TAMEST Member Profile: Former TAMEST Board President Francisco G. Cigarroa, M.D. (NAM), UT Health San Antonio
TAMEST Member and former Board President Francisco Gonzalez Cigarroa, M.D. (NAM), UT Health San Antonio, is a world-renowned transplant surgeon who has dedicated his life to his patients, family and leading the next generation of talent in Texas.
Born in Laredo to a medical family, some of Dr. Cigarroa’s favorite childhood memories were tagging along and watching his physician father provide care in his community. In high school, he watched his surgeon uncle perform a procedure and knew he wanted to follow in his footsteps.
After his formal training and fellowships, Dr. Cigarroa became a faculty member at UT Health San Antonio in 1995 where he introduced many innovations in pediatric and adult transplant surgery in Texas. He eventually transitioned his career to focus on academic leadership and in 2000 he was appointed the first Hispanic president of UT Health San Antonio. In 2009, he became the first Hispanic individual to lead a major university system in the United States when he was appointed Chancellor of the University of Texas System.
However, after nearly 15 years leading change at Texas institutions, Dr. Cigarroa decided to transition back to his passion for full-time patient care to perform transplant surgery, pediatric and adult hepatic and pancreatic surgery. Currently, he serves as UT Health San Antonio’s Professor and Director of the Transplant Center, is the Carlos and Malú Alvarez Distinguished University Chair and holds the Ashbel Smith Professorship in Surgery.
TAMEST connected with Dr. Cigarroa to hear more about his leadership, career and service to TAMEST.
Tell us about how you knew you wanted to become a surgeon.
It was an unexpected track. I always knew I wanted to become a physician because my father and my grandfather were physicians. Even as a youngster, my father would come home every day with a smile and convey what a privilege it was taking care of patients.
In fact, he was a very busy physician and we mostly spent quality time with him on the weekends seeing patients in their own homes during visits because they did not have transportation to clinics. I got to see firsthand this beautiful relationship between a physician and a patient in their home setting and with their extended family.
I thought I wanted to be like my dad. However, my uncle was a general surgeon and in high school I got to see an operation with him. As soon as I did, I knew, “this is for me.”
You got a degree in biology from Yale University and went to medical school at UT Southwestern Medical Center, where you studied under some of the greats – one of whom would go on to found TAMEST. Talk about those early mentors and their impact on your career.
I had two professors in UT Southwestern that had a magnificent impact on my life. One was Nobel Laureate Michael Brown, M.D. (NAM, NAS) who helped to establish TAMEST with then-Senator Kay Bailey Hutchison. He was my professor of internal medicine and was the one who encouraged me to go into academic medicine. He told me I should consider being a teacher in a medical school, so I could also contribute to my discipline.
He said the best place to do that would be at an academic health center and he encouraged me to go to Massachusetts General for my surgical training. It was one of the top surgical programs in the world and when I found out I got accepted, I couldn’t believe it. I remember running to Dr. Brown’s office and telling him that I got it. I thought I was going to get a big hug from him, but he just looked at me and said, “Don’t disappoint me. I wrote your letter of recommendation.”
It was an inspiring conversation. Suddenly I had the responsibility of doing a good job not just for myself and my family, but because somebody I really admired and who trusted me wrote a letter sticking up for me. I didn’t want to let him down.
How did you find your field of pediatric transplant surgery?
I didn’t go to Mass General thinking I was going to become a transparent surgeon. I thought I was going to be a cardiac surgeon. However, I ended up having an experience in pediatric surgery with Dr. Patricia K. Donahoe from Harvard University that made me change my mind.
I thought about my life and being able to go into a hospital and make a child’s life better. So, I pivoted after two years of research on fetal growth factors and inhibitors at Mass General and ended up pursuing a fellowship in pediatric surgery at Johns Hopkins University.
At Hopkins I got exposed to children who developed liver disease and didn’t have long to live. You would do a liver transplant on these children, and a week later you would see them doing so much better. You would see them thriving and see the transformation a transplant can give. I also realized how much I loved Immunology which was kindled to me as a student by Dr. Rupert Billingham at UT Southwestern Medical Center, and like Dr. Michael Brown, had a profound impact on my professional trajectory.
It made me realize how much I loved working in the field of transplants, especially getting to dedicate my life to giving children a better future. That’s how it happened – I didn’t think I was going to be a pediatric surgeon, but here I am decades later still coming to work with a smile.
You’ve been on faculty with UT Health San Antonio since 1995. What attracted you to come back to Texas to start your career?
I was going to stay at Johns Hopkins University because they offered me the directorship of Pediatric Transplantation. It was a spectacular job offer at one of the top hospitals in the world right out of fellowship. But I didn’t take it.
After speaking with my wife Graciela about it, we both realized we belonged back in Texas. It really had everything to do with family and wanting to expose our children to their cousins and grandparents. We wanted them to be bilingual and understand the culture of Mexico, just like we were raised.
It ended up being a perfect match. My children got exposure to family and Mexican culture and UT Health San Antonio gave me opportunities that no other academic institution could have possibly given me. I became the Director of Pediatric Surgery right out of fellowship. I started the pediatric liver transplant program together with my partner Dr. Glenn Halff. It was a lot of responsibility at a very young age and allowed me to make my name clinically. It also provided the opportunity to get into academic leadership, which was something quite unexpected.
