Surgical Topics Research Articles

Can ChatGPT generate surgical multiple-choice questions comparable to those written by a surgeon?

Background This study aimed to determine whether surgical multiple-choice questions generated by ChatGPT are comparable to those written by human experts (surgeons). Methods The study was conducted at a medical school and involved 112 fourth-year medical students. Based on five learning objectives in general surgery (colorectal, gastric, trauma, breast, thyroid), ChatGPT and surgeons generated five multiple-choice questions. No change was made to the ChatGPT-generated questions. The statistical properties of these questions, including correlations between two group of questions and correlations with total scores (item discrimination) in a general surgery clerkship exam, were reported. Results There was a significant positive correlation between the ChatGPT-generated and human-written questions for one learning objective (colorectal). More importantly, only one ChatGPT-generated question (colorectal) achieved an acceptable discrimination level, while other four failed to achieve it. In contrast, human-written questions showed acceptable discrimination levels. Conclusion While ChatGPT has the potential to generate multiple-choice questions comparable to human-written ones in specific contexts, the variability across surgical topics points to the need for human oversight and review before their use in exams. It is important to integrate artificial intelligence tools like ChatGPT with human expertise to enhance efficiency and quality.

The Accuracy and Reliability of ChatGPT as Compared to Wikipedia Across Key Cardiothoracic Surgical Topics

The Accuracy and Reliability of ChatGPT as Compared to Wikipedia Across Key Cardiothoracic Surgical Topics

Creating Impact in Surgery

Thank you for reading the latest edition of Impact Surgery. We are committed to fostering a platform that amplifies the voices and experiences of surgeons and researchers from across the world. In line with this vision, we are seeking pilot studies, global surgery studies, quality improvement projects, reviews, education, and deeper dives on surgical topics that are often overlooked or neglected elsewhere. We recognise the profound impact of surgical interventions on individuals, communities, and societies worldwide, and we hope to speed up solutions and policy changes to address the unique challenges faced by diverse populations.

Online versus in-person surgical near-peer teaching in undergraduate medical education during the COVID-19 pandemic: A mixed-methods study.

The coronavirus disease 2019 (COVID-19) pandemic stimulated a paradigm shift in medical and surgical education from in-person teaching to online teaching. It is unclear whether an in-person or online approach to surgical teaching for medical students is superior. We aim to compare the outcomes of in-person versus online surgical teaching in generating interest in and improving knowledge of surgery in medical students. We also aim the quantify the impact of a peer-run surgical teaching course. A six-session course was developed by medical students and covered various introductory surgical topics. The first iteration was offered online to 70 UK medical students in March 2021, and the second iteration was in-person for 20 students in November 2021. Objective and subjective knowledge was assessed through questionnaires before and after each session, and also for the entire course. Data were analyzed from this mixed-methods study to compare the impact of online versus in-person teaching on surgical knowledge and engagement. Students in both iterations showed significant improvement of 33%-282% across the six sessions in knowledge and confidence after completing the course (p < 0.001). There was no significant difference in the level of objective knowledge, enjoyment, or organization of the course between online and in-person groups, although the in-person course was rated as more engaging (mean Likert score 9.1 vs. 9.7, p = 0.033). Similar objective and subjective surgical teaching outcomes were achieved in both iterations, including in "hands-on"topics such as suturing, gowning, and gloving. Students who completed the online course did not have any lower knowledge or confidence in their surgical skills;however, the in-person course was reported to be more engaging. Surgical teaching online and in-person may be similarly effectiveand can be delivered according to what is most convenient for the circumstances, such as in COVID-19.

Exploring Horizons: Publish with us to Impact Surgery

Impact Surgery aims to expand options for authors of surgical research, with a fast, flexible platform that can offer deep dives on a wide range of surgical topics. It aims to be crosscutting across all surgical and perioperative disciplines, appealing to the generality of surgery. Our goal is to be inclusive of ethnicity, gender, income status, and other markers of diversity.

