The Road Less Traveled: Dr. Zack Borab on Medicine, Travel, and Work-Life Balance

In this episode of the So You Want to Work in Healthcare podcast, host Leigha welcomes Dr. Zack Borab, a fellowship-trained plastic surgeon who recently completed his training and joined a practice in Monmouth County, New Jersey. Leigha and Dr. Borab have a personal connection, having attended high school together, which adds a unique dynamic to their conversation.

Leigha begins by explaining the purpose of the podcast—helping students understand different areas of medicine and providing tips on how to pursue a career in healthcare. Dr. Borab shares his journey into the medical field, starting with his high school experiences and his curiosity about how the human body works, leading to his landing the top plastics fellowship in the country. This episode delves into his personal motivations and offers valuable insights for anyone considering a career in healthcare. Tune in to hear Dr. Borab's story and gain inspiration for your own medical journey.

*Not Medical Advice. Our views do not reflect the views of our employers.*

Thank you so much for listening! Let me know what you think and leave a review on whichever listening platform you’re enjoying on. In that review, write your instagram handle so I can shout you out on the next episode. And if you’re interested in being on the podcast, head over to my TikTok or Instagram account @helloimthepa and send me a message! I’m always happy to hear from you.

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Transcript

SPEAKER_02: Welcome back to the So You Want to Work in Healthcare podcast. Today, I have the pleasure of introducing a new guest. He is a fellowship-trained plastic surgeon. He also just recently finished his training and joined a practice in Monmouth County, New Jersey. We happen to have gone to high school together, so that's a fun fact. Welcome, Dr. Zack Borab.

SPEAKER_00: Thanks, Leigha.

SPEAKER_02: Thanks for coming on the show.

SPEAKER_01: Thanks for having me. This is such a cool little podcast and social media following you have.

SPEAKER_02: Thanks. Yeah, it's really fun. The podcast is like a bit of a hobby and I'm just hoping to help people with it. But it's cool that I could do it from anywhere because I'm currently in Spain. So that's fun.

SPEAKER_01: Can't say that I'm not jealous.

SPEAKER_02: Yeah, it's been good. Basically, the point of this podcast is to help people, students, understand what part of medicine that they might want to go into, how they can do it, and I like to have our guests give them tips, and I think you have a really cool story to tell, so I'm excited to ask you about that. But the first question I want to start with is why healthcare and when did you know you wanted to go into healthcare?

SPEAKER_01: Um, so that's, you know, personal for everyone. For me, it was, I remember being in high school and like science was easy and that's kind of the story. Everyone who goes into medicine talks about is that like, science is like their favorite class or whatever, math and science. So yes, that was true for me. But I remember being in high school and being like, I don't know how my own body works. Like, I don't know what a spleen does. I don't know what a stomach does. Like, I don't know what a liver does. And I remember being like, kind of upset, like, I want to know how this stuff works. And we went to the same high school, we didn't have an anatomy class. So I was like, I need to learn more about this. So me being me, I just kind of like figured everything out by reading and like, I don't even know if YouTube was out then, but maybe YouTubing to learn more about like, our bodies and how it works. And you know, that kind of catapulted my career into like, I like working with anatomy and physiology and then kind of incorporating that into like what I want to do with my life.

SPEAKER_02: I feel that. I mean, I was always the kid who asked like way too many annoying questions. So, but a lot of it was about that, like, how does this work? So I love that answer. Did you go to or apply to undergrad kind of knowing you were going to take a science

SPEAKER_01: I knew I was going to have a science path, even though I was like a business minor. So I was like toying with both the ideas. It's always hard to go into medicine and be like, I'm going to make it. You know, you always have like, everyone tells you from your guidance counselors onward from like high school and college that like only X percent make it. So it's really intimidating. I remember being an undergrad and they're like, yeah, I don't know. I don't know if you're going to make it. And I was like, tough to hear, but motivating.

