S04E80 - Balancing Precision and Passion: Dr. Jennifer Waljee, Plastic Surgeon

Ever wondered how top surgeons balance high-stakes surgery with a fulfilling personal life? Join us as we speak with Dr. Jennifer Waljee, an esteemed plastic surgeon and full professor at the University of Michigan, whose career is a testament to dedication and excellence. With 242 research publications to her name, Dr. Waljee shares her journey from medical school at Emory University to her rigorous training and fellowship at Michigan, revealing the resilience and passion it takes to thrive in the demanding field of plastic surgery.

Discover the intricate dance of managing a medical career and personal life from Dr. Waljee, who opens up about the evolving demands of everyday life and how autonomy as an attending physician provides the much-needed flexibility. Learn how her clinical decision-making has matured over the years and the significance of clear communication with patients about surgical outcomes. Dr. Waljee also takes us inside the operating room, sharing her favorite procedures and the collaborative dynamics that ensure surgical success, all while maintaining a positive atmosphere with the right soundtrack.

Reflecting on her transition from resident to faculty member, Dr. Waljee discusses the nuanced journey of gaining recognition as an attending and the importance of mentorship. We delve into future aspirations in surgery, emphasizing the need for continuous professional growth and leadership development. Celebrate the Michigan Plastic Surgery program's achievements and hear Dr. Waljee’s heartfelt appreciation for the mentorship and teamwork that have shaped her illustrious career. Whether you're an aspiring surgeon or just curious about the world of plastic surgery, this episode offers a wealth of insights and inspiration.

#PlasticSurgery #MedicalPodcast #SurgicalLife #SurgeonSpotlight #HandSurgery #DoctorInterview #HealthcareHeroes #InspiringSurgeons #MedicalJourney #PodcastLife #SurgeryEducation #FutureSurgeons #BotoxAndBurpees #BotoxandBurpeesPodcast #LifeInMedicine #SurgeonStories #WomenInSurgery 

@michigan_surgery @umichplasticsurgery @umichmedicine

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S04E80 - Balancing Precision and Passion: Dr. Jennifer Waljee, Plastic Surgeon

TRANSCRIPT

[00:00:04] Dr. Sam Rhee: My guest today is Dr. Jennifer Waljee, plastic surgeon from the University

of Michigan. As you'll hear, she has already achieved great heights at Michigan.

She is a full professor and has a multitude of responsibilities both at her institution and outside medical organizations, national and internationally. She has 242 research publications, which is absolutely staggering. And all of these impressive accomplishments over her 12 years as an attending surgeon would certainly prove that she is walking on rarefied ground as an elite academic surgeon.

But it is the manner in which she goes about achieving her success, which is truly special to me. I didn't know her well when I was a plastic surgery resident at Michigan. Dr. Waljee was a general surgery resident at that time. It was only years later when I would see her at the Plastic Surgery Division reunions or national meetings, where her name seemed to be everywhere.

She not only appeared to be contributing to every facet of administrative and clinical care at the university, but her research has had national and international impact as well. Jennifer facilitates positive interaction amongst her junior and senior partners within the division.

And let me tell you from personal experience, some of the senior surgeons at Michigan are not the easiest people with whom to work. She was in charge of the last alumni symposium at the University of Michigan Plastic Surgery Division, and it went off beautifully. I was really impressed how she managed to hold together a great meeting that included the current faculty and residents, as well as a large number of crotchety old surgeons from the outside.

And she has been truly able to bridge the culture between old and new within surgery.

Jennifer currently holds the record for the fastest response time to say yes to guesting on this podcast as well.

It was no more than exactly five minutes after I sent the email invitation that she replied that she would be glad to do it. And as you can tell, she managed to fit in this recording after being in the OR, on call, on a weekend, when she could have gone and should have gone home, instead of staying at the office.

I'm extremely grateful for the gift of her time. This is what success in life looks like. It is not being afraid of hard work, humility, the ability to work well with others, and a fierce inner drive that you only see when you step back and look at what she's accomplished.

Dr. Waljee is soft spoken, but her words do carry great weight. I hope you enjoy listening to her as much as I did speaking with her. Thank you very much.

Welcome, uh, everyone to another episode of Botox and Burpees, our surgical series. We have with us our guest, Dr. Jennifer Waljee. Um, she is a full professor of surgery at University of Michigan. Um, I guess medical school, right? Yeah. Or University of Michigan Medical Center. I don't even know what the right way to say that is.

University of Michigan Medical Center. Okay. Let's, let's, let's stick with that. Um, let me talk a little bit about you. Uh, Jennifer and your background, uh, so people know who you are. You, uh, graduated from University of Michigan, uh, in biology, uh, for your undergraduate training, and then you went to Emory University for your medical degree, and you also picked up two master's degrees along the way.

One in epidemiology at University of Michigan School of Public Health, and then another one also at Michigan in health services research. You did your general surgery residency at University of Michigan, and you did a full Looks like seven years. So you did seven years of residency at Michigan for your general surgery training.

So it's five plus two of research. Yes. So for those who don't know, and actually we had a previous guest as well, like nowadays, plastic surgery residency is integrated. So you do a couple of years of general surgery, usually like three years of training as a resident, and then. Maybe like another three in plastic surgery.

But for the really deep, well trained, old school surgeons, they did a full general surgery residency, which uh, is 5 plus usually a couple years of um, research, which you did, uh, And that's how all of our mentors did it, I think, pretty much. Um, obviously things have changed now. Um, and then you did your plastic surgery residency also at University of Michigan.

And you stayed on to do your hand surgery fellowship at University of Michigan as well. Um, so just kind of picking through your Background, uh, you're now a full professor of surgery, uh, in, uh, plastic surgery and in orthopedic surgery at Michigan. Uh, you are also, um, doing a couple of other administrative responsibilities.