The 30th Albanian Surgical Conference &amp; the 7th Albanian Congress of Trauma and Emergency Surgery

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; The 30th Albanian Surgical Conference (ACS 2023) and the 7th Albanian Congress of Trauma and Emergency Surgery (ACTES 2023) represent a significant milestone in the medical community. These concurrent events provide a platform for the exchange of knowledge, collaboration, and the advancement of surgical science in Albania.&#x0D; ACS 2023 &amp; ACTES 2023 gather experts, scholars, practitioners, and enthusiasts from the field of surgery, both in traumatic and non-traumatic areas, in the vibrant city of Tirana. The comprehensive program encompasses a diverse range of surgical topics, from abdominal and chest injuries to vascular injuries, emergency surgery, and the challenge of nurse services in the new millennium.&#x0D; The theme of this year's events, "Surgery and not only...," reflects the commitment to innovation, best practices, and groundbreaking discoveries. The programs include plenary sessions with renowned experts, scientific presentations, panel discussions, networking opportunities, an industry exhibition, poster awards, cultural and social activities, and Continuing Medical Education (CME) credits.&#x0D; Participants can expect a professionally enriching experience that also offers personal rewards. ACS 2023 &amp; ACTES 2023 value the role of each attendee in contributing to the advancement of surgical knowledge and patient care. The events promise to chart new horizons in the field of surgery and foster international collaboration.&#x0D; The 30th Albanian Surgical Conference and the 7th Albanian Congress of Trauma and Emergency Surgery are poised to create lasting memories, and their success hinges on the active participation of every attendee. It is an opportunity to inspire, collaborate, and make a lasting impact on surgical care worldwide.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Enhanced congenital cardiac surgery knowledge with multidisciplinary collaborative education series for paediatric cardiology fellows and nurse practitioners.

Paediatric cardiologists and nurse practitioners lack structured education tools focused on basic cardiac surgery principles. However, non-surgical specialties caring for surgical patients require this knowledge for comprehensive clinical care. We created a cardiac surgical educational curriculum focused on improving knowledge and attitudes towards communication for non-surgical trainees and advanced practice providers. Over one academic year, six paediatric cardiology fellows and seven paediatric cardiac surgery nurse practitioners at Seattle Children's Hospital participated in this study. With surgical supervision, six lectures were prepared by each fellow and delivered monthly. Sessions were hybrid and recorded for later viewing. Pre- and post-intervention survey of attitudes regarding surgical topics and pre- and post- test-based knowledge assessments were administered. Participants positively rated the usefulness of the lecture series (4.2/5) and would recommend it to a colleague (4.5/5). Self-reported confidence discussing surgical concepts with patients increased from 2.3 to 3.4 among paediatric cardiology fellows (p < 0.001) and from 2.8 to 3.9 among nurse practitioners (p < 0.001), out of 5. In both groups, knowledge assessment scores improved from 54 to 79% post-intervention (p < 0.001). After a six-part educational series taught by paediatric cardiology fellows, both paediatric cardiology fellows and paediatric cardiac surgery nurse practitioners demonstrated improved knowledge and reported increased comfort counselling families on basic cardiac surgery topics. Structured, active-learning lessons taught by fellows for non-surgical audiences can improve attitudes and build clinically relevant knowledge. Creating an effective level-appropriate multidisciplinary curriculum accessible to various types of medical providers could enhance comprehensive care of complex congenital cardiac surgery patients.

Assessing the effect of a canine surgical-neutering educational programme on the knowledge and confidence of Indian veterinary participants.

India has a large, free-roaming dog population, encompassing both owned and stray dogs. Canine surgical neutering is often a central component of dog population management and rabies control initiatives. The provision of practical, surgical training opportunities remains a major challenge for veterinary educational establishments worldwide to ensure competency in this routine procedure. A 12-day educational programme, focusing on surgical neutering skills, was developed to address this need. A questionnaire comprising 26 questions covering surgical and clinical topics, and a self-assessment of confidence in undertaking five common surgical procedures, was completed immediately before and after finishing the programme. A total of 296 participants attended, with 228 achieving the inclusion criteria for the study. Total knowledge scores increased significantly after the training programme (mean score pre-18.94, 95% CI 18.13-19.74; post-28.11, 95% CI 27.44-28.77, p < 0.05) with improvements seen in all categories (surgical principles, anaesthesia, antibiotic use and wound management). After accounting for other participants' characteristics, scores increased, on average, by 9 points after training. Being female was associated with significantly higher overall scores, while compared to younger and older age groups, those aged 25-34 were associated with lower overall scores. Amongst those with post-graduate qualifications, overall scores increased with age. Furthermore, there was an increase in self-rated confidence by participants in undertaking all five procedures. This study demonstrates that a targeted training programme can improve veterinary participants' knowledge and confidence in canine surgical neutering and may provide an effective way to develop surgical expertise amongst veterinarians engaged in dog population management initiatives.

