Chapter 3 of 6 · Fundamentals
Mentors & career
Mentors and Early Career Development
Cued at 22:33 · press play
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
V119 Use of transoral incisionless fundoplication for recurrent reflux after foregut surgery
Jeffrey Ponsky · Published Jul 2026
Video
StayCurrent Forums
Jeffrey Ponsky · Published Jul 2026
Video
From Idea to Ubiquity
Jeffrey Ponsky · Published Jul 2026
Video
Intra-operative Bile Leak During Cholecystectomy
Jeffrey Ponsky · Published Jul 2026
Video
Jeffrey L. Ponsky Master Educator in Endoscopy
Jeffrey Ponsky · Published Jul 2026
Podcast
Update Course Rewind: Pediatric Biliary Stones - Preventing Gallstone Pancreatitis 2024
Jeffrey Ponsky · 3 min · Published Aug 2025
What the experts said
Ponsky graduated high school with a 2.027 GPA and his college counselor recommended trade school instead of college.
Ponsky's father sold used tires for a living and the family had no money for college.
Ponsky attended Miami University of Ohio on loans and scholarships, studying by memorizing everything and taking copious notes.
Ponsky worked as an orderly at Mount Sinai Hospital during his first college summer, giving bed baths and changing bedpans, which increased his commitment to medicine.
Ponsky was promoted to scrub tech the following summer and was allowed to close fascia, despite the head nurse objecting.
Ponsky chose Case Western Reserve medical school partly because he had to live at home due to financial constraints.
Case Western Reserve had a 'new curriculum' with pass/fail grading (pass, fail, and honors) rather than letter grades during Ponsky's time.
Ponsky received honors in every medical school clerkship including psychiatry, internal medicine, cardiology, OBGYN, and surgery.
Bill Holden, chairman of surgery at Case Western, was an elegant teacher who used the Socratic method, though not the greatest technician.
Walter Pore taught using showmanship, including having students perform pinch grafts at bedside by injecting local anesthetic, cutting postage-stamp-sized skin pieces, and placing them on scraped bedsores.
Walter Pore made Ponsky rewrite his first paper (a letter to the New England Journal about paradoxical air embolism) six times and read German poetry to teach more poetic writing.
During residency, residents worked 36 hours on, 12 hours off, every other night.
The head of GI at University Hospitals refused to train surgeons in endoscopy, telling Ponsky 'we're not training any surgeons, just forget it.'
Ponsky trained in endoscopy with Jim King in Canton, Ohio, performing about 500 cases over 5-6 months using a mid-length colonoscope not designed to reach the cecum.
Ponsky's mother-in-law purchased his first colonoscope as a Hanukkah present after hearing he couldn't use the hospital's scope.
In the early days of endoscopy, scopes were washed with green soap (no high-level disinfection) and Ponsky kept his scope and light source in the back of his car.
By the end of Ponsky's senior residency year, he was performing all endoscopy cases at University Hospitals while the GI physicians were not doing cases.
Bill Holden provided Ponsky with grant money to purchase an ERCP scope instead of repaying his mother-in-law for the colonoscope.
SAGES was founded around 1980-1981 with approximately 300 members when Ponsky became president in 1990.
Jacques Perissat showed a video of laparoscopic cholecystectomy in the exhibit hall at the SAGES meeting in Louisville, Kentucky.
When laparoscopic cholecystectomy began, instruments couldn't be purchased and surgeons used GYN instruments.
Ponsky took one of the first laparoscopic cholecystectomy courses taught by Nat Soper, George Bercy, John Hunter, and John Sackier in Salt Lake City.
Ponsky's first laparoscopic cholecystectomy patient was a member of the Mount Sinai board of trustees, with David Dupper (who had done 8 cases) serving as proctor.
Ponsky joined the University Hospitals staff as chief of surgical endoscopy at age 29.
Ponsky performed endoscopy on newborn babies because there was no pediatric gastroenterologist, with Bob Ezan (head of pediatric surgery) as his supporter.
Ponsky and Mike Gower developed the PEG (percutaneous endoscopic gastrostomy) technique in May 1979, performing it on 5 babies with birth asphyxia and psychomotor retardation, without IRB approval but with family consent.
Ponsky became chief of surgery at Mount Sinai at age 32.
Mount Sinai Hospital was Ponsky's favorite workplace, a small hospital where every staff member knew each other, with an animal laboratory larger than the Cleveland Clinic's.
Mount Sinai was sold to a for-profit company after 18 years, and Ponsky left because the new owners 'could care less about quality.'
