Cold Steel: Canadian Journal of Surgery Podcast

AI is likely to change the way that medical and surgical education happens over the next decade. We needed to find out how, and Dr. Samir Grover joined us on this episode to talk about it. Dr. Samir Grover is a gastroenterologist, clinician-educator, and education researcher whose career has been defined by building the simulation and technology-enhanced learning infrastructure that trains the next generation of physicians, and by translating that work into national and international practice. He serves as Executive Vice-President, Academics at Scarborough Health Network (SHN), where he holds the hospital's inaugural Pialis Family Chair in Education.Samir and the Grover lab have really pivoted to study the impact of AI on medical education. In this episode, we take a deep dive into the implications of AI on medicine. Samir also talks to us about his current AI stack and how we might immediately start to use AI in our own practice.Links:Samir C. Grover | About | University of TorontoSamir Grover Substack:  Samir C. Grover, MD | SubstackAI empathy:  AI empathy is artificial. But could that possibly be better.AI stack for med students or residents:  The AI stack for the medical student or residentNeverskilling:  Neverskilling - Samir C. Grover, MDGrover Lab:  Grover Lab | Dr. Samir C. Grover | AI in Medical Education

Jeremy Heffner is a trauma and acute care surgeon at Lima Memorial Health System in Ohio. He is also the Chief Operating Officer of SurgeON, a social media company dedicated to surgeons. Heffner was also previously a bioengineer who worked at NIH. He has been incredibly open about his journey and struggles with PTSD as a surgeon, and how those struggles ultimately caused his breakdown. Sadly, Dr. Heffner's story is not unique, and we brought him on the podcast to hear his insights about how many surgeons struggle with PTSD. What is unique is Dr. Heffner's approach to dealing with his PTSD. His approach is outlined in his recently released book, Proof of the Impossible. Dr. Heffner used AI to try to find answers to many of the questions he had while struggling with burnout and PTSD. He had some very strange and unusual conversations with AI, including a moment where he felt the AI was having a "misalignment event", defined as when "AI acts in ways that go against human intent, safety, or core instructions". Our discussion spanned the gamut of PTSD in surgery, and how AI may or may not be a tool that can help with mental health and burnout. For me, the most powerful message Jeremy had for us was the power of human connection and also that the only way to deal with the hard things is to face them.We would just like to warn listeners that we do discuss some pretty traumatic things that Dr. Heffner experienced, and some of the description is pretty graphic. Also, we would always recommend professional help if you are dealing with mental illness, burnout, or suicidal ideation. We would love to hear your thoughts - do you think there is a role for AI in providing empathy to humans? Send us your feedback at [email protected].  Links:Source: LinkedIn https://share.google/yBOCofBF9BhotNeWhPre-Order "Proof of the Impossible"  https://share.google/w0jGPSiz9WLBstaqUSurgeON with Mark Soliman interview:  https://open.spotify.com/episode/3znH6DkcDDcg7Zqyca2YSb?si=p3zoYYb_RCiNvL5hkX4l9g&utm_source=copy-link&sci=spotify%3Acard-config%3A0qjrdqA8ITGkKr0375x09R

This week's guest is Dr. Bishal Gyawali. Bishal is an oncologist at Queen's University and a policy researcher. His focus as a researcher has been both sensational and at the same time extremely fundamental. Bishal has been asking questions around how we decide which drugs are approved for funding by the government, as well as how we might best allocate resources to help cancer patients around the world. Bishal has been an integral part of the "Common Sense Oncology" movement, which will promote interventions that measurably improve the lives of patients, promoting effective treatments but  also challenging interventions that might cause more harm than good.Our conversation focused around Bishal's training, how he became interested in cancer health policy and his thoughts around the idea of value in cancer care. We also discussed Bishal's thoughtful use of technology, blogs, and social media.Links:Grounded in Groundshot Podcast – Dr. Bishal GyawaliBG lab: Dr. Bishal GyawaliCommon Sense Oncology: Home - Common Sense OncologyMittal A, Kim MS, Dunn S, Wright K, Gyawali B. Frequently asked questions on surrogate endpoints in oncology-opportunities, pitfalls, and the way forward. EClinicalMedicine. 2024 Sep 13;76:102824. doi: 10.1016/j.eclinm.2024.102824. PMID: 39764569; PMCID: PMC11701476.Surrogate Endpoints: The 15 Most Common Misunderstandings in OncologyCancer groundshot: Access to proven treatments must parallel development of new therapiesDo Oncology Board Exams Make Us Better Doctors?Ending Medical Reversal: Ending Medical Reversal | Hopkins Press

In 2013, when I was a medical student, I wrote an essay entitled, #nomoretextbooks? for the Canadian Undergraduate Surgical Education Committee essay competition. In the essay I wrote, “Tomorrow, I start my vascular surgery rotation. Before bed tonight, I will watch a YouTube video of a femoral-popliteal bypass surgery, review the surgical anatomy from Zollinger’s Atlas of Surgical Operations on my iPad while waiting for my car tires to be changed, listen to a podcast on peripheral vascular disease while riding my exercise bike, and perhaps tweet about my new rotation.” At the time, I really felt strongly that the future of surgical textbooks would be virtual. To explore that future, I spoke with Tanner Schrank, the head of impact for the Journal of Medical Insight (also called JOMI). JOMI is a website that showcases a wide range of operations across multiple disciplines. What I really like about JOMI is the in-depth interviews that are done with surgeons before the operation, where the surgeon will describe their thought process and indications for the operation. The videos are also extraordinarily well filmed, often from multiple camera angles and with great detail. JOMI clearly offers a fantastic resource for residents and attendings to learn new surgical techniques.Tanner and I discuss the implications for a transition to a “virtual” textbook that is more reliant on video than an actual written textbook. I must caveat this episode by saying that I think there is pretty good evidence that reading something and actively trying to absorb information is more effective than passively viewing it. In other words, I am not totally convinced that you can effectively learn something by passively watching video. I think it’s important, especially for trainees, to learn actively.  As the great expert on performance, Anders Ericsson said, deliberate practice, not just practice, is required to really acquire mastery. However, there is no question in my mind that video needs to augment the learning that we do as surgeons. At Queen’s, we use video review on a weekly basis to give residents and fellows feedback on how they can improve their technique. We would love to hear your thoughts. Do you think videos are the way of the future for surgical textbooks? Shoot us an email at [email protected]. Links:AMBOSS: Beyond the Textbook: amboss.com/int/internationalpodcastJOMI: https://jomi.com/#nomoretextbooks: https://www.canjsurg.ca/content/57/4/E119 

In honor of National Nursing Week in Canada, which is May 11th to May 17th, we are re-releasing an early episode with Lauren Kiwan, nurse clinician for general surgery at the Foothills Medical Centre. Lauren shares what surgeons can do to improve the OR. Revisit this important episode with us.___Lauren Kirwan is the nurse clinician for general surgery at the Foothills Medical Centre. She is currently finishing up her nurse practitioner degree. We wanted to ask Lauren her thoughts about what it means to be an OR nurse and what she wishes surgeons would do to make the OR environment better. We also hear about the impact of COVID19 on our nursing colleagues. We’d love to hear from our nurse listeners – what are some things that make your day or make you mad in the operating room? Email us at [email protected] with your thoughts and comments. Links:1. Melinda Davis on the Anesthetist - Surgeon relationship: https://soundcloud.com/cjs-podcast/e40-melinda-davis-on-career-counseling-and-the-anesthetist-surgeon-relationship2.  Atul Gawande paper on Safe Surgery Checklist implementation in South Carolina. Perception of Safety of Surgical Practice Among Operating Room Personnel From Survey Data Is Associated With All-cause 30-day Postoperative Death Rate in South Carolina. https://journals.lww.com/annalsofsurgery/Abstract/2017/10000/Perception_of_Safety_of_Surgical_Practice_Among.14.aspx

I have a confession to make. I kind of felt that to talk about money or to be really into financial planning was akin to being the Wolf of Wall Street, where the only real principle was how much money I could make. After this week’s conversation with Dr. Mark Soth, I think of financial planning in a completely different way. In fact, I would argue that Dr. Soth provided on this episode some of the best advice on how to live in a truly fulfilling way.Dr. Soth is an intensivist at McMaster University. He has done significant work in the space of physician financial independence. He has a website called The Loonie Doctor as well as a limited run podcast called The Money Scope podcast. In this episode I basically ask Mark all the finance related questions I could think of, ranging from the utility of professional corporations in 2026 to tools for financial tracking. Most importantly, Mark explores how financial planning can help us all to life “the good life”. Check out all the resources and links from Mark in the show notes. Links:The Wealthy BarberThe Money Scope Podcast The Loonie Doctor's Bookshelf : Mark’s favorite finance booksbeyond MD podcast with Dr. Yatin ChadhaBreaking Bad Debt - Dr. Steph - YouTubeReboot Your Portfolio by Dan Bortolotti

