Editor’s note: The Bulletin of the American College of Surgeons is launching a new series of articles profiling leaders of the College. This feature will be published monthly. The questions are intended to give readers a look at the person behind the surgical mask and to inspire other members of the College to consider taking on leadership positions within the organization and the institutions where they practice.
For this first profile in American College of Surgeons (ACS) leadership, we interviewed L. Scott Levin, MD, FACS, Chair, ACS Board of Regents. He is chair, department of orthopaedic surgery; Paul B. Magnuson Professor of Bone and Joint Surgery; and professor of surgery (plastic surgery), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Why did you decide to become a surgeon?
My mother grew up in a household where her father was an otolaryngologist in Philadelphia, and he wrote a book titled The Human Voice, which I read as a resident in plastic surgery. He died in his 50s before I was born. He served in World War I, caring for critical injuries in France, and was awarded the French Medal of Honor, and I actually have his medals in my study. My grandmother spoke very fondly of him, so I guess you could say this was kind of my first “imprinting.”
His son, my uncle, became a urologist. He was the physician in the family when I was growing up. And then I thought, well, I’d be interested in a career in medicine. Even though I never knew my grandfather, what the family told me about him was really interesting, so I decided to apply to medical school and got in, and so now here I am 43 years later.
Then I went to college and worked in the emergency room as an orderly, wheeling patients around and mopping floors. I was a premedical student at Duke University (Durham, NC), and I observed both the medical and surgical side of the emergency room. And watching the surgeons was just so fascinating. I’d watch them suture up patients, crack chests, and resuscitate people, so that was another template for me.
So that’s why I became a surgeon—because I had very positive role models: my grandfather, who I didn’t know; an uncle who I did know and was in private practice; and all these amazing surgeons that I saw as an undergraduate student at Duke University, including William C. Sealey, MD, FACS, and W. Glenn Young, MD, FACS. A lot of these role models were cardiothoracic surgeons who are now deceased, but I can name them like I can name my children. They were a tremendous influence on me.
When I got to Temple University Medical School in Philadelphia, I had an open mind with regard to which field of medicine I would pursue. As an undergraduate, I was able to observe microvascular surgery and hand surgery while working my way through college as an orderly. I ultimately decided that I wanted to become a microvascular surgeon and hand surgeon. I thoroughly enjoyed my surgical rotations in medical school and subsequently applied for an orthopaedic residency. This included two years of general and thoracic surgery, as well as four years of orthopaedics at Duke University Medical Center. Following orthopaedic training, I completed a second residency in plastic surgery, also at Duke University School of Medicine.
Who are some of your mentors and role models in surgical leadership?
The person who had the greatest influence on me and countless others was ACS Past-President David C. Sabiston, Jr., MD, FACS. He was the President of the College when I joined his department as an intern in 1982. Dr. Sabiston had the highest standards of patient care. He himself was a surgeon-scientist, and he emphasized that “attention to detail is important.” We would leave no stone unturned with respect to excellence in patient care. The patient always came first. I’ll never forget the day I started my internship, and he mentioned the great physician William Osler, who said, “The key to success is summarized in two words: hard work.”
As part of my training in orthopaedics, I was required to do two years of general and thoracic surgery (1982–1984) as a prerequisite to orthopedic training (1984–1988), and was working at that time with people who, if you were to fast-forward, would wind up among the who’s who in American surgery. For example, people like Ron Weigel, MD, PhD, MBA, FACS, Chair, ACS Board of Governors, and I were residents together. (Dr. Weigel is E.A. Crowell Jr. Professor and Chair of Surgery; professor of surgery, surgical oncology and endocrine surgery; and professor of biochemistry, anatomy and cell biology, and molecular physiology and biophysics, University of Iowa, Iowa City.)
Others who have had amazing surgical careers but are now retired, such as Randy Chitwood, MD, FACS, and James Cox, MD, FACS. In fact, Dr. Cox received the 2020 Jacobson Innovation Award. Randy and Jim were my chief residents and went on to become esteemed cardiothoracic surgeons. My role models in orthopaedic surgery were James R. Urbaniak, MD, and the late J. Leonard Goldner, MD.
