Women in Surgery with Dr. KB Golisch

So often we are focused on the future and just making sure that we are doing what our future self wants for the right reasons.

Like the Bachelor.

Are you here for the right reason?

Hi everybody and welcome to the podcast.

The Steams Generation of md.

My name is Stephanie. I'm joined here by my colleague Dr. Sarah Davis, and who is also my mother. And today we have a very special guest, Dr. Brooke golden bullish. She is a 6th year General Surgery resident in Chicago and she has large social media following. I followed you for a long time, so I'm really excited to have you here and hear about your journey a little bit. Do you want to give yourself a proper introduction?

Thank you so much for having me. I'm so excited to be here. So, yeah, so I'm Brooke. I am in my six out of seven years because I'm at an academic general surgery training program. So we do two years of research and I'm applying to trauma fellowship right now and very honored to be on this call with Dr. Davis and future Dr. Davis. And I was just explaining to them that it's about 4am for me. So if my words, I'm tripping over them a little bit. I'm on a stretch of nights and I have had one day off in 12. So I've got my coffee here and I'm ready to chat and give some insight and I'm excited to wake up and do this.

Well, thank you again so much for being here and I know you're so, so busy and you talk a lot about on your social media. Just the reality of being a general surgery resident just, just kind of like backing up. When was. Because I do kind of want to talk about that later, but kind of backing way up. When was like the first time that you thought about being a doctor?

Yeah, no, absolutely. It's a great question. And really young, so I remember just being really interested in a lot of things when I was young. When I was like eight, I was like, I'm going to be a lawyer. And then When I was 10, I switched to being a doctor. And who knows, it was really, I think exposure to reading books and like seeing shows and TVs online and no one in my family is a physician, but I was just like, that sounds cool. And I stuck to that one. And so it was a running joke in my family because I had read a book about like a patient that had or a family that had gotten a car crash and needed like burn reconstructive surgery. Then I literally from age 10 was like, I'm being a reconstructive plastic surgeon to everybody. And that was like the running joke in the family because how specific is that to be a 10 year old and want to be a reconstructive plastic surgeon? And my grandma would always make the joke to you have to do my facelift if you go into. So I have pivoted a little bit from that. But I think from that moment I, I really liked the sciences and I set my path pre med in undergrad and just really joined as many clubs as I could do to make sure that was the path for me. And I just kept finding from all my interests were really aligning to go down this path. And then regarding surgery, when I got into medical school I was told what everybody is told, going to surgery, if you like anything else, you should do anything else. And unfortunately or fortunately, depending how you look at it, I did not like anything else. So here I am six years into my journey and I'm still glad that I chose it. But I think it's just really the, you know, kind of you get this gut feeling that you want to be the physician and then you just make sure that you still do on the route down the line. And a lot of clubs and a lot of exposure and a lot of shadowing experience led me to continuing to be a surgeon, although not plastic general. But in my fellowship I may get some burns. So I guess I'm holding true to 10 year old me self.

There you go.

Do you feel like that that is a. Because I think a lot of people in medicine have a similar experience of being like deciding that they want to.

Be a doctor and then just committing.

To it and this kind of determination and sometimes even stubbornness of being like this is what I'm going to do. Do you feel like that is kind of a reflection of your personality and can you see that showing up like in other aspects throughout your journey?

Yeah, I think one thing I really try to emphasize to pre med and med students is something that I feel like I wavered with a little is I don't think you should do things just for the your CV or resume. I think if you feel like you're doing that, that might not be like take a step back and reflect. Because I remember for me I'm not incredibly passionate about research and you have to do some of that to get to certain levels if you're going in academic medicine. But I feel like a lot of times that feels more force for me. I've now found a little bit of a niche and educational Research that I like better, but just straight clinical research or any type of lab research was never my interest. And so I feel like, you know, to even back up pre med, if you feel like you're joining this club or you're doing this clinic or you're doing anything just because that's, that's the perception of what you feel like you should be doing or that is what you thought your life was going to be going on and you're not actually enjoying it. That's. I would really take that and take a step back and reflect and say, is this actually the route I want to go on? Because a, there's so many journeys in medicine that you can do, like clinically there's obviously wonderful routes and PPA or dental or anything. And so I've watched a lot of friends throughout and I'm sure you all have to like through the pre med route, like go different directions and be really happy. But even in surgical Residency There's a 20% attrition rate still, still to date. I know it's, I know it's extremely high. And so I think it's like, I don't think anybody should just be doing something because it was your childhood dream or because yeah, you really, every point is a good check in and it's never too late to change paths or to sh. Like just do it now before you're 20 years down the line and having regrets. So I think just good check ins and to say like, am I doing this because I truly enjoy it or am I doing this because I think I'm supposed to and it's what I'm supposed to do to get to that next level is a good thing to kind of have like annually or like with your friends and family too, with yourself and then like talk to other people as well.