Mike Henderson recruited Ponsky to Cleveland Clinic to be head of surgical endoscopy, and Ponsky became the first head of minimally invasive surgery there.
Ponsky had been president of both SAGES and ASGE before joining Cleveland Clinic.
All but one of Ponsky's children were born before he finished residency; his last son was born during his final residency year and his daughter 3 years later.
Ponsky's wife had no partners helping her while he was on call every other night during residency.
Ponsky believes success requires a good partner and that his family's support was essential, making it a joint success rather than individual achievement.
Ponsky's parents saw his greatest achievement as becoming chief of surgery at Mount Sinai Hospital, which was meaningful in the Jewish community, rather than his academic positions.
Ponsky has two sons who are surgeons, one son who is a real estate developer, and a daughter who is a professional photographer.
During ERCP procedures, Ponsky would kick, headbutt, or nudge his fellows when his hands were busy; one fellow wore shoulder pads in response.
Ponsky counseled fellows to choose job opportunities based on overall life factors (family location, better academic opportunities, institutional need) rather than just institutional prestige, sometimes advising them away from his own institution.
Ponsky performed distal splenorenal shunts early in his career with Jerry Walkoff's assistance, believing it was 'the greatest thing since sliced bread' based on Dean Warren's physiologic approach to reduce variceal pressure without decreasing portal flow.
Distal splenorenal shunts became obsolete after a couple of years when rubber band ligation of varices was introduced.
Ponsky performed 180 vertical banded gastroplasties in one year in the mid-1980s, believing it would be a great bariatric operation, but these later required reversal.
Ponsky predicts that in 20 years, colonoscopy for screening may become obsolete, noting he performed 1600 colonoscopies in the previous year.
ERCP is Ponsky's favorite operation, which he compares to golf and would come in day or night to perform.
In Ponsky's last few years at Cleveland Clinic, he didn't have fellows learning ERCP and only performed cases when young gastroenterologists requested help or coverage.
The first ERCP was performed by surgeons at George Washington Hospital, but the procedure was really developed in Japan by Itaru Oi and others, with contributions from Germans and Peter Cotton's group in London.
Ponsky learned ERCP by watching videos and made a deal with George Brodmerkel (a gastroenterologist in Pittsburgh): Ponsky taught him laparoscopy under local anesthesia for liver biopsy, and Brodmerkel taught Ponsky sphincterotomy.
Hospital administrators encouraged Ponsky to get an MBA, saying he made decisions 'out of his gut' without knowing return on investment or financing, and they paid for the degree.
The business school dean told Ponsky's MBA class: 'you won't be a good businessman when you finish this, but you'll be able to sit in a business meeting and say bullshit at the right time.'
Ponsky states he hates business and isn't interested in his children's investments and startups, preferring horses and physical work.
The most important aspect of business school is the people you meet and learning their thought process and approach to problems, not the business content itself.
Ponsky was on the ASGE governing board when SAGES started and initially felt 'like a traitor to ASGE' because surgeons were starting their own society.
At an early SAGES meeting at the Legionnaires Hotel in Pennsylvania, Ponsky realized SAGES papers addressed surgically-specific problems (endoscopy in bowel obstruction, suture line evaluation, volvulus management) that differed from ASGE content.
SAGES founders included upper GI surgeons, colorectal surgeons (Ted Schrock, Jerry Marks, Lee Smith), foregut surgeons, and general surgeons from different areas.
When laparoscopy emerged, SAGES gained members who weren't involved with flexible endoscopy; today most SAGES members are laparoscopy/minimally invasive surgeons rather than flexible endoscopists.
Ponsky advocated to the residency review committee (when Joe Fisher was head) for a minimum endoscopy requirement; the 50-case requirement was initially hated but established endoscopy as part of general surgery training.
Ponsky advises always volunteering, never saying no, and getting involved in everything, stating 'you'll find the time' and don't have to do everything yourself—residents can help with papers.
Ponsky's wife traveled with him to most meetings; if he went to Paris she was there, but she didn't go to Cincinnati.
Ponsky maintains hobbies including a barn with horses, physical work (mucking stalls, fixing things, inventing watering systems), and has friends outside surgery who don't know what he does for a living.
Ponsky's wife gave him a Harley trike (three-wheeled motorcycle) when he was 70; she would not allow a two-wheel motorcycle. They have ridden to Sturgis, South Dakota.
Ponsky has never been tempted to move from Cleveland because his entire family lives there: his son Zach built a house on 5 acres next to Ponsky's 8 acres, his daughter bought a house 2 houses down with 5 acres, Todd lives within half a mile, and his other son Lee lives 2 miles away.