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Message from the President – October 2011

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“The world is getting smaller” and with that SAGES today is truly an international society more than ever. Though based in the United States, there are more than 1000 international members (from Europe, Asia, the Americas and even Africa), hundreds of international abstract submissions yearly and a dozen international outreach programs. I would like to take this opportunity to share with you some of these activities.

SAGES Go Global

Shouldn’t everyone have access to well-established surgical techniques aimed at reducing burden and discomfort associated with surgical procedures? Many think so, but the challenges of extending MIS beyond the wealthier countries are considerable. Born out of the early work of Ramon Berguer, who conducted basic laparoscopic training in rural setting in Latin America, SAGES Go Global program is now lead by Horacio Asbun and capably staffed by Jacqueline Narvaez. The mission of the Global Affairs Committee is: To promote global collaboration and exchange of knowledge to optimize patient care. SAGES members have donated their time and expertise in country to help train surgical teams around the world including: Horacio Asbun, Ramon Berguer, Sam Finlayson, Mark Pleatman, Julio Teixeira, Ian Soriano, Raymond Price, Suzanne Yoder, W. Scott Melvin, Jeff Hazey, Kevin Reavis, Brian Smith, Mike Marohn, Ted Trus, Alex Perez, Klaus Thaler, David Earle, and Allan Okrainec. Mission success is also dependant on folks who work in the background. Working stateside on these projects were SAGES members who supported the efforts behind the scenes working on presentations and during our teleconferences into the sites: Edgar Figueredo, Raul Rosenthal, Brant Oelschlager, Oznan Miereles, Michael Brunt, Jose Martinez, Danny Scott, Desmond Birkett and Tonia Young-Fadok. Finally I would also like to express my thanks to those allied health members who help round out and refine the team training aspect of these programs: Denise Puno, RN, Kelly Reavis, MPH, W. Cody Alley, Scott Provost, MD, Anne Price, Danny Droesbeke and Allison Wagner, RN. On many fronts SAGES has become regarded around the world as a “can-do” society. The talents and energy of SAGES members is unequaled, but this is also true of the SAGES staff, in this case Jaqueline Narvaez, Vannessa Cheung and Maribeth Balon who have used their considerable organizational skills to make all of this happen on time and within budget. The goals for 2011 were to conduct at least 3 courses, finalize and launch an outcomes database to assist with benchmarking the success of each location. After each course we must also find way to build an academic relationship with each institution to encourage sustainability and continued progress. Tentative locations being considered this year are Mongolia, Tanzania, and South America. The database is almost complete and will be ready to launch in 2012.

Since 2009 the courses that have taken place are:

May 17-21, 2009
Jorge Reategui Hospital
Piura, Peru
Course: Basic Laparoscopy

June 20-25, 2010
Pingchang Hospital (with Support from the University Hospital in Shanghai, China)
Pingchang, China
Course: Basic Laparoscopy

August 23 –27, 2010
Zamboanga Medical Center
Zamboanga, Philippines

The course was well received by the Philippine Association of Laparoscopic and Endocopic Surgery (PALES). SAGES also partnered with the Buddhist Compassion Relief Tzu Chi Foundation and the SAGES Foundation for support.

January 17-23, 2010
Pingchang Hospital (with Support from the University Hospital in Shanghai, China)
Pingchang, China
Course: Basic Laparoscopy

June 23-July 1, 2011
Regional Diagnostic and Treatment Center
Uvurkhangai Aimag, Mongolia
Course: Basic Laparoscopy

SAGES partnered with the Swanson Family Foundation (SFF). They provided ground support, equipment support, lodging, and additional support staff i.e. Biotech, anesthesiologist, nurse, and scrub tech.

Sites from around the world apply to SAGES for training. A detailed process of evaluation is initiated. The challenges of training MIS techniques in a constrained environment are many, not the least of which is sustainability. The careful site selection process strives to optimize potential long term success. Sadly many places are still not capable of supporting a sustainable MIS program. Where opportunities exist, we have learned the value of local commitment and the realistic biomedical support needed to create an enduring program. Since on-site training time is a precious commodity we leverage some of our existing tools such as FLS. Necessity is truly the never ending mother of invention. SAGES Communication Committee Chairman, Allan Okrainec, demonstrated that FLS skills could be taught and proctored utilizing Skype as a cost effective video transmission technology. This methodology has been employed effectively in China, Latin America and Africa once again making the world a smaller place. Challenges remain teaching and assessing the didactic portion of the FLS program, but I will return to that later.

