The Operative Word

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Erika Rangel, MD, FACS, from Brigham and Women’s Hospital. They discuss Dr Rangel’s recent article, “Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency,” which found that flexibility stigma in residency discourages pregnant and parenting trainees from using needed work-life accommodations, creating harmful double binds between training expectations and personal well-being. Structural and cultural reforms are essential to support equity, retention, and trainee health.
 
Disclosure Information: All relevant conflicts have been mitigated and Drs Varghese and Rangel, moderators, have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. This activity has been designated as Credit to Address Regulatory Mandates in the following categories: Cultural Competency and Behavioral Health. Individuals MUST check with their state or local medical board, hospital, or organization to verify that the content does meet the specific requirements. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Rangel EL, Zeineddine J, Lovejoy MC, et al. Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency Journal of the American College of Surgeons. Published online May 21, 2026. doi:10.1097/XCS.0000000000002046
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Lillian Erdahl, MD, FACS, is joined by Morgan Pettigrew, MD, from UT Southwestern. They discuss Dr Pettigrew’s recent article, “Artificial Intelligence Simplification of English and Spanish Surgical Consent Forms: 1-Size Does Not Fit All,” which found that while ChatGPT-4.0 improved the readability of English surgical consent forms, it did not improve readability of Spanish forms. To address this disparity, the authors developed a custom-trained GPT that improved readability of English and Spanish consent forms.
 
Disclosure Information: All relevant conflicts have been mitigated and Drs Erdahl and Pettigrew, moderators, have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Pettigrew, Morgan F MD; Nunez-Rocha, Ricardo E MD; Govindu, Sai R BS; Castillo, Samy MD; Heslin, Ryan T MD; Bain, Andrew P MD; Abreu, Andres A MD; Fatimah, Nafeesah MD; Polanco, Patricio M MD, FACS; Wang, Sam C MD, FACS. Artificial Intelligence Simplification of English and Spanish Surgical Consent Forms: 1-Size Does Not Fit All. Journal of the American College of Surgeons 243(1):p 202-214, July 2026. | DOI: 10.1097/XCS.0000000000001890
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Serena Lofftus, MD, and James Wu, MD, FACS, from UCLA. They discuss Drs Lofftus and Wu’s recent article, “Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial,” which evaluated whether incorporating patient choice into postoperative prescribing decisions could reduce opioid prescribing and consumption after ambulatory breast operation without negatively affecting pain control or quality of life.
 
Disclosure Information: Drs Varghese, Lofftus, and Wu have no relevant financial conflicts of interest to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
Of the AMA PRA Category 1 CreditsTM listed above, a maximum of 0.25 hours meet the requirements for Prescribing Opioids/Controlled Substances.*
*The content of this activity may meet certain mandates of regulatory bodies. Please note that ACS has not and does not verify the content for such mandates with any regulatory body. Individual physicians are responsible for verifying the content satisfies such requirements.
Lofftus, Serena Y MD1,4; Graham, Danielle S MD, PhD1,4; Le, Julie MD, FACS1,2; Zhu, Catherine Y MD1,3; Kaufman, Noy MD4,5; Huy, Tess C MD1,4; Kusske, Amy M MD, FACS1,4; Teshome, Mediget MD, FACS1,4; Baker, Jennifer L MD, FACS1,4; Wu, James X MD, FACS4,6. Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001974, April 13, 2026. | DOI: 10.1097/XCS.0000000000001974
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Lillian Erdahl, MD, FACS, is joined by Pringl Miller, MD, FACS, from Physican Just Equity, and Christine Heisler, MD, FACS, from the Mayo Clinic Health System. They discuss Drs Miller and Heisler’s recent article, “Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of American College of Surgeons Members,” in which the authors found that the most frequent perpetrator roles were surgeon colleagues and supervisors. A total of 57.4% of surgeons took action, with informal reporting to a colleague and/or directly confronting the perpetrator being most common actions taken. Surgeons who took action were less likely to choose a career in surgery again.
 
