#9: An Interview with a Neurosurgery Resident

welcome to another episode of the Zach Hailey show today I have the luxury of being in the Alina hatar Medina who is a seventh year neurosurgery resident here at Jefferson Alina was born in Amman Jordan and grew up in the Middle East as well as Odessa Ukraine and Montreal Canada her family immigrated to Ramsey New Jersey when she was just 13 years old and she attended John Hopkins University where she earned a dual degree in neuroscience and public health she returned to New Jersey after college to attend njms at Rutgers University for medical school Alina enjoys a variety of surgical cases she's exposed to and is planning on specializing on spine and skull bases correct yeah correct during her spare time she enjoys running with her husband Jose who's a family medicine resident at Jefferson having movie Nights with their dogs Macy and Snoop great names and spending time with her close-knit family in New Jersey welcome Alina thank you so much for having me thank you for coming so we always start with some statistics around whatever the specialty we're talking about so I'm going to talk about some statistics around neurosurgery and then you tell me how you feel about them okay so entering resident characteristics the step one score average of a USMD graduate is 248 compared to the 232 average so 248 for a neurosurgery compared to the 232 average step two score average was 251 for neurosurgery residents and 245 average for everyone else AOA membership so 33 percent of neurosurgery residents were part of the AOA versus the rest was 11.5 percent in regards to do students 15 applied in 2020 and three matched to neurosurgery in regards to IMG students in 2018 35 applied and 10 matched in 2020 the match percentage was 74.3 percent and it takes around seven years of training usually for a neurosurgery training salary wise attending the average salary of a general physician is 339 000. the average academic medicine associate or full Professor median salary is 752 000. for hours the average physician Works 51 hours a week while the average neurosurgery attending Works 58 hours a week in regards to burnout a 2020 printout report says general burnout percentage was 48 percent in neurosurgeons it was 51.1 percent and neurosurgeon residents it was 45.4 percent with the most important factor being personal accomplishment according to the report anything interesting anything surprising or uh I would say so those are some um six for kind of entry into neurosurgery can be uh kind of scary to people and I think um yeah they're ways of getting around this uh even if you don't have the highest step one score um and we joke every year when we're kind of interviewing medical students that the bar it seems keeps getting set higher and higher because people are just you know so accomplished and um and although that may be true I think if you're kind of uh your sites are set on neurosurgery there are ways of doing research and kind of rounding out your application to uh becoming somebody who who has a real chance of being able to do it uh and enter you know residency um some of the other statistics don't seem as uh uh kind of surprising I think neurosurgeons in terms of uh burnout I think uh oftentimes you kind of feel a it's very rewarding to to be in this field so uh you kind of get a lot of um I like in some ways you're very inspired by your patients and I think that helps with with that so the burnout part uh I guess I'm a little surprised that it's actually a little higher than for attending so yeah so that was interesting to me the 51 for neurosurgery attendings and 45 for the residents yeah that's weird I don't know yeah you would expect that yeah residents would be more burnt out because they spend more time in the hospital um yeah I don't know but also like you have the resident camaraderie we like form basically a family because you end up spending so much time with other residents and fellows in your program that you you have other people to rely on maybe when you're in attending it's that part of it is higher so let's get right into it what is neurosurgery uh neurosurgery is a field where we basically get to operate on the brain and the spine and it deals with lot of neurologic disorders and structural disorders that can be treated with surgical techniques and tools so kind of in vascular you have patients who have strokes subarachnoid hemorrhage you know brain hemorrhages dealing with patients like that you have patients who have experienced degenerative spine disease or have unfortunately had a spinal cord injury for example and treating those patients there are different subspecialties of neurosurgery but those are just some examples of what what some of those can look like and your interest you said is is spine and skull base is that like I'm trying to think so I guess I I don't know much about neurosurgery so I guess skull base as opposed to the rest of the skull you're not working kind of the front of the skull the lateral aspects of the skull yeah there's some overlap skull base deals with uh literally the base of the skull where a lot of important cranial nerves and and vascular structures live um so uh it's a I guess subfield in cranial neurosurgery and then I am doing an enfolded spine Fellowship currently an infolded spine Fellowship what is that so enfolded fellowships and neurosurgery just means a mean that you're completing a fellowship within your seven years um in the past there were some programs that were six years long and now every program is mandated to be basically seven years and there have been some kind of talk about kind of making the residency I think kind of an unnational scale of making residency for neurosurgery shorter or specializing at an earlier time but basically an unfolded Fellowship allows you to do a fellowship within your residency that's usually done at your own institution um it's pretty cool yeah so uh I did my kind of Neurosurgical years one year of research as well as last year I did my chief year where you're kind of running you know an entire service and and kind of pulling the strings behind what what it takes to kind of care for Neurosurgical patients um and kind of lead your Neurosurgical team and then this year I get to do specialize in of you know a specialty in neurosurgery and I chose to do uh spine so I'm basically just doing spine surgery and seeing patients and such that's great so what is so PG so pgy6 is Chief here pgy 7 is kind of a specialty you get to do more kind of pick and choose what you're more interested in yeah uh I mean you you still kind of apply into it and uh but uh my two other co-residents co-fellows are doing a vascular I see uh Fellowship currently uh so they get to do endovascular training as well as open vascular so you we