SPEAKER_02: Yeah, not sure I love that mindset. But you know, like of the guidance counselor who I get it. But yeah, it's it's it does kind of like light a fire.

SPEAKER_01: Yeah, it goes both ways. It can dissuade people or light a fire. And I think the ones that it lights a fire on are the ones meant to go into medicine anyway. So They probably have a strategy behind that and they want people to be successful. You don't want to get into medicine and then back out. That's not fun.

SPEAKER_02: True. True. Where'd you go to undergrad?

SPEAKER_01: Um, I skipped around a bit. I went to Rutgers for a semester. I transferred to UNC Wilmington. Okay. Way by the beach, which is an amazing school. And they didn't have a very strong, like health science department. So I transferred again to UNC Chapel Hill and I graduated from there.

SPEAKER_02: Not a bad place to graduate from.

SPEAKER_01: It was a wise move. I had the guidance of my older brother who was like, you want to graduate from a better school and that it'll help you in your career. He was right.

SPEAKER_02: I'm so jealous, actually. That was my dream college. I ended up not even applying, but I wanted to play soccer there and I knew I wasn't good enough.

SPEAKER_01: They don't call it the University of National Champions for nothing.

SPEAKER_02: Exactly. I actually bounced around too. I ended up making a last-minute decision. I was supposed to go to Penn State, made a last-minute decision, went to College of Charleston for a year, and then realized I didn't like that part of the South that much, then went to Fordham. Can relate to the whole jumping around, but I think we both ended up at pretty good places, so that's good.

SPEAKER_01: Yes, there's no like one and done. You can always move around and be successful, I think.

SPEAKER_02: Yeah, so when you graduated, what did you graduate with? Was it a bachelor's of science?

SPEAKER_01: Yeah, I was a BA in biology. Ultimately, when you transfer that many times, which I'm sure you lose some credits. I had to really load up the classes when I got to Chapel Hill. I was taking four sciences at the same time to make it in time for med school applications. It was hard, but I decided to do the biology route.

SPEAKER_02: Then you ended up going where for med school?

SPEAKER_01: I knew I wanted to take time off. I took a year off and I did something similar to what you're doing.

SPEAKER_02: Yeah?

SPEAKER_01: I got a Eurorail pass from, you know, all the money I could scrape together. And I spent like two and a half months in Europe. Awesome. So I traveled. I knew like I didn't want to go right into med school. So this was my plan to begin with. And I was going to apply during that year. So I traveled to Spain, Portugal, Italy, Turkey, Hungary, Romania, Czech, Germany, Amsterdam, London, and back home. Nice. That was my circle. But yeah, I knew during that time, I just wanted to like, study abroad, which I didn't get to do during undergrad.

SPEAKER_02: I'm so happy that you're talking about this, because I've probably said this on like every other episode of this podcast, but my one regret is not taking like a gap year or time off to travel. Luckily, I'm getting to do that now. But it's awesome that you kind of had the foresight to say, like, this is what I want to do or it was what I need to do right now. So you took a whole year.

SPEAKER_01: I did. Yeah. So I spent that portion in Europe and then I came back and I was supposed to do some like science research job that fell through. It was like a volunteer position. So I ended up working just in New York City with my sister. We did like film production.

SPEAKER_02: That's very cool then. What did you gain, I guess, from traveling? I'm thinking of people who are probably considering doing the same thing as you and maybe getting some pressure not to. Tell us what you got from that.

SPEAKER_01: I think the path is intimidating because you look at four years undergrad, four years med school, and then three to six years residency, and you're like, I don't have time to take off. But I'm 35 now, and I just started my first job, which is exciting. But at the same time, it doesn't matter if I'm 33 or 35. I ended up taking two years off. So this was one of them, and the next one was another four years ahead. But it doesn't matter. You can take that time. There's no rush. You're going to have a 20 to 40 year career. And if you can afford to take that time and then do something you really want to do, because there's really no time after that to take off a year. Really hard. You're doing it, but not many people in my position can do that.

