American Surgical Association 2025: Inclusive Excellence in Politically Divided Times.

Bob Sparkman was born in Brownwood, Texas. He attended college and graduate schools in Waco and Dallas, and received his MD in 1935. He served an internship at the Cincinnati General Hospital and a year in pathology at Baylor Hospital, followed by a year in surgery in Lexington, Kentucky, and a surgical residency from 1938 to 1940 at the Cincinnati General Hospital under Professor Mont R. Reid. FIGURE Figure. Robert S. Sparkman, MD After his medical training, he served tours of duty in Australia, New Guinea, and the Philippines during World War II. He was chief surgeon of the First Evacuation Hospital in North Carolina, but later was promoted to surgical chief and commanding officer of the 248th General Hospital. In addition, he was chief of a Mobile Surgical Team in the Luzon invasion and liberation of Manila. During his military service, Bob earned the Distinguished Unit Citation with Oak Leaf Cluster, the Bronze Star, three Battle Stars, and an Invasion Arrowhead. He ended his military career as a full Colonel and Chief Surgeon at Ashford General Hospital in McKinney, Texas. Bob returned to Dallas to begin an outstanding surgical career that included the establishment of academic, teaching, and research programs at several Dallas hospitals, and service as a civilian consultant to the Army Surgeon General. He served as a Governor of the American College of Surgeons from 1962 to 1970, and obtained high office in a number of other surgical societies, including the presidencies of the Dallas Society of General Surgeons and the Texas Surgical Society, and the vice-presidency of the American Surgical Association. In 1978, he served as President of the Southern Surgical Association. For twelve years, Bob served as Chief Surgeon of the Department of Surgery at the Baylor Medical Center and was a great mentor to his residents, who idolized him. During this time, he founded the Society of Baylor Surgeons, composed of former House Officers. He was also chairman of the Association of Program Directors in Surgery. Bob contributed many papers to the surgical literature and was widely sought after as a visiting professor and guest lecturer. He was a student of the history of surgery, with particular contributions to documenting the history of surgery in Texas. To honor the members of the Texas Surgical Society, he commissioned the construction of a gavel of wood from the deck of the battleship Texas. This gavel was presented to the American Surgical Association at the 1978 meeting in Dallas. A second gavel was presented to the Southern Surgical Association during Dr. Sparkman’s presidency in 1978. This gavel was made from the wood of a pecan tree from the San Jacinto battlefield. He was also the unofficial historian of the American and Southern Surgical Associations. Bob published several historical books and, just prior to his death, was writing a history on early Texas physicians. Unquestionably, his greatest historical project was the editorship of a detailed history of the first 100 years of the Southern Surgical Association, a professional group dear to his heart. In 1986, the Robert S. Sparkman Chair in Surgery was established at Baylor University Medical Center. In 1995, the North Texas Chapter of the American College of Surgeons established the Sparkman Endowed Lectureship, and in 1996, the Library as well as the Conference Center at Baylor University Medical Center were named in Dr. Sparkman’s honor. In addition to his medical achievements, Bob was an excellent amateur artist and calligrapher, and an avid collector of old maps, French floral prints, and the works of the naturalist James J. Audubon. Bob and his wife, Willie, had a wonderful life together. Willie always accompanied Bob to surgical meetings, and they were well-known and loved by the members and spouses of the Southern and American Surgical Associations. Each year on Willie’s birthday during the 55 years of their marriage, Bob presented her with a fresh gardenia from his carefully tended garden. For two years after his death, Willie reports that she discovered one lovely gardenia blooming in their garden on her birthday in September, even though she says that bush had never before bloomed out of season.

Walter Randolph Chitwood, Jr, MD: 2020 Recipient of the American Association for Thoracic Surgery Scientific Achievement Award

In memoriam Lawrence K. Pickett, MD, 1919–2003

<h3>To the Editor.—</h3> We found the study by Eagle et al¹using dipyridamole-thallium scanning to evaluate cardiac preoperative risk particularly relevant to our field of endeavor—anesthesiology. However, for those interested in the historical development of a risk index for preoperative patients, we would like to correct three points about the "risk classification developed by the Dripps—American Surgical Association." First, it is not a risk classification at all. Second, it was not developed by Dr Dripps. Third, it had nothing to do with the American Surgical Association. A classification of preoperative health or physical status was proposed under the auspices of the American Society of Anesthesiologists, not the American Surgical Association, in 1941 by Drs Saklad,²Rovenstine, and Taylor. This classification was not then nor is it now a classification of risk. Its purpose was to facilitate the tabulation of statistical data in anesthesia. It was hoped that classifying patients

Debas, Haile T. MD; Bass, Barbara L. MD, FACS; Brennan, Murray F. MD, FACS; Flynn, Timothy C. MD, FACS; Folse, J Roland MD, FACS; Freischlag, Julie A. MD, FACS; Friedmann, Paul MD, FACS; Greenfield, Lazar J. MD, FACS; Jones, R Scott MD, FACS; Lewis, Frank R. Jr. MD, FACS; Malangoni, Mark A. MD, FACS; Pellegrini, Carlos A. MD, FACS; Rose, Eric A. MD, FACS; Sachdeva, Ajit K. MD, FRCSC, FACS; Sheldon, George F. MD, FACS; Turner, Patricia L. MD; Warshaw, Andrew L. MD, FACS; Welling, Richard E. MD, FACS; Zinner, Michael J. MD, FACS Author Information

