How two fellowship alumni tackle tough surgeries together

Dr. Wilson Ventura Chan and Dr. Darl Edwards were both preparing to begin our Department’s fellowship in minimally invasive gynaecologic surgery when they met for the first time. It was July 2019, and they had been invited by their supervisor, Dr. Nucelio Lemos, to spend a warm summer afternoon on his boat getting to know their new co-fellows over cold drinks and barbecued picanha.

Sometime in that afternoon of Brazilian beef, boating, and bonding, Chan and Edwards began to stitch together the beginnings of a friendship that has not only endured, but grown into a unique professional partnership.

Four years later, the two surgeons — Chan with the William Osler Health System, and Edwards at the Scarborough Health Network, General campus — spend two days every month assisting each other in surgery. They tend to save their most difficult cases for those days, knowing they can lean on each other during key moments.

“On those days, we have each other not just as assists, which is a very technical role, but as expert consultants as well,” Chan said.

“It’s a very beneficial thing both for the surgery and the patient.”

We caught up with Chan and Edwards to learn more about their approach and how the two surgeons work together so seamlessly.

You met just prior to your fellowship. Do you recall how your working relationship eventually developed?

EDWARDS: In fellowship, you’re often really busy and with individual preceptors, so we didn’t get to operate together much — except on call, at nighttime. We usually backed each other up if we were on call as surgeon of the night. If one of us had a case, the other would come in and help.

So we got used to working with each other early on. A lot of our relationship was established during those on-call hours, as well as at social events afterwards, when we were basically trying to stay human and unwind.

But I’d say our working relationship has really flourished ever since we decided — almost from the beginning, really — to give each other one day a month to help each other in surgery. We’ve done really well with keeping that up through the first couple years post-fellowship.

How does that work?

EDWARDS: We each have our own OR schedule and our own staff and clinics. But we have privileges at each other’s hospitals. So Wilson and I discuss our OR schedules and plan it out in advance so we can do two days a month in the OR together, one at each site.

We usually save our hardest cases for each other. The nurses have picked up on that now — they’re prepared to stay a little late on those days that we’re both there.

Why do you think you work so well together?

CHAN: Through fellowship, we both got a similar foundation of basic training. Even though everyone in fellowship develops different styles of operating, when you’ve been trained in a similar way, many times when we’re operating next to each other we don’t even need to say anything — we just know what to do next.

Interpersonally as well, we get along well. We hang out outside of the OR. It’s a good working relationship.

I think we can do really hard cases fluidly both because we’ve been trained so similarly and because we complement each other so well in that way, but also because we do know each other and get along well.

What do you think are some of the benefits of the approach?

EDWARDS: When it’s your OR day, you have a different level of stress and a different level of responsibility. Sometimes it’s good to have an outside perspective from someone who is a little bit more relaxed that day.

If I’m the operator and I’m concerned about something, Wilson can show me a different angle. We have our moments in the OR where we’re both stressed trying to figure out a tough case, but at the end of the day, it feels good to know that we have each other’s back. And we definitely do get through some very hard cases that very few people would be able to do laparoscopically.

It also allows us to grow and develop our skills — almost as if we were still in fellowship.

What happens when you disagree about next steps?

CHAN: Ultimately, there’s a sense of trust. Obviously if someone’s the MRP (most responsible physician) and it’s your primary patient, that person makes a call. But we have a long history of trust and respect for each other’s styles. When someone can present an opinion you hadn’t thought of, I think that’s very helpful.

EDWARDS: There are a lot of times we will sway each other based on something we are seeing that day. The fact that we do trust each other and can be open to that and make a decision without being at odds is really important.

We do complement each other really well. We know when someone needs a push and when someone needs to be given a minute. We’ve never really gotten into a big disagreement. We work well together that way.

You mentioned you hang out outside of the OR. What do you like to do together?

CHAN (laughs): A lot of it is barbecue and beer.