Issue link: https://blog.providence.org/i/1518198
Where Surgeons Become Specialists Dr. Trevan Fischer talks about Saint John's Cancer Institute's prestigious surgical oncology program, which sends its graduates to top cancer centers nationwide. Trevan Fischer, MD, a surgical oncologist, is the assistant program director of the Donald L. Morton Complex General Surgical Oncology Fellowship at Saint John's Cancer Institute. With three decades of history to its credit, the two-year DLM program is one of the oldest and most prestigious fellowships of its kind. T he fellowship is named for longtime Saint John's surgeon and melanoma researcher Dr. Donald L. Morton, who was a pioneer in developing the sentinel lymph node biopsy. It was his dream that "one of the fellows would be the one who cured cancer." Dr. Fischer is an alumnus of the program himself, having spent two years post-residency focusing on specialized surgical oncology training. Here he discusses what's involved in the fellowship and what the specialized training meant to him. Why is the Dr. Donald L. Morton fellowship program significant? As cancer care becomes more complex, it's important to focus training on just cancer, as general surgery residency training does not go deep enough. The fellows are doing an extra two years just for that. It allows our trainees to be highly specialized. We're also a multi-fellow program—we have four fellows a year instead of just one. Having co-fellows at your level that you can bounce ideas back and forth with creates an enriched environment. How does the program make its fellows better doctors? We give them a lot of autonomy to make treatment plans about patient care, and we provide oversight. That prepares them for the needs of the real world—being ready to make decisions. They watch and they learn from each doctor they work with. They take a little bit from each person. In essence, it's an apprenticeship model. Collaboration seems to be a value that the fellowship emphasizes. How does that differ from medical training elsewhere? Surgery is just one piece of cancer care; we have to treat cancer as a team, with the patient at the center. "Multidisciplinary" is a word we use a lot, and this drives the best care and outcomes for our patients. What is the most unusual element of the program? We're a large program in a small community hospital. That provides the trainee with the opportunity to be recognized as a part of the care team. They get the value of being in an academic setting but with a personalized approach that our program provides. This opportunity gives them the tools and readiness to lead a cancer program from day one after fellowship because they are highly involved and engaged as a fellow. What impact did the DLM program have on you personally as a fellow? I already had a lot of confidence in my surgical skills, but the program gave me more confidence to take charge of a patient's care. There is also a really good mix of research opportunities; Dr. Morton's legacy and contributions to surgical oncology swayed my direction as a surgeon. He truly was a giant in the field. What is the benefit to a physician who serves as a DLM mentor? Teaching isn't always the easiest, but one of the benefits is the ongoing learning that is required to stay up to date with all aspects of cancer care. I learn something at each conference, and that makes me a better doctor for my patients. And it really reenergizes me when I get a call from a graduate asking for my input. And seeing them get their first job and thrive on their own is very gratifying. There are at least four or five of our alumni running fellowship programs in surgical oncology elsewhere. That's a strong marker of success that our graduates are teaching others. To learn more about the program, visit www. saintjohnscancer.org/fellowship Dr. Trevan Fischer