You're the vice chair of research strategy for the department. You are, you hold the, uh, Zunima endowed professorship, uh, and you are also vice for both faculty life and health services research. Um, you have One of the longest. Publication lists I've seen for someone. How long have you been in practice now?

Um, as

[00:05:24] Dr. Jennifer Waljee: I started in 2012.

[00:05:26] Dr. Sam Rhee: yeah, so that's 12 years and you have 242 listed publications, which is crazy. That is like one of the most I've seen for someone who's only, who's in practice for 12 years. Uh, you are, um, also a peer reviewer for the new, uh, England Journal of Medicine, which is, I don't know if I know another plastic surgeon who is a peer reviewer for that, uh, for that journal, um, as well as like a million other, uh, your board, you know, uh, board members and, uh, committee members for a number of organized, uh, organizations.

National organizations, which I'm not going to get into because there's so many to list. Um, thank you so much for agreeing to, to guest and, um, I really appreciate you spending the time. I know you were operating this morning, uh, and you just got out. So, I really appreciate that you were able to, to, um, be here.

[00:06:27] Dr. Jennifer Waljee: Thank you for having me. I'm really looking forward to our conversation.

[00:06:30] Dr. Sam Rhee: So, um, you are, except for your stint at Emory, a Michigan lifer for the most part. Um, and now you are at the institution that you trained at, for the most part. And I always feel like the people who are cho you know, who get to stay at the institution they trained at, are some of the Um, superstars for a couple of reasons.

One is they uphold the tradition and, you know, the excellence that is that, that institution that they trained at. And also they really know you, um, warts and all, and for them to want you to stay, like they know you, you know, more better than almost anyone else who comes in as a candidate. So it's really a mark of honor.

I think that they, you know, would want you to stay and become part of their, uh, faculty. Uh, that was not something that was offered to me when I finished, trust me. They were like, go, go forth. Uh, uh, as you trained at Michigan, um, is there anything that you remember in particular that was really impactful or, um, really sort of affected you as a surgeon in training?

[00:07:41] Dr. Jennifer Waljee: I think there are, um, Lots of memories that I have over the years and I do get to spend time in the same hallways and units that I was when I was an intern. Um, so I think about it in various phases of training. Um, I remember being an intern and I started on the trauma burn rotation in July. I knew absolutely nothing.

Um, and so I remember the kindness of the residents above me trying to, you know, teach me how to take care of, uh, really. Um, I had a lot of sick patients who had complex injuries. Um, I felt, you know, it's hard to come to a new place right out of medical school. Um, so I try to remember that and be, you know, particularly mindful of that for our residents that join us in July.

It's a tough month, and starting off intern year is really hard. And then I think as I moved through my general surgery training, which I loved, I found that I was really drawn to, um, breast cases and breast reconstruction, um, and had an opportunity to work with Dr. Amy Alderman. And that was really, uh, formative for me.

I then took 2 years off for research, and she was 1 of my mentors during that time. And I found that I really liked, um, the thinking about those, um, clinical questions and how we could impact somebody's quality of life. Then found kind of throughout the rest of training that I was drawn to a little bit more of the anatomic challenge that plastic surgery had to offer.

Um, and the first rotation I had when I started in plastic surgery here was the hand service. I didn't know what any of the various letters meant. So

[00:09:16] Dr. Sam Rhee: you

[00:09:22] Dr. Jennifer Waljee: Chung was a Tremendously influential mentor on me because now most of what I do is hand surgery.

So I fell in love with that and that challenge and variety that comes with that. And I think those things stick out of my mind when I reflect back on training. And I think the other big piece was, you know, we spent a fair amount of time

[00:09:44] Dr. Sam Rhee: Pacella,

[00:09:45] Dr. Jennifer Waljee: burn unit as junior residents and then as trauma chiefs.

Um, and so, uh, was, you know, very, um, Influenced by Drs. Wang and Dr. Hemmela, um, taking care of burn patients and then watching, you know, Dr. Siderna and others do reconstruction for them later and kind of having that longitudinal experience was really rewarding for me. When I first started on faculty in plastics, they had a need for someone to come back and cover a burn call.

And so I did that for a few years, um, which has been really fun. And I enjoy taking care of individuals with burns. You know, in, uh, injuries that require late burn reconstruction still, um, even if I don't cover the acute burn, uh, call anymore. So, um, I think those are some of the experiences that have stood out to me.

[00:10:33] Dr. Sam Rhee: You mentioned a couple of the mentors, and, and I know many of them, um, in the trauma burn unit. Um, I myself was also, uh, a resident there. Dr. Chung, uh, Amy Alderman, who was, uh, one of my senior residents when I was there, uh, training as well. Uh, did any of them just, uh, change your mind where you were coming into general surgery, not sure what you wanted to do, and then just suddenly decide, yes, this is exactly why I want to do that.

Uh, why, this is why I chose plastic surgery specific.

[00:11:08] Dr. Jennifer Waljee: Yeah, I think, um, it was rotating, um, on the surgical oncology service, and then kind of sticking around for the breast reconstruction when I could, um, I really enjoyed those cases. And those were the places where we got the most exposure, um, as a senior resident and surgical oncology. Yeah, got me. A little bit more exposure, um, when plastics would come in and do a complex reconstruction.

Um, and it was really towards the end of my general surgery residency, um, and I remember Dr. Altman was always so kind to let me stay and kind of watch some of her cases. And I think that's what really, um, flipped the switch in my mind that, um, wow, this is, you know, incredible anatomy and the things that you're able to do to manipulate anatomy to help somebody, help somebody's long form quality of life is pretty incredible.

