Career move: Veterans Affairs physician

Why did you choose to practice neurosurgery?

I always knew I wanted to be a doctor. I loved the idea of helping people with medical problems. When I was in college, I worked in an ophthalmology lab. I was doing microsurgery-cornea transplants on mice. It was phenomenally fun. I liked working with my hands and I liked working under the microscope. That was really the first time I realized I wanted to be a surgeon.

The next year, I worked in a transplant lab and loved it. At that time, I thought I’d never be a surgeon because the lifestyle is terrible and I saw how hard the surgeons worked. Then I went through medical school and I approached each specialty like that was what I was going to do for the rest of my career.

When I went through my internal medicine rotation, I pretended I was going to be an internist. When I went through my psychiatry rotation, I pretended I was going to be a psychiatrist. However, there was really nothing that made me as happy as neurosurgery. From my very first neurosurgery rotation at Cook County Hospital in Chicago, I knew there was nothing else I could do. This is what made me the happiest because I love the surgery part and I love the fact that intervention can completely and dramatically make someone’s life much better. We can cure people…it’s amazing what we can do

Why did you choose the VA?

The VA enables me to practice surgery in its purest form without having to deal with all the headaches and hassles that are generally associated with the practice of medicine. So, for example, I don’t have to deal with billing and insurance and fighting to do a particular procedure on a patient because I think it’s the best procedure for them. I can go ahead and do it.

I don’t have to justify to the insurance company why I used instrumentation X rather than instrumentation Y. Also, I get paid the same whether I operate or not, so there’s no pressure on me to do extra surgeries. If I see a patient in a clinic and I don’t think they need surgery, I can tell them, “Look,I don’t think you’ll need surgery. I don’t think it will help you.”

Physicians in private practice may also be under pressure to reduce length of stay and procedure cost. I don’t have to worry about that as much. The other advantage of the VA for me is doing research. I spend half my time doing research. The VA makes that possible for me. The database here is the best in any medical system. I have access to a phenomenal amount of data for research purposes.

And you’re also an assistant professor?

Yes, at New York University School of Medicine. I work with a lot of different residents and medical students at NYU SOM. I give lectures in the medical school on brain injury. This summer, I’m mentoring five students with research projects and last summer I mentored three. We are conducting two prospective studies including a clinical trial, and cohort study as well as several smaller retrospective projects all related to brain injury and hemorrhage.

I’ve mentored students every year since I first started, and every summer I’ve had at least one student win a research award or fellowship. All of my students have published papers in the scientific literature. It’s been fantastic working with medical students because they are really motivated. They ask a lot of questions, are incredibly creative and very hard working. It’s been a great experience.

What’s your advice for physicians who are interested in becoming a VA Physician?

I think the biggest advantage of the VA is that it allows you to practice medicine without the extra baggage that comes with it. Also, it allows you to do research, if that interests you. You can practice in the VA system without performing research, however I think the ability to do research is one of the biggest perks of the job and it would be a shame not to take advantage of it.

Was there anything that surprised you about the VA or becoming a neurosurgeon?

Becoming a neurosurgeon is a huge responsibility and a privilege. People literally put their life into your hands. It can be stressful and I knew that when I chose to go into the field. I still have some sleepless nights thinking about how I am going to do a complex case. I am surprised how happy I am and how much job satisfaction I have.

Anything else you’d like to share?

Statistically, I was tied for being the 200th board certified female neurosurgeon in the country. I’m also the first female neurosurgeon to be on the staff at NYU School of Medicine. I would encourage women who are thinking about neurosurgery to find mentors and look at the WINS (Women in Neurosurgery) website for advice.