Halsted's Hands - Where Surgery Leaders Begin
Where Surgery Leaders BeginDate: May 30, 2012
The legacy still holds. Take Selwyn Vickers, Jay Phillips Professor and Chair of Surgery at the University of Minnesota (UM). Vickers grew up in Huntsville, Ala., and inspired by his parents and family practitioner uncle, decided at 15 to become a doctor.
Vickers earned his undergraduate and medical degrees at Hopkins, then stayed for residency and a surgical oncology fellowship. While training under former Surgery Director John Cameron in the late 1980s and early 1990s, Vickers became enthralled with the challenges of treating pancreatic cancer. Today he, too, is a national leader in pancreatic cancer research, inspiring his own mentees.
Vickers left Hopkins in 1994 for the University of Alabama at Birmingham (UAB), where he quickly ascended from an assistant professor of surgery to a leader wearing many hats: co-director of the pancreaticobiliary center, chief of GI surgery, chair of general surgery and senior scientist with the university’s Comprehensive Cancer Center. In 2006, he was recruited by UM, where he has been working to strengthen collaborations across medical and research specialties.
Vickers continues to operate weekly on patients but also co-leads an $11.5 million Pancreatic Cancer Specialized Program of Research Excellence (SPORE) grant from the National Cancer Institute, through which scientists at UAB and UM conduct a number of projects, including identifying biomarkers that could be used to develop screening tests for pancreatic cancer and precancerous pancreatic changes.
He also is principal investigator for a $3.8 million grant from NIH’s National Center on Minority Health and Health Disparities for research focused on minority recruitment and retention in cancer clinical trials.
Vickers credits Cameron with seeing leadership potential in him and his fellow trainees. Cameron modeled high clinical excellence, he says, and taught him to do complex operations safely, understand the diversity of team members and have a high appreciation for research, all in the context of patient care being the central goal.
“The biggest memory for me is the actual commitment that Dr. Cameron had to each of us,” Vickers says. “He had phenomenal loyalty as a clinical and academic surgical “father” and has monitored us to ensure that his ‘academic offspring’ have all prospered and landed in positions to contribute as leaders in academic surgery.”
About 10 percent of surgery chairs in academic medicine are Cameron’s trainees, says Vickers, who enjoys seeing his former colleagues at professional meetings.
Vickers likens surgery chairmanship to running a small company, with budgets of more than $50 million, 50 to 100 surgeons and 300 to 400 staff members. “Most revenue in academic health centers comes from the department of surgery,” he says, “so you need to have strong management skills, communicate well, and be decisive and not easily offended.”
There are many challenges related to managing talent, managing resources and trying to grow outstanding research and clinical training programs, Vickers says. In the previous era, the philosophy was that surgery chairs should operate as much as they could. Now “if you’re in the OR all the time and not in meetings, you’re missing things. We all still like operating but there’s so much more required of our time to secure the futures of our faculty.”
Recruiting potential leaders also is tougher, he says. When he went to Hopkins, “cost/debt was not a factor—people were willing to sacrifice because the destination was so open. Now kids go to medical school often based on lifestyle and cost, coupled with the prospect of decreased future pay. I very much like to recruit people, but I don’t know if you’ll find them all in one place consistently over time, like what I had at Hopkins.”
Vickers was “very hard working, very competitive and very self-confident,” says Cameron. “He clearly was a future star.”
Despite the challenges, surgery chairs are “the best jobs in the world,” Cameron says. When positions for chiefs of medicine or pediatrics come up, they are often difficult to fill because they have become so administrative-heavy, he says. By contrast, surgery chair positions are highly sought after, in part because surgeons can continue their love of operating.
“If you pick a profession you love, you never have to work again,” Cameron says. “I’m 75 and I still work seven days a week—not because I have to but because I want to.”