AUGUST 2013 | VOLUME 98 NUMBER 8 | AMERICAN COLLEGE OF SURGEONS Bulletin Contents FEATURES COVER STORIES: ACS Resident and Associate Society: Diving into the evolving demands of resident training 11 Hold the onions: Training in an era of heightened diversity and expectations 12 Brian J. Santin, MD The role of politics in shaping surgical training 17 Jennifer Baker, MD; Subhasis Misra, MD, MS, FACCWS; Neil J. Manimala, MD; SreyRam Kuy, MD, MHS; and Gerald Gantt, MD Improved communication techniques enable residents to provide better care now and in the future 26 by Raphael C. Sun, MD; Afif Kulaylat, MD; Scott B. Grant, MD; and Juliet Emamaullee, MD International surgery provides opportunities for residents to serve and learn 33 | 1 Shannon L. Castle, MD; Nicolas J. Mouawad, MD, MPH; Konstantinos Spaniolas, MD; and Daniela Molena, MD Early surgical subspecialization: A new paradigm? Part I 38 Scott B. Grant, MD; Jennifer L. Dixon, MD; Nina E. Glass, MD; and Joseph V. Sakran, MD, MPH Early surgical subspecialization: A new paradigm? Part II: Interviews with leaders in surgical education 43 Afif N. Kulaylat, MD; Feibi Zheng, MD; SreyRam Kuy, MD, MHS; and James G. Bittner IV, MD Centennial reprint: Course coordinator describes purposes of ATLS® program 50 BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS ONLINE EDITION • All of the content in the print version • Easily read on mobile devices as well as on desktop computers • Links to “related posts” • Share content across multiple Bulletinonline social media platforms including Facebook, Twitter, and LinkedIn http://bulletin.facs.org. AUG 2013 BULLETIN American College of Surgeons Contents continued COLUMNS A look at The Joint Commission: NAPBC announces milestone: Preventing surgical fires 65 Accreditation of 500 breast centers 78 Looking forward 8 NTDB® data points: Geronimo 67 Procedure-Specific Consents David B. Hoyt, MD, FACS Richard J. Fantus, MD, FACS available online 78 What surgeons should know Report on ACSPA/ACS activities: about...Using S-CAHPS 53 NEWS June 2013 80 Jill Sage, MPH Susan E. Mackinnon, MD, FACS, Lena M. Napolitano, MD, Coding and practice management FRCSC, receives 2013 Jacobson FACS, FCCP, FCCM corner: Coding for damage-control Innovation Award 69 Chapter news 90 surgery 57 CoC general session focuses on Donna Tieberg Linda M. Barney, MD, FACS; Jenny updates, lessons learned in care J. Jackson, MPH, CPC; Charles D. for cancer patients 72 ScHOLARSHIPS Mabry, MD, FACS; Mark T. Savarise, Plan to attend these RAS-ACS Eighteen surgeons participate in MD, FACS; and Christopher K. events during 2013 Clinical Senkowski, MD, FACS 2013 Health Policy Scholarship Congress 76 program 97 ACS Clinical Research Program: College seeks Medical Director for ACS offers two-year Resident Improving cancer care through Washington, DC, Office 77 Research Scholarships 99 quality measures: Putting evidence 2 | MOC Review: Essentials for to work with the CoC 62 Surgical Specialties to be offered MEETINGS CALENDAR Christopher M. Pezzi, MD, FACS; at Clinical Congress 77 Henry M. Kuerer, MD, PhD, FACS; Calendar of events 100 and Heidi Nelson, MD, FACS A PUBLICATION OF AME RICAN COLLEGE OF SURGEO NS P ROFESSIONAL ASSOCI ATION (ACSP A) Influencing THE ACS Health Policy in Washington ADVOCATE and the States Each month, rely on the ACS advocacy eNewsletter: To keep you informed. To learn the College’s position on pertinent issues. To see how your involvement can make a difference. Downloadable from most digital communications devices. Also available online at www.facs.org/ahp/news/index.html. Advocacy Summit • AMA House of Delegates/Surgical Caucus • Cancer • Chapter Advocacy • Training • Coding • Electronic Health Records • e-Prescribing • Grassroots Efforts • Health Information Technology • Legislative Action Center • Legislative Advocacy • Liability • Lobby Day Grant Program • Medicaid • Medicare • Medicare Physician Payment • Pediatric Issues • Physician Quality Reporting • Political Action Committee (SurgeonsPAC) • Quality and Patient Safety • Relative Value Update Committee (RUC) • Socioeconomics • Surgery State Legislative Action Center (SSLAC) • Surgical Quality Alliance • Trauma and EMS • Workforce ADVOCATE ad half page Bulletin shorter.indd 1 1/14/2013 11:24:28 AM V98 No 8 BULLETIN American College of Surgeons The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. EdITOR-IN-CHIEF Letters to the Editor ! #$%^&* Diane Schneidman should be sent @ with the writer’s DIRECTOR, DIVISION OF name, address, InTEGRATED COmmUNIcaTIONS e-mail address, and E-mail isn’t for everyone. Lynn Kahn daytime telephone SDENIOR E ITOR number via e-mail to Tony Peregrin dschneidman@facs. org, or via mail to CO NTRIBUTIng EDITORS Diane S. Schneidman, But it is for Fellows of the American Jeannie Glickson Editor-in-Chief, Katie McCauley Bulletin, American College of Surgeons who want to College of Surgeons, GRaphIC DESIgnER 633 N. Saint Clair