+ The MIMIS Fellowship Paul Severson, MD, FACS Howard McCollister, MD, FACS Timothy LeMieur, MD, FACS Shawn Roberts, MD Educating the Rural Surgeon.

+

The MIMIS Fellowship

Paul Severson, MD, FACSHoward McCollister, MD, FACSTimothy LeMieur, MD, FACSShawn Roberts, MD

Educating the Rural Surgeon

+Disclosures

Paul Severson, MD Stryker Endoscopy: International Advisory Council

MIMIS Fellowship Covidien: unrestricted educational grant to MIMIS

MIMIS Fellowship Faculty: Paid consultants for rural hospitals

Surgical education - proctors

+

Sunrise on Serpent LakeCrosby, Minnesota

+The MIMIS Fellowship

The first rural fellowship

The first fellowship in a “critical access” rural hospital Cuyuna Regional Medical Center, Crosby, Minnesota

The first fellowship to be triple accredited in the United States and Canada MIS + Bariatric + Flexible Endosurgery

+The MIMIS Fellowship

The first rural fellowship

The first fellowship in a “critical access” rural hospital Cuyuna Regional Medical Center, Crosby, Minnesota

The first fellowship to be triple accredited in the United States and Canada MIS + Bariatric + Flexible Endosurgery

+

+

+The MIMIS Fellowship

The first rural fellowship

The first fellowship in a “critical access” rural hospital Cuyuna Regional Medical Center, Crosby, Minnesota

The first fellowship to be triple accredited in the United States and Canada MIS + Bariatric + Flexible Endosurgery

+Background – Surgical Education MIMIS – Minnesota Institute for Minimally Invasive Surgery

Created by our rural surgical group in 2002 to reflect our mission History of educating regional surgeons in advanced laparoscopy

and endoscopy since 1995 Laparoscopic Burch bladder neck suspension (urinary

incontinence in women) Laparoscopic Nissen fundoplication Endoscopy training (FP Residents, surgeons in private practice)

Additional courses offered after forming MIMIS Bariatric mini-fellowships Trivex faculty for varicose vein surgery Stapled hemorrhoidopexy regional training center

+Background – Surgical Education MIMIS – Minnesota Institute for Minimally Invasive Surgery

Created by our rural surgical group in 2002 to reflect our mission History of educating regional surgeons in advanced laparoscopy

and endoscopy since 1995 Laparoscopic Burch bladder neck suspension (urinary

incontinence in women) Laparoscopic Nissen fundoplication Endoscopy training (FP Residents, surgeons in private practice)

Additional courses offered after forming MIMIS Bariatric mini-fellowships Trivex faculty for varicose vein surgery Stapled hemorrhoidopexy regional training center

+Background – Surgical Education MIMIS – Minnesota Institute for Minimally Invasive Surgery

Created by our rural surgical group in 2002 to reflect our mission History of educating regional surgeons in advanced laparoscopy

and endoscopy since 1995 Laparoscopic Burch bladder neck suspension (urinary

incontinence in women) Laparoscopic Nissen fundoplication Endoscopy training (FP Residents, surgeons in private practice)

Additional courses offered after forming MIMIS Bariatric mini-fellowships Trivex faculty for varicose vein surgery Stapled hemorrhoidopexy regional training center

+Background – Surgical Education Regional Surgical Leadership Upper Midwest Bariatric Forum (Severson, McCollister)

Founded by MIMIS in cooperation with UM and Mayo Hitchcock Surgical Society Presidents (Severson, LeMieur) Minnesota Surgical Society leadership (Severson, McCollister,

LeMieur) Minnesota Trauma Task Force (Severson, LeMieur, Roberts)

National leadership opportunities emerge SAGES Program Committee – rural liaison (Severson) Fellowship Council Program Directors (Severson)

Global education efforts are recognized Severson and McCollister develop courses in Laparoscopy and

Endoscopy for surgeons in Pignon, Haiti – 13 years and running ACS Executive Director Dr. Tom Russell visits Pignon, awards

granted Severson appointed to Global Health Education Committee at UM

Incorporation of global health into medical school curriculum

+Background – Surgical Education Regional Surgical Leadership Upper Midwest Bariatric Forum (Severson, McCollister)Upper Midwest Bariatric Forum (Severson, McCollister)

Founded by MIMIS in cooperation with UM and Mayo Hitchcock Surgical Society Presidents (Severson, LeMieur)Hitchcock Surgical Society Presidents (Severson, LeMieur) Minnesota Surgical Society leadership (Severson, McCollister, Minnesota Surgical Society leadership (Severson, McCollister,

LeMieur)LeMieur) Minnesota Trauma Task Force (Severson, LeMieur, Roberts)Minnesota Trauma Task Force (Severson, LeMieur, Roberts)

National leadership opportunities emerge SAGES Program Committee – rural liaison (Severson) Fellowship Council Program Directors (Severson)