Yeah, I think that that is such an important conversation to have. And have you ever had those feelings like throughout, you know, medical school and especially just surgery residency?

Yeah, I think it would. People who say no probably haven't done enough deep reflection on themselves. We're all. This is an incredibly hard. Becoming a physician is an incredibly hard journey that starts probably at undergrad with the mcat. And that's a huge accomplishment. And then it just. Sorry to any pre med listeners, maybe gets worse in some ways as you continue to go on, but better in a lot of ways as well, obviously. But I think, yeah, I think honestly these last senior years of residency I'm starting to get even more nervous. And I'm sure Dr. Davis, as you made the transition from resident to attending. You can probably speak on some of that as well. But, you know, going out and being completely on my own and having these. This responsibility that is now I'm a senior resident, some of it is actually following on, falling on me. I'm the senior surgical resident in the hospital at night. There's no one else in the hospital for emergent things that are happening in the trauma bay. And so some of these decisions are now completely on me. And that's a whole level of responsibility and trust and blame if something goes wrong. That is really hard to find. Figure out how you're going to feel about that until you're doing that. And so now I think some of those feelings are creeping in and it's. It's a little bit more. I don't feel like I've had imposter syndrome, really, and I felt very fortunate about that until this point. And now you're like, whoa, there's a lot of responsibility here. And I'm. Am I going to be able to handle that? But I think you just have to kind of trust the process and again, with the kind of talking to other people, have really good mentorship and surround yourself with people that can. You can bounce these ideas off and that you can be open with your feelings. And as I ramble, my last point on this is a little bit why I started my social media channels is because I'm really bad at feeling like I'm alone in my thoughts, in some of these deeper reflections. And so I don't want other people to feel like that. And so I feel like I really try to be candid about some of these challenges so that other people maybe can resonate with them and feel like they're not alone when they're having these doubts or concerns or maybe feel like, am I supposed to be feeling like 110% of the time this is for me? Because the answer for most of us is no. You're going to have doubts. You're going to have. This is, again, I think, one of the hardest things you can dedicate your life to. So.

Well, and you're going to have bad days. You know, there's. There's bad days where you're just like, oh, my God, you know, why did I. Why did I do this? And. And, you know, and sometimes there's a little bit of that jealousy as you see people who have chosen other paths that seem easier or more lucrative and. And that type of stuff. And so I think that that's. I think those are normal or normal questions. But then, you know, I think that, I think in medicine our bad days may be a lot worse than other people's, but I think our good days are way better.

Yeah, I, I truly highlight that as well. Like, there is, I feel like this is such a rewarding career. Every day I talk about it. So again, to go back to the research realm, I probably shouldn't be like totally putting down research as I'm applying to fellowship, but I need to be who I am. And so I again, love. So I get a lot out of the education. I get even more out of the clinical aspect, obviously of these things. And I think that was a really hard part for me when I stepped away from clinical responsibilities for two years. And I didn't feel that fulfillment that I feel in the hospital. And even it's like the little things, it's like just discharging a patient home to get to go home to their family. Like, that's a win for me. And I think that like you can get wrapped up in a lot of the critique on yourself and the long days, but if I just take a step back and focus on all the little improvements that I make for our, you know, we have a census usually of like 10 to 20 patients that I'm seeing each day. Like we've made someone's life better that day. And I think that that's just such a cool thing to be a part of and something that still can gives me the motivation to continue and to be really excited about this career.

Yeah, I can imagine that being really difficult in the moment though, to actually like, remember to remember those sort of things.