[00:11:52] Dr. Sam Rhee: And then you ended up doing a hand fellowship. So what was it that you decided was So appealing about hand surgery itself that made you decide that's what you wanted to specialize in. Because in plastic surgery, there's so much, right? There's, like you said, uh, breast reconstruction, there's micro, there's, um, uh, general reconstruction, there's aesthetics, there's craniofacial, there's hand.

Like, you could literally choose anywhere on the body to operate on. What was it about, like, this That made it so fascinating to you.

[00:12:23] Dr. Jennifer Waljee: Yeah, I think, um, I really enjoyed the anatomy. I liked the breadth of, um, bony, um, being able to do bony reconstruction, tendon reconstruction, nerve reconstruction, some microsurgery, um, and feeling like, you know, even sometimes what we think of as, you know, a pretty routine condition like carpal tunnel syndrome has a huge impact on somebody's Um, if they're fingers catching and triggering, that is a huge impact on their quality of life if they can't type or they can't do the things that they like to do.

So, I like the fact that it's a huge swath of cases from things that take 5 minutes that, um, really impact somebody's quality of life to cases that are, you know, pretty complex and involved, um, and, you know, involve, you know, free tissue transfer and those kinds of things. Um, so, I like the breadth and depth of that.

[00:13:13] Dr. Sam Rhee: Um, you're clearly no stranger to hard work. You, you clearly have done a lot in your life as, as looked, uh, when you, when you look at the list of accomplishments that you've had, but also when you mentioned you covered burn care, um, uh, for the first couple of years as an attending, you, uh, you're operating today.

Um, how do you, uh, what kind of advice do you give to people who are like, Interested in what you do in terms of the amount of work and effort that you needed to do in order to get to where you are.

[00:13:54] Dr. Jennifer Waljee: I think that it is, um, I think it's a, it's a journey and I don't always operate on Saturday mornings. It just happened to be, um, that that's what this particular patient needed and I was on call. Um, so I do think it's really important to think about balance in your life. Um, I have two kids and it's important for me, especially, um, now that they're a little bit older, they have to, Lots of activities and things that they, um, I mean, I think our kids need us.

Hopefully they need us for a lot of, a lot of things that they do, but, um, I feel like I'm needed in different ways than they were when they were a little bit smaller. Um, so, and when I reflect back on that, when I first started on faculty, my kids were pretty young. Um, and so. They had different hours and times that they were awake and needed me than they do now.

And so, um, I think I could kind of structure my life around that. I think it gets easier and when you're in. On the other side is an attending because you have more autonomy over your schedule. Um, it doesn't necessarily mean that it's easy or they're not going to be things that, um, don't necessarily align with exactly when you wanted to do them, but you do have some choice over, you know, well, this is when I'm going to book these late cases, or this is when I'm going to take call, or this is a hard no for me because it's my daughter's birthday, or whatever the, um, situation might be.

I also look back on it and, um, For the most part, I've really enjoyed all the things that I've gotten to do. So it's not to say that it didn't feel like work along the way, um, but I feel like they were meaningful and rewarding experiences. Um, and so I think that kind of, uh, helps stay motivated every day.

[00:15:40] Dr. Sam Rhee: As you, uh, went along in your training and even now, um, how, how many years have you been as an attending at this point?

[00:15:47] Dr. Jennifer Waljee: Um, I started in 2012, so this is, I think, my 11th year.

[00:15:50] Dr. Sam Rhee: Yeah. Okay. So in, so both in training and also now, uh, as an attending, what is one way or method that you've used to become better?

[00:16:04] Dr. Jennifer Waljee: Um, I think that, um, you know. Try to, um, attend meetings, um, as much as possible, um, lean in to, um, our teaching conferences, our journal clubs when I can, but also not just those here, but also the ones that are offered through our professional societies, um, you know, The webinars and things like that that are at night, um, often are recorded on other platforms and you can listen to them when you're driving to work or, um, you know, whenever you have downtime.

Um, so I try to do that from my own continuous education. Um, I think I try to, um, be really critical about, you know, why I made decisions. How did that turn out? Was that the right thing to do or not? And I often seek the, um, counsel of my senior partners about, um. Should I have done this differently or how should I have thought about this case?

Or if I'm thinking about a case that I haven't done yet, what might be the pearls and pitfalls with that? I also think that over time, I've gotten more aware of, you know, what I'm good at and what I'm probably not as good at or should be handled by somebody else. And so I'm trying to be more mindful of that and not let my own ego get in the way.

I think it's important to me.

[00:17:17] Dr. Sam Rhee: Is it, uh, what has changed more? Your clinical decision making in terms of evaluation and, and treatment? Or have your operations the way you've done them? Like, is a carpal tunnel pretty much still the way you still do a carpal tunnel 11 years ago? Or is it that how you decide who gets it or, or how, um, you know, how you choose, uh, What operation for a particular person with a particular injury, um, has changed more?

[00:17:45] Dr. Jennifer Waljee: I think it's a little bit of both. I think probably for the, um, you know, more common stuff that we do, I don't know that the techniques have changed that much. Um, some have. The way I've managed deep returns has changed. The way I've managed nerve injuries have changed. Um, you For example, thinking about earlier nerve transfers or tendon transfers for individuals with peripheral nerve injuries.

So, some of those things have changed in terms of the techniques I might choose, but I think a lot of it more is the clinical decision making and or how I counsel patients in terms of what to expect after surgery.

[00:18:17] Dr. Sam Rhee: What do you do now that's different than, say, 11 years ago when you talked to a patient about, about surgery?

[00:18:23] Dr. Jennifer Waljee: Um, I try to be really realistic about, um, what it's going to, you know, what we can fix with surgery, or what symptoms we can address with surgery, and which ones I don't think that we can, um, and I, you know, think that, um, you know, whenever we have conversations, we only hear pieces of it, and so I try to keep reiterating that again and again, um, just because I know that people Patients are overwhelmed, particularly if it's a patient who has an injury, they're probably hearing part of what I'm saying, but not all of it.

