Microsurgery training at MITIE

An interview with MITIE’s Dr. Brian Dunkin

This is the third, and final, part of our three-part series on MITIE, the Houston Methodist Institute for Technology, Innovation and Education. To recap, MITIE is one of the largest and most comprehensive surgical education and research facilities in the world. Our first blog was a photo tour of MITIE. In our last blog, we talked about how MITIE provides physicians with a comprehensive training facility to learn new surgical techniques.

To finish our time together, I sat down with Dr. Brian Dunkin, the medical director of MITIE, to ask him why MITIE and the work done there is so important. When Dr. Dunkin isn’t at MITIE, he is an endoscopic surgeon, which means he performs surgery through small incisions or natural body openings to make surgery safer and recovery faster.

Me: Why is MITIE so important and why are you so passionate about MITIE that you’d move your family and practice to Texas to build it?

Dr. Dunkin: Passion is the right word to describe MITIE for me. In medicine, we have a pressing need to support the ongoing training of practicing health care professionals. With how quickly things are changing and constant advancements in technology, it’s become a real crisis. You could be in practice after your training for a relatively short period of time and you’re not up to date anymore and you have nowhere to go.

Dr. Brian Dunkin headshot
Dr. Brian Dunkin is MITIE’s medical director and an endoscopic surgeon.

I’ve developed training programs at several institutions, but nowhere did I see the opportunity to develop an educational facility of the scope and scale available at Houston Methodist. That’s what convinced me to move to Texas and become a part of this. I don’t think anyone else on the planet, and certainly in the U.S., could have done what we did with MITIE. No one else had the resources, the space, the commitment from hospital leadership, the people – it took a lot of things coming together for MITIE to be what it is. For example, I recently had the opportunity to give my mentor, a worldwide leader in surgical education, a tour of MITIE, and he was completely blown away by the facility, the scope of programs available, and the timeline in which we accomplished this. Even with our initial success, we still have a lot of things we want to do in MITIE, so we aren’t done yet.

Also, some practicing surgeons don’t understand the importance of or the value of educating other clinicians. I’ve been taught that you teach others what you know. I’ve found that in the process of educating others, you learn, too.

Me: You have a lot of ongoing projects, but what are some of the bigger projects you are working on right now?

Dr. Dunkin: The educational project I’m most excited right now is the MITIE Lapco program, which teaches laparoscopic colon surgery. Learners spend four days in MITIE doing hands-on training with experts from around the world. In most courses, that’s where the learning stops, leaving an educational hole where the surgeon goes back to his or her home institution and is alone in the operating room when trying to start doing this new procedure. I’ve always thought technology was the way to fill this gap.

We added telementoring, or the practice of using a videoconferencing system in the operating room to allow an expert surgeon to virtually mentor another surgeon, to the MITIE Lapco program. Learners have an expert with them virtually for their first 10 cases at their home hospitals. We believe that telementoring will help the learning surgeons perform better, safer surgeries and will help increase the U.S. adoption rate of laparoscopic colon surgery.

Microsurgery training at MITIE
Microsurgery is commonly used to reattach severed nerves and blood vessels. Microscopes are needed for these procedures to ensure that the cells in the nerve ending or blood vessel are lined up properly.

Telementoring is doable and every bit as powerful as in-person mentoring. I have hospital CEOs asking for us to offer telementoring for more courses because they’ve seen the outcomes. They know their surgeons will be able to do these advanced procedures safely and effectively and will have happier patients. I think five years from now, we’ll look back on this conversation and laugh because telementoring will be so common.

Me: What’s your favorite MITIE class or research project so far?

Dr. Dunkin: I think the clear favorite is MITIE Lapco. It wasn’t just the course we put on for the learners, but it was the thoughtfulness, time and effort we put in to designing the program from developing the curriculum and organizing telementoring opportunities after the course. And the feedback we got from learners during the course was unlike anything we’d heard before. Almost everyone in our first MITIE Lapco course had been to a previous course on laparoscopic colon surgery at another institution, and they were just blown away with the difference in their confidence level in performing this surgery at the end of our course compared to the others.

Me: What are some upcoming MITIE classes or research projects that you’re most excited about?

Dr. Dunkin: I’m most excited about the next stage of growth for MITIE because we’re right at the threshold of it.

The first stage was designing and building a physical structure. The next stage was building an infrastructure that could support volume and a variety of programs. In the seven years that we’ve been open we’ve had more than 28,000 learners here.

Now, we are at the point where I want to create more programs like MITIE Lapco that address the full spectrum of surgical education. I can’t tell you how many people have told me that no other place is doing what MITIE is doing. What’s really great is that where we want to go with MITIE fits with Houston Methodist’s goal of leading medicine rather than just practicing it. There are a lot of great courses and research projects in MITIE’s future, but it’s the whole MITIE package that I’m most excited about.

The more I see MITIE evolve, the more confident I am that we are going to change the medical world by creating better educational tools and providing them to colleagues from around the world.

Hannah Pietsch

Hannah Pietsch

Media relations coordinator at Houston Methodist
Hannah Farr Pietsch is originally from Stamping Ground, Kentucky. She now lives in Katy with her husband, Don. She is an avid University of Kentucky Wildcats and Houston Texans fan who is on a quest to find the best Vietnamese food in Houston.
Hannah Pietsch

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Hannah Pietsch

Hannah Farr Pietsch is originally from Stamping Ground, Kentucky. She now lives in Katy with her husband, Don. She is an avid University of Kentucky Wildcats and Houston Texans fan who is on a quest to find the best Vietnamese food in Houston.