SPEAKER_02: Well, you know, I don't have kids yet. And I am in just like a unique situation where it's working out. But right, I think most people have obligations. So I always tell any student who's thinking about it to just do it, just take the year or the six months or whatever it is and, and go and I actually had the same. because I transferred, I was told I couldn't study abroad. So this was always something I wanted to do. Yeah.

SPEAKER_01: Yeah. Like a little focus group for kids who transfer and they should have like the summer to do something.

SPEAKER_02: Yeah, for sure. So did you do anything? I know you said you worked in New York City in film, but was there anything you did to kind of like boost your resume for med school in that time off?

SPEAKER_01: Luckily, I had a really awesome biochemistry professor at UNC. He like realized that I like understood science. And he's like, I asked him if I get involved with research. He didn't have anything in his lab, but he put me in touch with a cellular biologist and I worked on pancreatic cancer. So I did my, like my own research experiments from like junior year to like the end of senior year. And she even gave me a job afterwards as like a research tech. So that was like one of the most important things I did. So I built that not only into like an honors thesis to like pad my resume. And like, I basically like knew how to do science, which is fun. Like you're in the lab and you're doing experiments. It's kind of cool. That's like a skill set that sets you apart from a lot of other people. That paid off four years down the road.

SPEAKER_02: Good. Awesome. Would you say that your research then set you apart, set you up for med school, residency, all of that? Is there anything?

SPEAKER_01: That was probably the most important thing because you can see how dedicated I was over that. I got a lot done in those two years. And you don't need to know how to do research to join a lab. I think anyone in undergrad, it's fine to do your science classes, but that's not impressive. If you go and ask your professors, can I get involved more? That's when you start to separate from the past.

SPEAKER_02: I agree. We have some weird similarities here because I did, I didn't take time off to do research, but I actually did work in a lab my senior year. And I think it really did set me apart from other applicants for PA school. And it was fun. And I was like doing real research and helping like figure out, you know, real problems. So, um, and a plus side, I don't know if people know about this, but just a side note, like some schools will actually pay you to work in the research lab. So I got paid to work in the research lab. So just another little hack.

SPEAKER_01: That's a nice bonus. Yeah, that's awesome.

SPEAKER_02: Yeah. So then you, where did you end up going to med school?

SPEAKER_01: So my MCAT scores were like slightly above average, like not great. So I applied to like the middle tier level of schools. And I think I had three interviews, but not many. But I didn't get in the first round, it was waitlisted. Ended up applying to like post-bacc science programs to like further increase my resume. Actually, I got accepted to the University of South Florida, started like the whole like enrollment phase. So this is like the summer before I was supposed to start in the fall. And then I get a call while I'm lifeguarding at the beach from a random like Philadelphia number. And it was Drexel University saying, do you want to start med school in two weeks? And I was like, absolutely. Sign me up. I'll be there. That was like a crazy, fun, exciting time.

SPEAKER_02: That must have been so exciting to get that phone call.

SPEAKER_01: It was, yeah. Unreal.

SPEAKER_02: Very cool. So you got in very last minute. How did you just like, you just had to get everything together and go, I guess.

SPEAKER_01: Pretty much just signed up for the first apartment I saw. I was at orientation within a week. It was pretty crazy. Luckily, you didn't have to buy a lot of stuff. In med school now, everything's recorded lectures with literal notebooks that are this thick of printed material. When I was there, I'm sure it's different now on iPads and things. But everything was set up for me, which was nice. You just walk in and it's like, It's like college but on steroids. It's really intense. But there's a little bit of imposter syndrome there because I didn't know if I was good enough to compete with these kids. Again, another fire, but it ended up being good because I'm a pretty competitive person. I like that. I don't know what med schools are doing now. When I was there, they would post your scores so everyone could see how they did compared to everyone else.

SPEAKER_02: Really?

