What do you wish you had known earlier in your surgical training? ACOS member David Kim, D.O., shares thoughtful perspectives on training, mentorship, career development, and what it means to be a general surgeon. We sat down with Dr. Kim for an interview to hear his perspective on choosing a specialty, making the most of residency, building confidence and learning from mentors throughout a surgical career. Q: What is one thing you wish you knew earlier in your surgical training? A: General surgery is a unique specialty in that we provide a measure of security and confidence in any hospital across all departments that no other specialty provides. What that means is that we are tasked with taking on questions and responsibilities across a broad spectrum that do not necessarily relate to the actual work that we are responsible for but provide a service for staff and colleagues because our training develops the confidence to be able to do so. Q: What’s one piece of advice you would give to medical students or residents? A: For medical students: spend time on personal insight and devote lots of time early on into thinking about what specialty suits you the best. Don't worry about how much money you're going to make or what lifestyle a certain specialty is going to bring you. You need to find a specialty that you're going to work for the rest of your professional career; better to pick one based on your persona and work ethic rather than annual salary and benefits. Being able to choose a specialty early on means you can start to prepare to speak on that specialty (anatomy, surgical lingo, etc.), this develops a strong foundation during clinical years when you can show your best to your chosen specialists and gives you the upper hand once you begin work in that residency. Residency into surgical specialties only gets harder as years go on. Put in the work early and gain the upper hand. For residents: Residency is the last time that you get to make hard decisions under the guidance of an attending physician. The day you leave your residency is when you make all of your professional/medical decisions without someone looking over your shoulder. Find extra opportunities to broaden your foundational knowledge, sharpen the skills you already have, be a little bit obsessed with your chosen specialty. All new attendings go through a period of Imposter Syndrome, the breadth and intensity of your training can minimize this significantly if you have the willingness to go above and beyond. Q: What lessons have you learned during your career? A: Every specialty is filled with both fascinating pathology and irritating nonsense; the two are not always balanced. You have to be equally good at the challenging work and have patience with the rest. The best surgeons are the ones who navigate both with confidence and grace. Q: Do you have a favorite memory from your career? A: The moment I graduated from residency, I knew that my training had been good and that I was going to confidently walk into my new job as an attending based on the hard work put into becoming an attending surgeon. Q: How has mentorship influenced your career? A: Every encounter with an attending surgeon provides a little piece of experience to add to your overall view and knowledge of the world of surgery. My persona as a General Surgeon is built upon thousands of bits of advice and experiences. Strong mentorship can significantly influence how you navigate our world. Q: What should every patient should know before going into surgery? A: Every patient that you are going to operate on should know that you are a safe surgeon. Not a flashy one, not someone who is unconfident in their skills. Their trust in you has to be based on your mission to provide a safe surgery with their best interests at hand. Dr. Kim’s experiences highlight the value of preparation, mentorship and continued growth throughout a surgical career. We appreciate him taking the time to sit down with us and share his perspective with the ACOS community. What lessons from your own surgical journey have shaped the way you practice today? Share your perspective in the comments and continue the conversation with your fellow ACOS members.

What does a day in the life of a robotic and minimally invasive urologic oncology fellow really look like? ACOS member Zac Taylor, D.O., shares an inside look at fellowship training—from high-volume robotic oncology cases and cutting-edge surgical technology to the mindset of continuous learning that defines the specialty. Read his reflections below. ⬇️⬇️⬇️ Q: What does a typical day look like for you? A: A typical day during my robotic and minimally invasive urologic oncology fellowship starts early with reviewing imaging, operative plans, labs, and overnight patient updates before heading to the operating room. As a fellow, nearly 100% of my focus is on the operative experience and refining my skills, much different than residency where inpatient responsibilities can require a significant amount of attention. Cases can range from robotic prostatectomy, partial nephrectomy to adrenalectomy, complex salvage operations, and upper urinary tract reconstruction. Additionally. I have a focus on percutaneous ablative procedures for renal cell carcinoma and prostate cancer. The surgical volume is demanding, but it provides constant opportunities to refine both technical surgical skills and clinical decision-making. Q: What aspects of your environment shape your experience? A: The fellowship environment plays a major role in shaping the experience because it is centered around a high-volume robotic oncology practice with exposure to complex pathology and evolving surgical technology. Being surrounded by experienced surgeons, dedicated operating room staff, trainees, and multidisciplinary cancer teams creates an atmosphere focused on continual growth and high-level patient care. Fortunately, my program director and other faculty are extremely supportive of me in achieving my professional and personal goals. The culture emphasizes preparation, efficiency, and accountability while also encouraging critical discussion of operative strategy and outcomes. In addition, the academic component of the fellowship (research, manuscript development, and conference participation) pushes me to stay engaged with emerging evidence and innovation within urologic oncology. Q: What might surprise others about your day-to-day routine? A: What has surprised me most during fellowship is realizing how much there still is to learn, even after completing residency and now nearing the end of subspecialty training. Before fellowship, I thought I had a solid understanding of robotic surgery and urologic oncology, but fellowship has shown me how much nuance exists within operative decision-making, surgical technique, perioperative management, and patient selection. Small technical details can significantly impact outcomes, and there is constant refinement taking place at every level. This is especially true in urology, which continues to rapidly embrace surgical innovation and new technologies. Whether it is advancements in robotic platforms, imaging, reconstruction, or minimally invasive approaches, the field is constantly evolving. Fellowship has reinforced that becoming a good surgeon is not a fixed endpoint but an ongoing process of learning, adapting, and improving throughout your career. That mindset has probably been one of the most valuable lessons of the experience.

