December 10th Meeting Notes:
Dr. Brad Greene
Facial plastic reconstructive surgeon
Careers in medicine: early decisions, choices, and philosophy of balance
Components of a medical career before M.D.
Grammar school (8-9 years)
High school (4 years)
College/university (4 years)
Graduate school (optional: 2 years)
Medical school (4 years)
M.D.
Components of a medical career after a M.D.
License exam: medical board exams
PGY 1: internship (1 year)
• Learning a speciality
PGY 2-8: residency
• Practice to be a specialist
• Different lengths of time required for different specialties
Board certification exam (primary)
• A test in your specialty
Fellowship (1-4 years)
• Optional/ extra, more specific sub-specialties
Board certification exam (sub-speciality)
Medical practices: many options
Academic university practice
Research
Military practice
Government (city, county, state, fed)
Large group: Kaiser, Sutter
Consulting: legal, political
Corporations (Genentech, pharmaceutical)
Private practice: one specialty- multi specialty
Private practice: one doc- many docs
If you don't want to meet patients, you can become a pathologist or radiologist.
1. Thoughts and decisions: high school
Academic success
Social success: family & friends
Financial success
Balanced life? 100% yes
2. Thoughts and decisions: college
Balanced life? 90% yes
3. Thoughts and decisions: medical school
Balanced life? 80% yes
4. Thoughts and decisions: residency
Balanced life? 50% yes
Bizarre conditions
Swollen tongue
• Amyloidosus- abnormal protein buildup
Nose cancer- basal carcinoma
• Can reconstruct nose with a little flap of the forehead & some bone from skull
Oral cancer- squamous cell carcinoma
• From cigar smoking, affected the palette
Lip cancer
• From chewing tobacco
Cancer started from inside of sinus
• Was a melanoma from the inside of the cheek pushing out
Throat cancer
• Started from vocal cords and bulged from inside to out to exterior neck
• From smoking
Lip cancer, even affected the jawbone
• Cut the fibula into 3 parts and reconstructed a new jaw for him
• From chewing tobacco
• 12 hr surgery of both leg & mouth
• Fibula was used b/c is bone closest in size and shape to the jawbone, tibia takes over
for now weaker fibula
• Can take tissue from other but have to worry about body rejecting organs of donors &
can graft tissues from cadavers but need radiation to make sure that there are no
diseases present
• But using tissue from your own body usually the most preferable
Cancer can even go to the brain by passing the plate
Cancer growing outward than inward is better b/c it's easier to cut off
Eye tumor
• Eye cannot be transplanted b/c nerve connecting eye to brain is so delicate that it
cannot be replaced
• But cornea can be transplanted
Tumor started in the salivary gland and was largest tumor that Dr. Greene had ever
seen
• Tumor weighed more than the patient's head
• But was a benign tumor
5. Thoughts and decisions: medical practice
Balanced life? 100% yes.
Because Dr. Greene had gone through all this training and seen the worst, the regular
cases are no big deal anymore.
US Air Force: military years
Paid for medical school
Additional pay even during med school
Flew F16
6. Thoughts and decisions: fellowship
Cosmetic surgery
Nowadays (cosmetic surgery):
Blepharoplasty- eyelid lifting
• To make look less tiring
Face lifting
• Lift off facial skin & tie up skin behind ear
• Neck lifting also
• If sewed meticulously, can even completely take away look of scars
Cheek/ chin augmentation
Early rhinoplasty
• Nose job, first one at JHU
Otoplasty
• Pull back ears that stick out
• Cut ear from behind and then put some stitches
Laser resurfacing
Botox