Behind The Knife: The Surgery Podcast

This episode includes two full, sample vascular scenarios pulled directly from our Vascular Surgery Oral Board Review Course. Listen in and test your clinical pathways in real-time as we walk through the perfect answers and provide high-yield commentary to help you pass the "hot seat."Sample Scenarios Included in This Episode: Case 22: Aortoenteric Fistula (AEF). A 78-year-old woman presents to the ER with a massive upper GI bleed and a history of an open AAA repair 10 years ago. We walk you through the immediate stabilization, CTA evaluation, and the definitive operative management—including axillobifemoral bypass, aortic stump closure, and duodenal repair. Case 27: Acute Mesenteric Ischemia. A 79-year-old woman with a history of atrial fibrillation presents with abdominal pain out of proportion to her physical exam. Test your decision-making on systemic heparinization, SMA embolectomy versus stenting (ROMS), and how to appropriately evaluate bowel viability with a second-look laparotomy. About our Vascula

In response to increasing surgeon burnout, unsustainable clinical demands, and ongoing loss of surgeon autonomy in the setting of employee-based models, the American College of Surgeons is speaking out. In this episode, hosts Dr. Steven Thornton and Dr. Emma Burke sit down with Dr. Douglas Wood, Chair of Surgery at the University of Washington and Dr. Thomas Varghese, Editor-in-Chief of the Journal of the American College of Surgeons, to discuss the new ACS Workplace Standards Framework. The conversation covers how this initiative grew out of discussions around unionization, what domains the framework addresses — from call intensity and OR block access to administrative burden and inpatient census limits — and how specialty-specific guidelines can be developed and implemented at the local level. Dr. Wood and Dr. Varghese also reflect on the culture of "unlimited endurance" that has long defined surgery, why meaningful systems-level change is both necessary and achievable, and how improving workplace sustaina

The House Judiciary Committee just dropped a 47-page report calling the National Residency Match Program a hiring monopoly that harms patients, doctors, and the public — and the surgical community is talking. In this episode, Dr. Patrick Georgoff is joined by BTK surgical education fellows Dr. Emma Burke and Dr. Agnes Prem Kumar, along with special guest Dr. Brian Carmody (aka the Sheriff of Sodium), a pediatric nephrologist and one of the sharpest analysts of medical education policy working today. Together, they break down the report's central claims: that the NRMP exercises monopolistic control over residency hiring, suppresses resident wages, and strips trainees of bargaining power — and they separate what the report gets right from where its rhetoric badly outruns its evidence. From the history of Section 207 and the antitrust lawsuit that nearly brought down academic medicine, to the real economics of GME funding, resident unionization, and what a match-free world would actually look like — this is the

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.In this third episode, we talk with Drs. Sheina Theodore and Tejal Brahmbhatt about their study examining the relationship between internalized shame states and burnout among surgery residents. They make a compelling case that addressing the well-being crisis in surgery requires looking beyond external stressors to the internal experience of shame: the quiet, invisible voice that tells residents they aren't good enough, and ask what role the culture of surgery plays

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons. In this second episode, we talk with Dr. ElAbd and Dr. Zammit about their study examining the relationship between shame-based learning, grit, and burnout across surgical specialties. Their findings highlight how grit may both protect against burnout and mediate whether residents go on to shame others. Host: Steven ThorntonGuests:1.    Rawan ElAbd (Plastic Surgery Resident, McGill University)2.    Dino Zammit (Assistant Professor of Plastic Surgery, McGill University

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons’ emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.In this first episode, we talk with Dr. Will Bynum and Professor Luna Dolezal about how they understand shame in medicine, why it's so hard to see even when it's everywhere, and how developing what they call "shame competence" might be one of the most important steps we can take toward humanizing surgical training.Host: Steven ThorntonGuests: Will Bynum (Associate Professor of Family Medicine, Duke University) Luna Dolezal (Professor of Philosphy and Medical Humaniti

Welcome back to the AI journal club! In this episode, we bring you a deep dive into a game-changing paper from The Lancet -- the MASAI study. This is the first randomized controlled trial to evaluate the use of artificial intelligence in breast cancer screening and we're so excited to discuss it.We'll break down the study's impressive findings on interval cancer rates, sensitivity, and massive workload reductions for radiologists. Beyond the data, we'll tackle the big-picture questions and some sensational recent headlines. Are we deploying AI too fast? Or is it time to go faster? Hosts: - Ayman Ali, MDAyman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. - Ruchi Thanawala, MD: @Ruchi_TJRuchi Thanawala is an Associate Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for compe