do have other um kind of uh fellowships in The Residency but that's what that's cool Fellowship within residency that's really nice yeah so and then the first you guys don't have to do a uh like prelim year or anything right it's just straight into neurosurgery right yeah so can you talk me through the first five so we know what sixth year is Chief here okay seventh year is you're kind of picking and choosing more your fellowship what are the first five years of neurosurgery residents like so intern you're first I would say intern year was the most stressful year of my entire training really only because you're given so much responsibility uh patients can be very sick who you're taking care of and you do have a lot of guidance like you're not you're not alone there's always oversight and you're kind of uh buddied up with a second year resident most of the time uh and when it comes to kind of like initially evaluating patients triaging things um but it's I just remember you know in medical school you're not taught that much about neurosurgery like you kind of have to make your own experiences happen and seek you know Neurosurgical experiences kind of do research on your own time and then fourth year you get to experience a little bit of it but uh oftentimes like med school is not really geared towards teaching you about neurosurgery specifically so and off and it's I think we make it a little more intimidating than it is like it becomes this black box of uh you know this person has this this issue and um but in reality it's uh you know it's I think you just have to have a strong work ethic and um you know it's it's possible for anybody interested in neurosurgery going to medical school to to do that ultimately you just kind of have to decide how much um if you're willing to make some sacrifices to be able to do it um so I think first year was very stressful in terms of kind of uh I felt like there was such a big change between going from my fourth year to intern year and um you uh you suddenly like are taken care of very very sick patients and um it's it's kind of more stressful and then you You Realize by the end of the year how much learning has happened uh because things just come second nature and then you're put into the position of needing to teach the other incoming class so then second year you're teaching away right yeah so then you're like oh wow I you know they ask you questions and to you like all of these things just you've internalized them because you've taken care of so many patients over the year and then um like there is progress that that is made but oftentimes like in the moment of you know dealing with multiple emergencies at the same time in the ER the trauma Department can be pretty grueling when you're when you're just an intern but we do have a lot of help like our our support staff is phenomenal our nurses are phenomenal or you know oftentimes like when I was an intern in the or a junior resident you know I would learn so much from like our nurse practitioners or just nurses in the or who would be like oh why don't you try this like you know you just have to kind of be open to getting some of that education in ways that you didn't think you would you would get it um so second year you're kind of uh more you're having more of that to teaching opportunity with a more Junior resident first year resident and then you get to start going to the or more I would say um because of course you're kind of you're more in managing people on the floors exactly for surgery before surgery yeah you're barely actually I mean maybe you've already scrubbing into procedures and things like that yeah I think like uh if you make if you make your own um you can kind of figure out a way to go to the or after hours like you spend the day after your work day exactly like if there's an emergency and you really want to you know operate you can you can go and so wave it right so so so so so so so you sign like sign out seven right yeah and then you stay to five and then if and then something comes in at 5 30. yeah and if it's a very exciting case I've done it I mean I've also had um I've also had uh senior residents just tell me like oh you'll you'll get your opportunity like in the future you should go home and get some rest because that's also important like there should be somewhat of a work-life balance but um you're just like so excited to be able to do these things sometimes you you just want to be there you know um but you have some uh opportunities in the or as a first year and especially now actually we've restructured um our uh program where because we have four residents we have three residents two residents doing kind of clinical rotations a third resident on neurology or uh kind of a another field of that's very collaborative with neurosurgery learning for example radial neuroradiology or neurology and then the fourth resident doesn't operative rotation so they get to to be in the OR which I did sometime in general surgery which we no longer do and that that's interesting yeah interns have rotations on their own that's kind of nice yeah yeah that's nice so now it's different but I was the last class that did a general surgery rotation and again general surgery we didn't really go I think I went to the or one day to like a surgery center uh otherwise it was just a lot of floor floor work seeing patients it seems like the first kind of year yeah you kind of have to learn medicine and learn how to take care of people uh perioperatively so it's that's good to do the fun stuff exactly that's an important part um so second year you get to go to the or um but you still have that role of like you're the overseeing person teaching a junior resident and more responsibility falls on you um in that in that sense like you need to know that everything is going to plan and and hopefully mistakes are not being made and you're kind of you run through things and like algorithms and protocols with the junior resident um third and fourth year you're doing more operative time too finally um and and uh like in our third year that's when we send residents to uh chop for their pediatric rotation uh and that's a rotation where kind of for the first time you're on a smaller team and you're immediately interacting with uh the attendings so you kind of become like your own Junior and senior resident at the same time like you're doing floor work but also you're running things by attending plus like you're going to the or it's it's uh you do a lot of learning that way um and you get like basically immediate feedback and they kind of tell you what they're thinking as well so it's it's pretty educational but kids are very different than adults so it's that's also another thing can you sub-specialize in Pediatrics afterwards yeah yeah that's a fellowship