Dr. Ali Wong is a plastic surgery resident in Nova Scotia, Canada and creator of the website Sketchy Medicine, in which she shares graphical representations of various medical concepts. Dr. Wong received her Bachelor of Science with Honours in Neuroscience (2009) and her MD (2013) at Dalhousie University. Following initial year in residency, she went on to receive an MSE (Master of Science in Engineering) from Johns Hopkins University (2016). Dr. Wong has been published in Plastic and Reconstructive Surgery, Journal of Hand Therapy, and Behavioral Brain Research.
When did you first decide to become a physician? Why?
I thought I would be doing graphic design. When I was in high school I enjoyed both science and art, but I figured that if I could go back to either of them, it would be easier to go back to art rather than try to go back to science so I ended up doing my undergraduate degree in neuroscience. The research opportunities at my university were, however, really good so I ended up having the opportunity to interact with some physicians and appreciated the breadth of the field of medicine, which allowed me to not have to feel limited in my choices. You could do so much within medicine that it was a decision that required the least amount of having to make any final decisions.
How/why did you choose the medical school you attended?
In Canada, there are very few medical schools, fewer than 20. As a result, students apply quite broadly and end up being somewhat regionally based, as a number of seats are reserved for students from certain provinces. I really liked my program because of its research background, and they were quite progressive with humanities, which improved my odds.
What surprised you the most about your medical studies?
How much it seemed like high school. The program was very small and you ended up being very close-knit. I would have expected it to be different. It wasn’t bad, but it was more just the feeling that we were together all the time.
What information/advice do you wish you had known when you were beginning your medical studies?
That there isn’t one set specialty for everyone. Sometimes finding a specialty is treated like the sword in the stone, when really most people would be happy in many different fields and you can mold your own practice.
Why did you decide to specialize in plastic surgery?
I was lucky because I had a few people independently tell me that I would like plastic surgery because the surgeries that are done involve more creativity. I also had the opportunity to do a plastic surgery elective in my first year of medical school and ended up really liking it. Because I hadn’t thought about doing surgery before medical school, I rotated through some other specialties quite early on and I liked them as well, but it wasn’t until I got into my core clinical rotations that I really found that I liked plastic surgery due to its creative aspect.
For the most part in Canada, practising plastic surgeons have a pretty broad practice. We all see a lot of skin cancer, we see a lot of hand trauma, and we do a lot of oncologic reconstruction. Burn surgery has become less and less common because safety has improved. People don’t sustain the same kinds of burns that they did historically. I’m just at the point in my residency that I’m looking to pick a subspecialty, assuming I want to. I really enjoy trauma cases, but I also like both upper and lower limb reconstruction.
If you had it to do all over again, would you still specialize in plastic surgery? Why or why not?
I think I would. I do really love orthopaedics as well. So it would be a tougher choice than it was when I first applied, but I think overall I probably would lean more towards plastic surgery because of its broad nature.
Has being a surgeon met your expectations? Why?
It has, though a surgical residency takes away most of your free time. In the end I feel that it is worth it because I really love the work. I love the creative and intellectual side, but I also love the patient interaction.
What do you like most about being a plastic surgeon? Explain.
There’s quite a bit of variety among the patients themselves. I really like our patient population, especially the patients who have had hand trauma. The variability within the actual operations themselves, for a lot of what we do, is because of each patient’s particular considerations. One particular skin cancer lesion has specific functional considerations and aesthetic considerations, depending on where exactly it is on the body. So there’s a lot of nuanced thought and planning that goes into what is technically a straightforward procedure.
What do you like least about being a plastic surgeon? Explain.
As a resident, variability – the thing that drew me to plastic surgery – has also become the most frustrating part. There is often no “right way” but to be able to say that requires an immense amount of knowledge so it is easy to doubt yourself.
Describe a typical day as a doctor—walk me through a day in your shoes.
I get there early in the morning and we do our inpatient rounds to make sure that they’re doing well and that all of their surgical wounds are healing. The rest of the day varies quite a bit: we’re either doing outpatient clinics which are very busy, or we’re in the operating room, or we do minor procedures which only require local anesthetic, or we’re covering day call, which is just the emergency or inpatient consults that come in through the day. On any given day, we’re doing one or two of those things.
Tell me more about how you started Sketchy Medicine.
