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Humanism in Medicine: 2008 AAMC Award Nominee, Rabih Salloum, MD
Dr. David Guzick, M.D., Ph.D.
May 22, 2008
A couple of weeks ago, I found myself in an operating room, a very familiar environment. But for the first time in my adult life, I was looking up at the operating lights instead of looking down at a patient. The operation I was about to undergo was minor hand surgery—no big deal. Nonetheless, the experience of being a patient undergoing surgery—even minor surgery—had a greater impact on me than I had imagined.
The procedure was masterfully performed by Richard Miller, MD, Professor of Orthopaedics. My stitches are out and I am virtually back to new. The part of the experience that lasts with me, however, was not the surgery (I don’t remember a thing, having received my first dose ever of the magical drug propophol), but the attentive caring shown by the entire staff. I now have a new understanding of our biopsychosocial model of medical education and practice: on the other end of the informed consent process, I have renewed appreciation for the importance of clarity and completeness; in the pre-op area, I gained an understanding—from a patient’s perspective—of the need for privacy and comfort; having not been on the receiving end of systemic anesthesia before, it was reassuring to be given a clear understanding of my options; and the importance of a warm blanket became quite apparent when I slid onto the operating table. Above all else, what made a difference was the caring and attention shown by the surgical team—Dr. Miller, my anesthesiologist Stefan Lucas, MD, my nurse anesthetist Mary Huether, CRNA, and the entire nursing staff.
Indeed, because of our biopsychosocial tradition, we can be proud of a very humanistic faculty and staff. But among this group, the medical students of SMD select one physician annually as the University of Rochester’s nominee for the Association of American Medical Colleges (AAMC) Humanism in Medicine Award. This year, the students selected Rabih Salloum, MD, Associate Professor of Surgery, as our nominee.
The Humanism in Medicine award is given by medical students in recognition of a physician faculty member who best exemplifies the attributes of positive mentorship, community involvement, compassion, sensitivity, collegiate collaboration, and professional ethics. Each medical school of the AAMC nominates one physician-faculty member for this national award. The Organization of Student Representatives (OSR) at each medical school solicit nominations from the student body, interviews the candidate faculty members, and selects one nominee for the national award. Led this year by Anna Cooper, Class of 2011, students identified a large number of deserving candidates in response to a call for nominations. Each physician was interviewed by an OSR representative. Representative quotes from medical students and residents reflect the widespread sentiment that Dr. Salloum is an extraordinary surgeon, not only because of his technical expertise but because of his humanistic care of patients and his teaching and mentoring:
“While Dr. Salloum thoroughly enjoys interacting with students in a didactic lecture hall, his preference is to teach one-on-one at the bedside. One example in particular stands out in my mind from my surgery rotation as a third year medical student. We were doing late evening rounds and we were all exhausted and ready to go home. We entered the room of a young 20 year old patient with ulcerative colitis who was scheduled to have her colon resected the next morning. Dr. Salloum sat down in the room and addressed the patient’s and family’s concerns about the surgery, intently listening and giving open and honest answer for an hour. I never saw an attending physician spend this much time with one patient, let alone after a 13 hour day. He has the best bedside manner I have ever seen.”
“Dr. Salloum represents the kind of doctor that every physician strives to be—he is warm, thoughtful, intelligent, kind, and compassionate. He goes beyond what is expected. In this way, he role-models what being a doctor is all about.”
“Rabih Salloum is quite possibly the most supportive and personable faculty member I have encountered in medical school. Dr. Salloum is the quintessential mentor and role model. He consistently takes time from his busy day and clinic/OR schedule to make sure the medical students on his service are actively learning and enjoying their educational experience. I specifically recall an interaction Dr. Salloum had with an adolescent patient and her family as she was preparing to undergo major abdominal surgery the next day. Dr. Salloum scheduled a family meeting in-house, brought the entire surgery team up to the patient's room, promptly took a chair from the nurses’ station into the patient's room, and sat with the patient and her family. He answered everyone's questions with sincerity and put the entire family at ease. His bedside manner is among the finest I have ever seen and I hope to emulate Dr. Salloum throughout my future career in internal medicine. As I prepare to graduate medical school and think about the essence of the biopsychosocial model instilled in us throughout our four years in Rochester, I look to physicians like Rabih Salloum as role models for how effective and meaningful doctor-patient communication should take place. Dr. Salloum epitomizes "the humanist physician."