yeah that's a fellowship it's a one-year Fellowship um and then fifth year you kind of get to do uh research on your own or do more clinical clinical work if you if you're interested um and then sixth year is our chief year now and then seventh year is kind of some more time you get to do either research you get to do an unfolded Fellowship um so you kind of get to decide yeah so you're kind of thrown into the fire then you teach the people that get thrown into the fire and then you start to get some or time and then you kind of get to do your research and then you get to go do your Chief years or your big big in charge person yeah and then you get to go do your specific interest once you're kind of nearing the end that's interesting yeah so you said the first year is the hardest you think I think so I thought I thought Chief here would be the hardest yeah but I mean you're just trained to uh you spent all this time training to you know take good care of patients outside of the or patient with patient selection and you take them to the or you feel much more comfortable doing all the surgical procedures you're given more autonomy and more responsibility and then you take care of patients you know outside out of surgery um and you're like kind of in this innate leadership position that you you kind of have to you have to have some leadership skills to be able to lead the team cohesively and um but at the same time you realize like we have some amazing support staff and nurses and um and it's always nice you know at the end of of uh a hospital stay that a patient had to hear that they had a great experience they love the nursing staff I don't think the food is great at the hospital they'll they'll uh um you know and then they'll tell you oh the the junior residents were amazing and kind of hearing about uh so many of the people who kind of make their care possible uh is something that you know I think makes makes us proud to be part of Jefferson that's great so how much are you working how much give me uh so first year when is the time you're working the most because I hear stories of you know people going into the hospital nurse or even my fourth year med student friends they say they go in they kind of sleep there a little bit they don't want to miss procedures or don't want to be there like or miss the morning start early true is the thing because the neurosurgeon I think has the biggest stigma in in my learnings as a medical student okay of being the most work intensive specialty there is right this is the this is what I hear from other people you know other Med students maybe not from real neurosurgeons or people that are actually in the field but from other Med students how true is that are you actually working all the time do you have no lives outside of I don't I think that part of neurosurgery is to some degree temporary yeah and now that there are work restrictions I mean some people have mentioned that you know it's very hard to do all the required training within the limits of the work restrictions but we still you know abide by those and kind of keep an eye yeah I mean we I to be honest I've never counted how many hours I spent in the hospital because I just to me I really enjoy my job and I really enjoy being there and especially if you love being in the OR the way time passes in the or is just different than how it is outside of it it's hard to explain but some people ask me you know how long it takes to do a certain procedure and they're baffled to hear that certain procedures take hours and hours but it I mean you don't think of it that way because every surgery has different stages and different challenges there are different things that you do with [Music] um I guess you're you're like very dialed in to to certain parts of the procedure you you maintain that throughout um but there are more you know intricate part to every procedure there are Parts where you're for example closing skin and it's just kind of a routine thing that you've done a lot a lot of I've thrown so many stitches you know over over seven years that it's like I don't even think about that part um but you still have to kind of be meticulous and just make sure you know you're you're doing every every part um uh well uh but it's you kind of lose track of time when you're there and I think like well I guess I'm sure you'll ask me about my normal work day but most of the time you would wait you would be in the hospital kind of by five or so five a.m and then you there's there's a lot to do and a lot to learn and uh we kind of make sure as when you're chief resident for example that there's an efficient transfer of information that happens whether that be in the morning when the night float person is signing out or in the you know 5 PM when the day team is signing out and you know you need to make sure that everybody gets their rest too um I think those those hours the kind of long hours that you spend in the hospital uh I think that's kind of a temporary thing and then once uh once you're in fellowship or and attending those things also change it's not it's not forever um and you kind of kind of makes you more I think resilient and able to do to do things even when you're a little tired but uh the work is exciting enough that like you being tired does it doesn't affect you as much yeah then you go home and you eat something or you sit on the couch and you immediately you know fall asleep uh because you don't have that like adrenaline that you have at work um so what is it now so so you said 5 a.m you'd usually get there yeah now now I get there a little later um but as Chief that's pretty much when you get to work 5 a.m you round on patients uh you round with the night team uh and the night team is really just one resident at each Hospital you ran with the night team as well it's not just hand off yeah you you round with them and then you kind of uh make sure that all the plans have been communicated to the day person um so we're we're doing um we're not doing like in-person rounds with the with the residents but as Chief you pretty much see um like every ICU patient and then floor patients as well and new patients when you're you know in the morning you round you [Music] um basically go make sure everything's ready for the patient you know whether they be elective or or kind of pre-admitted you make sure they're in the holding area that everything is teed up and ready to go for for surgery um the or starts at 7 15 that's when they get in the room usually uh before that you kind of go over cases a final time with the attending uh that you that you will be participating in um and oftentimes we'll have like an educational conference a few times a week uh prior to the or starting and then uh you go to the or you do an average of like one to three cases a