Episode 20: RUSM and Plastic Surgery

Milena Garcia: Welcome back future Rossies. Thanks for joining us again. So today we have Dr Sola Fasusi. Thank you for joining me. Let's have you take a moment to introduce yourself.

Sola Fasusi: Hey guys, how are you doing? Sola Fasus, RUSM graduate in 2010, I’m here today with Milena to talk a little bit about plastic surgery.

Milena Garcia: Tell us a little bit more about your background.

Sola Fasusi: Well, I'm from Maryland, grew up in the DC area. I went to Morehouse College for undergrad and after that matriculated into Ross. Like I said, that was around 2005 2006. Graduated in 2010 and then after that went to general surgery residency at the Medical College of Georgia and then subsequently did my classes or if you're training at the University California Davison

What is Plastic Surgery?

Milena Garcia: What is plastic surgery. Can you cover all the aspects of it?

Sola Fasusi: Yeah, of course. There's actually a lot of different elements to plastic surgery. Most people just think about the cosmetic element of it, but it's a very broad, in-depth field. So there's hand wounds, burns, cranial, facial, microvascular, reconstructive and of course, cosmetic. So within that scope, you can see there's so many different elements of plastic surgery, which is one thing that really, really drew me to it, because someone's like, the sky's the limit. You can get a chance to operate from top of the head to the bottom of the toes,  really all aspects of the body.

Milena Garcia: And how do you get into this specialty?

Sola Fasusi: It’s mainly two routes. At this point, there's the integrated route and then the independent route. The independent route was the more traditional route of getting into plastic surgery. So what I mean by independent route, that means that you basically went through an accredited surgical residency, most commonly general surgery, but you could also do things like EMT to a lesser degree. You've completed that, that residency program, and then you matriculate into plastic surgery residency and that would be an additional three years. More and more now, though, most programs are switching over to an integrated program, meaning that right out of medical school you would basically be applying to go into plastic surgery residency, which is six years straight. And within that six years, you would spend some time rotating through different surgical specialties- general surgery specialties and whatnot. But your main focus and crux would be focused on plastic surgery throughout those six years.

Milena Garcia: Now we only see her that getting into plastic surgery is very competitive. How competitive is it? Will there be a difference between the two routes?

Sola Fasusi: Traditionally is very, very competitive, no matter what. It's always been competitive, like most of your specialties are. This is probably the upper tier of the competition, you know, the independent route, and just to reiterate again that the independent route where you would do a surgery specialist or surgery residency at first and then matriculate the plastics was the more common way for a long, long time. And there were many, many programs. It's getting competitive on many fronts, because from my independent program standpoint, the number of those programs are actually shrinking. Matching into plastic surgery right out or after you finish a residency is actually pretty difficult. The end of the integrated routes, where you would match right out of medical school have always been very, very, even more competitive, than even the independent routes. And so because of the shrinking nature of the independent routes. The integrated route, which was already very competitive, is becoming even more so. It's just really, really key that you have to start thinking about doing extra and differentiating yourself as a medical student.  At an earlier time point you can't really wait for the latter portion of medical school to start making those decisions. It's important to really start at an earlier stage if you're going to match something. And that just doesn't apply to plastics, but any very competitive surgeries specialty, no matter what.

Milena Garcia: And as you mentioned, this is the top, right? And there you are. So you've accomplished it. First of all, I want to recognize you for all your hard work and your accomplishment. They're certainly amazing skills that you have to have to be this kind of complete doctor. So I think you're qualified to answer my next question, right, what kind of skills do you need to be a complete surgeon?

Sola Fasusi:That's a good question as well. Any great surgeon is going to be a critical thinker. Because the thing about being a surgeon across the board, no matter what kind of surgeon you are, especially with plastics, is that you have to be able to problem solve, critical think, sometimes on the fly because when you are attempting to fix very complex problems that are trying to restore somebody, for example, from a state of abnormal, whether it be from trauma or congenital or whatever the case may be, to the quote unquote state of normal. There's a lot of different ways to skin a cat, as they say. And so being able to kind of critically think and have that capability is an absolute must, as a surgeon, but especially as a plastic surgeon. Obviously, technical skill is very, very important as well. Being able to start working on your manual dexterity at an early point is going to help for sure, that's what all surgeons do. But again, especially with plastic surgeons. We're operating on a very, very complex thing, very tedious things. You're hooking up small little blood vessels under a microscope sometimes. And so it's very, very important to have those technical skills as well.

