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PRS Resident Chronicles
Friday, August 15, 2014
by Jacob Unger, MD

After a rather spirited discussion in our teaching conference last week, and an impromptu learning session that resulted after the end of conference, my mind began turning this rather simple, yet somewhat confusing topic.  The caudal nasal septum and how various actions upon it have completely different actions on the shape and structure of the nose.

One of our exceedingly bright junior residents was presenting a rhinoplasty in photo conference, where we are required to present our week’s cases with pre, intra, and post op photos on the first Thursday of each month.  She was deftly describing the maneuvers used in this case to both create a positive effect on the airway, as well as the aesthetic techniques utilized to create a better nasal shape. The confusion began when the line of questioning from our senior faculty turned towards the action taken at the caudal septum. A conversation on straightening of the septum and up-rotation of the tip and shortening the nose all became intertwined that, without the appropriate nomenclature, left the discussion participants and much of the audience confused.

The crux of the matter is the nasal spine, as we all talked about after the session ended. Anterior to the nasal spine, resection of the caudal septum has no effect on deflection of the cartilaginous septum or L-strut, which is all posterior to the nasal spine, but instead can have marked effect on the aesthetics of the nose.  Resection of the anterior caudal septum, when placed parallel to the natural angle of the septum here will result in shortening of the length of the nose as well as the creation of space for a columellar strut. A small amount of up-rotation of the tip will also occur with this maneuver. Conversely, an angled resection of this anterior caudal septum will result in primarily tip rotation and thus an increase in the columellar-labial angle, with a secondary change of decreased nasal length.

Importantly, none of the aforementioned resections will have an effect on an excessively deviated cartilaginous septum. However, if you perform a resection of the caudal septum POSTERIOR to the anterior nasal spine along the maxillary crest (sometimes referred to as the inferior septum to avoid exactly the confusion that occurred in conference), this will allow for resection of bowed or deviated excess cartilage which can allow for straightening of the septum and therefore an improved airway. It should also be noted that if this inferior septum is resected, parallel to the maxillary crest, but no action is taken on the anterior caudal septum or at the point of the anterior septal angle, there will not be any change to the aesthetic position of the nasal tip structure.

The final teaching point we discussed was that if you perform an inferior septal resection (or posterior caudal septum) to improve septal shape and airway flow, you must reattach the new inferior margin of the septum to the periosteum of the maxillary crest to restabilize the septum. Without this important step, often done with 5-0 PDS in a figure –of-8 fashion, you can have compression and collapse of your midvault with the healing process resulting in what appears to be a residual dorsal hump deformity at the keystone area, as well as an excessive supratip break.

As we held this spontaneous residents-only teaching session we not only developed a deeper and more comprehensive understanding of this topic, but also had the opportunity to bond as a group and make yet another small memory of our training experience that enriched not only our clinical knowledge, but our lives.


Wednesday, August 13, 2014

By Sammy and Rosa Sinno, Scott and Alicia Reis, Emily Cleveland and Gaurav Manchanda, Ajul and Shefali Shah, Anup and Rina Patel

 

“Behind every great man is a woman rolling her eyes.” -Jim Carrey

 

Life takes us down a great journey, full of peaks and valleys. Having a partner to share in the vicissitudes we encounter enriches our own journey and sheds light into this journey.  Undoubtedly, the path to becoming a plastic surgeon proves challenging. After years of working hard in medical school, residents spend a minimum of 6 years and up to 10-12 years (including research) to realize their goal of being a board-certified plastic surgeon. Then, there are fellowship and career opportunities that, like residency, may uproot a family to an unfamiliar location.

So much in our literature is focused on our path and journey as plastic surgery trainees. We have dissected every detail about residency applicants, optimal training pathways, and fellowship/career choices. In contrast, a paucity of information exists on the support system that accompanies this journey. Our significant others are such an important part of our lives, sharing in the joy and triumph, comforting in the grief and failure.

As residents, we decided to ask our husbands and wives what they thought about residency. We asked them several questions and below you will find a summary representation of the responses. Our hope in sharing this piece will encourage fellow readers of this blog to share with their loved ones to let them know others are traveling down a similar path and provide feedback to us.

 

Question #1: Is residency what you thought it would be? Please explain.

Virtually, dead on: I knew it would be stressful, busy, and a long journey full of hard work. Work/life balance can vary greatly from rotation to rotation, but overall it is more bearable than expected.

