Insight into the Life of a Vascular Surgeon

JYI Interviewer: Sai Mannam

Dr. Ravi Rajani is an Associate Professor of Surgery in the Division of Vascular Surgery at Emory University School of Medicine in Atlanta, Georgia. He is certified in General Surgery, Surgical Critical Care, and Vascular Surgery. Some of his clinical interests include vascular trauma, carotid artery disease, and lower extremity limb salvage. Having served as the principal investigator for multiple trauma-specific clinical trials, Dr. Rajani’s research interests include incorporation of endovascular techniques for the management of vascular trauma. Dr. Rajani is also a celebrated member of the editorial board for multiple Journals of Vascular Surgery, including the Journal of Vascular Surgery, the Annals of Vascular Medicine and Research, and the Annals of Vascular Surgery.

JYI: What made you want to pursue a career in medicine?

I was surrounded by doctors growing up. Many members of my family were physicians, and it transitioned from one generation to the next. There were certainly parts of it which attracted me, most importantly the ability to enact change on an individual basis. It is intellectually challenging and stimulating work, and it is never boring. No matter how much training and schooling you have, every day there is something you might not have seen before, and that remains true throughout your career. This leads to a lot of job satisfaction because you aren’t doing the same thing over and over again.  

JYI: What are the most interesting types of cases you deal with in your profession?

A vascular surgeon takes care of all of the veins and arteries inside a person’s body, aside from those specifically in the heart or in the brain. We prescribe medical therapies such as drugs to help manage cholesterol levels. We do operations, which involve cutting people open, and these are some of the biggest operations done to human beings. We also perform endovascular procedures where we go through the groin using needle punctures and do major interventions from inside in a minimally invasive way. My favorite procedures are those that incorporate all of those things. My favorite is a combination procedure where we re-route the blood flow to the head and neck by doing a complicated bypass immediately above the clavicle. We then go through the groin to deploy what is called a stent graft inside the aorta. This is done to treat a thoracic aortic aneurysm. It brings together the surgical skill set in doing a technically rigorous operation and the endovascular skill set in applying advanced technologies to offer patients a quicker route to recovery. Vascular surgery is an incredibly diverse field. It is not uncommon for vascular surgeons to do an operation on the neck, then an operation on the arm, then an operation on the leg, then one on the belly. 

JYI: What is a typical day at work like for you?

I usually get up around 6 a.m. and am at the hospital by 7 a.m. I then get everything set for the day. My days are divided very clearly: two days in the operating room (OR) and the rest outside of the OR. If I am in the OR, usually work starts at 7:30 a.m., and depending on how many cases there are, I am in there until around 5:00 p.m. In between cases, I will see patients on the floor and take care of other things. If it is a non-OR day, then I have clinic. Research is interspersed throughout that; usually, research happens on nights and weekends. Patient care is usually the highest priority in terms of time. Every once in a while, I get research done during the day, as I have some time and support set aside to get research done. There is also a large teaching component to what all of us practicing in academic medicine do: mentoring residents, giving lectures, or presenting at national meetings are other endeavors that I am a part of. 

JYI: What is the most enjoyable part of your job?

The people that I get to interact with every day are by far the best part of my job. This includes the patients that I take care of, but beyond that even the other individuals who are here at Grady taking care of patients, who are all incredibly interesting to talk to. They all have diverse life experiences that led them to this point. Working with people from a variety of different backgrounds ensures nothing is ever dull. I always learn something new and interesting. Everyone has an interesting set of hobbies, and everyone has an interesting family story. 

JYI: What is the most difficult part of your job?

An answer that a lot of physicians would give is some of the bureaucratic red tape that goes into taking care of patients. Quite honestly, I think that is a little overblown. That concept has always been there, and for the most part, we are all allowed to take care of patients. I work in a relatively resource-poor environment, but even the most financially advantaged hospitals have limitations in what they can offer to a single patient, whether that be because of insurance or because of a lack of resources. The most frustrating part is when there is a patient that we want to offer something to, but we cannot get them to the therapy we think that they need.

JYI: What was the hardest part of getting to the position you are in today?

You will have to make personal sacrifices any time that you are pursuing advanced training. You have to think about how your family fits into your career and deciding when would be a good time to start a family and when would be a good time to get married. Those things happen when they do, but it is foolish not to try to incorporate your career into those decisions. The schooling is rigorous and it is a full-time job. Those sorts of sacrifices where you can’t do everything that you would like to do from a family perspective without rearranging your schedule are certainly the hardest part. Not everything has to be sacrificed, however. My wife is also a physician, and we have an incredible balance with our work and life. 

JYI: Who is your inspiration for working in this field?

A lot of people, not just one, have inspired my work. Both my parents were physicians; my dad is also a vascular surgeon. My parents’ dedication and ability to balance difficult work and home life are examples to show that it can be done and that you can have a fruitful career and family life as a physician.

JYI: What are your hobbies outside of work?

Right now, it is playing with our two daughters. Outside of that, I am a big football fan, and I watch college and professional sports on most weekends when I get the opportunity to do so. My wife and I like good food, whether it be cooking at home or going out to eat, and we love to travel. 

JYI: What do you see yourself doing academically in the coming years?

I am certainly in the middle of my career, and so I am always looking for the next big challenge. We have grown the Vascular Surgery program at Grady over the last seven years with multiple faculty and mid-level providers. We are continuing to expand that, but I don’t know exactly what the future will hold in terms of the next challenges and the next steps. Much of what we do focuses on the education of our residents, medical students, and other trainees and integrating them into the Grady environment and ensuring that their experiences are as fruitful as possible.

JYI: What advice would you give to students about their college career?

Balance is key. It is very easy to become unbalanced one way or another, whether that be by spending too much time studying and not enough time growing or vice versa. There is no precise formula for the proper balance; it is individualized to each person. I think that it is important even if you are a workaholic in the library all the time to ensure you are getting out of college all the other stuff as well in terms of personal growth, development, maturity, as well as having fun.

JYI: If  you could do it all over again, would you do medicine?

Absolutely! People sometimes ask me this question about my daughters: Would you let your daughters go into medicine? Of course, if that is what they wanted to do. It all comes down to a calling, and some people stumble upon it later in life, but it is a calling nonetheless. There is no other option if that is what you’re meant to do. The things that people complain about from the current state of American medicine are not reasons to prevent it as a career.