Are There Video Characteristics That Improve the Accuracy and Quality of Ob-Gyn Procedural Videos? [ID: 1376966

INTRODUCTION: YouTube has emerged as a common resource used by ob-gyn residents to learn procedural skills. There has not been any research conducted that examines the relationship between video characteristics and the quality and accuracy of ob-gyn procedural videos. The purpose of this study was to assess whether YouTube video metrics, including number of likes, views, channel subscribers, geographic location, and organizational affiliations, can be used to gauge the quality and accuracy of ob-gyn procedural videos. METHODS: Using American College of Obstetricians and Gynecologists (ACOG) surgical curriculum topics, we conducted a search query into YouTube and sorted by relevance. Screening criteria were used to exclude videos. We then recorded video characteristics and scored the videos using the Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) video assessment tool for quality. Additionally, we scored videos for accuracy by comparing them to the ACOG Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist. RESULTS: Of the 306 videos analyzed, number of likes, views, channel subscribers, and geographic location were not of high quality with LAP-VEGaS scores less than 11. The number of likes, views, and channel subscribers were not significantly associated with LAP-VEGaS or SCOG accuracy. There was a significant difference in LAP-VEGaS score and SCOG accuracy with international health care organization/specialty society with P values of .004 and .001, respectively. CONCLUSION: Of the characteristics studied, number of likes, views, and channel subscribers, and geographic location did not have a statistically significant difference in accuracy of educational value. Only association with international health care organizations/specialty societies was significantly associated with an increased LAP-VEGaS, indicating increased quality of video and increased percent accuracy by ACOG standards.

Emergency burn education: Evaluating a surgical simulation-based intervention

Medical simulation has provided favorable outcomes in the improvement of clinical competence at both the undergraduate and postgraduate levels. The recall of information demonstrably increases when it has been taught in environments similar to the workplace. This study aimed to evaluate the role of a one-day burn simulation session in improving students' knowledge of burn management and interest in plastic surgery as a specialty. A one-day course was designed to deliver multiple lectures covering surgical topics such as the classification and management of burns, followed by a series of practical workshops. Participants were instructed to undergo a pre-course knowledge assessment and a survey focusing on interest in plastic surgery. Students were subsequently instructed to complete a post-course assessment and a survey of knowledge and confidence in managing burns as well as interest in plastic surgery both immediately and 6 weeks post-course. The students' knowledge demonstrated a 54.2% increase in the post-course assessment (p<0.01). 27% of participants (n=14) participated in a 6-week post-course quiz. The knowledge assessment of these participants at 6 weeks post-course also demonstrated a sustained increase of 61.0% (p<0.01). Interest in plastic surgery was increased by 31.4% post-course (p<0.01). At 6 weeks post-course, a sustained increase of 14.7% was demonstrated in comparison to pre-course data (p=0.03). Simulation teaching provides good outcomes in both information retention and interest in plastic surgery as a specialty. Therefore, medical school curriculums may benefit from including burn simulations.

Use of topic modeling to assess research trends in the journal Gynecologic Oncology

Study objectiveThere is scant research identifying thematic trends within medical research. This work may provide insight into how a given field values certain topics. We assessed the feasibility of using a machine learning approach to determine the most common research themes published in Gynecologic Oncology over a thirty-year period and to subsequently evaluate how interest in these topics changed over time. MethodsWe retrieved the abstracts of all original research published in Gynecologic Oncology from 1990 to 2020 using PubMed. Abstract text was processed through a natural language processing algorithm and clustered into topical themes using latent Dirichlet allocation (LDA) prior to manual labeling. Topics were investigated for temporal trends. ResultsWe retrieved 12,586 original research articles, of which 11,217 were evaluable for subsequent analysis. Twenty-three research topics were selected at the completion of topic modeling. The topics of basic science genetics, epidemiologic methods, and chemotherapy experienced the greatest increase over the time period, while postoperative outcomes, reproductive age cancer management, and cervical dysplasia experienced the greatest decline. Interest in basic science research remained relatively constant. Topics were additionally reviewed for words indicative of either surgical or medical therapy. Both surgical and medical topics saw increasing interest, with surgical topics experiencing a greater increase and representing a higher proportion of published topics. ConclusionsTopic modeling, a type of unsupervised machine learning, was successfully used to identify trends in research themes. The application of this technique provided insight into how the field of gynecologic oncology values the components of its scope of practice and therefore how it may choose to allocate grant funding, disseminate research, and participate in the public discourse.

