Editor’s Letter
Written by: Shannon Marie Foster, MD, FACS
Greetings colleagues and friends –
I hope to find all not only well but thriving as we prepare to celebrate the season of light.
You are reading the first Cutting Edge: Pathways to Leadership Edition – a collection of special interviews and personal perspectives of organizational progression and growth - a new supplement to our Cutting Edge quarterly and daily annual conference editions.
The success of our members and leaders is built not only on hard work and dedication, but an understanding of the wider environment. This insight includes home institution and local system, but also a much broader grasp of the complex overlapping professional organizational milieu that governs and maintains our professional standards. True achievement requires gaining the skills to navigate both. Situational awareness of the intersections of mandatory versus volunteer research, education and contributions to the field is beyond each of us alone.
As Acute Care Surgery has expanded to include a wide range of societies and membership options, each with a multitude of committees and task forces, we must learn where we can not only belong but thrive. With open and transparent organizational and engagement structures, each of us is then empowered to pursue and participate in one or multiple. Based on our personal interest, need, or skill set we may then find options that fit, promote, and bring us to others of similar goals and still allow full exposure to celebrate those who choose differently. Leaders open to sharing paths of success aid each one of us to identify and contribute to this complex world.
Those included here are not only examples of great success, but stalwart proponents of using that success to empower others. Please thank each of them for inviting us to share their journeys.
Happy Holidays - however you choose to celebrate the season – may it be with love and peace.
Warmest regards,
Shannon
Pan-American Trauma Society
A Culture of Collaboration: Interview with Dr. Paula Ferrada President of the Pan-American Trauma Society
Written by: Kaitlin A. Ritter, MD
Hailing originally from Columbia, South America, Dr. Paula Ferrada was born into the world of surgery. The daughter of a trauma surgeon and an Ob-Gyn nurse, she would frequently accompany her parents to work and quickly learned to think of the hospital as her second home. Instead of Legos she played with IV supplies; her coloring book were doodles along the side of progress notes. And, while it may have seemed inevitable that she would become a traumatologist, her father initially encouraged her to explore other career paths. At the age of twelve, after observing her father in an emergency operation where the blood shot up to the ceiling Dr. Ferrada realized this was her passion, recalling, “I did not pick trauma surgery, trauma surgery picked me.”
Her path through the medical training was far from standard, however. After a chance meeting with Dr. David Feliciano at the Pan-American Trauma Society annual meeting, she completed a four-month observership at Grady Hospital and made the decision that she would practice surgery in the United States. What followed next was a story of dedication, perseverance, and hard work that ultimately resulted in her achieving a categorical general surgery residency at Beth Israel Deaconess Medical Center. From there her surgical career took off, completing a critical care fellowship at University of Pittsburg and a trauma fellowship at Maryland Shock Trauma. “The key is just to never give up,” she reflected. “There is always hope. If you know in your heart you can do it, then you can do it.”
While Dr. Ferrada now considers Fairfax, VA home, she maintains a strong connection with her South American roots through the Pan-American Trauma Society (PTS). Indeed, membership and leadership within this organization has helped to shape her career. Having seen surgery in both Americas, she notes that to achieve the best care we can for our patients, we need an attitude of collaboration. As the current (and youngest ever) president of the Pan-American Trauma Society, Dr. Ferrada has prioritized bringing together the best of both systems—the research and resources of North America, combined with the technique and clinical acumen of our South American colleagues—with the goal of creating an environment where everyone can grow and improve. From its international trauma fellowship program to multicenter trials and research proctorship programs, the PTS empowers its diverse international membership to create opportunities for growth for not only their members, but also for each individual trauma system.
For Dr. Ferrada, this cooperative attitude extends not only beyond national boundaries, but also crosses organizational borders as well. “The same people working on education for EAST, are the same ones at COT, are the same at ASST,” she notes. Instead of working under the flag of an individual organization, she sees the possibility of breaking down these silos and bringing all the minds together to tackle the various priorities that exist in trauma surgery. This commitment to joint growth has manifested itself in a variety of the Pan-American Trauma society programs including their International Trauma Tele-Grand Rounds, co-sponsored by the AAST.
