By Hilary Bennett
By Sara Rimer, for BU Today
For all of Boston’s renown as a center of pioneering medicine, there remains one medical field where hospitals here lag, just like everywhere else: female surgeons.
That’s what makes Jennifer Tseng’s appointment in 2017 as chair of the BU School of Medicine department of surgery and as chief of surgery at Boston Medical Center a unique breakthrough: Dr. Tseng is the first woman appointed chair and chief of surgery at an academic medical center in Boston.
Women account for more than a third of all physicians and physicians-in-training in the United States and are half of all medical students. And yet, in 2015 they numbered only 19.2 percent of general surgeons, according to the Association of American Medical Colleges.
Dr. Tseng specializes in surgical oncology and gastrointestinal surgery. In a recent chair’s note, she writes of MED’s tradition of diversity and inclusion, dating back to one of its founding institutions, the New England Female Medical College, the first US institution to train female physicians, including the first black female physician, Rebecca Lee Crumpler, in 1864, and in 1890, Charles Eastman, the first Native American physician.
Dr. Tseng was born in northern California, the daughter of immigrants who fled their native China for Taiwan in 1949 and came to the United States in the 1960s to go to college. After graduating from Stanford University with degrees in biology and English, Dr. Tseng earned a medical degree at the University of California, San Francisco, School of Medicine, and a master’s in public health from the Harvard T. H. Chan School of Public Health.
MED’s James Utley Professor of Surgery, Tseng was formerly a professor of surgery at Harvard Medical School—only the fourth female full professor in the school’s history—and chief of surgical oncology at the Beth Israel Deaconess Medical Center. She is married to a cardiologist and has two children, ages 11 and 13.
BU Today talked with Dr. Tseng about how she chose medicine over a career in writing, the connection between surgery and humanism, and the lessons she’s carried forward from her first job as a medical receptionist.
BU Today: Were there any physicians in your family before you?
Dr. Tseng: My grandfather was a general and thoracic surgeon and my grandmother was an OB-GYN and primary care doctor during the day. She assisted him in their surgicenter they ran out of their house at night. They practiced in China and Taiwan. They both inspired me to go into medicine. They were in their 50s when they came to the United States—they were chain immigrants—and they retrained as psychiatrists.
There’s a certain type of surgeon that’s the contemplative, quiet, gentle surgeon with great hands. My grandfather was very much like that. The line between surgery and psychiatry for that type—it’s very profound.
What is it about surgery that attracts such a person?
Surgery is intense. It’s one of those things that, when the stars align in the operating room, you can be truly of the moment. Everything else needs to go away….You are so intimately connected to this person you’re operating on. People are literally putting their life and their body and their spirit in your hands…and if you mess up, the stakes are incredibly high.
And yet people do it. They surrender their beings to you. It’s this incredible privilege and trust.
Were you drawn to medicine as a child?
Yes, I was always interested. Some of it is this Asian immigrant, ‘You will be a doctor’ thing. At five, I said I was going to be a doctor. Then I was going to be a writer, then I was going to be a dancer, but I had no talent as a dancer, so I ruled that out.
At Stanford, poet Adrienne Rich was one of my advisors….I spent a lot of time thinking about not going into medicine, and becoming a writer….She was very supportive. She said that being of service was the most important thing.
Why did you decide to become a surgeon?
I felt in general surgery I could do the best part of medicine, understand the biology of disease, and still have the powerful tool of operating to help people.
Did you face resistance from men in the operating room?
I think most of the trouble comes from within. Maybe this is true of everybody, but it’s particularly true of successful women—I think there’s this little voice in your head that says maybe you’re not good enough, or maybe you don’t deserve to be there….That voice may be what drives many of us, men and women, to work harder…but I think it’s very easy for that voice to spiral into being just negativity, insecurity, putting yourself down.
The number of times I’ve been mistaken for a nurse or respiratory therapist is legion—if I spent time worrying about that, which I did early on, it doesn’t really help.
You know, I started as a medical receptionist…
When was that?
In high school. My mom made me take typing over the summer; if you can type, you can always have a job. At 16, I got a job as a medical receptionist. First I was at the Palo Alto Medical Center. The next summer I switched to Valley Medical Center, which is a county hospital in San Jose.