Representation of Female Speakers at the American Academy of Orthopaedic Surgeons Annual Meetings Over Time.

In the United States, women comprise 16% of orthopaedic surgery residents, 4% of fellows, and 6% of practicing orthopaedic surgeons. The underrepresentation of women in surgical subspecialties may be because of lack of early exposure to female mentors. Conference speaker roles are important for visibility. This study aims to evaluate the representation of women in speaker roles and responsibilities at the American Academy of Orthopaedic Surgeons (AAOS) meetings over time. The names of speakers and session titles at the annual AAOS meetings were obtained from conference programs for the years 2009, 2014, and 2019. Each speaker was classified based on sex and role. Sessions discussing scientific or surgical topics were classified as technical and those that did not were classified as nontechnical. Descriptive statistics are provided, as well as individual-year odds ratios (ORs) and confidence intervals (CIs) examining sex versus technical session status and sex versus speaker role; combined results controlling for year are calculated using the Cochran-Mantel-Haenszel method. Overall, 3,980 speaking sessions were analyzed; 6.8% of speaking sessions were assigned to women. Women were more likely than men to participate in nontechnical speaking roles (OR 3.85; 95% CI, 2.79 to 4.78). Among talks given by women, the percentage that were nontechnical increased (25.5% in 2009, 24.3% in 2014, and 44.1% in 2019). Among moderator roles, the percentage assigned to women increased (4.5% in 2009, 6.0% in 2014, 14.5% in 2019). Our findings demonstrate an increase in female speakers at AAOS meetings from 2009 to 2019. The percentage of female moderators and nontechnical sessions given by women increased since 2009. A need for a shift in the distribution of speaker role exists, which promotes inclusivity and prevents professional marginalization. Representation of women as role models increases visibility and may address the leaky pipeline phenomenon and paucity of women in orthopaedics.

Introducing Surgical Equity into Contemporary Medical Education: Results From Operation Equity, a Pilot Curriculum

To date, education about health equity for early-stage healthcare trainees is largely situated outside of surgical disciplines. This study aims to evaluate the effectiveness of a surgical equity curriculum offered to a voluntary group of medical and graduate students. Mixed-methods cohort study from January to June 2021. Pre- and post-course surveys measured domains of attitudes, self-reported confidence, and knowledge via 5-point Likert scale and multiple-choice questions. Paired t tests were used to analyze quantitative responses. Qualitative responses were studied via iterative thematic analysis. At the University of Pennsylvania in Philadelphia, PA which provides tertiary level, institutional care, 10, interdisciplinary 1.5-hour sessions were held over 1 semester, teaching surgical equity topics that spanned the peri-operative continuum. Twenty-four medical and graduate students from across the University of Pennsylvania enrolled. Twenty completed both surveys. From pre- to post-course, students improved across all domains. Students improved in their self-rated ability to identify strategies to talk about sensitive health topics with patients (pre: 20%, post: 90%) and identify strategies to address healthcare disparities in surgery (pre: 10%, post: 90%). Qualitatively, from pre- to post-course, more students could articulate the role of bias and identify opportunities for surgeons to engage in surgical equity. The course strengthened any pre-existing interest in surgical equity, and for 1 student, created interest in a surgical career where it had not previously existed. Many also expressed greater resolve to provide patient-centric care. Formal curricula can improve students' ability to advocate for surgical equity. A similar framework may fill a need for medical students interested in health equity and surgical careers at other institutions.