Disclosure Information: Drs. Erdahl, Miller, and Heisler have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Heisler, Christine A MD, MS, FACS; Godecker, Amy L PhD, MS; Verran, Deborah MbChB, MHSM; Sinha, Michael S MD, JD, MPH; Byam, Jerome MD; Miller, Pringl MD, FACS. Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of the American College of Surgeons Members. Journal of the American College of Surgeons 242(2):p 390-400, February 2026. | DOI: 10.1097/XCS.0000000000001648
 
Related work:
Primary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Workplace microaggressions: results of a survey of the American College of Surgeons members. Am J Obstet Gynecol. 2024 Aug;231(2):265.e1-265.e8.
 
Secondary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Impact of Workplace Microaggressions on Surgeon Career Status and Trajectory: A Cross-Sectional Survey Study.  Accepted to the Annals of Surgery Open on April 30, 2026.  
 
The secondary study was also presented at ACS Clinical Congress 2024:
Heisler CA, Godecker A, Verran D, Sinha MS, Byam J, Miller P. Workplace Microaggressions and the Impact on a Surgeon’s Career Trajectory: Results of a Survey of the American College of Surgeons Members. J Am Coll Surg. October 2024;239(5):S138-139.
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Carrie Chan, MSN, MPH, from the University of California, San Francisco, and Karthik Balakrishnan, MD, FACS, from Stanford Medicine Children’s Health. They discuss their recent article,“Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infections Using the NSQIP-P Database,” which represents the largest study to date on predicting pediatric surgical site infection. The authors developed machine-learning models and ultimately recommend a regularized logistic regression model for clinical integration, balancing performance and feasibility for implementation. Findings support using routine preoperative data for personalized infection prevention and preoperative planning.
 
Disclosure Information: Ms. Chan and Drs. Varghese and Balakrishnan have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Chan, Carrie T MSN, MPH; Pletcher, Mark J MD, MPH; Balakrishnan, Karthik MD, MPH, FACS; Hswen, Yulin ScD, MPH; Scheffler, Aaron PhD, MS. Development, Validation, and Comparison of Machine Learning Models for Predicting Pediatric Surgical Site Infections Using the NSQIP-P Database. Journal of the American College of Surgeons 242(3):p 712-722, March 2026. | DOI: 10.1097/XCS.0000000000001683
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Laurie J Kirstein, MD, FACS, from Memorial Sloan Kettering. They discuss Dr Kirstein’s recent article, “Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US,” in which 194 American College of Surgeons (ACS)-accredited cancer programs caring for 99,057 patients participated in a National Quality Improvement Collaborative led by the ACS, “Breaking Barriers,” which reduced radiotherapy non-adherence by over 30% at the patient and hospital levels across multiple program types, census regions, and disease sites.
 
Disclosure Information: Drs. Varghese and Kirstein have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Chan, Kelley MD, MS; Reilly, Eileen MSW; Janczewski, Lauren M MD, MS; Gentry, Sharon MSN, RN; Biggins, Camille MHA; Haffty, Bruce MD; Shelton, Charles MD; Yang, Anthony D MD, MS, FACS; Weigel, Ronald J MD, PhD, MBA, FACS; Kirstein, Laurie J MD, FACS. Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US. Journal of the American College of Surgeons 242(1):p 247-256, January 2026. | DOI: 10.1097/XCS.0000000000001637
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Liu, MD, MS, MPH, from the Department of Surgery, Harbor UCLA Medical Center. They discuss Dr Liu’s recent article, “Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review,” in which the authors identified the current diagnostic issues, clinical tools, and clinician feedback strategies in the older adult emergency general surgery (EGS) setting. While challenges unique to older adults exist, variability in the use of tools to improve identification of older adult conditions in EGS and gaps in feedback to improve diagnosis remain.
 
Disclosure Information: Drs. Erdahl and Liu have no relevant financial conflicts to disclose.
 
