The Scalpel - Winter 2018

A Dissection of News from the Department of Surgery As I drove in today, I noticed a fall chill in the air and the beautiful color changes that occur with the change of the seasons here in East Tennessee. The fall transformations are not the only changes occurring around UTGSM as changes are also occurring in the Office of the Dean and the Chair of Michael B. Freeman, MD Surgery. As outlined in this Interim Chairman edition of The Scalpel, Dr. Jim Neutens, who has served this institution well over 34 years, resigned as Dean. Dr. Paul Hauptman is the new Dean and comes with great accolades from Saint Louis University School of Medicine. He is a true academician who has excelled as a clinician, researcher, and teacher. We look forward to his leadership and vision for the future of the Graduate School of Medicine.

leadership position, knowing many of the surgical faculty could also serve in this role. I hope to serve in an exemplary manner that will carry on the great tradition of this surgical department.

The other changes occurring in the Department of Surgery are with residents and fellows as we said goodbye to those trainees who finished and welcome the new trainees. Each of the graduating residents and fellows have found new homes in great surgical practices or, as in Dr. Sneha Bhat’s case, a great fellowship. The faculty are extremely proud of their accomplishments and look forward to the new alumni excelling in their new endeavors. It is always a melancholy time of the year as we celebrate their graduation with end of the year festivities including research day and the graduation dinner. This year we were honored to have Dr. Jim Valentine present the Kimball I. Maull Lecture on the timely subject of Surgeon Burnout. For those who are experiencing the stress of a busy surgical practice I encourage you to read Dr. Soon after arriving in October, Dr. Hauptman received Valentine’s presidential address to the Western Surgical news that Dr. Bruce Ramshaw had resigned his position Society on which he based his talk at UTMCK : The as Chairman of the Department of Surgery. It was with a Hidden Cost of Medicine heavy heart that Dr. Ramshaw stepped down. As he stated to me personally and to the faculty, Dr. Ramshaw Having been at UTGSM/UTMCK for 31 years, I have felt he would need to dedicate more time than his seen this institution grow tremendously in regards to chairman duties would allow him to passionately pursue both facilities and the number of surgical procedures his vision for performance improvement through data performed but also into a nationally recognized center of analysis. His leadership will be missed and we all wish excellence for patient care. Even with all of the recent him well in his continuing endeavors to improve clinical changes in leadership, I believe the future is bright. I look outcomes. Dr. Hauptman has asked me to serve as forward to all the future advances that will catapult the Interim Chairman until the position is filled. I am humbled institution to even greater heights. by the opportunity to serve the department in a

GSM Faculty and Resident Awards Stacy Stephenson, MD – Excellence and Leadership in Basic Science Research Award Dr. Stephenson came to the UT Graduate School of Medicine in 2013 and has a current grant through the National Institutes of Health for her research on expressing humanized bacterial luciferase in stem cells.

Andrew Russ, MD – Excellence and Leadership in Clinical Research Award Dr. Russ shows true leadership through discovery and clinical practice. He has given three invited lectures, mentored six residents in scholarly presentations and authored two book chapters. Dr. Russ sits on three departmental committees, six hospital committees and two national society committees. He also holds two invention disclosures.

Shannon Beierle, MD – Best Original Research “A Correlation Between Emotional Intelligence and Burnout in Surgical Residents”

Clinical Outcomes Receives Publication Approval Data from an ongoing clinical trial was recently accepted and published in the New England Journal of Medicine as of July 2018. The trial focused on patients from May 2014 to October 2017 receiving thawed plasma during resuscitation during air medical transport verses those with standard resuscitation. The primary outcome was mortality at 30 days.

Participants of this trial include the Division of Trauma and Critical Care Faculty, Lifestar crews, Department of Pathology and Blood Bank, Susan Rawn, the Department of Anesthesia and the Volunteer Research Group.

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Surgery Resident Reflects on First Year

or encounter I could look back on, a great story to tell that

Beginning residency is an inherently

year I can think only of a constellation of “firsts”. Doing

characterized my intern year, but when I think back over the

confusing experience. Despite spending procedures unassisted, learning certain operative techniques,

Alan Good, MD

years preparing to make the transition

and getting more directly involved with larger cases and more

from student to physician, the change

complex patients blend together to illustrate some of the

occurs so quickly that it felt chaotic. In a few short weeks I said goodbye to friends and family, moved my family a

progress I have made and the challenges I still have ahead.

