Behind The Knife: The Surgery Podcast

Our oral board review course includes 92 scenarios that meticulously cover 115 SCORE core topics. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the Oral Board Review episodes at https://behindtheknife.org/premium/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Welcome to the second Surgical Palliative Care Journal Club, number four of a six-part series focused on the integration of palliative care into the practice of surgery.  Join us as we discuss the value of utilizing an advance care planning video during surgical oncologic care and define the similarities and differences between advance care planning and serious illness communication.  We then explore how a multidisciplinary committee may improve perioperative decision making and discuss the importance of the interdisciplinary palliative care team.    Please use the links below to learn more about advance care planning and serious illness conversation. Integrating Advance Care Planning Videos into Surgical Oncologic Care:  A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/30964385/ A Multidisciplinary High-Risk Surgery Committee May Improve Perioperative Decision Making for Patients and Physicians https://pubmed.ncbi.nlm.nih.gov/34851187/ What’s Wrong with Advance Care Planning? https://pubmed.

Surgical training is evolving, and with advancing surgical techniques, the traditional “time-served” model of residency may not best serve the needs of our learners or patients.  In this episode, we discuss recent efforts at the Indiana University surgical education program to implement a comprehensive laparoscopic cholecystectomy that utilizes all of the best practices of competency-based education.  We’re joined by first author Dr. Betsy Huffman, along with her mentors Drs. Jennifer Choi, Matthew Ritter, and Dimitrios Stefanidis for a practical review of their pioneering work.  Learning Objectives: ·       Review challenges to the current paradigm of surgical education ·       Define competency-based education ·       Discuss practical challenges facing surgical educators when implementing new curricula References: A competency-based laparoscopic cholecystectomy curriculum significantly improves general surgery residents’ operative performance and decreases skill variability – https://doi.org/10.1097/SL

Ductal carcinoma in situ, or DCIS, is a precursor lesion to invasive breast cancer; however, not all DCIS becomes invasive cancer. Given our inability to accurately determine which DCIS lesions will progress, current clinical management consists of surgical resection for everyone with the possible additions of radiation and endocrine therapy. Multiple clinical trials and leaders in the field of breast surgical oncology are challenging our assumptions about the uniform approach to DCIS and are attempting to design treatment based on biology— tune in to hear about the evolving approach to management of DCIS! Hosts: Alexa Glencer, MD Michael Alvarado, MD Rita Mukhtar, MD Laura Esserman, MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out other breast surgery episodes here: https://behindtheknife.org/podcast-category/breast/

We are facing a difficult case tonight: stab wound to the base of the left neck. Hope you know your anatomy well and are ready for a ride. Let’s see how one manages a patient whose injury is life threatening, a challenge to correctly diagnose, approach and repair. Join Drs. Urréchaga, Neeman, and Rattan from Ryder Trauma Center in Miami as they go through a real case trying to save a life and dominate the day. Learning Objectives:  Reviewing thoracic outlet anatomy. Simplifying primary survey and immediate care for penetrating great vessel injuries. Discussing possible surgical approaches for various great vessel injuries, incisions, extensions, tips and tricks. References 1) Feliciano DV, DuBose JJ. Cardiac, great vessel, and pulmonary injuries. In: Rasmussen TR, Tai NRM, eds. Rich’s Vascular Trauma. 4th ed. Philadelphia: Elsevier, 2022: 171-198. 2) Karmy-Jones R, Namias N, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating chest trauma. J Trauma Acute Care Surg. 201

Personal Statements and Letters of Recommendations- two things that can make or break any residency or fellowship application. Join our education fellow, Dr. Jessica Millar, Dr. David Hughes, and Dr. Gifty Kwakye as they discuss what makes a truly great personal statement and how to compile a strong team for your letters of recommendation.  Guests:  David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan  GIfty Kwakye, MD, MPH- Clinical Assistant Professor of Colon and Rectal Surgery, Surgical Clerkship Director- University of Michigan Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our Medical Student and Intern Survival Guide here: https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

It’s that time of year- when medical students across the country are preparing their residency applications. The process can be a bit daunting, and there have been a number of changes to process over the past few years. Join our education fellow, Dr. Jessica Millar, and Dr. David Hughes as they review the “nuts and bolts” of this year’s residency application cycle.  Guests: David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan  Important Dates:  ·      June 8, 2022: ERAS application opens at 9 a.m. ET. ·      August 1, 2022: Supplemental ERAS application opens for applicants. ·      September 7, 2022: Residency applicants may begin submitting ERAS applications to programs at 9 a.m. ET. ·      September 16, 2022: Supplemental ERAS application closes for applicants at 5 p.m. ET. ·      September 28, 2022: Residency programs may begin reviewing ERAS applications, MSPEs, and supplemental ERAS application data at 9 a.m. ET. Pleas