As a society, PTS also extends this collaborative attitude to all members of the healthcare team, not just trauma surgeons. “We all have blind spots,” Dr. Ferrada notes, “And who sees these blind spots; it is our nurses, paramedics, respiratory therapist, and pharmacists. If we have the goal of helping more people to survive, we need to work together with our entire trauma system.” A priority for the PTS has been cross-system training of all members of the health care team by offering courses ranging from advanced disaster medical response to trauma nursing, trauma quality improvement, and a paramedic exchange program.
So how do we build better trauma systems? In talking with Dr. Ferrada, clearly the foundation lies in a culture of collaboration and communication and in partnerships between societies like the AAST and the Pan-American Trauma Society breaking down organizational silos. As technology advances and the world becomes smaller, this aim for growth of one can become growth for all will be remain a leading principle that guides us into an era of truly global trauma surgery.
Committee on Trauma
Navigating the Committee on Trauma as an AAST Member
Written by: Caroline Park, MD, MPH
This month we are including a Cutting Edge Q&A on navigating the Committee on Trauma as an AAST member. I’m with trauma surgeons Dr. Leah Tatebe and Dr Samuel Mandell. Dr. Tatebe is an Associate Professor of Surgery and General Surgery Residency Program Director at Northwestern University, and Vice-Chair of Injury Prevention and Control within the Committee on Trauma. Dr. Mandell is an Associate Professor of Surgery at the University of Southwestern Medical Center and is the Section Chief of Burn Surgery, Director of the Parkland Regional Burn Center, and a prior Future Trauma Leader through the COT. Both are active members within both the AAST and COT.
CP:
What was your path to membership to the COT? How early did you get involved and what were your reasons, motivations?
LT:
I became involved with the Chicago COT via teaching ATLS. I was then asked to serve as a subcommittee chair for our Injury Prevention grant. Based on that role and my ongoing commitment to ATLS courses, I was sponsored into the Vice Chair of Advocacy position. I jumped at the chance to amplify the impact of prevention work supported by the ACS COT.
SM:
My path to involvement with the COT really started with encouragement from senior partners. While I knew that there was such a thing as the COT, it was Dr. Eileen Bulger who really showed me what it did and why I might want to be a part of it. Having an interest in quality improvement and safety that started when I was a resident, there was a natural alignment for me with the goals of the organization. I applied for the Future Trauma Leaders (FTL) program and was fortunate enough to be accepted. That got me to the meetings where I learned that the best way to get more involved is to volunteer! That can be harder than it seems, particularly as a junior person, but really, the organization wants your input. After that I became a state Vice Chair which allowed me to continue my involvement.
CP:
What major projects, initiatives or programs are you involved in that involve the AAST and COT and what are you most proud of, looking forward to?
LT:
After becoming a Vice Chair in the Chicago COT, I was able to attend the biannual COT meetings and sat in on the prevention committee meeting where I learned they were looking for people to help work on a firearm injury prevention toolkit for trauma providers. I volunteered and eventually helped create Firearm Safety and Patient Health: A Proactive Guide to Protecting Patients and Their Families. As part of the AAST Prevention Committee, I was able to work with other AAST members to publish "Walk the line: An ethical framework for interactions with law enforcement in trauma care environments." I enjoy being able to contribute to practical and multidisciplinary resources as I feel they support the mission of injury prevention.
SM:
I had the good fortune to be involved with the creation of some of the Best Practice Guidelines. These are very valuable reference documents that provide practical advice to a broad audience. As part of my FTL time I worked with Dr. Avery Nathens and his team to produce the initial data collection tool for the COT Preventable Death Project. Dr. Aaron Jensen, a later FTL, picked up that project and made it way better. The good news is that I still get to be involved, reviewing cases and helping him push that forward. That is the collaborative nature of the COT and its ongoing mission to always do better for trauma patients. In the coming years, I am hoping to better include more burn content / create some joint burn initiatives with the COT.
CP:
How was your experience at the recent Clinical Congress as both an ACS, AAST and COT member? What sessions did you attend and what are some helpful tips/advice for surgeons looking to be in this space?
LT:
The more involved I get, the more working meetings I end up having at conferences in order to meet collaborators in person. This means I end up not being able to attend as many educational sessions as I would like! It's a give and take. So many amazing ideas are hatched in the hallways of annual meetings! Look for opportunities to explore ideas with others.
