Louisville Medicine Volume 65, Issue 8 - Page 32

DR . WHO
( continued from page 29 )
were so many women coming to have babies delivered that a one patient room regularly had three . “ It was not uncommon to deliver babies on the floor . The labors were taking place all night , nonstop ”. The only four operating rooms in the hospital functioned at capacity 24 / 7 , performing C-sections , abdominal explorations for the nonstop stab wounds , or broken bone surgeries , with interns always involved . “ It was stressful , but a great experience .”
After the rotations ended , Dr . Ajkay completed his year of social service ( a government requirement before obtaining a full medical license ), while looking forward to a plastic surgery residency . There were just 12 residency positions within the entire country of 45 million people . It became a second job to connect with plastic surgery attendings and prepare for the national board exam .
“ I was 23 when I finished medical school , and patients always thought we were too young to be doctors . That was an interesting dynamic , and I learned quickly that I had to convey confidence to them . I ran my own primary care clinic and had several weekly shifts covering urgent care and the emergency room . In the afternoons and weekends , I ’ d go assist plastic surgery attendings in their surgeries and study for the test .”’
All that he ’ d done to that moment didn ’ t prepare Dr . Ajkay for the merciless residency course he ’ d soon begin . Once again , he rotated within three hospitals , but this time a military hospital was included . It would challenge his capabilities immensely .
“ At that time , Colombia had been in a civil war for many years . I remember lying in the call room in the middle of the night and watching the helicopters come one after another full of wounded soldiers . I knew I ’ d be up all night because the if the patients made it out of the battlefield with a high velocity military bullet wound , they always required orthopedics and plastic surgery care . And the next day would include regular academic and surgical work . It was brutal ,” he said .
When asked how he survived the regimen of long nights and sleepless study , Dr . Ajkay ’ s answer was simple . “ Fear . You were in fear of not doing your job correctly and being dismissed . Each year there were just four residents accepted , out of a pool of two or three thousand plastic surgery candidates . The motivation was ‘ We could always fire you and bring in someone else who is dying to be in your position .’ I didn ’ t need caffeine or anything . It was the mere desire to finish the program .”
Dr . Ajkay did it . He finished his residency in 1999 with body and soul intact . During his training , his mentor , a craniofacial plastic surgeon , encouraged him to pursue a craniofacial fellowship in the United States , specifically under Dr . Bill Magee in Norfolk , Virginia . Dr . Magee is the co-founder of Operation Smile , the non-profit organization providing surgical care to children born with a cleft lip or cleft palate worldwide . Now here ’ s where things became complicated .
To go to Virginia , Dr . Ajkay was required to take the US Medical Licensing Exam ( USMLE ). So , he had to study for the test and still work to provide for himself on the side . As he was trying to figure out how to proceed with his career , the chief of plastic surgery from the National Cancer Institute called , offering a one year fellowship in breast reconstructive surgery .
“ I thought it would be a waste of time ,” Dr . Ajkay remembered . “ But it was a decent salary and I could study in the evenings . I agreed to take the fellowship and started in July of 1999 very skeptical . It turned out , I loved taking care of breast cancer patients . It was so fortuitous that I said yes because my initial inclination was to say no .” He developed close relationships with the cancer patients at the Cancer Institute , who were often downtrodden by their lot in life . He found the science behind breast cancer and reconstruction absolutely fascinating . “ I operated a lot , I learned a lot , and I worked with very thankful people . Also , I was able to take the USMLE and pass .”
After 30 years in South America and over a decade of medical knowledge earned , Dr . Ajkay packed his bags and flew to Virginia to begin the next chapter of his life . Not only was he embracing a career that he couldn ’ t predict , but he was leaving behind a very dangerous situation in the country he ’ d called home .
“ The political situation in Colombia had gotten very bad . I trained in the 1990s during the rise of Pablo Escobar . I remember during medical school , he bombed a plane hoping to kill a presidential candidate . The Security Service Agency headquarters ( the FBI counterpart in Colombia ) was bombed by Escobar , and we had to take care of the victims . There were kidnappings . It was a difficult time .”