To put things in perspective, let me briefly summarize the history of the American Board of Surgery (ABS). It was exactly 100 years ago, in 1910, that Dr. Abraham Flexner, supported by funds from the Carnegie Foundation, recorded the state of affairs of medical training in the USA at the beginning of the century: the quality of medical schools was extremely variable, with some of them based on scientific principles and others completely devoid of proper training, resulting in practitioners of vastly different education and quality. By the same token, there were no standards for training in medicine and surgery or any standards to verify and validate the quality of the individual trainee at the end of specialty training. The field of medicine was in disarray and needed standardization of educational quality and certification of individual competence. The idea of certification by a specialty board was first adopted by the ophthalmology organizations, which formed a specialty board, the American Board for Ophthalmic Examinations, which was incorporated in 1917. By 1933, the name was changed to the American Board of Ophthalmology. The otolaryngologists formed the American Board of Otolaryngology, which was incorporated in 1924. The American Board of Surgery, a private, nonprofit, autonomous organization, was incorporated in 1937. Today the American Board of Surgery is 1 of the 24 boards of the American Board of Medical Specialties (ABMS), and its principal objective is to evaluate the education, training, and knowledge of broadly qualified and responsible surgeons and to issue certificates to all candidates meeting the board’s requirements and satisfactorily completing its prescribed examinations. The ABS considers certification to be voluntary and limits its responsibilities to fulfilling the purposes stated above and not to designate privileges, credentialing or special recognition in the practice of surgery or its subspecialties. In doing so, the ABS serves the public, by guaranteeing that certified surgeons are highly qualified, and it serves the diplomates, by conferring on them recognition of their special skills, training, and knowledge. The founding organizations of the American Board of Surgery were the American College of Surgeons (ACS), the Surgical Section of the American Medical Association (AMA), and the American Surgical Association (ASA), each providing three representatives, plus four regional surgical societies, the New England Surgical Society, the Pacific Coast Surgical Association, the Southern Surgical Association, and the Western Surgical Association, each providing one representative. With the increase in workload created by the growing number of surgeons seeking certification and the process of recertification started in the early 1980s, the ABS has added to the number of directors over the years by inviting representation from other surgical societies: currently 22 national and regional surgical organizations and 3 surgical boards provide 32 directors Society of Surgical Oncology 2010

The aim of this study was to determine characteristics of the most cited publications in the history of the American Surgical Association (ASA). The Annals of Surgery has served as the journal of record for the ASA since 1928, with a special issue each year dedicated to papers presented before the ASA Annual Meeting. The top 100 most cited ASA publications in the Annals of Surgery were identified from the Scopus database and evaluated for key characteristics. The 100 most cited papers from the ASA were published between 1955 and 2010 with an average of 609 citations (range: 333-2304) and are included among the 322 most cited papers in the Annals of Surgery. The most common subjects of study included clinical cancer (n = 43), gastrointestinal (n = 13), cardiothoracic/vascular (n = 9), and transplant (n = 9). Ninety-three institutions were included lead by Johns Hopkins University (n = 9), University of Pittsburgh (n = 8), Memorial Sloan-Kettering (n = 7), John Wayne Cancer Institute (n = 7), University of Texas (n = 7), and 5 each from Brigham and Women's Hospital, Mayo Clinic, and University of Chicago. The majority of manuscripts came from the United States (n = 85), followed by Canada (n = 7), Germany (n = 5), and Italy (n = 5). Study design included randomized controlled trials (n = 19), retrospective matched cohort studies (n = 11), retrospective nonmatched studies (n = 46), and other (n = 24). The top 100 most cited publications from the ASA are highly impactful, landmark studies representing a diverse array of subject matter, investigators, study design, institutions, and countries. These influential publications have immensely advanced surgical science over the decades and should serve as inspiration for all surgeons and surgical investigators.

Presidential address: SUS [mdash ] SOS?

Presidential address: SUS — SOS?

To comprehensively assess the level of achievement and demographics of national surgical society presidents. Data on the accomplishments needed to rise to positions of national surgical leadership is scarce and merit alone does not always yield such opportunities. Recognizing the shortcomings of sex and ethnic diversity within academic surgical leadership, the American College of Surgeon (ACS), American Surgical Association (ASA), Association of Women Surgeons (AWS), and the Society of Black Academic Surgeons (SBAS) partnered to address these challenges by performing a comprehensive assessment of their presidents over the last 16 years. ACS, ASA, AWS, and SBAS presidents' CVs, at the time of their presidential term, were assessed for demographics and scholastic achievements. Regression analyses controlling for age were performed to determine relative differences across societies. A total of 62 of the 64 presidents' CVs were received and assessed (97% response rate). There was a large discrepancy in the average age in years of ACS (70) and ASA (66) presidents compared to the AWS (51) and SBAS (53) presidents. For the ACS and ASA cohort, 87% were male and 83% were White, collectively. After controlling for age (52), the AWS and SBAS presidents' scholastic achievements were comparable to the ACS (and ASA) cohort in 9 and 12 of the 15 accessed metrics, respectively. The ACS and ASA presidents' CVs displayed unsurpassed scholastic achievement, and although not equivalent, both the AWS and the SBAS presidents had comparable attainment. These findings further substantiate that women and ethnic minority surgeons are deserving of additional national leadership consideration as organized medicine pursues a more diverse and reflective physician workforce.

