AWStudent


Winter 2012                              

The AWS Student Committee is thrilled to announce the addition of our student column of articles geared toward our Medical Student Members, led by committee members Melanie Subramanian, Gloria Sue, Mahvesh Javaid, and Katie Engeln. Just in time for the season, we are featuring a helpful guide on the residency interview, based on polling our rich database of academic surgeons and residents in the AWS community. Additionally, we are sharing personal interviews from three unique sources: one US-based surgeon, one international surgeon, and
one resident.

Ginger Slack, Chair of the AWS Student Committee


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In this issue. . .


The Surgical Residency Interview Process: Advice From AWS Attendings and Residents for the Female Applicant
By Gloria R. Sue, MA
AWS Student Committee Member

The residency interview process can seem like a daunting experience to rising fourth-year medical students. To help alleviate some of these qualms the AWS Student Committee conducted a survey of AWS attending surgeon and resident members, soliciting advice on the interview process with particular consideration of matters of interest to female applicants. We received an overwhelming amount of survey responses from all across the country, with 69 completed surveys from attending surgeons and 13 from residents.

Resident Interview ProcessThe surveys contained five open-ended questions, covering areas such as attending surgeon specialty, hair and suit preferences for female applicants, and general interview tips. Among the surveys completed by attending surgeons, 60 (87.0%) were completed by surgeons who conduct interviews for general surgery residency programs, four (5.8%) were completed by surgeons who interview for plastic surgery residency programs, and five (7.2%) were completed by surgeons interviewing in a variety of other surgical subspecialty fields.

Regarding whether an applicant with long hair should put her hair up or leave her hair down for the interview, the vast majority of surgeons gave a response similar to "it does not matter, as long as the hair is neat," though five (7.2%) recommended that the applicant wear her hair up to remove a potential distraction of having "hair falling down around the face" or "being fiddled with." Regarding whether a female applicant should wear a skirt suit or a pant suit to the interview, again the vast majority replied along the lines of "it does not matter, as long as the look is professional," though three (4.3%) stated that the skirt suit was a personal preference, while no respondent advocated for the pant suit as a personal preference.

There was also a consensus on the types of questions that attending surgeons felt that students should not ask of their interviewer. The majority of respondents felt that questions along the lines of "how much time off do we get" or "what is the call schedule like" to be inappropriate. Some respondents also discouraged the interviewee from asking questions about maternity leave and resident lifestyle.
Additionally, several attending surgeons recommended that the applicant "research the program ahead of time," "be prepared with questions," "be honest," "make eye contact," and "participate in mock interviews" (Table). One respondent even pointed out that applicants should strive to be excellent as the residency program is more or less "adopting" them.

The responses from the 13 AWS residents offer advice from the perspective of recent interviewees. The most commonly asked questions that the residents reported being asked were "why do you want to go into surgery" and "why did you apply to our program." Among the respondents, five (38.5%) reported being asked about either marital status and/or planning for children. Other unexpected questions encountered on the interview trail included "what are you the most proud of," "what was your biggest mistake," and "where will you rank us."

The vast majority of residents also felt that optional dinners or cocktail receptions associated with the interview day were worthwhile to attend, giving the applicants the opportunity to determine whether they can get along with the residents, get a feel for the culture at the program, and help distinguish between programs.

Table. Most Commonly Offered Advice from AWS Attending Surgeons

Advice

Times mentioned

"Do background research on the residency program" 11
"Be prepared with questions" 10
"Be professional in dress and/or demeanor" 8
"Be honest" 7
"Make eye contact" 7
"Participate in mock interviews and/or practice with others" 5
"Smile" 5
"Be yourself" 4
"Relax" 3

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An International Road to Surgery: An interview with Dr. Anna Riemen, BSc Hon Biochem, MbChB, MRCSEd
Dr. Anna RiemenSpeciality Registrar Trauma & Orthopaedic Surgery
Orthopaedic Suite
Woodend Hospital
Eday Road
Aberdeen AB15 6XS
0845 456 6000

Background:
I am currently a Speciality Registrar 3 in Trauma and Orthopaedic Surgery. I am German and grew up there and moved to the UK for university. I completed a BSc with Honours in Biochemistry and then went to Dundee University Medical School. During medical school I organized placements in T&O at Charite Hospital in Berlin and at Denver Health in Denver, Colorado. My elective was in a very remote hospital in Uganda on the border to Congo. I did my two foundation doctors years in Dundee and Perth and am now in Aberdeen for my run through Orthopaedic training. I did my MRCS at the Royal College of Surgeons of Edinburgh and I am involved in Medical Politics through the BMA.

