Father, husband, surgeon, interested in making all things/trainees/myself better. Associate Professor
@UABGISurgery
.
#itsnotjustahernia
. Tweets my own.
This is fantastic.
Perfect analogy for life as a surgeon. Sometimes we have to step outside of the seriousness of our work and remember that life is beautiful. It’s meant to be enjoyed
@UABSurgery
4 years of medical school
8 years of surgical residency
1 year of advanced MIS fellowship
7 years of busy academic practice
Over 2000 operations
And the pinnacle of my technical skill is *almost* perfecting the ballet bun
@BrianFishmanDO
This is NOT being a Karen. This is advocating for your patient and is one of the most anti-Karen things I've seen. Love the idea of peer to peer with the patient present AND documenting the "peer" in the medical record!
To everyone in the
#GenSurgMatch2022
- whatever happens tomorrow and this week, it does not mean the end for you. I didn't match and I'm right where I always wanted to be. You tell your own story and you make your own reality
On paternity leave - embarrassed to say I was obsessing about some work-related task. Daughter shouts, "daddy look at the pretty flowers falling from the tree outside! Let's run around in them!"
We did.
Now I don't even remember what I was obsessing about.
#kidsarebetteratlife
My technique for mesh rolling for robotic AWR that our
@UABGISurgery
MIS fellows apparently love so much (
@britneycoreymd
)
Apologies for the background chatter I can't help the trainee love
@UABSurgery
😉 😂
Today in the OR I got the highest compliment ever from a resident:
“Dr Parmar, sometimes I hate you. But like in a way one would sometimes hate their dad.”
I used to say lap inguinals were not intern-level cases. That was before I met the RAKE!
@SLRakestraw_
pictured here looking very heroic in a lap TAPP
@UABSurgery
Proud of my intern
@MarviTariq
! On her last week of MIS
@UABSurgery
she demonstrates excellent technique with closure of the peritoneal flap on this robotic inguinal hernia repair!
I used the think a lap inguinal was a senior level case but that was before I met R2
@NikitaWadhwani_
@UABSurgery
! One of the greatest joys of academic surgery is watching trainees improve and CRUSH operations!
How lucky am I to have amazing trainees like
@SamanthaBaker__
who buy me an awesome birthday cake like this! Guess I have to teach you stuff now
#unicorn
IYKYK
@UABSurgery
@JoshuaUmland
So sorry for you, I know how you feel; I didn't match either. I eventually matched in the field I wanted to enter and now have my dream job. You'll get where you want to be.
Loved seeing
@UABSurgery
's footprint expand
@SAGES_Updates
! Always refreshing meeting mentors, mentees, and friends, and making new ones! Sad to leave
#SAGES2022
. Extra excited to have a guest appearance by the hero Colorectal himself,
@DChu80
!
Ah,
#SAGES2023
you were incredible.
To trainees and fellow partial introverts, please learn this is an organization that believes firmly in mentorship, support, and kindness. I used to have a lot of anxiety/imposter syndrome/fear of meeting people, speaking up, asking ?s 1/
@ShikhaJainMD
I do it routinely but there is a double standard for men & women. When I do it I'm seen as a devoted dad but when my wife does it (also MD) she's made to feel she is shirking her work responsibilities. Would love for it to mean that we equally prioritize family first as we should
I didn’t match. I was faced with either not being a surgeon or working twice as hard to become one. I made it with the help of many amazing ppl along the way. In the end I learned about kindness in our field and am (now) grateful for the adversity to become better.
#silverlining
But if you didn’t match where you wanted, or didn’t match, know that there are many of us out there like that.
#TheMATCH
is a big part of medical school, but it is only one part. Where you do your residency doesn’t (have to) define you, so get out there and define yourself
@andrewswright
Agree 💯! Ever since my second child was born I have tried to avoid a first start. I'm able to take my daughter to school and actually be a normal parent and it's the best thing I've ever done
Me (to my 3yo): Do you know what a resident is?
3yo: Yess...
Me: What are residents?
3yo: They’re your work children!
If this is true CPS may come get me...
@DrNatStrand
I request a late start routinely and take my daughter to school 4 days a week. The OR
@UABSurgery
sometimes wonders why I don't start early but rarely pushes. I'm also blessed that when I'm stuck operating late I have supportive family to pick her up!