Portfolio-based learning in surgery : Making competencies "visible"

Due to an increasing competence orientation of medical studies, surgical curricula are being adapted in many places. In addition to surgical knowledge and practical skills, these should also teach competencies in differential diagnostics and treatment. The teaching of surgical knowledge through lectures and seminars and the demonstration of practical skills, e.g., through the use of logbooks in the Bock Practical Surgery (BP), only allows limited active engagement with surgical competencies on differential diagnostics and treatment. Areflection-based portfolio allows, through the independent written elaboration of surgical topics, an active engagement with the competencies and promises ahigher learning effect. In the context of the implementation of such aportfolio as part of the proof of activity in BP, the effects on the acquisition of competencies and on the way of learning were investigated. Using amixed methods approach, we compared competence acquisition using areflection-based portfolio with learning using alogbook. Students conducted aself-assessment of competencies using questionnaire surveys before and after the BP. Through focus group interviews with discussions among students using aguideline, we explored the different ways of acquiring competencies. In addition, the examination and evaluation results of both cohorts were compared. Students' self-assessed competency acquisition and examination and evaluation results showed no differences when comparing the two cohorts. During the focus group interviews, we were able to show that in the perception of the students, surgical competencies can be made more visible and thus more explicit with the help of areflection-based portfolio. In addition, self-regulated learning was promoted without neglecting practical skills. Students demanded greater supervision and guidance by mentors in both groups.

Is online objective structured clinical examination teaching an acceptable replacement in post-COVID-19 medical education in the United Kingdom?: a descriptive study

Coronavirus disease 2019 (COVID-19) restrictions resulted in an increased emphasis on virtual communication in medical education. This study assessed the acceptability of virtual teaching in an online objective structured clinical examination (OSCE) series and its role in future education. Six surgical OSCE stations were designed, covering common surgical topics, with specific tasks testing data interpretation, clinical knowledge, and communication skills. These were delivered via Zoom to students who participated in student/patient/examiner role-play. Feedback was collected by asking students to compare online teaching with previous experiences of in-person teaching. Descriptive statistics were used for Likert response data, and thematic analysis for free-text items. Sixty-two students provided feedback, with 81% of respondents finding online instructions preferable to paper equivalents. Furthermore, 65% and 68% found online teaching more efficient and accessible, respectively, than in-person teaching. Only 34% found communication with each other easier online; Forty percent preferred online OSCE teaching to in-person teaching. Students also expressed feedback in positive and negative free-text comments. The data suggested that generally students were unwilling for online teaching to completely replace in-person teaching. The success of online teaching was dependent on the clinical skill being addressed; some were less amenable to a virtual setting. However, online OSCE teaching could play a role alongside in-person teaching.

Surgical Residents Value a Longitudinal Leadership Curriculum Teaching Non-Technical Skills

INTRODUCTION: A paucity of leadership training programs exist for residents, and outcomes of those are limited in reporting. Based on a robust needs assessment, our program created a longitudinal cohort curriculum, Future Surgical Leaders (FSL), for residents and fellows of all levels to provide non-technical skills (NTS). We aim to evaluate our short-term outcomes and satisfaction. METHODS: Participants were sent a short survey after each session of the curriculum. Data was compiled after 18 months of delivery. Likert Scale responses and free text comments were analyzed with a 2 sample t-test and 2-way ANOVA. RESULTS: Survey response rate from 54 sessions among all PGY levels was 73%. Overall, 96% of residents/fellows either “agreed” or “strongly agreed” that topics of the FSL curriculum were important to learn during surgical training. Only 24% of learners reported they already knew “a lot” or “a great deal” about the topics prior to the session which rose to 73% afterwards (p < 0.01). Each PGY class shared this statistically significant knowledge increase. A total of 80% of learners wanted to investigate topics further. Open comment questions identified themes requesting delivery of specific sessions earlier in residency training and positive overall attitudes toward the FSL curriculum. CONCLUSION: Surgical residents overwhelming report topics in our longitudinal curriculum are important and want to learn more. Few residents had pre-existing knowledge of NTS topics which significantly improved following the sessions. Immediate survey feedback allows adjustment of the curriculum delivery time of NTS topics in the future.