To explore use of the notion of American exceptionalism by fellows of the American Surgical Association (ASA) (1880 through World War I) and how this proved instrumental in the rise of surgery in the United States. American exceptionalism is the belief that the United States is innately different from other nations because of its economic, geographic, political, religious, and social foundations. Although, currently, the concept of American exceptionalism implies superiority, in its original 19th century connotation, the idea referred to the distinctive character of America as a free nation. An analysis of published literature along with unpublished documents to provide new knowledge and unique insight into the use of American exceptionalism by members of the ASA as they promoted their specialty. Beginning with Samuel Gross's desire that the organization he founded represent "the genius of our republican institutions," to Frederick Dennis's declaration that "American surgery eclipses all other nations because of the wonderful adaptability of the American mind," plus Lewis Pilcher's explanation of how the "stimulating climate, prevailing religious tone, regard for learning, and pride of citizenship are the fruit of the American mind when turned to surgical problems," and ending with Edmond Souchon's 106 page article in the Transactions on surgical firsts, the ASA was the avenue that helped the nation's surgeons define and defend themselves. Use of the concept of American exceptionalism by fellows of the ASA was a key factor in the development of surgery in the United States.

The evolving role of SBAS – We’re getting in but we’re not going on

Judah M. Folkman, MD, 1933-2008

Charles Mayo was born in Rochester, Minnesota, on July 19, 1865, the son of William Worrall Mayo, a native of England and a general practitioner of medicine who had settled in the territory of Minnesota in 1855. The young boy accompanied his father and elder brother, William J. Mayo, on innumerable trips in both the village and the country as the father traveled to his patients. On several occasions he administered ether to the patients before he had earned his diploma in medicine. Charles Mayo studied in the public schools of Rochester, and received the degree of Doctor of Medicine from Northwestern University in 1888. When Mayo had been home for about a year, assisting his father and elder brother in their practice of general medicine, the sisters of St. Francis founded St. Mary’s Hospital in Rochester. Charles was one of three on the staff at the new hospital, the other two being his father and his elder brother. In later years, the elder brother recalled, “Charlie soon had me driven to cover by being a better surgeon, and I began to specialize in abdominal work and in operations on the ureters and kidneys.” He could master a difficult situation with exceptional speed, and he had a facility in a variety of challenging surgical problems which soon found him performing such dissimilar procedures as excision of a knee joint, sectioning of the gasserian ganglion, and hysterectomy. He also acquired a high degree of skill in operations on the eye, head, and neck, while his brother concentrated on abdominal operations. He devoted himself to the very extensive practice which he and his brother carried on together, after their father retired from active practice around 1890. The two brothers enlisted the aid of a third physician in 1892, another in 1901, and many others as the practice founded by their father in 1863 became well known in southern Minnesota, and then throughout the state. By 1903 the name Mayo Clinic was known not only to persons who sought the services of the brothers and their associates, but by other physicians outside the small group of practitioners in Rochester. In 1915, Charles and his brother established the Mayo Foundation for Medical Education and Research as a part of the Graduate School of the University of Minnesota, with fellowships in various specialities. The Mayos became famous teachers and were regarded with profound affection and respect by the hundreds of young surgeons who worked with them. This classic paper gives a fascinating perspective of the state of colon and rectal surgery at the turn of the century. In it Mayo suggests the advisability of the synchronous combined approach “if the surgeon has a good assistant.” He is believed to be the first to recommend this maneuver. Honors of every description were conferred upon Charles Mayo, as they were upon his elder brother. He was elected president of the Western Surgical Association, the Society of Clinical Surgery, the Clinical Congress of Surgeons of North America, the American Medical Association, the American College of Surgeons, and the American Surgical Association. He died in Chicago, where he had contracted penumonia during a visit, on May 26, 1939, at the age of 73. The death of his brother followed two months later.

This forum summarizes the proceedings of the joint European Surgical Association (ESA)/American Surgical Association (ASA) symposium on Quality and Outcome Assessment for Surgery that took place in Bordeaux, France, as part of the celebrations of the 30th anniversary of the ESA. Three presentations focused on a) the main messages from the Outcome4Medicine Consensus Conference, which took place in Zurich, Switzerland, in June 2022, b) the patient perspective, and c) benchmarking were hold by ESA members and discussed by ASA members in a symposium attended by members of both associations.