Gynecologic Surgeons Unscrubbed

Here's a sneak peak of Gynecologic Surgeons Unscrubbed. A series-based podcast focusing on surgical and medical education, featuring interviews and practice-changing discussion, hosted by Cara King, DO, MS. This podcast is a collaboration between MDedge and the Society of Gynecologic Surgeons.

Dr. Cara King (@drcaraking) hosts surgical leader and expert Tommaso Falcone, MD, Professor of Surgery at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Chairman of the ObGyn & Women's Health Institute at Cleveland Clinic. Dr. King also interviews women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). They discuss: New leadership at the Cleveland Clinic in Cleveland The Cleveland Clinic’s surgical hospital opening in London, England Cleveland Clinic’s endometriosis center in Cleveland Good judgement is birthed from bad judgement The master surgeon: How is he/she defined? Surgical meetings: importance to surgical education Endometriosis Women’s health advocacy with Megan Evans How did Dr. Evans become an advocacy specialist? Why is advocacy important to prioritize in our careers? One of the most rewarding projects Dr. Evans has worked on in advocacy This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts surgical leader and expert Tommaso Falcone, MD, Professor of Surgery at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Chairman of the ObGyn & Women's Health Institute at Cleveland Clinic. Dr. King also interviews women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). They discuss: What it takes to be a leader and the components of leadership to build an outstanding department (serving your staff, emotional intelligence, recognizing and fostering talent, living the passion for women’s health) Identifying talent to build a successful team Recruiting leaders When a recruit does not work out Advice for making the jump to department chairperson The 3 types of mentors and their roles * * * Women’s health advocacy with Megan Evans What is happening legislatively when it comes to endometriosis? 6368/A. 484: Bill at the federal level focusing on education. Introduced in New York by State Senator Monica Martinez and State Assemblymember Linda Rosenthal. It is awaiting the Governor’s signature. Requires State Commissioner of Health to provide educational materials on endometriosis to school districts (school nurses) and clinicians throughout the state—focusing on earlier diagnosis of the condition. Which campaigns are using social media to get the word out about endometriosis? For the New York bill, the Endometriosis Foundation of America is running a campaign called #LetsTalkPeriod Social media is a powerful tool to use for contacting local and national representatives to advocate for issues Favorite social media platforms to discuss bills What bills regarding endometriosis are currently active at the national level? Res. 118 (116th Congress): Bipartisan and bicameral bill that recognizes endometriosis as an unmet disease, designates March as endometriosis awareness month, and provides funding for endometriosis research. Introduced by Senator Tammy Duckworth and Congressman David Scott. Other bills that include endometriosis (but are not specific to the condition) include a House bill introduced by Congresswoman Carolyn Maloney (HR 3865). It amends the public Health Service Act, which aims to reduce the amount of chemicals included in feminine hygiene products and investigate the link to included chemicals and female cancers, infertility, and endometriosis. Another bill has been introduced and hopes to ensure contraception access (HR 2182 /S 1086), which is essential to women with endometriosis, as hormonal contraception is important as a treatment option for endometriosis symptoms. A final bill also is in the introductory stages (S 1461 /H 2803), and it aims to require insurance coverage for infertility treatments. * * * Suggested reading The Serving Leader: Five Powerful Actions to Transform Your Team, Business, and Community by Kenneth R. Jennings and John Stahl-Wert Team of Teams: New Rules of Engagement for a Complex World by Stan McChrystal, Chris Fussell, and Tatum Collins * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts surgical expert Ted Teh Min Lee, MD, Clinical Professor of Gynecology and Reproductive Sciences and Director of Minimally Invasive Gynecologic Surgery at the University of Pittsburgh Medical Center Magee Womens Hospital. Dr. King also interviews women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). They discuss: Lee’s challenges in moving to the United States from Taiwan at a young age and his career path Cultivating extracurricular activities, such as fly fishing Video’s importance in surgical education Prioritizing learning and learning style Lee’s break into gynecologic surgery with C.Y. Liu, MD The challenges of subspecializing in MIGS in ObGyn Tips for new graduates who are building a surgical practice Case selection and specialized back-up in the OR Taking appropriate risk during surgery * * * Women’s health advocacy with Megan Evans How does a bill become a law? Step 1: A bill is born Anyone may draft a bill; however, only members of Congress can introduce legislation, and, by doing so, become the sponsor(s). The president, a member of the cabinet or the head of a federal agency can also propose legislation, although a member of Congress must introduce it. Step 2: Committee action As soon as a bill is introduced, it is referred to a committee. At this point the bill is examined carefully and its chances for passage are first determined. If the committee does not act on a bill, the bill is effectively “dead.” Step 3: Subcommittee review Often, bills are referred to a subcommittee for study and hearings. Hearings provide the opportunity to put on the record the views of the executive branch, experts, other public officials and supporters, and opponents of the legislation. Step 4: Mark up When the hearings are completed, the subcommittee may meet to “mark up” the bill; that is, make changes and amendments prior to recommending the bill to the full committee. If a subcommittee votes not to report legislation to the full committee, the bill dies. If the committee votes for the bill, it is sent to the floor. Step 5: Committee action to report a bill After receiving a subcommittee's report on a bill the full committee votes on its recommendation to the House or