31 July 2019

I am tremendously grateful for the opportunity to be the 2019 American Society of Colon and Rectal Surgeons Travelling Fellow.  In a whirlwind week, I was able to visit two very different NHS hospital systems with thriving colon and rectal surgery practices (Addenbrooke’s in Cambridge, and Chelsea and Westminster in London) and attend the ACPGBI in Dublin, Ireland.   After months of planning, with the help of Mr. Jared Torkington, the ACPGBI International Representative, I was eager to embark on the itinerary we so thoughtfully crafted.

After an overnight flight into London, I boarded a bus for a scenic journey to Cambridge.  I was greeted for dinner by the Addenbrooke’s cohort, including my host Mr. Michael Powar, as well as Mr. Nigel Hall.   The next day, I got an early start with a hospital tour, morning pass-off, followed by theatre with Mr. Justin Davies.  I had the opportunity to see a wide variety of cases, very much a typical day: colectomy for cancer, rectal exam with biopsy for an atypical anal ulcer, laparoscopic appendectomy for a mucocele, SNS, and a Delorme for rectal prolapse.  From my experience at Addenbrooke’s, I learned a lot about how their surgeons make data-driven decisions on how to allocate finite resources in the context of the National Health Service. I spent the following day in London, making rounds and observing theatre at Chelsea and Westminster Hospital with Miss Sarah Mills.  While still an NHS hospital, Chelsea and Westminster’s urban patient population was exceptionally diverse, and notably quite sophisticated and knowledgeable.  I had the chance to observe an emergent laparoscopic total abdominal colectomy for toxic colitis—very similar decision-making and approach to the US. I then flew to Dublin for the ACPGBI, which was an incredible experience.  I was struck by the impressive collaboration and commitment to national registries (such as the National Emergency Laparotomy Audit) and high-quality clinical trials with some of the cleverest acronyms imaginable (e.g., CIPHER, CLOSE-IT, SUNRISE).  I was able to appreciate the challenges in the UK of how to balance the drive for innovation with the need to provide proven efficient and effective care to the population. At the meeting, I had the opportunity to present my research on female representation and implicit gender bias in the 2017 ASCRS-Tripartite Meeting, which generated interesting and constructive discussion, particularly among the trainees and junior surgeons, who are roughly even with respect to gender, much like the US.  I also gave a brief interview on my research on the “Behind the Knife” surgery podcast coverage of the meeting. Throughout my travels, I was tremendously grateful for the hospitality- from the junior registrars of the Duke’s Club, all the way up to the ACPGBI president and incoming president Mr. Brendan Moran and Miss Nicola Fearnhead and ESCP president Dr. Per Nilsson.  Being included as a guest at the ACPGBI Council Dinner was a tremendous honor and an unforgettable evening.  I spent my last night with the Duke’s Club and learned more about the UK training process than I could have ever imagined.  As the ASCRS Young Surgeons Committee Chair, I see many areas for potential collaboration! I returned home just in time to enjoy watching fireworks with my family- a perfect ending to a truly once-in-a-lifetime experience that has given me a broader perspective and lifelong friends, colleagues, and mentors.  I am so honored to have received this distinguished award and have had the opportunity to represent ASCRS in an international setting. Jennifer S. Davids, MD, FACS, FASCRS Assistant Professor of Surgery Division of Colon and Rectal Surgery University of Massachusetts Memorial Medical Center

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