SM:
The recent AAST meeting was great and, though I had to leave before the last day, I attended almost all the sessions. I am not a basic scientist, but I find that it can be a great place to see what is going on in that arena. At the Clinical Congress I started with the COT meetings of course! If you are a trauma surgeon, you should talk to your state / regional COT leaders and attend your local COT meeting. It is a great way to get involved particularly at the local level. The Scudder Oration on Trauma is also a great session. I look for sessions on things that I don’t do often or may expand my skillset. So often I will watch sessions on laparoscopy or even robotics so I know how those may be touching on Trauma / EGS. The major advice that I can give is if you go the meeting show up, meet people, make connections, and then follow-up. Most people are friendly and excited to work with people of similar interests. However, busy people sometimes forget things. It’s not likely you are being ignored… yes, send that follow-up email.
Thank you to both Drs. Tatebe and Mandell for their time!
To learn more about Future Trauma Leaders: FTL COT
Committee on Trauma
Pathways and Portals to the Committee on Trauma: A Conversation with Dr. Jeffrey Kerby
By Alexander C. Schwed, MD, FACS
I had the good fortune to interview Dr. Jeffrey Kerby earlier this week for this issue of The Cutting Edge. Dr. Kerby is the current chair of the American College of Surgeons’ Committee on Trauma (COT), as well as a trauma surgeon at the University of Alabama where he serves as the Director for the Division of Trauma and Acute Care Surgery. Dr. Kerby graciously shared his insights into participation in the COT with me, as well as discussing some aspects of the history of the organization, a variety of current and ongoing projects that the organization is tackling, and way in which the larger goals of the AAST align with the goals of the COT. It’s clear from our discussion how large the reach of the COT is, and how many different ways there are for young surgeons to become more involved with serving this committee and, by extension, our patients, colleagues, and communities.
We began our discussion with Dr. Kerby’s explanation of the “portals of entry and pathways of participation,” a framework for outlining how young surgeons can become involved in the COT. One of the recurring themes of our discussion was that much in the same way that the AAST has taken pains to expand its membership and open itself up to new and interested volunteers, the COT likewise is invested in demystifying the process of involvement in the organization and how participants can rise through the ranks of the COT. I will freely admit that my own understanding of the COT was somewhat limited prior to our discussion, but Dr. Kerby obliged me by outlining the different ways that involvement in the COT weaves through our profession. Whether this is via advocacy, education, campaigning for social justice, or working on injury prevention, so much of what we do as trauma surgeons are also goals for broader care improvement and delivery that the COT holds. From its origins as the Committee on Fractures in 1922, the organization was designed with intentionality surrounding broad geographic representation among the regions of the United States (and now internationally as well as representing the branches of the US and Canadian military). Getting involved in your state committee is one such portal of entry into participation in the larger COT. State and provincial committees can serve as an avenue for participation by younger surgeons who will, hopefully, ascend the ranks of the organization. Moving up the ranks of these smaller committees can transition into regional leadership opportunities, involvement in the Central Committee of the COT, and provides a possible blueprint for longitudinal participation in the COT. Dr. Kerby shared his pride in the fact that the larger organization has instituted term limits for leadership positions, and that there has been an intentionality about structuring leadership opportunities such that interested volunteers can dedicate their time and effort (“there are no committee tourists, we’ll put you to work”) in their local organization, and these same term limits help allow successive waves of participation by new voices over time, both at the state- and regional-level as well as on the Central Committee.