Yeah, yeah, it definitely is. You have to take a step back often from the chaos of everything and get some sleep and remember why you're here.

Well, yeah, and so just talking about like how did you decide to choose surgery and what about the residency? What so far have you felt like that maybe you didn't realize, you know, things that have been either better or worse than you anticipated?

Yeah, for sure. So coming in again, I thought surgery just from my crazy 10 year old self, but I'd always, I think, you know, coming into med school, if you're more procedural or not, I think that's a little bit of an innate thing. Whether you're more of a, like really not. This surgery I have actually like a TikTok where I do like a. Do you like thinking really hard or do you like using your hands? And that's like a very, very obviously like simplified version of what the Truth is, but I think for me, my personality is more. I want to act quick, fast, and do something that might have a result quickly more than have a really deep, like long, you know, internal medicine round joke of like the sodium discussion for two hours, which I am so glad that there are people that love and enjoy and want to do that. And people are so glad that I want to stand in the operating room for eight hours, you know, So I think that there is this kind of innate breakdown that you have. And so I say that's like the first thing that people should think about is procedural or not. And then the next thing I think is like more or even a separate, because sometimes the branch treat point doesn't go down that way. But also like hospital or clinic based I think is another type of decision. And I think that's also something that you kind of feel when you're in that environment. Like I talk about that when you like travel to, you kind of like have a vibe with the city. I think you kind of have a vibe with like a type of setting that you like working in or like an emergency department. And so for me, I much more enjoyed being in the hospital setting than being in an outpatient clinic setting. And, and surgery has both. You have clinic as well. But obviously the majority of the time is in the hospital. And so I think that is one thing that surprised me though, to answer the second point is I think in the perceptions of surgeons, a lot of the time is, you know, you come in, you see the patient for five minutes and then you leave. We see them preoperatively and postoperatively. And you know, yes, as in every specialty, everyone's time is way too short in your office visits. I can only imagine, Dr. Davis, from the family medicine perspective of things, I'm like, I can't even address one problem in 20 minutes. How am I going to go head to toe with somebody? So, you know, that's a, that's a difficulty. But something I think that I don't, I didn't necessarily realize is how much clinic and how much thought goes into every operation that you're planning. I'm going to trauma surgery. A little less people are rolling through the emergency department and it's quick thinking a lot of the time. But for planned surgeries, especially in something like surgical oncology, there is so much thought and decision and multidisciplinary discussion. So for people that don't know for like, there's things called tumor boards where you sit down with radiation oncology, the oncology Doctors, the, the radiology doctors. It's like six or seven specialties sometimes. And you go over a total surgical plan or medical plan or, you know, you talk about if this is an option for things. And so it's really cerebral as well for a lot of these specialties too. And I think sometimes that's a little bit more hand waved and something that I've really come to appreciate and really love about the specialty as well. So I think that was something that I have learned over this experience and I'm still learning about.

It's funny you say that. My husband and I always joke about how the surgeons hate clinic. And he does, he does a clinic, he's a sports medicine, primary care sports medicine doctor. And so he, and he does his clinic over at the university where he works once a week. And it's just for like a couple of hours, but every single week, no fail, he'll say, well, you know what I have today? I'm like, what? And he's like, clinic. We always just joke about how that's how the surgeons would always say, like, oh, I have clinic. Like, it was the worst thing. And I remember doing my surgery rotation, I was like, yeah, we have clinic. We get to talk to people.

Exactly. And for me, I'm kind of like a middle ground person. I actually really considered to back up on like the surgery journey. I really considered ophthalmology and dermatology because I knew I was procedural. But I also really knew I like talking to patients and spending time with them. And so quickly really realized eyes freak me out. So that was ruled out. But I did, I did think about dermatology for a while. And then ultimately there'd be these like large lipomas that would come in and they'd be like, that's probably better for general surgery. And they'd be like, ah, I want to follow that. And so, you know, my paths were converging in all ways. Even though I tried to branch out, like, you know, find something else that you love if it's not surgery. I tried and I ended up back here. But. But yeah, I think the point of, of kind of that is like, there's some of us that the clinic days are actually nice because it gets out of like maybe a little bit of the monotony of totally being in the hospital all the time. And so for me in my future, something I guess I also maybe didn't know in medical school, is I will be fully trained as a critical care doctor as well through my trauma fellowship. And so I'LL be able to staff in icu and I'll have weeks of just intensive care unit. And so for me, I really like that method. And depending on the practice pattern and the group that I join, it might be a week of like trauma call, a week of icu, a week of admin duties and education, as I hope to be in that sphere. And a week off might be the kind of the schedule. And I really enjoy that, that difference of everything. I don't think I could be a person that would walk into the office every day. I think then I'd be clinic again. If it's Monday through Friday, I would not make it. So.