2011 SAGES International Webcast

This activity brings value to our International Membership and creates SAGES awareness worldwide. The webcasts are also used as a tool to enhance the educational offering and promote academic relationships with International Societies and Institutions. We have seen some amazing growth in the viewing audience. In 2006, we had 300 participants with only five countries participating. In 2011, we had over 1,800 viewers and over 20 countries online! (Azerbaijan, Bahrain, Brazil, Bosnia, China, Colombia, Herzegovina, Hong Kong, India, Iran, Japan, Korea, Mexico, Portugal, Peru, Philippines, Romania, Saudi Arabia, United Arab Emirates, U.S. Military and Canadian Military).

2011 International Fellow Award

The purpose of this award is to provide outstanding investigators with the opportunity to gather experience, training, and expertise from some of the many courses SAGES has to offer at the annual meeting. Recipients are selected from among the top ranking podium, poster, or video presentations at the annual SAGES meeting. In 2011, SAGES awarded four International Fellow Awards in the amount of $2,500 each.

SAGES and Other Societies Around the World

SAGES is a member of IFSES, the International Federation of Societies of Endoscopic Surgery. It is this group that chooses the site for the World Congress of Endoscopic Surgery. SAGES has hosted this meeting several times in the past most recently in Washington, D.C. in conjunction with CAGS, the Canadian Association of General Surgery. We had such a great experience in DC that we look forward to working with CAGS again and are making plans to host another joint meeting in the next few years. We have enjoyed a long association with EAES, the European Association of Endoscopic Surgery. Through our combined efforts, Surgical Endoscopy, the official journal of both societies, has a rising impact factor. Mark Talamini and Sir Alfred Cuschieri lead the effort to make this collaboration recognized as one of the top surgical journals in the world.

In addition to CAGS in the north, we enjoy strong collaborations with our neighbors in the south. SAGES, through the efforts of the Program Committee, has hosted jointed symposia with ALACE and FELAC, the leading societies in Latin America but also with the national surgical societies in Guatemala, Brazil, and Colombia. Many thanks to Mark Talamini, Steve Eubanks, Jeff Marks, Mike Brunt, Dan Herron, Ted Trus and Brian Dunkin, for taking the time to serve as SAGES’ ambassadors in this effort with some of our closest neighbors. Much of the credit for this belongs to Natan Zundel, who is both a SAGES member and former ALACE president. He has been unfailing in efforts to make the world a smaller place.

If any of you have been to a SAGES Sing-Off then you have seen Manabu Yamamoto and his team in action. As a member of both SAGES and JSES, the Japanese Society of Endoscopic Surgery, Manabu has helped forged strong bonds between our groups. A series of SAGES-JSES reciprocal symposia have been held at our annual meeting as well as recent JSES meetings in Sendai (devastated by the recent tsunami) and Yokohama. These symposia have focused on comparing the treatments of similar diseases in both the east and west and many who have attended have marveled how both similar and different the care for these patients can be. The efforts of Sergio Larache, Scott Melvin, Horacio Asbun, Dan Jones, Nat Soper as well as our JSES colleagues like Manubu, Segio Kitano, Masaki Kitajima, and Go Wakabayashi have made these programs a huge success. Our efforts in Asia have recently extended to China. A recent invitation was extended to SAGES by the CSS, Chinese Society for Surgery, to attend a recent surgical meeting in Beijing. Joint sessions discussing SAGES educational programs, MIS complications, hernia, hepatobiliary surgery and bariatrics were given by CSS surgeons and SAGES members: Aurora Pryor, Allan Okrainec, Horacio Asbun, and Dan Herron. This was our first interaction with the CSS and we hope will lead to future collaboration in the years to come.

