features a debate on a current and controversial issue relevant to surgeons in training and in practice. The committee members selected Reframing Surgical Leadership in 2017: Surgeon-Scientist or Surgeon-Advocate? as this year’s theme.

A changing regulatory and social environment has led to diminished individual surgeon autonomy in the operating room (OR) and in patient care. Historically, the surgeon has been the “captain of the ship” inside and outside the OR. In 2017, the surgeon is one of the many members of a health care team, often with limited autonomy.

In today’s environment, with an ever-increasing focus on quality, safety, and outcomes, every aspect of surgical care is scrutinized—from our training models, to our patient care practices, to our OR attire. Although surgeons welcome changes that improve patient outcomes, many are troubled by the increasing regulatory and administrative burdens that lead to further loss of autonomy. How can surgeons preserve their role as leaders in patient care?

Some members of the surgical community advocate for increased surgeon involvement in the world of health care policy and advocacy, business, and regulation. Other surgeons want to refresh the traditional roles of service, education, and innovative research. What should surgical leadership look like in the 21st century? Should we strive for a seat at the table of business and politics? Or should we strengthen our commitment to direct patient care, surgical education, and research?

Surgical residents from across the country participated in this discussion by submitting essays describing the future of leadership in surgery. We received a number of impressive entries. The first- place winners, Ciara Huntington, MD, postgraduate year (PGY)-5, general surgery resident, Carolinas Medical Center Charlotte, NC, and Jeffrey Howard, MD, PGY-4, general surgery resident, University of Louisville, KY, were invited to present their views at the ACS Clinical Congress 2017. Leading the discussion at the meeting were Amalia Cochran, MD, FACS, FCCM, Chair, ACS Professional Association political action committee Board of Directors, and an ACS Governor; Caprice C. Greenberg, MD, MPH, FACS, immediate past-president of the Association for Academic Surgery; and David A. Spain, MD, FACS, an ACS Governor.

Following are the second-place entries on the topic.

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