Dr. Xiya Ma

PGY-2 Plastic Surgery – University of Montreal

ResidentPlastic Surgery University of Montreal

January 2023

About Me

My name is Xiya, and I am a PGY-2 in Plastic Surgery at Université de Montréal in Montreal, Quebec. I am of Manchu Chinese descent: my family immigrated to Canada when I was about five years old, and I have since grown up in Montréal.

After high school, I took part in the Quebec Collège d’enseignement général et professionnel (CEGEP) track, where I completed a two year program in Arts and Science at Marianopolis College and entered medical school at Université de Montréal upon graduation.

I then embarked on the MD-MSc program, wherein I worked for two years between preclinical years and clerkship to complete a Master in Experimental Medicine researching peripheral nerve regeneration, and a microprogram in health sciences education.

Why I chose Plastic Surgery

Plastic Surgery (sometimes referred to as Plastic and Reconstructive Surgery) is a true definition of art and science; it is restoring form and function anywhere in the human body.

Subspecialties are incredibly diverse, ranging from occupational-related hand disease, life-threatening burns, to post-traumatic facial deformities.

Plastic Surgery is based on creativity: we custom-design every single one of our surgeries based on the patient’s unique needs and anatomy. Our discipline is at the forefront of many innovations, from the first renal transplant by Dr. Joseph Murray to the more recent milestones in face and upper limb transplants.

The impact on a patient’s quality of life is significant, this makes our specialty an incredibly rewarding career with a variety of ways to practice our craft. As someone with an extensive background in art, passion for surgery, and the drive to help my community, Plastic Surgery was the best fit for me.

Clinical Life

What kinds of rotations are required in your program?

While programs differ in their exact content, all Canadian Plastic Surgery programs offer excellent training, starting with one – two years of surgical foundations. They involve both on-service and off-service rotations in other surgical specialties, such as Orthopedic Surgery, Otolaryngology (ENT), and General Surgery. We are also fortunate to have a surgical and anatomy bootcamp to master the basics and practice flaps.

Once we graduate from surgical foundations, we are fully immersed in Plastic Surgery rotating among different hospitals and clinics based on subspecialties (hand and wrist, craniofacial, microsurgery/reconstruction, breast, pediatric, burns, aesthetic/gender affirming).

In our senior years, we have a few elective rotations allowing us to focus on our interests or practice aspirations. Our program requires a minimum of one research project per year, although residents interested in an academic profile can do more or participate in the clinician-scientist program.

Which of your personality characteristics are particularly helpful in your field?

I believe my work ethic, resilience, and overall enthusiasm for Plastic Surgery have been helpful in my journey thus far and are traits that all my co-residents share. Plastic Surgery is a field which constantly challenges your creativity and adaptation skills, so adopting a growth mindset and humility are great assets given the challenges along the way.

Being an observant learner has also helped me be a proactive assistant in the operating room and I also have a keen eye for detail, which is crucial in our field. Finally, I love teamwork, and since Plastic Surgery often involves collaborating with other surgical specialties and health professionals, my academic experiences thus far have been very rewarding and fun.

What are the best aspects of your residency?

Our program offers extensive exposure to all subspecialties in Plastic Surgery: we are especially fortunate to host a unique provincial replantation expertise centre (Centre d’expertise pour les victimes d’amputation nécessitant une revascularisation en urgence (CEVARMU)) at the Centre Hospitalier de l’Université de Montréal (CHUM).

This is one of the largest Pediatric Plastic Surgery services in Canada (Centre hospitalier universitaire (CHU) Sainte-Justine) and a world-renowned centre for gender affirming surgery (Centre métropolitain de chirurgie). We serve a socioeconomically and culturally diverse population who present with a variety of medical conditions, encouraging us every day to think out-of-the-box and grow to deliver culturally-respectful and safe care to our community.

Our program is very supportive of our career aspirations and goes above and beyond to help us work towards our professional goals. The people are also what makes our residency program special: my co-residents and faculty have grown to become my second family.

What are the most challenging aspects of your current role?

As with most surgical residencies, our days start earlier and often end later than many non-surgical specialties. Our work can be physically demanding in the operating room and learning proper ergonomics early on is a must. As a smaller and sometimes misunderstood surgical specialty (it goes far beyond cosmetics!), learning to prioritize different tasks and advocating for our patients’ interests for operative time can be a challenge.

While the diversity of pathologies encountered in Plastic Surgery is fascinating, mastering the anatomy of the human body from head to toe and the manipulation of different types of tissues takes consistent work. Like they say: residency is a marathon, not a sprint. Learning to set your priorities and build sustainable habits for your personal and academic progress is very important.

What is one question you’re often asked about your decision to pursue a non-clinical career?

Students are often worried about the competitiveness of landing a spot in Plastic Surgery: they question whether they have the credentials or what they should do to be selected in a Plastic Surgery program.

While Plastic Surgery is one of the most competitive specialties in Canada, I encourage students to think about it the other way around, while the positions are few, why can’t one of these spots be for you? There is no magic checklist that will guarantee your success, but if you have confidence in your skills and potential, express your genuine interest in and understanding of the specialty, show your dedication to work hard and learning, you will certainly be on the right path.