While we hope that none of  us “botch a surgery”, medico-legal concerns are issues that affect most surgeons at some point in their careers. Previously on the podcast, Dr. Richard Mimeault and Liise Honey spoke to us about the landscape of medico-legal concerns in surgery, and the anatomy of a lawsuit. In this episode, we talk about the CMPA's innovative approach to try to prevent errors from happening in the first place. Richard Mimeault and Elisabeth Normand join us to talk about "Theatre Arts", a workshop developed by the CMPA to help OR teams improve the quality of the care, and most importantly, improve the culture and dynamics of the team. In this episode we talk about the Theatre Arts workshop and how improving culture may have profound impacts on patient safety and satisfaction. Links:Theatre Arts workshop: https://www.cmpa-acpm.ca/en/education-events/workshops/workshop-theatre-artsCMPA x Cold Steel on Medicolegal risks for surgeons: https://www.youtube.com/watch?v=7Mkw68prEP0CMPA x Cold Steel – the Anatomy of a Lawsuit: https://www.youtube.com/watch?v=LRUh95LauFw Contact the CMPA: https://www.cmpa-acpm.ca/en/connect/contact-us

Dr. Varun Kapila is a vascular surgeon in Brampton, Ontario. He is the author of “Six Lessons for Everyday Leadership: From the Operating Room Into Everyday Life, What Surgery Taught Me About Leadership That Can Be Applied by Everyone”. In this episode we delve into Dr. Kapila’s thoughts on leadership and why everyone can be a leader in their own lives.Links:https://www.amazon.ca/Six-Lessons-Everyday-Leadership-Operating-ebook/dp/B0GQWHNYFS https://learn.hms.harvard.edu/insights/learner-stories/driving-system-level-change-through-surgical-leadership https://ontariohealth.ca/clinical/cardiac-stroke-vascular/abdominal-aortic-aneurysm-programhttps://www.cmaj.ca/content/196/4/E112 https://www.thestar.com/news/hes-not-young-hes-my-doctor/article_bcec69e9-2822-54cf-bed1-c2322cefc558.html 

For a newly graduated surgical resident, one of the most interesting and perplexing question that many folks have to deal with is a surprisingly simple one: what should a full-time surgical job look like? For many of us, we simply looked at what our predecessors job looked like, and modeled our own careers after them. This meant ensuring that our schedules were jam-packed with clinical activities every day, without much consideration for other aspects of our career (such as call and research, for example).At the beginning of March, the American College of Surgeons released a framework of standards of what they think reasonable expectations are for a surgeon’s job. We have the link to the paper in the shownotes. The ACS is the one of the largest surgical organizations in North America, and this standard framework they have put out is really a statement on what they think is necessary to ensure that surgeons have a sustainable career. They put out standards for call, access to the OR, access to clinic, resource access, inpatient census, clinical support, and even fatigue mitigation.Dr. Pat Murphy, trauma and acute care surgeon at the Medical College of Wisconsin, was a previous guest on the show to talk about his work trying to define what a full time acute care surgeon should look like. He actually brought this framework to our attention, and we invited him to join us once again on Cold Steel to discuss the implications of such a framework.We would love to hear your thoughts. Send us an email at [email protected], or find us on X (@colsteelpod, @ameerfarooq & @pbatesmurphy)Resources from this episode:Wood, Douglas E MD, FACS, FRCSEd; Wolinsky, Philip R MD, FACS2; Dodgion, Christopher M MD, MSPH, MBA, FACS3; Farmer, Diana Lee MD4; Gantt, Nancy L MD, FACS5; Napolitano, Lena M MD, FACS, MAMSE6; Timmons, Shelly D MD, PhD, FACS. FAANS7; Welsh, David J MD, MBA, FACS8; Winfield, Robert D MD, FACS9; Bura, Connie BA10; Essig, Rachael MD11; Turner, Patricia L MD, MBA, FACS10. Developing Specialty-Specific Workplace Standards for Surgeons: A Framework to Support Sustainable Surgical Careers. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001880, March 03, 2026. | DOI: 10.1097/XCS.0000000000001880https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/acs-brief/march-3-2026-issue/acs-releases-workplace-standards-framework-to-support-sustainable-surgical-careers/Pat Murphy on Cold Steel: https://www.canjsurg.ca/content/e184-pat-murphy-workforce-planning-acute-care-surgeryhttps://calnewport.com/

Paul Fedak is a cardiac surgeon and translational scientist at the University of Calgary. He has written and spoken about what it means to pursue excellence and what it might cost us. Dr. Fedak unexpectedly had to cut short his clinical career as a surgeon due to spinal cord issues. The result has been a powerful exploration about identity, meaning, burnout and the pursuit of excellence. This is a conversation about that pursuit.Bio: https://profiles.ucalgary.ca/paul-fedak Links:https://www.theglobeandmail.com/opinion/article-as-a-heart-surgeon-i-chased-excellence-it-cost-me-my-body-and-my-mind/http://paulfedak.com/https://www.ted.com/talks/paul_fedak_beyond_mastery_how_a_heart_surgeon_found_his_own_hearthttps://calgaryherald.com/opinion/columnists/opinion-the-mountain-decides-who-goes-and-who-stays 

It's that time of year again. Can you sense it? The anticipation, the anxiety, the dread, the wracking of heart and head? Yes, it's almost time for final year Canadian medical students across the country to submit their rank lists to CaRMS.On this episode we explore the history of CaRMS and the underlying matching algorithms.We then talk about some of our top tips when building your CaRMS rank list.What do you think? How did you make your rank list? Send us an email at [email protected]:Young TA. Teaching medical students to lie. The disturbing contradiction: medical ideals and the resident-selection process. CMAJ. 1997 Jan 15;156(2):219-22. PMID: 9012725; PMCID: PMC1226912. https://pmc-ncbi-nlm-nih-gov.proxy.queensu.ca/articles/PMC1226912/ https://pmc-ncbi-nlm-nih-gov.proxy.queensu.ca/articles/PMC1226912/Roth AE. The origins, history, and design of the resident match. JAMA. 2003 Feb 19;289(7):909-12. doi: 10.1001/jama.289.7.909. PMID: 12588278.https://impact.stanford.edu/article/how-does-applied-economics-maximize-kidney-transplantsCal Newport’s books: https://calnewport.com/writing/

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed November 2025. This webinar was moderated by Dr. Alison Laws and Dr. Ameer Farooq, and featured panelists Dr. Nicole Culos-Reed, Dr. Christopher Booth and Dr. Bishal Gyawali.In this EBRS webinar, we discussed Structured Exercise after Adjuvant Chemotherapy for Colon Cancer (Courneya et al., 2025).Links:Courneya KS, Vardy JL, O’Callaghan CJ, et al. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. N Engl J Med. 2025;393(1):13-25. doi:10.1056/NEJMoa2502760

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed July 2025. This webinar was moderated by Dr. Kelly Vogt and Dr. Chad Ball, and featured panelists Dr. Bourke Tillmann and Dr. Emilie Joos.In this EBRS webinar, we discussed Getting out of the bay faster: Assessing trauma team performance using trauma video review" (Maiga et al., 2024).Links:Maiga AW, Vella MA, Appelbaum RD, et al. Getting out of the bay faster: Assessing trauma team performance using trauma video review. J Trauma Acute Care Surg. 2024;96(1):76-84. doi:10.1097/TA.0000000000004168

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed May 2025. This webinar was moderated by Dr. Alison Laws and Dr. Kerollos Wanis, and featured panelists Dr. Stephanie Wong, Dr. Sarah Knowles and Dr. Rebecca Warburton.In this EBRS webinar, we discussed Axillary Surgery in Breast Cancer--Primary Results of the INSEMA Trial (Reimer et al., 2024) & Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes (Gentilini et al., 2023).Links:Gentilini, O. D., Botteri, E., Sangalli, C., Galimberti, V., Porpiglia, M., Agresti, R., Luini, A., Viale, G., Cassano, E., Peradze, N., Toesca, A., Massari, G., Sacchini, V., Munzone, E., Leonardi, M. C., Cattadori, F., Di Micco, R., Esposito, E., Sgarella, A., Cattaneo, S., … SOUND Trial Group (2023). Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial. JAMA oncology, 9(11), 1557–1564. https://doi.org/10.1001/jamaoncol.2023.3759Reimer, T., Stachs, A., Veselinovic, K., Kühn, T., Heil, J., Polata, S., Marmé, F., Müller, T., Hildebrandt, G., Krug, D., Ataseven, B., Reitsamer, R., Ruth, S., Denkert, C., Bekes, I., Zahm, D. M., Thill, M., Golatta, M., Holtschmidt, J., Knauer, M., … Gerber, B. (2025). Axillary Surgery in Breast Cancer – Primary Results of the INSEMA Trial. The New England journal of medicine, 392(11), 1051–1064. https://doi.org/10.1056/NEJMoa2412063

