Rachael Forsythe (Edinburgh, UK) writes about an “enriching and rewarding” trip across the USA as the 2024 American College of Surgeons (ACS) John D Corson international guest scholar and encourages other vascular surgeons to apply for the fellowship.
The ACS John D Corson international guest scholarship is awarded to a young vascular or cardiac surgeon from the UK or Ireland each year. This generous endowment from Christina Hewes Corson, wife of retired vascular surgeon John Corson, supports travel to the ACS congress, as well as academic institutions of the scholar’s choice in North America. I was honoured to receive this scholarship in 2024, which supported a 2.5-week trip across the USA, visiting four prestigious vascular institutes along the way.
Starting on the west coast in San Francisco, home of this year’s ACS congress, I enjoyed a busy few days at the largest surgical congress in the country, where I also had the honour of meeting Dr and Mrs Corson and some of the ACS executive team at their philanthropic lunch. In the international scholar section, I gave a short presentation on the history of surgery in Edinburgh—a talk that is always a crowd-pleaser with its tales of grave-robbing and great discoveries. I visited an old friend from my London training days, Dr Susannah Rose, chief of general surgery at Kaiser Permanente San Francisco. It was interesting to hear about the challenges facing the different healthcare systems in the USA. There seem to be some broadly similar resource and staffing problems to those in the UK National Health Service, despite the apparent wealth of some of the major private hospitals in North America.
Next stop was Stanford, where Drs Dalman, Lee, George and team hosted me for three days. I spent time in clinic and in the operating room observing an off-the-shelf branched graft, a procedure that I’ve not seen often in the UK because of the ready availability of custom-made devices (CMD) to treat complex aortic disease. I later observed a physician-modified endograft (PMEG) by Dr Chandler Long at Duke. In contrast to the UK and Europe, CMDs are not currently available to most vascular surgeons in the USA. As a consequence, many surgeons have become so skilled at creating their own off-the-shelf or modified solutions that there is a question as to whether CMDs will be as widely used in the USA when approved, particularly in light of the weeks-long lead-time required. Perhaps CMDs will only be necessary for a small population of anatomically extreme cases? A matter for debate.
I also met some researchers undertaking a surgical sabermetrics study using a lightweight and compact headband electroencephalography (EEG), similar to a study by my colleagues in the Yule Lab back in Edinburgh. I joined the evening trainee educational session, where I presented my own research on imaging biomarkers in aortic disease, which I later also presented at Duke and Massachusetts General Hospital. Stanford is a place of great innovation, world-class research and certainly befit its centuries-old reputation for excellence.
I flew across a few time zones to North Carolina and spent three days visiting the University of North Carolina (UNC) and Duke University Medical Centre. I was wonderfully hosted by Dr Kate McGinigle at UNC, spent time with her excellent health sciences research group and delivered a talk about some of our own healthcare challenges in the UK. I spent two informative days with Drs Coleman, Minc, Gilmore, Long, Shortel and the rest of their colleagues at Duke, witnessing a talented team of surgeon educators providing excellent care to all of their community and an enriching education to their trainees. Through happy coincidence, I attended Duke’s Grand Rounds delivered by Dr Vincent Rowe from the University of California, Los Angeles, whose talk on leadership lessons learnt from cycling was inspirational. I was only sorry to miss my friend and official host of the Duke visit, Dr Adam Johnson, as he was tending to a newborn baby at home!
My final stop was on the east coast in Boston, where I reunited with my friend and vascular tour de force Dr Anahita Dua, spending five days at Massachusetts General Hospital. Dr Dua’s incredible energy and drive is reflected in the many concurrent activities that she manages to keep afloat. I spent a weekend shadowing her on call, observed in the operating room, clinics and also visited her coagulation research lab, where she is working to improve the management of peripheral arterial disease through personalised antiplatelet therapy.
This travelling fellowship was an enriching and rewarding experience that offered the opportunity for international knowledge exchange and collaboration, as well as encouraged an outward-looking attitude to clinical practice. By visiting a number of institutions around the USA, I have observed a wide range of clinical, research and educational activities, bringing back some of these to my own institution, along with a fresh sense of enthusiasm for my own practice. I have also had many opportunities to share my own research along the way.
I sincerely hope that the vascular friendships that I have forged through my travels are long-lasting and fruitful and I’m grateful to the Corson family for funding this opportunity.
I would encourage all new cardiac or vascular consultants in the UK or Ireland to apply for this scholarship: https://www.facs.org/for-medical-professionals/professional-growth-and-wellness/scholarships-fellowships-and-awards/international/igs/
Rachael Forsythe is a consultant vascular surgeon at the Edinburgh Vascular Unit in Edinburgh, UK, and the American College of Surgeons / John D Corson international guest scholar 2024.
