The SUS is Pleased to Honor the 2024 SUS Lifetime Achievement Award Winner: Ronald J. Weigel, MD, PhD, MBA

About the Lifetime Achievement Award

The Society of University Surgeons (SUS) has awarded the 2024 SUS Lifetime Achievement Award to Ronald J. Weigel, MD, PhD, MBA, EA Crowell Professor and Chair, Department of Surgery, University of Iowa and Medical Director, Cancer Programs, American College of Surgeons. Dr. Weigel will be presented with the Lifetime Achievement Award on Tuesday, February 11, 2025, at the 20^th Annual Academic Surgical Congress (ASC) in Las Vegas, Nevada.

The Society of University Surgeons initiated the Lifetime Achievement Award (LTAA) in 2005. This award was designed to recognize individuals who have had a sustained career in academic surgery with contributions to surgical science. In addition, these individuals have demonstrated a commitment to the Society of University Surgeons, whereby they have participated in the Society even after superannuating to Senior Membership status. Their participation in the Society is evidenced by the attendance of the meetings yearly and active participation in discussion of papers, attendance of the banquets, society functions, and mentoring the next generation of leaders in the society.

The Society of University Surgeons seeks to honor and recognize these individuals because of their embodiment of the principles of the Society. We seek to recognize these individuals to establish role models for younger generations of surgeons to honor and emulate their contributions to the science of surgery, and moreover to the Society of University Surgeons.

Dr. Ronald Weigel was nominated and selected based on his exceptional leadership, contributions to academic surgery, and strong support of the SUS and the ASC. The SUS greatly appreciated his years of service to the SUS and SUS Foundation, including his tenure on the SUS Publications Committee and the SUS Foundation Executive Committee. Dr. Weigel’s impressive accomplishments have included prolific impactful research focused on determining the mechanisms of hormone response in breast cancer, identifying transcriptional mechanisms regulating patterns of gene expression in breast and colon cancer, 11 years of continuous NIH T32 Funding and a CDMRP grant entitled “SUMO Inhibition Represses Mammary Oncogenesis Through Etv1.” Notable among his scientific contributions is that his laboratory has identified the TFAP2C transcription factor as a key regulator of genes expressed in the luminal breast cancer phenotype, and election in 2018 into the National Academy of Medicine. Additionally, Dr. Weigel has trained surgical residents, fellows, postdoctoral fellows, graduate, and undergraduate students, many of whom have gone on to hold academic positions and are rising leaders in the field. As a passionate educator, he has also served as Chair of the American College of Surgeons (ACS) Board of Governors, been appointed ACS Cancer Programs Medical Director, served as 2014-2015 President of the Society of Surgical Oncology, 2022-2023 President of Central Surgical Association, and 2024-2025 President of the American Surgical Association. The SUS is honored to recognize Dr. Weigel’s immense contributions to the field of academic surgery with the Lifetime Achievement Award.

Helping People in a Really Positive Way

Dr. Ronald Weigel was born in Port Chester, New York. His father received a job transfer when he was in eighth grade and they subsequently moved to Gastonia, North Carolina where Dr. Weigel attended junior high and high school. One of his grandfathers was a coal miner and his other grandfather was a gardener. His parents worked but did not have the opportunity to go to college. He was the first person in his family to go to college, along with his brother. Dr. Weigel joked that he was lucky to get into MIT since that is the only school to which he had applied. He graduated from MIT after 4 years with both a Bachelor’s and a Master’s degree. MIT ended up covering his tuition because he was a graduate student, which was immensely helpful because he came from a self-described big, blue-collar family.

Dr. Weigel was always interested in medicine, even as a little kid. He found medical issues interesting and would ask questions about how vaccines worked and how they prevented someone from getting sick. He recalled, “seeing a Western, where someone is shot, I would ask why would they die from that? You can fix that, you can operate on them. You can do all these things that help people in a really positive way, and I was always interested in that.” While knowing medicine was his ultimate goal at MIT, he decided that he did not want to be a pre-med because he wanted to utilize the time to learn something else. He explained that he was completely engaged in science, math, engineering, physics, and chemistry. Dr. Weigel stated “there was a lot more I wanted to learn about in quantum mechanics, higher level mathematics, chaos theory, manifolds and other things I didn’t have time for.” When he was a sophomore, he applied for graduate school at MIT and was admitted. As a senior, he was in the graduate program in Chemical Engineering and did his Master’s in Chemical Engineering. While busy studying chemical engineering, he had not taken any biology courses as they were not “hard sciences” courses. In his senior year, he ultimately did have to take a basic biology course as a pre-requisite for applying to medical school and thus officially began his medical career.