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed January 2022, in collaboration with UNITAR. This webinar was moderated by Dr. Chad Ball and Dr. Neel Detta, and featured panelists Dr. Keith Lillemoe, Dr. Majella Doyle and Dr. Jeff Barkun. In this EBRS webinar, we discussed Safe Cholecystectomy Multi-society Practice Guideline and State of the Art Consensus Conference on Prevention of Bile Duct Injury During Cholecystectomy (Brunt et al., 2020).Links:Brunt LM, Deziel DJ, Telem DA, et al. Safe Cholecystectomy Multi-society Practice Guideline and State of the Art Consensus Conference on Prevention of Bile Duct Injury During Cholecystectomy. Ann Surg. 2020;272(1):3-23. doi:10.1097/SLA.0000000000003791

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed February 2025. This webinar was moderated by Dr. Kelly Vogt and Dr. Chad Ball, and featured panelists Dr. James Byrne, Dr. Kimberly Bertens and Dr. Sean Gregg.In this EBRS webinar, we discussed Restrictive Strategy vs Usual Care for Cholecystectomy in Patients with Abdominal Pain and Gallstones: 5-Year Follow-Up of the SECURE Randomized Clinical Trial (Comes et al., 2024).Links:Comes DJ, Wennmacker SZ, Latenstein CSS, et al. Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones: 5-Year Follow-Up of the SECURE Randomized Clinical Trial. JAMA Surg. 2024;159(11):1235-1243. doi:10.1001/jamasurg.2024.3080

The William Ersil Research day invited guest and moderator for 2025 was Dr. Krista Goulding. Dr. Goulding is an Orthopedic Surgeon at Mayo Clinic Arizona, where she specializes in caring for patients with sarcomas and other cancerous and non-cancerous tumors of the musculoskeletal system. Dr. Goulding’s expertise is in limb preservation surgery using innovative techniques (synthetic and bone transplants, 3D printed and patient-specific implants, joint replacement). Her goal is to cure cancer while preserving function and quality of life. She is involved in research on a national and international scale, and is currently researching ways to improving surgical, oncologic and health-related quality of life outcomes for patients with malignant bone and soft tissue cancers.In this “How I Built This” segment of the research day, we explored Dr. Goulding’s career.Links:What are the 2-year survivorship outcomes of custom hemipelvis reconstruction after hemipelvectomy and revision arthroplasty? The evolution of a custom ilium "monoflange". https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/36255157/Košir U, Denis-Larocque G, Tsimicalis A, Freeman C, Turcotte RE, Cury F, Alcindor T, Goulding K. Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft-tissue sarcoma: A qualitative study. J Surg Oncol. 2020 Jun;121(8):1266-1275. doi: 10.1002/jso.25915. Epub 2020 Mar 27. PMID: 32221986.

Surgery has never been more complicated. The variety of surgical approaches and the complexity of treatment continue to grow exponentially, yet in many institutions, surgical training has not really changed. Dr. Adnan Alseidi, our guest for this episode, is trying to change that. Dr. Adnan Alseidi is a liver and pancreas surgeon at UCSF and is the associate dean of assessment, improvement, and accreditation. He recently gave the Langer lecture at the Canadian Surgical Forum in Montreal this year about surgical education and the path from novice to master. This episode was really a moment for us to ask all our burning questions about surgical education. What are the phases of mastery? Should we really be aiming for mastery? And how do we create trust between attending and trainees?We’d love to hear your thoughts and comments, so email us at [email protected]:Medical school accreditation is outdated. WSJ. https://www.wsj.com/opinion/medical-school-accreditation-is-outdated-holds-back-innovation-nyu-98fe80bdhttps://www.canadiansurgeryforum.com/biographiesAn Integrative Model of Organizational Trust. Roger C. Mayer, James H. Davis, F. David Schoorman. The Academy of Management Review, Vol. 20, No. 3 (Jul., 1995), pp. 709-734 (26 pages). https://www.jstor.org/stable/258792Ericsson. https://share.google/bRhcSSC7sKKp9bX9bThe Five-Stage Model of Adult Skill Acquisition. Dreyfus model. https://share.google/2GSuypiGKExQMeMPXWicked problems! Horst W. J. Rittel & Melvin M. Webber . Dilemmas in a general theory of planningThe Book Of Joy: Lasting Happiness In A Changing World. Dalai Lama,Desmond Tutu,Douglas Carlton Abrams

Dr. Teresa Purzner MD PhD FRCSC is a clinician scientist neurosurgeon with a special interest in neuroncology and general neurosurgery.  She completed her residency training at the University of Toronto, and her PhD training at Stanford University.  Her lab, run jointly with her husband Dr. James Purzner, is focused on interdisciplinary approaches to identifying novel drug targets for brain cancer as well as the translation of promising new drug targets into human-ready therapeutics.  Her work has led to the identification of a critical new drug target in the brain tumor medulloblastoma – a discovery that she has since translated into a novel drug for both brain cancer and skin cancer, currently being tested in phase 1 and phase 2 clinical trials.  This work has resulted in her being named a Stanford Interdisciplinary Graduate fellow, Biox fellow and SPARK fellow, and has earned her both national and international recognition including the Annual Award of the American Academy of Neurological Surgery, the K.G. McKenzie prize for Basic Science Research, AANS Louise Eisenhardt Award and the Neurosurgery Research and Education Fellowship.She is a mom, an entrepreneur, and design-thinker, having created her own baby food company as well as redesigned the Integrated Brain Tumor Program. Links:Integrated Brain Tumor Program: https://surgery.queensu.ca/administration/announcements/integrative-brain-tumor-program-achieving-best-class-patient-outcomeshttps://www.ibtp.ca/purzner-labhttps://www.theglobeandmail.com/business/economy/article-how-a-neurosurgeon-used-her-entrepreneurial-background-to-revamp-a/

Dr. Patrick Murphy is a trauma and acute care surgeon at Medical College of Wisconsin. In this episode we discuss his recent paper, “Understaffed and overworked: The stark reality of acute care surgeon staffing in the United States, an Eastern Association for the Surgery of Trauma multicenter study.” This conversation turned into more than just a discussion around workforce planning, but also around how surgeons are compensated and surgical culture.Links:Murphy, Patrick B. MD, MPH, MSc; Coleman, Jamie J. MD; et al; The ACS Staffing Authorship Group. Understaffed and overworked: The stark reality of acute care surgeon staffing in the United States, an Eastern Association for the Surgery of Trauma multicenter study. Journal of Trauma and Acute Care Surgery ():10.1097/TA.0000000000004700, July 4, 2025. | DOI: 10.1097/TA.0000000000004700 Murphy PB, Nahmias J, Bonne S, Coleman J, de Moya M. Defining the acute care surgeon: American Association for the Surgery of Trauma (AAST) panel discussion on full-time employment, compensation and career trajectory. Trauma Surg Acute Care Open. 2024 Sep 30;9(1):e001500. doi: 10.1136/tsaco-2024-001500. PMID: 39363886; PMCID: PMC11448165.Murphy PB, Coleman J, Karam B, Morris RS, Figueroa J, de Moya M. A national study defining 1.0 full-time employment in trauma and acute care surgery. J Trauma Acute Care Surg. 2022 Apr 1;92(4):648-655. doi: 10.1097/TA.0000000000003504. PMID: 34936589.Murphy PB, Coleman J, Maring M, Pokrzywa C, Deshpande D, Al Tannir AH, Biesboer EA, Morris RS, Figueroa J, de Moya M. Early career acute care surgeons' priorities and perspectives: A mixed-methods analysis to better understand full-time employment. J Trauma Acute Care Surg. 2023 Dec 1;95(6):935-942. doi: 10.1097/TA.0000000000004037. Epub 2023 Jun 15. PMID: 37418689.Smith RN, Freedberg M, Bailey J, DeMoya M, Goldberg A, Staudenmayer K. The importance and benefits of defining full-time equivalence in the field of acute care surgery. Trauma Surg Acute Care Open. 2024 Jul 4;9(1):e001307. doi: 10.1136/tsaco-2023-001307. PMID: 38974220; PMCID: PMC11227842.Robinson C, Lawless R, Zarzaur BL, Timsina L, Feliciano DV, Coleman JJ. Physiologic stress among surgeons who take in-house call. Am J Surg. 2019 Dec;218(6):1181-1184. doi: 10.1016/j.amjsurg.2019.08.023. Epub 2019 Sep 19. PMID: 31570199.Adi Kumar on Cold Steel: https://open.spotify.com/episode/52Hg2cCLGLZejD0QSfI9le?si=xSHFcSrPRdOOZ_RT_QWsAA 