SPEAKER_01: People hated that. I loved it. It was like, get to the next level and I could see that I was feeding people. Yes. Med school's fun in that regard. And people will see, once you get into med school, it's become like some of your closest friends. It's like a battle.

SPEAKER_02: Yeah. It's a battle. It's a tough experience. You know, PA school doesn't really compare, but it was, it was a lot and same kind of thing. You're in this classroom with the same, like in my case, like 45 people every day, like 8am to 6pm for 26 months or whatever it was. So yeah, some good friendships out of that. Did you like Drexel's program?

SPEAKER_01: Yeah, I think it was extremely well-rounded. It's also huge. So if you don't know, Philadelphia is the land of med schools. You are not special if you are a med student in Philadelphia. And I found that out while I was there, which is kind of funny. You think you're like so cool, but there's like everyone you see is a med student. So it's kind of funny, right? But yeah, the program is really well rounded, I think because it is like one of those middle tier med schools, you get people from like all walks of life. It's not like Ivy League snooty, like, it's a lot of people who's first generation doctors. So their parents aren't doctors, they just like like medicine, like science, and then they got in, they end up being like, pretty normal people. which is very refreshing. But the program overall, we did a structure that was like two years in the classroom, two years in the hospital, which I think has probably changed. They're going to like a year less time in the med school and more like earlier exposure to the hospital, which is probably better.

SPEAKER_02: Yeah, clinical years are so much more fun anyway. They really are. For me. Yeah. Alright, now what I want to know is like, I mean, sounds like you are a hard worker, you're competitive, like you defied the odds in some ways, but how did you get such an awesome residency? Like how did you get, how did you match into NYU? Because I feel like that's the question, like this is what people want to know.

SPEAKER_01: Yeah. Um, that is a story too. NYU was pretty much unreachable for me when I was applying as a fourth year. I think it's since I matched there and till today, I think it's the number one plastics program out of like a hundred and something. So there's very few programs and it's like one of the top ones, which I was very privileged and fortunate to be able to match there. I did this twice, so. two application rounds. During your fourth year, you apply for residency and usually do some sub I's, which are super important for matching into that program. So I did them. I didn't get one at NYU. I got it at a few other places. Penn being a really good one that I really liked as well, which ended up helping me in the future. But I ended up getting, I think, 13 or 14 interviews my first year. and didn't match, which is like the news that nobody wants to hear as a fourth year med student. You basically, there's like a match week and on Monday you'll get an email saying if you matched or not, and I got the email that said not. So you basically go into this program called the SOAP program. It's like a supplementary acceptance program. And you have the choice. You can either apply for whatever plastics spot is open. And my year, there was one at Lehigh, which I interviewed for, ended up luckily not getting because the kid had one more publication than I did. It was pretty funny. They defaulted me. They're like, we're going to take the other guy because they have one more publication. Oh my God. Not upset about that. Then you can choose, do you want to fill a general surgery spot, like an emergency room spot, something that's usually open. I decided way before that, that if I didn't match, I was going to work on research because I only had like three or four papers at the time, which is like one of the metrics. I would just do research and like buckle down and reapply the next year. which is hard to do because the application cycles in like four months from then. So you had to like really work. So I decided, pause graduation of med school, took a fifth year, another lap, But I had to find a research spot. They had a program at Drexel luckily, which is like usually between your third and fourth year, you take a year off and you do research and they'll sponsor it. And then they kind of like pause your tuition and stuff. So I did mine at the end of fourth year and they said, don't graduate, do this research thing, find a spot. Cause I didn't have one. Drexel doesn't have a plastics program. So it made it like super hard. So I basically became like a cold calling research hustler. So I, within like three days, I had UPenn on the phone, Hopkins and NYU. And I was like, and Cornell, I think, and had interviewed all of them for a volunteer research position. Of those three, I liked NYU the best. And they really liked that I had bench research experience. They were like, we need a bench research person. You already know how to do all this stuff. we have a great program. You should come here." I was like, okay, sounds pretty good. I'll do that. Luckily, my girlfriend at the time, now wife, lived in Hoboken.

