Recently The Student Doctor Network got the chance to speak with Joseph Disa, MD, FACS, who specializes in reconstruction of areas of the body after surgery to remove a tumor, particularly breast reconstruction and reconstruction of the head and neck.

Joe works at Memorial Sloan-Kettering Cancer Center in New York, and he is also involved in teaching medical students, residents, fellows and attending physicians. Thanks for the interview, Joe!

SDN: Describe a typical day at work.

D: There isn’t really a typical day when you’re working at a major cancer center in New York City. But, on most days I get to work, do some paperwork, do inpatient rounds and then I’m either off to the operating room to conduct reconstructive microsurgery, or I have clinic hours to see new patients and follow ups.

SDN: Why did you select academics over private practice?

D: I chose to pursue reconstructive surgery, which is a specialty that tends to lend itself to academics. We have three fellows and several residents and I enjoy all opportunities to teach. I also like that in academics I can focus on patient care, teaching, and research and not worry so much about the business of medicine.

SDN: What mix of clinical/research/teaching work do you do? How much power do you have to change that mix?

D: It’s 80 percent clinical and 20 percent research, with an 80 percent teaching overlap. There’s always research going on. I could tailor it to focus more on research, however, we get really busy clinically and you do what’s asked of you. Plus I really enjoy taking care of patients.

SDN: What are the advantages/disadvantages to academic medicine?

D: The advantages include the ability to interact on a regular basis with residents and be engaged in teaching, so the practice is more than clinical. Also, because I’m very academically involved, I get the chance to lecture around the world.

As for the disadvantages, some people think the salary is limited, because you are a salaried employee and in an academic setting, you may not get exposed to the breadth of cosmetic surgery procedures. Typically, you are relegated to one location, often urban which is not ideal for everyone. Similarly, some may see disadvantages in working with residents.

SDN: If you had it to do all over again, would you still become a Doctor? (Why or why not? What would you have done instead?)

D: Yes. I like getting up for work every day. I like working with patents, and the creativity involved in solving challenging problems. It’s a rewarding specialty, one that provides hope. I get a lot of personal satisfaction out of what I do.

SDN: Why did you choose your specialty?

D: It has a lot to do with my mentors. I became interested in anatomy, so surgery was a natural fit for me. I started my general surgery residency and when I rotated through plastics, I met some unbelievable people. I ended up interrupting my clinical training for one year to do basic science research with the plastic surgeons. My interest in plastics blossomed from there.

SDN: Did you plan to enter your current specialty prior to med school?

D: No, I started off in general surgery. When I came in I was one of the last groups of people to go from general surgery to plastics. Now most plastic surgery residencies match directly out of medical school. Therefore, unless a medical student has been exposed to plastic surgery, they may miss out on the opportunity.

SDN: Now that you’re in your specialty, do you find that it met your expectations?

D: Yes.

SDN: Are you satisfied with your income?

D: Yes.

SDN: What do you like most and least about your specialty?

D: I’ve already touched on what I like the most. As for what I like the least, as soon as you say “plastics” everyone immediately thinks about Botox and face lifts. There are so many things we do as plastic surgeons that are rewarding, but society tend to have a negative perception of it.

SDN: If you took out educational loans, is paying them back a financial strain?

D: Yes, I did take out loans. In the beginning it was a strain.

SDN: On average: How many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?

D: I work 60 hours per week and sleep about six and a half hours per night on average. I take about three to four vacation weeks per year. I’m on call for my patients whenever I am in town. I generally come home late, but it’s uncommon to have to come back in the middle of the night unless one of your patients is having a problem. Starting out, one could be on call one to two times per night—and some in my specialty will start out on call in the emergency setting.

SDN: Do you have a family and do you have enough time to spend with them?

D: Yes and yes. I have a wife and two kids. I’m not home at 5 p.m., but we spend a lot of time together on vacations, and as a family we make a great effort to balance my work life with our personal life; it is possible to have it all.

SDN: In your position now, knowing what you do – what would you say to yourself 10 years ago?

D: I feel that all the decisions I have made have been good ones. I would day the most important thing is to make sure you like what you’re doing and love the field you’ve chosen. There will always be external pressures, and if you don’t have satisfaction from your job you’re not going to be very happy.

SDN: What information/advice do you wish you had known when you were a premed?

(What mistakes or experiences have you encountered that you wished you had known about ahead of time so you could have avoided them?)

D: The best advice I would give to a premed is manage your finances. Try to minimize the amount of education/living expense loans you need. Medical school, residency, and practice are stressful enough without worrying about how much debt you have.

SDN: From your perspective, what is the biggest problem in healthcare today?

D: Technology is outpacing what insurance companies and the government will pay for, and physicians are trapped in the middle. I also foresee a shortage of surgeons in the next 10 to 15 years. Additionally, the legal climate physicians practice in needs to change.

SDN: From your perspective, what is the biggest problem within your own specialty?

D: I think the pendulum has swung too far toward cosmetic surgery and away from reconstructive surgery, but it’s starting to swing back.

SDN: What impact do mid-level providers have on your day-to-day practice?

D: They have a positive impact. We have three Physician Assistants with us, and we’re hiring a fourth. They are an outstanding resource, and without them it would be difficult to do what we do. I think it’s a great field to get in to.

SDN: Where do you see your specialty in 10 years?

D: I see it stronger as we work hard to make ourselves known for high quality reconstruction and aesthetic surgery. Plastic surgery as a whole will be stronger, and it won’t just be about focusing on elective, cosmetic procedures.

SDN: What types of outreach/volunteer work do you do, if any? Any international work?

D: The Army [Reserves] is my volunteer work. I volunteer two weeks per year, and I’m mobilized for three months every few years.

SDN: What’s your favorite TV show?

D: 24