Volunteerism

If you attended the SAGES meeting in San Antonio then you could not help but be moved by the powerful Presidential Address by SAGES President Jo Buyske and Marks Lecture by Cameron Wright. Jo reminded us that SAGES members have been bestowed with extraordinary gifts of talent and resource. As result we must give of ourselves to those less fortunate. During her presidency, she established the Humanitarian Task Force which is led by Tonia Young-Fadok. SAGES Humanitarian Task Force is working with Partners In Health (PIH) to develop the Mirebalis Hospital as a teaching hospital in Haiti. SAGES has almost completed work developing a donation registry to seek surgical equipment from industry. We are partnering with PIH to help equip the hospital. Once the hospital is up and running SAGES will help create a general and MIS curriculum, provide enduring materials and send faculty to actually train-the-trainers. The hospital should be ready to receive equipment by November. Let Barbara Berci or Tonia Young-Fadok know if you are interested in making a donation. Cameron Wright demonstrated a profound depth of commitment when he volunteered to join the reserves in order to serve in the same theater of operations as his son in the Middle East. When he finished his presentation, the room was silent. It was a surreal moment of remarkable energy and feeling. As a former reservist deployed to the Middle East, I can assure you that as a surgeon there are no issues of ideology. I joined the reserves in 1987 after my surgical training was complete with only one idea in mind. I had been the beneficiary of a marvelous education with the skills needed to help young soldiers who fall into harm’s way. It was one way of giving back. It worked for me, but have you thought about what might work for YOU?

All of today’s soldiers are volunteers. SAGES recognizes these efforts through our Military Working Group led by Rob Lim, (Army) and Charlie Godinez (Navy). Charlie is both a MIS surgeon and a jet fighter pilot (eat your heart out Maverick). The Task Force has been busy. They have done “live from the battle field” presentations at recent SAGES meetings. In addition, this group is also working on issues of transition for soldiers returning from international deployment dealing with issues like: how do you keep your MIS skills sharp in the field so you can function safely when you get back home? Thank you for your service.

SAGES as a Global Society: Is there value?

While the world is getting smaller, it is also changing in ways we are not entirely used to here in the US. We will have to share the stage of “first nations” with others emerging in these chaotic times. The economic realities of the world are harsh, but it’s not just that. We will have to overcome our myopic tendencies. “Every man takes the limits of his own field of vision for the limits of the world.” My friends, innovation is taking root in every corner of the globe. We will miss these exciting opportunities if we retreat into our own shell frustrated by bureaucracy, the payers, or our own unwillingness to look past our noses to learn what is happening beyond our borders. Yes, we still have a lot we can teach, but equally we have a lot we can learn. Have you any idea how to practice in a 7000 bed hospital? Do you know where the POEM (per oral endoscopic myotomy) was developed? Could you reduce the (actual) cost of your case by 50% without reducing quality? How many US surgeons have done 1000 minimally invasive gastrectomies or 500 laparoscopic hepatectomies? Why haven’t US surgeons done more than 2000 NOTES cholecystectomies as they have in South America and in Europe?

We need to be excellent worldwide partners if our patients are going to realize all of the opportunities available. We have made terrific strides, but there is still more we can do. For instance FLS remains the premier validated laparoscopic didactic/skills training program worldwide. Some countries like Australia have strong FLS adoption. What about non-English nations? We have found that skill training transcends language barriers as I noted earlier, but the didactic test in reality is an English language exam for many competent surgeons who have attempted it. It is not a simple matter of translation. The new material would have to be re-validated if it is to carry the same gravitas in other parts of the world. We would also have to find ways to provide the same examination security as we have here. None of this is easy or inexpensive, but it is not insurmountable or rocket science either. Perhaps we should find a way.

Several years ago SAGES changed its name (but not its acronym) by inserting the word “and” in order to reflect the idea that we are not just a video controlled surgery group but a GI society as well. This was prescient leadership as we have grown in body and stature since. I would ask you to consider something a bit more subtle and ponder what the term “American” in our name could mean. The Americas span from nearly the North Pole to the tip of Chile. It may seem simplistic, but the first step to becoming a real global partner is to change the way we look at ourselves, perhaps starting by interpreting our name and with that, our backyard, more broadly. Building these global partnerships can only enhance the outcomes for our patients here at home. After all, the world is becoming a smaller place.

If you wish to participate in these global programs or any other SAGES activity, please write me at president@sages.org. As always your comments are welcome.