Dr. Brian Cameron is a retired pediatric surgeon who has spent much of his life dedicated to global surgery. In this conversation, we discuss his new book Ripples from the Rupununi: Dr. Aidun’s Healing Journey. We talk about what it takes to write a book and also discuss the book itself. Let us know in the comments or via email: Have you ever thought about writing a book? Links:E78 Brian Cameron On Global Surgery: https://www.youtube.com/watch?v=bdetQSXBRMQRipples from the Rupununi. https://books.friesenpress.com/store/title/119734000491425890/Brian-H.-Cameron-Ripples-from-the-Rupununi Surgical training in Guyana: the next generation. Cameron BH, Martin C, Rambaran M. Can J Surg. 2015 Feb;58(1):7-9. doi: 10.1503/cjs.010414. PMID: 25621909 Free PMC article. Evaluating the long-term impact of the Trauma Team Training course in Guyana: an explanatory mixed-methods approach. Pemberton J, Rambaran M, Cameron BH. Am J Surg. 2013 Feb;205(2):119-24. doi:  10.1016/j.amjsurg.2012.08.004. Epub 2012 Dec 13. PMID: 23246285 International surgery: the development of postgraduate surgical training in Guyana. Cameron BH, Rambaran M, Sharma DP, Taylor RH. Can J Surg. 2010 Feb;53(1):11-6. PMID: 20100407 Free PMC article. Teaching in Fiji: practising medicine, coping with coups. Cameron BH. CMAJ. 1989 Apr 1;140(7):833-5. PMID: 2924235 Free PMC article. No abstract available.

Dr. Michael Leveridge is a urologist at Queen’s University. He specializes in urologic oncology and is the editor in chief of the Canadian Urological Association Journal. We spoke to him about his career, his role as editor in chief, and how he creates mental models in his practice. In addition, Dr. Leveridge did a masterclass with us on ureteric injuries. We also watch videos together and get his thoughts on how to avoid these injuries. Check out the YouTube masterclass here: https://youtu.be/izHOSh38J7ULinks:https://cuaj.ca/index.php/journal/indexCancel half of your clinic visits* (a Halloween hot take). https://cuaj.ca/index.php/journal/article/view/8996Mental models in practice: Calculus and the future self. https://pubmed.ncbi.nlm.nih.gov/35623001/

Campbell Roxburgh is a consultant colorectal surgeon and Professor of Colorectal Surgical Oncology at University of Glasgow in Scotland. Mr. Roxburgh is a multi-faceted researcher, surgeon and academic. He has a large body of research in systemic inflammation and tumor response, as well as clinical trials. We were lucky enough to have him join us at Queen’s University for a week.  In this talk he gave to the general surgery division, he talked about the development of robotic surgery in Scotland. What stood out for us from his talk was the deliberate, systematic approach to introducing a new technology adopted by the NHS, as opposed to the way that technology is often rolled out in North America. We also had a great time asking Campbell questions at the end of his talk, and we particularly liked his response to how to find work-life balance as a surgeon and an academic.What do you think? How should something like robotics be rolled out in Canada? Email us at [email protected]. Feel free to leave us a voicemail, and we might play your response on our next episode. Campbell Roxburgh on X: @C_RoxburghLinks:https://www.gla.ac.uk/schools/cancersciences/staff/campbellroxburgh/Ingham AR, McSorley ST, McMillan DC, Mansouri D, Chong D, MacKay GJ, Wrobel A, Kong CY, Alani A, Nicholson G, Roxburgh CSD. Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? J Robot Surg. 2025 Mar 5;19(1):98. doi: 10.1007/s11701-025-02261-0. PMID: 40042780; PMCID: PMC11882609.Ingham AR, Kong CY, Wong TN, McSorley ST, McMillan DC, Nicholson GA, Alani A, Mansouri D, Chong D, MacKay GJ, Roxburgh CSD. Robotic-assisted surgery for left-sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surg Endosc. 2024 May;38(5):2577-2592. doi: 10.1007/s00464-024-10749-3. Epub 2024 Mar 18. PMID: 38498212; PMCID: PMC11078791.

Andrea Merrill is a surgical oncologist in Charlottesville, Virginia. She is the creator of Scrubbed Out, a website dedicated to highlighting the talents and passions of surgeons and trainees outside of the operating room. As listeners will know, Chad and I have been obsessed with exploring how to be the best surgeons we can be without losing our humanity in the process. Dr. Merrill had some really important insights on how we might walk the line between being completely immersed in surgery, but also staying grounded. We also talked about several of her superb pieces of writing, including “Free Solo” and “Taylor Swift in the Operating Room”.  We’d love to hear from you – what hobbies or side hustles do you have? How do you balance them with a life in surgery? Email us at [email protected]:https://www.scrubbedoutsurgeon.com/Merrill AL. Free Solo Surgery. Ann Surg. 2022 Aug 1;276(2):e77-e78. doi: 10.1097/SLA.0000000000005499. Epub 2022 Jul 6. PMID: 36036994.https://kevinmd.com/2024/02/taylor-swift-in-the-operating-room-the-surgeon-who-found-strength-in-song.htmlhttps://kevinmd.com/2015/06/why-are-women-so-underrepresented-in-surgery-leadership.html

Dr. Mohammed Bellal is a consultant urologist based out of Birmingham, UK. He specializes in complex functional reconstructive surgery. He’s also the UK’s first paralyzed surgeon. Dr. Bellal has probably one of the most powerful talks we’ve ever heard called “The Gift of Adversity”. During our conversation with him, we explore the power of fate, and how letting go of the outcomes is such a difficult but powerful life lesson we all need to learn. We also delved deeply into how Dr. Bellal has adapted to his paralysis and has come back to practice as a surgeon, and his insights on how we might design the operating rooms of the future. Links:The Gift of Adversity: https://youtu.be/uTPVvPMod2Q?si=VTn616zCI8M7oF71https://www.bbc.com/news/uk-england-birmingham-63586045

In this second episode of our mini-series with the Canadian Medical Protective Association (CMPA), Richard Mimeault and Liisa Honey talk about the “Anatomy of a Lawsuit”. They talk about what you can expect if you are served with a College complaint or a lawsuit, what the process looks like, and how you can psychologically survive through it all.Links:https://www.cmpa-acpm.ca/en/education-events/elearning/anatomy-of-a-lawsuit

It’s hard to describe exactly what Dr. Stephen Foster is. Dr. Foster is a general surgeon, urologist, infectious disease doctor, entrepreneur, and missionary who has spent his career working in Angola. We caught up with Dr. Foster to talk about his life working in Angola and really to explore his thoughts on empowering non-MD providers to provide life-saving care. Dr. Foster has a fascinating biography called “The Benefit of Steel: The Life and Times of Steve Foster.” For us, the conversation with Dr. Foster has reminded us of the huge inequities that exist in the world, but also the tremendous effort of folks like Dr. Foster to make the world a better, more humane place.If you want to get in contact with Dr. Foster to support his foundation, you can find his email in our show notes.Links:Stephen Foster Email: [email protected] https://www.amazon.ca/Benefit-Steel-Times-Steve-Foster/dp/B07Y4K7CM4https://www.nytimes.com/2015/03/29/opinion/sunday/nicholas-kristof-a-little-respect-for-dr-foster.html

Clip of Senate hearing with Robert F. Kennedy Jr.That was a clip from a Senate hearing with  Robert F Kennedy Jr, who, as many listeners will know, is the current US Secretary of Health and Human Services. In 2025, many folks around the world have become interested in the way that science currently works, particularly around the process of peer review. Peer review is a process where scientific journals ask experts in the field to evaluate the validity and accuracy of articles that are submitted to the journal. There are many challenges around peer review in the modern era, and one particularly thorny one is finding reviewers who have the time and expertise to provide high-quality reviews.David Maslove is a Clinician Scientist in the Departments of Medicine and Critical Care Medicine at Queen’s University. He, along with economist Chris Cotton and a team of other researchers, recently published an article in the Journal of Critical Care Medicine entitled “Effect of Monetary Incentives on Peer Review Acceptance and Completion: A Quasi-Randomized Interventional Trial”. Dr. Maslove performed what is, in some ways, a very simple study conceptually – does paying reviewers increase the rate at which reviewers complete their reviews? We delve into this study in depth and hear Dr. Maslove’s thoughts on this really important topic.What do you think? Do you think peer reviewers should be paid? Send us your thoughts via email at [email protected] or on X @coldsteelpod.Links:Cotton CS, Alam A, Tosta S, Buchman TG, Maslove DM. Effect of Monetary Incentives on Peer Review Acceptance and Completion: A Quasi-Randomized Interventional Trial. Crit Care Med. 2025 Mar 6. doi: 10.1097/CCM.0000000000006637. Epub ahead of print. PMID: 40047491.Maslove DM, Tang B, Shankar-Hari M, Lawler PR, Angus DC, Baillie JK, Baron RM, Bauer M, Buchman TG, Calfee CS, Dos Santos CC, Giamarellos-Bourboulis EJ, Gordon AC, Kellum JA, Knight JC, Leligdowicz A, McAuley DF, McLean AS, Menon DK, Meyer NJ, Moldawer LL, Reddy K, Reilly JP, Russell JA, Sevransky JE, Seymour CW, Shapiro NI, Singer M, Summers C, Sweeney TE, Thompson BT, van der Poll T, Venkatesh B, Walley KR, Walsh TS, Ware LB, Wong HR, Zador ZE, Marshall JC. Redefining critical illness. Nat Med. 2022 Jun;28(6):1141-1148. doi: 10.1038/s41591-022-01843-x. Epub 2022 Jun 17. PMID: 35715504.Maslove DM, Badawi O. The Many Faces of Prediction Modeling in Critical Care. Crit Care Med. 2022 Apr 1;50(4):687-689. doi: 10.1097/CCM.0000000000005409. PMID: 35311775.https://med.stanford.edu/master-clinical-informatics-management/stanford-clinical-informatics/ms-phd-in-biomedical-informatics.html

