The Society for Surgery of the Alimentary Tract (SSAT), USA is constantly trying to foster international relationship among the alimentary tract surgeons across the globe and to make SSAT a truly international society. In this endeavour SSAT has joined hands with the Indian Association of Surgical Gastroenterology (IASG) in 2015. Initiated by the SSAT International Relations Committee, a new travelling fellowship was established in the same year. This fellowship award was set up to target all young Indian surgeons (< 45 years of age) having a strong interest in clinical or basic science related to surgery of the alimentary tract, and who are members of both the IASG and the SSAT. The yearly award of USD 5000 provides support to attend the Digestive Disease Week (DDW) in USA, and to visit one or two centers in USA or Canada. The idea behind this IASG specific fellowship award is to encourage Indian surgical colleagues to be an integral part of SSAT and to provide them a unique opportunity for the international exposure in the field of surgical gastroenterology. It is a pleasure to mention that the first SSAT-IASG Travelling Fellowship for the year 2016 has been awarded to Dr Vishal Gupta, Professor Junior Grade (Additional Professor), Department of Surgical Gastroenterology, King George’s Medical University, Lucknow, India, who is providing the following report:
It is a privilege for me to become the first SSAT-IASG Travelling Fellowship award recipient. Being a surgical gastroenterologist for the past nine years and a member of both the IASG and SSAT for more than 5 years, it has always been a desire to attend the Digestive Disease Week (DDW). However, due to various factors, specially the financial constraints, I never got the opportunity to attend the DDW. This fellowship gave me a great opportunity to attend not only the DDW but also to visit two renowned academic medical centers in the USA.
I came to know about this fellowship through the email notification from the IASG office. Following my application I gladly received notification about my selection from the SSAT office in February 2016. During making arrangement for my trip the SSAT administrative office and the chief administrator, Renne Russo, were very cooperative with prompt reply to any clarification sought. Most importantly, I got the opportunity to meet Prof Ernst Klar, Chair International Committee SSAT, in India during a conference before my visit. His valuable advice helped me a lot during my visit in USA, and in fact he played a perfect host on behalf of SSAT during the DDW at San Diego.After few correspondences, I decided upon two centres (Division of Thoracic and Foregut Surgery, University of Pittsburgh, Pittsburgh, USA and Division of HPB surgery, Washington University at St Louis, St Louis, USA) to visit after attending DDW.
A. Visit in USA
First, I visited San Diego to attend the DDW from May 19 to May 24, 2016. During this conference I got the opportunity to attend lectures delivered at various forums (ASGE, ASG) besides the SSAT-program. In addition I had a wonderful opportunity to attend many hands on courses including intraoperative ultrasound, POEM, advanced endoscopic procedures, and TAMIS/TEMS. However, most interesting part of the DDW was the lectures - the SSAT presidential address by Prof Selwyn M Vickers (Lessons Learned From Mentors and Heroes on Leadership and Surgical Resilience, specially the role of three Fs (Faith, Family and Friends) in some one’s success as symbolised by the classic “turtle on a fence post”), guest oration by H James Dallas (Mastering the Challenges of Leading Change), and the state of the art lecture by Bruce L Gewertz (The Best Medicine: Leadership Lessons for Work and Life). It was a proud moment for me to receive the award from the SSAT president Prof Selwyn M Vickers during the opening session on May 22, 2016 in front of large audience. In addition, Prof Ernst Klar invited me to the Foundation award reception on May 22, 2016 where I had an opportunity to meet other members from India and abroad.
At the University of Pittsburgh Medical Center Presbyterian Hospital, I was hosted by Prof James D Luketich. Here, in the division of thoracic and foregut surgery, a very busy department, I had the opportunity to observe various esophageal surgeries being performed by Prof Luketich. I could observe minimally invasive esophagectomy, minimally invasive giant paraesophageal hernia repair, repair of recurrent paraesophageal hernia, many open foregut procedures, endoscopic interventions for anastomotic leaks etc.It was a wonderful experience as I could interact directly with Prof Luketich who has one of the largest experiences in minimally invasive esophagectomy and learned his approach to the management of esophageal cancer and paraesophageal hernia including many surgical tips and tricks, and variations of postoperative management.In addition, I had the opportunity to meet and learn from Prof Toni Lerut, from the Department of Thoracic Surgery, University Hospital Leuven, Belgium during this stay who happened to be visiting the same department at that time.
Thereafter I visited division of HPB Surgery, Washington University at St Louis where I was hosted by Prof Steven M Strasberg whom I had the pleasure to join in his morning outpatient clinic. After finishing his clinic I joined Dr Hawkins’ clinic in the afternoon. I got another opportunity to attend Prof Strasberg’s clinic that week. These outpatient clinics were excellent in terms of both clinical learning and communication skills (with patients). I observed a lot of laparoscopic and open procedures on liver, pancreas, and bile ducts during this stay. It was a privilege for me to learn the tricks of safe laparoscopic cholecystectomy from Prof Strasberg himself whose contribution in the field of safe cholecystectomy culture is very well known.I participated in morbidly & mortality conference of the Department of Surgery. Here I learnt the systematic approach for presentation in morbidity & mortality conference meetings, and observed vivid discussion among the surgical colleagues from different divisions for better patient care.I also attended multidisciplinary HPB conference during where I observed discussions over many interesting cases and learned views of highly experienced hepatobiliary surgeons. I visited Becker library of the Washington University, and was impressed by the huge and updated collection of journals and books including many very old rare prints. On the last day of my stay Prof Strasberg took me around the Barnes Jewish Hospital and showed me round the HPB ward, surgical intensive care unit, and various other facilities of the hospital. Finally he took me for the lunch that was indeed an honour for me.
B. Impact of fellowship: Present and Future
Overall this visit has been a great experience for me. I had an excellent academic and clinical exposure during my 3 weeks of stay in USA. I came to know about Health Insurance Portability and Accountability Act (HIPAA) and newer technologies, learnt newer surgical techniques, revised and refined old surgical concepts, tried to learn newer procedures, observed the departmental/institutional organisation, had an opportunity to work with giants in the field of esophageal and HPB surgery and tried to learn tips and tricks from them for the better care of these patients at my own center. Such international exposure surely allows understanding the philosophy of managing patients across international boundaries having different social, economic and cultural environment.
I wish to thank selection committee of the SSAT (especially Dr Selwyn M Vickers, Dr Ernst Klar) and IASG (Dr Anil Agarwal, Dr VP Bhalla, Dr Pradeep Rebala) for providing me this rare opportunity by selecting me for this coveted fellowship. I am confident that this joint effort by the SSAT and IASG would be very helpful in building a strong relationship between these two societies. Many young surgeons from the Indian subcontinent fail to travel abroad due to many constraints, most importantly being the finances. This fellowship will surely encourage all those who are practicing alimentary tract surgery and find this fellowship very useful. I am sure it will infuse a new lease of enthusiasm in Indian surgeons to develop an inclination towards the specialised practice of alimentary tract surgery, and become actively involved in the activities of both the IASG and SSAT making these two societies more popular than ever before.
The SSAT Travelling Fellowship for IASG-Members is an important initiative encouraging me and others not only to participate in the activities of both the SSAT and IASG, but also to promote the professional practice of alimentary tract surgery and impart such knowledge to all those who are interested in the field of alimentary tract surgery.