Yale was where Dr. Weigel received both his MD and PhD. In medical school, he deduced that he would be spending his whole life learning about clinical medicine, therefore he wanted to get his PhD in molecular biology. Dr. Weigel explained that he wanted to understand basic science and that is how his career evolved. He then trained at Duke University, was a tenured faculty member at Stanford, and then was in Philadelphia for a few years at Thomas Jefferson and where he did his MBA at Wharton. Finally, he was recruited to the University of Iowa in 2005.

I Was Interested in Gene Regulation

As was stated previously, Dr. Weigel’s contributions to science were noted as prolific, impactful research focused on determining the mechanisms of hormone response in breast cancer, identifying transcriptional mechanisms regulating patterns of gene expression in breast and colon cancers, including identifying the TFAP2C transcription factor as a key regulator of genes expressed in the luminal breast cancer phenotype. The question was where this interest started. In medical school, Dr. Weigel was impressed by the surgeons and their surgical abilities. “The bottom line,” he said, “is that surgery was just so cool.” He described surgeons taking people to the OR, doing a huge operation on them, and the next day they were fine. On the surgery service, he noted that surgeons managed their patients medically and operated on them, they took care of people in the ICU and saw them in clinic. A surgeon’s experience in medicine was broad and covered every aspect of clinical care. Dr. Weigel stated, “I could not imagine seeing a patient of mine going off to surgery and having no idea what they did in the surgery. I wanted to avoid black boxes, I want to know what is inside, how does it work, and to be able to function across the board. A general surgeon is somebody who does whatever has to be done, whatever is required, it doesn’t matter what it is. You’re competent to take care of everything.”

As a surgical resident, he knew that he wanted to run a lab and do research. Dr. Weigel was interested in cancer research, which was related to his PhD studying the Epstein Barr virus. The Epstein Barr virus is a DNA herpes virus with oncogenic properties. As a junior resident, he loved being in the ICU, taking care of complex surgical issues, and doing big operations in the operating room. He also realized that he could not do liver transplants, resections and Whipple procedures, take care of patients with pancreatic cancer, have a service of patients in the ICU, and run a molecular biology lab. Dr. Weigel explained that he picked endocrine surgery because he could do the operations and the patients would be healthy and could go home the same day, and then he could spend the rest of the time doing research. When he went to Stanford, he realized that there were funding opportunities in breast cancer and the DoD had just come out with new breast cancer grants. Dr. Weigel stated, “The breast is a hormone responsive organ, and there is a really interesting association in gene regulation between the expression of estrogen receptor and the outcome in breast cancer. I was interested in gene regulation and how genes get turned off and on. No one understands why some breast cancers make estrogen receptors, and some don’t. I focused on transcriptional regulation and figured out it was transcriptional control and got into mechanisms of gene regulation in breast cancer.”

Study an Interesting Problem, Take it to the Next Level

Dr. Weigel was asked to describe his surgical mentors and how they impacted his career path and surgical practice/research interests. One mentor that Dr. Weigel had previously written about in his Central Surgical Association Presidential Address was Professor Edward Merrill, who provided mentorship to Dr. Weigel while at MIT doing his Master’s in Chemical Engineering. Dr. Weigel had taken a number of polymer science courses with Professor Merrill and worked in his lab. Professor Merrill was described as a very kind, energetic, and encouraging mentor that influenced the way that Dr. Weigel would eventually develop his own mentorship style. When Dr. Weigel was at Yale, he did his PhD in Dr. George Miller’s lab. Dr. Miller studied Epstein Barr virus and one of his big discoveries right before Dr. Weigel joined his lab was that Epstein Barr virus can cause lymphoma in New World monkeys. They went on to study mechanisms of gene regulation. Dr. Miller also instilled in him the way he did research, which was to study an interesting problem and then based on the findings, take it to the next level. This is opposed to migrating to the next hot topic that the editors at Cell, Science or Nature might be interested in. Dr. Weigel said “that is how I developed my career, I haven’t jumped from one thing to the other. We still study mechanisms of gene regulation and cancer. The way that it has evolved has always been based on our scientific findings. We read the literature and we’re influenced by that and bring in new techniques, but we don’t suddenly work on another field because it’s hot.” Dr. Miller became a great friend and a mentor for Dr. Weigel his entire career.