Despite the difficulty in residency, I have found it to be very

thousand miles, and immediately began with more

rewarding. I enjoy the opportunity to learn different techniques

responsibility, stress, and hours of work than any point in my

and management styles from various services and

life. Making the transition in July was an incredible challenge.

attendings, hoping to imitate what others do well for my

Every day presented new challenges, every rotation was

patients. It's also very fulfilling to work at something over time

new, and nothing seemed to come easily. Each day seemed and improve. More than evaluations and simulations, I feel a sense of satisfaction when I can see the improvement of my long, but the weeks and months went by so quickly that I had own technical skills and efficiency displayed in the day to day finished an entire year seemingly by accident. care of my patients. It’s also rewarding to be a part of a great As educational as my first year of residency was, I spent

group of residents that will spend time with each other after 80

most of the year realizing how much I still must learn. Surgery hours of working together each week. I’m very happy to be is a broad field with deep specialties, and the combined body doing surgery at UT, and I am excited about the opportunities of knowledge is challenging. I wish there was a single patient ahead.

Dean Neutens Retirement James Neutens, PhD, Dean of the University of Tennessee Graduate School of Medicine since 2007, retired October 1, 2018. He served UT for 34 years and was the third dean since the formalization of the UT Graduate School of Medicine in 1991. Dr. Neutens served the UT Graduate School of Medicine since 1990 where he taught clerkship and residency programs in OB/GYN. In 1997, he was selected to serve as Associate Dean and eventually Executive Associate Dean. He was appointed as the Interim Dean in 2005 and was selected to fill the Dean’s position in 2007. As Dean, Dr. Neutens oversaw incredible growth for the UT Graduate School of Medicine while supporting the mission of healing, education and discovery. His leadership in managing partnerships with physicians, UT institutions and area organization leaves a legacy that will continue to be prominent for UTGSM.

Residents and Fellows Celebrate Graduation The Department of Surgery gathered at the Cherokee Country Club on Saturday, June 16, to commemorate the achievements of three surgery residents graduating and two fellows completing fellowships. Dr. Sneha Bhat, Dr. Benjamin Ford, and Dr. Austin Lewis competed five years of general surgery residency.

Following graduation, Dr. Bhat entered a MIS Fellowship at Southwestern Medical Center in Dallas, Texas. Dr. Ford entered private practice at Roper Saint Francis Hospital in Charleston, South Carolina. Dr. Lewis entered practice at Carrollton Surgical Group at Tanner Medical Center in Carrollton, Georgia.

Dr. Sneha Bhat received the Resident Teaching Award; Dr. Andrew Russ received the Faculty Teaching Award.; the Exceptional Service Award was given to OR

Dr. Todd Nickloes (left) and Dr. Matthew Abraham at the Critical Care Fellowship Graduation

Surgical Technician Vicki Brabson; the Trauma Scholarship was awarded to Dr. Eric Whittington; first place for the Resident Performance award was Dr. Miles Landry, second place was Dr. Jordan Shealy, and third was Dr. Emily Pospiech. Dr. Austin Lewis

Dr. Jonathan Cudnik completed his fellowship in

received the Society of Laparoendoscopic Surgery

vascular surgery and will continue his career in private award. This years Golden Apple Award went to Dr. practice in Montgomery, Alabama. Dr. Matthew

Sneha Bhat. The award is given to the resident with

Abraham, Critical Care Fellow, entered private practice excellence in teaching medical students. in Concord, North Carolina. Dennis Van Dorp, MIS Fellow, is joining a private practice in Midland, Michigan.

Vicki Brabson

(From left) Dr. Brian Daley, Dr. Benjamin Ford, Dr. Sneha Bhat, Dr. Austin Lewis, and Dr. Bruce Ramshaw

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2018 Resident Research Day Resident Research day was held June 15, 2018 in Morrison’s Conference Room at UT Medical Center. Awards were presented to the residents and faculty at the Chief Residents Dinner that evening. Dr. R. James Valentine, Professor of Surgery, Division of Vascular Surgery, University of Minnesota Medical Center, was this year’s Kimball I. Maul Visiting Professor. His presentation was “Surgeon Burnout: Prevalence, Causes, and Solutions.”

Kimball I. Maul Awards

1st place John Mark McLain, MD: Sleep Fragmentation Delays Wound Healing in an Obesity-Induced Type 2 Diabetic Mouse Model

Dr. Michael Freeman (left) and Dr. James Valentine

2nd place Lynellen Gregory, MD: Contemporary Clinical and Financial Analysis of Open versus Percutaneous Thrombectomy for Occluded Hemodialysis Access 3rd place Jordan Shealy, MD: Can the Trauma Registry be a Fail-Safe for Notifying Patients with Incidental Findings?

Karlstad Receives Compliance Award The office of Research and Engagement third annual Research Integrity and Compliance Awards were held at the Howard H. Baker Jr. Center for Public Policy Tuesday, February 6. Robert Nobles, interim vice chancellor for research and engagement, celebrated faculty, staff, and students who practice excellence in safety and compliance areas every day.