#worklifebalance
Inspired by
@jeffsimmons
-
#MatchDay2008
It was 3pm- I had just gotten home from my radiology elective when I got the dreaded page. "I'm so sorry you didnt match."
There are rare moments in life that are a punch in the gut. 1/
Very proud of graduating chief
@AmmarAsban
and his timely discussion of
#IMGs
in surgery
@UABSurgery
grand rounds today. Ammar is the embodiment of resilience and is what all trainees should aspire for.
@UofUCTSurgery
is very lucky to have him next year!!
Earlier today I posted a video of a challenging robotic operation I had recently completed. But that was easy compared to this ballet bun I crushed today!
#dadgoals
#ballerinasareintimidating
You know what I've never regretted? Checking in on a patient before going home after a long OR day. My first patient from this morning just told me I "changed his life forever" and this is why we operate
Observation: infants are like postcall surgical residents: incredibly moody/prone to wild swings in emotion, capable of eating constantly, will sleep most of the day, possibly will hit the bottle, and liable to poop their pants. Ultimately, all they really want is to be held. 😉
So proud of this guy our fellow Matt Romine! Finishing his 75th minimally invasive AWR on his last day of fellowship!
@UABSurgery
@UABGISurgery
All I see are ♥️‘s today...
My mentee
@dasbellborg
came to my OR yesterday just to say goodbye before leaving for residency soon. This is the best part of academic surgery-seeing the successes of people you root for!
This made my day! Thanks
@SamanthaBaker__
and
@mfgleason
! I have faith as you continue your training you will in fact “suck less”. It’s a pleasure to train future leaders in surgery like you kids
@UABSurgery
!
So if you're at a conference and there's someone you respect/like/fanboy/fangirl over, go talk to them! I've never regretted it and they may become one of your greatest allies!3/x
FACS! Couldn’t have done it without the leadership of
@herbchen
!
...literally. He was a marshal and without him I would have had no idea where to sit! 😉
But seriously what a great boss for getting us primo seats & taking pics of his faculty reading the FACS pledge!
So much is terrible about
#COVID19
but there are good things too, like the strength of our division in the face of a crisis. No egos. No fighting. Just everyone helping to get it done. It may be 72hr call sleep deprivation talking but I love y’all!!!
@UABGISurgery
@QueenMD202X
Surgeon here. I think experiences like these are needed so students can get a realistic glimpse of life as a surgeon. Otherwise one might mistakenly think it's an easy 9-5 job. The reality is that surgery is unpredictable and you will be called on to function while sleep deprived
So very proud of
@CochrunSL
for publishing our work. It took him learning an entirely new methodology but he got it done!
@UABSurgery
Surgeon perspectives on the STITCH trial: a mixed methods study | SpringerLink
Virtual
#SAGES2020
is absolutely amazing!
@UABSurgery
watch party today - able to pause, discuss, rewind, review, and argue key points in real time with residents!!
We also had a special guest appearance by
@DrReddy_HPB
(not shown)
Maybe all conferences should go virtual!
As a surgeon who almost exclusively performs elective operations, I'm with
@AmCollSurgeons
on this. As much as I love fixing hernias there is a greater community need here and we must ensure inpatient beds are available for potential COVID patients.
@UABSurgery
@uabmedicine
Hospitals, health systems and surgeons should prepare now to manage elective surgical procedures during COVID-19 outbreak, with a plan to minimize, postpone, or cancel at this time. Read our guidance:
#COVID19
Looking for an awesome place with supportive MIS partners at a premier institution/regional powerhouse for complex hernia, foregut, & bariatrics?
@UABSurgery
More importantly we r cool & only rarely have impromptu arm wrestling battles. (Don't tell anyone who won
@britneycoreymd
)
Does any other faculty notice that when residents make a nice technical move or decision in the OR they stop and pause? It's like the residents
@UABSurgery
are asking for a cookie. Well, Xin did a good job today so he got his cookies.
