Episode 18: Sunday October 18

Drs. Sam Jejurikar, Salvatore Pacella, and Sam Rhee welcome special guest Dr. Rod J. Rohrich, M.D. In the world of plastic surgery, Dr. Rohrich is the Tom Brady or Michael Jordan of our specialty. World renowned plastic surgeon, educator, and innovator, Dr. Rohrich is one of the most influential plastic surgeons of our era. We talk with Dr. Rohrich about his secret of his success, what continues to drive him today, the role of mentorship in his life and words of advice for young surgeons (and all career-starters) today. In addition, we have a bonus mystery guest appearance joining us for this show along with Dr. Rohrich - DO NOT MISS!

Full Transcript (Click here for PDF)
Dr. Sam Jejurikar: [00:00:00] All right. good morning, everyone. Welcome to our latest edition of Three Plastic Surgeons and a Microphone. As you'll notice though, in our box today, we actually have four plastic surgeons because we are fortunate to be a, to be joined by a special guests. We'll introduce here in just a second, but just to want to introduce everybody, I'm Sam Jejurikar in Dallas, Texas @samjejurikar.
Also joined by my compatriots, Dr. Sal Pacella, whose Instagram handle is @SanDiegoPlasticSurgeon and Dr. Sam Rhee in Paramus, New Jersey @BergenCosmetic. And, we are doing our, I think this is our 16th or 17th episode of this. Just a little bit of informational stuff before we get going.
This show is not a substitute for professional medical advice, diagnosis, or treatment. And this show is for informational purposes, only treatment and results may vary based upon the circumstances, situation and medical judgment after appropriate discussion and always seek the advice of your surrogate or other qualified health provider.
With any questions you may have regarding medical care, never did regard professional medical advisor, delay seeking advice because of something in the show. 
Regardless of what your or someone's background is I think we all recognize the need for mentors. whether you're a surgeon, whether you are an accountants, whether you are a basketball player, there are people that are instrumental in shaping your career.
When we're medical students. We, we look to what doctors, we try to emulate to decide what profession we want to do. Even when you become a plastic surgeon, people. who you want to be like and who guides you. And so that's why we are so fortunate to be joined by Dr. Rod Rohrich.
I'll say on a personal level, Dr. Rohrich actually founded a group called Dallas plastic surgery Institute, which is one of the leading groups in the country. I'm happy to be one of the members of that group, but he is one of the founding members of that group. But beyond that, he has so much more, he is.
Just for the people that are watching this,  in 2014, when a study was actually done at the most influential plastic surgeons in the current era, he was one of the 10, most influential plastic surgeons in the world. He's a past president of the American society of plastic surgeons. He's a past president and, one of the founding members of the rhinoplasty society.
He is the editor in chief of the journal of plastic and reconstructive surgery, which is the leading journal in plastic surgery. He is the chair and founder of the Dallas rhinoplasty meeting, the Dallas cosmetics. meeting, which are huge international meetings in plastic surgery that are attended by thousands of plastic surgeons annually from across the world.
He's received the plastic surgery foundation distinguished award, I think three times, and, has also won the American society of plastic surgeons, special achievement award. I was looking at his CV yesterday to try to do an appropriate, introduction. It's I think it's 232 pages. I got overwhelmed, but anyways, we're really fortunate to have you, Dr. Rohrich, thank you so much for joining us today. 
Dr. Rod J. Rohrich: [00:02:41] thanks, Sam. I wish my mother, my late mother could have heard that because all she said to me ever after medical school, I just want you to get a job,
Dr. Sam Jejurikar: [00:02:49] but all modesty aside, you have accomplished in plastic surgery more than any other plastic surgeon I've ever met. When you at this point in your career, when you've done everything, I still know you to be one of the busiest and most driven surgeons. If not the most that I've ever seen, what keeps you motivated?
Dr. Rod J. Rohrich: [00:03:08] I love what I do. I think it's passion. I think giving back and now it's teaching the next generation. It's always been that, but I think passion giving back and loving what you do if you don't love what you do. everyday I do elevate her thoughts recently in the last six months and put them on Instagram because I think it's really, you have to be driven to do it.
Cause the other thing, the plastic surgery is not a job. We're very lucky. Cause it's just a way of life. And every, I go to job, I'd say this is so amazing that, I was able to do what I love to do and it's not really work. I think all those things help all of us. 
