Andy Smith, University Chair of General Surgery

Andy Smith (front row, 3rd from right, with the 2009 graduating general surgery residents

Surgical oncologist and translational researcher Andy Smith has been appointed Chair of the University Division of General Surgery. Andy has been Head of the Division of General Surgery at Sunnybrook Hospital for the past eight years where he has made major contributions in translational research related to colorectal cancer. (http://www.surgicalspotlight.ca/Shared/PDF/ Winter07.pdf ) He is excited about the opportunities and responsibilities of the research enterprise, the educational mandate and the clinical opportunities in the division. "The surgeon-scientists and career surgeons in general surgery are making major contributions across the broad spectrum of general surgical knowledge. Peter Kim's groundbreaking work in surgical technology development, Frances Wright's investigations into implementing Tumour Boards across Ontario, MIS general surgeons' collaborative work in implementing a program in obesity surgery and the basic science work of Steven Gallinger, Carol Swallow, Rebecca Gladdy and Andrea McCart are only a few examples of the outstanding projects currently under way." (Please see http://www.surgicalspotlight.ca/ Shared/PDF/winter03-04.pdf (page 8) for links to earlier articles on these individuals.) "Our continued success will require that we meet the challenges to support the research and training enterprise, and embrace opportunities to improve the lives of our patients through creation and translation of new knowledge."

Andy is addressing the educational mandate with a strong team of program directors including Najma Ahmed in general surgery, Carol Swallow in surgical oncology, Ted Gerstle in paediatric general surgery, Paul Sullivan and Allan Okrainec in minimally invasive surgery, Marcus Burnstein in colorectal surgery, Fred Brenneman and Avery Nathens in trauma surgery, and Paul Grieg and Carol-anne Moulton in hepatobiliary surgery. Training in specialized aspects of general surgery will continue to be a central, thriving aspect of general surgical training. At the same time, the division is keen to engage the numerous talented teachers at the distributed hospitals to ensure that we have "generalist" general surgical training that is second to none. "Some authorities have lamented the demise of the generalist but the rich pool of talented surgeons in our division allows us to be confident in our ability to train surgeons for diverse careers." (http://www.surgicalspotlight.ca/Article.aspx?v er=Spring_2009&f=ReaderLetters ) Andy has recently returned from a James IV travelling fellowship in the UK and Scandinavia where the competency-based model of residency education is being developed. The orthopaedic division has pioneered the implementation of such an approach at U of T. Similarly, innovation in the approach to residency training in general surgery will be explored in the years to come in our department.

Medical student education will emphasize nurturing appropriate students for careers in surgery and will be strengthened by mentorship from the varied surgeons in the division. Students who have a chance to shadow surgeons early in their careers are often profoundly influenced. As a first year medical student, Anand Govindarajan spent a "day with the doctor" with Andy eight years ago. Captivated by the opportunities for productive clinical and research opportunities, Anand finished the general surgery residency program, including two years in the surgeon scientist program where he authored high-impact papers on multi-visceral resection of colorectal cancer in the Journal of the National Cancer Institute. He recently graduated from the Gallie Program and is now training at Memorial Sloan-Kettering as a surgical oncology fellow. Anand was mentored in the lab by Calvin Law.

General surgery fellowships are in demand. Most of the 2009 graduating general surgery class went on to fellowship training. U of T fellowship programs are strengthening under the leadership of Vice Chair David Latter. Continuing medical education has been a very strong activity of the general surgery division. The award-winning Update in General Surgery is the largest such program in Canada. The Update in Surgical Oncology is similarly well-regarded. These will be continued and strengthened with innovative approaches aimed at responding to the needs of practicing surgeons. In addition, there is a vast array of other educational offerings in the division that bring honour to the "U of T General Surgery brand".

The clinical mission of the diverse general surgery faculty at the core and distributed hospitals is central to the division's mission. Recent advances include the establishment of a minimally invasive and multi-disciplinary obesity surgery program, (http://www.surgicalspotlight.ca/ Article.aspx?ver=Spring_2009&f=ChairColumn ) expansion of the paediatric general surgery program to include North York General Hospital, and plans for a collaborative, multi-institutional surgical oncology program for peritoneal based malignancy. Development of programs that cross traditional institutional boundaries represent a real opportunity for U of T general surgery.

Andy's management of the general surgery division will be enhanced by Linda Last, General Manager of General Surgery, who is helping to integrate the Sunnybrook office with the downtown University of Toronto surgery office. Important mentors in Andy's training include Zane Cohen, Sherif Hanna, Robin McLeod, Hartley Stern, Paul Walker and many others. Andy's leadership style is best exemplified by his work in championing the importance of quantitative node dissection in colorectal cancer. He enlisted the loyalty of surgeons in hospitals all across Ontario by travelling to their hospitals, scrubbing in, and gaining a better understanding of local issues and perspectives.

Andy summarizes his approach to management:
"My role as Chair is to collaboratively develop the vision for the division and to help catalyze change. I am surrounded with excellent, capable colleagues and it is important that they are allowed to fully realize their aspirations as U of T surgeons."

M.M.