So, making sure that I'm consistent and providing them as much information as they need to know ahead of time, particularly on what can I expect in terms of getting back to work, caring for my family, picking up my child. You know, I probably used to say, oh, yeah, sure. It'll be 3 to 4 weeks. I'm like, it's probably going to be more like 6 to 8.

Um, this is when you can drive. This is, you know, when you can lift things, those kinds of things. I think I'm a little bit more realistic now than I used to be.

[00:19:23] Dr. Sam Rhee: What is one of your favorite surgical procedures now that you really enjoy doing at this point?

[00:19:29] Dr. Jennifer Waljee: Uh, I love doing Z plasties. That has not changed. Um, Z plasties for burn reconstruction is like one of my favorite things to do. Um, I like any kind of peripheral nerve exploration, um, but particularly ulnar nerve, median nerve, radial nerve in the upper extremity. So, um, any types of reconstruction and, um, exploration for those I love.

I

[00:19:50] Dr. Sam Rhee: So the, uh, peripheral nerve stuff, is that just because it's sort of a puzzle, teasing out and figuring out where it goes? Or what is it about that, that, that you really enjoy, like, um, enjoying? When you explore a median or an ulnar nerve

[00:20:03] Dr. Jennifer Waljee: think it's just the, um, beauty of the anatomy. Um, you know, so often it's very consistent. It's right there. I have the privilege of being able to work with residents a lot of the time. And so, um, taking them through those cases is really fun. Um, and also it's so closely linked to what the patient's going to experience in terms of, you know, function and sensation.

[00:20:25] Dr. Sam Rhee: with Z plasty. So for the listener, it's when you have, um, it's like a tissue rearrangement. So you have a scar and maybe it's a scar from a burn. So it's like really tight. And so you have to release that scar. So you make incisions geometrically to rearrange the tissue around it, to release that scar tissue and allow better function or movement.

Um, I don't do as many for those anymore, but I think the elegance of the geometry and planning it and making it just so that it works perfectly. And then you have this really nice, smooth surface where before it was like this big scar band. Is that what? What do you like about it? Or is it just seeing the function afterwards?

What do you love about Z plastis?

[00:21:11] Dr. Jennifer Waljee: Well, I think it's the geometry and when it lines up nicely and it alleviates that scar contracture, um, it's just incredibly rewarding.

[00:21:19] Dr. Sam Rhee: Yeah, I love that too. I just love the geometry and how it makes it work. Like, there's an aesthetic sense of satisfaction just from doing something like that. I love that. And I think all plastic surgeons have that sense of like, just making that soft tissue work the way You know, like, just setting it up nicely like that, like, it's just a nice sense of accomplishment.

I think surgeons love accomplishment after a case like you're like, okay, I did something really, really cool or nice there. Like, that, that fulfills that. Um, so when you operate, um, it, you know, I know a lot of surgeons, they have rituals. They have certain things that they're always doing. There's certain things that are very important to them.

Is there anything that you have that's very, uh, specific to your setup or your prep routine or anything before surgery to help you optimize that surgical procedure?

[00:22:10] Dr. Jennifer Waljee: Um, I think that for probably most of the procedures that I have, I try really hard to go through every single thing I think that we're going to need, um, and let the team know, um, so that things then flow smoothly once we're all scrubbed in and we're started, um, so that, you know, people don't have to run back and forth to get a million things that I forgot about.

Um, I often will usually pick out the suture that I want, put all that up, put all the dressings up that I want, um, if it's not up already. Um, Because, you know, I just want to make sure that, you know, we're all moving through this expeditiously. Um, and so I think for almost all cases, I do that for ones that I think are going to be particularly involved or challenging.

I usually mentally go through. The steps in my mind multiple times before the procedures, um, write them out. Um, sometimes, especially if it's, um, something where there might be some nuance and I want to make sure that it flows smoothly. Um, and then it, especially when I'm working with trainees, if depending on what it is, I'll often share, you know, these are the techniques that I'm planning on.

This is my personal plan, A, B, and C. If you have other plans, Plans that you'd like to consider? Sure. We can talk about that too. Um, because I feel like when we're all coming to the operating room, it shouldn't be a pop quiz. Like, we should all be on the same page about what we're going to do. Um, I, you know, we may have different experience in terms of the number of years that we've been doing something, but we should all come there with the same, um, working knowledge of the anatomy, the plan A, B and C, um, and what the recovery and prognosis is going to look like.

[00:23:43] Dr. Sam Rhee: It's amazing how many surgeons I talk to have that pre visualization where they're kind of running through it in their head. Um, and everyone I've talked to has said multiple times. It's not just one time. It seems like it's several times. And then the checklist thing is, is something that seems to be universal for a lot of people doing critical things is like sort of making sure you have that flow.

Either written or at least mental in mind in order to make sure that you're hitting the steps that you need to in the order that you need to, to hit them. Um, and I, and I assume that some of the reconstructions you're doing are fairly complex and you need to make sure that, like, you're flowing through it stepwise because they're all different too in a lot of cases.

So it, you know, there are many variations probably on, on a particular type of operation you might. So, um, what do you listen to in the OR once you get in there then?

[00:24:35] Dr. Jennifer Waljee: Um, yeah. I actually let whoever's in the room pick. Um, I'm not super particular about the music, but I do like listening to music. Um, so. I would say usually it's some type of, you know, top 40 hits. Um, there's a lot of happy radio and fun radio tends to get played a lot. Um, so yeah, I'm usually open to anything.

[00:24:58] Dr. Sam Rhee: Are there any no go's? Like, you're like, no, we have to change it. Is there anything like that? Any genre?

