Episoder
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The dreaded esophageal injury. Do you still have nightmares about mock oral board scenarios torturing you with the ins and outs of how to manage traumatic esophageal injury? Think you remember all the nuances? Whether you do or you don’t, this episode should serve as a good refresher for all levels while offering some pearls for management of this tricky scenario.
Hosts:
- Michael Cobler-Lichter, MD, PGY4/R2:
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@mdcobler (X/twitter)
- Dylan Tanzer, MD, 2nd-year Trauma/Surgical Critical Care Fellow
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
- Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending:
Loma Linda University
Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship
- Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 5 years in practice
University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
@jpmeizoso (twitter)
Learning Objectives:
- Describe the diagnostic workup of a suspected traumatic esophageal injury
- Identify when someone with suspected esophageal injury needs immediate surgical management
- Describe appropriate surgical techniques for repair of both cervical and thoracic esophageal injuries
Quick Hits:
1. Don’t forget the primary survey. Unstable patients should be in the OR, as should patients with hard signs of vascular or aerodigestive injury
2. If there is concern for esophageal injury but no immediate indication for the OR, this should be further investigated with CTA of the affected area. Clinical exam has poor sensitivity.
3. The esophagus should be primarily repaired if the defect is able to come together without tension after debridement. Don’t forget a well-vascularized buttress
4. If you cannot perform a primary repair, your procedure of choice should be lateral esophagostomy with feeding jejunostomy and gastrostomy for decompression. Repair over T-tube can be considered for injuries with small amounts of tissue loss
References
1. Biffl WL, Moore EE, Feliciano DV, Albrecht RA, Croce M, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Diagnosis and Management of Esophageal Injuries. J Trauma Acute Care Surg 2015;79(6):1089-95.
https://pubmed.ncbi.nlm.nih.gov/26680145/
2. Sperry JL, Moore EE, Coimbra R, Croce M, Davis JW, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Penetrating Neck Trauma. J Trauma Acute Care Surg 2013;75(6):936-40.
https://pubmed.ncbi.nlm.nih.gov/24256663/
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
You have a patient with another episode of acute uncomplicated diverticulitis. This is the third episode. Do they need antibiotics? Is surgery the next step? What is their risk of recurrence with or without surgery? Tune in to find out!
Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jason Hall MD, MPH as they discuss high yield papers discussing diverticulitis.
Learning Objectives:
1. Describe the impact on quality of life for patients who undergo surgery or non-operative management of diverticulitis
2. Discuss the indications for surgery in patients with diverticulitis
3. Describe ongoing clinical trials in management of diverticulitis
**Video Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-diverticulitis
References:
Santos A, Mentula P, Pinta T, et al. Quality-of-Life and Recurrence Outcomes Following Laparoscopic Elective Sigmoid Resection vs Conservative Treatment Following Diverticulitis: Prespecified 2-Year Analysis of the LASER Randomized Clinical Trial. JAMA Surg. 2023;158(6):593–601. doi:10.1001/jamasurg.2023.0466
https://pubmed.ncbi.nlm.nih.gov/37074706/
Bolkenstein HE, Consten ECJ, van der Palen J, van de Wall BJM, Broeders IAMJ, Bemelman WA, Lange JF, Boermeester MA, Draaisma WA; Dutch Diverticular Disease (3D) Collaborative Study Group. Long-term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis: 5-year Follow-up Results of a Multicenter Randomized Controlled Trial (DIRECT-Trial). Ann Surg. 2019 Apr;269(4):612-620. doi: 10.1097/SLA.0000000000003033. PMID: 30247329.
https://pubmed.ncbi.nlm.nih.gov/30247329/
Hall J, Hardiman K, Lee S, Lightner A, Stocchi L, Paquette IM, Steele SR, Feingold DL; Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020 Jun;63(6):728-747. doi: 10.1097/DCR.0000000000001679. PMID: 32384404.
https://pubmed.ncbi.nlm.nih.gov/32384404/
Hall JF, Roberts PL, Ricciardi R, Read T, Scheirey C, Wald C, Marcello PW, Schoetz DJ. Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence? Dis Colon Rectum. 2011 Mar;54(3):283-8. doi: 10.1007/DCR.0b013e3182028576. PMID: 21304297.
https://pubmed.ncbi.nlm.nih.gov/21304297/
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Manglende episoder?