“I met Dr. Salloum at the beginning of my 1st year of medical school. We were introduced at a Surgery Interest Group student function. He immediately stood out in my mind as someone eager to foster relationships with medical students and residents. Throughout my 4 years of school, Dr. Salloum and I have maintained a close and unique mentoring relationship. Most notable for me is that, even after my decision to pursue post-graduate residency training in a non-surgical specialty, Dr. Salloum, a surgeon, still devoted substantial energy to advising me about career choices and future plans.”
“Dr. Salloum’s teaching skills are fabulous. He creates an open environment in which it is ok to ask questions, and to use humor as well. He always has a positive attitude and a laugh that is infectious.”
“As a student, I was most impressed by Dr. Salloum’s insistence on encouraging medical students to function as full members of the surgical team. He strives to provide student autonomy in making medical decisions for their patients all the while providing gentle guidance and useful teaching points along the way. Even further, he engages every patient with respect and dignity. Patients are consistently involved with their own care and the surgical decision-making process. Dr. Salloum ensures that patients never enter the operating room without having any and all questions answered to their fullest satisfaction and understanding. He frequently takes extra time in the pre-anesthesia waiting area to talk with patients and their families about their care, despite a busy and demanding operative schedule.”
“As for his effect on students and residents, Dr. Salloum is unparalleled in our institution …Dr. Salloum has been an ally since the first day I met him. He is more than willing to round with and teach the intern while the rest of the team is operating with other attending surgeons. His team rounds are enjoyable and offer residents at different levels the benefit of his considerable experience. In the operating room, Dr. Salloum has the uncommon ability to allow residents to push themselves to the next level while ensuring that the patient remains safe. His patience and its importance in teaching operative technique and decision-making cannot be overstated. He helps us as chief residents to meld all the knowledge and skills we have acquired over the years so that we may graduate safe and competent surgeons.”
“Dr. Salloum was my mentor during my fourth year of medical school on a surgery subinternship. He was always interested in teaching by example. On one occasion when all the residents were at conference, I first assisted Dr. Salloum on a hernia repair operation. He said, “Well this is your chance,” and handed me the blade to make the incision. It was the first time an attending gave me such an opportunity. Anytime Dr. Salloum walks onto a patient floor or a patient’s room the mood instantly changed. Even when he has to give his patients bad news about their cancer, he does this in a sensitive manner that makes a difference. I remember one patient with metastatic colon cancer; we walked into the patient’s room and Dr. Salloum pulled up a chair next to his bed and sat eye to eye. He told him what we had found in the OR and stayed with him until all his questions and concerns were addressed.”
“When students come out of medical school and begin surgical training, they are still driven by the idealism that led us all to medical school. Many surgeons drift from that idealism in the current environment. It is refreshing to find a teacher whose relationships with patients are so starkly un–surgical. He takes time with them in clinic, getting to know far more than is necessary to simply perform an operation. He develops a cooperative relationship with patients and calls upon his understanding of them as individuals to help them recover from their disease. Much of this recovery is aided by his affable demeanor and his ability to maintain the morale of patients in the face of significant illness. His patients love him and often keep in touch with him despite having long recovered from their surgical disease.”