day uh if it's three it's usually like shorter cases if it's one it's usually a longer one um and then for each case you sign out to the nursing staff taking care of the patient uh in the pack you are in the ICU for example and you sign out to your own team uh and then at the end of the day I would just go see all the patients that I've operated on that day and um wait for the last patient to kind of be out of anesthesia and be able to do a neuro exam on them as well before I go home so it's every day is kind of you don't end up doing the same thing every day on average is it like say is it like five two uh I would say like most days I I would go home by six or seven okay it's probably earlier now that I'm in Fellowship but also now in Fellowship I get to see patients in clinic which I've done a little bit of that during residency but it ends up being that like the there's so much to do in the hospital that we don't uh get as much experience in clinic uh and now I get to see patients in clinic uh for spine uh who are either uh you know referred by their primary care physician or by pain management and come to see us you counsel them about you know what you think is going on about surgery um and oftentimes it kind of takes a few Clinic sessions before you can before you sign them up for surgery because they basically need to exhaust a lot of conservative management options before you recommend surgery to them um and then you know if they are still experiencing uh pain or for example some neurologic deficit then you kind of talk more about surgery uh and then you get to see them postoperatively like weeks out um so that's that's always a good thing to see because in the hospital you oftentimes just you know take care of them for that perioperative period and then you don't see them for months on end or you know unfortunately if they have a complication or something they'll come back but um it's good to kind of have that longitudinal care exactly um and you get to have that as a as an attending but sometimes when you're a resident you it's hard for you to see the big picture of what you're doing so so regular days in the hospital or days would be kind of 12 hours five to six or seven uh and then Clinic days is that like shorter four or eight to five yeah something yeah and then you don't start doing Clinic days until fourth fifth year third year um it depends uh I did more Clinic personally in my fourth and fifth year um but uh and now there are more efforts kind of put in to have residents be involved in clinic earlier because it's still an important part of you know being able to select patients for for surgery and kind of figure out who might benefit the most from you know the surgeries that you can offer um so that's that's really important first yeah um uh so it's it's an important part of Fellowship training and Specialty training um and it's something that like we're actively trying to incorporate it's interesting because when I I mean before I even started medical I didn't think surgeons ever went to the clinic you know what I mean I thought they just lived in the or I thought that's with their entire job the surgeons they just stay they cut things and then they go home they cut things and then they go home I had no idea that's such an important part of I think it's not everybody's favorite part of the specialty um definitely Neurosurgical procedure that's kind of one of the biggest days of their lives so you kind of have to do a lot of counseling and talk to them about what they'll experience and you know what what to uh what to expect and that that becomes a big part of that I was talking to uh Dr okasani I don't know if you know a CT surgeon at Jefferson and he was saying he actually thinks the clinic days are the most important days out of that event more important than the or even because he's like these are where the decisions are made for sure he's worried he might miss something or make a bad decision because when you're in the or you know you're just you're of course there are different paths that procedures can go down but you're essentially doing a set set of things to do right yeah but in the clinic is where you're making these actual decisions for sure with this so it's harder to tell a patient uh to not operate on a patient sometimes and operate on them and you kind of have to have a clear idea of what aspect of the disease they have that you can help with and what what things you're not expected expecting to get better with surgery you can be in the greatest hands of some somebody very experienced and take you know every precaution give perioperative antibiotics or you know make sure every sterility is perfect and all of that but patients still can get infections and have complications that are just oftentimes just unfortunately bad luck and then uh you know you kind of have to weigh those risks against the kind of benefits that you can provide and and be realistic ation yeah it's where it's almost where I think medicine surgery becomes an art because you're taking these standardized risk calculations right which you're performing on every patient and saying okay their risk is say 10 on this procedure uh but then also maybe this could happen if they don't go through the procedure and it's where your kind of experience and your clinical training comes in to say listen work because they always ask the question this is my brief experience with patients they normally say what would you do what do you think I should do it's very rarely I mean sometimes it is but rarely in my experience they're saying listen I've done I've done the statistical analysis myself I know how I feel I know what the results of the procedure are going to be I want to do this usually they're turning to you yeah usually they're turning to you and saying listen make the decision for me I trust you as an expert my Advocate and my caretaker to kind of make this decision and this is decision oh yeah it's a tough decision yeah it's true so on more decisions if I were to give you 100 million dollars and I would say okay you have this 100 million dollars no taxes it's yours it's in your bank account do whatever you want would you a continue to train and become a full-time attending neurosurgeon and stay a full-time attending neurosurgeon B work part-time C quit entirely and go live on a beach or something like that or D switch careers personally I I would continue working for sure so uh it would be hard to do neurosurgery part-time okay too I think at this point I'm excited to be able to take care of patients with you know with Neurosurgical issues and and uh kind of practice uh I want to say that I would continue working I would like to yeah I would like to continue to work full-time exactly and I think it makes a little bit more sense maybe for you