Global education efforts are recognized Severson and McCollister develop courses in Laparoscopy and

Endoscopy for surgeons in Pignon, Haiti – 13 years and running ACS Executive Director Dr. Tom Russell visits Pignon, awards

granted Severson appointed to Global Health Education Committee at UM

Incorporation of global health into medical school curriculum

+Background – Surgical Education Regional Surgical Leadership Upper Midwest Bariatric Forum (Severson, McCollister)

Founded by MIMIS in cooperation with UM and Mayo Hitchcock Surgical Society Presidents (Severson, LeMieur) Minnesota Surgical Society leadership (Severson, McCollister,

LeMieur) Minnesota Trauma Task Force (Severson, LeMieur, Roberts)

National leadership opportunities emerge SAGES Program Committee – rural liaison (Severson) Fellowship Council Program Directors (Severson)

Global education efforts are recognized Severson and McCollister develop courses in Laparoscopy and

Endoscopy for surgeons in Pignon, Haiti – 13 years and running ACS Executive Director Dr. Tom Russell visits Pignon, awards

granted Severson appointed to Global Health Education Committee at UM

Incorporation of global health into medical school curriculum

Dr. Paul Severson proctors Haiti’s surgery professors

+

The Ride Across Haiti 2008

Dr. Howard McCollister teaches laparoscopy to Haitian surgeons

+ Dr. Howard McCollister

+

Dr. Tim LeMieur

MIMIS faculty

+

Dr. Shawn Roberts

Our first fellow

MIMIS faculty

+Educating the Rural Surgeon

So why develop a fellowship?

+The Problem with Surgical Education Many residency programs poorly prepare graduates

Endoscopy Gastroenterology control Limited exposure to therapeutic “endosurgery” Lack of commitment to endoscopy despite directives

Advanced laparoscopy Failure to develop “the laparoscopic mentality” Faculty still learning – residents don’t get enough experience

Bariatric surgery Failure to recognize obesity as America’s #1 health problem Surgery is currently the only and most effective treatment Failure to accept bariatric surgery as “mainstream” general

surgery

+The Problem with Surgical Education Many residency programs poorly prepare graduates

Endoscopy Gastroenterology control Limited exposure to therapeutic “endosurgery” Lack of commitment to endoscopy despite directives

Advanced laparoscopy Failure to develop “the laparoscopic mentality” Faculty still learning – residents don’t get enough experience

Bariatric surgery Failure to recognize obesity as America’s #1 health problem Surgery is currently the only and most effective treatment Failure to accept bariatric surgery as “mainstream” general

surgery

+The Problem with Surgical Education Many residency programs poorly prepare graduates

Endoscopy Gastroenterology control Limited exposure to therapeutic “endosurgery” Lack of commitment to endoscopy despite directives

Advanced laparoscopy Failure to develop “the laparoscopic mentality” Faculty still learning – residents don’t get enough experience

Bariatric surgery Failure to recognize obesity as America’s #1 health problem Surgery is currently the only and most effective treatment Failure to accept bariatric surgery as “mainstream” general

surgery

+The Problem with Surgical Education Many residency programs poorly prepare graduates

Endoscopy Gastroenterology control Limited exposure to therapeutic “endosurgery” Lack of commitment to endoscopy despite directives

Advanced laparoscopy Failure to develop “the laparoscopic mentality” Faculty still learning – residents don’t get enough experience

Bariatric surgery Failure to recognize obesity as America’s #1 health problem Surgery is currently the only and most effective treatment Failure to accept bariatric surgery as “mainstream” general

surgery

+The Problem with Surgical Education Rural surgeons need to be broadly trained

Endoscopy – therapeutic dilations, polypectomy, bleeds, ablations

Advanced laparoscopy – lap Nissen, colon, hernia Gynecology – lap hysterectomy, lap ectopic pg, C-sections Orthopedics – fractures and hand ENT – tubes and tonsils

General Surgery residencies are not providing adequate training to prepare the surgeon for rural America

Fellowships are needed until residencies do the job Even then, additional education is needed due to narrow

training focus both in residency AND in fellowships Cooperstown surgery residency training is a model for success

(JACS 2003, Reynolds)

+The Problem with Surgical Education Rural surgeons need to be broadly trained

Endoscopy – therapeutic dilations, polypectomy, bleeds, ablations

Advanced laparoscopy – lap Nissen, colon, hernia Gynecology – lap hysterectomy, lap ectopic pg, C-sections Orthopedics – fractures and hand ENT – tubes and tonsils

General Surgery residencies are not providing adequate training to prepare the surgeon for rural America

Fellowships are needed until residencies do the job Even then, additional education is needed due to narrow

training focus both in residency AND in fellowships Cooperstown surgery residency training is a model for success

(JACS 2003, Reynolds)