Sola Fasusi: So once you have those two, that's kind of like the baseline core of what you need: the ability to critically think and then the technical skills so you can build upon that. Anybody who's gotten into medical school and matriculated through medical school is obviously a smart cookie. And so your textbook smart is not something that's that's only relegated to one area to area medicine. I think we're all students and installers and are continuing to, kind of, you know, better ourselves and our craft as students. But at a baseline, I think that's what you need to be- a good surgeon.

A Typical Day in the Life of Plastic Surgeon

Milena Garcia: I can't be the only person thinking at this point that having a plastic surgeon talk about how to skin a cat just sounds different. I got stuck on that. You talk about how diverse plastic surgery is in the many different ways to skin a cat. It sounds like there's not a typical day for you. So can you just describe a day in your life?

Sola Fasusi: Sure. I mean, my day now is a little bit different than my day when I was in training because obviously when you're going through plastic surgery training, it's going to give you the springboard,  it’s going to give you the kind of platform to decide when I'm finished with plastic surgery, do I want to be practice general plastics and kind of do a broad amount of things or do I want to kind of sub specialize in one area of plastic surgery or another. So in training, you get a chance to kind of really go through every element of it and really kind of dive deep.

 I'll guess I'll talk about you know my training experience first and then my typical day now because I'm more on the cosmetic side of things at this point right now. A subset of what I do is a little more narrow than what I did in training. With training, essentially, we would rotate through different areas of plastic. Sometimes they would be rotating at the at the at the VA where obviously you're taking care of older generation of veterans. Those are typically kind of relegated to a lot of skin and soft tissue diseases, cancers of various types. A lot of hand surgery and carpal tunnel surgeries as well. There's kind of a difference between academic medicine and private practice medicine. Depending on what training program you go to, you can maybe get a mesh of both. We were kind of in a private setting. You're still a resident operating through that system. And if that's sitting, you know, it's great because you can get a mixture of things like, you know, cosmetics, as well as general plastics. So we would rotate through the pediatric hospitals. That means that's where we're doing a lot more craniofacial surgery, you know you're doing small little arrow reconstructions on patients. Microsurgeries. You're actually completely reshaping and remaking the smile of  a small child doing cleft lips cleft palates, things like that. And then essentially with our trauma colleagues, the trauma ecologist, the general surgery trauma ecologist, or the top colleagues doing reconstruction of Upper and Lower extremities after various different types of traumas, doing different free flaps to cover big holes and whatnot.

So on a day to day basis, especially when you're in training you could be doing any number of things. Depending on what you're rotating through it. So it's almost like the Wild West, in a way, but that's a great way to train. It's like having a huge textbook and you just basically get to read all kinds of different chapters at the same time. It's really good. If there's one thing I love about plastic surgery, there is absolutely nothing monotonous about it, especially when you're in the training room. You get to see and do so many different things. Obviously for me somebody like me, who would kind of get bored with doing the same thing over and over again, it is fantastic.

My life now is a little bit different because I'm on the cosmetic side of things. I'm in a situation to practice where we kind of routinely,  more or less, focus on Body cosmetics, body contouring. Brazilian butt lift is a thing that is very, very popular right now. And so that's, you know, what we tried to excel in. Obviously, you know, breast aesthetics, you know, facial aesthetics, all those different elements of aesthetics can be broken up into its own subset of a subset of plastic surgery. And that's kind of what I'm focused on now as well.

Milena Garcia: Which point in your academic career did you decide that you are going to go into plastic surgery?

Sola Fasusi: I always had an inkling but I think like most medical students, you don't know until you know, right? So many times or so often your decision will be kind of molded by your experience. And so if you're in a situation where you get a chance to rotate through, do a plastic surgery or rotation and you loved it and the experience was amazing, you know your teachers are great. They're trying to show you all different episodes of some training and all those kind of things. I mean, it just draws you to it right, especially if you already kind of heading in that direction. The same can be said about any type of rotation. I knew kind of early on, even coming into residency that that's sort of what I wanted to do and that's the thing about doing general surgery that is great because I went through the independent route. Obviously, I did general surgery first and then decided I wanted to do plastic surgery and did that well. Doing that was great for me, too, because general surgery is another realm where you get a chance to rotate through all these different aspects of surgery. Doing vascular surgery, Surgery Clinical Oncology, minimally invasive surgery, transplant surgery, trauma, critical care. You name it. There was an element of me that also was very, very drawn to that. I guess maybe by my second or third year in residency, I kind of solidified that. I really, really wanted to do plastic surgery. One thing that actually really helps a lot that I always kind of advise any medical students who I'm mentoring is to try to do a sub-internship in whatever specialty it is that you think you want to do. Because doing a rotation is one thing, because you don't really get the full aspect that was going on. When you do a sub internship and you get a chance to spend a solid month, for example, doing just plastics or just vascular surgery or just cardiology, or whatever it is you get a really in depth look, more so than you would on a regular rotation, to kind of forgot what it is you want to do. And you might get there and say ‘I really want to do this’ and then realize that this is nothing like I thought it was like, I don't want to do it. So doing that is actually duly beneficial because it really gives you a closer aspect of what it is that you're getting yourself into. And on top of that you're making a lot of key critical connections that can you can use for letters of recommendation. Essentially, you have a foot up when you're trying to actually matriculate into that field.