Our conversation moved on to speak about the as-yet unmet needs of our profession more broadly. Without missing a beat, Dr. Kerby identified rural trauma and care for patients who lack immediate access to a trauma center as vitally important issue that the COT is actively working to address. Depending on the source you cite, 30 to 40 million Americans live greater than 1 hour travel time from a trauma center, an inequity that would require the construction of at least 117 hospitals in specific locations, something that is currently not feasible in the current healthcare landscape where we find ourselves. I was intrigued by some of the thoughts that Dr. Kerby shared about expanding our vision about who can provide trauma care and where this care can be delivered. Taking lessons from our colleagues in other disciplines to expand the role of telehealth, and by critically examining our own participation in patient transfers, he and I discussed some of the larger systems issues that we are currently facing as a country. I was particularly struck by Dr. Kerby’s thoughts on how best to help support our existing trauma systems; saying an automatic “yes” to every trauma transfer might, in fact, not actually serve our patients or our systems well. By beginning to question that dogma of always saying yes, and instead focusing on appropriateness of transfers as well as investigating means of feeding back education and algorithms to smaller hospitals might be a meaningful way to help increase capacity of the system overall while also staying true to the ideals of education and advocacy. In addition, we discussed the possibility of increasing the role of non-surgeons in trauma care, ways of expanding our current trauma systems to address these needs and continuing to come back to guiding principles surrounding equity, access, education, and injury prevention. It is clear to me from chatting with Dr. Kerby that there are so many areas of care that the COT is involved with nurturing, developing, and critically appraising that I cannot begin to list them all here. It is truly astounding to hear Dr. Kerby describe all the ways in which the COT is working on projects in each of its pillars of advocacy, trauma systems, education, and quality. What is also clear to me is all the ways that the COT has been a part of my surgical training and practice thus far, whether or not I fully realized it, and also inspired me to be more intentional about my own involvement in the COT.
Finally, we discussed ways in which the COT and the AAST are aligned in their missions. There is, invariably, a lot of cross talk between our two organizations. Dr. Kerby was quick to identify the AAST as our profession’s premier scientific organization, and a forum for sharing discoveries that help inform improvement in trauma care delivery. Given that leaders within the AAST are often also leaders within the COT, and given the natural exchange of ideas and projects between our organizations, much of the work from one organization naturally leads to work taken up by the other. As an example, Dr. Kerby cited interest in further exploring what a 1.0 full time employee (FTE) looks like for a trauma center, and how best to staff a trauma center or group. Given that the ability of the COT to conduct work in this area is limited, this was an idea that was shared with a working group of the AAST to tackle. Likewise, the scientific forum that the AAST offers allows the propagation of new science and new ideas that helps the COT better analyze the care delivery as seen in center verification, for instance.
Throughout our conversation, a theme that Dr. Kerby and I both returned to is the ongoing effort by both organizations to share more broadly how they work, how interested people can volunteer and get involved, how the leadership structure is organized, and how to ascend the ranks of either organization. Just as the COT has taken pains to more clearly provide paths to participation and portals of entry into serving the committee, so too has the AAST expanded its membership and worked to make more transparent how the larger organization functions. When asked about advice to our younger members, Dr. Kerby shared the following: “The COT really needs to be a part of your career. If you look at the history of our organization… our role in education, advocacy, injury prevention, and trauma systems… we’ve always had a really strong ‘why’ for the work we’re doing.” It’s clear from my discussion that there are so many different ‘pathways and portals’ that each of us should be intentional about our work with this vibrant and exciting organization. I left our chat excited about new opportunities to serve my community and my patients, and I believe that increasing my own participation in the COT can help achieve my own personal and professional goals.
World Trauma Congress
The 6th World Trauma Congress
Written by: Miloš Buhavac, MD
My trip to the WTC congress came by way of my mentor Dr. Coimbra. He has helped me in my career on several occasions, providing advice on several things. I had been working on several research projects and thought that the WTC would be great opportunity to springboard the team's research and intent to improve our academic standing on a stage that would include not just national experts in trauma here in America but also globally.
The largest difference is the breadth of practice. Although not necessarily as scientifically focused, WTC offered an excellent opportunity to learn how different practitioners around the globe take care of patients and tackle the problem of trauma. This forum allows everyone to think differently and see if they can apply the lessons they have learned at WTC to their own practice. Truly the most collaborative and educational meeting I have been to.
I was truly honored to be able to bring two emergency medicine residents, Dr. Andrea Weitz and Dr. Cameran Mecham, with me to discuss a project on education and assessment tools in trauma training during ER resuscitations. The project was conceived, designed and performed at our home institution and we now have other centers also wishing to enroll and use our system. This was the first time our relatively new ER residency presented academic work. I also gave a presentation on an ongoing scoping review I am conducting on prehospital resuscitation and was able to learn from my colleagues around the world on how this practice varies and take away some things that will hopefully make our practice better.