"Incidental Small Cell Neuroendocrine Carcinoma and High-Grade Dysplasia in an Orthotopic Ileal Neobladder Three Decades Post-cystectomy: A Case Report" The utilization of a bowel diversion is standard following radical cystectomy for muscle-invasive bladder cancer. Neoplastic transformations are a known long-term complication of intestinal urinary diversions, although uncommon. Most documented tumors are adenocarcinomas, with neuroendocrine tumors present in exceedingly rare instances. To the best of our knowledge, we present the second case of neuroendocrine tumor found in an orthotopic neobladder. We review the workup and treatment as well as our proposed treatment for low- versus high-risk lesions within a neobladder. This case stresses the importance of lifelong, close monitoring of patients with intestinal urinary diversions. Read more: cureus.com/articles/499891-i…

What advice would you give to a medical student or resident trying to find their path? ACOS member Marcella Fornari, D.O. encourages students to focus on what they truly love, not what they think they’re supposed to do. For residents, especially those in surgical training, her message is simple: there is a light at the end of the tunnel. The challenging days are part of the journey, but finding a specialty that brings you joy can make all the difference. Watch Dr. Fornari share her advice for the next generation of physicians.

🔥 13 DAYS UNTIL ACA 2026! We’re just 13 days away from bringing the osteopathic surgical community together in New Orleans for four days of education, connection, and inspiration. With up to 40 CME, specialty programming, keynote speakers, networking opportunities, and more, there’s plenty to look forward to at this year’s meeting: ACA 2026: Lighting the Fire — Passing the Torch to the Next Generation of Osteopathic Surgeons. ⏰ Register today: facos.org/ACA You have until September 21 to register at the current rate. Pricing increases after that! 📍 Hyatt Regency New Orleans 📅 October 1–4, 2026 13 days. We’ll see you in New Orleans! #ACOSACA2026 #LightingTheFire

Leadership gets tested when the pressure is on. Are you ready? Join us for the Women’s Surgeons Forum: POWERFUL Leadership Under Pressure: Leading With Integrity When It Would Be Easier Not To on Thursday, October 1, from 5–8 p.m. CDT at ACA 2026. This isn’t just another leadership session. It’s a practical, high-impact conversation about what it takes to lead when the stakes are high, the priorities are competing, and difficult conversations can’t wait. Come ready to: 🔥 Build confidence, resilience, and authenticity as a leader 🔥 Navigate difficult conversations and high-pressure situations 🔥 Strengthen your influence, communication, and decision-making 🔥 Lead with purpose while staying true to your values and goals Three hours. Real strategies. POWERFUL leadership. If you’re a woman in surgery, make this session part of your ACA 2026 plans.

