I did a rotation and just knew. Before spending a week on the service, I had little idea what plastic surgeons actually did for a living. I was amazed by the variety of problems they tackled and the techniques they
employ. It wasn't unusual to do some hand cases in the morning, then see a TRAM flap breast reconstruction, and join a big free flap case later in the day (such as a free fibula for mandible reconstruction). I liked a lot of different rotations as a medical student and initially thought I
would have a hard time deciding. But I found that plastic surgery was a great way to combine certain aspects of them - we operate on people of all ages, all over the body, and incorporate new techniques all the time (lasers, microscopes, flow couplers, endoscopes. Unlike some areas of
surgery which are shrinking, plastic surgery is growing. Every day is different. It is impossible to be bored on a plastic surgery rotation.
How did you prepare yourself for application to
your chosen specialty?
I did two sub-internships and carried the Michigan Manual of Plastic Surgery everywhere with me. I talked to some residents ahead of time and asked them how I could help the team and have a successful rotation. The residents were all very helpful, loved to teach, and wanted me to succeed.
Who wrote your letters of recommendation for your
application?
Some Plastic Surgery programs require a letter from an academic chairperson, so I made sure to get a letter from the chairman at my home institution. It's important to have well-written letters from notable
names in the field. There is no doubt that these carry weight. Letters from non-plastic surgeons tend to be ignored. The reason is that outsiders are ill-prepared to judge a candidate's suitability for a
training program that they're unfamiliar with. I did a significant amount of research, and made sure to get a letter from my thesis advisor. Very few people mentioned this letter, however. Everyone focused on my letters from names that they recognized.
Which programs did you apply to and why?
I initially applied to 22 programs, got interview invites from 16, and attended 12 of them. I only looked at programs I thought I might go to, but tried to keep an open mind. I think it's important not to rule any
program out early. I wasn't all that limited by geography, so I cast a wide net, read as much as I could. I also asked the residents and faculty at my home institution about programs they liked and didn't like. THIS
WAS HUGE. There were programs I hadn't even considered until a few of the residents started raving about how much they loved it during their interview.
What kinds of questions did programs tend to ask you?
Just the sort of questions you might think. You MUST know (1) why plastic surgery, (2) tell me about yourself, (3) how do you stand out from other applicants, (4) why this program, (5) where do you see yourself in 10 years? There are still lots of programs that will ask you fact-based questions. It's not so much about knowing the answer (unless you've done research in a particular area or have otherwise espoused a knowledge base in something), as how you answer the question. If you're stumped, pause. Don't mumble. Keep your confidence. Try to say what you do know (VERY briefly), or if it's a question about how you would manage a certain problem, talk about your general strategy or what the goals of
reconstruction are. That shows that you're thinking. When you get to specifics, just admit you don't know and would need to look it up.
What was the most difficult part of the application
process?
Each phase has a difficult part. During the initial application, people struggle with the personal statement. We aren't a group that's terribly comfortable writing about ourselves. My best advice is to keep it simple
and try to keep it interesting. We don't want to read lengthy, sappy prose. Tell a story or two. Next, it's tough preparing for interviews. There isn't much information out there and, again, many of us have a hard
time talking about ourselves. It's all about preparation (check out http://www.plasticsmatchinsider.com/the-interview.html).
What should I look for on my interview and tour
day?
The tour isn't as important as taking the time to talk to the residents. Get to know them, just as you want to get to know the other applicants. These are your future co-residents and colleagues for life. Do you fit in
with the group? Find out if there is a mentoring culture. Ask about whatit's like to live in that particular city? If you're family oriented,find out if the other residents have families (you'll find some programshave lots of residents with families, others do not). What do people dowith their spare time? Every hospital largely looks the same and has the same resources. When it's 2am and you're on call for the 2nd week of q3,
you'll need people to lean on. Not a pretty lounge.
What questions should I ask of residents, faculty,
and program directors?
I would ask them about the case mix. Are there any weaknesses? Plastic Surgery is so broad that a lot of programs have a hard time exposing the residents to everything. Notable absences tend to be aesthetic/cosmetic, pediatric, craniofacial, or hand surgery experience. Are there fellows?
How do they contribute to or take away from the educational experience? How are didactics handled? What do graduating residents of the program do with their lives? Are there any changes coming to the program (new hospital, new faculty, faculty leaving, etc)?
How did you form your rank list?
As you interview, TAKE NOTES. You'll forget the small things about each place that catch your eye. Jot down a story you heard, your overlla impressions, strengths/weaknesses. As I interviewed, I put together a
preliminary rank list of the places I had been. I would fit each program into the growing list. There was a lot of rearranging at the end, but it was instructive to have a draft list at the end of the interview trail.
Once I had interviewed, there were 6 programs I really liked. I asked the residents and faculty at my home program about them.
What other advice can you give seniors applying
in your specialty?
Don't fool yourself. Plastic Surgery is becoming more and more popular every year. Many think of it as a "lifestyle specialty" but make no mistake that this is a surgical training program, at least 6 years long
(not counting any fellowship). You will work VERY hard. It is important to know for yourself the real reasons you are applying. You should enjoy surgery, enjoy working up and solving the sort of problems that plastic
surgeons manage. Think hard about taking some time to do a research project or at least writing up a clinical paper, not only to see if you're really interested but to show programs that you're committed.