Yeah, that's actually. That is nice. I love that like kind of rotating schedule. That, that does make make things a little bit more interesting. Yeah, yeah.

You talk a lot on your social media, just about being a woman in surgery. How did that impact your decision, kind of going into applying to a surgery or residency?

Yeah, so I, as I mentioned when I came in here, so I was just on an association of Women's Surgeons meeting virtual like webinar, where there was an orthopedic surgeon and a vascular surgeon who spoke before me. And so general surgery, I think is fortunate. We are doing better in our percentages than those two groups. And so it was really interesting hearing the orthopedic surgeons talk, specifically where the percentages are very low. So. So I do remember to presentation in my medical school that someone came in like a chair of a surgery department and was saying that there's been like psych, social, behavioral studies that you really need to reach the threshold of 30% of any demographic to really feel like you have a seat at the table of being heard and having that kind of like support. And no surgical specialty has reached that 30% yet. From the latest articles that I've been looking up, the one that I just found said general surgery is now at 22%. So we're, we're creeping up there. But I think it was ortho was still like 7% neurosurgery and that study was 9%. And so I think that, you know, just naturally from a numbers game, it's really hard to not feel like if you have specific issues pertaining to your demographic that they're going to be heard when it's not the majority opinion or why should people care necessarily. But so for me, I had really. I feel really fortunate and I think it's actually what helped get me into surgery is the mentorship at my medical school. Medical school was really wonderful. From women in surgery. We had a large support in that group and I actually thought I wanted to go into surgical oncology or breast because that was where a lot of my mentorship was. And they were all women. And actually all three of my letter writers for my residency were women from my home program. And when you're able to see what your future could look like, I think it's so much easier to go towards that future. I think it's harder to envision something that doesn't seem tangible or doesn't seem like other people have done it before you. There are people who are breaking glass ceilings, but it does seem very scary, especially if it's like an 80 hour week and you have to break glass ceilings. You get tired. So yeah. So I think that was really nice for me to see and be able to enter with that. I think there's other challenges as being a physician in general. I think being a surgery resident amplifies it a little bit. And so those are things like trying to find a relationship out of the hospital when you're working this many hours and exhausted. Again, any resident in general, the dynamics of maybe some people feeling like a surgeon who's a woman isn't a desirable partner for various reasons. A, B and C. Because I did.

See your social media and you, you talked about one particular subject, the outsourcing. And I was wondering if you, if you don't mind, if you wouldn't mind sort of commenting about that.

Yeah, so. And I've had mentors that you know, when you ask, I think this, the sentiment is it takes a village. And however you want to get your village there, like that's a personal decision for everybody. So on the call I the AWS call, the vascular surgeon was saying her husband is a stay at home husband and that's the dynamic that works for them. And so I think that that was just something and why I talk about it publicly on social media is one, because I have no filter and I probably need to learn how to have one. But two, because I think that this was something I really realized through this process is like that to me was not an important thing is discussing how much childcare is going to be done in the home or housework is going to be done in the home. Two separate topics. But for me they're a little bit intertwined versus discussing with a partner if you're going to be working 80 hour weeks sometimes. So my career will get better after residency in some weeks and some weeks it will be worse because if I'm On a trauma call week and I'm called into the hospital, it can be a hundred hour week still. And you see Dr. Grunch talk about this too, like she'll, she'll do her, you know, 36 hours and she, and she, you know, talks about her and I think she's a wonderful positive representation and how a supportive partner works and she talks about that often too. So it's not impossible obviously. But I think for me that was a huge learning curve and we, I think having those discussions early, if you're going into a field where you know, you're going to want to prioritize work sometimes and knowing that's okay because everyone has their own priorities and I don't think that will make me less of a partner or a mother. I think it's just when I have to turn that on, I'm turning that on and I want to turn that off. I'll turn that off. I like to hire out when I can on a resident salary. It's obviously difficult, but you know, or I'm picking at the fridge for my girl dinner at night and that's okay for me and you know, just not, not where I have the time or energy to, to spend when I'm spending so much time in the hospital and with patients. So that's really, my summary statement is, is if you're going to have a high power career, figure out for yourself what you're comfortable with outsourcing both child care wise and home tasks wise. And then just make sure you have that part, that conversation with your partner. And maybe that seems obvious to people, but it wasn't and it was a big learning experience for me.