Residency demands a lot of your time and energy—but making space for yourself is an important part of sustaining a long career in surgery. ACOS member Grace Kim, D.O., shares a reminder for residents to think beyond simply catching up on rest and find the activities that truly restore and recharge them. "Be sure to balance your time off wisely. A lot of residents tend to want to sleep or rest on the little time they have off. When you're tired, it's hard to drag yourself out of the house to socialize or to work on a hobby, which is completely understandable! We spend a lot of our waking hours answering pages, reading textbooks, and operating. The last thing you want to do sometimes is get out of bed. However, once you catch up on sleep, I wouldn't ask what I can do to catch up on rest. Instead, ask yourself, "What would rejuvenate me?" What restores your energy? What makes you feel young again? Yes, sometimes the answer is sleep for hours on end. But in my opinion, most of the time, the answer is picking up that crochet needle or paintbrush, scheduling a lunch with your friends, bicycling in the park, planning a trip, etc. You spend all your energy in the service of others but remember to protect some of that energy so that you can spend it on yourself. You deserve it!" How do you protect your energy and find joy outside of the hospital? Let us know in the comments below, and share this with a fellow colleague who needs the reminder today.

What does it mean to find purpose in surgery? For ACOS member Nicholas St. Hilaire, D.O., FACOS, a career in surgery is about more than the procedures themselves. It’s about earning patients’ trust, guiding them through challenging moments, and finding fulfillment in the opportunity to make a difference in their lives. We asked Dr. St. Hilaire about his path to surgery, staying grounded during challenging days, advice for medical students, and what the patient experience means to him. Read his perspective below. 👇 Q: What inspired you to pursue a career in surgery? A: As a medical student, I enjoyed rotating through many different specialties. The first time I shadowed a general surgeon, I knew that was the career path for me. I was intrigued about having the opportunity to improve patients’ lives through surgery. One of the best parts of this job is developing trust with my patients. It is humbling and an honor that they put their lives in my hands and trust me to address their surgical needs. Q: How do you stay grounded during challenging days? A: I remember my training and don’t panic. Q: What advice do you have for medical students interested in general surgery? A: Try to rotate through programs that you have researched and that you know have the potential to be a good fit for you. While rotating, work hard and be prepared. Read about cases you will be involved in and cases that you have seen. Ask questions that show you know the subject matter, to some extent, in order to inspire your mentors to know you are motivated. If there is a program that you like but cannot rotate in, ask to round with the team for a weekend and attend their journal clubs. You want to leave a good impression and for them to remember you (in a positive way, of course) when interview decisions come around. You will be competing with other eligible candidates. Interact with the residents in the program you want to match with; they have input on who gets selected for interviews at many programs. When you get into residency, work hard. Five years goes by very fast, and there is a lot to learn. You will be operating by yourself or doing a fellowship before you know it. If you put the work in during residency, the transition to being an attending will be much easier. I am 11 years into my practice, and I still love my job. Q: What does the patient experience mean to you? A: The patient experience means a lot to me. Most people are nervous about having surgery. I make it a point to take the time to explain their disease process and the options they have to treat it. I like to make sure my patients know that they have a voice in the options for the care they receive. I work hard to make them comfortable with our surgical plan and guide them through the pre-op and post-op process. Q: What’s a piece of advice you’d give your younger self starting in healthcare? A: Make sure you make time for yourself and your family. It is hard not to take your work home with you, and a part of us is always working. Give 100% effort at work, but when you’re at home, do the same for them.

What does it take to keep your own fire burning while helping ignite the next generation? At ACA 2026, Terra Ruppert, PhD, OTR will take the stage to explore the importance of self-renewal, personal well-being and maintaining the passion that drives us to lead and inspire others. With a career rooted in education, healthcare and leadership, Dr. Ruppert will share practical strategies for staying engaged and energized while navigating the demands of a challenging profession. For osteopathic surgeons, her message offers an important reminder: supporting the next generation starts with making space to care for yourself, sustain your passion and continue growing as a leader. Join us October 1–4 in New Orleans for her session: Fueling the Fire: Keeping Your Own Torch Burning So That You Can Influence the Next Generation. 🔥 Register today: facos.org/ACA #ACOSACA2026 #LightingTheFire

What advice would you give to early-career surgeons as they begin building their careers? ACOS member Gregory Messner, D.O., FACOS, shares the importance of creating a five-year plan before completing training, staying organized, prioritizing continuing medical education, and building meaningful mentor-mentee relationships. A successful surgical career is built through intentional planning, lifelong learning, and the connections made along the way.

The first 100 days of surgery residency can be a whirlwind. You're about to experience one of the biggest learning curves of your career and you're not alone. ACOS member Megan Barthman, D.O., shares encouragement for new surgical interns as they navigate new hospitals, new systems, and new responsibilities. Her advice? Stay positive, be open to feedback, treat everyone with kindness, and never stop learning. Watch Dr. Barthman's message for incoming residents and remember: every senior resident was once in your shoes. You've got this. The journey is just beginning.

