Reflections: A Discussion with Steven Stylianos, MD

We spoke with Steven Stylianos, MD, Chief of the Division of Pediatric Surgery and Surgeon-in-Chief, Morgan Stanley Children's Hospital/NewYork-Presbyterian (MSCH), about his tenure as chief as he prepares to step down from the role.

How long have you been part of the Columbia community?

I was here for the start of my career. I first set foot here in 1983 as an intern, did my general surgery training, and then left for four years for fellowship. Then, I came back as faculty and stayed for 13 years. I left again for a sabbatical; I took eight years to go out and learn how to be a chief. And then fate brought me back here to be the chief. And so, sitting in my predecessor's chair, Dr. Peter Altman, is like sitting in my hero's office.

You've established quite a career here as a leader and surgeon in a challenging field. What draws someone to pediatric surgery?

I believe it's a visceral force that brings clinicians to a children's hospital. There's a draw to take care of sick kids that's very powerful. And I think that's reflected in the faculty. Surgical, medical, radiology... all the people that work in a children's hospital feel it's their calling. It certainly was a guiding force in my career. And here, 30 some odd years later, I don't regret a day of it. I still get excited coming to work to help a baby who's in trouble.

Of course, there are unique aspects. The emotional toll on a family is just enormous. You have to be a good shepherd; you need to take care of them as well as the baby. So there are some challenges, but the rewards are absolutely phenomenal. The low points are as low as you can get, but there are a lot more high points than low ones. I think we just really appreciate the privilege and the responsibility of caring for people's babies. It's just very special.

You've overseen the development of key clinical programs that represent the division in an amazing way. Programs like the Pediatric Trauma Center and the ECMO Center are nationally and internationally renowned and accredited with the highest honors. How does it feel to know that growth happened on your watch?

I think that validation of excellence is important in medicine these days. There are all kinds of external influences and expectations. I suppose the US News and World Report is one of the biggest, but it's also the least impactful to the clinicians themselves. Getting verification from the governing body of experts in the field is something that we take very seriously. And the enormous preparation and sustained excellence required to attain that verification means you're at the top of your game. In so many areas, we have been repeatedly validated as being the best there is. That's something we take great pride in.

The division continues to attract the very best residents for your training programs. How do you sustain that?

It's a matter of building on our history of success. We have one of the original fellowship training programs in pediatric surgery. And every year, we interview and select from among the best residents in the country. We have them here with us for two years, acting almost as their finishing school; they've already trained in general surgery, they're already board-certified in general surgery, but they want to be pediatric surgeons. We have the luxury of picking from the best. Between the two pediatric surgical fellows and our two ECMO fellows, we have a rich stable of trainees to guide and teach and then set on their way to successful careers. And their success helps sustain ours. I'm confident that will continue.

You helped establish a peer support program to help with physician well-being. How did that come about?

Attention to well-being isn't historically part of the culture of surgical departments; we're supposed to be superheroes, tough as nails. When bad things happen, we're supposed to be able to shake it off and just go to work the next day and operate on other people. I think that over time, physician wellness and, in particular, peer support have been shown to be very important pieces for creating an environment where these physicians can be at the top of their game. I'm on a national committee for pediatric surgeons, where we implemented a peer support program. So I certainly thought we should have it here, too.

So, a few years back, I asked Dr. Craig Smith for his thoughts about establishing a program to provide that support, and he was incredibly supportive. I also asked him if we could get in touch with the chairs of four other departments here at Columbia: orthopedics, urology, neurosurgery, and ENT. All of those chairs were enthusiastic about participating.

So we gathered about 20 faculty and chief residents from those departments to be trained by Joe Shapiro, a surgeon at Massachusetts General Hospital and a national authority on peer support. This group was able to bring that language, that philosophy, to our departments and inject it into the culture.

There was no big splash ceremony or flag waving; it was just an effort to bring that information and try to incorporate it into our day-to-day conversations. And it seems to have made a real difference.

You mentioned innovation. What are some areas where the division faculty are pushing boundaries?

Our division is involved in so many national collaboratives to bring forth powerful research through our clinical studies. So many of our faculty are improving upon what we do. For example, Dr. Vincent Duran has started and grown the fetal surgical program over the last few years. It's highly successful and is now poised to expand in new areas. One of our colleagues, Dr. Erica Fallon, is deep into molecular research for children's tumors. It's a motivated group that is looking to move their field forward. I'm excited to see what comes next.

Can you share what your new position will be?

I wear many hats here at Columbia and NYP, and I will have a similar portfolio at my new home. I'm going to be professor and division chief at the Rutgers Medical School in New Brunswick. And similar to my role here at Morgan Stanley Children's Hospital, I will be surgeon-in-chief of the Bristol-Myer's Squibb Children's Hospital, which is part of RWJBarnabas Health. In addition to those roles, I will be the system director of pediatric surgery for the RWJBarnabas Health System.

Congratulations! You're originally from New Jersey, right?

Yes, it's very exciting. Back to my home state, back to where I went to college, it's come full circle. I'm glad to be able to offer my leadership services to them. And my wife and I are also going to finally turn our weekend beach house into our everyday home.

You leave some big shoes to fill. Do you have any advice for the person who takes over for you as chief?

There's such a wealth of talent and expertise in every hallway of MSCH, in all of Columbia. So I say this: collaborate, collaborate, collaborate. We have the sickest children here who need our help. We have the best trainees who need our guidance. In every area, I think doing it together is the key. Work with our colleagues in a spirited manner, that wealth of talent and passion is something that they should take advantage of.

Now that you're moving on, how would you describe your tenure at Columbia?

I think the division has a rich history of cutting-edge innovation while maintaining a family feel for our faculty, trainees, and support staff. I felt that was probably one of my highest callings and responsibilities: to be sure that I nurtured and maintained that standard over my 11 and a half years as chief.

I really was raised in this institution. I was nurtured here, given opportunities to succeed here by incredible mentors. I point out Dr. Altman at the top of the list, but the list is long. I'm incredibly grateful for those opportunities and hope I made them proud.