as opposed the answer makes more sense in my head to you as opposed to maybe someone who's later down their career because you know this is new to you and you're new you're going to be a new attending you want to get through all the training and stuff like that and the learning and the other good point which is the other ethical point that I sometimes think about when I am answering this question for myself is if I had a doctor would I want a doctor that dedicates their whole life to it spends every second doing research spends every second doing practicing their clinical skills their technique everything like that or would I want someone that works part-time on this yeah I don't know I think I want the guy who's Crazy mad about neurosurgery guy or girl crazy man in our nursery and spends every waking second of their life thinking about it right so I don't know I that that may be a little more extreme purpose but yeah yeah it also it brings up the point you know uh people talk about reimbursement and how much money uh the average neurosurgeon makes and although it's like the stats you had talked about earlier although it's more than uh the average double physician exactly uh you spend so much time in residency where you're not getting paid very much Fellowship um so you're technically I think for the hours you work if you make the calculation you're technically working like below minimum wage I I believe it I haven't made the calculation but I'm sure you're making below and then you know going through medical school going you know doing research before that maybe even uh you know all that adds up and that's in addition to of course completing College here so oh I don't think it's an unfair conversation at all I just think it's it's a it's interesting right because it's crazy it's it's a crazy amount of time and I think yeah yeah well I've never heard of somebody going into neurosurgery who purely said you know oh I'm doing it because like the compensation is so good at the end of it because I didn't do it exactly because it's so much um you you have to make a lot of sacrifices and uh I think that's true for nearly all yeah I think so I think so and then you have to enjoy also taking care of very sick patients sometimes even uh and uh being in tough you know life life or death situations making those decisions too so that all goes into it and there's no amount of money if you didn't have the heart to be in it that could possibly compensate you enough if you're not genuinely wanting to do it I would say definitely good point why neurosurgery then for me it was a combination of a lot of things you have to have a love for neuroanatomy and actually in college I did not plan to double major initially I did public health and I was really interested in population Health which can be kind of thought to be almost at odds with neurosurgery because it's such a small population of people who gets affected by certain neurologic diseases that require neurosurgery but um I did Public Health initially and then I started taking Neuroscience classes and they were like the weed out classes that I ended up enjoying so much for some reason I was taking them as an elective and I ended up accidentally like like classes where yeah they wanted to make sure that people were you know dedicated to that major and those were the hard known as the hard classes I didn't know that I just like just killed them anyway no but I I ended up kind of stumbling into those classes I'm like oh that sounds interesting and then basically almost accidentally double double majoring in Neuroscience because you just keep signing up for courses yeah like you might as well get them yeah exactly then then at a certain point somebody told me oh yeah it's possible for you to double major so I um so I genuinely enjoyed that that aspect um I think we touched upon a few things but basically it's uh a very rewarding uh specialty where you get to interact and and be part of patients lives and um so you know during some of their most impactful experiences uh and you get to interact with a lot of other sub-specialties where oftentimes intertwined with you know neurology Radiology ENT different Specialties where we're kind of having an ongoing discussion of a patient and that part is um I think you know very nice to be able to kind of have that interaction you have to have a strong grasp of medicine still because uh neurointensive care is very important in the care of neurosurgery patients so you have to be able to you know manage ICU issues uh throughout different systems in the body not not only that you know neurologic issues um you also uh get to kind of have your life be put into perspective when you treat patients with Neurosurgical issues because you realize you know patients are resilient and you learn a lot from that from from them from about that but at the same time like you realize your life can change in the split in a split second and to care for somebody for example with subarachnid Hemorrhage a stroke spinal cord injury somebody who's been diagnosed with cancer you know it just kind of makes you appreciate a lot of little things in your life and and your health your abilities that um I think kind of uh just add to to your life in a very impactful way so in college did so did you know neurosurgery in college well you did the neuroscience and then like at the end you're like I know for sure I'm going medicine and no you just thought medicine I thought medicine in college um I did do I signed up through that uh through that uh major I signed up for a like observership actually with shadowing uh shadowing a neurosurgeon at Hopkins uh Dr Biden actually he was a spine surgeon there and he was so kind and like uh went through uh MRIs with me went through Imaging uh wow I haven't talked about this in a while but he um like it gave me a different idea of what neurosurgery could be like I think it's nice to kind of meet charismatic people are people who are who you can relate to like people think of neurosurgery neurosurgeons as like uh mad scientists almost sometimes who have like very little social skills sometimes or they're just like singularly focused on their job and um it's nice to meet just real people who have other hobbies and others so Dr Biden was a real person yeah exactly now he was very kind and I think it was uh very nice and and I learned I learned a lot from him initially and then um and it was like a short rotation I'm sure he doesn't remember me but uh then I went on and kind of saw different experiences I after college I volunteered at Wild Cornell and their um Neurosurgical Ward this was also very random I just uh ended up spending a few hours uh every week kind of taking care of patients talking to their families hearing a lot about their stories is this a gap year