It's, it's, it's a great subject and I like, it's something that I talk to even patients about that are, you know, they're not even, you know, doctors, but they're sometimes busy, sometimes they just, you know, there's things you just don't want to do and if you can afford to pay somebody to do those things, like to me I'm just like, why would you. And I think about like your surgeon hands that, you know, cost like a good half million dollars. I mean, maybe more. That is a very expensive tool to use to clean the toilets.

Your, your words. But I'll put you on that in the future. That'll be, that'll be to my next.

I'll be like, yeah, I just like.

I mean just the way that you're talking, I just, you never hear a man justify prioritizing his Work over childcare. So I don't know. I think it is a really important subject and it is important because I mean even me, like at this stage of my education and like relationships and all of that, it's something that I'm just like, oh, well, yeah, obviously I want to outsource, but you know, I don't really think about having those conversations because you know, the, my partner might be thinking like, oh, obviously, no, we're not doing that. So I think that is so important to bring up.

Yeah.

And just to highlight, there's nothing wrong with either route. Like I, you know, I have a lot of people I think, so support me on there. They like jump down and it's like, listen, like people can have what they view on their lives and what they want. I think you just have to make sure you're aligned. And I think that's the take home message from it. So, you know, you can do whatever you want, but you just have to know that that's like a clear path for you. But I think you just hit on something that's really interesting too. And I'm sure in medical school you hear it too. Like, and you will hear it as you're picking your specialty, especially if it's a more time intensive specialty. The women will be, well, do you want a family? Do you want that? And I just maybe a little bit more now. Tides are shifting and people are talking a little bit more. Especially like paternity leave is now a thing. Thank goodness. Like it's crazy that, that that wasn't a thing before. So I'm glad. But it's still way more of a thing that's discussed with women going into things is this, that's a conversation. And the fact that it's, as you mentioned, not even really a thought for a lot of men or for a lot of people mentoring men, it doesn't come. And it's one of the first things I think women hear.

It's good to talk about it, you know, with people who want to pursue whatever, whatever specialty. But it can quickly become this. Well, you shouldn't choose this because you know it's not going to be the life that you want to have. And so then, then that's, then that starts discouraging women from doing these things when really it, it can be, it's just maybe they got to make a little changes in the specialties.

Yeah. So we have at my program we do these things called cultural M&Ms. Where we've talked about like minorities in medicine and experiences that People experience in that realm. We've done a women in medicine. We specifically had one of our moms who was a surgery resident give a talk on like breastfeeding and, and all of that and in residency and how it's a part time job and how men don't necessarily understand that and how you can't be in the operating room hours straight with things like that. So I do think that there's being strides made in that direction. But it is, it's just a whole different set of kind of things that you have to think about. So it's really interesting.

I do want to touch on talking about, if you're open to talking about it, like freezing your eggs and did you do that? And how, how did your residency program, like, how were they able to support that?