 

Question #2: What is the best part of being a plastic surgery resident's wife/husband?

Seeing how much he/she loves what he/she is doing and the impact these surgeries have on patients lives. Also, knowing that one day training will be over and all the hard work will pay off. Meeting new friends, having the opportunity to live in a different city, and hearing about interesting cases are also bonuses.

 

Question #3: What is the worst thing about being a plastic surgery resident’s wife/husband?

Not being able to spend as much time together as I would like. The long hours and uncertainty in scheduling make it difficult to see each other as much as we were used to and plan our time together.

 

Question #4: How do you manage the nights you are home and he/she is still at the hospital?

Initially, it is very tough to get used to waiting at home with cold dinner. Having hobbies helps, and I have come to accept “I will be home in 20 minutes” may actually in reality mean two hours. I try to do activities for myself, run errands, meet with friends, watch so when he/she is not working we can enjoy our time together.

 

Question #5: Out of all the operations he/she tells you about, which ones sound the most interesting?

A variety of cases prove interesting including face transplantation. DIEP flaps for breast reconstruction. craniofacial cases, ear reconstruction using autologous rib, and rhinoplasty.

 

Question #6: What are your thoughts about an extra fellowship year?

I am open to it. Time goes by so fast, so what is an extra year if it really can hone one’s surgical skills.

 

Question #7: If you could change one thing about his/her residency, what would it be?

I wish there was less home call and we knew the weekend schedule even farther in advance for planning purposes.

 

Question #8: What are you going to miss most when residency is over?

All of the great people in the program, especially the other residents

 

Question #9: If you could pick an area of training for him/hr, what would you pick? Why?

Whatever he/she enjoys doing that makes him/her the happiest.

 


Friday, August 08, 2014

by Anup Patel, MD, MBA

Almost a year ago Jim Clune, my co-resident, and Dr. Stefano Fusi, a plastic surgeon at Yale University, participated in an Operation Smile mission to Jordan. They performed the usual run-of-the-mill cleft lip and palate surgeries typically encountered on these trips. Yet, what took them by surprise was an Indian cleft surgeon who not only performed these surgeries so elegantly, but also so rapidly, finishing almost every case in less than 25 minutes. When they came back, they told me I must make a trip to the southern tip of India and visit Dr. Sunil Richardson.

With that background, I boarded a plane from Mumbai to Trivandrum followed by a 30-minute taxi ride to Kovalam. The town of Kovalam hosts a stunning cliff that overlooks the Arabian sea, gorgeous beaches, and the popular reported to have tons of gold within its vault. What I did not anticipate was a transportation strike in the State of Kerala, where the hotel was located, circumventing me from getting to Nagercoil, located in the State of Tamil Nadu. Given my linguistic constraints of not speaking Tamil or Malayam, I found myself in a bit of a predicament. Yet, around 5 PM, a call from Dr. Richardson came and told me that he had arranged for a taxi service to fetch me from Kovalam to his hospital the next morning. You can imagine the relief that came over me as we crossed the border of Kerala into Tamil Nadu without having the car stoned by those on strike. In 90 minutes, I arrived at The Richardson Dental & Craniofacial Hospital (Fig. 1 and 2).

Figs. 1 and 2: The Richardson Dental & Craniofacial Hospital, a recognized Operation Smile Comprehensive Care Center, located in the greenery of Nagercoil in Tamil Nadu.

Situated in the backdrop of mountains and lush greenery of Tamil Nadu, the four-story hospital provides comprehensive dental and craniofacial care to many of the indigent of India. It houses two operating rooms, a PACU, wards including ICU beds, clinic rooms, and a dental laboratory. Sweta, Dr. Richardson’s wife and dentist, works closely with orthodontists to ensure proper occlusion of teeth can occur in conjunction with the orthognathic movements. Furthermore, speech therapists and nutritionists work in the center and always available to offer their services.

Funding remains limited given the multitude of indigent Indians who travel kilometers across the country in hopes of receiving treatment. Dr. Richardson’s uses a great deal of his private earnings to provide care for the poor. In addition, Operation Smile supports the center given it fulfills the nonprofit’s push for comprehensive care centers such as the one in Guwahati. Cape Craniofacial Foundation donated a bus to enable a mobile outreach for patients in the state.