You're not officially a hernia surgeon until someone asks if you could also "take out some extra fat while you're in there" and you have to fake laugh as if that's the first time you've heard that joke
I’ve been on emergency general surgery call for the past 108 hours and while
#COVID19
has wrought so much havoc, here
@UABSurgery
I’m constantly reminded of the kindness & beauty of humanity. A sick patient’s daughter profusely thanked me for doing my job. 1/2
#wisdom
Like too many surgeons I can be overly judgemental at first meeting interns, but in my 4 years in practice Ive learned a resident's first months/years say little about how she'll finish. It's one of the many joys of academic surgery to see the transformation
@UABSurgery
@_BrainyMD_
Dedication & determination tough to gauge early on, but over time, result in success in the right environment. Always nice to see a timid intern evolve into a confident & respected senior resident. Gotta give some people time to adjust and grow.
#AWSChat
I hope these guys
@MCWVascSurg
know how lucky they are to have
@MHRajaei
in their fellowship! There are few residents as driven, capable, and conscientious. Congrats Mo, you deserve all the good things
Welcome Dr. Mohammad Rajei to our vascular fellowship! We are very excited to have him join us from the general surgery residency
@UABSurgery
@UABVascular
- a great match this year!
Things I've learned on paternity leave:
1 4yo 👎🏼 for baby sleep training
2 Holding hands is the best
3 I've had to say "don't tell mommy" more times than I can comfortably admit
4 Being a surgeon is wayyy easier than being a stayathome parent
#atleastcallends
#propstoallparents
Residents
@UABSurgery
- we have to change the culture of opioid prescribing for our low-risk patients (undergoing cholecystectomy or inguinal hernia repair) in Alabama!
You have the power to change practices!
Hey
#MedTwitter
#SoMe4Surgery
surgeons & residents! I recently received a grant funded by
@AmericasHernia
to understand surgeon perspectives on the STITCH Trial. By completing a short 3 minute survey you would contribute valuable insight into how surgeons adopt new techniques. 1/
Ribeye or meshoma? Pictured here are four-yes FOUR underlay meshes we recently explanted
@UABSurgery
on the way to repairing a massive flank hernia. What's your record for meshes explanted in a single case?
@VNikolian
So grateful for the opportunity to have visited
@AdralesG
and
@alisamae
& learn the intricacies of hernia from experienced surgeons at a world class center for hernia surgery. Thx to the
@SSATNews
Demeester Travelling Fellowship Award!
Surgeon dad life - I took the day off Tuesday to hang out and watch soccer with this little guy thanks to my partner
@britneycoreymd
who rounded for me!
#priorities
Surgeon mom life - yesterday I did daycare drop off, operated with residents & medical students, did pick up & a dinner date. Today I ran to his 5 year old check up when I had a break after clinic & before a meeting. It takes a good team but it’s totally possible.
#SAGES2023
really crushing it with this educators session!
So much I need to work on...
Remain calm?
No belittling?
😳
@UABSurgery
residents I shall try...
So excited to have finally brought LINX to
@UABSurgery
thanks to my partner Jayleen Grams and our proctor Gopal Grandhige. This exciting technology may revolutionize how we treat reflux!
@UABGISurgery
@LINXSystemUK
@Ethicon
Lately I feel like I’m taking out more mesh than I’m putting in...
Friends, please don’t keyhole your mesh when you place it minimally invasively. Also, metal tacks? Really?
#SMH
#banmetaltackers
#criticalviewoftheMPO
@AjvictoryMD
I actually view it as the opposite- its part of a shared team mentality, implies closeness/familiarity more than "the student" and since it works in both directions- ie "my attending" and "my fellow" for residents- ultimately levels the playing field.
Parenting pro tip:
There are a handful of red flag expressions from your kids you need to keep an ear out for - one is when your 6yo turns to your 2yo and says "hey let's see if you can fly"
#saturdaysarenotdaysoff
Remarkable talk on purpose by my hernia partner in crime
@britneycoreymd
.
If I have the same level of maturity, introspection, and clarity of purpose when I’m 4 years out (like her) I would be a made man.
@UABGISurgery
@UABSurgery
Today I saw one of our R4 residents push a patient on a stretcher by himself. JRP is cleaning in the image below. I love how for surgeons, nothing is beneath us.
#workethic
UAB General Surgery Residency Program Director
@PorterfieldJohn
showed off his cleaning skills last week in preparation for the first resident candidate interview day of the year.
