Chasing “More”: The Cost of Applying to a Competitive Surgical Specialty

12 Nov 2021

By Kelly Spiller

During a posterior cranial vault expansion on my pediatric plastics rotation, I was assigned a simple task: to stand at the back table and obtain bone shavings from the skull flap. Taking care not to fracture areas of thin bone, I went to work with the scraper, slowly filling the cup beside me with bone shavings. Holding the cup up to my attending, I asked him after a few minutes, “How does this look?” Quickly glancing up from the surgical field, he responded, “More.” Ten minutes and a few hundred scrapes later, I filled another cup to the brim. “How about now?”, I inquired. Peering over his loupes, he laughed and responded, “Kelly, I’m a surgeon. We always want more.”


Reflecting on his response that day, I recognized the greater truth in his sentiment. Throughout my medical school journey, I have constantly chased “more” with one goal in mind: to match to plastic surgery. With the conclusion of one milestone, I jumped to my next project, all too aware of the competitiveness of plastic surgery and the impressive statistics of previously matched applicants. Now that my residency applications are submitted and I reflect on my experiences, I can’t help but wonder: what personal sacrifices did I make in pursuit of plastic surgery, and was it all worth it?


The most powerful instance when I realized the cost of chasing “more” was the day I received my USMLE Step 1 score. Traditionally regarded by program directors as one of the most important components of the plastic surgery application, I knew the pressure was on to perform well. For the better part of 9 months, I dedicated my life to test preparation, spending each waking moment squeezing in additional Goljan podcasts, Sketchy videos, and UWorld questions. I kept picturing how happy I would feel upon achieving my goal score, and I rationalized skipping family gatherings, nights with friends, trips to the gym, and even meal preparation as acceptable in the pursuit of an excellent score.


When I finally received my Step 1 score three weeks after my test, I was flooded with happiness and rushed to tell my family that I had achieved my goal. However, after a mere 15 minutes, my elation was replaced by an unsettling, unexpected emotion: emptiness. Rather than celebrating my accomplishment, my mind focused on the next set of hurdles. I thought, “Ok, now if I can get more publications, be elected as the Plastic Surgery Interest Group President, and win more scholarships, maybe then I’ll match into plastics.”


After my experience with Step 1, I realized the extent to which my self-worth was tied to external academic achievements. In some ways, I think my insatiable desire for “more” allowed me to be productive during medical school and to accomplish my academic goals. However, at the same time, my personal relationships, mental health, and physical well-being suffered at the expense of my desire to become a plastic surgeon.


During my last two years of medical school, I realized that while it is okay to feel proud of my accomplishments, it is equally important to derive self-worth from relationships and hobbies that bring me joy. By allowing myself to view activities like going for a run, cleaning my apartment, or Facetiming friends as productive, I have achieved better balance in each aspect of my life. As explained by former Coca-Cola CEO Brian Dyson, in life, you choose a set of balls to juggle. Some balls, including family, friends, physical well-being, and mental health, are made of glass: they will crack or even shatter when you drop them. Other responsibilities such as research, school, and leadership are made of rubber. If you set these down, they will bounce back to you. So no matter where you are on your journey to surgery, choose carefully when setting your priorities. Because when you lay aside certain aspects of your life, you can’t always get “more”.



Kelly Spiller is a fourth-year medical student at Wright State University applying to Integrated Plastic Surgery this fall. Originally from Cincinnati, Ohio, Kelly obtained her Bachelor’s Degree in Molecular and Cellular Biology at Vanderbilt University prior to attending medical school. Her mom, a dedicated PACU nurse of 25 years, inspired her to pursue surgery. However, she became interested in plastic surgery after working in a lab studying congenital craniofacial abnormalities during her undergraduate years. As the first person in her family to obtain a bachelor’s degree and to pursue medicine, mentorship and teaching are of utmost importance to her. She hopes to continue her involvement in both areas during residency to make room for more female, first-generation students in plastic surgery. Her research interests include reconstruction of congenital craniofacial abnormalities, traumatic lower extremity reconstruction, and breast reconstruction after mastectomy in the obese population. She is also passionate about global health and has traveled to Jamaica with Wright State’s Global Health Scholars program. Outside the hospital, Kelly can be found hiking, running, traveling, and spending time with friends and family. Find her on Instagram: @kelly.e.spiller.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.