Decoding the Mind Behind the Scalpel: An Academic Surgeon’s Journey to Choosing Surgery

As an enthusiastic yet fatigued General Surgery resident, Dr. Abhisek Parmar began his morning in the pitch dark of yet another seemingly identical day on his path to becoming a fully trained surgeon. The early mornings held a certain tranquil when the city was at rest. The elusive “4 am” that coveted athletes and high achievers devoted their morning awakening to, was now nothing more than the norm in this world. Brothers and sisters were brought together in the early rise of dawn, ready to take you under their wings, tease you, or cradle you, only to push you to the farthest of limits. Adapting to his new work family, city, and a new way of life as a surgery resident, Dr. Parmar had his morning fully rehearsed: sign out, pre-rounds, wound dressings, morning rounds, discharges, progress notes, and finally, into the operating room!

Today, the rhythm came to a screeching halt as he discovered he was made the lead surgeon on a laparoscopic cholecystectomy. He recalled the experience was just as exciting as much as it was a struggle. Autonomy in the operating room is every surgical trainee’s dream. Nothing is more encouraging than coming to know that your mentor has recognized your readiness to play the role of a skilled lead surgeon. However, dreams often seem simpler than their reality. We spend day in and day out assisting our mentors, pushing ourselves to keep up to their speed with anatomic planes and structures as a constant internal sports commentary. It’s only natural to feel that we would be just as fast when handed the steering wheel, overlooking their multiple years of training and repetition, of course. Dr. Parmar remained resolute through the challenging case. With the patient’s gallbladder being significantly inflamed, progress was difficult. This ultimately led to the decision to convert the minimally invasive surgery to an open one – a crossroad he had encountered for the first time. A few hours in, he stretched out his aching shoulders and looked up, only to see his chief resident, Dr. Alexis Driggs, battling a runny nose. At this point, her mask was soaked in snot as she struggled to take a fulfilling breath. He soon learned that she came in to work that day with a severe flu, yet did not complain once nor take the case away from him to finish swiftly with her experienced hands. Dr. Driggs was remarkably patient and set a powerful example for Dr. Parmar that day, embodying the qualities of a devoted educator.

A little short of three decades prior, Dr. Parmar was born in the city of Gadsden, Alabama. His parents had then recently immigrated to the United States from India. He grew up as an ABCD “American-Born Confused Desi,” having lived, studied, and understood Indian culture without quite exactly living in India. At the age of 10, he observed a friendly surgeon from his hometown, Dr. Mac Bridges as he performed a laparoscopic cholecystectomy. 

He stood stunned when he first saw the gallbladder, wondering how such a peculiar looking, oblong-shaped bean could come out of a person. That’s the thing about surgery. When you find yourself in the operating room for the first time, discovering an unseen dimension to the human body, it can either leave you in complete horror, uncontainable curiosity, or both!

One sultry afternoon, during a middle school science class, Dr. Parmar captivated his teachers as he dissected his way into a squid. They cheered him on, idealizing his future potential to become a surgeon. In tandem with his tangible growing interest in surgery, he had a passion for playing video games, never imagining that it would foreshadow his future career in minimally invasive surgery.

He moved to Georgia for college and back to his home state, Alabama, to pursue medical school at the University of Alabama, Birmingham. On entering medical school, he knew his one and only way out would be specialty training in the field of General Surgery. To his complete surprise, he fell in love with his first clinical rotation, Obstetrics and Gynaecology. As he delved deeper into the honorable space of women’s health, he came face to face with a newfound passion for addressing all facets of their care. His excitement made him consider shifting his career to Ob/Gyn. However, once he rotated in general surgery, he was able to reaffirm that it was the best suited field for him. He was previously mistaken, as many other medical students are, in believing that surgery would be all technical, -involving very little medical decision-making. He was deeply moved by the mentors he encountered during his surgery rotation, considering them to be among the most capable physicians in the hospital, and saw them as a great source of inspiration. Throughout medical school, he persevered with a strong work ethic, even during times when he didn’t feel like he was excelling as a student. In retrospect, he reflects, saying that “being a workhorse is the most important characteristic of a successful surgeon.”

