Jim Rutka’s Annual State of the Department Address

“The top priorities for the academic year 2012-13 were successfully achieved, as all programs passed the Royal College Review, we surpassed last year’s record of grant capture and peer reviewed publications, and we successfully promoted many faculty to a higher rank. We implemented the Strategic Plan to reach our year 1 milestones and had a very successful advancement campaign to fund departmental initiatives. We are especially indebted to the excellent work of Ron Levine and David Latter and our Program Directors in getting all of our residency programs accredited. The Royal College commented that there were great strengths and very few weaknesses requiring attention. Excessive service demands continue at four of our hospitals, interfering with the ability of residents to access educational opportunities in some rotations, and providing less than optimal access to procedural experiences in the operating room for the junior residents.

“The pager problem was highlighted. In one institution there were 21,000 pages on the general surgery service over a six month period. That averages out to 115 pages per day. The reasons for these pages are often insignificant, and smart phones are an important part of the solution. In addition, we will benefit from adding more hospitalists to provide full time care to inpatients. Physicians Assistants have become very helpful at Mount Sinai Hospital, where they logged 113 hours compared to the 256 hours logged on services without physician’s assistants. The range of assistants includes physician- assistants, nurse practitioners, hospitalists, and navigators. The conclusions from our review were that consecutive number of hours worked is the important variable. Tired doctors are not necessarily unsafe doctors and restriction of duty hours is not necessary for patient safety. Suboptimal patient care and educational outcomes result in surgery from resident duty hour restrictions. Resident duty hour regulation necessitates reorganization of human resource deployment and care delivery. A Procedural Disciplines Taskforce has been formed by the Royal College of Surgeons of Canada headed by Najma Ahmed, and includes Nir Lipsman, Stan Feinberg, Jefferson Wilson, Todd Mainprize, and Ab Kulkarni. The taskforce has concluded that one size does not fit all specialities.

“We anticipate budgetary constraints in the upcoming academic year as we develop the Department of Surgery Prep Camp, the Surgeon Scientist training program, the Stewart building move and recruitment of a new Chief of Critical Care Medicine within the Department of Surgery. The faculty salaries have been harmonized under the leadership of Robin Richards. The details of this support are described on our website.” Important contributions of our Executive Committee, Division Chairs, Surgeons-in- Chief and research and education team and administrative staff were acknowledged. The promotions are listed in a separate article, as well as new academic appointments and awards. The Queen’s Diamond Jubilee medal recipients were presented and the remarkable harvest of external grant support celebrated. Advancement was a highlight of the year with $4.7 million contributed, nearly double the amount achieved in previous years. The international surgery experience, the welcome party for 1st year residents, and the inauguration of the Prep Camp were reviewed. The top priorities for 2013-14 include expansion of the Competency Based Assessment Programs, support of surgical-scientist trainees, increasing commercialization of surgical inventions, establishing best comprehensive quality and best practice programs across all divisions, development of departmental leaders, and building on our international outreach and global influence.

M.M.