Steve Schwaitzberg, MD

Message from the President – August 2011

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Early in July, the 6th annual NOSCAR sponsored Conference on NOTES was held in Chicago near O’Hare airport. I thought now would be the perfect opportunity to update you on the current status of the journey – what’s been accomplished, where are we now, where might we be going. The Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) was launched in 2005 through the vision of SAGES and ASGE past presidents David Rattner and Robert Hawes, as a dual-society collaboration to explore the feasibility, safety and challenges associated with translumenal surgery. Our collective imaginations were sparked by the preclinical work of Tony Kalloo and Sergei Kansevoy at The Johns Hopkins Hospital and the trans-gastric appendectomy performed by Rao and Reddy in India using off the shelf flexible endoscopic tools. How would this be developed? Would we repeat the frenzy (good and bad) of laparoscopy of the late 80’s and early 90’s? NOSCAR was formed as a SAGES/ASGE collaboration to responsibly guide the introduction of these techniques. I remember that first NOTES conference in Arizona. The excitement was palpable. How were we going to accomplish safe and reliable gastric closure? Would we finally realize the dream of scarless and painless cholecystectomies and appendectomies? What new tools would be developed? The first white paper charted the initial course for a prudent physician-led introduction of NOTES. In the first few years the NOSCAR Joint Committee raised 2.65 million dollars for competitive basic research. Grants were reviewed and awarded by the research committee independent of the funding source. NOTES societies sprang up around the world often modeled after the NOSCAR. A few years later, around the world the first clinical cholecystectomies appeared using trans-gastric and trans-vaginal (I didn’t see that coming) approaches. The feeling then was that all NOTES cases should be done on protocol and small series emerged demonstrated feasibility of the NOTES techniques to the point where we decided that a prospective clinical trial could be organized comparing NOTES cholecystectomy to standard laparoscopic cholecystectomy. This is underway.

Ten Accomplishments as a result of SAGES and ASGE forming NOSCAR.

  1. A valuable and durable relationship between SAGES and ASGE which has opened a heretofore unseen dialogue between GI and Surgical colleagues at a national and international level. As a result there is also opportunity to work jointly on a panoply of non-NOTES but still communal issues such reimbursement, training, research and education.
  2. An outpouring of tool development that will benefit laparoscopic or endoscopic procedures regardless of the success or failure of NOTES as a technique.
  3. A re-energizing of the commitment to furthering the march toward reducing pain or improving cosmesis. The explosion of single port procedures can be attributed to this journey. The multiple reports of single port procedures were largely ignored for years until the formation of NOSCAR.
  4. The engagement of industry to work in a previously unseen collaborative fashion to fund first the basic research grants and then the human clinical trial. Companies providing funding for cases where competitors products might be employed at least borders on the altruistic since it has never happened before. NOSCAR seeks to discover in a prospective fashion information concerning the safety and efficacy of NOTES as a generic platform. Five competitors (alphabetic) Covidien, Ethicon Endosurgery, Olympus, Karl Storz and Stryker have jointly contributed funding NOSCAR research in an arm’s length fashion allowing the consortium total control of grant awards.
  5. The interest in NOTES has fostered development and human application of the POEM (per oral endoscopic myotomy) procedure for the totally endoscopic treatment of achalasia. This may very well become the standard of care for this disease in the near future.
  6. The development of a transrectal NOTES procedure for the treatment of rectal cancer has been fostered by the NOSCAR basic research grants and now is in clinical trial.
  7. Six international meetings, two white papers and more the 600 PubMed citations since 2005.
  8. The initiation of the Human Clinical Trial for NOTES versus laparoscopic cholecystectomy conducted as a Society as Investigator Trial by NOSCAR. More than 30 patients have already been enrolled at Baystate, Yale, Oregon Clinic, Northwestern, UCSD hospitals with several more sites about to join.
  9. The international engagement of surgeons on many continents to initiate their own NOTES development including the creation of many NOTES collaboration groups modeled after NOSCAR. Thousands of NOTES cases have been performed worldwide.
  10. The recognition that concepts that we thought were sacred need constant re-evaluation.

