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From bench to bedside

New chair Selwyn Vickers, M.D., intends to build on the distinguished research tradition of the U’s surgery department

Ask medical leaders what influenced their career paths, and you’ll receive many different responses. In the case of Selwyn Vickers, M.D., who in August took over as chair of the University’s Department of Surgery, his guiding influence was a surgical procedure and the mentor who pioneered it.

As a fellow and surgical resident at the Johns Hopkins University School of Medicine in the 1990s, Vickers developed a keen interest in the work of surgeon John Cameron, M.D., who refined the Whipple procedure, an intricate operation to treat pancreatic cancer. Although Cameron’s refinements succeeded in reducing the procedure’s mortality rate from 25 percent to only 1 percent, pancreatic cancer has remained the nation’s fourth-leading cause of cancer deaths, with a five-year survival rate of only 4 percent.

“It was apparent that if surgeons alone were involved in the treatment, we wouldn’t cure this cancer,” Vickers says. “Dr. Cameron had a commitment not only to clinical medicine but also to research. He influenced me to define myself in a broader sense—to work as a developer of interdisciplinary teams to help patients.”

An interdisciplinary approach

Vickers came to Minnesota from the University of Alabama at Birmingham, where he was chief of the gastrointestinal surgery section and the John H. Blue Chair of General Surgery. He was also a principal investigator for a $4.5 million Pancreatic Cancer Specialized Program of Research Excellence (SPORE) grant and will continue that research here. One of only three awarded nationwide, the grant provides funding for scientists and clinical investigators to work together to bring research advances to patients.

We are one of the three or four great departments of surgery in the country. We've had leadership that has made us focus on developing novel ways of changing the lives of patients. - Selwyn Vickers, M.D.

“Although research is a big part of my background,” Vickers says, “I’m equally interested in people and patients. It’s from that passion for patients that I gained my passion for research.”

One of his first acts as surgery department chair was to recruit a new professor and vice chair for research, Ashok Saluja, Ph.D., previously professor of surgery, medicine, and cell biology at the University of Massachusetts Medical School. And he appointed David Rothenberger, M.D., deputy chair of the department. Rothenberger, a longtime surgery department faculty member, is also coleader of the University’s translational research program and associate director for clinical research and programs at the Cancer Center.

Building on tradition

Vickers believes the Department of Surgery’s 75-year bench-to-bedside tradition is essential to its identity and mission. “We are one of the three or four great departments of surgery in the country,” he says. “We’ve had leadership that has made us focus on developing novel ways of changing the lives of patients.”

Vickers plans to build on the spirit of innovation that thrived under longtime department chairs Owen Wangensteen, M.D., Ph.D.; John Najarian, M.D.; and David Dunn, M.D., Ph.D.

“The foundation laid by those former chairs is outstanding,” Vickers says. “We’re not in need of a revolution. We already have a good start for research in treatments that can be applied to a broad array of cancers: breast, pancreatic, colon, and others. Though we’ll emphasize innovative research, the way we will most readily affect patients is through our vision for novel treatments and our surgical skills.”

Vickers, the first chair since 1967 from outside the department, possesses the mix of qualities necessary to lead as a surgeon, administrator, and teacher, says Rothenberger, who headed the department for 14 months during the search for a new chair. “Dr. Vickers will be a great leader. He’s young, energetic, and dynamic, and he has great instincts.”

Involved in the craft

Vickers is co-investigator on a $5 million grant from the National Institutes of Health to study health disparities. In addition to providing screening and education programs for diabetes and colon cancer for minority communities, the project works with health care providers to examine and improve the effectiveness of cancer and diabetes treatment in minority patients.

“Where I lived and worked in Alabama, I saw tremendous disparities in cancer outcomes and access to health care because of financial and racial differences,” Vickers says. “In Minnesota, there may be opportunities to make improvements in the Native American community and in the growing immigrant population. When you remove the differences, it becomes a better place to live for everybody.”

As co-principal investigator on the SPORE grant, Vickers plans to continue his research on treatments for pancreatic cancer, and he intends to remain an active surgeon as he leads the department. “I think it’s oxymoronic to try to train others and not want to continue to be involved in the craft,” he says. “In this department we’re teaching others how to make hard decisions to improve patients’ lives. To teach that, you have to be involved in your own hard decisions.

“Just as I would feel incomplete working only as a private practitioner uninvolved in scientific investigation and the acquisition of new knowledge, I’d also miss building relationships with patients and their families if I stopped being a surgeon,” Vickers says.

Besides, he points out, the skills one needs as a surgeon are not very different from the abilities a good department chair brings to the job. In the operating room, the surgeon heads a team—an anesthesiologist, technicians, nurses, and other staff. “Running a department is building a team, too. You want balance, and you’re crucial in helping others find their own roles and build their own careers.”

When the discussion returns to pancreatic cancer, Vickers grows even more animated, his eyes alight with intensity. For years, he says, the number of new cases reported annually in the United States has almost exactly equaled the number of deaths. In the latest reported figures, however, there were 1,000 fewer deaths than new cases.

“That’s significant, and I believe it’s the direct result of science,” Vickers says. “We have more targeted therapies and new resources. When you put together a multidisciplinary team to advance the process of diagnosis and treatment, the situation improves.”

Under Vickers’ plan, the Department of Surgery will advance as well: “We will grow by providing excellent care and having the resources to offer that care, innovate, and fulfill the research part of our mission.” 

By Jack El-Hai

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