Behind The Knife: The Surgery Podcast

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? In this episode, our surgical education fellows and two expert mentors talk through the ins and outs of mentors – who are they, what can they do for you, how do you find one, and what do you do once you have one.  Hosts:  Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests:  Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Mentorship teams: think about 4-5 people who can help you in different ways.  Research mentor who can help you find opportunities and be productive 1-2 people who support you in all things (these might be residents!)  1-2 higher level sponsors who facilitate opportunities and pay for things Discipline and accountability RESPOND TO EMAILS. If you get an indication that a potential mentor would like to meet with you, take them up on the offer and be prompt with your replie

Challenges continue to plague the residency application process, with programs receiving increased application volume that makes holistic review difficult, and medical student applicants burdened with application costs and uncertainty about what programs best align with their values. As a specialty, Ob/Gyn is facing these problems head on, and have united within their field to create a new independent residency application system, ResidencyCAS. While substantial changes to an already stressful process can be intimidating, the new platform offers many advantages that hope to improve the residency application experience for applicants, programs, and the Ob/Gyn community as a whole. We’re joined by Dr. Maya Hammoud and Dr. AnnaMarie Connolly, two of the leaders in this effort, to break down the creation of ResidencyCAS, plans for its implementation starting in the 2024-2025 application cycle, and the reaction of the Ob/Gyn and medical education communities to this change. Learning Objectives 1.     Listeners wi

Direct Peritoneal Resuscitation!  We’re not just dumping fluids into the open abdomen.  What is DPR?  Why do it?  Who should get it?  Does it work? Come try and stay awake for some basic science talk before then learning all about why you should consider adopting DPR into your Trauma/EGS practice? Join Drs. Cobler-Lichter, Kwon, Meizoso, Urréchaga, and Rattan as they guide you through all this and more!  Hosts: Michael Cobler-Lichter, MD, PGY2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (twitter) Eva Urrechaga, MD, PGY6/R4: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @urrechisme (twitter) Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 3 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Rishi Rattan, MD, Attending Surgeon in Trauma/Critical Care, 7 years in practice

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 2 outlines the radical technical approaches to anteriorly invasive tumours, including en bloc cystectomy, perineal urethrectomy, inter-labial vaginectomy and radical pubic bone resections. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Paul Sutton from The Christie Hospital, Manchester, UK. Technical videos: Solomon MJ, Däster S, Loizides S, Sutton P, Brown KGM, Austin KKS, Lee PJ. Access to the anterior pelvic compartment in pelvic exenteration in women-the interlabial approach: video vignette. Br J Surg. 2021 Aug 19;108(8):e

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes, that we learn during surgical training, and into all compartments of the pelvis. Episode 1 provides listeners with an overview of the principles of exenteration surgery and preoperative patient assessment and selection. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Elaine Burns from St Mark's Hospital, London, UK. References and further reading: -Burns EM, Quyn A; Lexicon Collaboration of UKPEN and the ACPGBI Advanced Cancer subcommittee. The 'Pelvic exenteration lexicon': Creating a common language for complex pelvic cancer surgery. Colorectal Dis. 2023 May;25(5):888-896. doi: 10.1111/codi.16476.  -Brown KGM, S

This week, we discuss the experiences of residents and medical students in surgery who identify as LGBTQIA+. We discuss the question of disclosure during interviews, how to identify programs that are welcoming to diverse identities, and how AOSA has grown the community of trainees and faculty mentors and hopes to continue to support them in the future. Hosts: Jason Bingham, MD Nina Clark, MD Guests: Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center Christina Georgeades, MD, R4 General Surgery at Medical College of Wisconsin cgeorgeades@mcw.edu, Twitter/X: @CGeorgeades Cameron Smith, MS3 at Kansas City University Cameron.smith@kansascity.edu, Instagram: @cameron_smith_1996, Twitter/X: @cafe_aficionad0 Jillian Wothe, MD, R1 General Surgery at Brigham & Women’s Hospital jillian.wothe@gmail.com, Twitter/X: @JillianWothe Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Please visit https://behindtheknife.org to access o

Has the pendulum swung too far?  Is it time to put the drill down??  Or, drill, baby, drill!  While the number of rib plating cases has exploded the data supporting the practice is less-than-stellar.  On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill bring you up to speed on rib plating. If you haven’t already, we recommend you listen to Behind the Knife episode 298, published in May 2020. (https://behindtheknife.org/podcast/big-t-trauma-series-ep-10-rib-fractures/)  This episode covers comprehensive management of rib fractures, including multimodal pain control, regional blocks, pulmonary toilet, BiPAP, etc.   REFERENCES: GUIDELINES EAST PMG Rib Plating (2017): https://www.east.org/education-resources/practice-management-guidelines/details/rib-fractures-open-reduction-and-internal-fixation-of-update-in-process EAST PMG Rib Fracture Non-Surgical Management (2022): https://www.east.org/education-resources/practice-management-guidelines/details/nonsurgical-managem

You have a young patient with a horseshoe abscess. How should you address the abscess initially? What is the best approach to drain it? Now that it is drained, what do I do with all the drains? Tune in to figure out how to best approach the most challenging of perianal abscesses.  Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Julia Saraidaridis as they discuss the management of horseshoe abscess and complicated perianal fistula.  Learning Objectives 1. Describe the evaluation for perianal abscesses and fistula.  2. Discuss the different surgical options in managing horseshoe abscesses and post operative care to definitive management 3. Explain the rationale behind use of different fistula surgeries in complex perianal fistulas Link to episode video: https://behindtheknife.org/video/clinical-challenges-in-colorectal-surgery-management-of-horseshoe-abscess/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  Our