This year’s NOTES conference audience was polled: What percent of cholecystectomies will be performed via a natural orifice approach in 2020? As you might expect opinions varied, but no one (admittedly the group is biased) thought NOTES would be a historical footnote gone the way of gallstone lithotripsy.

What do you think? Make your voice heard by clicking this survey link.

Regardless of the future for NOTES, the creativity and imagination of surgeons around the world has been captured in a fashion similar to the early days of laparoscopy. Our surgical lives are not destinations; they are truly journeys. NOTES and the NOSCAR consortium embody the value of such an adventure. Most importantly, it has been traveled with great care and the foremost concern for the welfare of our patients.

If you have ideas, questions or concerns about SAGES or the future of surgery, please write me at president@sages.org

Steve Schwaitzberg, MD

Message from the President – June 2011

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The next time you sit in an airplane you might spend a moment thinking about how the flight crew incorporates the new technology that is added to the aircraft from time to time.  Certainly the advent of GPS occurred in the midst of the careers of many senior pilots as well as the evolution of more sophisticated instrument landing systems.  As a passenger you have the general expectation that the pilots were trained on these new systems long before you walked into the cabin that day.  As a pilot, each time I planned to fly a new aircraft I was required to take a check ride with a flight instructor in order to be certain I was able to manage the systems in the aircraft,  such as the new GPS,  in order to avoid a potential fatality – mine.  Is certainly been said many times in the aviation industry that the lessons pilots learn are too often written in their own blood. As surgeons, that’s not quite true for us, (think about whose blood) but that shouldn’t change our commitment to be the masters of all the new technology that enters into the operating room.  I suppose I’m dating myself when I confess that I finished my training prior to the advent of the ultrasonic dissector, argon beam, and sophisticated radio frequency coagulators. It was mostly the good ole Bovie in my training days. New energy devices that came along in the 1990s such as ultrasonic dissectors clearly enabled us to do more advanced minimally invasive surgical procedures than ever before.  Even recent graduates are confronted with new devices that deliver significant energy to tissue on a frequent basis.  In your own practice, how did you learn to use the latest tool that you added to your energy armamentarium?  Do you even know generally how it works? Can you assemble it? Could you (or your circulating nurse) successfully troubleshoot a malfunction? Do you know your responsibilities if it malfunctions? The answers to these questions are often disappointing from a patient safety point of view.  I found this troubling and initiated a series of discussions within the SAGES Executive Committee and the SAGES Board of Governors hoping to persuade my colleagues that in the footsteps of FLS and FES, our third fundamentals program could be born.  Like all new ideas that promote potential change a variety of responses were encountered.  Some were wildly enthusiastic while others questioned the need to devote financial resources and a lot of human surgeon volunteer capital for such a curriculum. After all “we are the experts aren’t we?”  But not unlike the new word you learn that you start to see it everywhere, the realization that there is a legitimate need for this curriculum began to emerge. Just in the last two months I have become aware of 4 recent OR fires.  Still unconvinced? Check out https://www.outpatientsurgery.net/search/?sQ=fire.

Our past president, Jo Buyske, appointed Dan Jones to head the newly created task force charged with developing the curriculum and validated assessment methodology in the area of surgical energy. True to form Dan immediately went to work on the first order of business – the project needed a name.  Blessed with a true inspiration, the FUSE project was launched.  Pascal Fuchshuber and Liane Feldman were named co-chairs and the team went to work developing the FUSE taskforce. The Fundamental Use of Surgical Energy is currently under rapid development.  FUSE Taskforce and PG Course Leaders members include Atul Madan, Brian Dunkin, Dana Portenier, Dan Herron, Danny Scott, Dean Mikami, Esteban Varela, Gerry Fried, Gretchen Purcell Jackson, Leena Khaitan, Sharon Bachman, Suvranu De, Thomas Robinson, Scott Melvin, Warren Grundfest, William Richardson, Stephanie Jones, Malcolm Munro, Randy Voyles, Mike Brunt, James Choi, Scott Helton, Jeff Hazey,  David Iannitti,  James Ulchaker, and  Carla Bryant and Jessica Mischna (SAGES staff) – my sincere thanks to all of you  for you hard work!

