CONVENTION ISSUE:
The Society of Critical Care Medicine Annual Meeting
GENERALSURGERYNEWS.COM
January 2014 • Volume 41 • Number 1
The Independent Monthly Newspaper for the General Surgeon
Opinion
Surgeons and the First Surgeon General’s Report B Y F REDERICK L. G REENE , MD
J
anuary 2014 commemorates the 50th anniversary of a milestone in public health in the United States. On Jan. 11, 1964, Luther L. Terry, Surgeon General of the U.S. Public Health Service, released the first report of the Surgeon General’s Advisory Committee on Smoking and Health. On the basis of more than 7,000 articles in the biomedical literature relating to smoking and disease available at that time, the Advisory Committee concluded that cigarette smoking is 1) a cause of lung cancer and laryngeal cancer in men; 2) a probable cause of lung cancer in women; and 3) the most important cause of chronic bronchitis. For several days, the report furnished newspaper headlines across the country and lead stories on television newscasts. Later, it was ranked among the top news stories of 1964. The release of the report was the first in a series of steps, still being taken 50 years later, to diminish the impact of tobacco use on the health of the American people. During the 50 years that have SURGEON GENERAL page 6
EXTENDED HERNIA COVERAGE Pullout Section Page 7
The Surgery Job Market: Most Positions Do Not Require Fellowship Training
Surgeons Develop Strategy To Save Lives After Mass Casualty Events
Many Employers Seek Broadly Trained General Surgeons
Physicians, Police Team Up: Goal Is To Reduce Time to Treatment
B Y C HRISTINA F RANGOU WASHINGTON—Just as senior general surgery residen nts crisscross the country for fellowship interviews comes a new study showing that the increeasing trend toward fellowship p training is out of step with th he current demands of the general surgery job market. Only one-third of general surgery job postings over the past two years listed fellowship as a requirrement, according to the study, which was presen nted at the 2013 Clinical Congress of the American College of Surgeons. Oveer the same period, almost 70% of general surgery traineees who finished residency sough ht fellowship training. Study co-author Nath han W. Bronson, MD, chief residentt iin generall surgery at Oregon Health & Science University, Portland, said the findings suggest twice as many fellowship-trained surgeons are produced than are needed. “These data suggest a disparity between the training general surgery trainees pursue and the skills that general surgery employers
INSIDE In the News
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Liposomal Bupivacaine Boosts Postoperative Pain Relief for Incisions of the Midand Lower Abdominal Wall
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B Y C HRISTINA F RANGOU
seek,” he said in an interview. The study Th t d iis b based d on d data t collected ll t d in Oregon and Wisconsin. Investigators acknowledge that their research is limited to a very small sample of the U.S. job market, covering only 3.1% of the population. However, these two states represent an important sample of the overall job market in the United States. Based on
WASHINGTON—On the morning of Dec. 14, 2012, trauma surgeon Lenworth M. Jacobs, MD, got word that gunshots had just been fired in an elementary school in nearby Newtown, Conn. The Trauma Institute at Hartford Hospital, in Connecticut, where Dr. Jacobs is director, went on alert. Staff readied for patients to arrive. They waited and waited. But no patients arrived from Sandy Hook Elementary School that morning. Instead, Dr. Jacobs received a call from the medical examiner’s office, requesting his assistance in the autopsies of the 26 bodies of schoolchildren and their teachers. “It [was] the single most powerful thing that I have ever done,” said Dr. Jacobs, during a press conference at the 2013 Clinical Congress of the American College of Surgeons (ACS). “I felt some good had to come out of this. … [It] has to be everyone’s responsibility and everyone, from law enforcement to the public, has to be part of the solution.” What Dr. Jacobs saw that morning has spurred a large-scale initiative that, organizers hope, will change the
see JOB MARKET page 26
see MASS CASUALTY page 23