University of California San Francisco

Dr. Mary McGrath

MSS McGrath Spotlight image
Interview with Dr. Mary McGrath by medical student Pariswi Tewari. Dr. McGrath is a Professor of Surgery in the Division of Plastic and Reconstructive Surgery at UCSF. She also served as a consultant for the Food and Drug Administration and the National Institutes of Health. She is a member of multiple professional associations and has served on the directing boards of seven plastic surgery organizations.

 

PT: Thank you so much for being here today. I'm so excited to sit down and talk with you. What inspired you to become a plastic surgeon?

MM: I think there are three things in plastic surgery that were the major motivators. The work itself, which is wonderful because of its variety. It's such a broad field and there are so many opportunities to go in different directions. You may choose to narrow it down to one area, such as hand or breast surgery, or cosmetic surgery, or maxillofacial surgery, or pediatric plastic surgery, but in the beginning, all the avenues are open. In addition to that are the patients. The patients stay with you forever. I have had patients with me for 20 years. It’s a very long relationship, which is different from a lot of other surgical specialties. The other big one is the people in plastic surgery. There was no question that I was deeply influenced by the plastic surgeons that I met as a medical student and when I was a general surgery resident, and because of them and their creativity, their enthusiasm, their eccentricities, their artistic ability, they're the most attractive group of people to work with. To join the ranks of plastic surgeons is a real privilege.

PT: Wow, that sounds incredible. As someone who is interested in going into the field, you make me so excited to get to know everyone there.

MM: It is. People have so many talents. You don't realize there are authors, sculptors, pilots, all kinds of people in Plastic Surgery with a lot of diverse interests. A lot of breadth of knowledge and background and interests. 

PT: What aspects of the field do you find most exciting? Reconstructive surgery? Aesthetic surgery?

MM: At different times, I've done all of them and I've liked all of them. I can't pick out one that I like any better than the other. I'm one of the people that believe that there's not a sharp delineation between reconstructive and aesthetic. They're one and the same. When you're doing reconstruction, you're trying to achieve the most pleasing result, and that's aesthetic. If you're a good aesthetic surgeon and can do wonderful facelifts, you're also going to be able to do a very good job on a trauma case where someone's sustained facial injuries. So, I think that the skill set is broader. It translates more than people realize when they're not very deeply into the field yet.

PT: What is one thing that you know now that you wish you had known during your training?

MM: One thing that I learned over the years is to be grateful for the mistakes that you make. Like many people, I would stress over something that wasn't perfect or didn't come out so well or something that didn't go exactly the way I wanted it to. But I've learned to accept good enough. It's always an opportunity to learn something.

PT: I'd love to know more about the impact of mentorship on your surgical career.

MM: You know, it's interesting. We use the word mentor now, but we didn't so much when I was younger. We just thought of people as teachers, and I had so many. Many of them taught in a certain area. So, there were people, or mentors, on the research side when I was doing bench research. There were others who were wonderful clinicians who were teaching me how to do surgery. There were others who were educators and wanted to inculcate into you the principles of how to be a good educator. They say that you stand on the shoulder of giants, and you really do. It may have only been your eighth-grade teacher, the one who gave you the confidence and made the suggestion, “Why don't you look into this area which seems to interest you?” There are myriad wonderful people who contributed to my career. Sometimes the ones who actually don't even like you that much and weren't terribly invested in you as an individual teach you something too, and that's a good thing because you can learn from that experience also.

PT: Absolutely. Dr. McGrath, how would you describe your medical school experience?

MM: It was very different then; there weren't nearly as many women in our class. Surprisingly people seemed happy to have us. I never felt that there was reservation or reluctance to have us in the ranks of the medical school class. The men had us join study groups and they were our lab partners. We also did everything alphabetically then so the people in the “M” group became very good friends. (Some of them are still friends.) The time when it became more different is when I became a general surgery resident. At one point in our five-six year program at the University of Colorado, I was the only woman in the program. There were people who had reservations, mainly about whether we had the stamina and the strength to do the work and to be on the call schedule (which in those days was every other night), and to do the things safely and well. But I never had anyone who was an obstructionist. They might have reservations, but generally speaking, they capitulated in the end and said, well, it worked out well. Some of the surgeons were particularly supportive, others were more neutral. When I finished General Surgery, I went into plastic surgery. When I finished training in plastic surgery, women made up 4% of the plastic surgeons in the United States. So we were not very numerous. Of course, now we're closer to 40%. We've come a long way over the time that I've been in practice.

PT: Yeah, it sounds so intimidating, but also very brave. Switching gears to your more recent career, I would love to know what motivated you to serve as president of the American Association of Plastic Surgeons, and how that experience has aligned with so many of the hats that you've worn across the span of your medical journey.