A pilot postgraduate course developed by the FUSE task force was rolled out at the SAGES annual meeting in San Antonio with didactic and hands-on components. These didactics are the basis for the upcoming SAGES FUSE manual to be published by Springer later this year. The task force which represents a multidisciplinary effort by general surgeons, gynecologists, anesthesiologists, urologists, nurses as well as others is hard at work refining the curriculum and developing validated assessment tools similar to those seen in FLS and FES.  In addition to the manual, the curriculum will be available as a web-based tool and will be designed to meet surgical residency training needs and MOC requirements in the area of patient safety. 

The challenges of providing specific tool-based training are formidable but not insurmountable.  The current climate designed to protect operating room personnel from excessive sales based interactions also raises barriers to very important informal in-servicing an instrument instruction.  SAGES’ positions concerning relationships with industry as a surgical professional society are stated in our white paper: https://www.sages.org/publication/id/COI/   ( see also Surg Endosc. 2010 Apr;24(4):742-4.)  This document goes on to describe why a transparent relationship of surgical societies working with device makers as education partners is in the best interests of patient safety and high-quality surgical outcomes.  The FUSE task force will work under this rubric with the makers of the most commonly used energy devices (who admittedly know the most about their specific devices) to independently create high-quality education modules designed to fill the tool specific knowledge gap. 

Our goal is to help each surgical team perform at the most efficient and safest level, kind of like what you would expect from your pilots and flight crew and next time you step into in a plane. The WHO got it right with the Checklist mantra: safe surgery saves lives.

If you have suggestions for the FUSE project or wish to participate, please write me at President@SAGES.org. 

Steve Schwaitzberg

Message from the President – May 2011

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This month I am writing to all current SAGES members and those of you in the general surgical community thinking about “how many societies do I need to belong to?” In this day and age of declining reimbursements and dramatic economic “belt-tightening”, this becomes an ever increasingly important question. In my mind a professional society has to be a good value proposition for its members. Clearly this can be achieved in a number of ways. Access to educational materials, Surgical Endoscopy subscription, terrific annual meetings, committee participation, networking with friends and colleagues are but a few. However, I would like to focus on what I hope you will find beginning this summer to be a key benefit of membership and a real plus to the value proposition of belonging to SAGES.

As many of you know the process of maintaining certification by the American Board of Surgery has evolved from a one-time exam, through an every 10 year examination process, to what we have today:  the Maintenance of Certification Program (MOC). Part 2 of this MOC program is: Lifelong learning and self-assessment, which is achieved through practice relevant continuing education and periodic self-assessment.

This summer SAGES will be launching its newest educational program, SAGES University. This program will enable participants to receive Part 2 MOC credits as an included benefit of SAGES membership. There will be no additional charge for participating in this program. SAGES members could earn all of their MOC credits without additional expense in the SAGES University program.

This program was developed by SAGES’ Continuing Education Committee which is chaired by Dr. Danny Scott and co-chaired by Drs. Tim M. Farrell and Simon Bergman. SAGES University will offer SAGES members online educational materials packaged with methods for self assessment. The educational content is incremental, with activities ranging from 15 minutes to 1 hour. All activities are linked not only to CME credit, but also to Self Assessment (SA) credit, which is required by the ABS for MOC Part II.

SAGES University will use an electronic learning management system (LMS) which will include a “My CME/My MOC” page to track all activities. These credits will be tracked according to specific disease-based content areas, such as hernia or bariatrics and by key designated areas including ethics, patient safety, etc. These activities will be directly downloadable to the ABS database for MOC purposes.

SAGES University will roll out with 2 programs: Journal Club and the Online Self Assessment Program (OSAP). Surgical Endoscopy articles (free to SAGES members) will be selected by the Editor-in-Chief, Dr. Mark Talamini. The articles will be accessible through SAGES University website or other online access through SpringerLink and identified as “SAGES University – CME/SA Credits offered”. Four multiple choice questions with a 75% minimum passing score is required to receive credit. 1.0 hr CME/SA credit per article. SAGES Journal Club has been coordinated by Dr. Don Selzer along with task force members: Rose Chan, David Crawford, Rajesh Aggarwal, Steven Bowers, Teodor Grantcharov, Niazy Selim, and Kent R. Van Sickle.