SPEAKER_02: Oh, perfect.

SPEAKER_01: I had a free room and board for a year. It made it a lot easier to board New York on a $0 salary.

SPEAKER_02: Yeah, for sure.

SPEAKER_01: So I ended up doing that and then they offered me a sub-I spot right before I started. So basically, didn't match, got the research spot, did a one-month sub-I like way before everyone else does their sub-I. They remembered me the next year while I was doing my research and then I ended up matching.

SPEAKER_02: I guess that that worked out for the best. It's funny how things work out sometimes. Then, you know, the other thing I was going to ask, and really, I'm just curious, because in our program and our research program, I guess you call it, I think other than publishing studies, I think one of the most helpful things that year is like the connections you make.

SPEAKER_00: Oh, yeah.

SPEAKER_02: And I found that the guys who make more connections and kind of like come to the conferences and come to the dinners and like keep, you know, those connections, they're the ones who end up getting more interviews and eventually matching. So was there any of that that year? Was it like strictly just research?

SPEAKER_01: Oh, no, it was it was all about like they are very friendly, like they invited me to their graduation and like the events throughout the year. So I got to know the residents as a researcher really well and I had to know the attendings. So that is, and still rings, like it's very important. Like if you're a med student or you're trying to get into residency, like you need to get to know the program director, the chairman, anyone who is like, their opinion matters. Like you need to get to know them.

SPEAKER_02: Yeah. Agreed. I see this every two years and, and I'm like, All you have to do, sometimes it's just the difference between sending a follow-up email or not, or showing up at an event or not. I don't think people always realize how important networking is. You can have the scores and you can get into your programs, but I think there's so much to be said for who you know, and then if you make a good name for yourself and they like you, and they end up being the residency director. they give you a spot. I see it all the time.

SPEAKER_01: Yes. If you can be personable during that time to the important people and then work hard and the residents see it, it's pretty much yours. I've seen people with really poor step one scores, shouldn't have matched in the program, that matched because everyone loved them. Their personality was great. They just jived with everyone. You could tell they're going to be a hard worker and that's what people care about.

SPEAKER_02: Exactly. Well, good for you. That's an awesome story. For people who haven't matched or you're in that year where you're hustling, it is possible. I've seen it a bunch of times and you're probably one of the coolest stories because you got into the number one program. That's awesome.

SPEAKER_01: Very lucky. Hard work pays off.

SPEAKER_02: Before we move on, I just want to know why you chose plastics because I have to be real with you. It is probably the one part of surgery that freaks me out. I can saw into bones all day long, but don't give me skin and tissue. What made you go into plastics?

SPEAKER_01: I was lucky enough to shadow a plastic surgeon when I was in high school. I was hanging out at Tom's River Surgery Center, which is where I work now, and some of the nurses remember me from high school, and they're like, you're that kid. And this week I did a surgery, I did a total nasal reconstruction after skin cancer where I had to borrow from the inside of the nose, borrow from the ear and flip down the forehead to make a new nose. And it was one of the cases I saw. 15 years ago. Wow. It's so funny. They're like, I remember you. But yeah, that was my initial like, I think this is really cool type of plastic surgery. Yeah, not to say that I like stuck with it. Like that was the only thing I thought I was going to do. But yeah, I saw like nasal reconstruction, like I talked about rhinoplasty, facelifts, rest reduction, like all the really cool plastic surgery procedures I got to see. really young. So I was exposed to it. And I just always kept in the back of my mind, I would go through every rotation of med school, like, I'll check this out, see if I like it, give it my all and then move on. It was always the default back to plastics if I didn't like that. And plastic surgeons are just happy people.

SPEAKER_02: I could see that. I think I feel the same way about orthopedic surgeons. It's just like fun people. It's nice to be around.