Dr. Sam Jejurikar: [00:03:45] Yeah. if you were to, I know how important education is for you.
And I see you with residents and fellows, as you are shaping the next generation, what are some important bits of advice that you give to young plastic surgeons about what to look for in a career and how to build their practice? 
I think the biggest thing is to four letter words that most people don't want to do.
And that's hard work. You have to work hard, be focused, be passionate and take great care of patients. I know that sounds very simple, but man, it's hard to do because there are a lot of barriers to that, The, just life in general, the business of plastic surgery. But if you focus on doing that every day, being the best you can be, and always, in the morning, I would say, what are the three things I'm going to do today?
And after that it's gravy. yeah. Have I accomplished my top three goals hopefully before noon? I'm good. So I think that, and giving back, the amazing thing it took me a long time to learn is that the more you give back, the more you get. And, so I love that. 
guys feel free to chime in here at any point as well. I feel like I'm hogging the conversation, but, but, 
Dr. Salvatore Pacella: [00:04:53] so rod, I just, when I was I'm a medical student and I was interviewing for. Residency's I first, met you, I think, back in 19, gosh, 97 or 98 when I was interviewing and I went down to, UT Southwestern and the, you gave a talk on. On how to be successful in plastic surgery, to the applicants. And there was a beautiful picture you showed 
of a, at the very end of the talk, you showed this picture of a very wide cleft 
lip in a, in an infant, probably, at least a couple centimeters. It's a huge one. and then you said you clicked the slide and you said, okay, if you follow along this path, you can do things that look like this and you click the slide and the final result.
and literally you could not tell that this child had a cleft lip. And I looked at that and I said, this is just absolutely unbelievable and amazing. And he's got it dialed in. So really impressive stuff. 
Dr. Rod J. Rohrich: [00:05:54] so when I was a medical student at Baylor, in the early, late seventies, early eighties, I was going to be a cardiac surgeon cause I was on dr. DeBakey service. So one day dr. DeBakey said, and I was one of four medicals. They finished early. It was very rare. He said, go watch this plastic surgeon. No, he helps us. I don't happen to be Mel Spira who just passed away this week. So I walk in his room in cleft lip. And he, and all of you who knew doctor Spira, he said, he always talking? Cause it comes from just scrub in. So I scrubbed in and watch him do it. And I said, you know what? After that I said, I'm out of here. I want to do what you do. I want to reform and remake. to me, plastic surgery was, not an, it was an edge of not announced. So it's been transformational.
So that is why I went into plastic surgery. 
Dr. Sam Jejurikar: [00:06:44] I'm jumping on Sal's story of a, of an interview. I interviewed also as a medical student, but the interview that's most, the six of them, most of my mind is the interview. For one, I try to be a part when I became a partner of Dallas plastic surgery Institute.
I, I came down, I was I was finishing up my first job and dr. Rohrich, and somebody other partners had required me to bring 25 of my cases for them to look at, to see whether I was worthy of joining this group. So I, nobody looked at him except dr. Warick. He flipped through about 25 cases and about. Less than 25 seconds said, he said B plus,
which I learned at that time was probably the highest grade I've heard him give out. I don't think I've ever heard him give about higher than a B plus. And I just thought, what am I getting myself into?
 Dr. Salvatore Pacella: [00:07:28] I have a question for you. who would you say are your. most cherished mentors in plastic surgery, 
Dr. Rod J. Rohrich: [00:07:36] I would say would be dr. Dingman, dr. May dr. Mathes, dr. Spira and then also dr. Bill grabb, I died when I was like a third year, but. But those are the people, you pick mentors when you want to, what they do and what they've done and how they live.
And I can tell you what I went to Michigan. I don't know, none of you got to meet doctor. I was very lucky because in one way, because. I had three chiefs, as I had dr. Grabb. Then I had dr. Dingman who came back. So the great thing is we had to all scrub with dr. Dingman as senior residents, because, we wanted to make sure everything was good.
Then we had dr. Mathes too. So dr. Dingman was awesome. I remember one night I was doing a free flap at children's, remember the children's is the only place where you stop. So all of a sudden I heard this, somebody breathing behind me, it was like nine at night. We were doing a leg. to save the leg, a latissimus. There was dr. Dingman at eight o'clock at night at the university of Michigan at children's hospital. Wow. then he said to me, can I take a look? I said, absolutely. Dr. Dingman.