At ACA 2026, Zachary W. Brown, D.O., FACOS will take the stage to examine what large-scale combat operations could mean for civilian healthcare—and whether our medical systems are prepared for what comes next. Drawing on current global conflicts and emerging threats, Brown will explore what the future of mass casualty events could look like and what healthcare systems can do to better prepare for the challenges ahead. For osteopathic surgeons and the broader medical community, his session offers an opportunity to consider how we can strengthen preparedness, adapt to emerging challenges and be ready to respond when the unexpected happens. Join us October 1–4 in New Orleans for his session: When the War Comes to You. 🔥 Register today: facos.org/aca #ACOSACA2026 #LightingTheFire

ACOS member Lauren Kopicky, D.O., FACOS discusses the importance of personalized care and shared decision-making for patients with ductal carcinoma in situ (DCIS). In this video, she explains how tools such as DecisionRT can provide individualized data to help guide treatment conversations, avoid a one-size-fits-all approach and give patients greater confidence in their care decisions.

🤖 Demystifying AI in Surgery at ACA 2026! Curious about how artificial intelligence can actually support your surgical practice? Join us in New Orleans for an engaging, interactive session hosted by the ACOS - AI General Surgery Committee! Get ready for an interactive deep-dive where you'll not only hear from experts, but actually see and test real-world AI applications. 👩‍⚕️ Featured Speakers: Dr. Deana Paley, Dr. Sarah Pergande & Dr. Tanja Gunsberger 📅 Date: Saturday, October 3, 2026 ⏰ Time: 2:30 PM – 3:15 PM 📍 Location: ACA 2026, New Orleans Whether you're looking to streamline workflows or just explore what's possible, this is a session you won't want to miss. See you there!

This Labor Day, ACOS extends its sincere gratitude to our members, volunteers, leaders, residents, students, and staff whose dedication and service advance excellence in osteopathic surgical care. We honor those who came before us, appreciate those serving today, and remain committed to preparing the next generation of osteopathic surgeons. Every contribution, whether in patient care, education, leadership, advocacy, mentorship, or service to the College, ultimately supports our shared purpose: improving the quality of care delivered to patients and the communities we serve. Thank you for carrying forward our mission and the values of honesty, integrity, adaptability, and surgical excellence as we continue lighting the fire and passing the torch to future generations.

Balancing surgical training and family life is a challenge many residents and surgeons navigate throughout their careers. ACOS member Zachary Brewster, D.O., shares his perspective on finding intentionality, staying connected with loved ones, and building a meaningful life while pursuing excellence in surgery. “My name is Zach Brewster, and I am a soon-to-be PGY-3 General Surgery resident in the Mid-Atlantic region. Having recently turned 40 during residency while raising a 3-year-old son with my wife, I have learned that balance is not something you achieve once and maintain perfectly—it is something you work at continuously, knowing there will inevitably be moments of failure along the way. Surgical training is demanding for every resident. It is long, exhausting, and all-consuming, often extending far beyond the walls of the hospital. Adding family to that equation introduces an entirely new dimension to how time, energy, and attention are allocated. More often than not, I feel as though I am running on reserve long before the day is over. The challenge becomes even greater given I am away six months of the year on outside rotations. Pursuing a future in Colorectal Surgery while also tutoring and mentoring medical students means there are days when every hour feels spoken for. Through all of this, the greatest lesson I have learned is the importance of intentionality. Staying connected with my family requires creativity and effort. When I am away, that means FaceTiming for bedtime stories, sending videos throughout the day—my son especially loves seeing the Da Vinci robot and saying hello to my co-residents—or planning small surprises for my wife simply to remind her that she remains my priority despite the distance. When I am home, I try to protect that time fiercely and be fully present in the moments we have together. Now, this would be so easy if the answer was simply, “just be intentional and everything will be great!” What I discovered, however, is that intentionality alone does not automatically make balance easier. It requires tremendous effort, planning, and, at times, a level of emotional energy that can be difficult to find after long days caring for critically ill patients. One of the hardest aspects of surgical training has been learning how to turn off “surgeon mode.” In the hospital, we are trained to constantly anticipate complications, stay mentally engaged, and carry the responsibility of patient outcomes with us at all times. That mindset does not always disappear when I walk through the front door or call home at the end of the day. There are moments when the emotional weight of the profession, the fatigue, and the constant mental checklist make it difficult to slow down and simply be present as a husband and father. I have had to learn that presence means putting the phone away, playing football or hockey with my son, reading him a book, and listening carefully to my wife instead of mentally replaying the day’s operations or preparing for tomorrow’s. Surgery demands an extraordinary amount from us personally and professionally, but my family continually reminds me why those sacrifices matter. In many ways, caring for patients and returning them to their families has deepened my appreciation for my own. For me, success in residency is not defined solely by becoming a skilled surgeon and effective clinician, but by learning how to pursue excellence in medicine while remaining fully present for the people who matter most. If any reader takes anything from this it would be – there’s always time for family, be creative in inventing opportunity and time, take care of yourself (you’re no good to anybody if you’re unwell), disciplined effort in small increments continuously over a long period of time net meaningful results, and find something good from each day. While we know this season of residency and fellowship will be difficult, it is just a season, and there’s not a day goes by that my wife, or I regret the life we are building together.” Residency is a demanding season, but the lessons learned during this time extend far beyond the operating room. Dr. Brewster reminds us that with intentional effort, self-care, and a commitment to the people who matter most, it is possible to grow as a surgeon while staying connected to the life being built outside of medicine.