The two years with Dr. Sabiston were the days before the Libby Zion 80-hour workweek restrictions. We were on call every other night. Those were formative years for me. Working in the department of Dr. Sabiston with all these great surgeons was really terrific and solidified for me what it meant to be a surgeon.
We can’t train people like that anymore because of the 80-hour workweek and concerns about work-life balance. It’s something people talk about, and it’s not inconsequential, but I wouldn’t trade those two years for anything. I remember in 1988, when the Libby Zion case came about and surgeons first started talking about curtailing work hours, I wrote to Paul Ebert, MD, FACS, then Director of the College, and I told him how meaningful my time was as an intern and junior resident in general and thoracic surgery.
The imprint that Dr. Sabiston left has stayed with me to this day. He trained us to be excellent physicians, to be competent surgeons, to communicate with patients and their families, to pay attention to detail, and to be available around the clock for problems. You can argue that’s not a good way to be, but that’s how I learned, and that’s how I’ve led my surgical career for the last 30 years in practice. These principles have served me very well. I’ve had the opportunity to become a leader—first as division chief of plastic, reconstructive, oral and maxillofacial surgery at Duke. I then became the department chair of orthopaedics at the University of Pennsylvania 12 years ago. I also lead the musculoskeletal and rheumatology service line at Penn Medicine.
What hobbies and interests outside of surgical patient care do you have?
I like to swim. I love Formula One racing cars. I’m sort of a car guy. I love old cars. My hobby is studying leadership and leaders. So, anything that has to do with leaders and leadership, I’m very interested in. I read a lot of books on leadership and principles of leadership, and that pastime has really helped me and my career.
What is your proudest accomplishment?
I have led both a division of plastic surgery and a department of orthopaedic surgery, and I’ve created a new specialty called orthoplastic surgery that is recognized now as an amalgamation of orthopaedic and plastic surgery. Furthermore, that amalgamation resulted in Penn Medicine doing the first bilateral hand transplant in a child. So, that’s my proudest accomplishment.
I’ve maintained dual board certification and have had leadership positions in both plastic and orthopaedic surgery societies both nationally and internationally. I’m also proud of establishing the hand transplant program at Penn and the hand transplant program at Children’s Hospital of Philadelphia, where our team performed the world’s first pediatric hand transplant.
We’ve also created what we call the Penn Orthoplastic Limb Salvage Center here at the University of Pennsylvania. The center is designed to offer cutting-edge surgery for limb salvage and reconstruction in patients whose limbs are at risk for amputation. The approach to salvage is heavily weighted in microvascular techniques. A new journal was recently launched—Orthoplastic Surgery—that’s dedicated to this area of surgical patient care. I serve as the editor-in-chief of this journal.
What advice would you give to a young person considering a career in surgery?
As we say, it’s a calling like being in the clergy or being a teacher. If you love what you do, you never work a day in your life. I love getting up in the morning and coming to work for the last 30 years. I was in the operating room all day yesterday with the residents and the fellows, doing really complex limb salvage and reconstruction—a wonderful day.
My advice to surgical residents is find your passion in the field of surgery. Whatever you’re passionate about, whatever you are keenly interested in, no matter what it is, that is where you will thrive and have a rewarding surgical career. There are specific principles that bind surgeons together and certain characteristics that are unique to each surgical discipline, but if you get up in the morning and feel like you’re making a difference, there’s no greater gift that you can give to yourself and to humanity.
As Chair of the Board of Regents, I’m excited to be working with David B. Hoyt, MD, FACS, ACS Executive Director, this year to really promote specialty engagement in the College. It’s such a great organization, and I sing its praises all the time because of the legacy of people like David Sabiston and other great surgical leaders. They’ve always used the College as a platform to promote surgical excellence. That’s why it’s such a privilege and an honor for me to be a member of this organization. As a matter of fact, when I first became board certified, I couldn’t wait to tell Dr. Sabiston, “I’m now a member of the College.” That feeling has never gone away.
Having a personal North Star is very important. My personal and professional relationships with so many members of the ACS are inspiring and extremely rewarding. Such relationships in aggregate are my North Star.