Dr. Sam Jejurikar: [00:08:39] Cool. 
Dr. Rod J. Rohrich: [00:08:42] They have enough faculty in the operating room was amazing. 
Dr. Sam Rhee: [00:08:46] it's funny. I remember being at Michigan, some of your, the people who trained with, you said you had ambition, even at that age, they like in training. They said you and I don't know, is this true? I wanted to ask you that as a third year resident, you created or brought together an international symposium, during that year, basically all by yourself is what they said. 
Dr. Rod J. Rohrich: [00:09:08] I did do the first international symposium on tissue expansion when I was doing my fellowship at Oxford, in my fifth year. And we brought everybody over, man rat Yvan and all, the Michigan did a lot of expansion tech, science and dr. Cherry and everybody, and yeah, it was fun. And, it was a riot. 
Dr. Sam Jejurikar: [00:09:27] It seems or not would be an appropriate time to continue the Michigan theme. and, and, Sam, you want to do the honors? 
Dr. Sam Rhee: [00:09:33] Oh no. We just wanted to honor dr. Rohrich and the legacy at Michigan. We have a special guest for you today who also may want to join in.
And I'm going to go ahead and introduce him. This is, let's put him in first. This is dr. Paul Cederna. He is the chairman of plastic surgery at university of Michigan.
Dr. Sam Jejurikar: [00:09:51] Yeah, it's I think we are, I'm talking about dr. Rohrich's  story about why people went into plastic surgery. I'm not even sure I've ever told Paul this story, but when I was a fourth year medical student at the university of Michigan, I thought I wanted to go into cardiac surgery, much like dr. Rohrich. I did my rotation. I realized that it wasn't really what I wanted to do. I, I My older brother is a plastic surgeon. He encouraged me to look at plastic surgery on my first day in the plastic surgery rotation. The chief resident was Paul Cederna. And Paul Cederna, I remember it was listening to the Barenaked ladies, in the area.
No, I think we're doing a breast reduction. He kept having me put in deep dermal stitches and take them out cause they were no good. And I think I got one in the whole case and I like, I love this case. I love this guy. I went into plastic surgery. So speaking about mentors, I think things are coming full circle.
the two of you or both leaders in plastic surgery, and you guys have been through a lot, you've been through, faced your share of adversity. You've your share of challenges, what's different now, plastic surgery training than it was when you guys were training. And, if you were to to take a medical student who's thinking about going into plastic surgery. Why would you tell them that it's a good endeavor for them? Like why would should someone do it. 
Dr. Rod J. Rohrich: [00:10:59] it is so different. I think that it's still the only specialty where you can do it all and be, the consummate physician, from head to toe, in a world where medicine is so specialized, you can still do it all as a generalist.
And I think that's very unique and, I love that. And of course, that's the path that I took. No. And right now I'm very focused on what I do, but everybody can start there and stay there as long as you do good work. And, that's what I tell the medical students, but I always tell them, you got to do hard work, you have the passion and you can do it.
But so many times people today want the shortcut. And, those are the people that I think, plastic surgery is not a shortcut, not if you want to be great. What do you think Paul? 
Dr. Paul Cederna: [00:11:46] Yeah. So thanks rod. I couldn't agree with you more. I got to tell you, I love plastic surgery. And the reason I love it is I love the fact that we just take some basic foundational principles and we solve an infinite number of problems with those principles.
And I love when somebody calls me they're in the operating room and they are just struggling and they can't solve some problem and they call me. I've never seen him, I walk in the room. I see that thing in front of me and I'm like, yeah, we got this. That's change the music on the radio first. Cause we got everyone just relax now because all of those other surgeons that are super uptight, they're gone and now we're all going to relax and we're to fix this really hard thing and we're going to help this patient. And I absolutely love that. And In my clinic, I've got a burn reconstruction, I've got a bad hand.
I've got a hole in a foot, a hole in a face. I have someone that's nose is crooked that they want straight. I have all of that in one clinic. There is no specialty. You can do that in. And that's what makes it so amazing. 