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We are seeing a 42F in the emergency room who underwent a laparoscopic sleeve gastrectomy 11 days ago. The operation was uneventful, and she had a negative airleak test. She had an uneventful postoperative course and was discharged on POD 1. Her medical history is significant for hypertension and hyperlipidemia, and he has no other surgical history. She has been able to keep up with her clear liquid diet. She complains that this morning she experienced abdominal and palpitations. You note her vitals show a mildly elevated blood pressure and her latest heart rate is 120s. Join Drs. Matthew Martin, Adrian Dan, Crystall Johnson-Mann, and Paul Wisniowski on a discussion about initial evaluation and management of bariatric patients with internal hernias.
Show Hosts:
Matthew Martin
Adrian Dan
Crystal Johnson-Mann
Paul Wisniowski
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
In this episode, we have a discussion about the intersection of health design/architecture and surgery with Dr. Andrew Ibrahim, a trained architect and practicing general surgeon and health services researcher. We discuss how hospitals, ICUs, operating rooms, and trauma bays are designed and the evidence behind them.
Host: Cody Mullens, general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens)
Guest: Dr. Andrew Ibrahim. Associate Professor of Surgery at the University of Michigan, Maud T. Lane Research Professor, Co-Director for the Center for Healthcare Outcomes and Policy. (@AndrewMIbrahim)
Guide to hospital design on Dr. Ibrahim’s website: https://www.surgeryredesign.com/resources
Paper on measuring hospital design and quality of care using clinical data: https://shmpublications.onlinelibrary.wiley.com/doi/full/10.1002/jhm.12987
Science paper: https://www.science.org/doi/10.1126/science.6143402
CHEST paper: https://secure.jbs.elsevierhealth.com/action/getSharedSiteSession?redirect=https%3A%2F%2Fjournal.chestnet.org%2Farticle%2FS0012-3692%2810%2960225-5%2Ffulltext&rc=0
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
In this episode, Dr. Scott Butsch from the Cleveland Clinic’s Bariatric and Metabolic Institute discusses the evolving landscape of obesity medicine. He covers the history of obesity treatments, from behavioral interventions to groundbreaking medical therapies like GLP-1 receptor agonists and their future potential. The conversation also explores the challenges of bias, accessibility, and the integration of medications with surgical options for effective, long-term obesity management.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
In this, the fourth of 4 in our “What’s Your Worth” series, Matt and Mark discuss various compensation models including salary and hybrid models (e.g., productivity, quality-based, incentive-based) and fee-for-service. In addition, other variables that can be included in your contract when comparing jobs are covered (time away, professional fees, benefits, vacation). Finally, our guests cover aspects to think about when the job is not working out and you may need to leave an organization.
Matthew J. Donnelly, Esq,, Executive Director, Professional Staff Affairs, Cleveland Clinic, Cleveland, OH. https://my.clevelandclinic.org/about/overview/leadership/executive/donnelly-matt; Linkedin: https://www.linkedin.com/in/matthew-j-donnelly/
Mark Elinsky, Director, Professional Staff Compensation and Analytics, Cleveland Clinic, Cleveland, OH
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General.
Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios.
El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito.
La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen.
Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a [email protected] y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español.
presentadores de podcast:
- Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University.
- Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador.
Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes.
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Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week.
Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors.
The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test.
Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing [email protected] and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish.
Hosts:
- Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University.
- Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
In the third episode in our 4 part “What’s Your Worth” series, Lauren covers the hospital-side of finances, going through the world of financial literacy. In this episode, basic definitions and importance of income statements, metrics of financial performance, and others including revenue and expenses are reviewed. She also provides an inside view as to considerations that hospitals have to take into account for the overall financial portfolio and how that may play into determining salaries, wages, and benefits.
