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Change is Invigorating

Thursday, January 10, 2008

At the spring 2006 AATS meeting in Philadelphia I had a chance to catch up with my former colleague, Dr. Leslie Kohman.  We spoke for an hour, mostly catching up on mutual friends, until our conversation drifted to the future. Leslie had just made the decision to close the thoracic residency at Syracuse due to many factors. Like all the senior surgeons at the meeting, she was saddened by the recent downturns of the profession, and she was worried about the future prospects of recent graduates. As it had been several years since we had spoken, she asked me about my career and my take on the future. What I said surprised her, and she asked that I share my thoughts so the younger generation can see what a bright future I believe we have.

My career path has been a bit unusual in that I have practiced in three different settings in my 8 years of practice. I began in a pure academic career, moved to a more private practice setting, and now am entering the administrative aspect of surgery. I began the path as an assistant professor of surgery under Dr Kohman’s tutelage and went to work. Several years later, with my academic journey proceeding as expected, I made a decision to move to New York City. Partly a personal move, more a desire to try something new, I became the Chief of Thoracic Surgery at Beth Israel Hospital, New York, NY.  Again came several years of hard work and long hours. After 7 years of practice, I began to question my future. I enjoyed surgery and taking care of my patients, but again felt that I needed a new challenge. Two of my resident friends asked me to join them as they started up the cardiac program at Mary Imogene Bassett Hospital. This is a small high quality academic hospital that was entering a profound growth phase, and there seemed to be a real feeling of momentum. I again made an unexpected turn in my career by moving from Manhattan to Cooperstown, New York. What I found there has re-energized me. 

Joining the Department of General Surgery in June 2005, I have had a wonderful experience developing several new aspects of my career. The clinical side came naturally, and I enjoyed developing strategies for managing cancer patients in a rural environment. I also began to work with my Chair on several new projects. One was to join the ACSNSQIP program. Another was chairing a safety action team. A third was developing a hospital wide skills lab. All of these projects required new skills, much different than the skills developed in residency training or during the practice of surgery. In the summer of 2006, I became the associate chief of surgery and assumed further administrative responsibilities. I found it very challenging and exciting to be involved at a different level than that to which I was accustomed. While we do not learn management skills in residency, I believe that the natural leadership skills that surgeons possess have served me well. While everyone agrees that the future will be dramatically different, I firmly believe that, as surgeons, we will play an important leadership role. 

I think it was my sense of optimism and enthusiasm that intrigued Leslie. I believe that my younger generation of cardiothoracic surgeons will find renewed energy as we emerge into leadership positions. Far from the pessimism expressed about our field, I feel we are at the forefront in so many interesting changes in healthcare, and cardiothoracic residents should look forward to intriguing and varied future careers in medicine.

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