Dr. Sarkis Meterissian needs no introduction. He is not only an accomplished cancer surgeon, but he is also the Associate Dean of Post-graduate Medical education at McGill University, an active cancer researcher, Director of the Cedar’s Breast Clinic and above all a well recognized educator and mentor. He graciously grants an interview for the Cancer Knowledge Network to offer counsel and inspirational advice to surgical residents and delves down memory lane to give us an account of his own passage in the field of medicine that led him to the specialty of surgical oncology.
Why surgical oncology?
Dr. Meterissian recollects that even as a medical student he was fascinated by the “why’s” of medicine. The pathology, biology and the mechanisms of diseases were as important to him as the technical details of surgical procedures. As a surgical resident nearly half of the surgeries he performed involved malignancies. Driven by diligence and a powerful curiosity about the biology of cancer he was drawn towards surgical oncology. He explains that the field is not just a technical specialty but intense thought, reflection and knowledge is required behind management of each cancer patient in addition to meticulous surgical technique.
The fellowship training
Dr. Meterissian completed two oncology fellowships, first a basic oncology research fellowship at the Dana-Farber Cancer Institute followed by a second clinical fellowship at the MD Anderson Cancer Centre. Although his research fellowship proved to be an important stepping stone, he does caution about the challenge to endeavour on a research fellowship after completing a surgical residency due to the lack of clinical and operative experience and opportunities.
His fellowship at the MD Anderson Cancer Centre proved to cement his surgical foundation. It gave him the opportunity to rotate through various rotations of surgical oncology sub-specialities, provided a large operative volume and an invaluable experience working with expert staff on challenging and unique clinical scenarios. In addition, the renowned cancer treatment centre has one of the largest oncologic databases to propel ground breaking research.
The most rewarding and the most challenging aspects of surgical oncology
When asked to name one aspect of his job that he enjoys the most, the surgeon replies “Communicating with his patients”. As expected, a cancer diagnosis is devastating, the treatment plans are complex and the prognosis difficult to explain and it is imperative for a surgeon to be articulate. Dr. Meterissian enjoys his daily interactions with patients and elaborates that excellent communication skills are indispensable for a surgical oncologist. Interestingly, when asked next to name the most challenging aspect of his job, he again replies “communicating with his patients”. Understandably, giving bad news is the most unpleasant aspect. Not only is the initially cancer detection difficult to announce but breaking news of metastasis, recurrence and poor response to treatment never gets easier.
Fulfilling multiple duties and roles
So how does he manage his multiple roles as an associate dean, cancer surgeon, cancer researcher and educator. Dr. Meterissian says “Compartmentalization” is his key. He finds that careful scheduling of time and adherence to these planned schedules are critical in meeting his objectives in every department. He has pre-planned set days for OR, clinics, his research and his deanery duties.
Advancement in surgical oncology
The progress made in surgical oncology has been rapid and includes advancements such as sentinel lymph node biopsy and effective cancer screening. When asked what one innovation he would choose to be the one that has changed his field in the last fifty years he chooses the advancement in the molecular biology of cancer to be of particular impact, especially in the fields of breast, colon and GIST. Discoveries such as Her-2, to mention a few, have led to target specific cancer treatments which in turn have led to better outcomes and revolutionized the practice of cancer treatment.
Preparing for fellowship
Dr. Meterissian has invaluable advice for residents wishing to prepare for a surgical oncology fellowship. Pursuing research projects is deemed essential to gain experience and knowledge of the field. He encourages all residents to take advantage of the opportunity to pursue advanced degrees such as Masters in Science, Masters in Epidemiology or Public Health. Research also provides the opportunity to present papers and attend important national conferences such as the annual SSO, ASCO and Canadian Society of surgical oncology. Attending such meetings provides self visibility, exposure to the leading surgical oncologists and the opportunity to interact, participate and learn about the field. Residents must also locate fellowship programs that are of interest to them during their residency years, and pursue electives in these institutions. This experience is invaluable in getting to know the institution and staff prior to applications and also an opportunity for the resident to showcase his/her application.
Quality of a surgical oncology fellow
When enquired about the characteristics that Dr. Meterissian looks for in surgical oncology residents, he says definitely “An inquisitive mind is essential”. Intellectual curiosity leads to constant learning and innovation. Another important attribute that Dr. Meterissian looks for in his candidates is humility. As he explains, there is nothing more humbling than treating cancer. There are surprises at every stage and often one has to deal with treatment failure. These qualities build a committed and empathetic surgeon who can be a leader in the field.
The McGill Surgical Oncology Fellowship
Dr. Meterissian explains that the McGill program is one of the oldest programs in North America and accredited by SSO (Society of Surgical Oncology). Its excellent reputations stems from the diverse research opportunities it offers and its exposure to a rich clinical and operative experience. McGill is the referral centre for complex oncologic cases in melanoma, sarcoma and rectal cancer to mention a few and the fellow is closely involved in the management of such patients. He also emphasizes that surgical oncology is a speciality that relies heavily on interaction and collaboration with other disciplines and the surgical oncology fellow at McGill obtains this much required multi-disciplinary training.
We thank Dr. Meterissian for his time and advice in guiding residents for a career in surgical oncology.
Please contact us with any other question that you wish to ask Dr. Meterissian.