Yeah, no, it's a great question. I love talking about it. And there I was also on like a webinar. Social media is so great because people reach out to you and like exactly how this happens. And you like, yes, I would love to like make this an official line on my cv talking about, passionate about. So we did this talk through the AWS as well and the fertility and there was like different people at different stages of their career and then also a fertility doctor on that giving some information. But for my program, this is where I think when you're interviewing for things for residency or fellowship or whatnot, like really getting to know the residents and knowing what their dynamics are like was really helpful because coming into my program I knew there was a lot of people with families. And then there were also people who had already undergone this process and they were very open about it. So there was already a pathway set up when I got here. We have a very large fertility clinic at my institution. It's a very large program in general. And so they have this. It's not necessarily a direct pathway for residents, but they just have. We all have the information very accessible to us. So there, it's like that's their own thing. They have a egg freezing process that anybody can go through, but the waitlist is pretty long. So you have to like get in initially and then it was about a year before my initial appointment. So you really have to pre plan all these things. But then once you're in the door, they walk you through the process and everything. And you know, the egg freezing specifics I don't necessarily need to get into. But it is like a month of dedication where you have to do shots and you have to do ultrasounds very frequently. So I did it over my research years where I had a lot more flexibility. But I do plan on doing it clinically again, and people have done it clinically in my program. You just have to obviously tell everybody that you're going to need to step out for a half hour. It's at your own program. So it's just down the hall. So that's nice of doing it, but I just for me, like that door being open, and I think that's something that people are actually asking on interview trails now is if this is something that the program offers as just an option and if there's a cost reduction for it. And so our residency insurance actually took it down to about $2,500 for us, which is. If you Google, like, the cost of egg freezing, it can be anywhere from like 20 to 40, depending on where you are. And it's out of budget for anyone, especially a resident. So it wouldn't be possible without the support of our training program, having our insurance that we do as well. Everybody definitely emphasizes do it when it feels right for you. I just think as we had talked about a little bit in my relationships, like, I think even if I wasn't in surgery residency, I might not be ready to be at that point in my life. So it just kind of lined up well that this opportunity was there. But no, no one is saying that has to be the option. I think it's just nice that it exists if you want to pursue that, because it's just nice to have, like, not feel like any door is closed for you. And so that's what I think the benefit of those types of things are. But I have, in our intern class, we have two moms right now, like, out of six people to, you know, that's a, you know, large number in that. So. So I do think it's like, people want to be supportive. Your life should come first. Like, obviously, being a doctor, being a surgeon is a huge part of who we are as people, but your life should come first. So.

Yeah, well, kind of going on as, why did you decide to do this trauma fellowship?

Yeah, absolutely. No, I love this question. And I need to prepare it for my fellowship.

Yeah, there you go.

Yeah, exactly. So, yeah. So I actually, as I was mentioning, my mentorship was so wonderful in medical school with breast and surgical oncology, that I came into the residency thinking gung ho. I was going to do that. And as I kind of got more into residency and started experiencing. It's nice. Similar to, like, internal medicine. General surgery is kind of, like, I say the internal medicine of the surgical specialties, because you have so many options, you can choose. I think it's like 11 fellowships you could have the option for going into. And so we rotate in month blocks. And so I actually started my first month on trauma surgery, and I was so overwhelmed. I was like, how am I, an intern, coming into this and just being thrown into absolute chaos in July, which there's higher, you know, trauma activations in the summer months, especially in beautiful Chicago. So I loved the month, though, but I kind of put that in the back of my head. Like, I've never considered that because I've always felt myself to be extremely type A, extremely want to plan, want to know what to do. Which is why I liked, as we were talking about the tumor boards earlier, I liked the fact of, like, sitting down, talking to a bunch of people, having a direct plan of what we're going to do, having bailouts, B, C and D, you know, all these things. What I've realized as I got more down this path is that you have the algorithm and you have the tools, once you become more competent, to do that same thing. Like, it's planned. It's just planned over years instead of, like, one session. So, like, now I have all these tools in my toolkit to go to this crazy level one trauma and just do all the things. So, you know, whether it's like cracking a chest or rushing a patient to the operating room, and, you know, that's gunshot wounds or stabbings or bad car crash, you can, like, use. Employ your algorithm. What you need to do. You know, trauma is very. This is like an ABCs in the. In the trauma bay of what you need to establish and make sure that you're, you know, helping this patient survive. So I've realized now that there actually is less chaos than I thought to it. It's organized chaos, really. And then I also, you know, reflecting on everything, people would be like, what is your favorite rotation? And I always be like, I'm on nights right now, and I just. I get this, like, energy from nights that I feel like is a telltale sign because not a lot of people say that. So I really enjoy that. I enjoy the camaraderie overnight. I enjoy the acuity of things overnight. You know, if something's going in the middle of the night, it obviously really needs to go. And there's a lot of tough conversations that come in. Trauma and the population also, there's a whole, you know, social aspect to an almost political aspect to trauma as well. And so I really Enjoy that. That expands out of the hospital and that there's a lot of work you can do on the ground beyond the hospital walls. And so that kind of all wrapped up together. And the final piece of that puzzle was when I got into research years and really stepped back and thought, like, what do I want my career to look like? And decided I wanted more of an educational role than maybe a clinical research role. The education in the trauma sphere, which what we talked about, like, having a week off just like dedicated to academic duties, I think fits really nice with that. And so there's actually a lot of program directors, a lot of clerkship directors that are trauma surgeons around the country. So it's like every little piece of the puzzle, even though it wasn't like the end picture I thought I was going to get, was slowly starting to fall into place over the years. And so coming back as a senior resident this year, it's been even more validating that this is where I'm supposed to be. I had my trauma rotation in January, and I definitely was tired, but I think when you're tired but fulfilled, you, like, really know that that's where you're supposed to be. Because if you're just as exhausted as you can be and you're still excited to go back to work the next day, like, that is. That's telling you something.