“These awards were created to highlight the value and importance of shared governance, which lays the foundation for UT’s continued success,” said Nobles. “I am indebted to those who contribute to our research integrity, safety, and compliance infrastructure, and appreciate their dedication.”

Michael Karlstad, PhD won the 2018 award for Promoting Animal Care and Use.

Residents Present at Tennessee ACS

molecular therapeutics aimed at vascular

In conjunction with the Tennessee

“Cell Mimetic Liposomal Nanocarriers

Committee on Trauma and Tennessee

Tailored for Vascular Smooth Muscle Cell

Committee on Cancer and Cancer Liaison

Molecular Therapeutics.”

Physicians in Tennessee, the American

Dr. Landry presented a modified technique

College of Surgeons Tennessee Chapter

for laparoscopic transgastric polypectomy

hosted the TNACS annual meeting in

and benefits of less invasive approach

Downtown Nashville, Tennessee.

illuminated by an unexpected finding on

pathology. The title of her presentation was

Two residents from

pathology. The title of

the Department of

his presentation was

Surgery were featured “Laparoscopic

Dr. Lauren Grimsley

presenters: Dr.

Transgastric

Lauren Grimsley and

Polypectomy:

Dr. Miles Landry. Dr.

Unexpected Finding

Grimsley presented

Transilluminates the

research on

Benefit of Minimally

biocompatible

Invasive Technique.”

Dr. Miles Landry

nanocarriers for learning opportunities and timely discourse on The ACS Clinical Congress features outstanding the most education and training opportunities at the premier relevant annual surgical meeting for surgeons, surgery surgical residents, medical students, and members of surgical practices and teams. The hallmarks of the Clinical Congress are a research, broad range of outstanding hands-on and didactic along with Dr. Goldman, Dr. Ramshaw and Chancellor Dr. Schwab unparalleled access to peers.

American College of Surgeons Alumni Reception

This years reception was held October 22 at the Westin Complex Plaza in Boston, Massachusetts.

Representatives met from each of the four campuses in Tennessee: Knoxville, Nashville, Memphis and Chattanooga.

Faculty, residents, and alumni at the reception

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Paul J. Hauptman, MD, Dean of UT Graduate School of Medicine

Hauptman received his bachelor’s

focused on the evaluation of care

degree from Columbia University

delivery and physician decision-

and his medical degree from

making in advanced heart failure,”

Cornell University Medical College.

Dr. Hauptman said. “Chronic

He completed his internship and

disease in general is increasing in

Dr. Hauptman

residency at Brigham and Women’s prevalence and we need to better

comes to

Hospital, a clinical fellowship in

understand what patients want and

UTGSM and UTMC after 20 years

cardiology at Mount Sinai Hospital,

what they need. I certainly intend to

with Saint Louis University (SLU)

and a combined research and

continue to participate in this area

School of Medicine, where he most clinical fellowship in medicine in the of research, in part because as recently served as assistant dean

cardiovascular division of Brigham

patients are living longer with heart

of Clinical and Translational

and Women’s Hospital. He also

failure, we are encountering new

Research, professor of internal

served on the faculty at Harvard

challenges in clinical care and

medicine, and director of the heart

Medical School for five years.

policy, and we need to be prepared

failure program at Saint Louis University Hospital, as well as an adjunct professor in the College for Public Health and Social Justice.

Prior to SLU, Dr. Hauptman held faculty appointments at Harvard

Medical School. “This is an excellent opportunity for someone to take the campus to a new level, while recognizing the tremendous accomplishments and achievements of Dr. Neutens,” said Dr. Hauptman. James J. Neutens, PhD, FASHA, has been the dean of UTGSM for more than 10 years. “I

was very impressed during my visits to the campus and there’s a clear dedication to not just preserve, but grow the educational and research endeavors of the Graduate School of Medicine. I look forward to participating in that process,” Dr. Hauptman said. Dr.

Dr. Hauptman was director of the

to meet those new challenges.”

Clinical Trials Office of the SLU

Dr. Hauptman said his overriding

School of Medicine, the regulatory

vision is to find ways to expand

authority for contracting, budgeting

upon current research initiatives,

and invoicing of clinical trials for the further enhancing the reputation of university. His research interests

UTGSM and UTMC, while growing

include outcomes assessment in

very specific areas of research

cardiovascular disease and

excellence. “We have a great

advanced heart failure, evaluation

opportunity to solidify that

of care delivery, and clinical

reputation and to make sure that for

research, and trials in congestive

the next 10 or 20 years it’s even

heart failure. He has garnered

stronger,” Dr. Hauptman said.

support through federal, foundation, “UTGSM is well known for its ability and industry-sponsored research

to educate third and fourth-year

grants, including from the National

medical students and train

Institutes of Health and the

residents and fellows in

American Heart Association. He

postgraduate training programs.

has also served as an expert

We certainly want to foster our

panelist for the FDA and has

standing in that regard. Many

authored over 145 papers in

clinical programs at the UTMC have

publications including JAMA and

both an important local impact and

the New England Journal of

a national reputation, and we want

Medicine. “My area of research is

to make sure those thrive as well.”