[00:25:03] Dr. Jennifer Waljee: I'm not sure I could probably listen to classical music for a particularly long period of time in the operating room. Like I need something that's upbeat. So

[00:25:12] Dr. Sam Rhee: That's great. Well, that's glad that you're generous with the OR music. Not everyone is that way. Um, what, what Uh, so when you have your team either in the OR or out, um, is there anyone that's particularly important to you that makes you Dr. Jennifer Waljee, the person that you are either operating or outside the operating room that helps you be the best person that you can be?

[00:25:40] Dr. Jennifer Waljee: I think it's all members of the team. Um, I think that, you know, I have the privilege of getting to work with people, um, for years now, um, you know, thinking back to when I was a trainee. Um, so for some people in the operating room, I've worked with them for a really long time. Um, and I really trust their judgment, um, and their wisdom and expertise.

Um, and that was really helpful, particularly when I was starting out in practice. You know, you're nervous, um, you're worrying if you're going to forget something and it's kind of nice to see the same team members in the operating room, um, because you know they've got your back. Um, I think the other, I mean, you know, certainly the most important people outside of the patient in the room are also the trainees that we get to teach, um, because this may be the operation that they've seen 500 times or it may be one of two that they, you know, Get to see before they go out into training and then are either doing it themselves or using the principles that they might have learned or the anatomy that they might have learned to apply in whatever way going forward.

So, um, I think that's really important.

[00:26:44] Dr. Sam Rhee: Now you've been at Michigan, you did your training there. You stayed on as attending at what point, and I know this because I had Seniors who also stayed on as faculty and you can't help it. Like they are attendings, but you kind of treat them like your big brother. Like you knew them, like, you know, like they, it took them a little while to sort of, uh, grow into that position because everyone knew them as a resident versus an attending.

At what point as an attending where you're like, people aren't treating me like a super resident. I now am an attending, attending at this point.

[00:27:24] Dr. Jennifer Waljee: I think it took a while. It may not feel that way yet. Um, I think it takes a long time and I think that's okay. Um, I didn't feel that different on June 30th than I did on July 1st. So, um, I think from a trainee perspective, um, You know, it probably takes, you know, through the period of time that people knew you as a resident.

Um, but I hope that, um, I'm still approachable and they feel like they can ask me questions and it's not intimidating, um, or, you know, uh, come to me with mistakes or those kinds of things, um, or questions and advice that they have. Um, I probably noticed it when, um, you start hearing about, you know, various things that come up, all of a sudden the residents, like, aren't telling you everything anymore.

Like, you're not Only one of them. And you're like, Oh, okay. I think they don't want, I think they're ready for me to leave now because they look at me as an attending. Um, so there's probably a little bit of that phenomenon. And then I think with my partners, um, they were all just really gracious in terms of, you know, giving me advice, um, along the way, especially, you know, when you have complications and you're not sure what to do, you're in a board collection period, um, they were all really supportive, but also, um, would be, you know, encouraging like, Hey, you've got this, you can do it.

Um, and so. That was very helpful along the way. I don't think it was like a black, like a black and white switch moment. Um, took a long time to reflect back on that.

[00:28:50] Dr. Sam Rhee: Is there something that you did in a mind, as an attending mindset that helped you sort of be like, okay, I can't think of myself as a resident anymore. I just, I really have to approach this as the boss or the buck stops here person. Did you, did you start that from day one or was that something that you grew into or, or is that something that you don't need to have as an attending?

[00:29:15] Dr. Jennifer Waljee: I think it starts on day one. And some of that is probably externally driven by the fact that we're board collecting, um, starting at day one. Um, and so you realize that, um, A, you're very responsible for the patient and everything that happens during, um, that episode of care. Um, but also, you know, all the small things, your documentation, your billing, um, how you, um, You know, set up your clinic such that you'll have enough time to spend with patients, um, and you'll be able to, you know, collect all the pieces that you need to get to the next step in terms of your board's verification.

So, I think we probably all do it subconsciously, but that is definitely an exercise during that board collection period. That really makes you feel like, okay, I'm in this experience and it's different for me than it was when I was a chief resident. And so I think that helps make that switch.

[00:30:07] Dr. Sam Rhee: don't really like using the term work life balance for surgeons because especially with my mentors, like work was your life, like there wasn't really a balance per se, but what would, how would you comment on what you think work life balance is? For you.

[00:30:28] Dr. Jennifer Waljee: Yeah, I agree. I think it's probably like integration or something. Um, I think part of that is just the World we live in, where we all have cell phones and devices and we're easily accessible, you know, all the time in a variety of different platforms. And so sometimes it's hard to shut off from that regard.

And sometimes, you know, the right time for me to be doing something might be on a Saturday afternoon or a Saturday morning, like when my head is clear and not necessarily, you know, on a busy day. Monday at 3 o'clock when, you know, I'm a little bit tired, um, you know, by towards the end of the afternoon, I find that I'm much better at, um, thinking in terms of writing research, um, and those types of things, um, in the early morning hours, um, you know, and then throughout the rest of the day and into the evening, I, um, you know, always have energy for, um, Um, you know, doing operative cases or signing notes or some of those kinds of things.

So I think it just depends on, um, you know, what are the right rhythms for a specific person. Um, some people, you know, might have a completely opposite schedule than that. Um, I also think that it's important to find time to completely shut off, uh, during the day. So there are some, you know, times during the day that I try to protect, um, particularly if, you know, I'm dropping my kids off or taking them to activities and those kinds of things, and I want to be there for dinner when I can, um, then those times I, I really do try to protect them.

[00:32:02] Dr. Sam Rhee: Did you always want to be a doctor and a surgeon? Like, is that something that you sort of came forth in kindergarten and was like, this is what I need to do and want to do? Or was this something that developed over time for you as you grew up?