Lauren Klein, MAcc, CPA, Executive Director, Financial Operations, Main Campus Submarket, Cleveland Clinic, Cleveland, OH.
Linkedin: https://www.linkedin.com/in/lauren-klein-cpa-67787213/
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General.
Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios.
El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito.
La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen.
Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a [email protected] y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español.
presentadores de podcast:
- Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University.
- Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador.
Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes.
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Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week.
Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors.
The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test.
Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing [email protected] and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish.
Hosts:
- Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University.
- Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General.
Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios.
El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito.
La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen.
Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a [email protected] y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español.
presentadores de podcast:
- Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University.
- Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador.
Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes.
------
Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week.
Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors.
The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test.
Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing [email protected] and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish.
Hosts:
- Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University.
- Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
This second episode of our 4 part "What’s Your Worth” series picks up what Dr. Maykel left off. Strategies regarding contracts and what can be negotiated into your contract are reviewed. In addition, gender-equity differences are discussed, as well as strategies to approach your contract negotiations depending on the stage in your career.
Justin A. Maykel, MD - Chief, Division of Colorectal Surgery, UMASS Medical Center, Worcester, MA.
https://www.ummhealth.org/about-us/our-caregivers/caregiver-justin-maykel-md-colorectal-surgeon-chief-division-colorectal-surgery
X; @JustinMaykel
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General.
Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios.
El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito.
La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen.
Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a [email protected] y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español.
presentadores de podcast:
- Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University.
- Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador.
Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes.
------
Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week.
Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors.
The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test.
Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing [email protected] and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish.
Hosts:
- Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University.
- Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
Our first episode in our 4 part "What’s Your Worth” series introduces some of the basics of identifying all that factors that go into determining your worth as a surgeon. Topics vary from your “value" (ie., contribution margin, profit margin), revenue structure, hospital costs, and value based case. Further, Dr. Maykel covers how physician salaries are determined, average salaries across a spectrum of disciplines, and resources to find out more.
Justin A. Maykel, MD - Chief, Division of Colorectal Surgery, UMASS Medical Center, Worcester, MA.
https://www.ummhealth.org/about-us/our-caregivers/caregiver-justin-maykel-md-colorectal-surgeon-chief-division-colorectal-surgery
X; @JustinMaykel
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen -
In this episode, we review key components of the landmark MAGIC and FLOT-4 trials that investigated perioperative chemotherapy in the treatment of locally advanced gastric cancer. We discuss limitations of both trials and the evolving clinical landscape of gastric cancer treatment.
Hosts:
- Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist/HPB surgeon at Brooke Army Medical Center.
- Daniel Nelson, DO, FACS (@usarmydoc24) is a Surgical Oncologist/HPB surgeon at Kaiser Permanente Los Angeles Medical Center.
- Connor Chick, MD (@connor_chick) is a Surgical Oncology Senior Fellow at Ohio State.
- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology Junior Fellow at MD Anderson Cancer Center.
- Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center.
Learning Objectives:
1. Understand background, methodology, results, and interpretation of the MAGIC trial.
2. Understand background, methodology, results, and interpretation of the FLOT trial.
3. Be able to discuss the evolution of chemotherapeutic regimens in the treatment of locally advanced gastric cancer and rationale for their use.
4. Be able to describe key limitations for the above regimens.
5. Discuss the the evolving clinical landscape for chemotherapy in gastroesophageal junction tumors.
Links to Papers Referenced in this Episode:
Journal Articles:
Cunningham, D., Allum, W. H., Stenning, S. P., Thompson, J. N., Van de Velde, C. J., Nicolson, M., ... & Chua, Y. J. (2006). Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. New England Journal of Medicine, 355(1), 11-20.
https://pubmed.ncbi.nlm.nih.gov/16822992/
Al-Batran, S. E., Homann, N., Pauligk, C., Goetze, T. O., Meiler, J., Kasper, S., ... & Hofheinz, R. D. (2019). Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. The Lancet, 393(10184), 1948-1957.
https://pubmed.ncbi.nlm.nih.gov/30982686/
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Is the medical publishing industry a scam? As the open access model has grown, pay-to-publish has helped large publishers maintain profit margins similar to that of large tech companies. The problem? They do so by exploiting the blood, sweat, and tears of academics and the institutions that support them. Join Dr. Patrick Georgoff (@georgoff, Duke Surgery), Dr. Ayman Ali (BTK education fellow, Duke Surgery), and special guest Dr. Allan Detsky for an engaging discussion.