Dr. Rod J. Rohrich: [00:12:47] Yeah, I totally agree, Paul. I mean that, when I was, especially when I was at UT, I had the same thing cause I was in Miami.
We do hand surgery. I know I'm going to answer, I did everything and I, I miss that, but that's what plastic surgery is. This is a differentiator. So I tell medical students, you want to be the best you can be, then work hard, be focused and be passionate because I think the biggest thing that we lack in our specialty today, In some people, it's the passion.
And if you have the passion, you can be fantastic. I don't care how smart you are because I, and your background, it doesn't matter where you came from. It's where you're going. That's important. like I grew up in North Dakota, didn't speak English, and I ended up in Michigan and a few other small placements, but none of them does the university of Michigan.
My English still isn't so good. 
Dr. Salvatore Pacella: [00:13:39] sorry. w what I was gonna say is, in listening to both of you guys and my two colleagues, it's clear that. 
I think an overlying theme of plastic surgery is that we as plastic surgeons and work, and mostly this is in the realm of reconstructive surgery, but also cosmetic surgery.
We are the surgeon, right? we are the people that solve them. Those types of problems, they're the, we are the doctors that other doctors call to solve those problems. And I just, I think that's a true honor. somebody wants described to me, in fact, sometimes patients, I'll do a forehead flap on a patient or a nasal labial fold flab or something, and patients tell me, Hey, this is just unbelievable how you can do this.
And I said, much smarter people than myself have created these, these techniques. And, I use the, saying that I learned at Michigan standing on the shoulders of giants. you can only see as far as you can because somebody else you're standing on their shoulders. And I think that's an overlying theme in plastic surgery.
It just builds on it, 
Dr. Rod J. Rohrich: [00:14:38] Yeah. we're very lucky to get to train at Michigan. you don't know it until you leave and go someplace else. You really don't. And, I didn't know it, honestly,  I remember when I was at medical city, he said, You're too good to stay.
You got to go to Michigan, cause then he built revenue and he were good friends. So I go to Ann Arbor. I had never heard of Ann Arbor before and I go there and I went, wow. And I'm, you meet guys like touch a grab and dr. Dingman and people that you read about, you go on to you.
This is like impossible. And, the rest is history as Paul mentioned, 
Dr. Paul Cederna: [00:15:09] but I gotta tell you for me, so I come here and I have people like you and like Jack Gunther and all in math and all these giants and plastic surgery who came through this place. And then the place that I'm working at has people like, Kevin Chung and bill Kuzon and Steve Buchman and all these people, who've been president of everything and you go, this is awesome.
And then at the same time, you're in this. Beautiful college town with this massive volume of stuff to do. She have all the complexity you could ever dream of as a surgeon to solve the problems that no one else wants to touch. And you're like, those are actually the ones I want. those are my cases.
So bring those to me and you get to do that stuff. And at the same time to do it in a beautiful place that looks like this, even in January,
you think it's nice to, and January. Hi,
Dr. Sam Jejurikar: [00:16:04] I'm going to take Dallas. 
Dr. Salvatore Pacella: [00:16:06] Yeah, 
Dr. Rod J. Rohrich: [00:16:08] you were doing so good it until you mentioned the weather
Dr. Sam Jejurikar: [00:16:10] credibility. At that point, 
Dr. Rod J. Rohrich: [00:16:15] it looks like a nice day today, but I can tell the thing is. The people, you forgot one person and that's you, Paul, you have been transformational. I can tell you what I can go back. I've been back to Michigan so many times recently. I can tell you, it is like, A whole, of course I was the last resident went last resins in the old university hospital and none of you guys footprint, but it's been transformational to go there.
It is unbelievable. And, and Paul, you are the consummate leader and what really makes plastic surgery just tick today and Michigan and I'm not just blowing hot air at you because if it wasn't true, me, I wouldn't say a word about it, but kudos to you. 
Dr. Sam Rhee: [00:16:55] Yeah. I wanted to ask about leadership since we brought it up.
Paul's, he mentioned a lot of big people that he's working with now and dr. Rohrich you've been working with, you establish one of the biggest greatest centers, in Dallas with some of the biggest, greatest plastic surgeons there. 
What is it? Like being a leader with people who are obviously very passionate, very successful, plastic surgeons are very independent and there can obviously be, is there a room, like how do you make room for everyone as a leader?