Senate. This procedure is called “ordering a bill reported.” Step 6: Voting After the debate and the approval of any amendments, the bill is passed or defeated by the members voting. Step 7: Referral to other chamber When the House or Senate passes a bill, it is referred to the other chamber, where it usually follows the same route through committee and floor action. This chamber may approve the bill as received, reject it, ignore it, or change it. Step 8: Conference committee action When the actions of the other chamber significantly alter the bill, a conference committee is formed to reconcile the differences between the House and Senate versions. If the conferees are unable to reach agreement, the legislation dies. If agreement is reached, a conference report is prepared describing the committee members’ recommendations for changes. Both the House and Senate must approve the conference report. Step 9: Final action After both the House and Senate have approved a bill in identical form, it is sent to the president. If the president approves of the legislation, he signs it and it becomes law. Or, if the president takes no action for 10 days, while Congress is in session, it automatically becomes law. If the president opposes the bill he can veto it; or if he takes no action after the Congress has adjourned its second session, it is a “pocket veto” and the legislation dies. Step 10: Overriding a veto If the president vetoes a bill, Congress may attempt to “override the veto.” If both the Senate and the House pass the bill by a two-thirds majority, the president’s veto is overruled and the bill becomes a law. ACOG’s advocacy efforts and lessons learned * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts surgical expert Ted Teh Min Lee, MD, Clinical Professor of Gynecology and Reproductive Sciences and Director of Minimally Invasive Gynecologic Surgery at the University of Pittsburgh Medical Center Magee Womens Hospital. Dr. King also interviews women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). They discuss: Lee’s “favorite” surgical failure The benefits of recording surgeries and producing surgical videos Finding endometriosis as a passion The surgical frustrations of treating endometriosis Choosing a fellow: Who edges out their peers? Taking your time to “interrogate tissues” and solve a problem Creativity and flexibility in the OR The importance of “always learning” Evolving tissue extraction techniques when power morcellators removed from the market Lee’s perspectives and plans for being president of AAGL in 2012 * * * Women’s health advocacy with Megan Evans How ObGyns can become involved in advocacy Sign up for ACOG’s government affairs emails Follow Twitter feeds and consider joining Twitter Become involved in your local medical and/or ACOG society Contact your state rep at ACOG ACOG’s Gelhaus and McCain fellowships The wellness benefits of advocacy * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts endometriosis patient advocate and educator Nancy Petersen, (@nancynursez637) retired RN who developed with David Redwine, MD, the first endometriosis excision treatment program in the United States. Nancy has spoken on the topic of endometriosis across the nation and currently serves as a mentor to women with the disease through Nancy’s Nook, a Facebook resource for endometriosis education, discussion, and support. They discuss: Nancy’s early life and influences to pursue nursing Nancy’s back pain and initial diagnosis of endometriosis The first hearing of Dr. David Redwine’s early research “Endometriosis reconsidered” is published Nancy’s second surgery for endometriosis Nancy’s back pain forces her retirement The Endometriosis Research Center chat group The growth in the numbers of patients with endometriosis joining the social group Reimbursement concerns for endometriosis gyn surgeons Are surgeons looking in the right places statistically to find endometriosis? Nancy’s worries in preparing physicians on the whole picture of endometriosis * * * Resources http://endopaedia.info/ * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts endometriosis patient advocate and educator Nancy Petersen, (@nancynursez637) retired RN who developed with David Redwine, MD, the first endometriosis excision treatment program in the United States. Nancy has spoken on the topic of endometriosis across the nation and currently serves as a mentor to women with the disease through Nancy’s Nook, a Facebook resource for endometriosis education, discussion, and support. They discuss: Are residents exposed enough to endometriosis education? Targeting MIGS programs The role of imaging in identifying endometriosis and preop planning The importance of patients having high-volume surgeons The strength of a multidisciplinary team Nancy’s knowledge gathering in the disease state Nancy’s Nook educates patients with endometriosis to advocate for themselves How Nancy selects surgeons to be on their recommended list Pregnancy before or after surgery? Contacting physicians that you’ve visited in the past with no cure Nancy’s one piece of advice to physicians who treat endometriosis Multispecialty treatment centers * * * Resources http://endopaedia.info/ * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts expert urogynecologist Marie Fidela Paraiso, MD, Head of the Center for Urogynecology and Reconstructive Pelvic Surgery and staff physician in the Department of Obstetrics and Gynecology at the Cleveland Clinic.  They discuss:  FDA black box warning for transvaginal mesh for pelvic organ prolapse (POP) in April 2019 Vaginal mesh procedures versus surgical repair with native tissue  Complications of mesh implants  Varying types of mesh  Can surgeons still use transvaginal mesh for prolapse repair? Outcomes with high volume vs low volume surgeons  Credentialing for repair surgeries  ASPIRE trial as part of the Pelvic Floor Disorders Network FDA-mandated 522 studies  The opportunity of joining Cleveland Clinic’s FPMRS and MIGS sections to conduct prospective randomized trials  Dr. Paraiso’s AAGL presidential duties  Planned AAGL programs and celebration of global surgical education Dr. Paraiso’s first AAGL presentation and early career aspirations Opportunities that academics offer The first female surgeons’ aspiring legacy of leadership  This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking For more MDedge Podcasts, go to mdedge.com/podcasts