The clinic witnesses a gamut of craniofacial pathology from patients with poor primary cleft lip repairs requiring revisions with rhinoplasties to rare disorders such as Binder’s syndrome requiring correction of nasomaxillary hypoplasia. Most patients arrive NPO as Dr. Richardson often adds them onto this already packed OR schedule knowing they have exhausted all resources just to see him once. To this end, he sees patients in between cases and works well into the night.

Fig. 3: Dr. Richardson and I after finishing a uvuloplasty for a cleft palate.

In the OR, he moves confidently and efficiently, facilitated by his ambidexterity as well as profound anatomical knowledge. He treats a diverse number of craniofacial problems Monday through Saturday with a daily case log comprised of the following: repair of palatal fistula , cleft rhinoplasty, LeFort I with genioplasty, ORIF of orbital floor fracture, and unilateral cleft lip. Always a student of plastic surgery, he advises to identify great mentors to bounce ideas off as well as using Plastic and Reconstructive Surgery to continue to remain innovative.

Fig. 4: Dr. Richardson repairing a cleft lip at his the center that serves many indigent of India.

He continues to conduct research and give lectures internationally. Next week, he will travel to Palo Alto to teach in a course entitled “International Humanitarian Course” to Stanford University Medical School on cleft care in India. Furthermore, he participates in many oral and maxillofacial conferences throughout the world discussing orthognathic movements related to clefts. Continuing his academic commitment, he trains two fellows each year with a packed waiting list for those wanting to train with him.

Those of you wishing to elevate your surgical skills related to clefts and orthognathic surgery must pay Dr. Richardson a visit. Sweta and him are down-to-earh people who will take you out for authentic Tamil Nadu meals including eating off a banana peel, develop your surgical skills, and enable you to participate in changing the lives of so many indigent Indians.

Look forward to your thoughts!

Figures:

Figs. 1 and 2: The Richardson Dental & Craniofacial Hospital, a recognized Operation Smile Comprehensive Care Center, located in the greenery of Nagercoil in Tamil Nadu.

Fig. 3: Dr. Richardson and I after finishing a uvuloplasty for a cleft palate.

Fig. 4: Dr. Richardson repairing a cleft lip at his the center that serves many indigent of India.


Tuesday, July 01, 2014

by Anup Patel, MD, MBA with assistance from Dr. Akshay Deshpande (microsurgery fellow)

India proves home for me for many reasons despite being born in the United States. First, most of my family and many of my friends reside there. Second, Cents of Relief, the nonprofit that I co-founded with Rina, my wife, endeavors to empower victims of human trafficking in India through healthcare and education. Third, with some good fortune, I have had the chance to participate in cleft and burn missions across India in conjunction with Operation Smile. Thus, with my remaining elective time, I decided to head to India after Paris to continue my plastic surgerytraining.

Following a tumultuous departure from France including having all of my credit cards, driver license, and cash stolen off a train, I managed to arrive at Charles de Gaulle Airport and board the ten-hour flight from Paris to Mumbai. Yet, while I hate long journeys, ten hours seemed to be the average time each patient traveled to get to the next hospital I began my stint at. That hospital was none other than Tata Memorial Hospital (TMH) in Mumbai: India’s “Mecca” for oncological resection and reconstruction. Yatin mama (uncle on mother’s side) and Shrutimami (aunt on mother’s side), who work in the medical field, contacted their friend Dr. Shirpad Banavalli, the chair of medical oncology at TMH, to assist me in garnering a rotator position in TMH’s arm of plastic and reconstructive surgery.

Synonymous with the “best in cancer treatment, “TMH treats a wide-range of cancer pathology divided into disease-management groups (DMG). Dr. Banavalli, the chair of medical oncology, advocates this approach as it enables patients with a certain disease to see all the respective consultants in a single area maximizing efficiency. I opted for the head and neck oncologic DMG not only because of a strong interest in the field, but also because Dr. Stephan Ariyan, one of my attendings, recommended it highly.

As a side note, Dr. Ariyan visited TMH in the 1980s at the request of Dr. Jatin Shah, the current chief of head and neck surgery at Memorial Sloan-Kettering, for them to perform joint head and neck tumor extirpation and reconstruction. Dr. Ariyan remembers vividly going to the floor to identify patientswho would require head and neck reconstruction with the pectoralis major myocutaneous flap, which he described its use for head and neck defects in 1979.(1) The task proved immensely difficult as he looked down the hallway seeing numerous patients, with varying types of head and neck tumors, in different anatomical locations, at various disease stages. He told me at TMH one will witness every type of head and neck tumor including many fungating and exophytic lesions due to the abject poverty that delays treatment.