Alumnus Joins Department Faculty Kyle Kleppe, MD joins the Department of Surgery as Assistant Professor. Dr. Kleppe graduated in 2017 from the General Surgery Residency Program. He completed his fellow ship in Minimally Invasive and Advanced GI Surgery at the University of Wisconsin in 2018. His training focused on benign foregut diseases, hernia, and bariatrics with a goal of returning to UTMC with unique skillsets. Dr. Kleppe said, “I plan on brining this training in surgical endoscopy techniques to the region, where these procedures are not currently being performed. These will initially include therapies for achalasia, spastic swallowing disorders, and gastroparesis,” but adds that he plans to expand treatment of dysplasia, benign tumors, and early malignancies of the esophagus, stomach, and duodenum. He will practice with University Surgeons Associates focusing on minimally invasive hernia repair and bariatrics and

also serve as Assistant Surgical Director for the UT Center for Advanced Medical Simulation. He shares his position with Dr. Mitchell Goldman. “My future plans for research include management of gastroesophageal reflux, minimally invasive hernia repair techniques, and hernia mesh physiology,” said Dr. Kleppe.

ATLS Course Launched in Zimbabwe

Medical Center

The purpose of the trip – started in 2015 when

ATLS, training a little

the first nursing and medical group went from UT

over 100 nurses in

Medical Center (Dr Blaine Enderson, Dr Lou

trauma care in

Smith, Niki Rasnake, Debi Tuggle, and Theresa

Zimbabwe under the

Day), sponsored by the Rotary International, and

continued leadership

partnered with South Africa ATLS to take the first of Debi Tuggle. ever organized trauma education courses to the medical and nursing staff of Zimbabwe. The training takes place at Mater Dei Hospital St Phillips Training Center. In 2015 both ATLS and ATCN Provider courses were taught as well as Instructor courses for both. ATCN has continued being taught twice a year since 2015 through Skype technology

The 2018 trip was a continuation of that effort and an official launch of continued ATLS Program in Zimbabwe was established with an ATLS course, again with

the support of South Africa ATLS course management and instructors. Zimbabwe will continue to grow their program through the support of the South Africa ATLS and the Rotary International to further grow their equipment and instructors.

of UT

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Hernia Screening a Successful Event Dr. Melissa LaPinska hosted a hernia screening on October 6. With assistance from Dr. Kyle Kleppe and Dr. Mariah Beasley, Twenty-one people were screened and 16 hernias were found. Many people came with the screened person (i.e. significant others), with 40 people present for the event. Also included in this “unscreened” number were two previous hernia repair patients of Dr. Melissa LaPinska, that came to the event to show support and see the robot that had helped in the repair. A patient who already had an appointment in the UT system for hernia repair was also present to meet his surgeon ahead of time. Speaking on this this event Dr. LaPinska said, “I am hopeful that we will be able to recruit the 16 hernia patients into the UT system as many of them made appointments to come back to our clinic on the day of the event. All but one of the hernias that we found were compatible with a minimally invasive repair and the excluded one was because the hernia defect is too large. Overall, I think this was a great event.”

We Value Your Support!

SAVE THE DATE

The UT Graduate School of Medicine and the Department of Surgery are thankful for generous

Department Holiday Party

support from people like you! If you are

Friday, December 7, 2018

interested in giving please contact

6:30PM-9:30PM West Club at Neyland Stadium

development@utmck.edu or 865-305-6611.

Further Reading The Department of Surgery is actively engaged in research. Check out our recent

publications and presentations at: http:gsm.utmck.edu/surgery/scholarlyactivity.cfm

Department Faculty and Alumni http://gsm.utmck.edu/surgery/faculty.cfm http://gsm.utmck.edu/surgery/alumni.cfm

Contacts Us The University of Tennessee

Department of Surgery 1924 Alcoa Highway, U-11

The University of Tennessee Medical Center comprises the

Knoxville, TN 37920-6999

University Memorial Hospital and the Graduate School of Medicine. Together, these entities embody the medical center’ s philosophy and mission through the spirit of exploration, the

Phone: 865-305-9294

passion for teaching, and the compassion to restore. The

Email: thescalpel@utmck.edu Website: http://gsm.utmck.edu/surgery/main.cfm

University of Tennessee is an EEO/AA/Title IV/Section 504/ ADA/ADEA employer.

E20-6358-00-0002-08

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