Yeah, that's great.

Yeah, that is. And I just. I really like your story, and I really like how you're describing all the puzzle pieces that are coming together over time. I think a lot of people, kind of my peers, who are also like first year, second year, third year medical students, I. I feel a lot of pressure to, like, decide what you want to do and decide what. What do you want your life to look like? You got to apply to residency. But I just really like the way that you're describing your story of being like, okay, then I did general surgery residency. And then like through these years, I figured this part out and this part out. So that's like, inspiring for me to hear.

Yeah, I don't think a lot of people I know have like a completely linear path. It's pretty. And I think I thought I was. I thought I was coming and I was like, I'm a hundred percent doing surgical oncology. Like, no one's going to convince me out of this. And this is a total. People are all like, it's really different fields. So if people are very confused by it. And I'm like, well, I don't know. This is my. This is My path. But yeah, I went from, you know, plastic surgery to dermatology to back to general no to ob GYN to general surgery to breast surgery, surgical oncology, trauma surgery. So. So it's, you know, more focused. But there definitely were times where. And I think that's totally normal. And I think you're doing a disservice to yourself if you're not questioning things and trying to make sure that this is exactly what you want to do. So I don't think first and second year, I think is about, you know, people like ask what they should be focusing on if they're interested in surgery first year. And I honestly say like the task at hand, like really immerse yourself in all your blocks and what you know, however your school does it, really immerse yourself in all your pre clinical classes and shadow in some things you think you might be interested in and maybe get an involved in some research projects that you might be. So that you can see like the behind the scenes and if you're really interested in that too. But I think overall it's like it's okay if it's not until the middle of third year where you've seen some things on the ground that you really start to understand yourself because it's really hard to know until you're in the environment. And so that panic that you're feeling as a first and second year I think is totally normal. Like, feel it, sit with it, feel it and then, you know, just kind of start making lists of pros and cons and it'll come together. And. And also the thing is, if you need an extra year to take some time to do some research or something to figure that out, that's great, that's fine. I mean, financially sometimes that's hard, but if you have the means to do that or the support to do that, I think that's a huge thing at the program I'm at right now. It was less of a thing at my med school, but I think that that's totally an opportunity as well to do that. There's no rush. This is the rest of your life life.

That is a great point about general surgery that really has so many different avenues. You know, really until you said that, I hadn't really thought about that quite so much. So I think that's, that is an interest. That's, that's kind of good for people to think about, you know, I mean, you have to just like, if you want to do urology, you've got to like match to urology or orthopedics or ent, those things you have to do from the match. But general surgery, you can go into general surgery and then a fellowship afterwards and figure out exactly where to go.