SPEAKER_01: Yeah, we tend to get along ortho and plastics.

SPEAKER_02: Yeah, yeah. So you finished residency, and you decided to do a fellowship. Do most plastic surgeons do a fellowship?

SPEAKER_01: Because I know most orthopedic surgeons at least like it's like not, not as required as orthopedics.

SPEAKER_02: Okay.

SPEAKER_01: Because what is it like 90 or 95% go into a fellowship?

SPEAKER_02: It feels like it. I don't know the numbers, but yeah, it just feels like it's something you kind of have to do now.

SPEAKER_01: And especially in the Northeast, like people want a fellowship trained surgeon. That's just like what we know to look for. Even like my mom and her friends, like they know to like look for that. It's kind of funny, but for plastics, it's probably, I don't know, 60 or 70%. Okay. Not required. I mean, we did everything in residency, like literally everything. And some people don't do fellowship and they do just fine. For me, I wanted to get really good rhinoplasty. So that was like a passion of mine that we didn't have like the top rhinoplasty aesthetics people at NYU. So I kind of sought that out and I went down to Dallas to learn that.

SPEAKER_02: Nice.

SPEAKER_01: Yeah.

SPEAKER_02: And that was a year, one year.

SPEAKER_01: Oh, yeah. Everything for our fellowships for plastics is one year, which is great. It's like anyone can do a year anywhere. It's pretty easy. Um, like time commitment wise. Um, and I think, you know, just choosing what you want to do and becoming an expert in it is, is fun.

SPEAKER_02: Do you, so you, do you feel it was worth it to do the fellowship?

SPEAKER_01: Yeah. I mean, I learned like invaluable lessons, so. Yeah. Otherwise I'd be figuring it out on my own and then that's why people like give up procedures. Like you'll see some plastic surgeons like, ooh, I don't do that anymore. It's because they like weren't really taught how to do it. They like looked at a book, they tried it and it didn't work out so well. So having that year of like just constant exposure, it was like a four room OR with all four rooms going with aesthetic surgery five days a week. So it was just nonstop.

SPEAKER_02: Well, it sounds like it's going to set you apart and your mom and her friends can now call you a fellowship trained surgeon. It is funny how people know what to look for. I know you said, I think we talked about this prior to the episode, but you said your focus is in aesthetics, but you do want to make sure you work in some reconstruction for like, was it skin cancer and breast cancer?

SPEAKER_01: Yeah, those are the two that I'm doing now. I think they're like, it's like kind of embedded into plastic surgery, like skin cancers and breast cancer. Like there's always some sort of reconstruction that those two cancers are going to need. With the other cancers, like of the body, like you don't always need a plastic surgeon. So those are like the two main ones I would say throughout residency that we really did a lot of. And I just wanted to like continue that. That case I did this week or last week was super fun. They're challenging, they're fun cases and the patients are super grateful.

SPEAKER_02: That's awesome. Do you think most of your practice is going to be rhinoplasty? That'll be front and center?

SPEAKER_01: Yes, I think so. There's not many people that do it around here and it's in plastic surgery. You want to differentiate yourself. So that is the way for me to differentiate myself. Like people don't do rhinoplasty. So I offer it to it. Usually you have like, I don't know, a 90 mile radius of people that will like come in and have surgery. Some people will find it, but that's not as common. Um, so I wanted to like be known for that. And then I'm more than happy to do any of the other aesthetic plastic surgeries, but in terms of insurance, those are the other two that I'll do, which will probably be like 20 or 30% of my practice. Okay.

SPEAKER_02: Well, luckily for people at the Jersey Shore, now they don't have to go all the way to New York to have like a New York train surgeon. I should put that on a billboard, right? You should put it on a billboard.

SPEAKER_01: Get your nose done here.