Walking into TMH, everything Dr. Ariyan said proved true. The patients come from all over India, often using every bit of their money just get to TMH, only then to find themselves without any funds left for food or lodging. Thus, one can routinely find patients waiting for surgery sleeping on the footpaths outside the hospital. The ones covering their mouths with masks or handkerchiefsare attempting to hide some sort of fungating lesion in order to avoid the associated social stigmata. The clinics are teeming with patients, many of whom, must wait weeks before being brought to the operative room.

To keep up with this demand, the plastic and reconstructive surgery service at TMH routinely perform three to four free flaps per day operating from head to toe. Specifically, at TMH, of the 500 free flaps performed last year, 400 were for head and neck defects, 50 for breasts, and 50 for lower extremity and chest wall defects.

The unit consists of Dr. Prabha Yadav, its chief, Drs. Vinay Kant Shankhdhar and Dushyant Jaiswal, its two-full time attendings, and a slew of residents and fellows. Drs. Akshay Deshpande and Saumya Mathews proved to be the fellow and resident, respectively, whomI got linked up with and, ultimately, became close friends with. Every member of TMH welcomed me into the operating rooms and took me through the thought-process of the case. Our exchange facilitated provocative discussions continuing to advance the field of reconstructive surgery.

In one operating room, Dr. Jaiswal designed a free fibula flap with a double skin paddle to resurface the mandibular defect (Fig 2).(2) The double skin paddle enabled one free flap to provide both internal mucosal lining and external cutaneous coverage. Rapidly, the flap was elevated identifying the perforators to the skin, dissecting the anterior and lateral compartments off the bone, and garnering adequate pedicle length. The flap was inset and the microanastomosis were performed with the microscope. With the fibula fixed in place with a plate, the soft-tissue was redraped restoring facial harmony.

While at our institution the veins are generally anastamosed using couplers, at TMH, largely due to the costs constraints, the veins are hand-sewn. The high-volume combined with the surgical skillset at TMH enables the veins to be done as if couplers were being used. In fact, one case I remember standing out was when Dr. Vinay Kant Shankhdhar performed an end-to-side internal jugular vein to the vena comitantes of a free ALT flap for resurfacing the oral commissure and submental area. Using horizontal mattresses stitches to compensate for the size discrepancy, he performed the otherwise challenging suturing effortlessly. After the arterial anastomosis was completed, the flap turned pink without any leaks from the anastomoses.

In fact, these attendings love teaching holding a monthly microsurgical workshop that includes a cadaver dissection course for learning the essentials of flap harvest. The course selects four candidates (on a first-come, first-serve basis) who are required to pay the course fee of $600. The course focuses on head and neck reconstruction providing instruction on how to perform free flaps such as fibula, anterolateral thigh, and radial artery forearm as well as pedicled flaps such as the pectoralis major myocutaneous flap. Comprehensive, didactic lectures are delivered on flap harvest techniques and later in the day the attendees are taken to the operating room to observe the relevant surgeries from Monday to Thursday. The last day consists of an organized cadaver dissection course where the attendees harvest the flaps on the cadaver under the guidance of the faculty. 

The TMH plastic surgery section proved to be one of my best experiences witnessing how in a resource-constrained setting, its staff delivers optimal care to treat some of the most complex oncological cases in the world. The gregarious and welcoming attitude stems from how Dr. Yadav as she treats each and every person with respect and kindness. The surgical education utilizes articles from Plastic and Reconstructive Surgery to stimulate thought and discussion for the weekly didactics and M and M lecture. Furthermore, Drs. Akshay and Dr. Saumaya told me the white journal’s videos and online content enable them to quickly review technical steps for cases the next day.

Those of you wanting to see diverse oncologic pathology, particularly in the head and neck region, should visit TMH to see how the plastic surgery unit here continues to work advance the reconstructive frontier.

Figure 1: Tata Memorial Hospital’s clinic with Saumya and Akshay

Figure 2: Dr. Jaiswal and a fellow are harvesting a free fibula flap for a head and neck oncologic defect at Tata Memorial Hospital.