On March 27, 2020, Dr. Cara King (@drcaraking) hosts Vicki Reed, MD, (@ReedVickiMD) Residency Program Director, Department of Obstetrics and Gynecology, and Vice Chair, Education, Cleveland Clinic They discuss: Cleveland Clinic’s unique ObGyn residency program Resident prep for treating COVID-19 patients Online learning resources Resident participation in virtual visits Redeploying residents in a pandemic setting Work-hour requirements The impact to residents long-term Opportunities in competency-based education Involvement of medical students Ongoing emotional support Potential for pushing back the academic year * * * Resources Academy of Pelvic Surgery Rosh Review Open access SGS Video Library SurgeryU APGO CREOG * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @ReedVickiMD For more MDedge Podcasts, go to mdedge.com/podcasts

On March 27, 2020, Dr. Cara King (@drcaraking) hosts Sarah Cohen, MD, MPH, Division of Minimally Invasive Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota They discuss: AAGL guidelines – starting the discussion Global collaboration among AAGL and other societies to craft guidelines Potential viral spread during laparoscopic surgery Potential viral spread during open procedures Thinking outside of the box (minilaps and vaginal hysterectomy) COVID-19 testing in surgical patients – what is possible today Universal chest CT before surgery? Recommended PPE for the OR Rethinking MIGS surgical steps to optimize for infectious disease Ideal surgical masks for the OR Ongoing updates to AAGL joint statement guidance Reliance on global colleagues * * * Resources COVID-19: Joint Statement on Minimally Invasive Gynecologic Surgery * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking For more MDedge Podcasts, go to mdedge.com/podcasts

