Halsted's Hands - Never That Far From Hopkins
Never That Far From HopkinsDate: November 28, 2012
Russell Postier has come full circle.
Chair of the Department of Surgery for the University of Oklahoma (OU) College of Medicine and former chairman of the American Board of Surgery, Postier grew up in Oklahoma and went to college and medical school there. When he attended OU as a medical student, the majority of the professors including the chair had a Johns Hopkins connection or trained at Hopkins. They encouraged Postier and one of his classmates to apply for residency at Hopkins; Postier came in 1975 for residency, and when he finished in 1981 he returned to OU as an assistant professor, working for Hopkins alums Rainey Williams and Ron Elkins. Postier became chair of surgery in 1997.
His Hopkins connections continued during his leadership roles with the American Board of Surgery (ABS). Postier said when his name came up to chair the ABS in 2008, at least four of the 26 surgery program directors in the organization had trained at Hopkins. There were at least three other Hopkins alums active in the ABS during most of his tenure, Postier says, so “going to board meetings was almost like going to Old Hands meetings.”
“I never dreamed of (leading the ABS)—to me it would be like winning the lottery,” says Postier, whose interests lie in gastrointestinal, biliary and pancreatic surgeries. “It was the highlight of my academic surgery career.”
During his time as president, the ABS redefined the curriculum for general surgery residents, working with six other organizations, including the Association of Program Directors in Surgery, to create the Surgical Council on Resident Education (SCORE) curriculum.
When the leaders got together to discuss what a general surgeon should do and in which operations they should be proficient, Postier says, most had trained a generation ahead of current residents, and some of the operations he and his colleagues had learned had been made obsolete by improvements in medical technology. For example, during Postier’s training, common bile duct explorations to remove stones or other blockages were open procedures. Today, stones are removed more commonly by endoscopy. In fact, in reviewing recent surgical procedures completed by residents, Postier and colleagues could not find any reports of open procedures. They decided that teaching the operation in a simulated environment would be unreasonable, so they dropped it from residents’ requirements.
Postier and ABS colleagues, with the Society of Surgical Oncology, also worked to better define fellowships in surgical oncology, carefully figuring out how to advance the field but not threaten the role of general surgeons operating on cancer patients in community hospital settings.
At Hopkins, Postier says he fondly remembers working hard, living in the Compound, and the high-quality chief residents he worked with, which he appreciated throughout his training and when he became a chief resident himself.
The idea that surgical residents had to balance patient care, teaching and research “permeated the entire place,” Postier says. “Less than excellence was unacceptable and you tried hard to meet that challenge.”
Today the residency programs at OU, which Postier directed for 15 years before becoming chair, “continue to have a strong Hopkins flavor,” he says.
“Work hours have evolved and changed, and resident expectations have changed,” he says, “but as long as you keep patient-centered care as the focus, you are going to have a strong program.”
Many of Postier’s trainees went to Hopkins for fellowships, some of whom have come back to OU for full-time positions. “The Hopkins-Oklahoma connection,” he says, “is still strong, and beneficial to both groups.”