A Century of Camaraderie for Urological Surgeons at the ACS

Hand-painted paperweights, blown glass, carved boxes: objets d’art, many of them gestures of gratitude from patients, filled the office of urologist Atmaram Sitaram Gawande, MD, FACS (1934–2011), at O’Bleness Memorial Hospital in Athens, Ohio. His office was described by his son, surgeon-author Atul Gawande, MD, MPH, FACS, in his 2002 book, Complications: A Surgeon’s Notes on an Imperfect Science. The younger Dr. Gawande discussed his father’s successful career in urology in an essay on surgical advancements, describing his efforts to learn new techniques “on his own, fifty miles from his nearest colleague.”

In the same book, Dr. Gawande, a general surgeon at Brigham and Women’s Hospital in Boston, Massachusetts, and assistant administrator of the US Agency for International Development in Washington, DC, described a partial solution to professional isolation: an annual conference that he, his father, and other surgeons attend to learn surgical techniques, communicate with colleagues, and recharge from work.

“Doctors belong to an insular world,” he wrote. “The isolation of practice takes you away from anyone who really knows what it is like to cut a cancer from a patient or lose her to a pneumonia afterward or answer the family’s accusing questions or fight with insurers to get paid. Once a year, however, there is a place full of people who do know. They are everywhere you look…our own nation of doctors.”

The conference to which he referred was the ACS’s own Clinical Congress, one of the largest gatherings of surgeons in the world. Clinical Congress and the ACS have always been a resource and place of welcome for surgeons of all specialties and disciplines. This meeting is one of the many ways the ACS helps empower all surgeons and enhance our ability to practice evidence-based medicine.

This inclusive engagement began long ago. For example, at the 1922 Clinical Congress, Andrew Fullerton, CB, CMG, MB, BCh, MD, MCh, FRCSI, FACS (1868–1934), became the first urological surgeon to receive an Honorary Fellowship in the College.

Dr. Fullerton was a graduate of Queen’s College Belfast (MB, BCh, MD) and Queen’s University Belfast (MCh) in Northern Ireland. His expertise in urology came via his WWI service with the Royal Army Medical Corps, through which he learned to treat gunshot wounds to the kidney, ureter, and bladder. He enjoyed exchanging knowledge with the surgeons from many nations he met during the war, and he later hosted many world-class surgeons, including the Mayo brothers and Harvey Cushing, MD, FACS, in Belfast. He often adopted their ideas for surgical advancement, and he soon earned his own international reputation for innovation. Through the then-novel act of concentrating on urologic issues, he helped establish and expand the nascent field, an effort that resonates today.

We continue to celebrate those who advance urological surgery. At last year’s Clinical Congress, the ACS granted  Honorary Fellowship to urologist Christopher Chapple, BSc, MBBS, MD, PhD, FRCS(Urol), FEBU, FCSHK(Hon), and at this year’s Clinical Congress, we will similarly honor Emmanuel A. Ameh, MBBS, FACS, FWACS, a pediatric urologist from Nigeria. Dr. Chapple is a reconstructive urologist in the Royal Hallamshire Hospital in Sheffield, England, who has treated patients referred nationally and internationally and researches the effects of neurological disease on the urinary system.

Our engagement with our urologic colleagues extends far beyond Honorary Fellowships. Each year, Clinical Congress offers several sessions devoted to urological surgery, as well as multidisciplinary sessions with vascular surgery, trauma surgery, obstetrics and gynecology, and other specialties. The annual flagship meeting begins with the Martin Memorial Lecture, which is named for ACS founder Franklin Martin, MD, FACS, and sponsored by the American Urological Association (AUA).

Our connection with the AUA is strong and multifaceted as well. The ACS offers a jointly sponsored annual ACS/AUA Health Policy Scholarship for the Executive Leadership Program in Health Policy and Management at Brandeis University, in Waltham, MA, which is also open to surgeons in breast, cardiothoracic, colon and rectal, gastrointestinal and endoscopic, neurological, otolaryngology-head and neck, pediatric, plastic, trauma, urogynecologic, and vascular specialties.

This past September, experts from the ACS helped promote Prostate Cancer Awareness Month. Additionally, opportunities for leadership exist on our Board of Governors and Advisory Council.

The current Chair of the ACS Board of Regents is a urologist. Anthony Atala, MD, FACS, is the George Link Jr. Professor and director of the Wake Forest Institute for Regenerative Medicine and W. H. Boyce Professor and Chair of Urology at the Wake Forest University School of Medicine in Winston-Salem, North Carolina. He is renowned for completing foundational research in regenerative medicine, including implanting the first  laboratory-engineered organ as a permanent replacement (a bladder) in 1999. He continues to innovate in regenerative medicine and urology and was the winner of the 2022 ACS Jacobson Innovation Award.

Dr. Atala has said that, in his view, ACS membership is valuable to urologists in the same way that hosting international surgeons was meaningful for Dr. Fullerton a century ago or attending Clinical Congress is helpful to all surgeons now. It permits surgeons to connect with colleagues across disciplines about the clinical and nonclinical issues we have in common.

Dr. Atala’s view captures a key aspect of the ACS. All surgeons, from Athens, Ohio, to Belfast, Northern Ireland, and beyond, are welcome to engage with the American College of Surgeons—the House of Surgery. We aspire to offer an essential network in which all surgeons, including those in urology and every other specialty, can support each other across our profession—to become, to borrow a phrase, our own nation of doctors.

Dr. Patricia Turner is the Executive Director & CEO of the American College of Surgeons. Contact her at executivedirector@facs.org.