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Liu, Jessica K MD, MS, MPH; Peters, Xane D MD, MS; Remer, Sarah L MD; Beestrum, Molly MLIS; Cooper, Zara MD, FACS, MPH; Russell, Marcia M MD, FACS; Hall, Bruce L MD, FACS, PhD; Ko, Clifford Y MD, FACS, MSHS, MS. Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review. Journal of the American College of Surgeons 241(5):p 904-916, November 2025. | DOI: 10.1097/XCS.0000000000001480
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, JACS Editor-in-Chief Tom Varghese, MD, FACS, and Digital Media Editor Lillian Erdahl, MD, FACS, review 6 impactful articles from the past year, highlighting key themes shaping modern surgical practice. Dr Erdahl focuses on the surgeon as a subject, discussing research on moral distress, second-victim syndrome, health policy challenges, and peer surgical coaching. Dr Varghese then explores advances in surgical science, including pragmatic applications of artificial intelligence for risk prediction and operative documentation, as well as comparative evidence on robotic, laparoscopic, and open operation. Together, they emphasize clinically relevant research, thoughtful innovation, and ongoing critical inquiry to support surgeons and improve patient care. Listen to the podcast episodes mentioned at facs.org/operative-word.
 
Articles discussed:
Surgeon Perception and Attitude Toward the Moral Imperative: Institutionally Addressing Second Victim Syndrome in Surgery
A Framework for Managing Moral Challenges Related to Health Policy for the Surgeon
What About the Coach? Mixed Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program
Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study
Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video
Robotic vs Laparoscopic vs Open Ventral Hernia Repair: Insights from a Network Meta-Analysis of Randomized Clinical Trials
 
Disclosure Information: Drs. Varghese and Erdahl have have no relevant financial conflicts to disclose.
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
 
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In this episode, Tom Varghese, MD, FACS, is joined by Ziad Sifri, MD, FACS, from Rutgers New Jersey Medical School, and Matthew Linz, MD, from Rutgers Robert Wood Johnson Medical School. They discuss Drs Sifri and Linz’s recent article, “Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons,” in which they found that surgeons in the US prescribe significantly more opioids after inguinal hernia repair compared with when they operate on short-term surgical trips to low- and middle-income countries, despite continued efforts to reduce opioid overprescription in the US.
 
Disclosure Information: Drs Varghese, Linz, and Sifri have nothing to disclose.
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
Linz, Matthew S MD1; Parvin-Nejad, Fatemeh P MD2; Srinivasan, Nivetha MD3; Vegunta, Geetasravya MD1; Eng, Ashley K BS1; Kim, Eugene BA MBS; Alexander, Imani BS1; Elgammal, Fatima MD2; Benson, Ryan MD2; Benneh, Albert Y MD4; Gyakobo, Mawuli K MD5,6; Lopez, Lorena MD7; Jalloh, Samba MD8; Sifri, Ziad C MD FACS2. Postoperative Pain Management in the US vs Low-and-Middle-Income Countries by US Surgeons. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001538, July 30, 2025. | DOI: 10.1097/XCS.0000000000001538
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
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In this episode, Lillian Erdahl, MD, FACS, is joined by Eilidh Gunn, MBChB MRCSEd, from the SurgicalSabermetrics Laboratory at the University of Edinburgh. They discuss Dr Gunn’s recent article, “What About the Coach? Mixed-Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program.” As peer-led surgical coaching becomes an increasingly popular professional development activity, this study explores the impact of participation on surgeons acting as coaches. Using a concurrent, mixed-methods design, results demonstrate that coaches found participation worthwhile and that it affected their own clinical practice.
Learn more about the SCOPE program here.
 
Disclosure Information: Drs Gunn and Erdahl have nothing to disclose.
To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.
 
Gunn, Eilidh GM MBChB MRCSEd1; Sinyard, Robert D MD MBA2; Cummins, Emily R PhD3; Yule, Steven PhD4; Smink, Douglas S MD, MPH, FACS5. What About the Coach? Mixed-Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001506, July 24, 2025. | DOI: 10.1097/XCS.0000000000001506 
 
Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.
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