Bringing back an oldie but a goodie - Join Dr. Patrick Georgoff and Dr. Vahagn Nikolian as they discuss common and critical intern dilemmas.  This episode is Part 2 of 2. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our entire Medical Student and Intern Survival Guide series here - https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Bringing back an oldie but a goodie - Join Dr. Patrick Georgoff and Dr. Vahagn Nikolian as they discuss common and critical intern dilemmas.  This episode is Part 1 of 2. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our entire Medical Student and Intern Survival Guide series here - https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Pilonidal cysts – a simple disease or a sneaky nuanced problem? Drs. Shanaz Hossain,  Patrick Georgoff and Scott Steele sit down to discuss the difficulties encountered in the management of pilonidal cysts and the myriad of treatment options available, ranging from non-operative management to outpatient pit picking to major operations involving flaps. Dr. Steele dropped his “8 Key Principles for Pilonidal Cyst Management”: 1.    Control Sepsis 2.    Do the Least Amount of Work Possible 3.    Avoid Too Much Excision 4.    Remove All Hair, Un-Roof All Disease, and Debride Granulation Tissue 5.    Use Off-Midline Excision and Closure 6.    Tension Must Be Minimized with Primary Wound Closure 7.    Change the Anatomy – Flatten the Natal Cleft 8.    Never Underestimate the Impact of Postoperative Care Tune in for detailed insights regarding management and learn about all the options for surgical treatment!   Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos an

Join our Emergency General Surgery team as they discuss Necrotizing Soft-Tissue Infections. Hosted by Drs. Jordan Nantais, Ashlie Nadler, Stephanie Mason and Graham Skelhorne-Gross. Necrotizing Soft-Tissue Infections: - Also known as “flesh eating disease”, gas gangrene, necrotizing fasciitis/myositis, Fournier’s gangrene. - Early findings are non-specific - Rapidly fatal - diagnostic delay can lead to tremendous additional morbidity and mortality Classification: - Type 1 - polymicrobial category (most common) found in immunosuppressed or elderly - Type 2 - monomicrobial infection [Group A Streptococcus > Methicillin-resistant Staphylococcus aureus (MRSA)] - Type 3 - monomicrobial infection (Vibrio or Clostridium) - Type 4 - fungal (rare) in immunocompromised or after penetration or trauma from candida or Zygomycetes. Initial Workup - History: (comorbidities, immunosuppression, recent infections or trauma) - Exam: swelling, open lesions, drainage, erythema, crepitus, and pain out of proportion      - M

You get consulted on a 34-year-old with ileocolic Crohn’s disease on Humira. You determine he needs surgery for recurrent partial obstructions. When do you do the surgery? How long should he be off his biologic medication? When to restart it post op? Join Drs. Abelson, Marcello and Aulet as they take us through two articles to help us figure it out! Learning Objectives: 1.     Describe the complications of biologic medications in the peri-operative period 2.     List the different classifications of medications for Crohn’s disease 3.     Discuss the approach to managing timing of surgery for patients with crohn’s disease Articles: Cohen BL, Fleshner P, Kane SV et al. Prospective Cohort Study to Investigate the Safety of Preoperative Tumor Necrosis Factor Inhibitor Exposure in Patients With Inflammatory Bowel Disease Undergoing Intra-abdominal Surgery. Gastroenterology. 2022 Apr 10;S0016-5085(22)00359-6. doi: 10.1053/j.gastro.2022.03.057. Online ahead of print. Brouquet A, Maggiori L, Zerbib P, Lefevre JH,

Want to learn more about achalasia and its procedural management? Excited about the POEM procedure?  Learn what the current literature says when it comes to recommending POEM or the tried-and-true Heller myotomy from the Swedish Thoracic surgery team. Learning objectives -        Review basics of achalasia -        Discuss the current literature comparing POEM and Heller myotomy with fundoplication -        Understand the major differences in outcomes for these procedures Hosts: Peter White, MD Megan Lenihan, MD Brian Louie, MD Kelly Daus, MD Referenced Material Werner YB, Hakanson B, Martinek J, et al. Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia. N Engl J Med. 2019 Dec 5;381(23):2219-2229. doi: 10.1056/NEJMoa1905380. PMID: 31800987. Gu L, Ouyang Z, Lv L, et al. Safety and efficacy of peroral endoscopic myotomy with standard myotomy versus short myotomy for treatment-naïve patients with type II achalasia: a prospective randomized trial. Gastrointest Endosc. 2021 Jun;93(6):1304-131