Dr. David Sabiston was the Chair of Surgery at Duke University for the entire time that Dr. Weigel was there and had a strong influence on his career. One of the things that Dr. Sabiston did was he had morning report with the chief resident. The chief resident would tell him about the OR, what was happening on the service, and if there were any problems. Dr. Weigel said, “I adopted this when I became Chair and to this day, I meet with the Senior or Chief residents and do exactly the same thing and go through all of the admissions overnight, the emergent cases, what’s happening in the OR, any issues with the residents, work hours violations, anyone sick with COVID, whatever the key issues are. I get a report at 6:45AM and I have done that for the last 20 years as Chair, every single day. I want to hear from the residents, and I think it helps the residents too because it helps them learn how to run a service.” Dr. Weigel explained that he has tried to blend what he learned under Dr. Sabiston with his other mentors, which is to add to that intensity and expectations of the residents a heavy dose of kindness. He does not believe that he has yelled at a resident or been angry with a resident or a medical student. Dr. Weigel’s philosophy is to try his best to be encouraging and to recognize that with that kindness and love, they will flourish to be the best surgeon that they could be.

Dr. Weigel spent a year in Dr. Joe Nevins’ lab at Duke and he also was an influential mentor in terms of trying to expand what is understood about gene regulation into translationally valuable findings. Dr. Weigel appreciated the support that Dr. Nevins provided, by reading grants and making helpful comments through his years at Stanford. Clinically at Duke, Dr. Weigel did the majority of his endocrine training with Dr. George Leight, who he viewed as an outstanding, fantastic endocrine surgeon. Dr. Weigel learned a tremendous amount about endocrine surgery from his leadership, as well as his calm demeanor in the OR. Dr. Dirk Iglehart, who was at Duke and moved to the Dana-Farber Cancer Institute, was also a mentor. Dr. Weigel was influenced by him in that he was a busy breast surgeon, did other general surgery cases, and ran a busy molecular biology lab studying breast cancer. He had a great sense of humor and Dr. Weigel stated “if you’re going to be a surgeon-scientist, you have to have a great sense of humor because you will be beaten down continuously.” Dr. Iglehart had a strong influence on Dr. Weigel’s career, and he was a very positive influence as a surgeon and scientist.

I am Dealing with the Same Challenges

Dr. Weigel was lauded for training more than thirty surgical residents and research fellows under the T32 funding at the University of Iowa Surgical Oncology Research Training Program, along with many postdoctoral fellows, graduate and undergraduate students that trained in his laboratory. In terms of his philosophy on training, mentorship, and sponsorship for both trainees and attending faculty, the one way that Dr. Weigel felt he provides mentorship is by leading by example. He stated, “that is why I still publish papers and still write grants. No matter how busy you are, you find the time to write another grant, and I recognize how difficult it is and how much effort goes into it. It also allows me to see what are the processes that we have in the department and the institution that facilitate or inhibit the ability to get this done. By doing it myself, I can influence making sure that we have processes in place that allow for this, and we have the support to get these grants done.” Residents, students, and junior faculty seeing that Dr. Weigel continues to write grants is the first way to be a mentor to them in that he understands and is dealing with the same challenges. Dr. Weigel also described putting mentorship committees together to figure out what people want as part of mentorship. He explained, “everybody is different. Trying to pull out a cookie cutter and shove everyone into that same mold is not going to be successful. I do wish that we could attract more trainees to surgery who want to run basic science labs. The average trainee takes an academic job, but most are primarily clinical. Few are actively putting the time and effort into being a surgeon-scientist. It’s like sowing wildflowers, you throw out a million seeds and if 5-6 grow up and bloom, it was all worth it.”

The Right Decisions are the Easy Decisions

In terms of advice for surgeons who are contemplating whether to stay at their institution, Dr. Weigel thought that it’s related to deciding what it is that’s important and what it is that someone really wants. He explained that he had been at Stanford for 10 years, was tenured, and could have stayed there forever. But ultimately, he felt that he needed to grow and the opportunities to grow were not available when he was at Stanford. Therefore, in order to expand, he recognized that he needed to leave. When Dr. Weigel went to Philadelphia, it was clear that he would be there for 2-3 years to get his MBA at Wharton and to look at Chair jobs. Dr. Weigel’s wife Paula is from Des Moines and went to the University of Iowa as an undergraduate student. When this job opened up, he said that it was a perfect opportunity. His advice on big career decisions was “I don’t want to make it sound overly simple because I know it can be very anxiety provoking, but the right decisions are the easy decisions. If you are unsure or it requires a lot of debate, it’s probably not the right decision. The right decisions feel right and are easy decisions.”