The only thing that can save us from our irascibly self-centered existence is to make sure that our existence is in the service of othersMark Shrime, ENT surgeon, global surgery researcher and now career coach is our guest on this episode. The quote I read was from his wonderful book, “Solving for Why: A Surgeon’s Journey to Discover the Transformative Power of Purpose”. It’s important to understand just how much of a fascinating person Mark Shrime is to get a context for this conversation. Dr. Shrime was the International Chief Medical Officer at Mercy Ships, an international NGO that operates hospital ships. Mark is also one of the major figures in the global surgery space, and was part of the 2015 Lancet Commission on Global Surgery. If that were not enough, he is also an American Ninja Warrior! We explored why Mark felt the need to write a book on purpose as well as his insights on global surgery, amongst many other topics. This was such an important conversation not just for surgeons but for anyone trying discover meaning and purpose in their life. Links:https://www.markshrime.com/ https://www.hachettebookgroup.com/titles/dr-mark-shrime/solving-for-why/9781538734162/?lens=twelvehttps://www.thelancet.com/commissions/global-surgeryShrime MG, Alkire BC, Grimes C, Chao TE, Poenaru D, Verguet S. Cost-Effectiveness in Global Surgery: Pearls, Pitfalls, and a Checklist. World J Surg. 2017 Jun;41(6):1401-1413. doi: 10.1007/s00268-017-3875-0. PMID: 28105528.Smith ER, Kapoor P, Concepcion T, Ramirez T, Mohamed M, Dahir S, Cotache-Condor C, Adan Ismail E, Rice HE, Shrime MG. Does reducing out-of-pocket costs for children's surgical care protect families from poverty in Somaliland? A cross-sectional, national, economic evaluation modelling study. BMJ Open. 2023 May 2;13(5):e069572. doi: 10.1136/bmjopen-2022-069572. PMID: 37130683; PMCID: PMC10163539

Tsuyoshi Konishi Dr. Tsuyoshi Konishi is an associate professor of Colon and Rectal Surgery at the University of Texas M.D. Anderson Cancer Center, in Houston, USA. We again got a chance to hear several of his talks at the COLOSOS conference in Toronto in Oct 2024. Dr. Konishi is really helping to bridge the gap between “Eastern” and “Western” approaches to colorectal cancer. In this episode, Dr. Konishi really broke down the sometimes nebulous concept of complete mesocolic excision in right sided colon cancers. We’d really encourage you to head over to our YouTube channel www.youtube.com/@coldsteelsurgery to check out the accompanying video and slides. One of the really enjoyable parts of this conversation was discussing some of the differences between Japanese and North American training – there’s lots we can learn! Maybe we should incorporate the Japanese system of having everyone upload their operative video prior to board certification?? What do you think? Send us an email at [email protected] out YouTube version with Dr. Konishi's slides here: https://youtu.be/PGIBtYyBAxU Bio:After completion of advanced training in the field of Surgical Oncology and Colorectal Minimally Invasive Surgery at top institutions including the University of Tokyo, Cancer Institute Hospital of the JFCR and Memorial Sloan-Kettering Cancer Center, Dr. Konishi served as an attending colorectal surgeons since 2010, and Head Attending since 2017, at Cancer Institute Hospital of the Japanese Foundation for Cancer Research in Tokyo, Japan. He took a leadership in advancing a minimally invasive surgery program for complex colorectal cancer.Dr. Konishi’s research interest includes combining multidisciplinary approaches for complex colorectal cancer, including neoadjuvant therapy, extended surgical resection and a minimally invasive surgery. Particularly, he has been taking an international leadership in studying lateral pelvic lymph node dissection for rectal cancer.Dr. Tsuyoshi Konishi is currently an associate professor of Colon and Rectal Surgery at the University of Texas M.D. Anderson Cancer Center, in Houston, USA. Links:Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation--technical notes and outcome. Colorectal Dis. 2009 May;11(4):354-64; discussion 364-5. doi: 10.1111/j.1463-1318.2008.01735.x. Epub 2009 Nov 5. PMID: 19016817.Konishi T, You YN. Complete Mesocolic Excision and Extent of Lymphadenectomy for the Treatment of Colon Cancer. Surg Oncol Clin N Am. 2022 Apr;31(2):293-306. doi: 10.1016/j.soc.2021.11.009. Epub 2022 Mar 5. PMID: 35351279.RELARC trial: Lu J, Xing J, Zang L, Zhang C, Xu L, Zhang G, He Z, Sun Y, Feng Y, Du X, Hu S, Chi P, Huang Y, Wang Z, Zhong M, Wu A, Zhu A, Li F, Xu J, Kang L, Suo J, Deng H, Ye Y, Ding K, Xu T, Zhang Y, Zhang Z, Zheng M, Su X, Xiao Y; RELARC study group. Extent of Lymphadenectomy for Surgical Management of Right-Sided Colon Cancer: The Randomized Phase III RELARC Trial. J Clin Oncol. 2024 Nov 20;42(33):3957-3966. doi: 10.1200/JCO.24.00393. Epub 2024 Aug 27. PMID: 39190853.Motoyama S, Yamamoto H, Miyata H, Yano M, Yasuda T, Ohira M, Kajiyama Y, Toh Y, Watanabe M, Kakeji Y, Seto Y, Doki Y, Matsubara H. Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan. Esophagus. 2020 Jan;17(1):41-49. doi: 10.1007/s10388-019-00694-9. Epub 2019 Oct 3. PMID: 31583502; PMCID: PMC6976551.

This week we were joined by Dr. Jenny Seligmann. Dr. Seligmann is a Professor of Gastrointestinal and Translational Oncology and Honorary Consultant in Medical Oncology at the University of Leeds. Dr. Seligmann is one of the authors of the seminal FOxTROT trial, which investigated the use of neoadjuvant chemotherapy in advanced colon cancers. Dr. Seligmann is the lead investigator on the FOxTROT platform, the ARIEL trial, and continues to be on the leading edge of trials for colorectal cancer. In this episode, we explored neoadjuvant chemotherapy for colon cancer specifically. There's lots to take away from this conversation, but one of the things that stood out for us was some of the differences in the structure of the multidisciplinary tumor boards in Dr. Seligmann’s centre versus many centres in Canada. Perhaps in the future, all colorectal cancers will get discussed at tumor boards! What do you think? We’d love to hear your thoughts – email us at [email protected]:Dr Jenny Seligmann is Professor of Gastrointestinal and Translational Oncology and Honorary Consultant in Medical Oncology at the University of Leeds, UK. She is the Chief Investigator of the FOxTROT Platform and the ARIEL trial, and has a programme of translational research. She is a member of the ESMO Lower Gastrointestinal Faculty and the UK NCRI Colorectal Cancer Executive Group.x/twitter: @jenseligmannLinks:Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized Controlled Trial. https://ascopubs.org/doi/10.1200/JCO.22.00046Professor Dion Morton: https://www.birmingham.ac.uk/staff/profiles/applied-health/morton-dionProfessor Phil Quirke: https://medicinehealth.leeds.ac.uk/medicine/staff/700/professor-philip-quirkeARIEL trial: https://fundingawards.nihr.ac.uk/award/NIHR129268FOCUS4 trial: http://www.focus4trial.org/FOxTROT platform website: https://ctru.leeds.ac.uk/foxtrot/COLOSOS trial: https://mycs-cdn.myconferencesuite.com/other/Project/3222/91/c0/PRELIM%20PROGRAM_COLOSOS%20CANADA_DL.pdf 