The highlight of course was the series of talks from our colleagues in Ukraine. It is easy to practice medicine when it is safe, comfortable, resource abundant and you are getting reimbursed. These talks reaffirmed to myself and I think everyone in the room, that we took an oath to help those in need, when it is easy or hard, safe or dangerous, reimbursed or done for free. There is nothing glamorous about war, no winner or loser, only tragedy. Although every conflict brings innovation and learning in trauma, it comes with the greatest of prices, we should therefore strive to learn as much from the civilian trauma world so that we can help when the time inevitably comes.
World Trauma Congress
Ichigo Ichie at the 6th World Trauma Congress
Written by: Nicole Fox, MD
On August 9th, 2023 the 6th World Trauma Congress commenced in Tokyo, Japan. The mission of the WTC is “the establishment of sustainable trauma care across the globe.” To fulfill that mission, representatives from across the world gathered to collaborate, educate and advance trauma care at the Keio Plaza Hotel. The meeting brought to life a Japanese concept called “Ichigo Ichie” which translates roughly into “one moment, one lifetime.” It describes the fact that each moment in our life happens only once. If we let it slip away, we lose it forever. Ichigo Ichie is often spoken in Japan when greeting someone or saying goodbye, to convey that the encounter is unique and special. The WTC reflected Ichigo Ichie as experts in trauma care discussed a range of topics including the Russian invasion of the Ukraine, trauma survivorship, women in trauma surgery and trauma prevention. The AAST, ACS and EAST sent representatives from their respective organizations to participate as speakers, moderators and guest lecturers. Dr. Eileen Bulger, president of AAST moderated engaging sessions on Women in Trauma Surgery and Trauma Systems in the World. In the spirit of Ichigo Ichie this was a unique opportunity to speak to Dr. Bulger about our field, the AAST presidency and her plans for the future.
- After your AAST presidential year ends what is next on the horizon?
As a Past-President, I will continue to work with the AAST Board in the implementation of our strategic planning initiatives for this year which are focused on building community in the AAST. I will also continue to support ongoing development of the AAST Leadership Academy which we are launching at the annual meeting. I continue to serve as the Medical Director for Trauma Programs at the ACS and in that role am excited about launching our multidisciplinary Healthcare Coalition for Firearm Injury Prevention this fall and continuing our efforts to advocate for a National Trauma and Emergency Preparedness System. I will also enjoy continuing to work with the Coalition for National Trauma Research to strengthen the infrastructure to support advances in trauma research.
- What major changes do you see occurring in our field over the next 5 years?
I am encouraged by the growing interest in Acute Care Surgery as a profession and the growing number of women entering our field. I think the value of ACS services to hospitals will be increasingly recognized as the primary service managing not only trauma and critical care but responsible for all emergency general surgery and surgical rescue. I believe there is opportunity to continue to expand this skill set and in the next 5 years we will see increasing use of ECMO as a mechanism of patient rescue which should be led by Acute Care Surgeons. I also think the incorporation of AI technology will be useful to support decision support and standardization of care and in the development of advanced monitoring systems to identify patients at risk of deterioration in the hospital and ACS researchers will be at the forefront of the development of these programs. Finally, I think we will see a continued focus on all of the factors impacting the long-term recovery of our patients including the social determinants of health and health disparities. I think we will continue to see the growth of violence intervention programs and trauma survivor clinics and strategies to incorporate social care into medical care. Acute Care Surgeons are driving this change as well.
- As a division chief what issues do you think challenge your faculty the most?
I think the greatest challenge continues to be work -life integration and how we can best support faculty over the course of their career.
- What do you believe is the key to a sustainable career in our field?
I think one of the great things about a career in ACS is the opportunity to evolve one’s career over time and rise to leadership positions in the hospital and healthcare system. We need to continue to focus on defining standards for our field including defining expected clinical FTE and ensure opportunities for faculty to engage in emergency and elective general surgery as desired. I think engagement in our professional societies such as the AAST provides opportunities for ongoing growth and building relationships with colleagues across the country which is extremely rewarding. We should continue to work on building a welcoming, inclusive ACS Community where we can work together to advance the care of our patients and support each other at the same time.