Join the Johns Hopkins Thoracic Surgery Subspecialty team on this rapid research review revealing how investigative efforts have changed the way we view and use Veno-venous (VV) ECMO therapy in the pre-lung transplant patient population working to avoid ventilator dependence and the associated morbidity while facilitating continued ambulation and preoperative optimization. Hosts:- Dr. Alfred J. Casillan, MD, PhDAttending Thoracic Surgeon Johns Hopkins Hospital - Kyla Rakoczy, MD Johns Hopkins General Surgery ResidentReferences:Awake ECMO as Bridge to Lung Transplantation Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. American Journal of Respiratory and Critical Care Medicine. 2012;185(7):763–768. PMID: 22268135 Link: https://pubmed.ncbi.nlm.nih.gov/22268135/Predictors of Successful ECMO Bridging Tipograf Y, Salna M, Minko E, Grogan EL, Sonett JR, Bacchetta MD. Outcomes of extracorporeal membrane

Welcome back to Behind the Knife with Cody, Patrick, Jason, and Ayman. Today, we are tackling a defining professional ritual for every surgical trainee: the Morbidity and Mortality (M&M) Conference. We are providing a practical roadmap to help you build clear, high-quality presentations that facilitate real learning for the entire room. Whether you are a junior resident preparing for your first case or an attending looking to moderate effectively, this episode covers exactly what to include, what to leave out, and how to properly frame a complication.Hosts: Cody Mullens, MD Patrick Georgoff, MD Jason Bingham, MD Ayman Ali, MD ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Surgical Instrument Flashcard Course: https://app.behindtheknife.org/premium/surgical-instrument-flashcardsPlease visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen

Xenotransplantation—the use of organs from other species to treat human disease—has long existed at the intersection of science fiction and surgical innovation. While early efforts were marked by limited success and ethical controversy, recent advances in genetic engineering, immunosuppression, and organ preservation have brought the field closer than ever to clinical reality.In this episode of Behind the Knife, we are joined by Dr. Joshua Mezrich to explore the history, science, and future of xenotransplantation. Through a narrative lens, we trace the evolution of transplantation from its earliest experimental days to the modern era of gene-edited porcine organs, highlighting key breakthroughs, ethical challenges, and the pioneers who shaped the field. We also examine the current state of clinical trials and what xenotransplantation may mean for the future of organ availability and transplant practice.Hosts - Madeline Cloonan, MD PhD, General Surgery Resident, University of Nebraska Medical Center, @maddie_

INTRODUCING Behind the Knife OBGYN Oral Board Review!The oral boards aren't just about knowledge—they are about executing under pressure. This course is designed to give you the structure and confidence to command the room. We have curated 98 high-yield scenarios covering the "Big Three" of the exam: Obstetrics, Gynecology, and Office Practice. Whether it’s a surgical emergency or a complex clinic workup, we will walk you through exactly how to articulate your plan, defend your decisions, and pass this exam.Each scenario includes 2 parts. The first part is a perfectly executed scenario.  If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics. We are confident you will find this unique, dua

In this episode, we explore the grueling realities of the general surgery preliminary year—a high-stakes, one-year audition for surgical trainees operating without a safety net. We sit down with a program director, a former IMG prelim turned attending, and a recently successful SOAP applicant to uncover exactly what it takes to survive the scramble and excel clinically. Listen in to learn actionable strategies for navigating hospital expectations, securing vital mentorship, and ultimately turning your preliminary position into a secured categorical spot.Hosts:Ayman Ali, MDDr. Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital. Kevin Naresh Shah, MDDr. Kevin Shah is an Assistant Professor of Hepatobiliary Surgery at the Duke University School of Medicine and Program Director of General Surgery. Katharine Louise Jackson, MBBSDr. Louise Jackson is an Assistant Professor of Colon and Rectal Surgery at the Duke University School of Medicine and the Medical Student Clerkship Director

Identification of pancreatic cystic lesions has become increasingly common due to improved resolution and increased utilization of cross-sectional imaging. However, there are many types of pancreatic cysts, each with varying degrees of malignant potential. In this episode from the HPB team at Behind the Knife, listen in as we discuss the clinical presentation, diagnostic work-up, and management strategies for various pancreatic cysts: Pseudocysts, Serous Cystadenomas, Mucinous Cystic Neoplasms, and IPMNs, amongst others. HostsAnish J. Jain MD (@anishjayjain) is a current PGY4 General Surgery resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.Jon M. Harrison MD is a Hepatobiliary & Pancreatic (HPB) surgeon at the Massachusetts General Hospital in Boston, MA and a former HPB Surgery fellow at Stanford University. Learning Objectives·      Develop an understanding of the clinical presentation, diagnostic work-up, and treatment of benign pancr