Can you describe the transition from clerkship to residency?

You can expect to be on your feet throughout the first months of residency. After all, residency will be a constant adaptation to different work environments, faculty, and different expectations and responsibilities. That is especially true for many Plastic Surgery programs, where we rotate through several off-services teams to better learn and understand what our frequent collaborators do in their fields.

It took me nearly half a year to establish a sustainable routine that optimizes my professional and personal life. This new level of responsibility residents carry can seem intimidating at first, but even the most difficult times will turn out to be insightful experiences if we stay open to learn from them.

What are your future practice plans?

After residency, I aspire to subspecialize and practice in Canada as an academic surgeon to combine my excitement for complex cases, passion for research, and enthusiasm for mentorship.

I strive to continue sharing my love for Plastic Surgery and encourage the next generation – especially those from underrepresented and marginalized groups – to pursue this incredible field.

I also hope to maintain my involvement in global surgery by pursuing my advocacy and research work with non-governmental organizations and participate in sustainable international partnerships to improve access to reconstructive care for people who need it the most, both locally and beyond.

What are your fellow residents like, how do you interact with each other?

I am incredibly lucky to grow in a supportive culture created by my co-residents; we celebrate our successes together, lean on each other during difficult times, and advise each other on all things work and life. We regularly share jokes in our group chats and organize outings to catch up. As we are often at least one junior and one senior resident per site, we frequently have opportunities to give or receive teaching from each other, which is a great complement on top of the educational activities held by the program.

Non-Clinical Life

What are your academic interests?

While I am still exploring different Plastic Surgery specialties, I have been involved in several research projects spanning hand, microsurgery, and peripheral nerve. Global surgery is one of my long-time passions, and I am grateful to be working with Operation Smile in their surgical system strengthening initiatives in low- and middle-income countries.

I co-run our program’s social media platforms and help our program during CaRMS season. Finally, I work with our local resident wellness team, as I care about helping my fellow colleagues thriving through surgical residency, which is known to be particularly challenging.

In terms of research I have mostly focused on COVID research and a quality improvement study on time to patient discharge.

What is your work-life balance like, and how do you achieve this?

Work-life balance looks different for everyone, and it needs regular reflection and adjustments throughout residency. Outside of academics, I love to run (currently training for my first Spartan Trail Race), rock climb, and do hot yoga. One of my longest passions is visual arts, especially painting and creating on any surface I feel inspired to transform. I try to visit my parents at least once a week and spend quality time with my partner whenever possible.

I strive to incorporate a slice of my interests/hobbies even on the busiest of days, although we must accept sometimes we cannot do everything at once. I believe it is important to be kind to ourselves. The sooner we understand that stumbles and mistakes are crucial to personal and professional growth, the more we can enjoy the journey of residency!

Impact of COVID-19

RDoC recognizes the ongoing impact COVID-19 has had on residency. We wish to raise awareness of its effects on residents’ day-to-day lives.

How has COVID-19 impacted your required rotations (clinical, research)?

The COVID-19 pandemic has been difficult for the field of Plastic Surgery, as many of our activities were deemed non-urgent, which resulted in a sharp decrease in surgeries and clinical activities. Fortunately, I have not been as affected by COVID-19 as residents above me when I started residency in 2021.

My required rotations happened as scheduled, although residents working in 2020 were less exposed to Plastic Surgery cases and occasionally required to help on COVID-19 wards. The pandemic turned most of our educational activities virtual, which decreased engagement and social connection. Research productivity had temporarily slowed down, but as with clinical work, it has mostly recovered now compared to the beginning of the pandemic.

Due to COVID-19, what are the biggest changes you’ve experienced compared to previous years in clerkship and/or residency?

I have only known residency during the pandemic. Even as regulations soften, several of our teaching activities remain virtual as a legacy of social distancing, which comes with its perks and disadvantages. Our hours and case levels have mostly recovered to pre-pandemic levels, but COVID-19 testing patients remains the norm and can jeopardize whether the surgery will occur.

More appointments are now being held by phone, which turns out to be more convenient for many patients who need to travel far to visit our clinics. Clerkship rotations and observerships in Plastic Surgery were limited to students from our own institution, although we hope to be able to extend opportunities to others in the coming months.

How has COVID-19 impacted your work-life balance?

The pandemic made meeting friends and extended family more difficult over concerns of transmitting COVID-19, which encouraged me to focus on more personal activities and hobbies. It turned out to be a great opportunity to reflect on my journey thus far and my priorities in life and work, which helped me better focus my efforts on what matters most to me. During my first year of residency, several of our social activities were cancelled last minute by new government restrictions, but we are catching up now! I am also grateful for the return of travelling to visit extended family and continue exploring the world.

Disclaimer: These specialty profiles illustrate some aspects of the lives of individual residents/physicians, and convey their personal perspectives on the challenges, opportunities, and rewards of their chosen fields. These views may not be shared by all residents, as there is tremendous diversity in lifestyle, experience, and interest among the residents in each specialty.