Congrats to Lauren Tanner, the 1st member of
@UABTrauma
to demonstrate true hernia hero chops! Not only is she a skilled trauma/acute care surgeon+expert surgical intensivist, she crushes fascial closure with small bites! Like black widow, she is not 2 be trifled with
@UABSurgery
What incredible leadership on display by
@herbchen
giving a truly inspirational talk! A definite must-read, I wish I was there for the original. Thanks for all that you do for us
@UABSurgery
Hard to put into words the remarkable pride/joy/excitement I have for
@Jameson_Wiener
in publishing our work. If you're half as motivated in your future MIS career as you were on this project you will be unstoppable! What an honor
#whyacademicsurgery
Now I am doing exactly what I wanted to do.
I'm so happy for all the smiling faces on
#MedTwitter
but for those of you scrolling through with different feelings, please don't despair. There is hope. I should know, I've lived it! Fin/
Obvious selection bias here -
If I can safely take out a GB in its entirety, I will. If I can't, I do subtotal. Higher complexity of disease with the latter and worse outcomes expected.
The idea that open will somehow make the dissection easier is also not evidence-based
Subtotal cholecystectomy is associated with higher short-term morbidity compared with
#cholecystectomy
for acute
#cholecystitis
, even when adjusting for severity of disease.
@keeley_md
Feeling joy in academic surgery this week! Another reason- when your partner goes to a conference, gets inspired to expand your teaching curriculum and in turn motivates you and snowballs the whole process with rapid fire emails!! Appreciate ya
@britneycoreymd
!
My favorite educational activity as a resident
@UCSF_EastBay
was the oral board scenarios (HOTSEAT!)
It’s even more fun as an attending.
But I was not able to break
@SamanthaBaker__
— she crushed it!
@SAGES_Updates
is it illegal to cast
#SAGES2021
to a room full of residents and a fellow? Because this is the best learning they've gotten all week! (Not pictured is me yelling at my fellow about subtotal choles. Clearly pictured is
@adamtlucy
not paying attention)
@UABSurgery
I love my job
@UABSurgery
but today I was truly proud to work
@uabmedicine
. Took dtr to get her
#CovidVaccine
& Tiffany in injection services personally walked us to clinic AND WENT TO HER CAR & got my daughter a pass for a free popsicle! Inspired by
#basichumankindness
To the residents exhausted by my hypercriticisms in the OR:
Today while I was getting my 3 year old ready for her weekly swim class: “Make sure you put my hair up in a bun so it won’t get wet. Not like how you FORGOT last week. And my hair got all wet.”
So.
#karma
is a thing.
As a resident on 24hr Saturday trauma call, I remember my attending
@kelleyb_md
would always bring delicious treats for the team. It made everyone happier. I vowed to do the same for my residents one day.
Remember your mentors and the good things they did for you.
We all know
@VNikolian
posts the most exceptional hernia videos BUT V:
have you ever gotten a triple double in the OR?
I already got one lined up for clinic 😂
#marchmadness
@arghavan_salles
The people who you will miss the most on your deathbed are your family. Prioritize them above all else. At work you are replaceable this is not the same at home
⭐️ intern Michelle Wahlgren demonstrating amazing one-hand dexterity on one of the resident work room lap trainers -- start using them everybody
@UABSurgery
I had the same experience. At the time I thought it was the worst page I ever got. Ended up being a gift to make me a stronger, better version of myself
"If the path before you is clear it is probably someone else's path"
As a person who was once summoned to the office to be told I didn't match:
I wish all of you luck tomorrow, and for those that get bad news (as I once did), there are still many paths forward, even if you can't necessarily see them now.
I am proud to announce that we have identified our very first hernia heroine outside of
@UABSurgery
!
@UABOBGYN
should be very proud to have such a forward thinking surgeon in
@MLiangMD
who adopts evidence-based strategies for fascial closure!
@UABobgynres
y'all are lucky!
❤️ this tweet. Particularly as someone who does primarily elective surgery, it is MY duty as the surgeon to help the patient make an informed decision
@UABSurgery
. "Cardiac clearance" are bad words in my clinic
It's surgeon's role to weigh risks & benefits of operation/ not operating (+/- input from anesthesiology, other relevant specialty) & then engage in shared decision making w pt/family. Abdicating that responsibility in favor of someone else's "clearance" often ⬆️delay &⬇️outcome