Every Day Heroes: Dr. A Leo Winter

EVERY DAY

HER ES Volume 7

Dr. A. Leo Winter has been awarded the Every Day Hero Award from the McMaster University Department of Surgery. This award serves as a way to recognize and thank surgeons within our academic community who consistently go above and beyond in their service to others. These individuals dedicate themselves to making a difference — to making sacrifices that are many times unrecognized. This award is one way for us to bring these amazing individuals into the light and thank them for everything they do.

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Dr. Winter has a longstanding commitment to the teaching of medical students during their surgical rotations, as well as providing teaching sessions and lectures.

Every Day Hero: Dr. A Leo Winter

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his award is being presented to acknowledge Dr. Winter’s lifetime dedication to surgical education.

Dr. Winter has been helping to train and equip the next generation of Everyday Heroes since 1983, when he joined McMaster’s Department of Surgery, in the Division of Urology at St. Joseph’s Hospital. In addition to the supervision and teaching of surgical residents, Dr. Winter has a longstanding commitment to the teaching of medical students during their surgical rotations, as well as providing teaching sessions and lectures during the renal unit of the Undergraduate curriculum.

One of the most rewarding experiences for Dr. Winter came during a time when he had been struggling many years to teach medical students, residents, and gynecologists about a condition that affects pregnant women in their second trimester. The condition, a physiologic obstruction of the right ureter from the kidney to the bladder, “Hydroureter of Pregnancy,” causes severe pain for several days before resolving itself. One day, his wife’s niece began exhibiting symptoms of this very condition.

She wanted to proceed to an emergency room, regardless of Dr. Winter explaining that the condition should be treated with pain medication for a few days and then it would abate with no lasting effects. She insisted, so off they went. Once at the ER, Dr. Winter was anticipating disappointment, thinking the condition would almost certainly be misdiagnosed, and his wife’s niece would not receive the proper diagnosis, potentially having unnecessary tests and treatment. To his surprise the young ER doctor diagnosed her properly, confirming Hydroureter of pregnancy. When speaking afterwards, the ER doctor explained that Dr. Winter had taught her during the kidney unit in medical school and that Dr. Winter’s teachings on the condition of Hydroureter of Pregnancy had stuck with her. It was a rewarding moment for Dr. Winter and an encouragement that his teaching was making a real difference.

As a medical student himself, Dr. Winter was first mentored by a urologist practicing out of a small hospital in downtown Toronto.

He showed Dr. Winter how practicing urology had many aspects to it — office practice, cystoscopy, open surgery, and laparoscopic surgery. Dr. Winter’s interest was piqued, and he decided to follow in his mentor’s footsteps.

When becoming a mentor himself, Dr. Winter strived to exhibit many of the characteristics he had seen and appreciated in

his own mentor. Dr. Winter finds having patience and allowing students to come up with their own conclusions to be some of the most important parts of teaching.

Dr. Winter wants to make sure that surgery has a prominent focus in undergraduate medicine. He advocates that students need to be taught the surgical aspects of different conditions, not just the medical aspects. To reach this balance, he would love to see surgeons more involved in undergraduate teaching.

When asked to give advice to up and coming medical teachers, Dr. Winter’s suggestion was engagement through case studies. He has found that the most exciting aspect of teaching for students is the use of case studies from his many years of practice. Case studies are able to highlight and bring to life the conditions being discussed in the classroom. They are also critical for showing students the wide range of severity in conditions and the surgical aspects involved.

Dr. Winter has seen various shifts in the styles of medical teaching throughout his long career. He used to see surgeons using residents to hold retractors during operations, which, although a necessary function, limited the opportunity for the residents to gain practical hands-on experience. The advances in minimally invasive and robotic surgery means there are fewer retractors to hold these days, but now residents often hold cameras during procedures. However, the camera affords the advantage of allowing more junior learners a better view of the operation then seen during open procedures. To help residents make the jump to operating surgeons, Dr. Winter sees the benefits of simulation in surgical training, particularly for laparoscopic surgery. Dr. Winter believes simulation can build confidence in training residents before they are put in an operating room. In addition, he opines that learning to fulfill the true function of a surgical assistant is an excellent prelude to becoming an operating surgeon.

McMaster’s Department of Surgery and the Michael G. DeGroote School of Medicine have been extremely blessed to have Dr. Winter working with us and helping to train our students and residents. Over the years, he has had a profound impact on many young physicians and surgeons, providing advice and teaching that withstands the test of time. Every day, Dr. Winter continues to inspire the next generation of Every Day Heroes, and, for that and everything else, we are most grateful.