 

References:

1.         Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg. 1979 Jan;63(1):73-81. PubMed PMID: 372988.

2.         Yadav PS, Shankhdhar VK, Dushyant J, Seetharaman SS, Rajendra G. Two in one: Double free flap from a single free fibula osteocutaneous unit. Indian J Plast Surg. 2012 Sep;45(3):459-65. PubMed PMID: 23450653. Pubmed Central PMCID: 3580343.

 


Friday, June 27, 2014
by  Ajul Shah, MD
 
On May 1st, 2014, a group of volunteers embarked upon a plastic surgery mission trip to Mbale, Uganda with the non-profit foundation “Changing Children’s Lives”.  The foundation, founded by Dr. Mark Weinstein, has embarked upon yearly mission trips to areas in need – most often, for children with cleft lips and/or palates.  The foundation has been to multiple countries, including Vietnam, Thailand, Uganda, and others.  I was fortunate enough to be a part of the trip to Uganda this year (the foundation has been to the same site twice in the past), and I can say without hesitation, the experience will change your perspective.
 
The group, consisting of surgeons, students, residents, nurses, physician assistants, and administrators from three separate institutions, met at JFK on May 1st to start upon the long journey to Mbale.  After an eight hour flight to Amsterdam, a ten hour flight to Entebbe, and an eight hour bus ride to Mbale, the group arrived tired and sweaty to the Mt. Elgon Hotel.  The traffic leaving Kampala was….tricky. A view on Google Maps showed a distance from Kampala to Mbale that should have taken 2.5 hours to traverse, but we quickly realized that we would have no chance of leaving Kampala itself in that time period. It took nearly 4 hours to navigate the potholes, single lanes, traffic, and lack of street-lights and stop signs to leave the city of Kampala (25 miles). After arriving in Mbale, the group met at the hotel bar for a few glasses of wine, and turned in for the night in preparation of the next full day of screening.
 
Figure 1 – Entrance to Mbale Regional Hospital
 
We arrived at the hospital the next morning to set up the operating rooms and screening tables. The hospital environment was striking – although a sizable complex, most wards were no more than open-air buildings with four walls, packed with beds side-by-side. Chickens ran freely throughout the various wings, with patients crammed in to each ward of the complex. The operating theater consisted of three operating rooms stocked with the basic necessities – a table that cannot be moved up or down and operating room lights that often failed to work. We brought the remainder of the supplies with us, including gloves, instruments, anesthesia equipment, and dressings. The operating rooms and the screening areas were set up simultaneously, and then…we waited. And waited.  As I was informed by Dr. Weinstein, the patient screening process was markedly different in Uganda than it was in the Southeast Asian countries – during the first day in Vietnam the year before, the staff screened 150 patients.  He told me that although the foundation had a contact in the local community that spread the word of the upcoming mission trip, the local population demonstrated a general sense of hesitation to visit the international surgeons.  He let me know that rather than screening all patients on the first day, there would be a constant daily stream of patients after word of successful surgeries spread through the community. And he was correct.  Slowly, patients arrived. A patient with a bilateral cleft lip. A unilateral cleft lip. A burn contracture. A Veau II cleft. A Veau III cleft.  By the end of the day, the operating schedule for Monday was full.
 
Figure 2 – One of the hospital wards
Figure 3- Senior Administrator Shefali Shah in foreground beginning the screening process with Dr. Mark Weinstein and Dr. Devinder Singh (attending surgeons) in background evaluating patients
 
The week was filled with operating and screening. The patients arrived on a daily basis as successful surgeries were completed.  The majority of patients operated upon had cleft pathology – cleft lips, cleft palates, or both.  There were also patients with AV malformations, burn scar contractures, soft tissue tumors, and others.  Some stories were truly emotional. A 28 year-old male patient presented with an incomplete unilateral cleft lip.  He said that during his school years, he was so ridiculed by his peers that he could not stand the thought of returning. He left school at the equivalent of the 7th grade, and later went to look for work in the city. He found that older people were just as malicious – he felt so ostracized in his surroundings that he left the city and moved, in his words, “to the edge of the forest to be away from people”.  We completed a Fisher repair of his cleft lip, and let him look in a mirror – his face relayed his underlying emotions.  My feelings were bittersweet – I felt very grateful for the opportunity to help this man, but also felt saddened at the thought that a simple 45-minute operation as a child could have saved him a lifetime of heartache.
 
