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Making the Rounds with Founding Dean Dr. Barbara Atkinson
 Issue 147 - May 29, 2018
Nearly 300 young physicians currently pursue their specialties in graduate medical education through residencies and fellowships at the UNLV School of Medicine. The 11 residency programs are in emergency medicine; family medicine; family medicine-rural; general surgery; internal medicine; obstetrics and gynecology; orthopedic surgery; otolaryngology; pediatrics; plastics surgery; and psychiatry. Advanced fellowships are available in acute-care surgery; cardiovascular medicine; colon and rectal surgery; gastroenterology and hepatology; hand and microsurgery; minimally invasive gynecological surgery; pulmonary and critical care medicine; sports medicine; urgent care; and child and adolescent psychiatry. It’s no secret that graduate medical education is demanding. And yet as we learn from general surgery resident Dr. McNicoll, featured in today’s newsletter, it is training that can be highly rewarding, that can help make a dream come true.
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DR. CHRISTOPHER MCNICOLL: GETTING THE MOST OUT OF A RESIDENCY
Christopher NcNicoll MD resident surgery
Dr. Christopher McNicoll, a true believer in research-based medicine.
It’s not uncommon for Dr. Christopher McNicoll, a 35-year-old general surgery resident at the UNLV School of Medicine, to work 80-hour weeks and, up to four times a month, put in 28 hours at a stretch at the school’s teaching hospital, University Medical Center (UMC).

Such is the grueling graduate medical education path to becoming a trained physician in the United States. After pre-med studies and four years of medical school, freshly minted M.D.s spend anywhere from three to seven years (depending on which specialty they choose) training as “residents.” Essentially institutional apprenticeships, medical residences serve the dual purposes of training the profession’s next generation and attending to a hospital’s labor needs.

“I love what I do, making my dream come true,” says McNicoll, who is married with three small children. “But I do look forward to the day when I have more autonomy and receive more compensation for what I do.” According to Medscape’s 2017 Residents Salary and Debt Report, medical residents earn an average of $57,200 annually in the U.S. McNicoll says it is largely because of loans and his wife, Jennifer, who works outside the home as a nurse when when she can, that he is able to follow his dream. “I couldn’t do any of this without Jennifer’s support. I often leave before my wife and kids wake up and come home after they’re asleep.”

McNicoll, seen by UNLV Medicine President/CEO Michael Gardner as a prime example of the high quality residents UNLV now has, chose to make his general surgery residency even more challenging by adding on two years of research to the normal five year program. A peer reviewer for Surgical Innovation, a bi-monthly journal, as well as the Journal of Graduate Medical Education, his research has been recognized in six journals, two book chapters, 18 oral presentations, six completed research grants, 10 poster presentations, four invited presentations, and a video presentation. He also has been a member of more than 20 study teams, as either a co-investigator or sub-investigator, on medical research projects.

“He’s very thorough, inquisitive,” says Dr. Charles St. Hill, an assistant professor in the UNLV School of Medicine’s Department of Surgery. “He’s intent on answering clinical questions with research. He wants to understand the big picture.”

In March, at the annual meeting of the Americas Hepato-Pancreato-Biliary Association in Miami, he presented research, and answered questions, dealing with the effectiveness of killing cancerous cells in pancreatic cancer patients through electrical pulses. Research co-authors included St. Hill, the principal investigator, who was present for the presentation, and UNLV Professor Dr. Daniel Kirgan and UNLV Associate Professor Dr. Jennifer Baynosa.

McNicoll, who completed a visiting resident rotation at the Memorial Sloan-Kettering Cancer Center in New York, recently returned from the nation’s capital in Washington, D.C., where he participated in the American College of Surgeons (ACS) Leadership and Advocacy Summit. A paper he co-authored last year for the ACS was titled, “Surgical leadership is required to reverse the opioid crisis.” Currently vice-chair of the ACS Resident Advocacy and Issues Committee, McNicoll will take over as chairman next year. In June he will become a resident member of the Clark County Medical Society’s Board of Trustees. “I think being involved in these organizations is a great way to influence how our profession changes, learns, and is perceived by the public.”

McNicoll’s dream of becoming a physician began after watching his father, a family practice physician in Simi Valley, CA, practice. “I first became enamored with the idea of being a doctor because of the love for the job he had. I saw that he had the ability to treat the members of our community, and I was impressed by how selfless he was in taking time out of his own life to take care of others. I feel like I grew up around the hospital, because I remember sitting at a nursing station or outside of a patient’s room in the hallway when my dad had to go in and see someone there after church or before a soccer game.”

After volunteering in the emergency room of his local hospital during high school, McNIcoll became an emergency medical technician (EMT) during his freshman year at UCLA, where he completed his pre-med work. Prior to receiving his Doctor of Medicine degree from Michigan State University in 2013, he earned a Master of Public Health degree from Boston University and a Master of Science degree from Tulane University in New Orleans.

As a resident surgeon, his best memories have come from what has happened in the operating room. “Each time I can complete an operation efficiently without needing to seek assistance from the supervising surgeon encourages me that I have made the right career choice... and I fondly remember the patients who are truly appreciative for my care as a resident, who have taken the time to write me a card or give me a gift as an emblem of their gratitude.”

McNicoll says his most challenging moments have come from helping children who are victims of abuse. “It is difficult for me to empathize with people who harm innocent and vulnerable persons in any way, so I cannot comprehend the injustice of a child being severely injured by a negligent or abusive adult. As a parent, it is very easy to see my child’s face in a patient’s…”

While the UNLV School of Medicine’s initial freshman class of 60 students has understandably received most of the attention during its brief existence it is the first public, allopathic medical school in Southern Nevada the nearly 300 young physicians pursuing their specialties in graduate medical education through residences or fellowships at the school will undoubtedly make a more immediate impact on the practice of medicine in both Nevada and the U.S.

State officials are counting on many of the trained physicians staying in Nevada, which ranks 48th in the nation per capita for physicians across all specialties and 50th for primary care physicians. McNicholl says he would enjoy working at the UNLV School of Medicine, but he needs to first finish a Complex General Surgical Oncology Fellowship out of state.

“After I finish my residency in two years, then I’ll have the two year fellowship, which Nevada doesn’t offer at present. I know I want to be involved with academic medicine, and that’s what UNLV is doing so well. I have the greatest respect for faculty here. We’ll just have to see if there are any openings.”

MEDICINE BY THE NUMBERS - 122,004
According to a 2017 report by the Association of American Medical College, there are 122,004 residents active in accredited specialities and subspecialties.

Source: Association of American Medical Colleges (AAMC) | https://www.aamc.org/data/484718/report-on-residents-2017-b3table.html
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