[00:32:15] Dr. Jennifer Waljee: No, I wanted to be a doctor. My father was a physician and so I really admired him and, um, the, how much he loved his, his practice. I had no idea I was going to do surgery at all. I discovered that late, um, in my third year of medical school and found I Really liked my surgery rotation. I, in fact, I think scheduled it intentionally last because I was dreading it so much.

I rotated on it. I was like, wow, this is pretty amazing. Um, so no, not at all. And then kind of going into residency, I, you know, liked all of my rotations. And so, um, had opted to, um, go into general surgery and then, um, liked all of the rotations, but then was increasingly, um, drawn to plastic surgery and hand surgery.

Um, so, Yeah, it's been a little bit of a circuitous path. I would not have imagined I was going to be a hand surgeon.

[00:33:07] Dr. Sam Rhee: Was your father a surgeon? What specialty was he?

[00:33:09] Dr. Jennifer Waljee: he did hematology and oncology.

[00:33:11] Dr. Sam Rhee: Oh, wow. Okay. Yeah. My dad's a hematologist too. It's a very different mindset than a surgeon's mindset. Um, so at this point, you have, um, You've accomplished an amazing amount in the time that you've been, uh, and attending. What other future goals do you have at this point for yourself that you need to accomplish or plan on accomplishing or want to work towards accomplishing?

[00:33:41] Dr. Jennifer Waljee: Um, I would, I mean, I always am striving to, um, Take better care of patients. Um, think more critically about the treatments that I can offer them, hone my surgical skills, um, learn about new, um, treatments that might be appropriate for a specific condition. So I don't think that, um, that will always be probably first and foremost on my mind.

I think, um, trying to figure out how to be a better surgical educator. Um, I think I probably have a lot of blind spots in the operating room. I'm, you know, Trying not to do an operation, but talk somebody through it. Um, so I'm trying to be more cognizant of that and giving them, um, You know, verbal cues and advice rather than trying to take over the operation and doing it myself.

Um, I think in terms of, um, you know, research and, you know, the more academic part of my life, um, I, you know, really enjoy mentoring, you know, students, residents and other faculty members. So I hope that will always continue. I think there's, you know, a lot of our work now is trying to understand how we can help individuals with substance use disorders, mental health conditions, kind of.

Support them through perioperative care. So I think there's a lot of work to do there, which will be, um, you know, really enjoyable going forward. Um, so yeah, those are things that I think about over the next 10 years.

[00:35:02] Dr. Sam Rhee: When I talk to, uh, Um, surgeons, I think the experience that women in surgery have had, uh, versus men, especially in, uh, either in terms of finding mentors or their residency experience is different. And they've pointed it out to me multiple times in terms of what that was. Was that similar? Do you find that to be the case for you?

Or what kind of comments would you make, um, Either going through surgical training as a, as a woman or now on the other end as a leader, as a mentor yourself now, um, being a surgeon who's a woman.

[00:35:46] Dr. Jennifer Waljee: I think that, uh, you know, as you just mentioned, I mean, mentorship is probably one of the most critical factors in success. Um, true for any specialty or discipline, but particularly I think, you know, we feel it a lot in surgery and I think, you need different mentors. Throughout your career, um, you know, individuals that are going to be honest with you and tell you, Hey, like, you maybe didn't make the right decision with this patient or, um, you know, you you.

You know, need to think about your surgical skills in this area. And I'm thinking about like the surgical attendees that you have when you're a resident, like the ones that give you, you know, critical and kind feedback about, hey, you know, think about doing this a little bit differently. You need more reps.

Um, you know, you need to be prepared for a case in a different way. That's really helpful. They may or may not be the same mentors that are going to give you advice about, um, you know, if you're, If you want to take an academic position, these are the pieces of, um, the pieces or skills that you need to be successful and, um, get promoted, um, along the way, particularly during that early career faculty phase, which is, um, important when you're trying to, uh, make it to kind of the next level of promotion, um, which I think is a big point of attrition, uh, for women faculty.

Um, and then having both, you know, um, Perhaps senior mentors and peer mentors who are helping you along the way when, um, you have, you know, children, loved ones, other partners at home, um, and trying to navigate all of those, um, other factors. Not everybody's family structure looks the same, but we all have a lot of things that are going on on the outside outside in our professional world.

So figuring out how you balance that, um, is really important. And I sought that advice out from different people. Um. Perhaps that I did, um, for other aspects of my professional life.

[00:37:34] Dr. Sam Rhee: You're only, what, you said 11, 12 years into your practice now, right? And so you're young as a surgeon. Uh, maybe in the rest of society, people look at us and are like, you know, not young, but that's because we have a different sort of career span and, and sort of arc versus say, Um, a lot of occupations, but at some point, um, and we've seen older surgeons, uh, either sort of operate until they literally can't hold up a scalpel anymore, or they have exit strategies in terms of like what they plan to do or what aspects of their life they plan on keeping or, or changing.

Have you given any thought to what? You will be doing in the distant, distant, distant, distant future for yourself, um, once you start sort of getting to that point.

[00:38:26] Dr. Jennifer Waljee: Yeah, I think, um, I want to, I think you bring up a great point about being mindful of it. Um, you know, not being afraid that, you know, perhaps this chapter is closing and the next one is starting. Um, I, Like when I reflect upon my dad and when he retired, he stayed um, incredibly active in his professional society.

He was still taking tough self assessment examination tests like well past his retirement. He's

[00:38:52] Dr. Sam Rhee: Oh, wow.

[00:38:53] Dr. Jennifer Waljee: the job. Um, so he, you know, tunes into all the webinars and all that kind of stuff. He learned a language, he's, you know, volunteering in a variety of things across the community. And I think, um, I don't know exactly what things will look like, but, um, I imagine that I will stay active hopefully in, you know, teaching and being able to impart some knowledge or wisdom to the next generation of surgeons.

