Cross training promotes broader perspective

From the Department of Surgery 2012 Annual Report

Transplant FellowshipHepatobiliary surgeon Steven Strasberg, MD, mentors transplant fellow Yiing Lin, MD, PhD, as part of a new crosstraining program that gives fellows in both of these specialties a broader understanding of the other service.A new arrangement between two fellowship programs — transplant surgery and hepatobiliary pancreatic (HPB) surgery — allows trainees to spend a two-month rotation cross training on the other service. The arrangement has broadened trainees’ perspectives and strengthened both programs, according to fellows and program leaders.

The approach makes sense because the two specialties are closely related and treat many similar conditions, especially in the area of liver disease.

“I spent several weeks with each of the HPB surgeons and participated in liver, pancreas and bile duct surgeries,” says Yiing Lin, MD, PhD, who completed the transplant fellowship in June 2012 and has since joined the transplant faculty. “There are some unique aspects to surgery with both groups. For example, with liver transplants, the way transplant surgeons handle and cut through the liver is different than the techniques used by non-transplant hepatobiliary surgeons.”

Lin says he also gained valuable experience in working with cancer patients during all phases of treatment.

“How they deal with issues in their specialty really informs the way I am going to practice in the future,” says Lin.

Kamran Idrees, MD, who completed an HPB fellowship in 2012, helped procure organs from donors with irreversible brain damage at Mid-America Transplant Services in St. Louis and also took part in liver, kidney and pancreas transplants.

Idrees says even the kidney transplants were valuable because they involved sewing blood vessels and creating anastomoses, or connections, between vessels, which is also required during pancreas tumor removal. By participating in transplant conferences, he also developed critical thinking skills that will allow him to assess the appropriate treatment for liver cancer patients, with options such as resection or downstaging the cancer before transplant.

William C. Chapman, MD, chief of the Section of Transplant Surgery and the Eugene M. Bricker Professor of Surgery, says the Transplant Fellowship is the first in the United States to offer certification by both the American Society of Transplant Surgeons and the American Hepato-Pancreato-Biliary Association. The cross-training has helped make both fellowships highly competitive, which is especially important in the transplant field, where a number of fellowships go unfilled. This is partly because prospective fellows see that the number of openings for transplant surgeons is limited by the scarcity of donor organs.