Sorta Random Sunday: 13 Things I Wish I Knew Before I Became a Plastic Surgeon

The following Sorta Random Sunday post is a response to a Cosmopolitan Magazine article titled, “13 Things I Wish I Knew Before I Became a Plastic Surgeon. It was written by a (at that time) plastic surgery resident at UCLA, Gina Farias-Eisner, and myself for PRS Resident Chronicles, a blog by the Plastic and Reconstructive Surgery journal.

I think this is a really timely post given that the match takes place soon. And now there are tons of 4th year medical students getting ready to be a resident (in any specialty) for the first time!

Consider this some good advice for anyone!

On July 1, hundreds of new interns will arrive promptly for morning rounds

They will do this with crisply bleached white coats, a sun-kissed glow to their well-rested faces, a delighted strut that shows off their new pagers, and a light in their eyes that emanates the enthusiasm that today, “I am a plastic surgery resident!”

As time goes on, most of us grow to wear a fleece for the practicality of warmth; our skin is anemic in appearance from the hours in the hospital. The sound of our pagers is likely to propagate palpitations with the hope that they may “accidently” fall into the toilet. And our eyes yearn for a long blink, as they are open more hours than they are closed.

In reading the article in Cosmopolitan Magazine, “13 Things I Wish I Knew Before I Became a Plastic Surgeon,” I think about if there are things I wish I knew before I became a plastic surgery resident. What would I tell that person on July 1?

You may not be operating consistently…for a while

Plastic surgery residency is a hierarchical system. For the first year or so of your residency, you will likely not be operating on a consistent basis. You are more likely to be on the floor placing orders, fielding consults, or suturing lacerations in the emergency room. Depending on the structure of your program, you may even be on general surgery services rather than your “home” plastic surgery team. Even if you are in the operating room, you are probably retracting or running Monocryl rather than being under the microscope. This is okay. You need to walk before you can run! Trust the system, continue to prepare and practice as if you are actually doing all of the cases, and when your time comes, you will show your attendings and co-residents that you are ready!

You will not always be the best or know everything

Coming into residency after the match process, it is easy to feel on top of the world. You just matched into a prestigious residency! However, it is important to remain humble and realize that we have an infinite amount of information and skills to learn. You are now going to be working with other residents, both inside and outside of your specialty, that were also among the best medical students in the world. Learn from everybody and try to improve in one area every single day.

Actively balance your life outside of work

Residency will consume much of your life…and it should. In order to become top-notch plastic surgeons, we need to commit a seemingly infinitesimal amount of time to master each aspect of the specialty. However, we must also balance our lives. It can be easy to become one-dimensional. It’s important to have activities and hobbies outside of work, no matter how small they are. This is easier said than done but having a cathartic outlet will allow you to re-focus and ultimately be a better physician.

You will spend more time with your co-residents than anyone else in your life…even your significant other.

Your co-residents will become a huge support system. These are people who can, more often than not, relate to exactly what you are going through. You are in the trenches together. Continue to grow these relationships; they will become some of the most important in your life.

A number of additional proverbial clichés come to mind, “Hope for the best, but prepare for the worst; Easy come easy go; Practice makes perfect; Patience is a virtue; Do unto others as you would have them do unto you; There’s no place like home; When the going gets tough, the tough get going.”

All of these sayings have a profound amount of applicable truth. However, this wisdom is not a result of the words themselves. Rather, it is the understanding gained from experiences along the way that give them meaning. Lack of sleep, perseverance, and grit are not foreign to incoming interns. Somehow, no amount of advice can prepare someone for being awake for over 30 hours, operating the following day, triaging page after page, only to finally be exiting the hospital to discover that your patient needs you and turning back around. The reality of scut work, demanding hours, copious documentation, and personal sacrifice can become disenchanting.

Yet, we continue to do what we do. Why? This brings up the last “thing I wish I knew:”

You will still be happy!

Because, at the end of the day, what we do is truly awesome and the people we do it with are amazing! When I think about what I would say to that person on July 1, I would tell them that survivability and resilience are directly correlated to a sense of humor, ability to laugh, and clarity to see through the minutiae to the heart of our amazing lives as plastic surgery residents. Despite the white noise, the functional and aesthetic transformations between “before” and “after” plastic surgery continue to be mind-blowing.

In the end, I think about when I am asked, “What do you do for a living?” A smile spreads across my face, as I answer, “I am a plastic surgery resident.” (Ed. – And I do plastic surgeon things!)

What do you think? How should new to-be residents prepare for their training? What things do you wish you knew before becoming a plastic surgeon or any other type of doctor? Let me know in the comments below!

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