Um, and then, you know, Traveling, finding ways to, um, you know, continue to expand my own knowledge base, I think will be really rewarding.

[00:39:26] Dr. Sam Rhee: When you mentor, uh, the people that you have now, what approaches do you take that you know are different than, say, how maybe you were mentored or, or is it exactly the same? Like, how do you, how do you make sure that you are reaching the young students, residents, trainees that you have at this point?

[00:39:49] Dr. Jennifer Waljee: Um, I don't know if this is the right thing to do or not, but I try not to be pretentious. Particularly prescriptive, like you have to do X, Y, and Z, um, if it's, you know, individuals that come to me and they're interested in a specific research area or topic of interest, I usually try to push them pretty hard to get down to a question that's interesting to them, because if it's not interesting to them, then it's not going to be enjoyable when they're doing, um, the project and the work.

Um, and so. And I want to challenge them to think about, uh, what is meaningful rather than what's meaningful to me, what matters the most to them. Um, so that's kind of how I think about it from like a research standpoint. When I have individuals who come to me and they're interested in plastic surgery and they, um, you know, wondering, you know, what do I have to do to, um, you know, make it to the next step, um, either in medical school or in residency training.

Um, I think I'm, you probably maybe a little bit more prescriptive because there are some, you know, a few more external metrics as far as that's concerned. Um, but I think that there's, um, a place and a space for everybody. I think it's so easy for us to get caught up on, um, you know, board scores and numbers of publications and how many away rotations that we did.

Um, and I think at the end of the day, while many of those things are important, um, what really matters is that you're, you know, passionate and committed to it. Um, and you're, you know, pursuing things that make a difference, um, you know, in the world around you and are meaningful to you rather than, um, you know, just trying to write a lots of papers to put on your CV.

[00:41:28] Dr. Sam Rhee: I think that you need to have that passion for sure. So if, if you were to ask someone, um, like what it, like, if I were to ask you, and I was a student, I, I really want to be a plastic surgeon. I have all the passion in the world. This is my, my dream. This is what I really want to do. But if my board scores are in the toilet, I don't think there's a chance.

Like, it's such a competitive residency to, to get into, uh, that, you know, You would probably have to say the chances are very small or very little like there are certain external metrics that do define whether or not you actually have a fighting shot to be, you know, to get a residency in plastic surgery, for example.

So do you tell students who are looking to, you Apply into plastic surgery. This is really what you need. And without these minimums, you probably aren't going to have a shot.

[00:42:23] Dr. Jennifer Waljee: I think it's, um, about thinking about their whole portfolio, you know, perhaps like one area. Um, and I think the step ones and step twos are hard cause you only get to take them once. And so, um, that's a really stressful day, but, um, Lots of other things that you can do in terms of, you know, doing some dedicated research time or other academic time or, um, global, you know, taking time off to do global health or other things to round out, um, who you are coming into the application process, um, that will allow you to, you know, connect with other mentors, um, across our specialty.

Get the letters of support, um, that can strengthen your application. Um, I think it's also helpful to just, you know, if there's places on your application where, you know, you wish things looked a little bit different, um, you know, perhaps just being as honest and open about that as, as you can be and saying, you know, yes, I recognize that, um, you know, this score wasn't exactly what I wanted it to be, but I have done X, Y, and Z things.

And I think I'm prepared to come into this residency, um, for all those reasons. And I think that, um, while, you know, There's, you know, only kind of one chance to take step one and step two. There's lots of different chances and pathways to, um, move into our specialty. And so trying to encourage, um, our students that, um, there's lots of opportunities, um, is important.

[00:43:44] Dr. Sam Rhee: As a surgeon. And now you have a lot of, uh, administrative responsibilities and leadership responsibilities, both as faculty in, in, in your lab, um, in organized plastic surgery, um, We all know surgeons who are really good at being surgeons in terms of their surgical skills, great hand eye coordination, really good clinical skills in terms of managing patients, treating certain operations, but maybe lack the ability to lead the team.

groups to talk to large numbers of people to be able to, uh, or, you know, be a good organizer to do the things that it takes to, uh, ascend higher in, you know, if you really want to impact more people, either outside of, uh, your department or, uh, medical school or hospital, or, you know, organized plastic surgery as a whole. How did you develop those skills? Did you always have them? Were you really good at managing, organizing, communicating, or was that something that you had to pick up along the way as well?

[00:44:52] Dr. Jennifer Waljee: No, I'm not sure. I don't know that I'm, I don't feel very good at any of those skills, but I feel like there's lots of opportunities to learn and practice them. And I think in many of the spaces that we're in, either in our professional societies or the institutions or organizations that we're in, there's lots of different leadership development programs that have emerged over, um, you know, the last decade or so.

And I am really encouraged to see that the residents have access to these as well. Um, so Um, I often encourage them to, you know, we have several in our department to participate in those. Um, because I think, you know, we're leaders when we're leading our teams as a chief resident. Um, you may not realize it or feel like that at the moment, but all those skills in terms of, um, you know, your emotional intelligence, your ability to communicate, um, your ability to be efficient and organized, um, that matters at five o'clock in the morning when you're rounding with a team of, you know, people.

5 other residents and you've got 70 patients to see just as much as it does when you're trying to lead a group, you know, in your research team or a clinical team. So, I think I've been really excited to see those programs emerge for our residents and I think it's about lifelong learning.

[00:46:02] Dr. Sam Rhee: What is the biggest improvement you think you've made personally in those skills over the past 11 years?

[00:46:09] Dr. Jennifer Waljee: Um, I hope I'm better at communication. I Sometimes, you know, we feel like, oh, my gosh, we've said this like 10 times, but then you realize, like, maybe you didn't say it to the same people 10 times. Um, you know, maybe you said it in a variety of different spaces. And then, um, so making sure that you're, I don't think it's possible to over communicate.