SPEAKER_02: Don't go over the bridge. Oh, man, that's awesome. So something I wanted to ask you, since you're early on in your practice and, you know, you haven't really experienced the full on like attending life just yet, I guess. how do you feel you're going to incorporate work life balance? I know that that's kind of like a trendy word, trendy term right now, but I'm really curious because obviously like I care about living life and I and I think we share some interests and hobbies like surfing. And so how are you going to work this into the life of a busy plastic surgeon?

SPEAKER_01: Well, to be honest, it does take a few years for plastic surgeons to like have a full schedule and be completely booked. So right now it's great. Work-life balance is great. My wife loves it. I could see my kid all the time. But yeah, as I get busier, I think it's going to be tough, but I did choose like a mostly elective practice, like there's not many emergencies. So I did that, obviously, on purpose and had the foresight to know, I don't want to be on call every night, like I want to be able to spend time with my family, I want to be able to go on vacation without worrying, I want to be able to do all those things. So I knew that early on, I didn't want to live like a completely, you know, emergency or urgent type of life where I had to go into the hospital all the time.

SPEAKER_02: Yeah, for sure. Well, that's that's great. I think coming from like the busiest orthopedic hospital in the country, I all I see is that like academic mindset that like you have to do like eight cases a day to keep up. And it's just these surgeons, they don't they live at the hospital. They don't really like take much time. And I kind of had to My co-PA and I had to have a talk with our boss at one point. We're like, I think it's time to take Fridays because he actually surfs too. We're like, you need to take a day because this is too much. He ended up thanking us for it a year later because it ended up being an admin day and it was great for all of us. I think it'll, in the end, make you a better surgeon, a better husband, a better father, just to have some time for yourself to do your hobbies and spend time with your family.

SPEAKER_01: Super smart to have suggested that. One of the guys down in Dallas that I worked with, he always took off the afternoon on Wednesdays. and that was his work-life balance time. He had a completely packed schedule. He's a really good surgeon. He's late 40s, prime of his career, and he's like, nope. Wednesday afternoons, I'm going to play tennis with my family or whatever he did. That's his time. You can definitely see a mindset change because you get run down. That's why residents are so unhappy.

SPEAKER_02: Burnout is real. People, I just quit my job. Like, it's real. So definitely take time for yourself. What was one thing or a couple of things, whatever you want to say, that you love about your job so far? And what is one thing that you really don't like about either medicine or being a plastic surgeon, if there is anything?

SPEAKER_01: So I'll start with the bad thing first. And people who are like, they like to know like a full set of instructions before they do a procedure, plastics is not the right thing for you. It is not like a total knee, like you just do it your way. Same thing every single time. If you change something, like you probably messed up. For us, it's like, we're constantly changing the way we do surgeries. And like, I can do a facelift three different ways. I can do a breast reduction like eight different ways. that is both good and bad. For me, it's good because I get to explore a little bit, but for people who like evidence-based medicine, plastics is absolutely horrible for that. We don't have good evidence for almost anything except for breast reconstruction because it's measurable. I never thought about that. That's where the artistry comes in. People just think that their results look better the way that they do it and everyone's complication rate is zero, of course. Never had a complication. It makes it really hard to compare. For people who like repetition and the same thing every time, not plastics.

SPEAKER_02: Right.

SPEAKER_01: Good advice. Then my job, things I really love is the freedom of my schedule. I can choose which procedures I want to do and not want to do. I can choose what things I want to offer. I can choose what patients I want to see, when I want to be on call. I can, I can choose all those things. So private practice is definitely tough. Like you are out on your own and I'm seeing that like every day, like somebody calls out sick, like the whole office day is like kind of ruined and you don't have backup. And then you need to like call somebody else in who doesn't do that job and fill in. It's like, it's tricky to run a business.

SPEAKER_02: Yeah. Yeah. No, I bet. I mean, I know too, cause I was sort of, I was in that, private practice world for a while, but how are you handling being on your own in the OR? Because I feel like that's super scary for surgeons in the beginning.