The utilization of point-of-care ultrasound and other non-invasive cardiac output monitoring technologies varies because of knowledge, resource availability and cultural practices. In this  Clinical Challenge in Surgery episode from the Surgical Critical Care team at Behind the Knife, we provide a brief history of the use of cardiac-output monitoring in the ICU, introduce a few clinical scenarios in the context of point of care ultra-sound and other less-invasive cardiac-output monitoring technologies. Learning Objectives:  In this episode, we review the historical uses of central venous pressure monitoring, pulmonary-artery catheters and the more frequently utilized point-of-care-ultrasound (or POCUS) in managing complex ICU patients. We review the outcomes behind these technologies, describe the views and utility of POCUS, and introduce less-invasive or completely non-invasive ways to measure cardiac-output monitoring.  Hosts: Brittany Bankhead, MD, MS (@BBankheadMD) is an Assistant Professor of Surgery

Dr. Jordan Frey, a Plastic Surgeon in Buffalo NY, joins us to talk about how he uses investments in real estate to diversify his portfolio.  We discuss:  -Types of real estate investments and the pros and cons -Books to read on real estate investing -How to get started in real estate -Criteria he uses to choose a property and more Books recommended: The Millionaire Real Estate Investor - Gary Keller https://www.amazon.com/Millionaire-Real-Estate-Investor/dp/0071446370 Doctor's Guide to Real Estate Investing - Cory Fawcett https://www.amazon.com/Dr-Cory-S-Fawcett/e/B01FGK0IC8/ref=aufs_dp_fta_dsk Find Dr. Frey at his website or on social media. Prudentplasticsurgeon.com  or @JordanFreyMD Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Dr. Jill Streams, Trauma Surgeon at Vanderbilt, takes us through the ins and outs of understanding your first contract and how and when to negotiate.  In this episode we cover -When/how to apply for your first job -Break down each part of a contract -Why you should negotiate -What and how to negotiate -Salary expectations -Contract landmines and more! You can connect with Dr. Streams on Twitter @JCRStreams Read more at WCI https://www.whitecoatinvestor.com/things-to-ask-for-in-a-physician-contract/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Kevin interviews Dr. Adam Tanious a Vascular Surgeon at MUSC about the ins and outs of managing student debt. Adam is passionate about personal finance and student debt and is happy to discuss further with our listeners, please reach out at tanious@musc.edu . Want to learn more at student debt? Check out White Coat Investor resources on student debt.  https://www.whitecoatinvestor.com/ultimate-guide-to-student-loan-debt-management-for-doctors/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Kevin Kniery and Jason Bingham interview Larry Keller of Physician Financial Services on how and when to choose the right disability policy. You can reach Larry here Lkeller@physicianfinancialservices.com or at his website.  https://www.physicianfinancialservices.com/ White Coat Investor Article breaking down Disability Insurance https://www.whitecoatinvestor.com/what-you-need-to-know-about-disability-insurance/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Kevin Kniery and Jason Bingham interview Dr. Jason Mizell, a colorectal surgeon at University of Arkansas and pioneer in finance education for surgeons. He won the 2020 White Coat Investor Award for excellence in financial education. In this episode they discuss how to invest, and what to invest in, also cover topics regarding real estate, and biggest financial regrets.  Links to articles discussed Financial Waterfall for Docs https://www.whitecoatinvestor.com/financial-waterfalls-for-new-residents-and-attendings/ Backdoor Roth IRA Point/Counter Point https://www.physicianonfire.com/the-backdoor-roth/ Simple Path to Wealth https://jlcollinsnh.com/stock-series/ Dr. Mizell can be reached at jsmizell@uams.edu Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Kevin Kniery and Jason Bingham interview Dr. Jason Mizell, a colorectal surgeon at University of Arkansas and pioneer in finance education for surgeons. He won the 2020 White Coat Investor Award for excellence in financial education. In this episode they discuss his lecture "How to Resuscitate Your Critically Ill Finances".  Dr. Mizell can be reached at jsmizell@uams.edu Book Recommendation: The Psychology of Money  https://www.amazon.com/Psychology-Money-Timeless-lessons-happiness/dp/0857197681 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.