+The Problem with Surgical Education Rural surgeons need to be broadly trained

Endoscopy – therapeutic dilations, polypectomy, bleeds, ablations

Advanced laparoscopy – lap Nissen, colon, hernia Gynecology – lap hysterectomy, lap ectopic pg, C-sections Orthopedics – fractures and hand ENT – tubes and tonsils

General Surgery residencies are not providing adequate training to prepare the surgeon for rural America

Fellowships are needed until residencies do the job Even then, additional education is needed due to narrow

training focus both in residency AND in fellowships Cooperstown surgery residency training is a model for success

(JACS 2003, Reynolds)

+The Problem with Surgical Education

Urban surgeons have limited themselves to very few procedures Primarily gallbladder and hernia - maybe breast, maybe trauma No colo-rectal No endoscopy

There is an ever increasing divergence between the urban and rural surgical repertoire

We need to educate rural surgeons to expand their capabilities Revenue from procedures lost to regional centers is needed to keep

our rural hospitals healthy (43% of rural hospital revenue is surgical) Educating the practicing rural surgeon in advanced laparoscopy and

endoscopy is almost impossible without proctoring relationships

+The Problem with Surgical Education

Urban surgeons have limited themselves to very few procedures Primarily gallbladder and hernia - maybe breast, maybe trauma No colo-rectal No endoscopy

There is an ever increasing divergence between the urban and rural surgical repertoire

We need to educate rural surgeons to expand their capabilities Revenue from procedures lost to regional centers is needed to keep

our rural hospitals healthy (43% of rural hospital revenue is surgical) Educating the practicing rural surgeon in advanced laparoscopy and

endoscopy is almost impossible without proctoring relationships

+The Problem with Surgical Education

Urban surgeons have limited themselves to very few procedures Primarily gallbladder and hernia - maybe breast, maybe trauma No colo-rectal No endoscopy

There is an ever increasing divergence between the urban and rural surgical repertoire

We need to educate rural surgeons to expand their capabilities Revenue from procedures lost to regional centers is needed to keep Revenue from procedures lost to regional centers is needed to keep

our rural hospitals healthy (43% of rural hospital revenue is surgical) our rural hospitals healthy (43% of rural hospital revenue is surgical) Educating the practicing rural surgeon in advanced laparoscopy and Educating the practicing rural surgeon in advanced laparoscopy and

endoscopy is almost impossible without proctoring relationshipsendoscopy is almost impossible without proctoring relationships

+The Problem with Surgical Education Current educational models are inadequate

Weekend courses, major meetings Cadaver labs, inanimate labs, “hands-on” training Invitations to observe at tertiary centers

Patient safety and proper credentialing are not possible without numerous cases monitored by an experienced proctor

MIMIS surgeons provide long-term consulting relationships with rural hospitals to solve their problems Advanced laparoscopy Endoscopy Surgical education for all the physicians Administrative support, systems based protocols, credentialing

+The Problem with Surgical Education Current educational models are inadequate

Weekend courses, major meetingsWeekend courses, major meetings Cadaver labs, inanimate labs, “hands-on” trainingCadaver labs, inanimate labs, “hands-on” training Invitations to observe at tertiary centersInvitations to observe at tertiary centers

Patient safety and proper credentialing are not possible without numerous cases monitored by an experienced proctor

MIMIS surgeons provide long-term consulting relationships with rural hospitals to solve their problems Advanced laparoscopy Endoscopy Surgical education for all the physicians Administrative support, systems based protocols, credentialing

+The Problem with Surgical Education Current educational models are inadequate

Weekend courses, major meetings Cadaver labs, inanimate labs, “hands-on” training Invitations to observe at tertiary centers

Patient safety and proper credentialing are not possible without numerous cases monitored by an experienced proctor

MIMIS surgeons provide long-term consulting relationships with rural hospitals to solve their problems Advanced laparoscopy Endoscopy Surgical education for all the physicians Administrative support, systems based protocols, credentialing

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in MIS, Bariatric, and Flexible Endosurgery in December, 2007 The first program to achieve triple accreditation in the US and Canada

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in MIS, Bariatric, and Flexible Endosurgery in December, 2007 The first program to achieve triple accreditation in the US and Canada

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in MIS, Bariatric, and Flexible Endosurgery in December, 2007 The first program to achieve triple accreditation in the US and Canada

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in MIS, Bariatric, and Flexible Endosurgery in December, 2007 The first program to achieve triple accreditation in the US and Canada

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in MIS, Bariatric, and Flexible Endosurgery in December, 2007 The first program to achieve triple accreditation in the US and Canada

+The MIMIS Fellowship

We were encouraged by the Fellowship Council to join in the effort to educate at the fellowship level (Dr. Dan Smith - 2001)