The Online Self Assessment Program (OSAP) is based on existing online SAGES content. This can be accessed via SAGES University or via random access during review of online content (Flagged with link for “SAGES University – CME/SA Credits offered”). The initial content will be based on 30 videos featured on SAGES TV. The will be a 15 minute content review and 1 multiple choice question per .25 credit. New content will be added every six months. OSAP is coordinated by Danny Scott along with taskforce members: John Sweeney, Nicole Fearing, Limaris Barrios, Paul Hansen, Elisabeth McLemore, Michael Cahalane, and Marina Kurian.

SAGES University began from ideas generated at the 2008 leadership retreat. Lead by the Continuing Education Committee and supported with internal investments authorized by the SAGES Board of Governors for the development of the Learning Management System, SAGES University represents a commitment to SAGES members to provide CME/MOC for recertification in general surgery as a value benefit of SAGES membership. In addition, all CME earned at the SAGES annual meeting from 2011 onward will also qualify for Part 2 MOC if the surgeon replies to the self assessment questions that will be emailed after the meeting.

If you are wondering where you are in the MOC cycle (like I was recently), go to https://home.absurgery.org/. Log in to your account and examine your MOC timeline listed in the MOC section. You might discover (like I did) that you have some Part 2 MOC to earn and a form to fill out. Fortunately you will be able to use SAGES University to meet those Part 2 needs right from your desk.

I would like to congratulate the entire Continuing Education Committee and the SAGES University team along with the SAGES staffers like Yumi Hori, Erin Schwarz and Vanessa Cheung who have worked hard to bring this project online. Their efforts are just one of the many reasons why more than 6,500 general surgeons are SAGES members. If you are not member, there has never been a better time to join. If you are already member, check out SAGES University when the doors open this summer.

See you in class!

If you have ideas how together we might make SAGES an even stronger value proposition for membership, or if you have concerns, please write me at president@sages.org .

Steve Schwaitzberg, MD

Message from the President – April 2011

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Like many of you I recently returned from the SAGES annual meeting in San Antonio marking our 30th anniversary. More than 2000 surgeons and allied health professionals registered for this year’s meeting. I would like to personally congratulate Brian Dunkin, this year’s program chair and his whole team for an extraordinarily engaging series of post graduate courses and scientific sessions. Many sessions were packed and a few were standing room only. There was so much great information it was like trying to drink from a fire-hose – you could not possibly take it all in! It was exciting to follow the SAGES Twits, our own version of the digerati who sent Tweets via the SAGES Meeting Twitter application alerting attendees to what was hot and where to find it in real time. If you could not make to the meeting, all is not lost. You can catch many parts of the meeting as well as more than 700 other videos on SAGES TV – check it out.

Despite all of the technologic advances the virtual meeting, is not (yet) ready to replace the real thing. Clearly our HD televisions provide the most granular view of any sporting event you can imagine, yet stadiums, arenas, and parks are still packed for the “big game.” Nothing beats being there. If you want to feel the energy of the crowd, you still have to go there in person. I will admit to being biased, but in general surgery, the SAGES annual meeting is one of the few “big games”. You just have to be there. Whether it was training time in the Learning Center, a hands-on course, a trip through the exhibit hall, rooting for your favorite Top Gun contestant, watching us sing, catching up with an old friend, or a chance to debate the presenter in person, the live meeting is still a singular experience. Moreover, as I sat with more than a thousand people during Jo Buyske’s Presidential address “Those to Whom Much is Given, Much is Required” you could actually feel the power of inspiration moving through the room. When coupled with the Marks Lecture that followed delivered by Cameron Wright” describing the nature of service rendered by the American military surgeon, we left the room thunderstruck.

If you are a regular attendee, you know what I mean. Dan Jones and Danny Scott, the program chairs for the 2012 meeting have given me a sneak peak of what’s in store for 2012. I can assure you there will be unique opportunities unseen before in a surgical meeting. If you have never been or have not been recently, it might be time to plan a trip to San Diego for the annual meeting March 7-10, 2012. There is nothing like a SAGES meeting.

If you want to find out how to participate or have comments, questions, concerns, or ideas how SAGES might continue to improve patient care or surgical education, please write me at president@SAGES.org.

Steve Schwaitzberg