Milena Garcia: And it is all about the connections, right? Developing a connection and obviously

if you impress, some people remember. You were the chief resident doing your residency?

Sola Fasusi: Yeah, yeah. Typically speaking every program does it a little bit differently. I mean, you're going to be at the chief level at some point. But that's when you've kind of got to that level of the last year in your residency. Different programs do it a little bit differently. They have the head chief resident and administrative chief and whatnot.

Milena Garcia: Why Ross? Let's go back, way back then. Why Ross?

Sola Fasusi: Excellent. That's a great question. Well, my road to Ross was probably nothing normal. Well, maybe there's a normal way; I don't know how everybody else started.

Milena Garcia: I'm not sure there is a normal way.

Sola Fasusi: You know, when I was applying for medical school I was in a situation where I took the MCAT, I think maybe my junior year in college. I did okay on it, actually, but said I wanted to do even better, just to guarantee myself a good set of options when it comes to medical schools. So I actually took some time off right after college and I studied, probably the hardest I've ever studied in my entire life. Eight months, eight hours a day. I knew exponentially more the second time I took it. I took the test again and I scored worse the second time. And that was kind of really devastating to me in a way because I put all this time and effort into it and I've gotten a worse result. It was kind of baffling. But either way, I decided to go ahead and apply. I got a waitlist in a couple of places in the US and a friend of mine that I met during the MCAT prep course told me about Ross. And I said, ‘kay, well, I don't really know much about it, but you know, I'll go ahead and apply because they have rolling admission essentially continuously around the year, which is different because usually you can only apply one time of year. Most schools, I got waitlisted and that means I was going to have to wait in the car for an additional year.

Ross got back to me and said ‘Listen, we don't have any space in our class right now but we have what's called the MERP program and for people who don't know, that's the Medical Education Readiness Program. And so when they're kind of trying to figure out if you can cut it in medical school, this program is basically the mimic of the first semester in medical school. It allows you to be able to take the same classes, see how you do. You have to at least get, I believe, a B or better if I'm not mistaken, to move on.

Milena Garcia: Actually, we did an episode on it. So for everybody listening, please check out the MERP episode. It's episode number two. So check back.  How did it go?

Sola Fasusi: It was great. I mean I got A's and everything,and then you're guaranteed a position in the next class. And so I took that opportunity and ran with it and it allowed me to matriculate into medical school. Favorite word again. One thing I didn't realize going to medical school is that I didn't know how to study. I was used to things coming easy to me. There's a certain way you have to study in medical school because the amount of information is daunting. I didn't realize that I didn't know how to study correctly. One thing that worked for me especially was allowing  myself to understand how I need to be able to study, which helped me incredibly through medical school and actually even to this day, when I was studying for board exams and things like that. I actually went through the MERP program. So you get into Ross University and kind of took off from there. So that's how we kind of got into Ross in the first place.

Milena Garcia: And here you are from MERP to chief resident to plastic surgery. Dr. Fasusi, we're proud of you, we're proud of your accomplishment. Thank you for taking your time to speak with me today. Co-hosting the podcast with me certainly doesn't pay as well as plastic surgery, but you're welcome to come back anytime, please. I would love to have you again as a guest.  Any last advice or recommendation for our future Rossies?

Sola Fasusi: If there's any doubt in your mind that Ross can get you to where you want to be, I can be somewhat of a testament to the fact that, you know, even getting into Ross was hard. With hard work, and with a lot of help and determination and things like that, you're able to make your dreams come to reality. Whoever is on the fence is thinking about where they want to go, or if they should apply and whatnot and worried,you know, you can get exactly where you want to be, so perfect.

Milena Garcia: Thank you, sir. Appreciate your time. Thank you so much. And for everybody out there listening. Thank you for joining us. We will see you next week.