To close or not to close - that is the question!  Internal hernias following bariatric surgery can be a vexing source of delayed postoperative morbidity.  Join Drs. Matthew Martin, Kunoor Jain-Spangler, Adrian Dan, and Vincent Cheng for this EXCELLENT Journal Review in Bariatric Surgery.   Article #1: Stenberg 2023 - Long-term Safety and Efficacy of Closure of Mesenteric Defects in Laparoscopic Gastric Bypass Surgery Two mesenteric defects are created during Roux-en-Y gastric bypass (RNYGB) Petersen’s Defect Jejuno-jejunostomy mesenteric defect  Consensus does not exist regarding the standard of care for mesenteric defect closure (e.g., closure of one or both defects, material used for closure).  Risks of leaving defects open: internal herniation with or without bowel ischemia  Risks of closing defects Kinking the bowel (especially near the jejunojejunostomy) leading to obstruction  Chronic abdominal pain This article discusses a randomized controlled trial of obese patients undergoing bariatric RNY

This week we sat down with the Association of Out Surgeons & Allies (AOSA) leadership in the first installment of a BTK/AOSA collaboration addressing issues important to LGBTQ+ surgeons, patients, and allies. We are joined by Guest Host Dr. Andrew Schlussel, BTK Members Drs. Nina Clark and Jason Bingham, and AOSA Leaders Drs. Nicole Goulet, Alexis Moren, and Courtney Collins. More information about AOSA and how to get involved can be found at https://www.outsurgeons.org. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management.  We discuss key concepts including the genetic

How do you counsel the patient with a large painful hernia who still smokes a pack of cigarettes every day? Join Drs. Michael Rosen, Clayton Petro, Sara Maskal, and Ryan Ellis as they discuss some of the highlights in the literature on smoking and its impact on postoperative outcomes in elective, clean open ventral hernia repairs.  Hosts:  - Michael Rosen, Cleveland Clinic - Clayton Petro, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan Ellis, Cleveland Clinic, @ryanellismd Learning objectives:  - Evaluate historical data on smoking in surgery - Compare with newer literature specific to contemporary ventral hernia repairs - Understand how the historical and new data can be applied in clinical practice References:  Møller AM, Villebro N, Pedersen T, Tønnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002 Jan 12;359(9301):114-7. doi: 10.1016/S0140-6736(02)07369-5. PMID: 11809253. Kubasiak JC, Landin M, Schimpke S, Poirier J, M

Surgeons are trained to, well…do surgery, but is that always the right treatment for the patient? Not offering surgery can be a challenge, especially when you’re consulted about a sick patient in the middle of the night and the clinical momentum is moving toward the OR. Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington as we discuss how to recognize when a surgery is potentially not beneficial and communicate serious news with the patient and consulting team. Hosts: Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow.  Dr. Lindsay Dickerson (@l

While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries.  Hosts: - Dr. Tam Pham: UW Medicine Regional Burn Center - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center - Dr. Alex Morzycki: UW Medicine Regional Burn Center - Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: - Review the epidemiology and common mechanisms for electrical injuries  - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release - Recognize possible long-term complicati

While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries.  Hosts: - Dr. Tam Pham: UW Medicine Regional Burn Center - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center - Dr. Alex Morzycki: UW Medicine Regional Burn Center - Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: - Review the epidemiology and common mechanisms for electrical injuries  - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release - Recognize possible long-term complicatio

Surgical residency is hard. In some ways, intern year may be the hardest. We’ve been there. We’re a group of surgical residents formally known as the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional organization of surgical education research fellows working together to foster peer mentorship, networking, and scholarly collaboration. We’ve collectively reflected on our experiences as surgical interns across the country. Join Drs. Ananya Anand, Joe L’Huillier, and Rebecca Moreci as they discuss three tips for thriving as a surgical intern.  Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101 –Dr. Rebecca Moreci, Louisiana State University, @md_moreci –COSEF: @surgedfellows Learning Objectives:  Listeners will:  – List CoSEF’s three tips for thriving as a surgical intern – Challenge their definition of patient ownership – Recall the “Golden Rule” of treating others how you want to be treated – Appreciate the im

For patients with insufficient future liver remnant (FLR) volume, adequate hypertrophy after Portal Venous Embolization (PVE) is associated with reduced likelihood of post-operative hepatic insufficiency. But what happens when PVE isn’t enough to obtain adequate volume prior to surgery? In this episode from the HPB team at Behind the Knife, listen in on the discussion about advances in venous deprivation techniques that can potentially increase resection rates and hypertrophy  Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center.  Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Cha

Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons.  Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical

Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons.   Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical

We know cardiac surgery can seem a bit daunting on the surface. However, most surgeons will come across cardiac surgery patients at some point whether in the OR, ICU, ED, etc. As the FIRST cardiac surgery specialty team for Behind the Knife, we are excited to bring you episodes focused on high-yield topics to help you navigate common cardiac surgery challenges, discuss relevant literature to help you in practice, and help our listeners feel more comfortable around cardiac surgery patients.  In this episode we’ll discuss common cardiac surgery post-op problems. Whether you're on a cardiac surgery rotation or just covering an ICU with cardiac surgery patients for the night, these common post-op problems are bound to occur. Hosts:  - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 - Aaron William, MD- Cardiothoracic Surgery Fellow, Duke University, @AMWilliamsMD - Nick Teman, MD- Assistant Profressor of Thorasis and Cardiovascular Surgery, University of Virginia, @nic