I worked there every summer, holidays, weekends. It was great. I got paid $9 something early on—a huge amount of money at the time. I would type, and answer the phone, and deal with the patients who walked in.
It was a cancer clinic. Nobody spoke English. I learned to work with two other secretaries, who were older than me, and a bunch of doctors and nurses and radiation technologists, and early on I started to realize that it’s not just about the doctor, it’s a team.
I could not do surgery if I didn’t have a nurse, a scrub tech, and a resident, an anesthesiologist, and a CRNA [certified registered nurse anesthetist].
People say that oncologists are deeply compassionate and empathetic…
When you’re with somebody who has a new diagnosis of cancer or who thinks they might have cancer, everything that is unimportant falls away and the things that are the most relevant remain—your essential humanity, your family, your religion, your belief system….You’re with somebody when they’re focusing on their legacy or what their place in the world is. That can be a huge pit of despair for some people, so if you can be there, that’s an incredible privilege and it can be a joy because you can really help them.
This interview was condensed and edited for clarity.
What is it like — really like? — to be a practicing general surgeon? What are the rewards? The challenges? And what exactly does the field of general surgery encompass? These are just some of the myriad questions medical students may ask themselves as they ponder their future career options.
The best way to find answers to these and other questions is to go directly to the source — practicing general surgeons — and hear what they have to say. So that’s precisely what a group of student leaders from the Boston University Surgical Society did. Under the mentorship of faculty member Tracey Dechert, MD, the Surgical Society was established to foster interest in general surgery and the surgical subspecialties among BU’s medical students.
Using equipment loaned by the BU College of Communications, the students spent two months creating a video featuring interviews with five BUSM/Boston Medical Center surgeons, who describe their subspecialty areas, dispel some common myths, and share what they love about their work. The result is an engaging, informative 21-minute video that pulls back the curtain on a field of medicine that is sometimes not well understood.
The faculty who were interviewed for the video represent different subspecialty areas of general surgery: Dr. Dechert (acute care and trauma surgery/surgical critical care), Cullen Carter, MD (minimally invasive and bariatric surgery), Thurston Drake, MD, MPH (surgical endocrinology), Jason Hall, MD, MPH (colon and rectal surgery), and Teviah Sachs, MD, MPH (surgical oncology).
In collaboration with Dr. Dechert and General Surgery resident Sherif Aly, MD, who did the editing, the students who conducted the interviews and did the filming are: Daniel Aldea, Susana Benitez, Matthew Peacock, Michal Plocienniczak, and Nirupama Vellanki.
“This is a well-produced and very informative video that captures so much of what is so special about being a general surgeon and provides answers to questions that may help medical students decide if this is the right career path for them,” says Surgery Chief and Chair Jennifer Tseng, MD, MPH. “I am grateful to my fellow surgeons for sharing their insights about our amazing profession; to Dr. Aly, who did a terrific job with the editing; and to the BU Surgical Society medical students, who conceived of this video and worked so hard to make it a reality.”
Geoffrey Habershaw, DPM, chief and founder of Podiatry Surgery and the Podiatry Residency Program at Boston Medical Center (BMC) and Boston University School of Medicine (BUSM), received the Lifetime Achievement Award from the Massachusetts Foot & Ankle Society. The award for outstanding accomplishments and service to the society and the profession of podiatric medicine and surgery was voted upon unanimously by the society’s board and presented at its annual meeting in October.
Dr. Habershaw graduated from the Illinois College of Podiatric Medicine. He completed residency training at New England Deaconess Hospital (now known as Beth Israel Deaconess Medical Center). Following graduation, he joined the Department of Surgery at New England Deaconess, and became Chief of the Division of Podiatry at the Deaconess and the Joslin Diabetes Center.
Dr. Habershaw’s primary interest is diabetic foot ulcers and he is known nationally and internationally as an expert in the field, lecturing around the world and drawing patients with this condition from around the country. Dr. Habershaw has trained many residents to become expert in treating diabetic foot ulcers and other podiatric problems.