This episode is an edited version of a talk I gave to our first years during their Surgical Foundations course. It’s mainly a reminder to myself: this too shall pass.Links:Steven Covey 7 Habits of Highly Effective People: https://www.amazon.ca/Habits-Highly-Effective-People-Powerful/dp/0743269519“Memento Mori”: https://dailystoic.com/memento-mori/Hans Zimmer soundtracks: https://www.youtube.com/channel/UCJeBQabyLa_FvMxb6G67lkw

Selwyn O. Rogers Jr., MD, MPH, FACS, is a widely respected surgeon and public health expert. As founding director of the University of Chicago Medicine Trauma Center, Dr. Rogers is building an interdisciplinary team of specialists to treat patients who suffer injury from life-threatening events, such as car crashes, serious falls and gun violence. His team works with leaders in the city's trauma network to expand trauma care on the South Side.Dr. Rogers has served in leadership capacities at health centers across the country, including most recently as vice president and chief medical officer for the University of Texas Medical Branch at Galveston. Dr. Rogers has also served as the chair of surgery at Temple University School of Medicine and as the division chief of trauma, burns and surgical critical care at Harvard Medical School. While at Brigham and Women's Hospital (BWH), he helped launch the Center for Surgery and Public Health to understand the nature, quality and utilization of surgical care nationally and internationally.Additionally, as executive vice president for community health engagement, Dr. Rogers works with faculty across the University of Chicago as well as members of the community to develop a multidisciplinary approach to trauma care and health disparities. His work will help enhance the understanding of social factors that affect victims of violence and underserved populations, in addition to identifying approaches necessary to achieve better outcomes for trauma victims.Dr. Rogers' clinical and research interests focus on understanding the healthcare needs of underserved populations. He has published numerous articles relating to health disparities and the impact of race and ethnicity on surgical outcomes.Twitter: https://x.com/selwyn_rogers Links:Ann Surg. 2024 Jul 1;280(1):29-31. doi: 10.1097/SLA.0000000000006258. Epub 2024 Mar 5.When Equality Is Not Equity: The Ethics of Access to Trauma Care: A Surgical Perspective. Bethany L Strong 1, Franklin Cosey-Gay 2, Kenneth L Wilson 2, Selwyn O Rogers Jr 2Scarlet S, Rogers SO Jr. What Is the Institutional Duty of Trauma Systems to Respond to Gun Violence? AMA J Ethics. 2018 May 1;20(5):483-491. doi: 10.1001/journalofethics.2018.20.5.msoc2-1805. PMID: 29763395.Chang DC, Oseni TO, Strong BL, Molina G, Ortega G, Chen H, Rogers SO Jr. The Other Global Pandemic: Scientific Racism and the Normality Bias. Ann Surg. 2021 Dec 1;274(6):e646-e648. doi: 10.1097/SLA.0000000000005168. PMID: 34387208.

This episode is a recording of the Queen’s Department of Surgery William Ersil Research Day. This year our invited speaker was Dr. Thomas Forbes, chief of surgery at University Health Network in Toronto and Editor-in-Chief of the Journal of Vascular Surgery.In this “How I Built This” style episode in front of a live audience, we explored Dr. Forbes background, his training, the future of residency/fellowship training, his approach to leadership and how he goes “all in” for both work and his family life. Thanks again to the Department of Surgery at Queen’s for allowing us to record this and to all those in attendance for being such a wonderful audience.Bio: Dr. Forbes is Professor of Surgery and Chair of the Division of Vascular Surgery at the University of Toronto, a position he has held since 2014. He obtained his medical degree in 1990 from the University of Toronto and completed his general surgery and vascular surgery training at the University of Western Ontario. He is the co-Program Director of the Advanced Aortic Surgery Fellowship at the University of Toronto, a collaborative fellowship between vascular and cardiac surgery in open and endovascular therapies for thoracoabdominal aortic pathologies. Previously he was Chair/Chief of the Division of Vascular Surgery at the University of Western Ontario (2005-2014) and the inaugural Graduate Program Chair of the Masters of Science in Surgery program. He has published over 200 peer-reviewed papers, editorials and book chapters and given over 100 invited lectures or guest professorships. He is currently an Associate Editor of the Journal of Vascular Surgery and the Canadian Journal of Surgery and a member of several editorial boards. He is the Past-President of the Canadian Society for Vascular Surgery, Section Editor of Rutherford’s Textbook of Vascular Surgery and the Chair of the Vascular Care Working Group of the Cardiac Care Network in Ontario. He is also a former Program Director and vice-Chair of the Vascular Surgery Specialty Committee of the Royal College of Physicians and Surgeons of Canada.Links:https://surgery.queensu.ca/research/william-ersil-resident-research-dayProviding high-quality open aortic surgical care in the endovascular era. https://www-sciencedirect-com.proxy.queensu.ca/science/article/pii/S074152142200427X?via%3DihubAdvanced Aortic fellowship: https://surgery.utoronto.ca/sites/default/files/inline-files/2025%20Fellowship%20in%20Advanced%20Aortic%20Surgery.pdfhttps://www.audiblebleeding.com/forbes/

We are delighted to release our new collaborative mini-series on “Medico-legal Risks forthe Surgeon”. The Canadian Medical Protective Association and the Cold Steel podcasthave teamed up to release this mini-series exploring some common legal issues thatmight arise for surgeons.In this first episode, we explore some basic legal issues that surgeons might face. Weexplore the peer-review system, documentation, inherent risk, the role of the system inmedico-legal errors, and the impact these issues have on surgeons.Stay tuned for our other episodes!Bio:Dr. Richard Mimeault completed his medical degree at McGill University in 1982. Hewent on to do an internship at the Wellesley Hospital in Toronto, followed by a generalsurgery residency in Ottawa and then a two-year transplant fellowship at the UniversityHospital in London, Ontario. In 1989, he returned to Ottawa where he started a practiceof general and hepatobiliary surgery at the Ottawa Hospital. He was in practice for 27years during which time he was closely involved with the residency training programand undergraduate education. He was also peer assessor for the College of Physiciansand Surgeons of Ontario (CPSO) and volunteered in third-world surgery and surgicaleducation. He joined the CMPA as a physician advisor in 2017.Links:Documentation workshop. https://www.cmpa-acpm.ca/en/education-events/teaching-resources/physician-patient/documentation--principles-of-medical-record-keepingTest result workshop. https://www.cmpa-acpm.ca/en/education-events/workshops/workshop-test-results-follow-upHaytham Kaafarani on Surgeons as a Second Victim: https://open.spotify.com/episode/6MiYBhgt2k7qDMCxUZt537https://www.cmpa-acpm.ca/en/research-policy/know-your-risk/what-general-surgeons-need-to-knowReducing Diagnostic Error with Janice Kwan: https://open.spotify.com/episode/6HJjgK3756tb7NO5fFQUDY

Thank you for joining us on Cold Steel!Dr. Caprice Greenberg is a surgical oncologist at UNC School of Medicine in North Carolina. She is a preeminent health services researcher and also the founder of the Academy for Surgical Coaching. We caught up with her to do a deep dive on surgical coaching and the work that she’s done on a state-wide level to create a coaching program. Dr. Greenberg is an iconoclast and provides some really important insights on the importance on having a vision and pursuing it, no matter how off the beaten path it may be. Bio:Dr. Greenberg is a world-renowned health services researcher and surgical oncologist, and she most recently served as chair of the Department of Surgery at the Medical College of Georgia at Augusta University.She also is a leader in the study of care delivery in operating rooms and innovative approaches to collaborative learning and will bring research projects to the School of Medicine related to surgical coaching and methods to improve rural cancer care delivery.Greenberg earned her MD from the University of Chicago Pritzker School of Medicine and her Masters of Public Health from the Harvard School of Public Health. Her general surgery residency was completed at Brigham and Women’s Hospital in Boston and she completed her surgical oncology fellowship at the Dana – Farber/Partners Cancer Center in Boston.Links:https://pubmed.ncbi.nlm.nih.gov/28650360/https://pubmed.ncbi.nlm.nih.gov/28146224/https://pubmed.ncbi.nlm.nih.gov/33605579/  Academy for Surgical Coaching. https://surgicalcoaching.org/ Presidential address for AAS https://pubmed.ncbi.nlm.nih.gov/29078918/ 