SPEAKER_01: I am lucky in that I had Bellevue Hospital, which is, if you don't know, it's a public hospital in New York. where it's a pretty resident-run hospital. The attendings are around, but the residents are running it. So I was rather independent there. And then we had a cosmetic surgery clinic, like discounted plastic surgery at NYU. where the attendings would say, hey, how you doing? And then bounce and you were operating by yourself or with another resident. So that was also another independent. And then I was an attending in Dallas where I did my fellowship. We had full attending privileges. Oh, okay. So I could admit people and, you know, I didn't need a surgeon in the room with me. Even though they would like staff it, the cases I would do, like, again, we offered discount plastic surgery there and we need like, 30 or 40 cases throughout the year. I'm pretty lucky in that I've had a lot of experience by myself or with a co-fellow or a co-resident where there was no one above me telling me what to do.

SPEAKER_02: Right.

SPEAKER_01: That's great. I oddly feel comfortable with it.

SPEAKER_02: Good.

SPEAKER_01: It is always a little nerve wracking for your first couple of cases. Everything needs to go perfect. And I'm in my board's collection period where I have to document everything, take pictures of everything, and then submit everything at the end of this year. So you're always like, it's somebody looming over you, judging your work as you're doing it. So that is nerve wracking.

SPEAKER_02: Yes, but I'm sure you'll be fine. It's really cool that I feel like in many ways you've come full circle, like you used to volunteer or work at this practice and now you're an attending at the practice, which is really awesome.

SPEAKER_01: It's weird, but it's cool.

SPEAKER_02: I think you're representing the Jersey Shore really well. Also, the surf community, because I know, I was thinking about this earlier, I feel like surfers get a bad rep. It's like, They've always been the rebels or whatever. Here's an example of somebody who grew up a surfer and is now gone to med school in one of the best residencies and a plastic surgeon. I think that's really cool. I just wanted to add that in. Not all surfers are rebels and crazy people.

SPEAKER_01: We're not all just hanging out at the bar after work. Exactly. We can work and not smoke pot like they're accused of.

SPEAKER_02: True, true. Well, I think we went through pretty much everything. I think you gave some really good advice. Is there any other tips or pieces of advice that you want to give to either a student or somebody who's trying to match in a residency or wants to go into plastics?

SPEAKER_01: I would just, you know, tell the, for kids in undergrad, it's really, it's tricky to figure out what you want to do. That's like a short amount of time. It's four years usually to like, okay, what am I going to do with the rest of my life? I would say to those kids, don't get dissuaded by people who say it's like really hard or whatever. Like you have to try it. So go volunteer, do whatever. So volunteer, get the research, do anything you can to like get involved in medicine and see if you love it. If you like it, don't do it. If you like it, don't do it. If you love it, do it.

SPEAKER_02: Yes, exactly. I agree. Don't do it for the money either because

SPEAKER_01: It takes a really long time for that to come through.

SPEAKER_02: Yeah, for sure. Well, thank you. This has been really great. I'm glad that you're taking your skills back to New Jersey. So if you guys are in Jersey and you need some plastics work, check out Dr. Borab. Do you want to say what the name of the practice is?

SPEAKER_01: Oh yeah, so I joined, his name is Michael Nagy. He's a local surgeon in Wall Township, so literally a town we grew up in. And he does sort of the same as what I do. He does like probably 80% aesthetics and about 20 to 25 maybe of reconstructive. Um, but really, really good guy. He has done a great practice and has been like super welcoming to me. So the staff has been awesome and, you know, just happy to be able to provide to the people where I grew up and provide the plastic surgery things I learned how to do.

SPEAKER_02: Yeah. Very cool. Well, thanks again, Zack. I am happy that you came on the podcast. I think people are going to get a lot out of this episode.

SPEAKER_00: Thanks Leigha.

SPEAKER_02: This is the so you want to work in health care podcast with new episodes every month Don't forget to subscribe to stay up to date on the latest releases