uh this was a gap Year yes and I did something else like I worked at a Pediatrics office actually but most of the time and did other things um but uh I ended up doing that and I was very inspired by the patients and kind of learning about what they had gone through what their recovery looked like and little by little I kind of um saw different experiences and uh I think going into Medical School initially I don't I don't know if I knew that I would ultimately pursue neurosurgery I had other people telling me you know you kind of have to rule everything else out and if you're still interested in neurosurgery at the end of the day you know that's what you should do but it's such a grueling specialty that uh you know you have to be prepared to like not talk to your family for a long time and that's right I hear that but I hear that too or like people tell you you know I knew I wanted to do neurosurgery and I and I knew a neurosurgeon and they told me they you know couldn't spend time with their kids or and I think there are certain sacrifices you make but at the same time like if there are things that are important to you you can still make it work and I come from a very tight-knit family too so uh I think uh I heard these stories and they kind of scared me but at the same time you know I have a very supportive family and uh they they really kind of supported me and and pushed me to still still do it because at the end of the day you know I still that's what you wanted to do it's what I wanted to do and uh they knew I could make it work and when I didn't have you know full faith in myself they kind of pushed me at the same time not to say that uh my mom is is the only person in my family who's in healthcare she's a nurse and I learned a lot from her but my parents never expected any of us you know my siblings and I to go into medicine at all um and but you know it's it's important to have somebody on your side when you have doubts to kind of uh support you along and I'm really thankful for that yeah do you think um because I'm sure you've experienced challenges and hardship you know going through not only medical school but neurosurgery would you say the biggest helpers for you the people that kept you in it the people that kept you motivated and focused and not burning out or not getting depressed or sad or frustrated was was your family did you use was there anything else that helped you say quote unquote well yeah I I mean I think my family uh I I got married at the end of medical school actually right before starting a residency and my husband too he's um he keeps me saying he's a family medicine attending actually uh he just finished his residency last year and he's a hospitalist a Farber hospitalist at um in our department in neurosurgery actually so we get to kind of work together and I get to call him and say you know what do you think about this collaborate oh yeah he calls me about things all the time and I run things by him too because there are certain things um like more medicine things that I may not be as fresh on that aren't like Critical Care related or just like oh what do you do for I don't know yeah exactly or little things that I'll ask him about um or how do you follow this you know uh and he yeah it's it's been cool to kind of so it's a family relationships those of you think were the major support structure and it's it's funny because when I was applying it to neurosurgery I was engaged at the time and uh I'm not sure you know I kind of had different different things said to me about being a woman going into neurosurgery who is in a long-term relationship um do they say well they say it won't work out or or and it's not from people I was interviewing with it's just from like other medical students or other people uh who I was talking to before and you know I think it was thought and I don't know if this is true but for a man going into a specialty like neurosurgery it kind of um if they're married it kind of shows that they're like in a stable relationship they have a lot of support that may not be the same for a woman or I like there were other things that I was told that made me kind of I decided not to wear my engagement ring for interviews at all really yeah I kind of didn't really worried about they're worried you're not going to be as focused on neurosurgery because you're in a relationship yeah whether you might get pregnant I don't know exactly but uh those are kind of like illegal questions people yeah they can't they can't ask you those things or um but I didn't even want it to come into the kind of I didn't think anybody needed to know about my relationship or whether whether that'll impact my experience positively or negatively so did you see that in practice when you were kind of at when you're on the interview Trail and that like that did people ask you about relationships no nobody no this is just other Med students that's good to hear that's yeah yeah so you've so you did College you did this Neuroscience thing and you're like this is kind of cool and then you did your experience you're like this is pretty cool I'm going to do medicine so you go to medicine you're in med school at what point is the neurosurgery decision made I think I kind of had a good idea that I wanted to get into it like at the time around my second year yeah uh I had done some research and neurosurgery between first and second year then after that summer you really just keep going I think like you don't have as much exactly and then you're a fourth year you have a little bit more time but yeah exactly but before that you're like just in med school non-stop I put so much importance on step one I remember and I was uh I fortunately ended up doing well but I was so stressed about okay is it is it going to be prohibitive for me to you know entering neurosurgery like is it a death sentence for you know being able to get in I would say I I did well and I I was a you know I was able to get interviews and everything a little less stress when I when I got my score and then I was able to do my clinical rotations and I loved my Neurosurgical rotation I think I did a short rotation during my neurology clerkship and then got to do some neurosurgery and then ended up doing yeah fourth year you really have to do SUB eyes and AIS and all of that so um you get like three four to four months of neurosurgery um so it's uh I guess I knew pretty early on and that was an advantage that you know I was able to do some research early on um but I've had friends who kind of decided late and were still successful in getting in and making it happen great you have and you're happy with the decision of nursing yeah yeah I couldn't imagine doing anything else to be honest were there anything close it was definitely not I think for a split second I thought