DR . WHO
DR . WHO
MEMBER SPOTLIGHT DR . TATHYANA FENSTERER
AUTHOR Kathryn Vance
In Brazil , students bypass college and go straight from high school
into professional education . This is highly unusual in the US , as is the 23 years she spent training to become a physician . But Dr . Tathyana Fensterer did both .
Dr . Fensterer grew up with a passion for drawing and designing and thought for years that she would pursue a career in architecture . However , her older sister went into medicine , becoming the first doctor in the family . As she saw her sister work through her medical education , becoming an OB-GYN , Dr . Fensterer realized that there was an intersection between her two passions . “ I thought to myself , well , plastic surgery is basically architecture in the human body .” The two sisters would eventually go on to practice medicine side by side and would often share cases and operate together .
While in medical school at Santa Casa de Sao Paulo , Dr . Fensterer had a much different experience from the typical American one . She was studying in the largest emergency room and hospital in Latin America and beginning with their very first year , students went straight to the wards alongside seasoned professionals .
“ Because it is a public hospital , it is free of charge to the patients , so they try to involve everyone as early as possible ,” she said . “ My medical school was very good at following the students and were very concerned with our development . But it was very hard in the beginning . I was immature and it was a major reality check for me .”
After finishing medical school in 2001 , Dr . Fensterer entered her first residency program in general surgery . Because of the public nature of hospitals in Brazil , residents have more independence than they would in the US . The most senior resident in the program assigns surgeries to other residents , often unsupervised by attendings . However , Dr . Fensterer noted that junior residents are never given an assignment they are unprepared for . This level of autonomy allowed residents to get closer to their patients and form
36 LOUISVILLE MEDICINE a better relationship .
“ I felt like we could follow our patients and be closer to them . I was his doctor , and he was my patient . Not my attending ’ s patient . It wasn ’ t like I was going to perform the surgery , and then never see them for a follow-up again .”
After her general surgery residency , she completed three more years in plastic surgery residency , and finished in 2007 . She was finally free to practice on her own , finished with training … for now , at least .
Before the end of her plastic surgery residency , she took a backpacking trip to Europe and while in the South of France , saw an American man having issues ordering his breakfast . “ I saw this good-looking American man trying to buy cheese . He couldn ’ t speak French and she couldn ’ t speak English , so I started helping him out . I really got the best souvenir ever from that trip .” The two stayed in touch and dated internationally over the next several years .
She then opened a private practice of her own in Brazil and experienced all of the financial , emotional and professional struggles that private practitioners know all too well in their start-up years . In addition , there is also a requirement in Brazil to practice in the public hospital setting , which she said actually worked to her advantage . “ You have your private office and you see patients that have insurance . But you also work in a government institution or university seeing patients that cannot afford insurance . It helps the patients , but it also helps position you as a good surgeon . The private practice patients want someone who sees cases at these big institutions . The patients feel like they have a better surgeon if they come from a large institution .”
Growing her credibility in the government hospitals was important , as she said you are not allowed any advertisements about a private practice in Brazil . You must earn your name and reputation based solely on your work and word of mouth . But working in the