Kenneth A. Azarow, M.D., FACS, FAAP
Mackenzie Professor and Chair
The University of Oregon has been around since 1887 and is one of the oldest medical schools west of the Mississippi. We were part of the Oregon University system until 1995, when OHSU was born as a nonprofit public corporation. The new structure created an opportunity for OHSU to nimbly navigate a very competitive healthcare and research environment without wavering from our mission to serve the educational and clinical needs of Oregon. As a result, OHSU has been on a steady growth curve in research, education, and clinical care over the past two decades, a trend much admired in our community and across the country. The leadership of our physicians and scientists can be captured in three words: imagination, excellence, and focus. As a result of this chemistry, many revolutionary advances in medicine and surgery have started at OHSU, including the first mechanical heart valve, the first percutaneous angioplasty and coronary arteriography with specialized catheters, the first balloon embolectomy catheter, the first kidney transplant in an adolescent, the first use of imatinib for myelocytic leukemia and gastrointestinal stromal tumors, and the first totally endoscopic esophagogastric fundoplication. Many of these innovations started in the Department of Surgery.
The Department of Surgery consists of nine integrated yet independent divisions. In some institutions, departments of surgery are merely “holding companies” for the independent surgical subspecialties. However, our Department of Surgery is held together by a culture of community and a great deal of interdisciplinary collaboration. For example, our liver cancer program spans the divisions of gastrointestinal, oncologic and transplant surgery. The esophageal cancer program brings thoracic surgeons and GI surgeons side-by-side, and our emergency general surgery service is a combined effort of general surgery and trauma surgery and critical care. A “first in the nation” collaboration between otolaryngology and endocrinology brings the skills of both disciplines to the care of the patient with thyroid and parathyroid disease. One might ask how the naturally competitive spirit of surgeons is put aside for the betterment of the patient and institution. This is where leadership comes into play. OHSU is interested in “The knowledge of all for the care of one.” Indeed, we have found that the collective intelligence of individuals from different backgrounds is not only refreshing but brings innovative care solutions to the bedside.
The spirit of collaboration also extends to the laboratories where our research programs tie basic scientists, health researchers and surgeons together to answer some of the fundamental clinical questions that continue to plague us. Built on the history of innovation alluded to earlier, the Department of Surgery has re-launched an innovation program, assembling surgeons, engineers, entrepreneurs, and investors to create engineering solutions to the problems encountered daily by surgeons and patients alike.
Now let’s talk education. OHSU is one of the two largest surgical residencies in the country. As the only residency program in the state, we are sized correctly to provide surgeons for a population of over four million, including both urban and rural areas in Oregon and Southwest Washington. A referral area of this size typically has two or three residency programs, which in total would be about the same size as ours. The advantages of such a large program are two, as I see it: First, you have lots of peers. One or more of these individuals will be close friends for life. Better to have a larger group to choose from! Second, a large program gives you the opportunity to learn general surgery in a variety of settings. How many programs offer you the chance to rotate in five different community hospitals, two children’s hospitals, two level 1 trauma centers, a VAMC, and a world class University Hospital? While there may be a concern amongst some students that a resident might get lost in this giant cosmos, the Monday morning gatherings and teaching sessions bring us all together and offer a chance for any resident to reconnect with peers and faculty from the University and VAMC. Certainly, the accomplishments of the residents would argue that the ‘system’ is working. It would take me another several pages to list all the grants, honors and publications of our residents over the past decade, so you’ll have to do your own research on this one. Suffice it to say that the OHSU surgery residency is sufficiently flexible that every resident’s experience is a little different. The list of individualized pursuits include one to four years of research, rural surgery rotation, advanced degrees, and surgery training in Africa, Haiti and other low- and middle-income countries. Two-thirds of our residents elect to do additional fellowship training, and almost all get one of their top choices for fellowships. For the one-third who elect to go directly into general surgery practice, almost all have the opportunity to pick their city, hospital, or practice group of choice.
In closing, let me talk about the people. The faculty and staff at OHSU rarely leave. Sure, Portland is a great city and the Northwest as a very desirable portion of the country to live in. More importantly though, the longevity of our faculty reflect upon the culture and work environment of OHSU, where people truly enjoy coming to work every day and enjoy working side-by-side with some of the brightest scientists and most remarkable physicians in the nation. Come see for yourself.