Applications are open. Fellowship is not an award applied for on a hunch. It is conferred on members whose service to this College and to the profession is already a matter of record — the committee years, the teaching, the board certification. FACOS requires 70 points across three activity categories and two letters from ACOS Fellows. DFACOS requires 300 points, ten years as a Fellow, and three letters. Membership Services will review your point total before you file. An application fee, nonrefundable, accompanies the submission; the current fee is at facos.org/fellow. Applications close November 16 #ACOS #OsteopathicSurgery #FACOS #DFACOS

Surgical training can teach you how to care for your patients, but some of the most important lessons are about caring for yourself. ACOS member Rebecca Douglass, D.O., reflects on the importance of emotional resilience and knowing when to ask for help. What is one thing I wish u knew earlier in your surgical training? "Emotional resilience and knowing when to ask for help is vital for a long and successful career as surgeon that I wish I realized earlier on. As surgeons, we see and do very difficult things on a daily basis. We are taught to be self sufficient and to sometimes ignore our own feelings to get through a hard day. It is vital that we learn early on how to process the emotional toll our jobs take on us and that it is ok to ask for help from your surgical colleagues, family, and friends." Knowing when to lean on others is an important part of building a long and sustainable career in surgery. What’s one lesson you wish you had learned earlier in your training?

Why urology? For many surgeons, the path to a specialty is anything but straightforward. For ACOS member Lynne M. McCormick, D.O., FACOS, urology wasn’t something she chose. It chose her. Dr. McCormick shares her thoughts on urology, the changing surgical workforce, the role of robotics, and her advice to medical students exploring their specialty options: “Urology. I have to say, I didn’t choose it, it chose me. After I gave into that life choice, I discovered that I didn’t have to look for work, it looks for me. I’ve always said that, and it’s true. No one knew, when I started in this business, that the critical shortage of physicians was coming. When I was a trainee, what I saw was private practice groups that competed with each other for work. No one was an employed physician. It was unheard of. The cut in Medicare dollars back in the early 1990s by Congress cut training dollars by roughly fifty percent. The dominos fell from there. Retirement, death, burnout, Covid, the numbers of all physicians plummeted. Hence, the shortage we have today. So, how does a medical student choose a specialty, especially one like urology? Rarely do students even get exposed to our specialty. I have often said, urology is the best kept secret of surgery. We have fewer life-threatening emergencies than most surgical specialties, and fewer, limb or organ sparing emergencies as well. The advent of robotics, however, has heralded a new interest in our specialty. The robot is a workhorse in our operating rooms. Students who are interested in the use of the robot will find urology one of the specialties using the robot primarily for their cases. While on their required surgical rotations, I recommend that students look at what other specialties have cases going on that might be interesting. ENT, vascular, cardiothoracic, plastics, urology, ophthalmology, and whatever else might pop up on the tacking board. Most attending surgeons are willing to have a medical student observer on their cases. We like to have students interested in our specialties. We know that the elective time allotted to rotations in the specialties is quite limited. Not only does having a student in our operating rooms help to bolster our specialty, it can help, even if the student chooses another surgical specialty, to learn a little more about what we do every day and why. When it comes down to the choice, I tell students: What makes sense to you? What specialty do you find easiest to learn and understand? What articles and internet feeds do you click on? There’s your answer. Mine was urology.”