With the increasing incidence of colorectal cancer in those less than 50 years of age, one must wonder how many patients present with a Stage IV diagnosis. Take a deep dive with us discussing the management of metastatic colorectal cancer by joining our team and guests, Drs. Cathy Eng, Michael D’Angelica, and Nina Sanford.Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center- Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian- Dr. Philip Bauer, Assistant Professor of Surgery, Division of Colon and Rectal Surgery, The Ohio State University Wexner Medical Center, Arthur G. James Cancer Hospital-  Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Guest Speakers:- Dr. Michael D’Angelica MD, FACS – Hepatopancreatobiliary Surgery, Memorial Sloan Kettering Cancer Center, Enid A. Haupt Chair in Surgery, Vice Chair, Education- Dr. Cathy Eng MD, FACP - Division o

In the final installment of the Healthcare Econ 101 miniseries, Dr. Christopher Childers and Dr. Nina Clark demystify the "black box" of medical billing and coding. This episode breaks down the two essential components of every medical bill: ICD codes, which identify the patient's diagnosis (the "why"), and CPT codes, which describe the specific services or procedures performed (the "what"). The discussion emphasizes that surgeons are legally and ethically responsible for the accuracy of these codes, regardless of whether a professional coder or an automated system handles the data entry. Listeners will gain insights into the "Global Period," the pitfalls of illegal "unbundling," and how to use modifiers—such as the -22 for increased procedural services—to accurately reflect the complexity of a case.***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, chec

Ever wonder why a complex gallbladder surgery only nets the surgeon about $350, while the hospital collects thousands? In this episode, Dr. Christopher Childers and Dr. Nina Clark pull back the curtain on how the money actually flows in medicine. From the birth of the RVU to the "Two Midnight Rule," we’re breaking down the math behind your paycheck.Next Step: Ready to make sure you're actually getting credit for the work you do? Join us for Episode 3, where we dive into the "Black Box" of Coding and Billing. ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.  Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other h

Ever feel like you’re fluent in medical jargon but totally illiterate when it comes to the business side of surgery? You’re not alone. In this series premiere, Dr. Christopher Childers (Surgical Oncologist and health policy expert) joins Dr. Nina Clark to demystify the "second world" of medicine: healthcare finance. We’re breaking down the basic vocabulary every surgeon needs to advocate for themselves and their patients.Next Step: Ready to see how this translates to your paycheck? In Episode 2, we dive into Physician and Hospital Compensation, RVUs, and the flow of funds.***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: http

The high-stakes world of surgical oral boards just got a high-tech upgrade. In this episode, the Behind the Knife team dives deep into the 2026 evolution of their AI Oral Board Simulator. With over 10,000 exams completed and a 99% recommendation rate from recent examinees, we’re showing you how AI is leveling the playing field for residents everywhere.Join Drs. Georgoff, Swenson, and Ali as they break down the new features designed to mimic the modern, non-linear, and "rapid branching" style of the American Board of Surgery. Whether you’re a junior resident honing your consult skills or a chief preparing for the "hot seat," this is the ultimate guide to dominating your boards without breaking the bank.Simulator: behindtheknifeoralboardsimulator.org

In surgery, when we think of research, often we picture randomized controlled trials, meta-analyses, and big data sets. But have you ever considered what we might miss by limiting our research programs to quantitative inquiry? What if you want to understand the culture or identity of your department or your training program? Or, what If you want to understand the values, priorities, and lived experiences of your patients? Some of the most meaningful insights about how we teach, learn, and practice surgery come from talking to people. Their words, their stories, and their experiences, and that's where qualitative research comes in. In this episode we dive into the “why” and “how” of qualitative research with leaders in the space, Professor Nicole Perez and Dr. Maya Hunt.Host:  Steven Thornton, MD (General Surgery Resident at Duke University)Guests: Nicole Perez (Assistant Professor of Medical Education, University of Illinois Chicago) Maya Hunt (General Surgery Resident, Indiana University) Publications Discu

Surgical quality is a term that is often thrown around in surgical practice. We have multiple quality improvement projects, metrics and benchmarks that motivate us to do better, and of course the ever expanding patient reviews to possibly “reflect” the type of surgical care provided. But what does quality actually mean? What metrics can we use to understand the type of care being provided by ourselves, our colleagues, and the health system at large. Today, we delve into these questions to understand how quality is currently understood within surgery and how we hope it to evolve in the future. Joining BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam are two fantastic guests - Dr. Mark Cheetham, joining us from the UK, has deep experience in national audits and system-level quality improvement. Dr. Cheetham is a colorectal surgeon and the National Clinical Lead for General Surgery at the Getting it Right First Time Programme in NHS England, or GIRFT. Dr. Alexander Perez is representin