And I think making sure that you are communicating consistently again, back to that point that, you know, we all hear different things from, um, you know, a single person. A piece of information that's being delivered and so, um, trying to be as clear and consistent about that is, um, I think, uh, something that I'm working on.

I hopefully, hopefully I'm getting better at that.

[00:46:53] Dr. Sam Rhee: How do you balance your clinical responsibilities with your research responsibilities with your other responsibilities? Uh, Professionally, do you make a conscious choice? Like I'm going to be spending X amount doing this X percentage doing this X percentage doing this, or is it just whatever feels most interesting or what needs to be done at a time, or I need this goal for this.

And that's how you sort of divvy it up because there's only X amount of. days for, you know, minutes in a day to do anything. So how, how do you best organize yourself in order to achieve the goals that you want?

[00:47:30] Dr. Jennifer Waljee: Um. I think, uh, well, I think it's related to how I partition out my schedule. So, um, I have a couple of days where I operate a week and then I have a full day of clinic. Um, and on those days I'm pretty, um, focused on almost entirely clinical care, signing my notes, making sure I'm following up on whatever patient issues, um, prepping for cases, making sure that whatever I need for specific cases is all being taken care of because, um, I don't know.

I think my brain just, you know, It's already kind of in that mindset, and that's easier for me. And then I can respond to some emails or messages that are relatively quick and don't necessarily require a deeper conversation. I block out 1 day a week for my email. Research, um, and a lot of that is meetings, but I try to break that up so that there's also time to catch up on things and then address some of those deeper questions or things that are going to require a little bit more time.

And then I have another day that's a bit of research and a bit of admin. So, again, kind of more meetings and those, but it's a little bit of a faster pace because it's kind of back to back meetings. So I try to, um. Set aside chunks of time, um, when, because I find that, you know, if somebody is emailing you something that's, you know, perhaps sensitive or requires a lot of attention that I can't respond to on my phone and then, you know, email such a vacuum, then all of a sudden, you realize you haven't responded to it at all.

Um, so I think being intentional about your time, um, is something that, um. I have been trying to do better over the last several years and also leaned on my administrative partner, um, as well to help me with that saying, like, listen, we're going to block off this morning. Um. And maybe I have to add a case on, maybe I don't, but otherwise, like, we're not going to add other, like, meetings and those kinds of things on there.

[00:49:21] Dr. Sam Rhee: Um, if there was one thing that you tell your trainees, your mentees, they look at you, they're like, I want to be Dr. Jennifer Waljee. This is exactly what I want to do. What is the most important thing I would need to do to become you? Is

[00:49:42] Dr. Jennifer Waljee: Gosh, I don't know. I should follow their path. Um,

[00:49:48] Dr. Sam Rhee: good enough.

[00:49:49] Dr. Jennifer Waljee: know what I would tell them.

[00:49:51] Dr. Sam Rhee: I

[00:49:53] Dr. Jennifer Waljee: I guess I would, you know, tell them to, you know. Stay focused and, um, you know, and stay committed to, um, the things that, uh, are meaningful to them, um, and, um, do what makes, what brings them joy, um, because there's a lot of times during the day that are not necessarily joyful and are hard.

Um, so, um. You know, you want to make sure that you feel like, you know, the things that you're doing every day are meaningful. I, I think so.

[00:50:33] Dr. Sam Rhee: really appreciate you spending the time on a Saturday after taking call to, uh, share a little bit about your life and your experience. I think it is very inspiring. I think, like I said, it's very, uh, Uh, it's a challenge, uh, I think anyone to stay at their own training institution and then make it theirs, uh, as an attending.

And I, and the people that I know who have done that have been the most highly regarded, uh, both at their institution and out. And, you know, Michigan Plastic Surgery, let's face it, I think is the premier plastic surgery, uh, training program in the world. I mean, not just because I went there, but because I see it on the outside looking in now and having seen other programs.

Um, And so it's so impressive to see, uh, just how much all of you as faculty and as attendings have accomplished there. Um, and honestly, also how well you have meshed with the senior surgeons there and have sort of, Taken what they've done and, and, and gone beyond. Um, many of your senior surgeons were also my mentors when I went through and it was challenging to say the least for, for, for many of us and, uh, um, and for you to excel and thrive there, um, just shows, uh, Like you said, you may have found what really interested you and drove you, but I cannot underestimate or no one should underestimate the amount of work, hard work, time, and commitment that anyone who has faculty there has spent to achieve what you have.

And so, you know, I find that inspirational. Um, the fact that you've spent the 11, 12 years so far there. And I think that most people who look at your life should Also say, I mean, I would say hard work. Like if I, if, if one of your mentees were like, how do I get to where Dr. Waljee is? I'd be like, you got to work really, really, really, really, really hard because you're not, you know, as much, uh, joy that you might get from your work.

Like it, it is probably, um, to have spent your general surgery years, your residency, and then to continue to progress the way you have. I can't imagine how much Um, you were able to do within that time in terms of, uh, being efficient and just, you know, nose to the grindstone with that sort of stuff. So, so I really, it's, it's admirable.

So that's really cool.

[00:52:59] Dr. Jennifer Waljee: Well, thank you. I feel very privileged to be here and thank you so much. Um, it's been, it's been fantastic to have this discussion and go blue.

[00:53:08] Dr. Sam Rhee: yes, go blue. And, uh, I keep following the, the new, uh, coaching and, uh, what the plans that they're having for next year's football season. Um, so. I will continue to wear mine and cheer from afar and, and I hope, uh, your, our institution continues to do really well next year as well. So thank you, Dr. Waljee. Um, and I appreciate it very much.

[00:53:32] Dr. Jennifer Waljee: Thank you. I appreciate this. Thank you.