On March 27, 2020, Dr. Cara King (@drcaraking) hosts Jonathan Dort, MD (@JonathanDort1), Vice Chairman for Education in the Department of Surgery; Program Director, General Surgery Residency; and Director, Minimally Invasive Surgery at Inova Medical Group, Falls Church, Virginia They discuss: SAGES’ COVID-19 resources Assumptions being made about viral transmission during laparoscopic surgery Should surgical patients be tested pre-surgery for COVID-19? PPE for the surgical and anesthesia team in the operating room Reducing operating teams to required personnel Optimizing filtration systems Which surgical cases are nonessential Use of masks in the OR COVIDsurg: Conoravirus global collaboration on surgical experience with COVID-19 Safety for residents and INOVA’s educational shift A new way of conducting grand rounds Working out virtual visit kinks for attendings and residents GME start date of July 1: Should it be pushed? * * * Resources SAGES COVID-19 resources CDC Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings Globalsurg.org/COVIDsurg * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @JonathanDort1 @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

On March 27, 2020, Dr. Cara King (@drcaraking) hosts Beri Ridgeway, MD, (@beridgeway) Institute Chair, Department of Obstetrics and Gynecology and Women’s Health, Cleveland Clinic. They discuss: Ohio’s state of affairs regarding COVID-19 Testing sites and tests completed to date Who can be tested for COVID-19, based on allocation of resources and underlying conditions The virtual approach to testing using telephones, FaceTime, and Google Duo Insurance coverage of virtual visits and charity care In-patient and out-patient visitation policy and hospital entrance checkpoints Wearing masks: current evidence-based approach COVID-19 modeling for Cleveland Clinic: contingency plans for worst-case scenarios Reducing nonessential operations COVID-19 preparations with many unknowns Elective surgeries: the slowdown of operations Supertracking GYN and early OB patients in a COVID-19 hot zone Redeployment strategy for now low-volume providers, including ObGyns Supporting staff emotionally * * * This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @beridgeway For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Javier Magrina joins host Dr. Cara King (@drcaraking) live at the 2019 annual AAGL conference. Other experts join in the discussion, including Pouran Malekzadeh, MD; Laura Cano, MD; Rashad Pasic, MD; and Luis Gonzalez, MD.  They discuss:  Dr. Magrina’s path to pelvic surgery The creation of ObGyn as a specialty 130 years ago Limitations of low-volume surgeries  General ObGyn residency programs vs tracking residency programs What the United States can learn from other countries When to incorporate experts from other specialties into pelvic surgery Video review of surgery, and it role in evaluating surgical skill Subspecializing in surgery Assessing residents for surgical expertise What makes a good mentor?  Dr. Magrina’s most influential mentors What can a mentee do to enhance the relationship with a mentor?  Dr. Magrina’s advice to the graduating resident Views from podcast listeners on, “Should the OB be separated from the GYN?” This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking  For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts surgical researcher and educator Caprice Greenberg, MD, MPH, Professor, Department of Surgery, Division of Surgical Oncology, and Morgridge Distinguished Chair in Health Services Research.  They discuss:  Intraoperative surgical performance and the attending surgeon’s role in outcomes Applying engineering factors to surgical performance  Surgical coaching: Proof of concept Differences in surgical mentors, teachers, and coaches Attributes of good surgical coaches Identifying surgeons who will be good coaches Creating a culture change to allow coaches in surgery Matching coachees with coaches The Academy for Surgical Coaching and its goals Video-based platforms for interactive surgical coaching Video-based surgical assessment  The Academy for Surgical Coaching’s summer 2020 summit  Resources Academy for Surgical Coaching  This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