Please let me know if you have any further questions; I would be happy to help.

What motivated you to choose a career in surgery?
I came to medicine on a slightly unconventional route for a UK graduate. I was convinced I would become a Biochemist and never thought about medicine until I spent a year at Stevens Institute of Technology. From our campus, I saw the twin towers fall. That year I felt drawn to medicine as a way to combine research and hands-on care. I finished my degree taking extra Anatomy classes and then went on to study medicine at the University of Dundee skipping 1st year. But it was only when I discovered surgery and especially Trauma and Orthopaedic Surgery during an extra summer placement I had arranged in Berlin, Germany, that I really got hooked. My first day in an operating room I saw the Trauma surgeons fixing this patient who had massive life-threatening injuries from a terrible accident. I love the immediate effect. People get better quickly, I can positively influence their lives and even in a bad situation the aim is to restore function and provide freedom.

How has a career in surgery met your expectations, and over the years,
what advances have you seen evolve for women in surgery?

I love it! I consider myself to still be in the early stages of my career having entered my third year of T&O speciality training. Every day I come home and feel satisfied that I have learned something new and made a difference to one of my patients or taught a student or foundation doctor. I even manage to squeeze in some medical politics and a bit of research. I have not noticed any changes for women in surgery recently but then throughout medical school and the initial years as a doctor all the surgical attendings have encouraged and supported me. In my training programme in Aberdeen I feel well supported as a trainee, and as there are at least five other girls training to become Orthopaedic surgeons here, and we have quiet a few general surgical trainees who are women, it seems normal.

What are the challenges of being a surgeon (as women and in general)?
The biggest challenge is yourself. You have to be self-confident and although a healthy amount of self criticism is good don't let it take over. I have noticed women are more self-critical then male surgeons. At the same time you have to live with and deal with your complications.

What advice can you offer to women who wish to pursue a career in surgery?
It is a hard and long training programme and you have to be committed right from the start. If you let yourself go, then at least three people are in line behind you to overtake. You have to do a lot of self study and always be prepared. It's a great career and I would not want to do anything else.

What have you found to be beneficial, in terms of balancing professional and family obligations?
I have been single for a long time now so maybe I am not the right person to answer this question.

I love the time I spend in surgery and I make a point of keeping in touch with close friends and my family via the phone and e-mail and at least once or twice a year I fly back to Germany to visit them.

You should always have something to balance work with. I love singing and I play the flute and clarinet when I get a spare minute. As an Orthopaedic surgeon I need to be fit so I regularly go to the gym and for a special treat I have some big power kites with which I zoom along the beach.

What recommendations can you offer to women in surgery regarding family planning?
Again I have not yet had the chance to have kids but one of my colleagues and inspiring women surgeons I have met on placements in the USA along the way have had kids at varying stages of their careers. It seems to me that the facilities in Scotland to be a (trainee) surgeon and have kids are good but having family nearby and a supportive partner certainly help, as do excellent friends.

International SurgeryWhat have been the most rewarding and gratifying aspects of your surgery career?
I love working with my hands and the tactile feedback from what I do. Using everything I learned to solve a problem. In Orthopaedics I often have clear diagnoses from history and examination and it is nice to have an x-ray or other investigation to confirm. Fixing fractures and doing joint replacements -- seeing people walk again is just amazing. I work with a variety of people; one moment I see a 100-year-old lady, next I might see a toddler followed by a 20-year-old athlete.

Why did you join AWS?
AWS is a group of fantastic surgeons and they give the opportunity to learn from them and to experience encouragement. I like the way they focus on education and professional support. There is no similar alternative for women surgeons in Scotland, and although all my bosses are encouraging I have so far only met three female attending orthopaedic surgeons -- so it's nice to know there are more.

What do you find being enjoyable as a member of AWS?
I love hearing about others' success stories while at the same time getting guidance and encouragement on how to achieve the same.

Why should medical students join AWS?
Although there are more women in surgical training, still there are few female consultants surgeons. It helps to have role models and mentors. AWS has great educational resources and it is great to find like-minded people!

What do you enjoy about the annual events like the AWS Conference?
I still have to go to one. Maybe next year.

This interview was conducted by Mahvesh Rana Javaid, member of the AWS Medical Student Committee.

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Success as a Surgeon: an Interview with Dr. Nancy Gantt on her experiences in training for surgery, managing a successful career, and striking a work-life balance

Dr. Nancy GanttDr. Nancy Gantt is Professor of Surgery at Northeastern Ohio Medical University and the Curriculum Director of M3 surgical clerkships. She is general surgeon at St. Elizabeth's Health Center in Youngstown, Ohio and the current vice president of AWS. Her medical areas of interest include breast surgery and surgical education, and she is passionate about AWS and mentoring young women who are initiating their careers in surgery. Her interview for AWStudent offers insight into her pathway to surgery and advice for budding surgeons.

