Kelsey: Oral and Maxillofacial Surgeon

I’m very excited about today’s career profile! Why? Because it’s crazy in-depth and the researcher in me loves that. Also, I tend to not edit these very much because I want you all to hear the voice of these women and Kelsey has a strong voice. I think that is especially important in researching careers that don’t have as many women because it helps us to imagine how we’d fit into a specific position. Enjoy!

What is your job title?   Oral and Maxillofacial Surgeon/Surgical Resident

What is your job description? Oral & Maxillofacial surgery (OMFS) specializes in treating many diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the Oral (mouth) and Maxillofacial (jaws and face) region. It is an internationally recognized surgical specialty. It is recognized as both a specialty of medicine and dentistry. An oral and maxillofacial surgeon is a regional specialist surgeon treating the entire craniomaxillofacial complex: anatomical area of the mouth, jaws, face, skull, as well as associated structures. The scope of surgical training includes proficiency in the following areas: Head and neck cancer – microvascular reconstruction, Cosmetic facial surgery, Craniofacial surgery/Pediatric Maxillofacial surgery/Cleft Surgery, Cranio-maxillofacial trauma, Head and neck reconstruction (plastic surgery of the head and neck region), Maxillofacial regeneration (reformation of the facial region by advanced stem cell technique). Oral and Maxillofacial surgeons will be trained to perform the following treatments- Dentoalveolar surgery (surgery to remove impacted teeth, difficult tooth extractions, extractions on medically compromised patients, bone grafting or preprosthetic surgery to provide better anatomy for the placement of implants, dentures, or other dental prostheses), Surgery to insert osseointegrated (bone fused) dental implants and maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids, Cosmetic surgery of the head and neck: (rhytidectomy/facelift, browlift, blepharoplasty/Asian blepharoplasty, otoplasty, rhinoplasty, septoplasty, cheek augmentation, chin augmentation, genioplasty, oculoplastics, neck liposuction, lip enhancement, injectable cosmetic treatments, botox, chemical peel etc). Corrective jaw surgery (orthognathic surgery), surgical treatment and/or splinting of sleep apnea, maxillomandibular advancement, genioplasty; Diagnosis and treatment of, benign pathology (cysts, tumors etc.), malignant pathology (oral & head and neck cancer) with (ablative and reconstructive surgery, microsurgery), cutaneous malignancy (skin cancer), lip reconstruction, congenital craniofacial malformations such as cleft lip and palate and cranial vault malformations such as craniosynostosis, (craniofacial surgery), chronic facial pain disorders, temporomandibular joint (TMJ) disorders, Dysgnathia (incorrect bite), and orthognathic (literally “straight bite”) reconstructive surgery, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry; soft and hard tissue trauma of the oral and maxillofacial region (jaw fractures, cheek bone fractures, nasal fractures, LeFort fracture, skull fractures and eye socket fractures).  {see here for more}

What did you study in college? I obtained my Bachelors of Science degree in Biology from the University of Nebraska-Lincoln, my DDS from Creighton University, and my M.D. from University of Nebraska Medical Center.

Why did you decide to pursue that degree? I fell in love with the scope and surgical capabilities of Oral and Maxillofacial Surgery as a profession, and I knew that in order to pursue this career I would need a strong scientific background.

Was there anything about your education that surprised you? Yes- there are still very few women in my area of surgery, approximately 2%. As a female you will encounter gender bias barriers because of this high proportion of males. The bias will often come more so from patients than other practitioners, however you will encounter sexism among male colleagues in this and other areas of surgery as well. Another factor to consider is the student loan debt. Because we attend dental and medical school, most of us will end residency with close to $450,000 to $500,000 of student loan debt. In general, we make a very high wage that will enable us to pay off our debt more efficiently than a lot of other health professions, however it is still something to consider as that is a huge loan burden and can sometimes restrict your options on pursuing jobs after residency.

How does your education relate to what you do at work? My education related directly to what I do, and I am still educating myself as a resident. Surgery and medicine in general is evolving at a rapid pace, and a huge portion of my time in residency is spent in continuing education and academic/didactic case conferences or journal clubs in an attempt to learn all that I need to know to be an excellent surgeon as well as keep up with the rapidly progressing pace of modern medical and surgical technology.

What specific aspects of your education prepared you for your career? Dental school prepared me for the intraoral procedures by familiarizing me with the teeth, jaws, occlusion, and anatomy of the head and neck. Medical school contributed significantly to my management of medically complex patients. Performing surgery on a healthy 16-year-old vs a 72-year-old on 18 different medications with multiple chronic diseases are two totally different things; my medical training is what really helped me to know what considerations are important in more aged or less healthy patients.