As match day approached for his medical school class, Dr. Parmar felt as though he was on the brink of achieving his lifelong dream of becoming a surgeon. However, when the day finally arrived, it turned out to be a devastating experience for him. Unfortunately, he was unsuccessful in securing a residency training position that year. With his lifelong dream of training in this field slipping away, he couldn’t hold back his tears – it was the first time he had cried as an adult, feeling that his world had fallen apart. With the passage of time, he gradually grew confident and appreciative of the efforts he had invested and the accomplishments he had attained along the way. He painstakingly taught himself resilience through this time and learned to accept the situation to move forward. He refused to let go of his lifelong dream and pursued a preliminary residency position in General Surgery, demonstrating strong commitment towards achieving his goals. Soon after, he successfully matched at the prestigious University of California San Francisco – East Bay Department of General Surgery. He went on to contribute to research in the areas of health services and identification of treatment inequities and deviations from the standard of care with a focus on gallbladder disease. Additionally, during his research position at the University of Texas Medical Branch, Galveston, he developed a prognostic nomogram to be a resource of direction for surgeons treating older patients with biliary disease[1].

In recognition of his pioneering contributions, he was presented with the Charles F. Otis Endowed Award for Clinical Research (2013) and the Julia Burke Outstanding Research Resident Award (2014). During his surgical residency, Dr. Parmar was deeply inspired by the trust patients placed in him and was grateful to be able to impact lives so profoundly. He had to make extensive sacrifices during his journey, including missing out on some of life’s most precious moments, such as attending the weddings of his closest friends and spending time with his loved ones during the prime years of his life. Despite the challenges, his unyielding passion for his work kept him going, and looking back, he doesn’t regret a single moment of it.

Dr. Parmar reflects on his surgical residency, fondly reminiscing about the time he performed a challenging cholecystectomy as a junior resident. He credits the unwavering dedication of his chief resident, Dr. Alexis Driggs, for making it one of the happiest memories of his career. Her commitment left a lasting impression on him. In fact, he now finds his greatest fulfillment through teaching, a passion he has fostered since his days in residency. Teaching reminds him to not only stay current with modern surgical techniques and knowledge but also greatly invigorates him. He says, “Performing surgery is undoubtedly thrilling, but as one gains expertise, it becomes more of a profession than an excitement. For me, true joy comes from witnessing my trainees grow over time. It fills my cup to see them “get it” and develop their skills.” Over the years, he developed great insight into recognizing good performance in the operating room. He says, “Just like how some residents “get it,” see tissue planes and understand how to dissect, I think that I have the same ability to pick apart a trainee’s technical skill.” He hopes to inspire his students to follow in his footsteps toward a career in academic surgery and surgical education.

Dr. Parmar completed advanced training in Minimally Invasive Surgery at the Oregon Health and Science University Department of Surgery and soon after joined the esteemed University of Alabama Birmingham Department of Surgery as a faculty member. He has been a practicing surgeon for six years and has a special interest in complex hernia management. 

While revisiting his interest in Ob/Gyn during medical school, he recalls, he once believed the field would have been the ultimate opportunity to have a positive impact on the lives of women. However, he soon discovered that hernia disease is very much a women’s health problem. Those early days were when the seeds of his passion for women’s health were first planted and he is now driven to tackle many of the unanswered questions for hernias in women. The path to our dreams is seldom a linear one, often fraught with twists and turns. However, it’s always the unexpected detours that ultimately add meaning and purpose to our lives. 

Dr. Parmar currently serves as the co-chair of the American Hernia Society Resident and Fellow Training (RAFT) Committee, compounding on his passion for educating future surgeons across the country and is very active in the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), additionally serving as a member of the SAGES RAFT Committee. He looks back at his surgical training and remembers it as the most rewarding life experience he could ask for. Therefore, he is excited to nurture many future generations of surgeons. Interestingly, his love for surgical education extends beyond just his focus on surgical trainees. He advises all children to keep playing video games to enhance their potential performance in the operating room [2] because, who knows, the next big breakthrough in surgery could come from a kid who spent all their childhood mastering Call Of Duty!

[1] Parmar, Abhishek & Sheffield, Kristin & Adhikari, Deepak & Davee, Robert & Vargas, Gabriela & Tamirisa, Nina & Kuo, Yong-Fang & Goodwin, James & Riall, Taylor. (2014). PREOP-Gallstones: A Prognostic Nomogram for the Management of Symptomatic Cholelithiasis in Older Patients. Annals of surgery. 261. 10.1097/SLA.0000000000000868.

[2] Lynch J, Aughwane P, Hammond TM. Video games and surgical ability: a literature review. J Surg Educ. 2010 May-Jun;67(3):184-9. doi: 10.1016/j.jsurg.2010.02.010. PMID: 20630431.