Robert V. Rege, MD
The Hall and Mary Lucile Shannon Distinguished Chair in Surgery
Professor and Chairman
As I reflect on my years since I was named as Chairman of the Department of Surgery, I am pleased with the progress the department has made. Clinical programs are thriving, research programs and the faculty associated with them are maturing, and education programs are strong and becoming stronger. We attract strong candidates for our training programs and are recruiting impressive young faculty with great potential. We have much to be thankful for and are truly blessed by the quality of the individuals assembled in this department and at this institution.
There have been significant changes in clinical programs at University Hospital, Parkland Memorial Hospital, Children’s Medical Center, and the North Texas Veterans Administration Hospital. The large patient populations and the breath disease seen in our patients remain one of our greatest assets and provide the basis for excellent training programs in surgery and subspecialties. Our challenges have been to meet the needs of this growing practice while maintaining and expanding education and research programs. We remain committed to providing the highest quality health care to all of patients on our campus and to expand our research activities into our large practices by developing transitional, clinical, and health service research programs. In this regard, the University purchased both St Paul and Zale University Hospitals and integrated them into a single entity, University Hospitals. In addition, an Ambulatory Care Building with an outpatient surgical center was build and opened in December, 2006. These venues provided the resources needed to develop key new and expand existing programs on campus.
In many areas, clinical activity has reached critical mass for the performance of clinical and transitional research. The department administers a very large emergency medicine/emergency and surgery/trauma program. This well-integrated system allows us to perform and control care and studies, from the scene of an accident, through intensive care and hospitalization, to follow-up outpatient care. This has culminated in a NIH designation as a resuscitation center and several important multi-center clinical trials are planned with the other designated centers across the country. Likewise, multi-institutional studies examining the role of genetics on inflammatory response (so-called Glue Grant) have been quite productive and we have been a large contributor to these studies. Similarly, we are proud of programs in minimal access surgery, breast disease, genetic profiling of breast cancer, pancreatic and upper GI malignancy, melanoma, colorectal disease, domestic violence and trauma prevention, and bariatric surgery which are now well-established, growing, and increasingly multidisciplinary.
Our efforts to meet external and internal demands on our teaching programs, especially work-hour limitations, without affecting the quality of our training programs are coming to fruition. Resident work hours on the average are below the 80-hour limit. Residents currently meet the criteria for consecutive hours in the hospital, and they are ensured to have a 24-hour period free from clinical duties each week. The increasing clinical duties and the conscientious nature of our residents tend to result in “creep” back to old habits, but effective monitoring and intervention ensure that we do not return to old paradigms. We have had to reorganize services, change resident expectations and habits, and institute an emergency surgical service at Parkland Memorial Hospital to deal with the large number of emergencies that present to us there. We have not solved all of the problems, but we have crossed major hurdles to control the imbalance between increasing clinical demands and education/social needs of trainees. These changes have been an impetus for us to “think out of the box” and to develop novel methods of training our residents. This is especially apparent in our skills training program mentioned above.
Although we have done extremely well in attracting students into our training programs over the past 3 years, we are not complacent and have actively changed our educational programs to meet student needs. We are seeing increased interest in surgery as a career, and students are beginning to perceive that there is a growing need for surgeons in this country. I receive calls, on a daily basis, from Parkland graduates who are seeking partners that they need “yesterday” and I have to tell them that most of our residents interested in entering practice have had prospects and offers since their 3rd year of training. UT Southwestern surgery residents have more offers than ever, and the job opportunities are in excellent communities. They are also receiving some “interesting” deals, demonstrating the competitive market that now exists for general surgeons in this country. I believe that general surgery is alive and well, and that it will take many years to correct discrepancies between supply and demand since our training programs take so long.
We are proud of our institution/department and the fine individuals – faculty and staff, residents and students, research technicians and clinical caregivers – who ensure the excellence of our programs. We have excellent working relationships with our hospital partners and appreciate the expertise they bring to our healthcare system. Please examine our programs through this website, or better yet, visit us. There is plenty of room in our department for faculty, staff, and trainees who are interested in improving surgical care of patients, educating students, residents, and surgeons in practice, and/or expanding surgical knowledge. This is an invigorating environment that will expand your abilities and desires to remain on the cutting edge of surgical care for the rest of your care.