You made history as the first Hispanic president of UT Health San Antonio. What made you decide to transition into academic leadership from full-time surgery?
Well, I wasn’t looking for it at all. In fact, I was only four years out of fellowship when they asked me to interview. I was surprised that somebody nominated me to be considered for President and wasn’t going to interview until my father convinced me otherwise. He said, “You do not want to disappoint the Regents.”
We decided the chances of it coming to fruition were one in 100,000, so I thought I might as well not disappoint anyone and go through the process. I thought I’d have some nice dinners and go back to my job. Well, the prediction was wrong and I ended up getting it.
I remember driving back from finding out and experiencing the waves of nausea at having to leave my daily practice for pediatric surgery and transplants. However, once you get a responsibility like that, and once you hear in your mind the echo of Nobel Laureate Michael Brown saying, “don’t disappoint me,” you’re going to give it your best. That’s exactly what I did, and I still got to do surgery part-time by taking calls every other weekend.
It was fantastic being President. We accomplished a lot in terms of enhancing research, philanthropy, diversity at the school of medicine and more. However, after nine years I felt very proud of what I’d accomplished and submitted my intent to retire from the Presidency to the Board of Regents, thinking I was going to go back to full-time surgery.
But you didn’t return to full-time surgery. In 2009, you were elected as the first Hispanic Chancellor of the University of Texas System. What changed?
A month after retiring from the presidency at UT Health San Antonio, I got a call from the Board of Regents to ask me if I would consider interviewing for the Chancellor of the University of Texas System.
I told TAMEST Member Kenneth I. Shine, M.D. (NAM), who was UT’s Vice Chancellor for Health Affairs at the time and another person with great influence on my life, that I wasn’t certain I wanted the opportunity. I wanted to go back to the bedside and take care of patients.
I’ll never forget the answer he gave me. He told me that I would still be taking care of patients and would still be by the bedside – just that the patient is the state of Texas, and the bedside are our universities and health centers. He said that opening the opportunity of an education for the students of Texas was the greatest public health initiative we can provide any individual. It changed my whole perspective and I interviewed for the job.
What were some of your proudest moments as Chancellor?
It was such an honor to be designated as the Chancellor of The University of Texas system. It is one of the best systems of higher education in the world and I have so many proud moments.
A few that come to mind are helping to improve graduation rates across campuses, increasing the number of Tier One research institutions in the University of Texas system, establishing the University of Texas Rio Grande Valley, helping establish the Dell Medical School at UT Austin and the Medical School at UT Rio Grande Valley, and investing in engineering across the system.
When you’re in that position you can really influence a lot by working with the Board of Regents. If you’re lucky and the timing is right, you can make some spectacular investments that improve education and research across the state of Texas.
I was fortunate that the timing was right, the economics were right, and that the Board of Regents supported many of the initiatives I undertook. It was a fabulous six-year experience.
What made you decide to transition out from academic leadership and return to full-time surgery?
It was another conversation with my wife, Graciela. I had put together a policy that our Presidents and Chancellor needed to be reviewed every six years, like a tenure review. I thought if it applied to faculty, it should also apply to Chancellors and Presidents, and we should have to present to the board why we want to stay in the position and what we can bring in the next six years.
When I looked back at all I and my leadership team had accomplished in six years, I couldn’t see myself doing better or more with another six. I also felt like I got removed from the full-time practice of surgery very early in my professional life and had yet to fulfill some personal professional desires.
I realized that I had to decide to let myself go back to full-time surgery.
What about your work makes you the most passionate?
Taking care of patients and being able to give the life-saving gift of a transplant while honoring the donors who sacrificed to save somebody’s life.
It also gives me a lot of satisfaction to mentor and ensure junior faculty reach their fullest potential. Those are the things that give me the most joy apart from my family.
You were there from the very beginning of TAMEST, even serving as an early TAMEST Board President. What was that like?
I think TAMEST is one of the greatest stories and I was honored to be there even before the beginning. I was with then-Senator Kay Bailey Hutchison in her office in Washington, D.C. with several other Presidents of Texas universities to discuss the concept she had with Nobel Laureates Michael Brown and Joseph Goldstein.
They were asking for a way to advance science, engineering and medicine in Texas, garner more federally peer-reviewed grants in the state and increase the number of Texas National Academy members that would rival states like California or New York.
Texas certainly had the human intellectual talent and the innovative science to make the dream a reality, we just didn’t have a game plan to mentor the gifted. It made sense for all of us to convene as a group, learn from each other, and to identify and recognize our talent in Texas.
And then it happened and TAMEST was created. It is a great joy to see how the vision has unfolded this many years later and I was happy to be a part of its origins.
Why is the TAMEST Protégé Program important to TAMEST’s mission?
Everything is about human relationships and sustaining and growing excellence. The way you do that is by making sure that you mentor the incredible human talent around you.
The TAMEST Protégé Program sustains a pipeline of rising talent that is crucial in cultivating the future of research and innovation in our state. It’s important for early and mid-career researchers to understand that it is not impossible to become a member of the National Academies.
It’s really a matter of being mentored and having advocates willing to guide and support you. I had Nobel Laureate Michael Brown willing to advocate for me and I’m honored to be able to pass that forward to help lift the next generation.