Q. What were some of the most memorable experiences during your time at AUC that helped shape your medical career?
One of the first experiences that helped shape my career was participating in anatomy lab. Being assigned a cadaver to dissect from head-to-toe while learning was a great experience. This is how the earliest doctors learned about the human body. The process of meticulously making our way through an actual human body helped to put the idea of pursuing a career in surgery into my mind.
I also spent a lot of time working with Dr. Bill Hayden (former faculty at AUC). He was a mentor to me in a lot of ways and helped shape my career path. We even ended up writing a book on ECG interpretation together, geared toward emergency medical services (EMS) personnel. We still keep in touch to this day.
Q. What inspired you to pursue this specialty? Can you share your journey from AUC to matching into a trauma surgery/surgical critical care fellowship?
I tried to keep an open mind toward all specialties when I was in the first two years of medical school, i.e., during the classroom-based years. Surgery was my first rotation of third year, and I immediately fell in love with it. Surgery gives you the ability to identify problems, fix them in definitive and meaningful ways, and then see the result of your efforts. Very few other specialties are able to offer that, and it is gratifying.
My fellowship choice was partially influenced by my previous work experience in EMS. Being able to pursue surgical critical care will give me the opportunity to once again take care of some of the sickest patients in the trauma bay and in the trauma intensive care unit and will still provide plenty of emergency general surgery experience.
Q. How did AUC prepare you for the challenges of a surgery residency?
AUC did a great job of providing foundational knowledge of anatomy and physiology, which are both integral to surgery.
At the time that I was a student, there were various options for clerkship rotations around the United States, so I felt I had several good choices for rotation sites available to me.
One of the most important things that AUC provided me with was a faculty mentor. They put me in contact with a surgery program director at a well-known program who had multiple phone sessions with me to discuss my plan for applications, looked over my application and personal statement, and provided excellent career advice.
Q. Talk to us about a typical day in your current role as a postgraduate year 5 (PGY-5) resident.
I arrive at the hospital fairly early, about 5:30 a.m., and begin chart checking on all the inpatients on our service. After I have written down all the pertinent labs and results and reviewed everything, I will go and round on all the patients with my team. We examine all of our patients, collaborate with nursing staff, place orders, change dressings, arrange discharges, etc., and then write notes for each of the patients. I will then head to the operating room and perform the elective (scheduled) cases for the day. In between those cases, I follow up on test results, see new consults, and round with my attending.
That morning routine is essentially the same for all surgical residents. As a PGY-5, I am the chief, and this comes with additional responsibilities such as creating rotation, call, and holiday schedules for all the residents. I also belong to a few different committees that require me to attend meetings and make certain decisions that affect the program and hospital.
Q. A surgical residency is demanding. How do you maintain your well-being and create work-life balance?
This is the ultimate struggle. Work-life balance is a hot topic in residency programs in general but is especially an issue for surgery. The problem is multifactorial. Surgery is inherently demanding and has potential for life-and-death consequences in a way that is more visceral than most other specialties. This means that the training must be rigorous and involve many hours in the operating room and in managing sick inpatients. The majority of surgical specialties will also have call days instead of shift work, which makes managing hours as residents problematic. The day ends when the work ends, as opposed to ending at a set time. I have seen lately that there is more attention being brought to the issue, and many programs are taking steps to ensure that residents are in a learning-based environment rather than a work-based environment. Certain protections are now being enforced for doctors’ appointments, mental health, didactics, etc. It is still a big problem and there is much work to be done to fix it, but I feel that the tides are slowly turning and that some meaningful progress is being made.
Personally, I am lucky to have the support of my wife and daughter. They keep me grounded and are always there for me. I also make it a top priority to get to the gym at least three days per week, if not more. That’s my Zen time when I can mentally decompress and also maintain physical health.
Q. Can you share a particularly challenging case during your residency and how you managed it?
There was a case recently where we performed a ventral hernia repair on a patient. It was elective, and everything went smoothly, but unfortunately the patient returned several days later and was found to have formed an enterocutaneous fistula (an abnormal connection between the small bowel and the skin) which caused bowel contents to leak out of their incision. This was challenging because fixing this problem involved maintaining careful fluid and electrolyte balance, using parenteral nutrition (feeding via IV fluids), wound care to protect the patient’s skin and remaining wound from the leakage, and working with home health and social work in order to provide the necessary resources for the patient to improve. I think this is a good example of a challenging case because it did not require a trip back to the operating room, but was extremely demanding in that it involved higher-level clinical management and a multidisciplinary team effort.
Q. How has your experience working in multiple hospitals within the University of Kentucky network influenced your approach to patient care?
Working at multiple hospitals has been helpful in that it has exposed me to different environments with greatly differing resources and unique challenges. I think it is beneficial in terms of career development to learn to be an effective doctor in a variety of settings.
Q. Can you discuss your involvement in your hospital’s Interdisciplinary Trauma Performance Improvement and Patient Safety Committee and how it has impacted your professional development?
It has allowed me to participate in a lot of important changes that are being implemented at our home institution regarding the management of patients that present with traumatic injury.
Q. What do these changes mean for both the patient and for the institution?
By participating in this committee, I am able to help improve patient care. Our hospital is not a trauma center, but we do often have patients arrive either by private vehicle or by ambulance who have suffered traumatic injuries from various mechanisms. These include car accidents, shootings, stabbings, falls, etc. Even though we are not a primary destination for these patients, we still need to have an organized approach and ability to implement our available resources to care for them and get them safely to their definitive destination. Essentially, this committee integrates emergency department personnel, radiology, lab/blood bank, and surgery (which is where I come in) in order to rapidly assess and stabilize these patients and perform any lifesaving interventions that may be indicated. It involves a lot of moving parts and coordination, which has been beneficial for me to partake in as this directly relates to my career path.
Q. Looking ahead, what are your career aspirations after completing your fellowship, and how do you envision contributing to the field of trauma surgery?
After fellowship, I will pursue a job at a Level I Trauma Center, preferably at a large academic institution. I say that because I enjoy being in an academic environment where I have the opportunity to teach residents and participate in research and quality improvement. I have a special interest in trauma systems expansion and emergency medical service (EMS) integration.
Q. What are some of the key skills and qualities that you believe are essential for trauma surgery and surgical critical care?
The ability to stay calm in tense situations and to be able to confidently make decisions under pressure is essential. You also need to be someone with leadership qualities; someone who can function well within a team.
Q. What role do you see for compassion and empathy in surgical practice, and how did AUC help you develop these attributes?
Compassion and empathy are crucial to delivering quality patient care. AUC did a great job at fostering these attributes, though I do believe that doctors must inherently be passionate about caring for others in order to genuinely integrate these qualities into their career. Patients want to know that someone is being sincere with them rather than just checking boxes.
Q. What advice would you give to prospective medical students considering AUC, especially those interested in pursuing a career in surgery?
Anyone interested in pursuing a career in surgery needs to be performing as best they can at every step along the way in their medical school journey. Good grades and test scores are of course essential, but the successful applicants are those who take it a step further. Surgery is very competitive, especially for international medical graduates. Make sure to seek out leadership opportunities, do research projects, attend conferences, and network as much as you possibly can. That way, when the time comes, you will have a strong application.
Dr. Jonathan Barney’s journey from AUC to a successful career in trauma surgery is just one example of what is possible with dedication and the right education. His story highlights the comprehensive training, supportive community, and real-world experiences that AUC offers its students. If you’re passionate about making a difference in medicine, AUC can provide the foundation and support to help you reach your goals. Learn more about starting your medical degree journey with AUC and see where it can take you.
