Stephanie Caterson, MD, director of the Perforator Flap Breast Reconstruction Program in the Division of Plastic Surgery, received the 2017 Bernard Lown Teaching Award, which celebrates BWH physicians who are outstanding clinical teachers.
In this Q&A with BWH Bulletin, Caterson shares her thoughts on her career in plastic surgery and her education style.
What drew you to the field of plastic surgery?
SC: I was an aerospace engineer as an undergraduate, and when I went to medical school, I was not even considering surgery. I was seeking a higher-level degree so that I could apply for the astronaut program. I thought I would study emergency medicine because it would be applicable in space. But as I started my clinical rotations, I fell in love with the technical aspects and challenges of surgery.
Plastic surgery stood out to me due to the parallels to engineering. You have a set of “tools,” and you must solve the problem, which is different for each patient. During my formative years as a medical student, the most inspiring role models I came across were plastic surgeons. They loved what they did, and it was contagious.
As I completed my surgical residency, I began to question my path to the astronaut program because, as an astronaut, I wouldn’t practice any clinical medicine. In the end, the pull of plastic surgery won. I applied for a fellowship and I was lucky enough to match.
What is your education style when working with trainees?
SC: I try to teach using encouragement instead of intimidation. I gauge my audience for their level of training and prior clinical exposure, then go from there. For instance, the complexity will be different when teaching a first-year medical student versus teaching an instructional course at a plastic surgery conference. I enjoy the challenge of tempering my style for the audience, and I like to provide a comfortable but stimulating atmosphere in which to learn.
I would say the most intensive teaching takes place in the operating room, but there’s a lot that goes into the pre- and post-operative stages. I think you would be remiss in just teaching trainees how to do the operation, but not teaching them how you get the patient to the operation.
What nonclinical skills do you also reinforce in your teaching?
SC: The doctor-patient relationship is something that I try to emphasize. Dr. Bernard Lown is famous for teaching the doctor-patient relationship and its importance in healing and care. I place a special emphasis on practicing empathy. Every patient responds differently to their diagnosis, and it is our responsibility as caregivers to be respectful and supportive.
In addition to teaching medical trainees, I am also passionate about patient education. Recently, our deep inferior epigastric perforator (DIEP) flap program started a preoperative education class for patients who are preparing for DIEP flap surgery, as well as their families. We host the class in the hospital on the floor where the patients will be staying post-operatively. They get a tour of the facilities and a demonstration of the medical equipment we will be using during their care. Patients gain a better understanding of recovery and meet surgical team members who will be caring from them and other patients about to undergo the same procedure. At the same time, I am learning what concerns patients have pre-operatively, which allows me to improve my consultations. The response has been tremendously positive for patients and caregivers alike.
How do you think medical training could be improved?
SC: I think personalized mentorship is much more powerful than teaching in large group settings. The more we can do to center the instruction around the learner, the more effective we can be. Additionally, I think early exposure to specialties is important for students. Often these areas of medicine are competitive and difficult to pursue, so starting off on the right track is important.
Lastly, I am a strong believer in collaborative interactions improving the field of medicine. The DIEP flap program is an example of a multi-disciplinary team – including office staff, physician assistants, nurses and nurse practitioners, OR staff, anesthesiologists, plastic surgeons, physical therapists, staff from radiology, surgical oncology and medical oncology and the patient – all working together with the common mission of optimizing patient care.