In 1999, Dr. Habershaw was recruited to the Boston Medical Center Department of Surgery to start a podiatry program. The practice has grown to nine providers, with 26,000 outpatient visits and more than 1,000 operative cases per year. Dr. Habershaw also started the Podiatry Residency Program at BMC/BUSM.
According to BMC/BUSM podiatrist Hau Pham, DPM, who trained under Dr. Habershaw at New England Deaconess and nominated him for this prestigious award, “Without much fanfare, Dr. Habershaw has treated numerous patients with diabetic foot ulcers and given them back an active life free of foot ulcers. He has trained many providers directly and indirectly to achieve the same goal. No one is more worthy of the Lifetime Achievement Award in Podiatry than him.”
The BUSM/BMC Department of Surgery is providing pilot funding* to catalyze innovative translational research in the following areas to support the goals of the new Boston Trauma Institute:
- Trauma and Acute Care Surgery
- Injury Prevention
- Trauma Survivorship
- Socially Responsible Surgery
* direct costs up to $10,000
REQUEST FOR APPLICATIONS: 2019-2020 ACADEMIC YEAR
Application Due: December 1, 2018
Funding Announcements: December 17, 2018
This RFA is open to ALL members of the BU/BMC community.
To learn more about the grant program, RFA requirements, and submission details, click here: BTI Pilot Award Announcement
BMC/BUSM AT AMERICAN COLLEGE OF SURGEONS CLINICAL CONGRESS 2018
FRIDAY, OCTOBER 19
Department of Surgery Grand Rounds (Visiting Assistant Professor Series)
Location/Time: L110, 8-9 AM
Topic: A Beginner’s Guide to Health Services Research: From Bariatric Surgery to Mark Bellhorn
Presenter: Luke M. Funk, MD, MPH, FACS
Assistant Professor of Surgery; Associate Program Director, Advanced Gastrointestinal Minimally Invasive Surgery Fellowship; Director, Minimally Invasive Surgery Research, University of Wisconsin School of Medicine and Public Health
SATURDAY, OCTOBER 20
Association for Academic Surgery 2018 Fall Courses (registration required:https://www.aasurg.org/aas-fall-courses/aas-fc-2018-graphic-maroon/)
Location/Time: Sheraton Boston Hotel, 7 AM- 6:30 PM
SUNDAY, OCTOBER 21
Association of Women Surgeons (in conjunction with AWS meeting Oct. 20-22) https://www.womensurgeons.org/page/AnnualConference
Location/Time: Marriot Copley Place, 9:30-10:45 AM
Topic: Practical Pearls in Negotiating with Surgeons: 4 8-minute talks and 20 minutes of panel discussion
- Herbert Chen, University of Alabama: Understanding Your Value as a Surgeon
- Dr. Julie Ann Sosa, University of California, San Francisco: Beyond Salary — What Can I Negotiate For?
- Jennifer Tseng, Boston University: Negotiating for Things after You Start
- Ann Prestipino, Massachusetts General Hospital: The Business of Hiring You: The Hospital’s Perspective
Surgical Skills Competition
Location/Time: Boston Convention and Exhibition Center (Room 160ABC), 3-5 PM
MONDAY, OCTOBER 22
Time: 9:45-11:15 AM
Session Title: Surgical Education
Presentation: The Effect of Patient Code Status on Surgical Resident Decision Making
Presenter: Miriam Neufeld, MD
Time: 9:45-11:15 AM
Session Title: Diverticulitis 2018: Every Year the Recommendations Change
Co-Moderator: Jason F. Hall, MD, MPH, FACS
Time:11:30 AM – 1 PM
Session Title: Vascular Surgery I
Moderator: Jeffrey Siracuse, MD, FACS
Time: 1– 5:15 PM
Session Title: Negotiation Skills Training
Panelist: Virginia R. Litle, MD, FACS
BUSM/BMC SURGERY RECEPTION 2018, 6-9 PM
Tuscan Kitchen, 64 Seaport Blvd. 7 PM: Honoring Dr. Glantz
TUESDAY, OCTOBER 23
Time: 9:45-11:15 AM
Session Title: General Surgery II
Presentation: There is an Important Difference in the BMI Threshold for Increased Complications after Open vs. Laparoscopic Ventral Hernia Repair
Presenter: Rumbidzayi Nzara, MD
WEDNESDAY, OCTOBER 24
Time: 9:45-11:15 AM, Session of Interest
Presenter: Matthew Kulke, MD (Chief, Hematology-Oncology, BUSM and BMC)