about ENT I did my rotation on BNT and um it was interesting but honestly the cases that were the most exciting to me were cases that we were doing with neurosurgery and then I realized okay there's a reason for that I should you know and I I love it yeah I'm so glad I did it so your husband's a family medicine attending and you're a neurosurgery neurosurgery seventh year do you notice differences in lifestyle work life those kind of things because you know we hear things about family medicine and then we hear things about neurosurgery are those things true does he have a chill relaxing life and you have no relaxing life or is it kind of less less true than me I think I think that's less true yeah uh we definitely uh he isn't attending he's an attending but I think going through uh residency it's funny to hear about uh just they're kind of more of like an empathic Huggy residency group and I'm not saying that we're not impacted but they're like very warm and fuzzy and we're we're different at the same time um but you I don't think you see those differences as much outside of of work um yeah but he still gets gets a taste of what neurosurgery is because he takes care of Neurosurgical patients as well now so you send him all the neurons he has to take them exactly that's funny so what is the best thing about being a neurosurgeon the best thing um I think getting to uh operate on incredible structures and on patients and and be able to be a part of hopefully their journey to recovery and um it's just the kind of it's incredibly rewarding I would say that's the biggest thing that that I love about it that's great and now you know the next question what is the worst thing about being a neurosurgeon that's a hard question you can say there's nothing bad about it it's all good I guess I mean I guess the hours that you you have to spend um sometimes you feel like you end up missing out on certain parts of of uh being with loved ones but uh at the same time I think you you kind of have to be more diligent about scheduling things and figuring out what things are important to you and what you don't want to miss out on what's the longest procedure you've been in that's that's a hard question I think in medical school I've been in certain skull based cases that went into the night and they were like first first case so starting at 7 30. um and going to like seven o'clock or five o'clock oh like what do you mean 5 p.m oh no no like like past midnight sometimes so seven a.m to midnight and I mean I've had I've had some procedures that take take a long time that's 17 hours in an operating room yeah it's a long time I've I've heard of people you know being in doing surgery even longer but that's very unusual to take breaks yeah especially surgeries that are that long usually have uh kind of combined teams okay working so sometimes like an ENT surgeon will be involved or other teams um yeah there there are surgeries where you usually it's uh skull based I would say um where you have multiple teams involved and they can take a long time but that's I would say that's an anomaly even for skull base especially neurosurgery residency how do you maintain your like wellness and positive attitude and feeling you know not burned down because you're not do you you are you burnt out or not I don't think so yeah I don't think so so how do you how do you maintain your Wellness I just have other things outside of neurosurgery that like I think it's still important to kind of have an identity outside of your specialty as much as you can love it I think uh sometimes you need breaks from it to be honest uh recently I got into something that I was doing in college actually uh I started doing a lot of indoor rock climbing indoor rock climbing yeah I was just talking to one of my what level walls do you do I was just talking to one of them so I'm doing more bouldering right now I'm like V3 V4 Boulder that's pretty good uh but I'm I'm still you know trying to improve and just focusing on being like as healthy as possible hopefully not you know not enjoying myself I think a lot of the time people enjoy themselves from like pulling muscles and doing things that uh maybe they're not their body's not ready to do so I'm just like taking it slow and uh enjoying enjoying it med student and I'm interested in going into neurosurgery what should I do maybe in my medical school career or maybe even undergrad to make myself the most competitive the best chances of getting into a neurosurgery program oh towards other Specialties um and you know if in the back of your mind you want to do neurosurgery and learn more about it be more exposed to it that's great you should definitely seek opportunities I've seen people as young as you know high school students be involved in research Labs Neurosurgical research research Labs oftentimes you have like college students and medical student level researchers but um if you're motivated I think you can kind of find your own opportunities email people don't get discouraged if a neurosurgeon doesn't reply to you just because I think they get like hundreds of emails a day I'm sure they get a lot of emails but um at the same time you know uh try to find kind of research opportunities um I did I mentioned like an observership uh type of experience that was being offered at my school um I applied to be like basically a nursing Aid uh for just an additional experience a volunteer experience at Wild Cornell um then I think research really helps and even if you don't end up ultimately doing neurosurgery uh it can help for any field in you know in medicine so uh that's always something good to have under your belt um and then kind of I think when you're applying you know some some people kind of talk about oh I've always known to be you know I've always known that I wanted to do neurosurgery little boy yeah and it's like uh I mean I think that's that's fine but at the same time like you don't always have to know that you've wanted to do it your entire life and that your entire life culminated towards you you know doing this that uh it's possible you know to to kind of um kind of figure out later on that you want to do it oftentimes when you're interacting with a Neurosurgical team or doing a sub eye you know we really just want to get to know you get to know your personality and see that you're a good fit for our group um so that becomes like really the important most important part at the end of the day because you can have a lot of qualifications but you also you know want to have that personal connection that makes sense what do you think are the characteristics of someone that would excel in neurosurgery so I think you have to be resilient uh kind of be able to take feedback yeah do you have any tricks or tips for say someone's going into neurosurgery