Satisfaction of Medical Students with Surgical Training: A Survey of Northern Italy

Background: Medical student satisfaction regarding the inclusion of surgical education into the medical curriculum may vary among learners. In this study, we analyzed the satisfaction of medical students in regard to how surgical topics were taught in Italian schools in 2021 through a survey. The results collected can be used to not only improve the quality of medical education in the future but to help students make informed decisions about their own education. Methods: An electronic survey was sent out to medical students in their third to sixth years across three medical schools in Northern Italy via their respective institutional secretaries. The questionnaire was available in Italian and English. It included both closed and open-ended questions regarding satisfaction with the teaching of surgical topics in Italian medical universities. Results: Results were reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Most respondents (87%) preferred to have an increase in surgery-related electives and/or extracurricular courses. Further, 51.2% of respondents expressed an increased interest in surgery after having observed in the Operating Room (OR). The majority of respondents (73.3%) also expressed that the coronavirus disease 2019 (COVID-19) pandemic had negatively impacted the quality of teaching of surgical topics. Conclusion: In the present survey study, Italian medical students preferred hands-on practice over theoretical lectures for surgical education. The majority of students stipulated that the inclusion of suturing, scrubbing, and good surgical practice workshops along with an increased OR attendance would facilitate a better understanding of surgery.

Management of Malignant Obstructive Jaundice: Defining the Relevance of Various Palliative Surgical Options in Resource-Challenged Settings: A Review Article.

Malignant obstructive jaundice (MOJ) constitutes an important surgical problem with high morbidity and mortality worldwide. Presentation is usually delayed with a majority of patients benefitting only from palliative treatment. Surgeons practicing in developing countries face herculean task in managing MOJ due to lack of minimally invasive endoscopic procedures. Palliative surgical procedures are associated with high morbidity and sometimes mortality. Abdominal pain, generalized pruritus, and gastric outlet obstruction are some of the symptoms of MOJ requiring palliation. Successful surgical palliation may improve the overall quality of life in patients with MOJ considered fit for surgery. Bypass procedures and regional nerve blocks constitute the most effective surgical palliation available to surgeons practicing in resource-limited settings. This review article discusses the indications, the role, and types of surgical bypass procedures in the management of MOJ in contemporary surgical practice. This is important for surgeons in countries where expertise and resources for the less morbid endoscopic and radiologic approaches are not available. Relevant articles up to January 2021 published in PubMed, Google Scholar, and Hinari on the surgical management of obstructive jaundice were reviewed for inclusion. We also reviewed some modern surgical textbook topics on obstructive jaundice.

Surgical applications of ultrasound use in low-and middle-income countries: A systematic review.

Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income countries (LMIC), specifically for surgical applications. The review includes characterising and evaluating trends in the geographic and specialty-specific use of ultrasound pertaining to surgical disease. The databases such as Medline OVID, EMBASE and Cochrane were searched from 2010 through March 2019 for studies available in English, French and Spanish. Commentaries, opinion articles, reviews and book chapters were excluded. A categorical analysis of ultrasound use for surgical disease in LMICs was conducted. A total of 6276 articles were identified, with 4563 studies included for the final review. A total of 221 studies were selected researching ultrasound use in LMICs to treat surgical disease. Most studies identified ultrasound usage focused on general surgery, acute care surgery and surgical ICU topics (52%, 115) followed by computed tomography surgery studies (20%, 44). Most studies were retrospective in nature, with 81% (180) of research studies generated in four countries (India, Pakistan, Nigeria and Egypt). Ultrasound proved to be a feasible technique for utility in pre-operative diagnosis, cost-effectiveness and prediction of surgical outcomes. Findings are limited by the limited number of randomised clinical trials reported. Our systematic literature review of ultrasound use in LMICs demonstrates the growing utilisation of this relatively low-cost, portable imaging technology in low resource settings for surgical disease.

The 2020 Pandemics: Lessons Learned in Academic Surgery and Beyond.

2020 was a significant year because of the occurrence of two simultaneous public health crises: the coronavirus pandemic and the public health crisis of racism brought into the spotlight by the murder of George Floyd. The coronavirus pandemic has affected all aspects of health care, particularly the delivery of surgical care, surgical education, and academic productivity. The concomitant public health crisis of racism and health inequality during the viral pandemic highlighted opportunities for action to address gaps in surgical care and the delivery of public health services. At the 2021 Academic Surgical Congress Hot Topics session on flexibility and leadership, we also explored how our military surgeon colleagues can provide guidance in leadership during times of crisis. The following is a summary of the issues discussed during the session and reflections on the important lessons learned in academic surgery over the past year.