Rabih Salloum, MD, grew up in Lebanon and received his B.S. and M.D. degrees from the American University of Beirut (AUB). Founded in 1866 as a private, independent, non-sectarian institution of higher learning, functioning under a charter from the State of New York, AUB became a gift from the American people to promote education in Lebanon. Although it developed a proud tradition as a prestigious University in the Middle East, by the latter part of the 1980s, when Dr. Salloum was in his last year of medical school, the area was mired in a civil war. At that time, many students from his medical school sought a clinical rotation in the United States for academic advancement and in reaction to the political turmoil. In 1988, Dr. Salloum was accepted as a sub-intern on the surgical service of the University of Florida, just before his graduation from medical school. There he met Wiley (Chip) Souba, MD, a surgical oncologist who is now Dean at Ohio State University School of Medicine, who offered him a post-doc position in his laboratory, which was focused on metabolism and nutrition, specifically glutamine metabolism in patients with critical illness and with cancer. Dr. Salloum remained in this position from 1988-1991. After this research experience, he entered the residency match in Surgery and successfully matched at Florida. He completed six years of residency (including an embedded research year) in 1997.
While at Florida, Dr. Salloum was influenced by several role models. Dr. William Pfaff was the first attending surgeon he met in the United States. Dr. Salloum was very impressed with the bedside manner of this distinguished general and kidney transplant surgeon. At the bedside, Dr. Pfaff showed patience and a highly respectful demeanor, always expressing himself clearly to patients in language they could understand, and referring to them as “my friend.” Dr. Salloum was also influenced by Dr. Ted Copeland, the Chair of Surgery, a “total southern gentleman,” who advised the residents that when they walked into a patient’s room, they should imagine that that the patient is their mother, father, sister or brother. Dr. Salloum internalized that lesson and to this day, transmits it to medical students and residents.
A stellar mentor who taught by example the qualities of a proficient yet compassionate surgical oncologist, Dr. Souba’s influence led Dr. Salloum to pursue a Fellowship in Surgical Oncology at the University of Chicago. From 1997 until 2000, Dr. Salloum studied at Chicago under the mentorship of Drs. Mitchell Posner and Fabrizio Michelassi, two additional highly influential mentors. He recounts that both of these surgeons were “able to gain the trust of a patient the moment they entered the room;” this ability had a profound effect on Dr. Salloum, who saw—patient after patient--the impact of a trusting, successfully communicative relationship between patient and physician. He learned from these oncologists how to communicate a realistic balance of honesty and hope. While at the University of Chicago, from 1997-98, Dr. Salloum was the recipient of a National Research Scholar Award (NRSA, National Institutes of Health). Also, as a forerunner of things to come, in 2000 he won the University of Chicago medical student Golden Apple Award for Excellence in Teaching.
In 2000, Dr. Michelassi was giving a Grand Rounds here as a visiting professor. Dr. James Sitzman, Chair of Surgery at that time, mentioned to Dr. Michelassi that he wished to recruit a surgical oncologist with special expertise in colorectal surgery. Dr. Michelassi immediately said: “I have your guy!” Dr. Salloum visited Rochester for the first time to be interviewed for this position. A few months later, he arrived as a new Assistant Professor of Surgery. The rest is history. Since 2000, Dr. Salloum has excelled as a clinician and teacher, with significant accomplishments in clinical research and contributions to the literature as well. At Rochester, he has won the Elethea Caldwell Award for Excellence in Teaching in 2003, the Seymour I. Schwartz Excellence in Teaching Award in 2005 and the Marvin Hoffman award for student mentorship in 2008. He was promoted to Associate Professor in 2006.
I end this newsletter with one final quote from a member of the Class of 2008: “Dr. Salloum’s decision-making is grounded and contemplative, and his understanding of the limits of surgical intervention is part of what makes him unique. His ability to help patients with or without a scalpel is exceptional among surgeons and his example is one for which every student and resident that knows him strives…On a daily basis, his efforts focus on the needs of his patients and students. He is a caregiver, a teacher, a mentor and a role-model, and as such, I can think of no one more deserving of an award for humanism in medicine.”
The AAMC National Selection Committee will meet during the summer to select the National Humanism in Medicine Award recipient, who will be recognized during the 2008 AAMC Annual Meeting. Meanwhile, however, I think you will agree that the honor is in the nomination, an honor worthy of recognition.
Meliora,
David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry
University of Rochester
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