When I was in high school, and during my undergraduate degree, I worked as a website designer and freelance graphic artist. When I was in med school I would often add drawings and diagrams to my notes and thought that maybe other people might find these helpful. I started Sketchy Medicine when I was in my 3rd year of medical school which was my first fully clinical year, and it was a nice way to study while also being able to apply my technical skills.
What do you like most about running Sketchy Medicine?
It gave me a way to really cement down certain concepts that I was working on. It has been really interesting and rewarding to see others be able to use them to study.
What do you like least about running Sketchy Medicine?
The thing that has been frustrating for me is that as I’ve been getting further in residency, I’ve not been able to commit as much time like I would love to be able to produce more doodles to put on the website so I feel bad that there hasn’t been as much new content lately.
On average: How many hours a week do you work? How many weeks of vacation do you take?
It’s hard to really break it down because plastic surgery gets almost all of my waking hours. Sketchy Medicine still gets some: once a week, I might be able to devote a little time to general maintenance of the website and replying to emails.
As residents in Canada, we get a set number of vacation days that we can take every year, much like other civil servants, and we are encouraged to take them.
How do you balance work and life outside of work?
I’m not the best example for a good work-life balance. I really enjoy running, so that’s my big stress reliever. I think it is really important that people hold on to at least a few hobbies and maintain social connections, otherwise it’s easy to only do your work in medical school and residency and even as an attending physician, because there is always more that could be done. You have to become good at drawing your own lines in terms of commitment.
What types of outreach/volunteer work do you do, if any?
There is no specific cause that I support, but I feel very passionate about supporting the local community. Whenever there’s a community event, I try to find time for it. I also feel very strongly about participation in sports, especially for children, as it creates many opportunities. If you can give people those opportunities while they’re young, the positive impacts increase as they age. It links with preventative medicine, which is another passion of mine.
From your perspective, what is the biggest problem in health care today?
We’re too reactive, as opposed to being truly preventative. It is so easy to be reactionary and throw everything you can at a certain problem, when that problem is pressing. But really, if you step back and try to get at the root of a problem, you might be able to make a bigger impact, but the reduced immediacy of results makes it more difficult to get everyone really excited about focusing on prevention.
Where do you see medicine in five years?
I think we’re at a very exciting time for medical innovation in general due to the increased communications across and between medical disciplines. In North America, everyone is quite primed for medical innovation and people want to be making changes, so I think there is a lot of excitement to be had in the next few years.
My field is quite reactionary. You can make a big difference with surgery, but it would make a bigger difference to avoid what is causing a health concern in the first place. Like I said earlier, we don’t do many burn surgeries anymore due to increased health and safety. It’s hard because preventative medicine is different from how we currently think about medicine.
Where do you see medical education in five years?
It’s been really nice to see the trend towards competency. In Canada, our Royal College has been working on going beyond the didactic medical knowledge that someone needs to become a good physician or surgeon, to improving how well doctors communicate with their colleagues or their patients and how well they collaborate. We are also increasingly engaging in epidemiological research and I think that the fact that now we are trying to focus on creating physicians and surgeons and medical graduates that can foster all of those skills really creates better care for patients.
I think there is a role for some arts education in medical school. In the past, there have been initiatives for teaching anatomy drawing and music, but I don’t think one should necessarily invest in teaching specific artistic skill sets. I do think that encouraging medical students to have some sort of creative outlet is good. That can be in something that is more traditionally creative, like writing or painting. But I think that the act of creating is exciting. I’m someone who likes building, which may or may not be seen as typically creative. Designing a research study, or even planning an event, might be thought of as creative. The focus should be on using all parts of your brain.
What is your final piece of advice for students interested in pursuing a career in your field?
If you want to do plastic surgery, or you’re interested in any field, make sure you really learn about the scope of the field. There is a lot of breadth to all the fields of medicine and surgery, and you should really find what makes you excited. But understand that there are going to be exciting things in every field. Every experience you have as a medical student, and even as a resident, is going to be beneficial to your learning. I think people unfortunately pigeonhole themselves too early. Be excited about all of medicine and surgery – if you are, you’ll do research because you’re curious and you’ll volunteer because you are genuinely interested in something.
Also authored by Chigozie Onwuneme, a sixth-form student in Milton Keynes, UK. She is interested in science and hyperrealistic art. In her spare-time, she writes, draws, and listens to all sorts of music.