Interview with Dr. Kelsey Millonig on the topic of surgery , by William Bui Tran a current 2nd-year podiatry student from Des Moines University College of Podiatric Medicine and Surgery
Dr. Kelsey Millonig is a current fellow at Rubin Institute for Advanced Orthopedics International Center for Limb Lengthening (Baltimore, MD). She completed her residency at the Franciscan Foot and Ankle Institute (Federal Way, WA). Dr. Millonig will be joining East Village Foot and Ankle Surgeons upon graduation of her fellowship in Des Moines, Iowa.
Dr. Millonig grew up in a rural farming town in North Central, Iowa on a cattle farm. After high school, Dr. Millonig competed in collegiate softball at Luther College in Decorah, Iowa with a biology major and graduating as an All-American catcher. During her undergraduate studies, she worked as an EMT as well. She started medical school at Des Moines University where she pursued a dual DPM/MPH degree and was the first podiatric medical student to earn an internship with the World Health Organization Headquarters in Geneva, Switzerland. Besides academia, Dr. Millonig enjoys all outdoor activity and sports, as well as spending time with her family.
Q1.Which surgical procedure is your favorite? And why?
My favorite procedure is a supramalleolar osteotomy. It is a very versatile procedure involving deformity correction that can be done acutely or gradually, which I love. It is utilized for several indications including joint salvage or a possible future total ankle replacement. As surgeons, we can make a big difference in patients’ lives who have post traumatic injuries or congenital conditions. What I love about deformity correction is planning meticulously preoperatively and the thought process with it. It is very similar to one of my favorite parts of being a catcher in college, scouting before the game for pitch calls. It’s enjoyable to me to methodically plan surgeries and then get to physically perform them. One of the many similarities between my love for athletics and surgery.
Q2.Can you tell Hallux readers about your involvement with APMA and ACFAS?
I have served on the Post-Graduate Affair Committee of ACFAS, where I got to help with planning and thinking through graduate medical education such as fellowships and how to improve the resident experience. In APMA, I have served on the Preventive Health Committee for several years due to my public health education and experiences.
In addition, I have been involved in advocacy for our profession. That’s how I started the Podiatric Medicine Advocacy (PMA) group at DMU when I was a second-year student. Several years later after graduating from DMU, the club spread to all 9 podiatric medical schools. I believe in the importance of grassroot advocacy, that is why I started PMA. I love to go out exploring the world, learn new things and have new experiences, but my goal is to always bring it back home to my roots. Being involved at a national level is similar to that, you can see how changes are made and be part of that, but ultimately it affects the direction and role of foot and ankle surgeons everywhere. I think it is important to serve as well from student level beyond to learn new skill sets and expand your network.
Q3.Have you found any obstacles/challenges as a female surgeon in a male-dominated field?
Absolutely! I feel like I experienced very little sexism in my life until I actually got into medical school and from there I have noticed it both subtly and not subtly at many levels.
I have had personal experiences such as attendings telling me as a student I would never be a successful surgeon because I am a married woman. I have been turned down for opportunities after specifically being told they didn’t want women due to a possibility of childbearing. In my residency interviews, I was asked several times about my husband’s plan to move or my potential of having children during residency; which my married male counterparts did not experience. While these questions shouldn’t be asked, the power dynamic still allows people to feel entitled to ask. Patients assume your role in their care is not as the physician or surgeon almost daily. As women assume authoritative roles, staff or colleagues alike view them as aggressive rather than authoritative largely due to their sex.
This phenomenon is so common, it’s known as the likeability bias or penalty due to historic roles of men and women that society has with women expecting to be in servitude and communal so when they lead it is not well received. This is a very prevalent bias for female surgeons. Every experience like this is a burden and can limit female surgeons in several capacities including achieving leadership positions. I think there is a transition certainly occurring in medicine, but just having women in the profession does not necessarily mean the additional biases are disappearing for women. We all need to make a cognitive effort to stop our own bias and to expose bias when it exists.
Q4.How do you balance between life as a fellow and your social life/family?
My life is little different than most people.
My husband and I are in our fifth year of a long-distance marriage. So while simple my advice is to do what works best for you. What has worked for my husband and I as I pursued my advanced training would not work for everyone. Many people think we are crazy for going long distances, but for us we have made it work. There is no right answer to handling life, you only do what works for you. I have definitely got better at balancing my work and life as time has gone on. During my first year of medical school, I committed 100% of my time to studying, and that was not good for me or my family. So, I have taken different approaches during residency. My husband and I see each other once or twice a month. When I see him, I commit to putting the computer down and not work at all since our time is so short. I work really hard to schedule my work around my commitments to my husband and my family.
The other thing I do is intentionally spend more time on myself with activities that bring me energy such as working out and personal development through podcasts or books. These activities really help me feel more grounded. When you are in training, your schedule is constantly changing. So, you have to learn to roll with the punches and both you and the people important to you have to recognize that and be okay with it. Being prepared to rely on your values despite any challenges and trusting yourself are really important.
Q5.If you could give one piece of advice to future female surgeons out there, what would that be?
As I have stated, I love personal development content and there is a quote saying you are the sum of the five people you spend the most time with. The reality is that you are the sum of what you bring into your life whether that be social media, news, books, friends, spouses, family, coworkers, or mentors. So you need to be very particular about what you choose to let into your world. Be very conscious about what your daily life looks like and who you bring into your life. It’s important to keep a positive mentality. Being a surgeon of any capacity is a commitment. Being a female surgeon comes with additional challenges making it even more of a commitment. You want to be surrounded by the people and content that uplifts you and encourages. Additionally, you should really give time to consider what you want your personal brand to be.
Everyone you meet has a personal brand that represents who you are. I want part of my personal brand to be encouraging and uplifting others, so I need my actions to reflect that in all my interactions.
Q6.Do you have any rituals before the surgery?
The night before I always read through my cases, analyze X-rays, and do my operative planning especially for complicated deformity cases. When I played softball in college, we used to do a “focus” before the game. This included laying down, staring at a softball, and envisioning how your game will go. What pitch you will hit, what play you will make, what that will feel like. Psychologists have shown that if you visualize things first, it helps them come to fruition. I utilize this in surgery, I visualize how the cases will go, how the dissection will happen, where I will make my osteotomy, and where I place my hardware. So, I kind of do the surgery in my head first, and then when I go to do the actual surgery it feels like you’ve already accomplished it.
Q7.What do you do when the surgery goes down south?
When you prepare the case you need to prepare for plan A, plan B, and plan C because you never know what could happen. If you get to plan E or plan F, you may have to think on your feet.
I am very fortunate to have several mentors who force me to think about surgical plans like this and challenge me to recognize several ways to do things so I can be best prepared for when I do need to think on my feet. If something goes wrong, you have to rely on yourself and your training skill set in order to perform and do well. At that point, it comes down to your character, which is why I think it’s important to recognize your personal brand. I work to be confident in what I am doing for those specific moments.
Q8.In your opinion, what is the number one skill a surgeon should master?
I think there are several things that are important for surgery and your demeanor/personal brand is one of them. The ability to be calm and collective during a stressful case is a critical skillset. Additionally, 3D spatialization or 3D anatomical knowledge is the basis of all we do in surgery and is very important to master.
Interview by William Bui Tran
Des Moines University College of Podiatric Medicine and Surgery