Figure 4 – Ajul Shah with a patient after the completion of the patient’s operation
 
These types of feelings pervaded the trip.  The backdrop of the Ugandan countryside, lush and green, contrasting to the poverty and underdevelopment at its forefront, was striking. I felt happy to provide assistance to a community that needed it, but felt distraught by the lack of resources available to the general public. Discussions with local staff and surgeons revealed a community torn by strife and corruption whose natural resources, in their opinion, were being misused and mismanaged. The interactions we had with the people of the community were the most affecting.  Each patient, each parent, and each relative brought with them an individual story of achievement and overcoming the odds in an environment where the odds were set against them.  I stood in admiration of a community in solidarity, whose children were stronger than most adults I know (including myself). It puts life in to perspective, and makes you question what is truly important in your own.
 
If you have any stories from mission trips of your own, please do not hesitate to comment.
 
Here's a link to the documentary of the trip:
 
About the Blog

Plastic and Reconstructive Surgery

PRS Resident Chronicles” is the official Resident blog of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons. Visit this blog to follow the unique journeys of several young doctors as they go through residency in their respective Plastic Surgery Programs across the country.

We want to hear from Plastic Surgery Residents across the globe as well: how do you use PRS in your residency? What are some of the challenges you’ve faced and successes you’ve had? Join the on-going conversation by commenting, and if you think you have a potentially interesting-enough entry to be a unique blog post, email us at prs@plasticsurgery.org.

Bookmark the “PRS Resident Chronicles,” subscribe to the RSS feed and join in the on-going conversation with Plastic and Reconstructive Surgery. This is your journal; have fun, be respectful, get engaged and interact with the PRS community.

Keep in mind that the views and recommendations presented in this blog do not necessarily indicate official endorsements or opinions of the Publisher, PRS, or the ASPS. All views are those of the authors and the authors alone.

Rod J Rohrich, MD
Editor-in-Chief

Contributors

Andre Alcon is a fourth-year medical student at Yale University where he is starting a one year research fellowship in tissue engineering with the department of plastic and reconstructive surgery.

Ashley Amalfi is currently a fifth year Plastic Surgery Resident at Southern Illinois University School of Medicine. She attended the George Washington University and received dual degrees in Fine Arts and Art History. She returned home to attend The University of Rochester School of Medicine and Dentistry in Rochester, NY. Ashley met her husband, a urologist, during her training at SIU. She enjoys yoga, reading, travel and cooking in her free time.

Jordan Ireton is in her first of six years at the University of Texas Southwestern Plastic Surgery residency program.

 

 Anup Patel, MD, MBA, is a resident in the Yale Plastic and Reconstructive Surgery Program. He co-founded Cents of Relief, a 501(c)3 nonprofit, that empowers victims of human trafficking through health and educational initiatives including those related to reconstructive surgery. Along those lines, he has interest in surgical burden of disease and healthcare policy. He has been selected to serve on the American Society of Plastic Surgeons Board of Directors as resident representative.

 

Justin Perez is a fourth-year medical student at Weill Cornell Medical College. Born and raised in Reading, Pennsylvania, Justin moved to New York City to attend Fordham University, where he graduated summa cum laude with degrees in Biology and Spanish Literature. His academic interests include tissue engineering and wound healing, the topics of his current research. His hobbies include theater and biking.

 

Raj Sawh-Martinez, MD is a current resident at the Yale Plastic and Reconstructive Surgery program.  He grew up in Yonkers, NY and completed his undergraduate work in Neural Science at New York University.  He graduated from the Yale School of Medicine in 2011.

Ajul Shah, MD is a graduate of University of Texas Southwestern Medical School and is now a resident in his second of six years at the Yale Plastic Surgery residency program.

Jacob Unger, MD was raised in New Jersey on the shore. He attended Tulane University for his undergraduate work where he rowed on the Tulane Crew Team and majored in Philosophy. He graduated Phi Beta Kappa, Summa cum Laude with honors and then attended New York University School of Medicine. When not working, he enjoys traveling with his wife, surfing, and skiing.

Former Resident Chronicle contributors

Eamon O’Reilly, MD LCDR USN is an active duty US Navy full-time outservice resident in his second of three years at the University of Texas Southwestern Plastic Surgery residency program in Dallas, TX.