Dr. Adom Bondzi-Simpson is a general surgery resident and PhD student at the University of Toronto. He’s been nationally recognized for his advocacy work and research work on social justice and social determinants of health. He is a winner of the Canadian Medical Association for Young Leaders, the 2023 winner of the Mikhael Award for Medical Education from the Resident Doctors of Canada, among other accolades. In this episode we do a very deep dive on Adom’s upbringing and background, and his thoughts on how we can make the house of surgery a more diverse and welcoming place.         Links:1.       https://temertymedicine.utoronto.ca/news/faces-temerty-medicine-adom-bondzi-simpson2.       “Where is the Black doctor!?” CMAJ piece. https://www.cmaj.ca/content/194/34/E1175 3.       https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/37640638/4.       https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/37063147/ 5.       CMA Award: https://www.cma.ca/get-involved/awards/awards-young-leaders/dr-adom-bondzi-simpson  

Thank you so much for joining us on Cold Steel!The tremulous surgeon seems like such an oxymoron, an impossible paradox. The reality of course, is that many surgeons have a tremor. Our discussion on this episode with Lilli Cooper on tremors was a wonderful exploration of performance anxiety in surgery. Lilli Cooper is a plastic surgeon in the UK, and produced a segment for the BBC on tremors in surgeons. We caught up with her to talk about what she’s learned about tremors and the insights she has on performance in surgery. You can check out all the work she does on her website https://lillicooper.co.uk/. Links:1.       https://lillicooper.co.uk/ 2.       https://www.bbc.co.uk/programmes/m0021j9y3.     A pilot study of performance enhancement coaching for newly appointed urology registrars. https://pubmed.ncbi.nlm.nih.gov/38767172/4.     Enhancing surgical performance by adopting expert musicians' practice and performance strategies. https://www-sciencedirect-com.proxy.queensu.ca/science/article/pii/S00396060173063235.     Romy Nitsch and Jen Mccall on Imposterism in Surgery. https://open.spotify.com/episode/3UuP5JTGuhP8J2JvycoEFh 

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers  to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. Dr. Morad Hameed is an innovator, leader, and trauma surgeon. He currently is the chief of acute care surgery at Stanford University and held many leadership roles within Canada. We don’t really think we can do justice to this talk. Nominally this talk was about transitions in practice during a surgical career, but really this talk was an ode to joy in surgery and how we can find fulfillment as both surgeons and human beings.  As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]:Morad Hameed is a trauma surgeon, intensivist, and public health researcher. He completed medical school and surgical residency at the University of Alberta, graduate studies in public health at Harvard University, and fellowships in Trauma Surgery and Surgical Critical Care at the University of Miami. He spent 3 years on the surgical faculty at the University of Calgary, before moving to the University of British Columbia (UBC), where he spent 19 years at the Vancouver General Hospital (VGH), which is the home of province-wide centers of excellence in trauma surgery and critical care.  His clinical interests span innovations in trauma surgery and emergency general surgery (including chest wall trauma, abdominal wall reconstruction, and applications of extracorporeal life support in trauma), process and quality improvement, surgical rescue, value-based healthcare, and surgical systems. He has been a committed surgical educator who served as the director of one of Canada’s most dynamic surgical residency programs, and one of its most accomplished trauma and acute care surgery fellowship programs. He has won divisional, departmental, hospital-wide, and province-wide awards for his teaching. His main research interest is in public health aspects of trauma and emergency surgery, including social determinants of health and disparities in access to high quality emergency surgical care, and his research programs have received support from the Michael Smith Foundation and the Canadian Institutes of Health Research.  Dr. Hameed’s leadership roles have included terms as the Head of the VGH and UBC Divisions of General Surgery and President of the Canadian Association of General Surgeons. His work with these organizations has prioritized creativity, innovation, inclusive networks, and cross-disciplinary partnerships to rethink and redesign systems of surgical care.  He is excited to arrive at Stanford, where he is blessed to begin to work with another exceptionally talented group of trauma and acute care surgeons and intensivists. At Stanford, Dr. Hameed is inspired to help build surgical services that explore the intersections of surgery with data science, organizational theory, public health, global health, and sustainability, and that contribute to the pursuit of universal access to high quality surgical care and the highest standards of human health in California and around the world.Links:E141 Journal Club with Morad Hameed on Cardiac InjuriesE105 Death, Dying, and MAID in Surgery with Kelly Vogt and Morad HameedE94 Mental Health and Surgery with Rebecca Afford, JJ Sidhu and Morad HameedE28 Equity in Surgery with Julius Ebinu, Shahzeer Karmali, and Morad HameedE14 COVID19 with Neil Parry And Morad HameedE02 Morad Hameed on Process-Mapping in ACS 

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers  to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. Dr. Morgan Schellenberg is a trauma and acute care surgeon who recently joined us back in Canada as a staff surgeon at St. Michael’s Hospital in Toronto. She lays out some very practical advice about one of the most important decisions we have to make at the end of the very long road of training: how to choose your first job! Dr. Schellenberg also has some really keen insights into working in the US versus Canada. As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]:Dr. Morgan Schellenberg is a trauma and acute care surgeon at St. Michael’s Hospital in Toronto. Previously she did her residency at Queen’s University and fellowship at Keck School of Medicine of USC and subsequently went on to practice in Los Angeles.

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers  to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. Dr. Ashlie Nadler is an Assistant Professor at the University of Toronto and practices at Sunnybrook Hospital. She has unique training in both acute care surgery as well as surgical oncology. In this talk, she examines the adage of being “Available, Affable, and Able” as a mantra for success in a surgical career.As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]:Dr. Ashlie Nadler has been appointed in the Department of Surgery, Division of General Surgery, University of Toronto as an Assistant Professor and Surgeon-Teacher at Sunnybrook Health Sciences Centre. Ashlie completed the medical program and General Surgery Residency Program at the University of Toronto. She then did a surgical oncology fellowship in Philadelphia at the Fox Chase Cancer Center and at the same time did a Master of Public Health, Drexel University, in Philadelphia. Ashlie is Sub-section Lead, Acute Care Surgery, Department of Surgery and Integrated Community Program, Sunnybrook Health Sciences Centre. Her clinical interests are in acute care surgery and emergency surgical oncology.  Her research interests are in quality improvement, education, and acute care surgery.

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. Dr. Kelly Vogt is an acute care and trauma surgeon at Western University in London, Ontario and is an outstanding surgeon-scientist. Dr. Vogt lays out her advice for starting a career in research as a surgeon, and how to navigate everything from involving trainees to writing your first grant. She’s a longstanding friend of the podcast, and you can check out all the other episodes we’ve done with Dr. Vogt in the shownotes. As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]:Dr. Kelly Vogt joined the Division of General Surgery, Department of Surgery, Western University in September of 2014, and is appointed at London Health Sciences Centre’s Victoria Hospital. Dr. Vogt is a recipient of the Schulich Clinician-Scientist Award. As a Schulich Clinician Scientist, she will have protected time to further her research in clinical epidemiology, specializing in clinical trials, and registry-related research in the field of Acute Care Surgery and Trauma.After graduating from the University of Waterloo with a BSc in Health Studies, Dr. Vogt received her medical degree and general surgery residency training at Schulich School of Medicine & Dentistry, Western University. Dr. Vogt also received a MSc in Health Research Methodology from McMaster University, a degree she completed during her residency. Upon finishing her residency, Dr. Vogt joined the Division of Acute Care Surgery LA County, University of Southern California Medical Center in Los Angeles where she completed a fellowship program in trauma and surgical critical care, followed by an appointment to the Division as a Clinical Instructor.Links: https://soundcloud.com/cjs-podcast/e04-csf-edition-kelly-vogt-on-the-evolution-of-acs-tips-for-a-career-in-academic-surgeryhttps://soundcloud.com/cjs-podcast/e105-death-and-dying-in-surgery-with-kelly-vogt-and-morad-hameedhttps://soundcloud.com/cjs-podcast/surgical-companion-2-rbghttps://soundcloud.com/cjs-podcast/surgical-companion-1-the-aging-surgeon

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers  to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. Dr. Rob Leeper is an acute care and trauma surgeon at Western University in London, Ontario. Dr. Leeper gives a talk that I wish I had heard when starting out in practice, and gives some profound advice on how to think about a surgical career as well as some really practical advice such as, “Give me Cordis or give me death!” As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]:Dr. Rob Leeper is an Assistant Professor in the Department of Surgery at Western University. He is an acute care and trauma surgeon with an interest in resuscitation, both inside and outside the operating room. He did residency in Western and went on to do a prestigious trauma fellowship at Johns Hopkins University. He is the father of 3 and a former college football player.Links: https://soundcloud.com/cjs-podcast/e127-rob-leeper-on-data-driven-competitive-trauma-simulation-and-starting-out-in-practice

