Doctor of Medicine, Brown University (2019)
Master of Science, London School of Economics (2015)
Bachelor of Science, Brown University (2013)
MD, The Warren Alpert Medical School of Brown University
M.Sc, The London School of Economics and Political Science
Sc.B, Brown University, Neuroscience
The Program Director Perspective: Perceptions of PGY5 Residents' Operative Self-Efficacy and Entrustment
A 2020 survey of post-graduate year 5 (PGY5) general surgery residents linked to the American Board of Surgery In-Training Examination (ABSITE) revealed significant deficits in self-efficacy (SE), or personal judgment of one's ability to complete a task, for 10 commonly performed operations. Identifying whether this deficit is similarly perceived by program directors (PDs) has not been well established. We hypothesized that PDs would perceive higher levels of operative SE compared to PGY5s.A survey was distributed through the Association of Program Directors in Surgery listserv; PDs were queried about their PGY5 residents' ability to perform the same 10 operations independently and their accuracy of patient assessments and operative plans for components of several core entrustable professional activities (EPAs). Results of this survey were compared to PGY5 residents' perception of their SE and entrustment based on the 2020 post-ABSITE survey. Chi-squared tests were used for statistical analysis.108 responses were received, representing ∼32% (108/342) of general surgery programs. Perceptions from PDs of PGY5 residents' operative SE were highly concordant with resident perceptions; no significant differences were observed for 9 of 10 procedures. Both PGY5 residents and PDs perceived adequate levels of entrustment; no significant differences were observed for 6 of 8 EPA components.These findings show concordance between PDs and PGY5 residents in their perceptions of operative SE and entrustment. Though both groups perceive adequate levels of entrustment, PDs corroborate the previously described operative SE deficit, illustrating the importance of improved preparation for independent practice.
View details for DOI 10.1177/00031348231157862
View details for Web of Science ID 000935997000001
View details for PubMedID 36802912
Open Abdominal Aortic Surgery in the Endovascular Era-Will we have Enough Volume for Vascular Trainees?
MOSBY-ELSEVIER. 2021: E418
View details for Web of Science ID 000707158200214
Open Abdominal Aortic Surgery in the Endovascular Era - Will We Have Enough Volume for Vascular Trainees?
MOSBY-ELSEVIER. 2021: E259-E260
View details for Web of Science ID 000691401100398
Complication to consider: delayed traumatic hemothorax in older adults
Trauma Surgery Acute Care Open
View details for DOI 10.1136/tsaco-2020-000626
Safety of Foregoing Operation for Small Bowel Obstruction in the Virgin Abdomen: Systematic Review and Meta-Analysis.
Journal of the American College of Surgeons
Our objective was to assess the safety of foregoing surgery in patients without abdominopelvic surgery history presenting with small bowel obstruction (SBO). Classic dogma has counseled early surgical intervention for small bowel obstruction (SBO) in the virgin abdomen - patients without abdominopelvic surgery history - given their presumed higher risk of malignant or potentially catastrophic etiologies compared to those who underwent prior abdominal operations. The term virgin abdomen was coined before widespread use of computed tomography, which now elucidates many SBO etiologies. Despite recent efforts to re-evaluate clinical management standards, the prevalence of SBO etiologies in the virgin abdomen and the current management landscape (non-operative vs operative) in these patients remain unclear. Our random-effects meta-analysis of six studies including 442 patients found the prevalence of malignant etiologies in patients without abdominopelvic surgery history presenting with SBO varied from 7.7% [95% CI:3.0-14.1] to 13.4% [95% CI:7.6-20.3] on sensitivity analysis. Most malignant etiologies were not suspected prior to surgery. De novo adhesions (54%) were the most common etiology. Over half of patients underwent a trial of non-operative management, which often failed. Subgroups of patients likely have variable risk profiles for underlying malignant etiologies, yet no study had consistent follow-up data and we did not find convincing evidence that foregoing operative management altogether in this population can be generally recommended.
View details for DOI 10.1016/j.jamcollsurg.2020.06.010
View details for PubMedID 32574687
Concurrent large bowel obstruction secondary to idiopathic mesenteroaxial gastric volvulus.
Trauma surgery & acute care open
2020; 5 (1): e000582
View details for DOI 10.1136/tsaco-2020-000582
View details for PubMedID 33024829
Fast Brain Volumetric Segmentation from T1 MRI Scans
SPRINGER INTERNATIONAL PUBLISHING AG. 2020: 402–15
View details for DOI 10.1007/978-3-030-17795-9_30
View details for Web of Science ID 000490725100030
Sjögren Syndrome and Cryoglobulinemic Glomerulonephritis.
American journal of kidney diseases
2015; 66 (3): 532-535
We report the case of a 53-year-old woman with Sjögren syndrome and cryoglobulinemia. The patient presented with nephrotic syndrome, hematuria, and reduced estimated glomerular filtration rate. The kidney biopsy revealed diffuse endocapillary proliferation and leukocyte exudation with focal intraluminal hyaline thrombi, prominent tubulointerstitial inflammation, and vasculitis. Diffuse granular mesangial and segmental to global capillary wall staining was observed on immunofluorescence with antisera to C3 and immunoglobulin M (IgM), with less intense staining indicative of IgG and κ and λ light chains. A biopsy diagnosis of Sjögren syndrome-related cryoglobulinemic membranoproliferative glomerulonephritis and vasculitis was rendered. Subsequent investigations revealed the presence of circulating type II cryoglobulins with cryocrit of 9%. Although rare, Sjögren syndrome is the most common cause of non-hepatitis C virus-related mixed cryoglobulinemia. We discuss the possible pathogenic mechanisms involved in the development of mixed cryoglobulinemia and its evolution to lymphoma, as best described in the setting of hepatitis C virus infection. Although the specific antigen involved is unknown, it is likely that the mixed cryoglobulinemia in Sjögren syndrome is triggered by the long-term B-cell stimulation, resulting in clonal proliferation of B cells. Additional chromosomal aberrations and cytokine milieu alterations, as seen in hepatitis C virus infection, may result in prolonged B-cell survival and progression to non-Hodgkin lymphoma.
View details for DOI 10.1053/j.ajkd.2014.11.032
View details for PubMedID 25661680