Ben Alman: Training the Next Generation of Academic Surgeons

Ben Alman

Ben Alman, Vice-Chair of the Department of Surgery for Research and a distinguished paediatric orthopaedic surgeon and researcher, will leave the University of Toronto after 16 years of an exemplary career in academic surgery. He will join the faculty at Duke University as Chairman of the Department of Orthopaedic Surgery.

Ben has been a Canadian citizen for the past 5 or more years. He spent 16 years in Canada as a U.S. expatriate and has a deep affection for both countries. He describes the Department of Surgery at the University of Toronto as a “large distinguished cohort of surgeons doing the highest level of surgical science. It is like no other, and despite the flux of science and of science funding, it has grown and continues to grow.

Q: Can you compare academic surgery between Canada and the United States?

A: “Overall, at least in orthopaedic surgery, clinical practice is similar in academic centers. The community practice of orthopaedics is quite different. There is more money in healthcare in the US, but it does necessarily flow to surgeons. For instance the overhead is higher in the US. Also, because of how money follows procedures, the number of surgeries performed per population is higher. Duke has a very strong clinical orthopaedic department, and several excellent researchers. It just became a separate department, so there are unique opportunities. I will have the mandate and the resources to expand their academic activities and their clinical reach. The system in the United States, at least at Duke, is similar to ours- private practice in groups at the hospital level, integrated at the Chair of Surgery level.”

Regarding the limitation of duty hours, Ben feels that using the CBC framework (the Competency Based Curriculum) “balances this problem out. The CBC, a major advance in orthopaedic education, has transformed training practice. It has been an incredible success and this educational framework will likely become the standard in North America. The board of orthopaedic surgery is extremely enthusiastic about this model. The Program Directors’ meeting in Orthopaedic Surgery this coming year will have a special focus on the CBC, with planned participation of the many of Toronto faculty, including Markku Nousiainen, Richard Reznick, Peter Ferguson, and Ben Alman.

“The Hospital for Sick Children has been a wonderful experience. It is unique in North America. Because of its large referral net, we have the luxury of deciding how to organize practice, how to prioritize the treatments and provide optimal care for patients. My clinical practice was unique. The patients were largely ‘rare birds’ with unusual syndromes, neuro-muscular syndromes, problems of great complexity. My day to day practice included trauma, paediatric fractures, and scoliosis. The technical aspects have evolved only slightly, but it’s the thinking, that challenges the surgeon.

from left to right: Ben Alman with his wife Zena and their children Joshua and Sophie

Q: What are your interests other than science and surgery?

A: “I like to read.” There is a Chekhov short storybook on his office shelf. He is currently reading Deception Point by Dan Brown, and the last book he read was Thinking Fast and Slow, by Daniel Kahneman. Ben is interested in backpacking in the Grand Canyon, running, and photography. His family includes his son Joshua, a senior at Massachusetts Institute of Technology, studying combinatorics and looking at graduate schools in Mathematics. His daughter Sophie will be a freshman at Duke this year. She is interested in neurobiology and the law. They heard a fascinating lecture on the biological basis of ethical decision making during a recent visit there. His wife Zena is a University of Penn and Wharton School graduate. She has been a very active volunteer in the Toronto School system, in skating, and other activities centered around their children as they grew up in Toronto.

Ben was a Material Science in Engineering major at Penn, where he graduated summa cum laude. He chose that major in part because it had no language requirements. However, he came to dislike engineering practice and went into biomaterials. This eventually led him to take up medicine - to our great advantage. He sees surgery as evolving toward less and less invasive procedures, and transformation by biologics.

His primary clinical mentor was his partner at Tufts, Michael Goldberg, a dismorphologist who wrote the Dismorphic Child. “He encouraged me go to Toronto, although it was bad for him. A true mentor is someone who will do what’s good for you, even if it is bad for them. Advisors usually do what’s good for both of you. Bill Cole taught me how to integrate clinical work with high quality science. Bob Salter and Mercer Rang taught me how to talk with patients, John Wedge taught me trainee management and leadership, and Richard Reznick taught me to think big. Jim Rutka has been a spectacular chairman, leader, and friend. In more recent years, I’ve learned the most from the trainees I work with and from my patients. My lessons for readers are summarized in a slide from a recent talk I gave at Hospital for Sick Children” (summarized in a box on page 8).

David Naylor pointed out the importance of training the next generation of academicians and gave Ben the advice to make sure he can do this in his future. That’s what Ben has done so spectacularly at the University of Toronto. He has mentored and advised over 100 students at the summer student, Master’s degree, and PhD level in addition to his clinical trainees. He will continue in the Research Institute of the Hospital for Sick Children and his laboratory will continue in the Mars building, so that while Duke will be enriched by his joining their faculty, our Department will continue to benefit from his inspiring leadership and scholarship.

M.M.