How did you decide on a career in medicine?
Loving animals; I originally wanted to be a veterinarian. I grew up in Illinois and went to the University of Illinois at Urbana-Champaign. I ended up being allergic to cats, which put a stop to my career aspirations of being a veterinarian. However, I loved biology and I admired the people I knew in medicine so I decided to apply to medical school. I didn't have much financial support to go to college, which required lots of loans and jobs, and also prevented me from doing much research. I attended the University Of Chicago Pritzker School Of Medicine.

When did you know you wanted to do surgery? What inspired you?
I started out interested in family medicine. I thought it was a great career where you have the ability to forge long-term relationships with your patients. I also relished the idea of caring for all age groups -- from children to senior citizens. However, I have to say that the surgeons at Pritzker were just truly dynamic and inspiring role models. I loved the problem-solving aspect of surgery, and the ability to work with your hands. I still remember observing Dr. Wolfgang Schraut explaining to a Crohn's disease patient about the process of the laparotomy that he was going to perform -- what would stay in, what would be cut out...it was all just very inspiring. I was intrigued by thoracic surgery and transplant surgery, and eventually was accepted to University of Pittsburgh's surgical residency program.

Were there other women in medical school who had similar aspirations to go into surgery?
There were a surprisingly large number of women who ended up matching in surgical residency programs, but I didn't really find out about their interest until Match Day. There was a Women in Medicine group when I was in medical school, which provided wonderful camaraderie.

What was residency like?
It was rigorous. Here's some advice -- if you want to do something, don't go to the world's busiest place for it. There was a liver transplant being conducted every 16 hours, but the opportunity for a resident to get a lot of hands-on involvement in the transplant procedures was slim due to the incredible amount of competition and number of patients on the service in need of care. Also, the lifestyle at that time was just crazy and I needed more balance. I eventually became interested in all of general surgery. I also really fell in love with breast surgery. It just felt truly amazing to work with women admitted for a mastectomy. There were few women surgeons back then, and it was always a gratifying experience to talk to patients before and after their surgery, and really support them. You really got to know them, and they were wonderful to care for.

What was your residency experience like as a woman?
It was pretty crazy. They accepted five Categorical residents a year and usually only one was a woman. Fortunately, the Chair of surgery, Dr. Henry Bahnson, was fantastic. He was completely gender-blind, yet very old school. He just trained you to be a skilled surgeon, no matter who you were. He never gave you any indication that you couldn't do what you wanted to do because you were a woman. There were plenty of women who left there as cardiothoracic and plastic surgeons.

How would you characterize your career now?
It has been fantastic. I became engaged to my husband (an orthopedic resident at the time) during the lab year of my residency. I wanted to go back to Chicago, but he wanted to move back to his hometown of Youngstown, Ohio, where they had only one young orthopedic surgeon at the time. I went into solo practice and taught medical students from Northeast Ohio Medical University. I had plenty of responsibilities, from managing the SICU to trauma call. I also became the surgical clerkship director, and served in that position for 20 years. I truly love my work developing curriculum and educating students. I have been advanced to full Professorship based primarily on my educational work. I haven't been as involved in clinical research, but that is currently being ramped up so the Joanie Abdu Comprehensive Breast Care Center at St. Elizabeth Health Care Center (of which I am co-director) can be accredited and offer clinical trial participation to our patients.

Have you faced any challenges balancing your personal and professional life?
With all of my responsibilities, it has been challenging. I realized that I needed to slow down when I was pregnant with my first child. I went into pre-term labor at 19 weeks, and that was a changing point for me. Professionally, I focused more on breast surgery, which made my schedule a bit more predictable. In 2006 I was diagnosed with stage I breast cancer. That was another wake-up call. My diagnosis did give me a new tool to relate to my breast surgery patients. It is nice how I can comfort them with my own experiences on dealing with breast cancer and connect with them on a new level. I eventually switched from solo private practice to being employed by the health system. The transition was good. For example, I went from having an $85,000 bid for malpractice to not having to worry about it.

What would you say are the most rewarding features of being a member of AWS?
I would say the mentorship. AWS provides mentorship for women at every stage in their career. I really regret not seeking out more mentors early on. AWS is just a fantastic source of support. Everybody has everyone else's back. If you want to succeed, you need to have approachable people you can talk to. AWS has these people. And the women of AWS can help you with more things than just networking. They can help with life issues too. They are just incredibly supportive.