Dr . Ajkay ’ s family wasn ’ t immune from the rising violence . A distant relative was murdered leaving his mother ’ s farm by thieves who simply wanted to steal his car . “ They shot him to death for a
30 LOUISVILLE MEDICINE
DR. WHO (continued from page 29) were so many women coming to have babies delivered that a one patient room regularly had three. “It was not uncommon to deliv- er babies on the floor. The labors were taking place all night, non- stop”. The only four operating rooms in the hospital functioned at capacity 24/7, performing C-sections, abdominal explorations for the nonstop stab wounds, or broken bone surgeries, with interns always involved. “It was stressful, but a great experience.” After the rotations ended, Dr. Ajkay completed his year of so- cial service (a government requirement before obtaining a full medical license), while looking forward to a plastic surgery res- idency. There were just 12 residency positions within the entire country of 45 million people. It became a second job to connect with plastic surgery attendings and prepare for the national board exam. “I was 23 when I finished medical school, and patients always thought we were too young to be doctors. That was an interesting dynamic, and I learned quickly that I had to convey confidence to them. I ran my own primary care clinic and had several weekly shifts covering urgent care and the emergency room. In the af- ternoons and weekends, I’d go assist plastic surgery attendings in their surgeries and study for the test.”’ All that he’d done to that moment didn’t prepare Dr. Ajkay for the merciless residency course he’d soon begin. Once again, he ro- tated within three hospitals, but this time a military hospital was included. It would challenge his capabilities immensely. “At that time, Colombia had been in a civil war for many years. I remember lying in the call room in the middle of the night and watching the helicopters come one after another full of wounded soldiers. I knew I’d be up all night because the if the patients made it out of the battlefield with a high velocity military bullet wound, they always required orthopedics and plastic surgery care. And the next day would include regular academic and surgical work. It was brutal,” he said. When asked how he survived the regimen of long nights and sleepless study, Dr. Ajkay’s answer was simple. “Fear. You were in fear of not doing your job correctly and being dismissed. Each 30 LOUISVILLE MEDICINE year there were just four residents accepted, out of a pool of two or three thousand plastic surgery candidates. The motivation was ‘We could always fire you and bring in someone else who is dy- ing to be in your position.’ I didn’t need caffeine or anything. It was the mere desire to finish the pro- gram.” Dr. Ajkay did it. He finished his residency in 1999 with body and soul intact. During his train- ing, his mentor, a craniofacial plastic surgeon, encouraged him to pursue a craniofacial fellow- ship in the United States, specifi- cally under Dr. Bill Magee in Nor- folk, Virginia. Dr. Magee is the co-founder of Operation Smile, the non-profit organization providing surgical care to children born with a cleft lip or cleft palate worldwide. Now here’s where things became complicated. To go to Virginia, Dr. Ajkay was required to take the US Medi- cal Licensing Exam (USMLE). So, he had to study for the test and still work to provide for himself on the side. As he was trying to figure out how to proceed with his career, the chief of plastic sur- gery from the National Cancer Institute called, offering a one year fellowship in breast reconstructive surgery. “I thought it would be a waste of time,” Dr. Ajkay remembered. “But it was a decent salary and I could study in the evenings. I agreed to take the fellowship and started in July of 1999 very skep- tical. It turned out, I loved taking care of breast cancer patients. It was so fortuitous that I said yes because my initial inclination was to say no.” He developed close relationships with the cancer patients at the Cancer Institute, who were often downtrodden by their lot in life. He found the science behind breast cancer and reconstruction absolutely fascinating. “I operated a lot, I learned a lot, and I worked with very thankful pe ͼ$݅́Ѽ)хѡUM51̻t)ѕȀ啅́MѠɥٕȁ)ݱɹȸ́́܁ѼYɝ)ѼѡЁѕȁ́9Ё݅́Ʌ)ɕȁѡЁձeЁɕаЁ݅́٥ٕ)ɽ́ͥՅѥѡչ䁡e+qQѥͥՅѥ ѕٕ䁉$)Ʌѡ́ɥѡɥ͔A͍ȸ$ɕ)ɥ͍Ѽɕͤ)ѥєQMɥM٥䁡Յѕ̀ѡ) $չѕЁ ͍݅́Ȱݔ)Ѽхɔѡ٥ѥ̸Qɔݕɔ̸%Ё݅́)ձЁѥt)ȸé݅ͻeЁչɽѡɥͥ٥)хЁɕѥٔ݅́ɑɕ٥́ѡˊéɴѡٕ)ݡͥ݅ѕѼѕ́ȸqQ͡ЁѼѠȁ