Yeah, and even with those specialties though, as I'm learning more and I'm, I cannot speak officially for them because I know very little. But like for example, like ortho, like ortho on is a totally different field than like spine. And then so there's fellowships in all those surgical specialties as well. Different way of life and things. So like an ENT specifically, like you could do more outpatient things and then you could do these, these crazy 12 hour flaps that then we take care of in the ICU. So like I know about that more than I know about their outpatient things. But you know, you can really make your career what you want to. And so I think that's a misconception with surgery too. Like there's different paths you can take for, for trauma even. Like I can go into a very lengthy, I can pick the amount of shifts I want. I can do an academic center where you have more responsibility. Or there's these more like they're calling them, I think they're calling them, I don't know, the trauma, traumalogist, I don't know what exactly the term is, but it's basically like hospitalist for surgicalist I think is actually maybe the term. And so you're basically employed like 12 shifts a month, like an emergency medicine or a hospitalist where you are just working like night shifts or day shifts and it's shift work. And so it's very interesting. And so there's lots of changes. There will continue to be a lot of changes, especially in the current like medical climate of what the career looks like. And so you can really kind of cater or try to cater what it looks like to you. And again, a breast surgeon has a ton totally different life and patient population than I will as a trauma surgeon. So it's, it's really interesting the more, you know.

Yeah, for sure. Lots of different options and lots to explore for sure. But you were kind of touching on this a little bit. I always ask all of our guests this. We have a lot of listeners from pre meds to physicians to non medical people. So do you have kind of any advice for people like me early in their medical journey as we kind of like continue on this path?

Yeah, so to summarize a little bit earlier. So I think there's, I think believe it's called the arrival fallacy. Where you're constantly looking for the next step and forgoing things. And so I think I diagnosed myself with that problem. But being in the moment I think is that, you know, the short advice is stay in the moment and whether that means just like appreciating where you're at because past you is so proud of you for getting to this point. You know, you didn't think you'd get here and now you're here and so the next step, if you're doing your best, if you're staying true to yourself, will come. And I think so often we are focused on the future and just making sure that we are doing what our future self wants for the right reasons. Like the Bachelor, like are you here for the right reason? Just making sure that you are feeling really secure and the place that you are right now. And so that means like, like looking around, looking at your setting and just making sure that you're asking yourself like, am I doing this for me? Am I doing this for my cv? Am I doing this for other people? And just making sure that the answer is that first one that you're doing this for you and that, that you keep doing those check in points. And then like I said for the first year medical student, like I think looking 10 years or I get messages on social media a lot for medical or for sorry high schoolers and I'm like, no, like take a deep breath and enjoy because these moments in your life, high school, college, med school, like this is a block of your life where you are like it's so unique, each part is so unique. So focus on that and everything else will come. I know it seems like it won't, but it will. So to back up, to reiterate as I answer this question, if you're a first year medical student, focus on your work ahead of you. Do the best you can on your exams, you know, develop some mentorships, develop your friendships. These are going to be friendships for life. And start to do some shadowing. But you don't need to have your step one plan set up in your first month of, of medical school and then in residency too. It's like continue to just focus on what is ahead like in front of you and make sure you're doing the best in that and make sure that that's the path you want to continue going on. And then everything else really does kind of work itself out.

Yeah.

Thank you so much for being here. I know you're probably exhausted, so we.

Really appreciate you being here and giving.

Us so Much of your time. Do you want to, like, plug all of your socials and everything?

Yeah.

So on Instagram and TikTok, my handle is live laugh xlap. So E, X, L, A P. I did not know what that was as a medical student. It's an exploratory laparotomy, which is like the most common surgery we will do as a trauma surgeon. So. And then on Twitter, if people that Twitter is. Or X is more like medical professional, I'm more. I'm less candid on that. My. My bosses follow me on that. So that one is actually Brooklyn, which is a surgical technique and it's a play on words. It's a procedural. So anyway, I like puns if you can't tell. So, yeah, so you can follow me on there. And I'm always happy. It's hard with some of the dms. There's a lot. So there's my email address on there too. I'm more likely to respond to that or. And I'm always happy to do if I can, if it's in my schedule to do. Like, I was just at. As I was talking to. Dr. Davis is here about the association of Women's Surgeons presentation. So if you have like a medical school event coming up or a residency event, I am happy to chat about it. I really love of mentorship and it's something I hope to do and continue to do in my career. So thanks for having me.

That's amazing. That is amazing. I don't know how you have enough hours in a day.

Yeah. And you guys know where to find.

Us @Generations MD on Instagram and TikTok. And if you have any questions, you can email us at ask generations MD gmail.com and we'll talk to you next week. Bye, guys.

Bye.