3 years to develop MIMIS, investigate fellowships, and prepare

Hired Dr. Shawn Roberts as new partner and “test” fellow, 2004

Applied to Fellowship Council for MIS fellowship in 2005

Entered the match in 2006 as a new program “pending accreditation”

Granted full 3 year accreditation in December, 2007 in MIS, Bariatric, and Flexible Endosurgery The first program to achieve triple accreditation in the US and Canada

+Fellowship Councilwww.fellowshipcouncil.org

History 2001: “MIS Fellowship Council” established

“to advance high quality surgical education in MIS, GI, HPB, and bariatric surgery”

2003: SSAT, SAGES, AHPBA join together to organize fellowships for GI, MIS, and HPB surgery Non-ACGME accredited fellowships First match (NRMP) held for 60 programs, 90 applicants

2005: ASBS joins to support bariatric surgery fellowships Name changes to “Fellowship Council”

2008: Fellowship Council holds its own match 130 programs, 217 applicants (165 US, 15 Canada, 37

Foreign)

+Fellowship Councilwww.fellowshipcouncil.org

+Fellowship Councilwww.fellowshipcouncil.org

Notable programs that did not match Penn State University of Miami Brigham and Women’s (0 of 2) Cleveland Clinic (research fellow) University of Iowa Fresno Bariatrics Columbia/Cornell (1 of 2) New York Hospital Queens SUNY Brooklyn University of Illinois Chicago

So how does a private practice program in a critical access hospital in rural Minnesota match excellent candidates year after year after year?

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS FellowshipSurvey of fellows – Why MIMIS?

More cases in a lot less time (864 total - 535 Endo, 329 OR)

Large endoscopic experience, preparation for NOS

GI Lab – expertise in pH and manometry, PillCam

Opportunity to join faculty in teaching MIS surgery in Haiti

Respect for the fellow as a surgeon, autonomy

Excellent quality of life in the rural setting

Favorable call schedule

No research abuse

+The MIMIS Fellowship

The MIMIS Fellows1. Matched Dr. Michael Black, our #1 on the rank order list

August 1, 2007 – August 1, 2008 Practicing MIS/Flex Endo rural surgery (Appleton,

Wisconsin)

2. Matched Dr. Jeremy Joyner, our #1 on the rank order list August 1, 2008 – August 1, 2009 (our current fellow) Returning to Americus, Georgia to join his father in rural

General Surgery practice as MIS/Flex Endo specialist

3. Matched Dr. Karen McFarlane, our #1 on the rank order list August 1, 2009 – August 1, 2010 (our next fellow) From inner city New York, interested in the underserved and

global education volunteerism

+The MIMIS Fellowship

The MIMIS Fellows1. Matched Dr. Michael Black, our #1 on the rank order list

August 1, 2007 – August 1, 2008 Practicing MIS/Flex Endo rural surgery (Appleton,

Wisconsin)

2. Matched Dr. Jeremy Joyner, our #1 on the rank order list August 1, 2008 – August 1, 2009 (our current fellow) Returning to Americus, Georgia to join his father in rural

General Surgery practice as MIS/Flex Endo specialist

3. Matched Dr. Karen McFarlane, our #1 on the rank order list August 1, 2009 – August 1, 2010 (our next fellow) From inner city New York, interested in the underserved and

global education volunteerism

+The MIMIS Fellowship

The MIMIS Fellows1. Matched Dr. Michael Black, our #1 on the rank order list

August 1, 2007 – August 1, 2008 Practicing MIS/Flex Endo rural surgery (Appleton,

Wisconsin)

2. Matched Dr. Jeremy Joyner, our #1 on the rank order list August 1, 2008 – August 1, 2009 (our current fellow) Returning to Americus, Georgia to join his father in rural

General Surgery practice as MIS/Flex Endo specialist

3. Matched Dr. Karen McFarlane, our #1 on the rank order list August 1, 2009 – August 1, 2010 (our next fellow) From inner city New York, interested in the underserved and

global education volunteerism

+

MIMIS Fellows Dr. Michael Black and Dr. Jeremy Joyner

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+Educating the Rural Surgeon Conclusions

The rural surgeon needs to be trained in modern techniques of laparoscopy, endoscopy and bariatric surgery

The rural surgeon frequently needs a broad scope of training that might include common procedures from other specialties

Residency programs do not adequately prepare the graduate surgeon for the needs of the rural patients they serve

Fellowship training programs are needed to help address these training deficiencies

MIMIS has demonstrated initial success with its fellowship The impact of this training will need to be measured to

determine its value and applicability Similar training opportunities are sought after by graduate

surgeons and we believe are needed in rural America We encourage others to join us in the effort!

pseverson@cuyunamed.org; hmccollister@cuyunamed.org

+

The MIMIS Fellowship

www.mimismn.orgwww.mimis-obesity.comwww.fellowshipcouncil.org

Educating the Rural Surgeon