And how do you use establish yourself as a leader with all these types of people there? 
Dr. Rod J. Rohrich: [00:17:31] I think the biggest thing is that you have to listen, be respectful and, and honor those that. That come before you, but also that are with you. imagine I was with people, and Sam knows is Hamra Barton and Burton they're all great people.
Everybody has big egos, but I think, we're all in it because we love plastic surgery and the common bond has been always, we want to teach and do good things for our patients and for the specialty. So I think when you put people in that arena of common things that we all love, then all the other things tend to go away normally, which is a lot of egos.
Believe me, we have a lot of egos in Dallas and, And so I think it's always been a challenge, but if you give people the recognition that they deserve, I think people are, then there are our font and sometimes, it can be a challenge, but I think recognizing everybody's expertise in what they do and do well, I think we can then do things better together.
And I think that's been a big challenge in plastic surgery, as for that's prevented us from doing even greater things as a specialty. 
Dr. Sam Rhee: [00:18:41] the other followup I wanted to ask real quick, sorry, is, and maybe both Paul and you can comment on training the residents now versus say 10 years or 15 or 20 years ago.
when I remember when I was taking my mock orals and I was preparing, we had a bunch of UT Southwestern residents, and I will tell you, they told some hair raising stories about their conferences every week, but they were certainly the most articulate, the most knowledgeable. the most impressive in terms of displaying their knowledge in these mock orals than I've seen of any other program, but they certainly said it was a very challenging time for them during that period.
And so how has that compared to how things are now? 
Dr. Rod J. Rohrich: [00:19:24] it was a different time and, I actually try, I try and, I try and have people be as good as they can be. And, I always tell my no. And as part of that PowerPoint, Sal and Sam and and Sam, one of my last slides was that you will be the best you can be.
And so my job was to make you the best you can be. And that's the same today for fellows in the resident. rotators is that. And I really learned that at Michigan. Obviously I took it to another level because it was, I'm a little softer today, but people you need to challenge. If you don't challenge people, especially millennials.
And I challenged them in a different way today, you have to challenge them to be better. And so even with the fellows and residents today, I always ask them, what are the three things we're going to accomplish? What did you learn in the case? What are the five things you've learned? And we put that on Instagram.
I think the reason is if you don't challenge yourself, many people today, see, I challenge myself every day, but if you don't challenge others that don't have that capability, they're just going to get by. Isn't that amazing? They're all tired, but many people just want to get bought. And to me, getting by is failing.
And now we express it a different way in the nineties and how we taught, because today we'd probably be put in jail, honestly, 90% of the things. 
Dr. Salvatore Pacella: [00:20:40] What do you mean by that? What do you mean?
Dr. Rod J. Rohrich: [00:20:41] That was not a correct answer and you didn't read it. So you're going to come back next. We can become the expert and you, they had this little box. But, it challenged them to be better. Now, today we say, that was very good. That's okay. And I know you, he didn't get any sleep cause you had eight hours of work, maybe tomorrow we can do better.
And you asked me to go home now, but everybody. Everybody has a different level of being able to, and sometimes there read in the last month or I'm a visual learner, that was AKA code I'm not reading, so he became a visual, but also a reader two in a month. 
Dr. Paul Cederna: [00:21:19] So I think things are actually really, they're just really different now.
And people are very different now and because they've been raised differently, we need to employ different strategies for them to get the same amount of information. Because if we use the strategies we used in the nineties, people, most people are going to shut down and you're going to get nothing out of that.
Yeah. The way people weren't raised getting spanked. People weren't raised getting sat on the bench, on their sports team cause they just didn't perform. They were raised in equal playtime. it's just different things and that we have to employ different strategies also. And so our job more than anything is to figure out the individual needs and we actually are doing our best to personalize training and personalized education to each individual because everybody needs a little bit different, right? Old era of one size fits all, beat them until morale improves. that doesn't fly anymore. And so we work really hard and we have actually external consultants coming in, helping us understand the dynamics, helping us build new programs, helping us to build these things so that we can actually make everybody give everyone yeah.
Opportunity to achieve their potential in whatever area that is. And 
Dr. Rod J. Rohrich: [00:22:36] that is. That is very right. I want to tell you, Paul is right. And it takes a lot more work because in the past I would do a bit of, with one broad stroke and saying, okay, this is the level you must come to. Okay. It would be my level. And of course, sometimes that's a little hard, but you know what, the amazing thing was.