Paper discussed: The Changing Medical Publishing Industry: Economics, Expansion, and Equity (https://link.springer.com/article/10.1007/s11606-023-08307-z)
DR. ALLAN S. DETSKY, MD, PhD, FRCPC, CM is Professor, Institute of Health Policy, Management and Evaluation, and Department of Medicine at the University of Toronto; former Physician-in-Chief, Mount Sinai Hospital(1997-2009); and former Head of the Division of General Internal Medicine at The Toronto Hospital and University of Toronto (1987-1997). Dr. Detsky received his B.S. from Massachusetts Institute of Technology, his M.D. from Harvard Medical School, and his Ph.D. (in Economics) from Massachusetts Institute of Technology in 1978. He has served on the editorial board of the New England Journal of Medicine, and as a member of the Drug Quality and Therapeutics Committee for the Province of Ontario where he spearheaded the effort to formally include cost-effectiveness considerations into the Canadian drug reimbursement process. Dr. Detsky has received 2 Tony nominations as a producer (Jesus Christ Superstar 2012, Come From Away 2017 and an Olivier Award for Best Musical in 2018. In June 2018, he was appointed by the Governor General to the Order of Canada.
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Welcome to the first episode of our new collaborative series with the Association of Surgeons in Great Britain and Ireland! During this series, BTK fellow Jon Williams and ASGBI hosts Kellie Bateman and Jared Wohlgemut compare and contrast the surgeon profession between the United States and the United Kingdom, debating who does what better. In this episode, we take a deep dive into surgical training in the US and the UK, from fostering student interest to trainee operating to specialization and certification. Dr. Jeremy Lipman represents the US while Dr. Jon Lund represents the UK in this thought-provoking conversation.
Dr. Lipman is a colorectal surgeon at the Cleveland Clinic and the director of graduate medical education for all training programs at the Cleveland Clinic. Additionally, he is an Associate Dean for Graduate Medical Education and Professor of Surgery at Case Western Reserve University. After going to Boston College for his bachelor degree, he obtained his medical degree from Drexel University College of Medicine in Philadelphia. Subsequently he completed his general surgery residency training at Case Western and his colorectal surgery fellowship at Cleveland Clinic. After practicing at MetroHealth Medical Center where he served many training and education leadership roles, he returned to Cleveland Clinic as faculty where he remains today.
Dr. Lund is Professor and Head of the Department of Surgery at University of Nottingham at Derby, and Consultant Colorectal Surgeon at Royal Derby Hospital. He is Chair of the Joint Committee on Surgical Training, and before that was Surgical Director of the Intercollegiate Surgical Curriculum Programme, the online training management system used by all trainees and trainers in Surgery in the UK. He has recently been appointed as Dean of education at the Royal College of Surgeons of Edinburgh.
So, who trains surgeons better? UK or US? Give the episode a listen and decide for yourself!
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In this episode, podcast hosts Dr. Josh Roshal, Dr. Darian Hoagland, and Dr. Maya Hunt dive into two important papers that provide guidance on navigating the hidden curriculum of the surgical residency match process. Joined by fellow CoSEF members Dr. Ariana Naaseh and Dr. John Woodward, the discussion revolves around practical tips for finding your perfect surgical residency and filtering out the noise during the application process.