We’re really excited to bring you talks that we recorded as part of the CANUCS Surgical Fellows course. CANUCS is a national organization that stands for Canadian collaborative on urgent care surgery. Dr. Chad Ball and Kelly Vogt were instrumental in bringing together some really fantastic speakers  to talk about the critical knowledge and skills that surround obtaining a staff job, as well as being successful both personally and professionally in a demanding career. I was really honoured to be asked to talk about culture in surgery. It was great to reflect on many of the discussions we’ve had through the years on the podcast and think about what we can continue to improve the culture of surgery. As always, we’d love to hear your thoughts and feedback, so please email us at [email protected]. Links: Treatment of Ongoing Hemorrhage: The Art and Craft of Stopping Severe Bleeding. https://www.amazon.ca/Treatment-Ongoing-Hemorrhage-Stopping-Bleeding/dp/3319634941https://canucs.ca/Rhea Liang and Simon Fleming on Culture Change in Surgery: https://www.canjsurg.ca/cold-steel-episode-81-rhea-liang-and-simon-flemingEffects of Hierarchy in the OR: https://academic.oup.com/bja/article-abstract/110/3/463/249144Elaine Bromiley: https://www.youtube.com/watch?v=6qKYRDxwQf8Haytham Kaafarani : https://open.spotify.com/episode/6MiYBhgt2k7qDMCxUZt537  

As a trainee, I rarely thought about the details of setting up your own office, and yet I always felt that there had to be a way of doing it better. Dr. Erin King-Mullins is a colorectal surgeon in Fayetteville, Georgia. She created the Colorectal Wellness Center. On this episode, we talk to her about why and how she created the Colorectal Wellness Center. Along the way we get her insights on entrepreneurship, creativity, and paving your own way. Links:Dr. King-Mullin’s children’s book “Mommy! I made a Boo-Boo”: https://www.amazon.ca/Mommy-Made-Boo-Boo-Erin-King-Mullins/dp/B0CF4LKWRCCorona-Mamas: https://www.godaddy.com/resources/mindset/godaddy-qa-corona-mamas-erin-king-mullinshttps://colowellness.com/

Dr. Elena Parvez is a surgical oncologist and Assistant Professor in the Department of Surgery. Her clinical expertise and research interests are in breast cancer. She is exploring breast cancer outcomes in refugees to Canada who have breast cancer. She has received funding from Canadian Institutes of Health Research (CIHR) to conduct a trial which identifies a strategy to avoid post-neoadjuvant radiation therapy in patients with locally advanced breast cancer who have a complete response to neoadjuvant chemotherapy.She presented this work at the “Best of CSF Research 2023” session last year.Join us at the upcoming CSF in Winnipeg!https://www.canadiansurgeryforum.com/Links:Adjuvant radiation therapy among immigrant and Canadian-born/long-term resident women with breast cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718225/https://experts.mcmaster.ca/display/parveze https://www.canadiansurgeryforum.com/ Well the summer has come and gone and we’re back into the swing of things! We’re really excited that in a couple of weeks, many surgeons from across Canada will be meeting for our largest national conference, the Canadian Surgical Forum. This year it is in the lovely city of Winnipeg. It’s a time to catch up with friends and colleagues across the country, and to hear the amazing work that’s been going on. This is a teaser for the type and calibre of work that goes on at CSF. Dr. Elena Parvez presented this work last year at the best research of CSF 2023 session. Dr. Parvez is an assistant professor of surgery at McMaster University in Hamilton. Her clinical practice is in surgical oncology. In this episode, she presented her work on adjuvant radiation therapy among immigrant and Canadian-born women with breast cancer. We look forward to meeting many of our listeners at CSF this year and we’ll be recording some interviews live at CSF. We’d love to hear your feedback and suggestion for content for the upcoming year. As always, you can also send your thoughts to [email protected]. 

Thank you so much for joining us on the podcast!In many philosophical and religious traditions, there is an emphasis on how intentionality is one of the fundamental tenets of being able to live a fulfilling life. Marcus Aurelius wrote, “You have power over your mind – not outside events. Realize this and you will find strength.” One surgeon who is trying to restore that intentionality back to the culture of surgery is Dr. Sharon Stein. Dr. Stein is a colorectal surgeon who has been at the pinnacle of academic surgery and has been among many other things the past president of the Association of Women Surgeons, Chair of American College of Surgeons Women in Surgery Committee, and an executive council of the American Society of Colon and Rectal Surgeons. Recently, Dr. Stein started the Intentional Surgeon podcast, dedicated to helping surgeons rediscover their purpose. We had a powerful discusson on a whole myriad of topics, with the throughline of how we can try to restore intentionality and purpose to everything that we do. You can find Dr. Stein on her website www.intentionalsurgeon.com and you can also email her at [email protected] as well as on X at @slssteinmd1. Links:Intentional Surgeon podcast: https://www.intentionalsurgeon.com/Gender Inequity in the Clinical Setting. Clin Colon Rectal Surg. 2023 Sep; 36(5): 309–314.Association of Women Surgeons 2020 Presidential Address: Sculpting our Future. https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/33046220/ 

In this episode, we spoke with Drs. Jen McCall and Romy Nitsch about imposterism. Dr. McCall is a minimally invasive gynecology fellow at the University of Ottawa and Dr. Nitsch is a minimally invasive gynecologist at Queen’s University. The two researchers, along with Jessica Pudwell and Jamie Pyper, recently published a study in the Journal of American College of Surgeons on imposter phenomenon in women surgeons. Their study highlights the near universal phenomenon of imposter phenomenon among women surgeons, some of the risk factors associated with imposterism, and perhaps some strategies for how we might mitigate it.  Jennifer McCall X/Twitter: https://x.com/jenn__mccall Romy Nitsch X/Twitter: https://x.com/romynitschLinks:Dr. McCall and Nitsch’s article in JACS: Impostor Phenomenon and Impact on Women Surgeons: A Canadian Cross-Sectional Survey. https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/38712839/Mann A, Shah AN, Thibodeau PS, et al. Online well-being group coaching program for women physician trainees: a randomized clinical trial. JAMA Netw Open 2023;6:e2335541 –e2335541.

On this episode, Dr. Elizabeth Squirrell joined us to talk about Crohns disease. Dr. Squirrell is a staff gastroenterologist at Queen’s University and has a special expertise in inflammatory bowel disease. In this two part series, we first talk about the diagnosis of crohns disease and the different patterns of its presentation. In part 2, we talk about the changing landscape of medical therapy for Crohns disease and how Dr. Squirrell approaches the treatment of Crohns. Make sure to check out the links below for all the papers that are discussed in both part 1 and part 2 of this series. Links: Is there an optimal sequence of biologic therapies for inflammatory bowel disease? – Brian Bressler: https://journals.sagepub.com/doi/10.1177/17562848231159452Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease – Sandborn et al. - https://www.nejm.org/doi/full/10.1056/NEJMoa1215739They measured Clinical remission at week 6 and did have a significant result in one of their groups (p=0.02) but had a remission rate of 14.5% in the double-blind group and 17.7% in the open label group. Contrasted to the ustekinumab study (below) where they measured at 8 weeks and record 40.2% remission in biologic naïve patients and 20.9% remission in prior TNF exposed patients (the vedo study was a mix of bio exposed and bio naïve so would expect somewhere between).  Ustekinumab as Induction and Maintenance Therapy for Crohn’s Disease – Feagan et al. - https://nejm.org/doi/full/10.1056/NEJMoa1602773#APPNEJMoa1602773SUPECCO-ESCP Consensus on Surgery for Crohn’s Disease – Bemelman et al. - https://academic.oup.com/ecco-jcc/article/12/1/1/3813784Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis – Ytterberg et al. - https://www.nejm.org/doi/full/10.1056/NEJMoa2109927ACG Clinical Guideline: Management of Crohn's Disease in Adults – Lichtenstein et al. - https://journals-lww-com.proxy.queensu.ca/ajg/Fulltext/2018/04000/ACG_Clinical_Guideline__Management_of_Crohn_s.10.aspxCanadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease – Panaccione et al. - https://www.cag-acg.org/images/publications/CAG-CPG-Luminal-Crohns-Disease-JCAG-July2019.pdf   

On this episode, Dr. Elizabeth Squirrell joined us to talk about Crohns disease. Dr. Squirrell is a staff gastroenterologist at Queen’s University and has a special expertise in inflammatory bowel disease. In this two part series, we first talk about the diagnosis of crohns disease and the different patterns of its presentation. In part 2, we talk about the changing landscape of medical therapy for Crohns disease and how Dr. Squirrell approaches the treatment of Crohns. Make sure to check out the links below for all the papers that are discussed in both part 1 and part 2 of this series. Links: EXPERIENCES WITH PREFRONTAL LOBOTOMY FOR INTRACTABLE ULCERATIVE COLITIS. https://jamanetwork.com/journals/jama/article-abstract/304807 ACG Clinical Guideline: Management of Crohn's Disease in Adults. https://journals-lww-com.proxy.queensu.ca/ajg/Fulltext/2018/04000/ACG_Clinical_Guideline__Management_of_Crohn_s.10.aspx The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856208/