Was your degree the only path to get this job? For what I wanted to do and the scope of surgery I want to be qualified to perform, the path I took is the best. My path was: 4 years of undergrad (Bachelor’s degree), 4 years of dental school, then a 6 year residency with 18 months to approximately 2 years of the 6 composing the third and fourth years of medical school to obtain an MD degree. There is a second option to become an oral surgeon in which you go to dental school and then pursue a 4 year residency and do not earn an MD. These oral surgeons will have all the surgical capabilities within the oral cavity and jaws, however their surgical scope on large-scale facial reconstructions as well as facial cosmetic surgery will be limited once they are out of residency due to the fact they did not obtain their medical education.

kelsey3

The first time I became a doctor. (yeah, she said first)

What are your plans for continuing in your profession? I have 3 years of residency left, so I am not 100% sure where I will settle. My choice will come down to staying in academics and working at a hospital vs going into private practice. Both have advantages and disadvantages.

What are some of the challenges of your job? The hours can be challenging. An average day in the world of surgery will start at around 6:00am with rounding on patients, then the first operating room case of the day needs to be prepped by about 6:30 or 7. The first case will usually start at 7:30. Depending on the length of cases and how many scheduled, operating room days can go late, sometimes until 7 or 8 pm….or later if it is a busy trauma week. If you don’t have operating room cases that day, working in the clinic is more cases but they are shorter, usually 20 to 30 minutes, so it tends to be more fast-paced. Clinic work usually ends at around 4:30 or 5pm, then you generally have about 1 hour or more of patient notes to write from that day. If you are the resident on call, your work hours may extend through evening and any time over night, depending on what emergencies come into the hospital. On weekends, if you are on call you sometimes may end up working full days or all night, because of high amounts of trauma (this is especially true in warmer weather and around holidays when people are drinking and driving). Generally, as you progress through residency and have more seniority, your on-call hours will decrease.

What is rewarding about your job?  It is extremely gratifying to be a specialist who can come into an extremely traumatic patient situation, such as someone who has just experienced a horrible car accident and has multiple facial lacerations, and have the knowledge and skills to immediately treat the patient in a way that will make a huge difference in their quality of life. A person’s face is not just their appearance, it is their identity, and to be able to walk in a room for a patient who is severely injured and disfigured, put on some gloves, and “put them back together” to restore their appearance and function within a short period of time is a great honor and privilege.

kelsey5

Are there any stereotypes in your field that you have to deal with and how do you deal with them? Mainly the gender bias of being a female in a highly male-dominated field. Patients will almost always assume I am a nurse; even after I introduce myself as a doctor, patients still tend to assume I am a nurse. Often times patients will ask me a question, I will answer it, and then when one of my male colleagues comes into the room (even if they are a lower level resident than I am) the patient will repeat the question to the male, as if I had never answered it. At the beginning of my residency, things like this really infuriated me; but I have learned through my training thus far appropriate ways to handle these situations with patients to point out their behavior but not be unprofessional or embarrass them, simply to remind them that I am in fact the doctor and am highly trained and qualified. It’s important to learn to diffuse these situations without creating animosity with patients, because that is the only way to change the gender bias moving forward. If patients can remember the fantastic experience they had with you as a female doctor, they are very unlikely to underestimate other female doctors in the future.

kelsey6

How do you balance work with your other life obligations and goals? The first year of residency was sometimes difficult to find time for other activities because of being on call and working 80,90, or 100 hours per week or more during those busy call weeks. Now as an upper level I have much more free time. I will say, however, that even during that busy year you have a co-resident who is sharing the responsibility with you, so there are at least 50% of the weekends that you will have to spend time with friends and family, rest up, and catch up on household chores. You learn quickly how to maximize your free time and enjoy your days off.

castle

Proof you can have a life during residency–pictures of castles from a trip my (now) husband and I took to Ireland last this past March.

castle2

What do you think could change in your field in order to make that more possible? Honestly, this profession is extremely rewarding and will provide a good financial living long-term; however, the realities of the training commitment during residency can be rigorous, and it is a very difficult time to pursue having a child as a woman, if I would want to do so. I do know women who have done it, but the long hours can make for a very difficult pregnancy and it is very hard to take adequate maternity leave and stay on track with the program. The women I know who have babies during residency often will only take 2-3 weeks of maternity leave. It’s also very difficult to breast feed long-term because it is frowned upon to break scrub during a long surgical case to go pump, and there are very few bathrooms around the operating rooms to find a private place to pump. Most women will postpone having a family until the later years of residency, or just wait until they are done. The only way these things will improve, however, is if more women come into the field and “normalize” that process of being a female, pursuing surgery, and having a family.

