Pediatric surgery isn't for the faint of heart. Along with a variety of operations needed by patients as small as infants, there are anxious parents to engage and overlapping tasks to juggle. According to Daniel DeUgarte, MD, a pediatric surgeon at UCLA, these challenges are what make his job so rewarding.
The path to pediatric surgery
A physician's son, Dr. DeUgarte wanted to be a doctor since childhood. And as a student in the David Geffen School of Medicine at UCLA, he considered many different specialties. He finally found his passion during his general surgery residency.
"I had a couple great mentors who were pediatric general surgeons, and the breadth of their practice was amazing," says Dr. DeUgarte. "We were operating on the chest and abdomen, and doing really cutting-edge, minimally invasive surgeries."
This variety appealed to Dr. DeUgarte; while many general surgeons primarily perform appendectomies and other basic surgeries, pediatric general surgeons operate on most of the body. "At a big academic center like UCLA, we have some pediatric specialists — urologists and ENTs who deal with particularly complex issues. And [although] we don't do much neurosurgery or cardiac surgery, we do handle thoracic, plastic and gastrointestinal surgeries."
Far from home
Being a pediatric surgeon at UCLA is never dull, Dr. DeUgarte's career often takes him far from home. As co-director of UCLA's Global Health Education Program, Dr. DeUgarte helps set up research projects and clinical electives for students at multiple sites around the world. "This gives students global experiences that are well-mentored, thoughtful and educational," he explains. "They develop a more mature perspective by being exposed to different healthcare systems and ways of practicing medicine."
Dr. DeUgarte also spearheads surgical exchanges and training programs in underdeveloped areas. "The program I've been most involved with is in Mozambique," he says. "When I started, there was only one native pediatric surgeon for the whole country. Now there are two, and we're helping to train more."
Back to basics
Like most top surgeons, Dr. DeUgarte has become well-versed in several technological innovations. He learned to perform robotic surgery almost a decade ago, as it was first becoming popular, and has mastered many other minimally invasive procedures.
Yet, time and experience have changed his philosophy on medical breakthroughs. He says, "After traveling abroad and gaining perspective from my global-health experiences, I have come to believe that some of the greatest innovations are not technology-based, but have to do with alternative, less expensive and perhaps even nonoperative approaches to care."
For example, Dr. DeUgarte helped to implement UCLA's innovative treatment program for the nonoperative management of appendicitis. "The first phase of my career was figuring out ways to decrease scarring and pain from an operation," he explains. "Now we've gotten to the point where the ultimate approach is not even doing an operation. These are the innovations of the future."
Pediatric surgery: what it takes
Pediatric surgery is a highly competitive field, requiring years of practice before one can feel comfortable operating on babies and young children. Just as important, the Los Angeles resident says it requires strong communication skills and passion for helping kids.
"Much of what we do as pediatric surgeons is communicating with pediatricians, kids, teenagers and parents," says Dr. DeUgarte. "Parents can be very anxious, so it's not for everyone. You have to be sympathetic and know how to appropriately manage expectations so people are prepared for good and bad outcomes."
Despite the challenges, Dr. DeUgarte simply loves working with children: "It's nice to care for a young, relatively healthy population."
By Taylor Mallory Holland