Chairman's Corner

John A. Savino, M.D. Professor & Chairman

Welcome to the Department of Surgery!

Like any successful organization, the Department of Surgery is much more than the sum of its parts. First and foremost, it is comprised of the relationships and interactions among its faculty, residents, students, staff, patients and colleagues. These relationships and interactions define the culture of the department. I am proud and confident in telling you that ours is a culture of excellence, compassion, inquiry, collegiality and vision. It is a culture that is perpetuated and nurtured by our continual focus on integrating and balancing our educational, research and patient care missions. This focus is supported and promoted by a vast network of functional, collegial ties that have been cultivated over many years between our department, the medical school and our affiliated teaching hospitals, each of which provide the very best in services and facilities.

The philosophy of surgery at New York Medical College is to provide an environment attractive to the best academic surgeons, where fundamental principles for teaching and patient care are co-mingled with the exciting technological resources that are revolutionizing modern surgery and reducing morbidity and mortality. This co-mingling is perhaps best illustrated by our progress in minimally invasive surgery. During the last 20 years the widespread application of minimally invasive surgery has developed into a reality. The 1990s saw a flourishing of advanced laparoscopic techniques, and the learning process of surgeons and other specialists began to be systematized. Over the past several years, we have increased the scope and breadth, as well as the volume of procedures performed using minimally invasive techniques. Our challenge is to evolve in ways that build on the strengths of the traditional approaches and enhance our ability to care for patients and educate our students.

In recent years, members of our faculty have been selected for major leadership positions in the American College of Surgeons, the Society of Laparoendoscopic Surgeons, and other national and international organizations, and serve on national review sections of the National Institutes of Health (NIH) and the Association of Surgical Education. Regional and local recognition are even more abundant as one reviews the accomplishments of individual faculty members. These range from serving as regional and state representatives in a number of surgical organizations to recognition for excellent teaching by graduating medical students. Other specific recognitions and accomplishments include the listing of multiple faculty in publications identifying the "Best Doctors in New York," and numerous publications in leading clinical and scientific journals.

Current projects include the further development, refinement and application of minimally invasive surgery in: cardiac transplantation, living donor nephrectomy in renal transplantation; living donor adult and pediatric liver transplantation, robotic surgical treatment of morbid obesity; the treatment of cancer and the expansion of robotics and sophisticated energy sources to the operating room. In addition our program offers skills courses and tele-surgery.

The Department of Surgery at the Westchester Medical Center, one of our two primary academic medical centers, is composed of six divisions: 1) General Surgery, 2) Trauma/Surgical Critical Care, 3) Cardiothoracic Surgery, 4) Pediatric Surgery, 5) Vascular, Endo-Vascular and Transplant Surgery, and 6) Burns and Plastic and Reconstructive Surgery. General Surgery includes: (1) gastrointestinal, hepatobiliary, pancreatic and colorectal surgery; (2) endocrine surgery; (3) oncologic surgery; (4) minimally invasive surgery; (5) image guided surgery; and (6) bariatric surgery.

The Westchester Medical Center has organized six centers of excellence - the Cancer Center, Heart Center, Trauma Center, Neuroscience Center, Transplant Center and Pediatric Center. The department of surgery is involved either directly or indirectly as the core element in each of these centers. Experts from multiple disciplines have been brought together simultaneously to see patients and design treatment plans collectively. This model enhances not only the care of our patients, but also fosters the development of a more integrated research and teaching effort across the basic and clinical sciences, enabling scientific discoveries to be applied to patient care more rapidly.

The American healthcare system is experiencing a radical transformation, driven by pressures to reduce costs. This new healthcare climate has created major challenges for academic departments of surgery, and these pressures have enormous implications for the future of surgery. The infrastructure of the Department of Surgery is strong and the financial base continues to remain stable despite a difficult environment. Our educational programs are thriving; our research programs are expanding and our efforts in faculty development are meeting with progressively increasing success.

We are always overjoyed to hear from past graduates of our program. It is often the comments from these residents, who after taking fellowship and attending positions at other institutions and interacting with graduates of programs across the country, that are the most telling and informative about our program. The testimonial included below so accurately and eloquently summarizes the strengths of our program that we decided to include it in the brochure.

