CHAIR'S COLUMN

Academic Position Descriptions: What’s in a Name?

James Rutka

For years, the Department of Surgery has designated academic position descriptions for its full time faculty in three separate categories: 1) Surgeon-Scientist; 2) Surgeon-Investigator; and 3) Surgeon - Teacher. While these three designations encompass and represent the roles surgeons play in the Department of Surgery, and on which they are evaluated annually, with the evolution of a number of new interests amongst faculty members, these three designations now seem insufficient. For example, it became quite obvious to me that we had many surgeons who were actively engaged in global health and global surgery. In fact, some of our faculty continue to spend substantial times away from Toronto helping develop infrastructure and capacity for communities of surgeons in developing countries.

Accordingly, with the assistance of Avery Nathens, Vice Chair of Integration, the Surgeon-Global Health (SGH) position description was developed and approved. For this particular position description, the meritorious activities for a surgeon in global health were articulated. Surgeons with SGH designation may be involved in low to middle income countries (LMICs) by creating and enhancing research and clinical endeavors in these locations, training learners, creating partnerships, and creating educational infrastructure among other things. Surgeons in the SGH category would be evaluated for their impact in the field by virtue of their leadership positions locally or nationally, their mentorship of surgeons in LMIC’s, their capacity building, and their publication of scholarly works in peer reviewed journals. I am pleased to provide some references below of papers published by our faculty and residents in this regard. At the moment, several faculty members have now chosen the SGH career pathway as their primary academic job description.

More recently, the Department of Surgery has approved the Surgeon-Ethicist (SE) position description. This arose in part from the interests of Martin McKneally, Editor of the Spotlight, and colleagues who have devoted themselves to this particular topic area. In this position description, the SE is focused primarily on ethics with the objective of improving patient care and giving learners and colleagues skills for ethical reasoning. Scholarly work in this category is related to ethics in surgery. The surgeons in this category will be teaching ethics to learners across the spectrum of training. In this role, there is great opportunity to collaborate with the Joint Centre for Bioethics at the University of Toronto, to participate as a consultant to research ethics boards. In addition, such SE designees will be leading major ethics initiatives in the Department through visits and lectures. Evidence of impact for this category would include publications of scholarly works in peer reviewed journals in ethics, awards recognizing contributions made to surgical ethics, and peer reviewed funding to support ethical ethics research in the Department of Surgery.

I am delighted now that we have been able to create these two new position descriptions, which will be of great benefit to faculty members whose contributions in the Department would otherwise not be recognized in such clear terms. I am grateful to Avery Nathens for the SGH position description, and to Martin McKneally, for the SE position description which will be used now and in the future for years to come for faculty going forward for promotion.

James T Rutka, RS McLaughlin Professor and Chair,
Department of Surgery

GLOBAL HEALTH AND SURGERY REFERENCES

Cadotte DW, Blankstein M, Bekele A, Dessalegn S, Pain C, Derbew M, Bernstein M, Howard A. Establishing a surgical partnership between Addis Ababa, Ethiopia, and Toronto, Canada. Can J Surg. 2013 Jun;56(3):E19-23. doi.10.1503/ cjs.027011.

Chandauka T, Leusink A, Hsiao M, Kahn D, Azzie. The International Association of Student Surgical Societies: creation and dissemination. Can J Surg. 2016 Oct 1;59(6):816. doi: 10.1503/cjs.000816 (Epub head of print)

Cintolo-Gonzalez JA, Bedada AG, Morris J. Azzie G. An International Rotation as a Systems-Based Elective: The Botswana-University of Pennsylvania Surgical Experience. J Surg Educ. 2016 Mar-Apr;73(2):355-9. doi:10.1016/j. jsurg.2015.09.019. Epub 2015 Nov.17. Review.

Ibrahim GM, Cadotte DW, Bernstein M. A framework for the monitoring and evaluation of international surgical initiatives in low-and middle-income countries. PLoS One. 2015 Mar 30;10(3):e0120368. doi:10.1371/journal.pone.0120368. eCollection 2015

Ng-Kamstra JS, Riesel JN, Arya S, Weston B. Kreutzer T, Meara JG, Shrime MG. Surgical Non-governmental Organizations: Global Surgery’s Unknown Nonprofit Sector. World J Surg. 2016 Aug;40(8):1823-41. doi. 10.1007/ s00268-016-3486-1.

SURGEON-ETHICIST REFERENCES

Camp MW, Gross AE, McKneally MF. Patient Views on Financial Relationships between Surgeons and Surgical Device Manufacturers. Can J Surg. 2015; 58:323–9

Ibrahim GM, Bernstein M. Models of Neurosurgery International Aid and Their Potential Ethical Pitfalls. Virtual Mentor 2015. 17 (1), 49-55.

Lipsman N, Giacobbe P, Bernstein M, Lozano AM. Informed Consent for Clinical Trials of Deep Brain Stimulation in Psychiatric Disease: Challenges and Implications for Trial Design. JMed Ethics. 2012 Feb;38(2):107-11.

Snelgrove R, Ng S, Devon K. Toward a Recognition of Ethics in Everyday Practice. Journal of Graduate Medical Education: July 2016, Vol. 8, No. 3, pp. 462-464.

Suri M, McKneally M, Devon K. Tragic Knowledge: Truth Telling and The Maintenance Of Hope In Surgery. World J Surg. 2014 Jul;38(7):1626-30