Some of them, it took years, but I would tell you, 95% of them would come call me in three to five years and say, dr. Work, if you didn't do that to me, I wouldn't be the plastic surgeon I'm done today. I've met you. I had that from a hundred of my trainees know that was the hard work and the quote unquote spanking.
but Paul is right today. It's a lot more, we have to individualize. everybody gets a trophy type thing, but believe me, I have two kids and that's how I had to raise them. But I also have to say when I was at the university of Michigan, On those Thursday afternoons, dr. Graham would sit in the back.
It was not necessarily nice when you said something that wasn't good. Even dr. Dingman who sat in the front. It was interesting. Dr. Graham sat in the back. Dr. Dingman sat in the front and lay me if you were trying to be as one of those guys, it didn't go over very well. That's all. I don't know if you remember that.
Dr. Sam Jejurikar: [00:23:46] So then I have to ask both of you gentlemen, both being leading educators, do you feel like the quality of product you're turning out now that things are more gentler and fewer work hours is the same as it was in the nineties. Cause being a product of the earlier era, it was definitely miserable at times don't get me wrong and there were many nights of unhappiness, but I'm a better surgeon for it.
And I feel really well trained for it. I think I emerged a little bit of a psychopath because of it, but I'm better for it. So the question is, do you guys, but in all honesty, cause one of the things that you always worry about is are you turning out the same quality of product? What do you guys think about that?
Dr. Salvatore Pacella: [00:24:24] And let me say Samira was my chief resident, so I can attest to the psychopathology.
Dr. Rod J. Rohrich: [00:24:28] He was a better. 
Dr. Paul Cederna: [00:24:32] so I guess I'll go first. I don't actually think it's probably a fair comparator because our people finish now. They have accomplished so much more than people accomplish. 15 years ago, and 20 years ago they are coming in with CVS that would make them eligible to become assistant professors.
On a, on the faculty and they're just applying for residency position. The applicants weren't like that 15 years ago, 20 years ago, and the drive of our people, we have people finishing, who've published 50 manuscripts and just outrageous levels of accomplishments and our training is Good now that they're actually getting no six years of clinical plastic surgery training, they're hardly spending time doing other things.
And so they're so good. So I got to tell you, I think the product we're putting out is amazing are so good. And, and they're just using fellowship years to this find two things cause they had great experiences. Now I'm incredibly optimistic about where we are. 
Dr. Sam Jejurikar: [00:25:34] That's wonderful. 
Dr. Rod J. Rohrich: [00:25:35] I would agree. I think the quality of the plastic surgery training applicant, it's the most, sought after residency is that in dermatology?
And I think the quality of X is amazing, but it also attracts, a different type of individuals. Some of them necessarily shouldn't be in plastic surgery either. But hopefully we leave those out, but it is just a different time. it's like Paul said, we have to tailor the learning toward the, what that applicant needs, whether it's visual, whether it's other learning, it's so much different.
The other thing is we so much more directly interact and teach them one-on-one. I don't know, when I was at Michigan and even when I was at Harvard, I rarely saw a faculty member. If it was like something bad happened. That's why it was always surprising when I saw that, when I saw that pop up behind me at eight at night and children's, but so it's a different mentoring, much more one-on-one and I think that's what this modern group of people need and want.
But the product, I think like Paul said is. It's better. I think that if I'd have had the same training that I give my residents today, I wouldn't be, I needed 30 years to become a rhinoplasty yet. I mean it, because, I would be doing random buses at the prison at Jackson. And then doctor, I would say, why did you do, I did open rhinoplasties, an African American patient said, dr.
Demon, you mean? I said, dr. Greg, you were my staff. Oh, okay. of course she never was out there, these are the things that, I think we do a better today, to be honest with you, 
Dr. Sam Rhee: [00:27:04] where do you see plastic surgery being say then in the future, it looks bright. I think it's, I have a very optimistic view of plastic surgeon.
Both of you, you have better perspectives and views and experiences about predicting what you we'll see. 
Dr. Paul Cederna: [00:27:20] Rod, go ahead. 