Dr. Cara King (@drcaraking) hosts women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). Dr. Evans is Assistant Professor, Tufts University School of Medicine, and Associate Program Director, Department of Obstetrics and Gynecology, Tufts Medical Center. They discuss:  How GME is funded Growth in resident training  GME caps for hospitals CMS’s GME programs Projected physician shortage Increased enrollment in medical schools Resident Physician Shortage Reduction Act of 2019 Opioid Workforce Act of 2019 This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @MeganEvansMD For more MDedge Podcasts, go to mdedge.com/podcasts

On June 29, 2020, Dr. Cara King (@drcaraking) hosts Beri Ridgeway, MD (@beridgeway), Associate Chief of Staff, Cleveland Clinic. They discuss: Reactivating services at the Cleveland Clinic Decision making for re-opening Space studies and design COVID testing for surgery Capacity for COVID testing Ongoing plans if COVID rate increases Better understanding virtual care being provided Reimbursement for telehealth visits Cleveland Clinic’s surgical reactivation workflow Antibody testing for COVID at Cleveland Clinic This podcast is developed in collaboration with the Society of Gynecologic Surgeons Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgeObGyn @drcaraking @beridgeway For more MDedge Podcasts, go to mdedge.com/podcasts

In this episode, Dr. Cara King speaks with LaShyra “Lash” Nolen, a medical student at Harvard Medical School and the school’s first Black woman student council president. Lash talks about the systemic racism she has seen during her medical education and what motivated her to address it through writing with her first article, “How Medical Education Is Missing the Bull’s-eye.” She also shares what advice she would give to young Black students interested in medicine as well as her thoughts on how healthcare professionals can use their position to help change these deep rooted issues within the institution.   Resources:   "How Medical Education Is Missing the Bull’s-eye" by LaShyra Nolen ACCEM Becoming by Michelle Obama LaShyra Nolen’s website LaShyra Nolen on Twitter

In this episode, Dr. Cara King speaks with Dr. Linda Bradley, Professor of Surgery at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. Dr. Bradley is the first female African American surgeon to join the staff over 25 years ago and is the Medical Director of the American Association of Gynecologic Laparoscopists (AAGL). She talks with Dr. King about her upbringing in Cleveland and how she integrates her family into her work life. She also talks about her passion for cooking. Listen as she shares how to encourage more Black men and women to enter the medical profession and how to make the most out of a mentorship.   Resources: The Warmth of Other Suns by Isabel Wilkerson Coach Sam's Inner Circle Foundation Celebrate Sisterhood American Association of Gynecologic Laparoscopists (AAGL) 2018 Celebrate Sisterhood Flavor Over Fat: Cooking Made Simple! Cookbook

In this episode, Dr. Cara King speaks with Dr. Mathew Leonardi, an advanced gynecologic surgeon and sonologist (ultrasound specialist) at McMaster University Medical Centre in Hamilton, Canada. As March is Endometriosis awareness month, Mathew talks about advanced endometriosis imagery and how it impacts preoperative counseling, planning and intraoperative surgical intervention. He also talks about how he created his own path to get to where he is today. Listen as he shares how to build skills in advance sonography and incorporate this into residency as well as fellowship education.   Resources: Dr. Mathew Leonardi’s website Dr. Mathew Leonardi on Youtube “How to perform an ultrasound to diagnose endometriosis” by Dr. Mathew Leonardi IDEA (International Deep Endometriosis Analysis group) MUSA (Morphological Uterus Sonographic Assessment) International Ovarian Tumor Analysis (IOTA) Closing the communication loop between gynecological surgeons, diagnostic imaging experts and pathologists in endometriosis: building bridges between specialties by Dr. Mathew Leonardi, Dr. Mercedes Espada and Dr. George Condous

In the first episode of a two-part series, Dr. Cara King speaks with Dr. Cecile Ferrando, director of the transgender surgery and medicine program at The Cleveland Clinic, following International Transgender Day of Visibility on March 31. Cecile talks about her journey into reconstructive transgender surgery and how she prepared for her first few cases post-fellowship. She also discusses the importance of transparency with her patients.   Resources: Dr. Cecile Ferrando at the Cleveland Clinic Dr. Cecile Ferrando on Twitter