The next WTC will be held in conjunction with the meeting of AAST in Las Vegas in September of 2024. It promises to be another opportunity to experience Ichigo Ichie and collaborate to advance the care of trauma patients worldwide.
World Trauma Congress
Learning from an Internationally Renowned Leader in Acute Care Surgery: An Interview with Dr. Raul Coimbra
Written By: Rachel L. Choron, MD FACS
1. Looking back on your career, what early academic roles (both locally and nationally) provided you with the experience and opportunity to ultimately become the Surgeon-in-Chief of Riverside University Health System Medical Center and the Editor-in-Chief of the Journal of Trauma and Acute Care Surgery?
These two positions require different skill sets from a technical point of view, while the leadership skills are similar. The Surgeon-in-Chief position was a natural evolution of technical and leadership opportunities that happened over time (ICU Director, Trauma Associate Director, Trauma Director, Department of Surgery Executive Vice-Chair) over a two-decade-long career in the same hospital. In parallel, I always maintained a very busy clinical and scientific activity. Being recognized as a competent surgeon and a prolific scientist with marked consistency throughout the years helped me tremendously to become the Editor-in-Chief of JTACS. Mentorship played a fundamental role in everything I did in my professional career.
2. As the Director of the Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), what advice do you have for early career surgeons trying to build their own research centers or labs?
These are the critical steps, in my opinion: Find a good, dedicated mentor and stick to the individual (these are lifetime two-way relationships), start small but think big, adapt to the environment you are in, join others and collaborate, always try to contribute so others will help you when you need it. Funding is essential but should not be a reason for personal and mental suffering. Explore internal grants and scholarships from professional organizations, and never underestimate the power of philanthropy to fund your research initially or your center later in life.
3. As a Surgeon-in-Chief and Professor of Surgery who successfully acts in many leadership roles, how do you balance the quadruple threat: administrative, education, research, and clinical efforts?
I am unsure if I have the correct answer to this question because I do not know if there is one. Time management and setting priorities are two essential skills a person must have to be successful. Working in teams and learning how to delegate is also critically important. Nobody does anything alone. I had reasonable success doing all four activities, but it could have been better. Family time was compromised multiple times because of my work, but having a supportive family that understands what you do is also essential. Show up early, be always ready and prepared for meetings, and try to do your best every single day.
4. As Past President of AAST, how did your early path through involvement in the organization help lead to future career successes in the society? Were there any challenges or obstacles you faced along the way?
The trauma surgery community is like a big family. Always living on the West Coast, I did not take advantage of EAST membership as a junior attending, so under the guidance of my mentor (Dr. Hoyt), I started at the local COT in San Diego instead as vice-chair, eventually advanced to chair, and met many people already participating in the AAST that were a bit older than me. Also, presenting research papers at the annual meeting of the AAST was very valuable in meeting the leaders of American Trauma Surgery. However, at the end of the day, you have to develop your reputation as a team player, a thoughtful person who delivers what you promise, and someone who completes the work you volunteered to do. You have to get your foot through the door initially and then show your value. After several years as a regular member and volunteering in committees, I was asked by the then president-elect Tim Fabian to reorganize the Multi-Institutional Trials Committee. That appointment gave me the needed exposure to the board, and from there, I was asked to serve in other positions, board appointments, chair of the program committee, and president.
5. As the Founder and Director of the World Trauma Congress, what inspired you to build this organization? And what are your goals for the organization in the future (both short and long term)?
We created the World Coalition for Trauma Care because we felt that trauma surgery needed a united voice globally. The World Trauma Congress would be the venue to come together and discuss what was essential to advance care globally, establishing personal connections, and opening the door for new collaborations and initiatives. At the time, there was some movement to develop a global strategy for trauma systems development and education at the World Health Organization. Still, we, trauma surgeons and local leaders were not initially invited to sit at the table and participate in developing those strategies. In addition, strategies are good on paper, but somebody has to do the work to implement them and follow through. Twelve years later, the World Coalition for Trauma Care has grown tremendously, the World Trauma Congress remains strong, and many international trauma organizations that are part of the coalition have markedly advanced trauma care, systems development, education, and injury prevention worldwide.