Presentation: Neuroendocrine Tumors: What Are They and How Should They be Managed? PS312
Time: 2:30-4 PM
Session Title: General Surgery VII
Presentation: Socioeconomic Status Affects Access to Ambulatory Cholecystectomy
Presenter: Megan Janeway, MD
Presentation: Comparing Risk-Standardized Readmission Rates of Surgical Patients at Safety Net
& Non-Safety Net Hospitals
Presenter: Stephanie D. Talutis, MD, MPH
Time: 4:15-5:45 PM
Session Title: Bariatric/Foregut IV
Moderator: Donald T. Hess, MD, FACS
FRIDAY, OCTOBER 26
Department of Surgery Grand Rounds
Location/Time: L110 at 8AM
Topic: The Surgical Critical Care Initiative (SC2i)
Presenter: Eric A. Elster, MD, FACS, Capt., MC, USN, Professor and Chairman of Surgery, the Uniformed Services University
Patients with chronic kidney disease frequently develop stenosis of their intrathoracic large veins (i.e., central venous stenosis), which jeopardizes their prospects of having a functional dialysis access. The current method to diagnose this complication is fraught with inaccuracies.
An interdisciplinary team (members of the Evans Center IBR Thrombosis and Hemostasis ARC) at Boston University has received a major grant from the biotech company Philips to tackle this challenge. The group will lead a clinical study to assess the potential of intravenous ultrasound (IVUS), an emerging technique, to investigate and diagnose the mechanical properties of central venous stenosis.
The results from this study will address one of the critical bottlenecks in the management of dialysis access malfunction, particularly in BMC’s underserved patient population. It is also likely to seed larger clinical trials in the future to guide endovascular therapies.
The Department of Surgery recently published its Annual Report 2018, "Building a Healthier Future for All." In addition to news about the many achievements of faculty and trainees, the report includes features on innovations in patient care, research, equity, and quality, as well as a profile of an alumnus.
Click here to download a PDF of the 2018 Annual Report. To request a printed copy of the report, please contact Kim Wenzel (email@example.com) in the Department of Surgery.
Jennifer F. Tseng, MD, MPH, was appointed Deputy Editor of JAMA Surgery, effective January 1, 2018. Dr. Tseng serves as the Utley Professor and Chair of the Department of Surgery at Boston University School of Medicine (BUSM), and Surgeon-in-Chief at Boston Medical Center (BMC).
Dr. Tseng's clinical specialty is surgical oncology and gastrointestinal surgery, with a focus on the upper grastrointestinal tract.
Dr. Tseng founded and codirects Surgical Outcomes Analysis & Research (SOAR), a clinical and outcomes research institute initiated at the University of Massachusetts Medical School in Worcester, continued at Beth Israel Deaconess Medical Center and Harvard Medical School, and now based in Boston at BUSM/BMC.
Dr. Tseng’s research interests include developing models for cancer treatment-sequencing strategies, cancer biomarkers, and healthcare disparities and outcomes research. Dr. Tseng is a member of numerous surgical societies including the American Surgical Association, the Society of University Surgeons, and the Society of Surgical Oncology. She serves as the secretary of the Society for Surgery of the Alimentary Tract (SSAT) and as president-elect of the Society of Asian Academic Surgeons (SAAS).
Peter Burke, MD, Acute Care and Trauma Surgery
Alik Farber, MD, Vascular and Endovascular Surgery
Jason Hall, MD, MPH, Colon and Rectal Surgery
Donald Hess, MD, Minimally Invasive and Weight Loss Surgery
Jeffrey Kalish, MD, Vascular and Endovascular Surgery
Maureen Kavanah, MD, Surgical Oncology
Virginia Litle, MD, Thoracic Surgery
David McAneny, MD, General Surgery, Surgical Endocrinology, Surgical Oncology,
Jaromir Slama, MD, Plastic and Reconstructive Surgery