St., keep current on the latest news Tina Woelke Chicago, IL 60611. from their professional society. EdITORIal ADVISORS Letters may be edited Charles D. Mabry, MD, FACS for length or clarity. Leigh A. Neumayer, MD, FACS Permission to publish Marshall Z. Schwartz, MD, FACS letters is assumed If we don’t have your current e-mail Mark C. Weissler, MD, FACS unless the author address, you’re really missing out. FRONT COVER DESIgn indicates otherwise. Tina Woelke We have a lot to share, so let us connect with you. Bulletin of the American College of Surgeons (ISSN 0002-8045) is published monthly by the American College of Surgeons, You can add or update your e-mail at 633 N. Saint Clair St., Chicago, IL 60611. It is distributed without charge to Fellows, Associate Fellows, Resident and Medical www.efacs.org. Student Members, Affiliate Members, and to medical libraries and allied health personnel. Periodicals postage paid at Chicago, IL, and additional mailing offices. POSTMASTER: Send address changes to Bulletin of the American College of Surgeons, 3251 Riverport Lane, Maryland Heights, MO 63043. Go to the home page, click on My Profile, Canadian Publications Mail Agreement No. 40035010. Canada returns to: Station A, PO Box 54, Windsor, ON N9A 6J5. and follow the prompts. The American College of Surgeons’ headquarters is located at Questions? Contact Member Services at [email protected]. 633 N. Saint Clair St., Chicago, IL 60611-3211; tel. 312-202-5000; toll-free: 800-621-4111; e-mail:[email protected]; website: www.facs.org. Washington, DC, office is located at 20 F If you would like to make sure all e-mail from the Street N.W. Suite 1000, Washington, DC. 20001-6701; tel. College is promptly sent to your current e-mail 202-337-2701; website: www.tmiva.net/20fstreetcc/home. Unless specifically stated otherwise, the opinions expressed account(s), and to ensure that we can reach you for and statements made in this publication reflect the authors’ years to come, go to http://efacs.org. Registration personal observations and do not imply endorsement by nor official policy of the American College of Surgeons. for this service is quick, easy, and free. ©2013 by the American College of Surgeons, all rights reserved. Contents may not be reproduced, stored in a retrieval system, or transmitted in any form by any means without prior written permission of the publisher. Library of Congress number 45-49454. Printed in the USA. Publications Agreement No. 1564382. We need your e-mail half-page 06--06-13.indd 1 6/6/2013 3:00:03 PM Officers and Staff of the American College of Surgeons Gerald M. Fried, MD, AllIANce/AmeRIcaN FACS, FRCSC COLLEGE OF SUrgEONS Officers Montreal, QC Advisory Council CLINIcaL Research *A. Brent Eastman, MD, to the Board PROgram *Barrett G. Haik, MD, FACS Heidi Nelson, MD, FACS FACS, FRCS (Ed) (Hon) Memphis, TN San Diego, CA of Regents Chair PresIdeNT B.J. Hancock, MD, FACS, FRCSC (Past-Presidents) CONveNTION AND MEETINgs R. Phillip Burns, MD, FACS Winnipeg, MB Felix Niespodziewanski Chattanooga, TN Enrique Hernandez, MD, FACS Kathryn D. Anderson, MD, FACS Director FIrsT VICE-PreSIdeNT Philadelphia, PA Corona, CA DIVISION OF EDUcaTION John M. Daly, MD, FACS Lenworth M. Jacobs, Jr., MD, FACS W. Gerald Austen, MD, FACS Ajit K. Sachdeva, MD, Philadelphia, PA Hartford, CT Boston, MA FACS, FRCSC SecOND VICE-PreSIdeNT L. Scott Levin, MD, FACS John M. Beal, MD, FACS Director Courtney M. Townsend, Jr., MD, FACS Philadelphia, PA Valdosta, GA EXecUTIve SERVIceS Galveston, TX L. D. Britt, MD, FACS Barbara L. Dean SecreTarY *Mark A. Malangoni, MD, FACS Philadelphia, PA Norfolk, VA Director Andrew L. Warshaw, MD, FACS FINANce AND FacILITIes Boston, MA Raymond F. Morgan, MD, FACS John L. Cameron, MD, FACS Charlottesville, VA Baltimore, MD Gay L. Vincent, CPA TreasUrer Director David B. Hoyt, MD, FACS *Leigh A. Neumayer, MD, FACS Edward M. Copeland III, MD, FACS Salt Lake City, UT Gainesville, FL HUmaN ResOUrces AND Chicago, IL TaleNT MANagemeNT EXecUTIve DIreCTOR Valerie W. Rusch, MD, FACS Gerald B. Healy, MD, FACS Michelle McGovern Gay L. Vincent, CPA New York, NY Boston, MA Director Chicago, IL Marshall Z. Schwartz, MD, FACS R. Scott Jones, MD, FACS C HIef FINANCIal OFFIceR INFOrmaTION TECHNOLOGY Philadelphia, PA Charlottesville, VA Howard Tanzman Howard Snyder III, MD, FACS Edward R. Laws, MD, FACS Director Philadelphia, PA Boston, MA 4 | DIVISION OF INTegraTed Officers-Elect Beth H. Sutton, MD, FACS LaSalle D. Leffall, Jr., MD, FACS COmmUNICATIONS (take office October 2013) Wichita Falls, TX Washington, DC Lynn Kahn Steven D. Wexner, MD, FACS Lloyd D. MacLean, MD, FACS Director *Carlos A. Pellegrini, MD, Weston, FL Montreal, QC Journal OF THE American FACS, FRCS(I)(Hon) College OF Surgeons Seattle, WA Michael J. Zinner, MD, FACS LaMar S. McGinnis, Jr., MD, FACS Atlanta, GA Timothy J. Eberlein, MD, FACS PresIdeNT-EleCT Boston, MA Editor-in-Chief Layton F. Rikkers, MD, FACS David G.