MM: In organized plastic surgery, my focus has always been as an educator. In the early days, as someone trying to contribute to the science, my favorite organization was the Plastic Surgery Research Council, which I was very involved with when I was more active in research. Then I went on to become involved with the Educational Foundation of the American Society of Plastic Surgeons and taking on different tasks, like developing exam questions and producing educational materials for medical students and other things that led eventually to my getting involved in the American Board of Plastic Surgery, which is the body that creates the corpus of what is the specialty and what people need to be trained in in order to be able to become board certified  in plastic surgery. It also got me involved with the Plastic Surgery Residency Review Committee, which is the group that monitors, reviews, and regulates all the training programs. Those jobs heavily weighted toward education. The American Association of Plastic Surgeons is sort of the culmination. It's the premiere plastic surgery group for education, for science, for breakthroughs, for innovation, for the presentations of what's the newest thing in plastic surgery. I was really excited about having the opportunity to serve, as it was a great honor to be president of that group. One thing that I accomplished during the year that I was president, I'm very proud of it, we started a fund for medical students to attend the meeting free of charge. We arranged for senior plastic surgeons to make generous donations, which they continue to do to this day. Medical students fill out an application about why they want to come and we've been hosting about 20 students a year free of charge to attend the meeting and have a chance to hear the marvelous papers that are presented there, attend the social functions, and network with the senior plastic surgeons who are writing The books and papers. That is why being with that organization was really a privilege.

PT: Wow, that sounds incredible. In a similar vein, I was wondering which hats that you've worn across your medical journey have been your favorite so far?

MM: In recent years, the thing that's been the most fun is getting involved internationally and starting to work with educators and programs in other nations. I visited many countries in my capacity as a plastic surgeon to meet with leadership there and to give presentations, from Japan to Kuwait to Saudi Arabia (where I was two years ago). In each case, it's been interesting to meet with the women surgeons there and to see how active and how powerful they were in some countries, particularly, for example in Germany, and how difficult it is for them and how much they're prevailing in other countries, like the Arab countries where the women surgeons are amazing. They often will be wearing a full hijab at work, but be putting on surgical garb in the operating room and doing the same surgery we do. So it's been inspiring, but it's also been interesting. I think that's possibly been one of the most enjoyable areas. When I was very young, I used to work every year in Haiti at a charitable hospital, and I always wanted to go back there after I retired. Not do surgery, but work in some other way, perhaps He record room or triage at the main desk. But unfortunately, it's not safe right now to go to Haiti. I'm hoping that still may someday come to fruition, because that it has always been my dream to spend a couple of months there each year as part of the sunset of my career.

PT: I hope that it will. Following along your career path, in 2011, you were awarded the American College of Surgeons Distinguished Service Award. I was wondering how your involvement with the ACS began and what this work has meant to you?

MM: It meant a great deal. I became involved with the college just at the local level, in a local chapter, which many people do. Ultimately, my involvement grew where I saw my role largely as one to represent plastic surgery. The college is made up of all surgical specialties. Plastic surgery is not a huge specialty, but to have someone who was deeply involved in the College’s their work and came from our specialty was very important. My work with the college eventually culminated in being on a number of committees, developing several initiatives for them: being on the Board of Regents as the plastic surgery representative for nine years, becoming an officer of the Board of Regents, and getting that distinguished Service Award. My goal throughout was to be a representative of plastic surgery in the house of surgery, the American College of Surgeons.

PT: Oh, that sounds incredibly meaningful. That's such a special thing to have.

MM: There is a coterie of plastic surgeons always involved with the college, but I think that as all of surgery becomes more specialized, it's unfortunate because everyone becomes more siloed in their own world of plastic surgery or orthopedic surgery or urology or ophthalmology. We don't cross talk as much, yet we all share similar problems. We all work in similar workplaces. That's why I think the American College of Surgeons is an important entity, because it can address the broadest issues that touch on the life of the surgeon, if not on the specifics of exactly what your specialty entails.

PT: That's very interesting. Now to shift gears a little bit and just learn more about you as a person, who is someone that you admire and why?