6. As the Editor-in-Chief for JTACS, are there any specific original research topics you would like to see addressed in the near future by investigators for submission to the journal? In your expert opinion, what are some of the biggest problems facing our trauma and critically ill patients today and what would you like investigators to focus on?
This is a difficult question. I have an open mind about science (even being a basic scientist for most of my career)!!!. The journal is always interested in high-quality, impactful research, whether it is clinical, epidemiological, basic science, or translational. We need more clinical trials. We must continue to conduct basic science research to test new discoveries in clinical trials. I would like to see the Journal having its fair share of those studies. Another area in comparative effectiveness research. Now that the development of EGS as an area of focus in Acute Care Surgery has been completed with the launch of the EGS verification program, we have many opportunities to define the best therapies for EGS diseases. I would also welcome more surgical critical care studies that are robust and relevant to change or better define practice in the ICU. Finally, there has been high interest in disparities, injury prevention, and global trauma research. I support all of those fields. However, we must go from problem identification (which we have done well for the past 30 years) to practical (and tested) ways to mitigate some of those problems. Problem identification without a proposal of solutions is not what we are interested in the Journal.
7. Who were your mentors and sponsors, and what are the top 3 things you learned from them that you continue to pass on to your mentees?
My two primary mentors are Dr. David Hoyt and Dr. Samir Rasslan from Brazil. I learned from them the importance of developing a critical mind and the curiosity that researchers should have. They taught me the importance of being tough but fair, working in teams, helping others, being transparent and straightforward, and thinking about the team first. I also learned from them that persistence, accountability, dependability, and, most importantly, honesty are critical traits of a leader. These are the things I pass along to my mentees and young partners.
In my presidential address to the AAST in 2017, I also listed several impactful “Influencers”. These are individuals who developed an interest in me for what I am and helped me without asking for anything in return: Ron Mayer, L.D. Britt, Tim Fabian, David Feliciano, and Tim Eberlein. I have been blessed with the opportunity to develop many friendships over the years by participating in the AAST. It is impossible to list all of them. Still, I have to mention two because of the impactful work we did together: one in the COT, one in the Panamerican Trauma Society, and more recently in the development of the Emergency General Surgery Course: Michael Rotondo and Andy Peitzman.
SAFER conference
Navigating the Path to Equitable Trauma Care
Written By: Vanessa Ho , MD, MPH
My journey into the realm of trauma equity was sparked by the stark disparities I encountered in my role as an Asian female surgeon at urban safety net hospitals. These inequities, whether gender-based, racially influenced, tied to socioeconomic factors, or evident in the career paths of the professionals around me, ignited a fire within me to drive change. It was this passion that ultimately led to the impetus to develop SAFER-Trauma (the Summit for the Advancement of Focused Equity Research in Trauma).
SAFER-Trauma was a collective effort propelled by the Equity, Diversity, and Inclusion (EDI) Committee at CNTR, where I serve as the committee chair. Drawing together representatives from diverse trauma societies across disciplines, our committee undertook the task of envisioning a summit that would not only bring to light the gaps in equity research but also inspire collaborative initiatives. Our R13 conference proposal for SAFER-Trauma was awarded by the Agency for Healthcare Research and Quality on the first submission. The summit itself, held in August 2023, was a dynamic evolution, growing from a mere concept to an opportunity to brainstorm on ways to encourage collaboration between attendees to unearth disparities, share insights, and lay the groundwork for future research opportunities.
The landscape of equity research and practice applications in trauma care is not without hurdles. Systemic biases, resource disparities, and underrepresentation remain persistent challenges. Equity research encounters obstacles in data collection and interpretation, which can hinder the development of effective interventions. Yet, amidst these challenges, there are inspiring successes. Each success has grown from seeds planted and tended to by individuals who are passionate about driving change.
SAFER-Trauma has significantly complemented and influenced my practice as an academic trauma surgeon. Through networking, sharing research insights, and engaging in candid discussions, the summit enriched my understanding of equity challenges. These insights have informed my clinical and research practices, driving me to tailor patient care strategies to mitigate disparities and champion inclusivity.
Others seeking involvement in similar endeavors can explore pathways through professional networks, such as those at the AAST. I would highly encourage those passionate about DEI to join the initiatives that resonate with their convictions and seek mentors in these spaces. There is much work to be done.