and they're starting they've this is a couple months away we're in interview season right now for uh interview season I guess is just starting for residency but do you have any tips and tricks for kind of incoming neurosurgery residents like I know some people surgeons they keep a notebook where they keep all their procedures and attending preferences and stuff like that are there certain tips and tricks that you've learned through neurosurgery things that you've seen successful interns and Junior residents do um tips and tricks I think uh just keep an open mind be willing to learn uh be willing to uh ask questions uh and that's a lot of you know a lot of the time how how you learn and I think a lot of the time how you avoid complications to uh you know just having a clear understanding of the protocols and you know the pathway to caring for a certain type of patient is important and you can get that guidance from from senior residents um uh be humble uh you know I think even when you're a junior resident you're put in kind of a leadership position when you're for example going down to the trauma Bay and you're the only neurosurgery representative maybe with another like second year resident um and uh it becomes very important to be able to know uh you know uh know how you can help the team and be a team player but at the same time you're like now put in a position where you're the neurosurgery doctor and you have to kind of assess that situation and yes you talk to other more senior residents who also comes assess the patient until you um discuss the case with attendings and everything but uh you're kind of like thrown into this position I remember starting off you know you hear like Dr hatar and you turn around you're like they're talking to me like you're just starting and somehow somehow uh you're put in this position but I think those are the main things just keeping an open mind staying humble being a team player uh and just working hard because at the end of the day if you keep putting one foot in front of the other and working diligently you'll get where you need to be sometimes you get you have growing pain starting off but that's normal everybody experiences that that's helpful and then for the future of neurosurgery is there anything exciting what is there anything that's exciting to you about the future of neurosurgery are we going to be able to you know transplant heads at any time soon or brains or you don't think so I don't I don't think so [Laughter] um the future of neurosurgery uh I think something exciting for me in surgery in general and neurosurgery too is uh just seeing more uh kind of the visibility of women in the field because I I think starting off and that's the experience I've heard a lot of other female surgeons have that um and now it's a little better but sometimes you kind of just have to have a blind faith that things will work out but you don't see like yourself represented in certain Specialties and women unfortunately uh we don't have that great of representation in neurosurgery about I think 12 of neurosurgery neurosurgeons are women um so it's one of the fields where not as many women are entering the field that could be for many reasons but I think the kind of that is changing to some degree and it's nice to have some representation some Role Models like Dr Drew mccara she was one of the uh she was the first like female dual trained endovascular vascular neurosurgeon in the U.S the resume is pretty yeah it's really incredible uh Shelly Timmons was one of the doubling s first pres one of the president's past presidents a few years ago there's women Neurosurgery Group which which is a national group uh kind of promoting women in the field as well uh so it's and I think a few years back there was like that campaign of this I am a surgeon or this I'm probably butching this I don't know um like this is what a surgeon looks like and it was women posting on social media that they were surgeons so it's kind of uh it's nice for people to to see that uh you know there's diversity and and neurosurgery as well and I hope that more people get to um kind of be exposed to that and realize like oh wow people are able to and you are helping with that right I hope so you are you are um so I think we're nearing the end here do you have any closing remarks for medical students who are interested in neurosurgery say they're a first or second year and you know they're they're kind of like they're kind of like I think this is cool but you know everyone in school is telling me neurosurgery is hard or anything like or any closing remarks you want to say whatsoever I would say if you love it uh and you really want to do neurosurgery there are ways to to um pursue it uh there's you know I know people who might have not not had the highest grades or might have not had the largest amount of research or there are always ways around that and you can always if you're truly dedicated you may need to take you know a few years off and maybe polish up your your resume a little bit but it's it's feasible to do in terms of um kind of sacrifices I think it's an incredibly rewarding career choice uh it may be a lot of hours that you spend training but uh it's worth it and I wouldn't say um you you have a lot of support with other people going through it at the same time uh I think a lot of people could do it I wouldn't be just discouraged based on what other people say about you know uh work-life balance and things like that um and uh that's basically it perfect and final question what is your favorite song to listen to in the OR do you have a favorite song or favorite artist favorite artist I know some say Dua Lipa or who else who are famous Jefferson people like we do listen to Dua Lipa contemporary [Music] uh I've been into Amy Winehouse recently uh I think it's it's uh she's just uh so talented and uh procedures as well no not really no but but uh I I would say I've recently I've listened to a few of her songs again after many years of not listening to them and that's perfect and that's perfect the Cadence is good it's not too too fast it's pretty catchy uh yeah she's an incredible vocalist amazing well Amy Winehouse that's the answer to the entire podcast thank you so much Lena for appearing it was fantastic and really helpful all right thank you thank you

Channel: The Zach Highley Show

Views: 76,820

Keywords: the Zach Highley show, zach highley, podcast, Zach Highley podcast, medicine, med school, studying, growth, personal growth, doctors, medical school, study tips, study, personal development, self improvement, self-improvement, launch, launch trailer, podcast launch, insane podcast, doctor, medical doctor, md talk, neurosurgery, surgery

Id: MC19X75Je9A

Length: 65min 37sec (3937 seconds)

Published: Mon Mar 27 2023