I thank you for considering our program and I hope we've succeeded in conveying the excitement and optimism that we in the department share on a daily basis.

Sincerely,


John A. Savino, M.D.
Professor and Chairman

 

Testimonial from Ovidiu Cristea, Class of 2007:

Dr. Cristea

“I completed my general surgery training at Westchester Medical Center between 2002 and 2007. When deciding where to apply to train, several key elements were important to me:

First, and most importantly, I wanted a program in which I would get a strong hands-on experience in a patient population with diverse pathology, so that once out on my own, I would feel comfortable doing not only basic procedures but more rare and complex ones as well. Implied in this was the desire to be in a center where technology was up-do-date, where surgical simulation was employed, and where critical care was strongly emphasized. Second, I wanted to ensure that I would get a good theoretical and cognitive foundation that would allow me to do well on my board examinations. Third, I wanted to train somewhere where I could work hard yet be treated humanely. Fourth, I wanted a program that would allow me to get into a good fellowship, if I chose to pursue one after finishing training.

I can say that Westchester Medical Center met and exceeded my expectations in all of these areas. Upon completing the program I logged over 1100 cases, many of which were complex and included transplantation, hepatic and biliary resections, pancreatic surgery, bariatric and other advanced laparoscopy (laparoscopic colons and donor nephrectomies), and the treatment of cancers of all types from sarcomas to endocrine tumors. In pediatrics I participated in tracheo-esophageal fistula repairs, diaphragmatic hernia repairs in the NICU, and PDA ligations. The vascular experience was top-notch in both open and endovascular and prepared me for some of the work I am eventually doing. The experience at St. Vincent's hospital solidified a broad base in general surgery with a strong emphasis on laparoscopy - including laparoscopic inguinal and ventral hernias, colon resections, thyroid and adrenal surgery and breast. Since WMC serves a very large catchment area, there is a virtual endless supply of different pathology that one sees. Upon completing the program, I feel comfortable operating on a wide array of conditions and tackling difficult intraoperative dilemmas with confidence. An excellent skills lab affords the opportunity to further sharpen skills.

Because critical care is emphasized in the program almost as much as surgery itself, I developed the ability to take care of very sick surgical and trauma patients. Regardless of whether one will likely use right-ejection fraction (REF) catheters or continuous-cardiac output Swan Ganz catheters in practice, using these on a daily basis while in the ICU teaches you an incredible amount about cardiopulmonary physiology which is something that every surgeon needs to know. The residents learn and co-manage critically-ill trauma, transplant and general surgery patients right alongside the ICU fellows, and there is plenty of work to go around such that resident's experience is unsurpassed by that of the fellows.

The five years of training was not easy - nor should it be if you are to be successful at mastering the many skills demanded of a surgeon in such a short period of time. Furthermore, regardless of where you go, a lot of what you get out of a program is what you put in. For me, I was able to work hard and get my work done, but at the same time, had enough time to study for cases and for the boards, which I passed immediately upon graduation from the program. The repeated Socratic questioning I received from Dr. Savino and others helped me develop my surgical reasoning, and learn to think in such a way that helped me not only for my oral boards, but also for general patient care. And although the work was difficult, I felt appreciated as an individual by my attendings, which is not something universal at other programs.

Upon graduating, I matched in plastic surgery at Indiana University, a program which I recently completed. I have subsequently entered the world of private practice plastic surgery in Indiana and greatly enjoy what I do. Even while in training at IU, the vascular skills I had acquired from Westchester Medical Center helped me with learning microvascular flap and hand surgery. The Westchester ICU experience helped me take care of sick reconstructive plastic surgery and burn patients with ease.

Graduates of the program choose varied paths, and have entered such fields as laparoscopy/bariatric, vascular, pediatric surgery, plastics, cardiothoracic, trauma/ICU and general.
As I look back, I have fond memories of Westchester Medical Center and the excellent training that I got there, and would train there again if I had to do over. Anyone who wants to get a strong foundation in surgery that will then open doors to virtually any desired path, and who is not afraid of working hard, should consider Westchester Medical Center. I am happy to answer any specific questions from any applicant.

Best of luck to everyone!”

- Ovidiu Cristea (cristeamd@gmail.com)