Dr. Rod J. Rohrich: [00:27:23] I think the future is bright. I think we're going to be doing so much more, online learning. I think the access through COVID has pushed education forward five years, because now they look at what we did.
we did, I did grand rounds. It. 12 or 13 different universities in six weeks. And I was on the university of Michigan ran rounds. M&Ms multiple times. And I think that's phenomenal. So teaching is better. I think the one-on-one I think the ability to learn plastic surgery. Without actually doing surgery, that ability is going to be so much better suturing doing, Wheeler, literally learning how to do it with microsurgery without going to the operating room.
I think so much of that is going to be automated on the line. And we are raising, our generation that did all of the things like Fort that they're very computer savvy. When you look at your kids, They do this automatically. Why do you think endoscopic surgery is no popular? Because this is kids now that are surgeons, but you think Paul that they get it, 
Dr. Paul Cederna: [00:28:25] and I would say as far as I think our training is getting better and better, and I think we have lots of new opportunities to train people outside of that incredibly stressful environment of the operating room.
And they can develop the skills before they're in this horribly stressful situation right in front of them, significant consequences. But I also think our specialty is really good. I know a lot of plastic surgeons get. Worried because something gets developed in plastic surgery and then other surgeons take it and bring it into their scope of practice and things.
There is no limit to the innovative spirit of plastic surgeons. And I am not even marginally concerned about our ability to continue to innovate and discover, and just say so far ahead of other surgeons that we will always have. Great things we're doing, and we are never going to be the group of surgeons that are gonna listen to what other surgeons tell us.
So we're going to do it. We're always going to be the group of surgeons that tell everyone else how to do it. 
Dr. Rod J. Rohrich: [00:29:23] I'm so good. Say that Paul, because so many people in plastic surgery would not agree with. That because you are a true leader because I am never been worried about other people learning what I do, if, and do it safely and and give good outcomes.
I teach people in cosmetic medicine all the time, in the past people said we only need to teach each other. I say, we teach people if they're doing it to do it well, to do it safely. So they get great outcomes. And most of the time that's in plastic surgery and I don't worry about other people learning.
we do microsurgery if they do it. I think hands-off to that. No, I think it's good. I don't worry about that because if not, you're not the leader of the pack and the leader of the pack, we don't like to view from behind. 
Dr. Sam Jejurikar: [00:30:07] No. No. I think gentlemen, this has been incredibly educational for closing thoughts.
If you were to give one bit of advice to a plastic surgeon, just embarking on their career now, the most important thing they can do to have a successful career, not just financially, but more importantly, from an intellectual and a enjoyment standpoint, what would be that advice? Either one of you guys can go first.
Dr. Paul Cederna: [00:30:34] Thanks, John. I think the most important thing of all is to do that thing that you are most passionate about, whatever that is. It isn't what everyone else thinks you ought to do it. Isn't what is going to be most financially beneficial to you. It should be that thing that you are most passionate about.
If you're most passionate about that thing, you will read about it. You will study it. You will work hard to be the best you can possibly be at it. And then people will come from everywhere to you to have that done. And you can live your dream every single day. I got to tell you there's so many people locked into jobs that they're doing because they could make a good living or somebody told them, they thought they ought to do that or whatever.
And every day is a struggle. but I gotta tell you, I wouldn't do my job for free. it is an amazing job. I love it. And, and I got to tell you do that thing. You're passionate about. 
Dr. Rod J. Rohrich: [00:31:28] Paul, you must've been listening to me early on, but you are, so you are so right every day, Hey, I wake up and I say, thank God for plastic surgery.
And of course, that's, one of my insignias, because it's all about passion focus and doing the right thing and giving back. If you have those four things. You have mastered life. Cause this is not a dress rehearsal. You only live once. And I can tell you if you have those things, you will rock the world.
And that's it. Great thing about plastic surgery that it's the secret of life and no matter what you do, but plastic sort of gives you all of those.
Dr. Sam Jejurikar: [00:32:07] No, I, it's always wonderful to hear from people that you respect and admire, and both of you guys fall into all three of us just feel so honored that you joined us today. I think those are amazing words of advice for anyone starting in, not just plastic surgery career, but life in general.
So on behalf of the other two, thank you so much for joining us today and, go blue. 
Dr. Rod J. Rohrich: [00:32:27] thanks so much. This is great. What a surprise?