MM: That is a very hard question. There are so many people that I have admired that I find it almost impossible to pick out anyone. I have always been very captured by so many different types of contributors. There are the sort of the superstars, the extremely talented people These people who have these wonderful skills in the operating room, people who have the courage and the insight to come up with innovative approaches to plastic surgery, who think up the next idea in reconstructive Surgery. Then there are the people who may have enormously powerful communication skills and can express themselves and sway others and their opinion. I admire those people. But I also admire the sort of Quirky people. I mean, there are mercurial people who go along and they're not superstars, but every once in a while, they have this incredibly brilliant idea. And it may be like a flash in the pan. But sometimes those flashes of brilliance are amazing. I have a number of those people that I admire. Another group that I really think well of are the hard workers, the everyday people who do the right thing, the good thing, who make the wheels turn, who do a wonderful job with their patients, who are patient advocates, and who are wonderful teachers. They have the tenacity and the resolve, and you see them contributing over time in a really powerful way. So I think they're terrific, too. I really have trouble trying to pick out who I would say, you know, is the one person I admire the most. I don't think I can do it. 

PT: I think that was very well put. Dr. McGrath, what is the best piece of advice that you have received?

MM: My professor when I was an intern in surgery, Dr. Ben Eisman at the University of Colorado, a really charismatic general surgeon, said to always be ready and to visualize before you start taking on an operation or even a patient care scenario. What he meant by that is to always be one step ahead in your thinking in the operating room. With this piece of advice, I learned to build a storyboard about surgical cases. So as the years passed on, driving to work in the morning, or walking down the hall to the OR, to think through the surgery that I would be doing and review the steps that would happen so that they would be fresh in my brain, even though I’d done them many times before.

PT: Pivoting a little bit, what are you most proud of personally and what are you most proud of professionally?

MM: Personally, my children. My older child is a woman, and she is a physician. She also went to UCSF medical school and she's a primary care physician, which is a very challenging, hard specialty. My younger child is an attorney, and I'm very proud of him. My father was an attorney, so it kind of ran in the family. This medicine thing initially was kind of a sideline in our family. My children are my pride and joy. I'm very proud of everything that they've done and that they're doing. They're very wonderful people and very thoughtful. Professionally, I'm proud that I have made some contributions to plastic surgery. They haven't been earth shattering. But I do think that I am proud of having introduced some concepts and to have supported other plastic surgeons to come up with educational initiatives that go with the times and fit in with how things have evolved over the 40 years I was in plastic surgery.

PT: I'm curious to know, what is a quote or mantra is that you live by?

MM: This is something that my father said to me, interestingly, when I was about 18. We went to an event in college, and it was a father daughter sort of event, and we were having dinner. He said, in the end, “the only thing that I regret are the chances that I didn't take”. I was really struck by that. I thought he had had a very successful life. Obviously, he had instances which he didn't necessarily share with me of things that he wished that he had done. So, following that, I have always taken chances. Sometimes they didn't work out, and some of the things that I applied for, I didn't get. But some of them you do. I always thought that was important to keep reminding myself that I'll never regret the things that I have done because I've tried to do them reasonably and thoughtfully, but I could potentially regret something that I let go by without taking advantage of it. So that piece of advice, that mantra, has always been really, really essential.

PT: Yeah, I think that will be very inspirational and actually very essential for the people who are tuning into our interview today, too. Next question that I have for you is what are your hobbies outside of the hospital?

MM: Oh, well, now I'm a citrus farmer. That's what I do full time now. Not entirely, but largely, and I love it. I've always liked gardening, but this is this is like, light years or a quantum leap beyond gardening. This is, like, major work. But I'm outdoors. I'm healthy. It's very exciting. 

PT: Dr. McGrath, what is the question that you wish more people asked you?

MM: I wish more people had said to me over the years, “do you want to know my idea for solving this problem?”. By that, I mean people are really good about telling you about all the difficulties and all the problems and all the negatives. But the one thing I wish that people would have come up with much more often and asked me was, “what do you think about this idea for fixing it?”. That's a question I just never heard as much as I would have liked to. We need to find solutions for so many things. Even if people's ideas seem outlandish, they're certainly worth hearing out. My advice to anyone would be, when you're working with someone and you're starting to look at all the difficulties, just go ahead and ask them, “do you think there's any possibility that going in this direction might be helpful?”.

PT: That's great advice, honestly. What advice would you like to give to any aspiring female surgeons who are tuning in? 

MM: Surgery is such a wonderful vocation, and patient care is both challenging and very fulfilling. But the advice I would give to people is to try to keep their eye on the big questions that arise from, but exceed, just everyday patient care. In other words, keep your eyes open to see if there are ways that you can contribute to the scientific understanding of what we're doing at the time, and see if there's a way that you can contribute to moving forward the body of medical knowledge and not simply accept the day-to-day work - as exciting as it is as a job. Realize that there's an opportunity, if you keep your eyes open, to contribute even more meaningfully. 

PT: That's incredible advice. Well, thank you so much for your time, Dr. McGrath. 

MM: Thank you.