What benefits does your work offer in regards to maternity leave/family needs? The previous question references to difficulties with children during residency. After training, however, once you are in practice Oral and Maxillofacial Surgery will provide a great life. Most OMFS’s work a 3 ½ to 4 day work week and do very well financially. They also will get great vacation and in general have a very high job satisfaction ratings due to the amount of control they have over their lives because of their financial freedom and practice hours.

What advice do you have for other women who are pursuing this field?

First, you must be aware: it is very competitive to gain acceptance into this training program. In order to realistically pursue this career track, you must work extremely hard in school and keep your grades very high. When you are in dental school, you will be among the top 5% of students in the country, and you will have to be at the top of your class among these very high achieving individuals. I will not kid you, following through with this career field is not for the faint of heart; it is a long track, with many years of hard work and razor-sharp focus required, but it is totally worth it. If you think you may be interested in this field, I would encourage you to seek out other women or very open-minded, encouraging male surgeons who are in residency or practice. You will meet a lot, and I mean A LOT of naysayers who will criticize your choice of profession, indicate you will not “make it” through the long training period, or try to insinuate that you are choosing to have a career and will not be able to have a family because of this. You MUST ignore these people and seek advice from those who will be realistic with you about the challenges of this profession but can also acknowledge that it is absolutely possible to pursue this amazing career and have a family. No one ever tells my male resident colleagues that they can’t have a family because they are going to be surgeons. You should not accept that either. Yes, there is another element of difficulty as the woman trying to have a baby and be the surgeon, but it absolutely can be done, and more and more women are doing it all the time. This profession is extremely rewarding and philanthropic, and more and more patients are requesting female surgeons as the face of our professional workforce in this country continues to change. It is a gift and an honor to be able to have the knowledge and surgical capability to give someone their face back after a terrible tragedy like a trauma or a large facial resection from cancer. You will have many, many life changing experiences as you pursue your training and learn how to restore individuals facial form and function through your area of surgery. If you know that you have the academic ability and the determination to be in this field, I would strongly encourage you to move forward and work hard to get there, I know you will be glad you did.

The final thing I will say to you as women who may pursue this career: choose your partner wisely. It takes a very special man to be willing to support a woman throughout this journey. The average guy is not going to be thrilled about a long, competitive, grueling career track which will require you to possible wait a few more years on having children. This is not any reason for you to avoid becoming a surgeon. The man who will stand by you and support your training is exactly the kind of man you want to marry, because he will stand by you and support you through anything. You must choose your companion wisely. Marriages have often failed throughout surgical residency because of weaknesses that were already in the relationship but that were magnified when the stress and pressure of surgical training came into the picture. You must realize that putting your career first for a time and seeking marriage second is NOT a mistake, (men have been doing this since the dawn of humanity!) You will need to find a partner who respects what you are doing and realizes that there are going to be many times that he may have to pull an unequal amount of weight in household chores due to your residency schedule, but that a relationship is not a competition, and you should not be keeping score. You also need to find a man who is humble and secure enough to accept that you are a doctor, and this may be even more challenging if he is not one (my husband is a carpenter and he is amazing), because our society places so much emphasis on the imagined “prestige” of this title of doctor. You will also find it challenging to find a man who can fathom the fact that you will very possibly make more money than him some day *gasp!*   All of these factors make your choice of relationship partner critical to your success and happiness as a wife/partner and as a surgeon. You will likely have to hold out for someone who really is that special person who will support you through this and anything, because of your “non-traditional” career path. I just got married 2 months ago, at 30 years old (which is young and fantastic, by the way, and I couldn’t possibly be happier) and my husband is solid as a rock and absolutely worth the wait of investing in myself and my career until the right one came along. PLEASE do not avoid surgery or any other challenging career because you think you won’t find someone to marry you, you will! You just have to be patient until you weed through all the average Joe’s to find your non-traditional guy who was also holding out for someone as unique, hardworking and special as you.

Pictures from my recent wedding (2 months ago), which I was also able to plan during residency

Pictures from my recent wedding (2 months ago), which I was also able to plan during residency

kelsey2

 

This is Katie again, wasn’t I right to be excited? Kelsey was great to also provide a couple other resources to give further information on this career:

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s