What advice would you give to women who are just beginning their training?

  1. Choose your partner very carefully. It is better to be alone than to be in a bad relationship. Be with someone who is supportive and thinks that what you do is very cool. My husband still thinks I look cute in scrubs!

  2. Make time for your family. You need to pay attention to your parents and your children at all the stages of their lives. Cherish your friends and nurture your friendships.

  3. If you will not make time for yourself, you will not stay healthy. Eat well and exercise.

  4. Only say "yes" to the activities that you value or to the tasks that you think will significantly promote your career. Learn to say "no" to requests that don't.

  5. Find mentors for all aspects of your life -- professional and personal.

  6. Keep your hobbies and your passions. I love gardening, cooking, and reading for my book club.

  7. Earn enough money to pay for chores you don't want to do, like cleaning your house, so that you have quality time to do what you want to do.

This interview was conducted by Melanie Subramanian, a second year medical student at Harvard Medical School. For any questions, please contact Melanie.

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On Surgical Inspiration, Mentorship, and Managing Life as a Resident: An Interview with Prathima Nandivada
General Surgery Resident and Research Fellow
Beth Israel Deaconess Medical Center
Harvard Medical School, Boston, MA

Choose SurgeryWhat motivated you to choose a career in surgery?
What I think motivates most people to go into any field is the mentors that they have, and I think a big reason why I chose to go into surgery was being inspired by the mentors around me, both men and women. Early on in medical school, I just had a couple of mentors that exemplified what it meant to be a physician -- they could take care of any problem, were great teachers and great leaders, and I essentially just wanted to be like them, and so I decided to pursue a career in surgery, and it's been a fantastic journey.

What do you find enjoyable about being a member of AWS?
I've been a member of the AWS since I was a medical student. And the things I love most about coming to these conferences is meeting women in every stage of their career who are thriving and seeing how they are accomplishing their goals. It's extremely motivating and inspiring to see that. And I think the other side of it is the tremendous opportunity to meet mentors. I've had opportunities to plan these meetings, get involved in programs at my own residency, and I think it gives you a small network of people that you can get to know well and really learn from.

You've spoken about the importance of finding a mentor. How would you advise students on how to find a good mentor?
The key to finding a good mentor is putting yourself out there. It can't be overemphasized how important it is to get involved with societies, get involved with networks within your own hospital, and then get involved with national societies where you get to meet with people all over the country. The goal of finding your mentor is finding someone you really resonate with. And the likelihood you are going to find someone like that is related to how much you go out there and meet people. So I think it's certainly great when your residency has built in programs to help you find mentors in your own institution, but the second step is really taking your own initiative to contact people. I have never run into a situation where I have e-mailed someone and asked for help and haven't received at least some direction. So I think it's about making yourself available.

What have you found to be beneficial in terms of balancing your professional and relationship/family life?
Being a woman in surgery comes with its set of unique challenges. I think that's part of what I've benefited most from being in AWS is talking to women who have been through these challenges before I have and gaining from their insights. It is certainly possible to have a personal life and be a female surgeon. I have been married for two years, so I'm still a newbie, but I think the key for our relationship and for most that I have seen be successful is communication and honesty. I think if you really make clear what your commitments to work are and where you are flexible, it makes your partner have reasonable expectations about what they can get from you. I think the second part is really when you're home and you've decided to be home, be home. Put the work away. Letting the people in your life, whether it's a spouse, family member, or friends, know that they're important to you, even if your time is limited, is making the time count. Certainly discuss your career choices with your partners, friends, and family so that they are aware of why you are choosing what you are choosing, why it's important to you, and how it's going to affect them, because it will.

What do you enjoy about going to national conferences like the AWS Conference?
Getting involved in national conferences is critical to succeeding in academic medicine. Not only because it's a great opportunity to learn about the scientific advances but because it's an opportunity to meet people who are doing what you are doing and doing it well. The AWS is a great network among the national networks because it also narrows it down to women who are doing well what you are doing. So I think it's important for medical students and residents to come to these meetings to see the possibilities, the range of careers that you can have, and find people who will help you achieve that. It's important to get the broad perspective. If you just stay at your own institution you will only see things one way. So get out there, go to the meetings, meet people, and enrich your minds with all the possibilities!

This interview was conducted at the AWS National Conference in Chicago, Illinois on September 30, 2012 by Ginger Slack, 4th year Medical Student at UCLA David Geffen School of Medicine. This document is a transcript with the exception of editing for grammar.

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