Journal Club Hosts:
–Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, [email protected]
–Dr. Darian Hoagland, Beth Israel Deaconess Medical Center, @DHoaglandMD, [email protected]
–Dr. Maya Hunt, Indiana University, @dr_mayathehunt, [email protected]
–CoSEF: @surgedfellows, cosef.org
Journal Club Authors:
-Dr. Ariana Naaseh, Washington University in St. Louis, @ariananaaseh, [email protected]
-Dr. John Woodwad, University at Buffalo, @JohnWoodward76, [email protected]
Medical Students:
-Rachel Kalbfell (MS4), Washington University in St. Louis, @rachelkalbfell, [email protected]
-Keith Makhecha (MS4), Indiana University, [email protected]
References:
1. Woodward JM, Lund S, Brian R, Anand A, Moreci R, Navarro SM, Zarate Rodriguez J, Naaseh A, Tate K, Roshal J, Silvestri C, Gan CY, Sathe T, Thornton SW, Cloonan M, Weaver L, Oh MH, Godley F, L’Huillier JC. Find Your Perfect Match for Surgical Residency: Six Steps to Building Your BRANDD from the Collaboration of Surgical Education Fellows. Annals of Surgery. 2024;5(3). doi:10.1097/AS9.0000000000000466.
2. Naaseh A, Roshal J, Silvestri C, Woodward JM, Thornton SW, L’Huillier JC, Hunt M, Sathe TS, Hoagland DL, Godley F IV, Jindani R, Tieken KR, Rodriguez JGZ, Anand A, Chen JH, Navarro SM, Lund S. Filter Out the Noise: How to Narrow Your Search for the Perfect Match by the Collaboration of Surgical Education Fellows (CoSEF). Journal of Surgical Education. 2024;81(10):1394-1399. doi:10.1016/j.jsurg.2024.07.010
https://pubmed.ncbi.nlm.nih.gov/39178489/
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Low urine output – when is it a cause for alarm? Emma Burke is joined by Dr. Bryan Tucker to discuss quick hits on acute kidney injury as part of the Med/Surg Consult series.
Host:
- Emma Burke, MD – General Surgery Resident at Baylor College of Medicine, @emmaburke017
Guest:
- Bryan Tucker, DO – Nephrologist at Baylor College of Medicine, @bmtucker3
Learning Objectives:
- Define acute kidney injury (AKI) using KDIGO guidelines.
- Develop a framework for initial workup of perioperative AKI.
- Discuss the importance of in urine output in AKI management.
- Identify AKI risk factors and preventative measures for high-risk surgical patients.
References:
- KDIGO AKI Guidelines: https://kdigo.org/guidelines/acute-kidney-injury/
Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
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DOMINATE THE DAY -
Welcome to another episode of our medicine-surgery consult series! If your case was just cancelled because you and your patient did not know to hold their new GLP-1 agonist and you’re wondering what to do in the interim, this may be the perfect time to tune into a quick refresher of diabetes quick-hits as it pertains to surgical teams.
You’ve just finished rolling a patient up to the OR in the middle of the night after a gunshot wound to the chest, and now you need to deal with something even more intimidating – finishing admission orders on your patient with chronic, poorly controlled diabetes on 7 different medications. Join Dr. Katherine Neal and Ayman Ali as they go over some general principles and tips and tricks in this ever-growing and complicated patient cohort!
Hosts:
Katherine Neal, MD. Assistant Professor of Medicine, Duke Hospital.
Ayman Ali, MD. General Surgery PGY-3, Duke University School of Medicine.
Learning Objectives:General principles of in-patient diabetes managementReview of common medications and their side effectsLearn some common pitfalls and how to avoid them
Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
DOMINATE THE DAY -
You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards.
Hosts:
- Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska
- Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95
Learning Objectives:
- Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting.
- Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation.
- Identify common risk factors for atrial fibrillation in the post-operative setting.
- Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery.
References:
1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal. 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004
https://pubmed.ncbi.nlm.nih.gov/23194493/
2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA. 2014;312(6):616. doi:10.1001/jama.2014.9143
https://pubmed.ncbi.nlm.nih.gov/25117130/
3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921.
https://pubmed.ncbi.nlm.nih.gov/14678921/
4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine. 2002;347(23):1825-1833. doi:10.1056/nejmoa021328
https://pubmed.ncbi.nlm.nih.gov/12466506/
Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
DOMINATE THE DAY - Vis mere