You Have to Have Leadership Willing to Do What it Takes to Support People to Pursue an Academic Mission

In the current landscape of academic surgery, hospital administrations and academic leaders often have opposing missions. Dr. Weigel was asked what advice he had for faculty members who have aspirations of becoming future surgical leaders. Dr. Weigel felt that the first thing is to have leadership that appreciates research and values R01s more than RVUs. If a Chair doesn’t believe in that, it’s going to be difficult for faculty to be supported to pursue research.  While at Stanford, Dr. Weigel explained that he was not getting a bonus or pay increase but he was committed to writing grants and research. He stated, “you have to feel it in your bones, and you have to say I’m going to do this. It’s important for us surgeons to stand up to the people who are in charge of the institutional finances and recognize that what we have to do is advance the care of our patients. That requires that we understand disease at a greater level, which includes doing basic science and clinical research.” Dr. Weigel felt that the largest segment of growth in the healthcare system has been administrators that have not added value to the knowledge base or patient care. He argued that “you have to have leadership willing to do what it takes to support people to pursue an academic mission. We have to advocate politically to increase NIH funding and increase funding for surgeons. Surgeons need to commit to do whatever is required to advance patient care. If that means learning about epigenetic modification of chromatin to understand why some cancers have a worse prognosis, we better get working, reading the literature, and doing experiments to figure this out.”

Keep Engaging and Making Opportunities

Dr. Weigel is currently the President of the American Surgical Association, and a past President of the Society of Surgical Oncology and Central Surgical Association, as well as Chair of the American College of Surgeons Board of Governors and Medical Director for Cancer Programs at the American College of Surgeons, and was formerly a SUS Publications Committee and SUS Foundation Committee member, to name just a few of the leadership positions he has held in professional associations. On advice for participating in and advancing in professional organizations, he advised that members not be discouraged if they don’t get what they want at the time they think they should have it. He urged members to keep engaging and making opportunities. He stated, “it may be different than the role that you want, you engage and do a good job. If you get on an Editorial Board on a journal and they send you articles, you have to accept them and do them immediately. That will get recognized, maybe not immediately, maybe not after the first 10, but maybe after the first 100, and you’ll be recognized for doing a great job. My advice to people who want to get involved in surgical organizations, the number one thing you have to do is say ‘yes.’ I have been impressed by my surgeons and my surgical colleagues, their capacity to get to work and get things done.”  He recalled that Dr. Sabiston used to always drill home to work hard, all the time. Dr. Weigel remembered working long hours in the hospital every week, with 36-hour shifts as a resident, or with 12 RO1s to review over Christmas holiday as a faculty member. He would have dinner with the family and when they went to sleep, he would read and review the grants, figuring out how to get it done.

We Have to do a Better Job of Continuing to Tell People How Valuable They Are

When asked about the challenges facing mid-career academic surgeons today, Dr. Weigel felt that there was not a monolithic set of reasons that applied to everyone. He did however cite one of the universal challenges for mid-career surgeons is potentially a sense of loneliness. Mid-career surgeons might be worried about their career, they may not feel fulfilled or are unsure of what they want. Dr. Weigel stated “we have to do a better job of continuing to tell people how valuable they are and that what they are doing is critically important and necessary. The thing that wears you out is worrying about your patients. Not being able to sleep at night because you don’t want to hurt them or that they may have a complication. That wears on you and as an attending surgeon, you’re responsible for that patient. In our current environment, the administration often looks at the value of the person based on the revenue they generate and believing that general surgeons who are taking care of uninsured patients aren’t as valuable as other specialties like sports medicine. This is the challenge of people who are trying to be academic surgeons because the system does not value them. You need to have leadership in surgery that recognizes the true value of those individuals.”

Blooming Continuously

When asked if Dr. Weigel had any interests that may surprise people, he did not think that he had any. He described enjoying spending time with his family where they do a lot of hiking and skiing, including at Copper Mountain. Dr. Weigel then stated that he does grow orchids. When he and Paula were married, a surgeon friend gave them an orchid and it has bloomed continuously for the last 26 years and is in fact blooming right now. From that, he bought many others, and they now have them in the house, blooming year-round.

The Society of University Surgeons is honored to present Dr. Ronald Weigel with the 2024 Lifetime Achievement Award at the Academic Surgical Congress on February 11, 2025, taking place in Las Vegas, Nevada.