Education Recognition

Leading in Surgical Education: Paul Wise, MD

Paul Wise, MD, teaching a resident

Colon and rectal surgeon Paul Wise, MD has served as the General Surgery Residency Program Director since 2014. For over almost a decade, he has guided and mentored dozens of trainees within the program as they begin their career as surgeons.

“It makes me the most proud to see our residents become independent senior residents,” he says. “They mature into amazing surgeons and academic leaders.”

This June, Wise was selected as an at-large member of the Association of Program Directors in Surgery’s (APDS) executive committee.

The APDS is an organization that provides a forum for the exchange of information on a wide range of subjects related to post-graduate surgical education. They aim to improve graduate surgical education and patient care, and provide advice, assistance, and support to program directors on matters pertaining to surgical education and to accreditation.

During this three-year appointment, Wise will assist in the management of the affairs of the Association and appointment of agents. Serving on the APDS executive committee demonstrates Wise’s commitment to graduate medical education and the future of surgical training.  He has also served on the APDS Application Cycle Task Force since 2021, a group focused on setting standards for General Surgery recruitment in the face of ever-increasing application numbers and the recruitment changes that have necessarily occurred during the pandemic, including virtual interviewing.

Below, Wise answers questions about general surgery training at Washington University and initiatives that he has helped put in place and/or continue to improve trainees’ experiences, such as Flexibility in Surgical Training, resident mentorship families and multiple wellness resources.

What are the advantages of Flexibility in Surgical Training?

Flexibility in Surgical Training (FIST) and early specialization is something that we have been incredibly passionate about for a number of years now at Washington University. Our senior residents have the opportunity to create and develop their fourth and fifth years in a way that will help them to be able to better transition into fellowship.

They’re able to focus on the training that they want and help to design an educational curriculum that works best for them. At most programs, the residents might at most get a say in the order of their rotations, but those rotations are otherwise set in stone. But here, the senior residents actually get a chance to organize and adjust their training in a way that works for their professional development and their career goals. In doing this type of training, we have found that it’s been incredibly helpful to facilitate their autonomy as well as transition into fellowship.

If a trainee is impassioned about going into any particular subspecialty, there are incredible opportunities to be able to explore that more deeply and have longer and deeper experiences on different services. Essentially, almost mini-fellowships as a senior resident.

What role does mentorship play within the Department of Surgery?

Mentorship is an incredibly important aspect of career development for surgical residents, and it’s a big focus of what we do within the Department of Surgery. Mentorship is really an organic thing, it’s not something that we can totally force, and we find that to be the key to the system that we’ve set up.

As soon as a medical student matches with us, we immediately start constructing a mentorship family where we pair the incoming intern with a faculty member as well as multiple “big sibs,” who are individuals the new intern can work with to ease their transition into residency and St. Louis. This includes second, third, fourth and fifth year residents, as well as lab residents and a faculty member and Associate Program Director.

Essentially this creates a group of support for the interns when they come into the program. If they’re making a new transition to St. Louis, or if they have issues in the transition, this creates a safety network – a group of individuals who can be there to help as the intern transitions in. Thereafter, we let the more organic mentorship experience take shape as they get to know people in the program and develop their areas of interest and focus, such that their lab mentors and others can become their “true” mentors as they transition into the mid- and senior-level training (and beyond!).

What research and professional development opportunities are there within the Department of Surgery?

The academic and research opportunities at Washington University are almost unlimited, and so it’s incredible to see how the diverse group of residents within our Department of Surgery take advantage of that.

As soon as a student matches with us, we immediately start getting the wheels turning to try to get them set up for a successful professional development time or research time during their residency. Most of our residents do that after their second clinical year. We do have some associated with our flexibility in training who would like to do that after their third year, and they’ll spend anywhere from one to two, sometimes even three years in the lab to be able to have exposure to anything from basic science to surgical education to population sciences and really anything in between.

We have a number of residents who’ve really taken advantage of that and even further explored getting different degrees such as masters in population health sciences or a masters in clinical investigation. We even have residents who have done PhDs during their time in the lab!

The Department of Surgery at Washington University is also one of the best funded departments in the country, so we have great amount of support for the residents in their training. I would say that the academic experience that our residents have is second to none, and their productivity underscores that fact!

It’s really been fun to work with the residents and create unique and individual research and professional development opportunities for them to be very prepared for the next stage in their careers.

How do you support resident wellness?

The Graduate Medical Education Consortium at Washington University School of Medicine and Barnes-Jewish Hospital has fantastic support and resources for wellness for residents, including two full-time psychologists (for trainees only!) as well as a great employee assistance program. We have a department-only, 24/7 Wellness Center with treadmills, free weights, a Peloton exercise bike, and a rowing machine. Our General Surgery resident-only lounges are stocked with healthy snacks.

Additionally, we have department-supported social and after-hours events, and an annual resident retreat focused on program improvements and team building. The department also sponsors resident-only tickets to the St. Louis Cardinals and St. Louis Blues (including playoff tickets) and the Broadway series at the Fabulous Fox Theater.

Our residents are actively involved in program committees and a resident advisory council to help shape the program in addition to weekly class meetings with me to help inform me of any needed rotation changes in real time (as opposed to only at the end of the year based on rotation evaluations, for example).

We also believe that flexibility in training adds to their wellness as it offers residents some control and allows them to design their training and get what they want out of residency.