Dr. John Trangucci '16: Plastic surgery fellow at Temple University

UMHS 2016 grad Dr. John Trangucci never planned to become a doctor or a plastic surgeon. The New Rochelle, NY native wanted to be a pro baseball player. When he entered college on a scholarship for a NCAA Division II school, he realized he was “good but not great” as an athlete and decided to forfeit his athletic scholarship and instead obtained an academic scholarship to study pre-med courses. After completing his undergrad, he chose UMHS because he had been put on waiting lists for US schools and, after extensive research and meeting the admissions director, he liked the small class sizes and the personalized attention from professors and staff. When he was accepted to UMHS, he was thrilled.

“I always tell people UMHS is the one that gave me the shot to achieve my dream,” he said.

“At UMHS, classes were smaller in size, the education seemed to be more individualized. I didn't want to be just a number. There was also the reason why I didn't go to a bigger university for undergrad. I know St. George's has classes of 500, Ross University is very similar. I did not want that. I don't do well in that environment. And so, for me, UMHS essentially was a replica of my undergrad and that's what I was used to, that's what I enjoy, and that's what I thrive in as a student. So that's also one of the other reasons why I chose it.”

The UMHS Endeavour spoke to Dr. Trangucci about why he decided to become a doctor, why he chose UMHS over other Caribbean medical schools, his general surgery residency at UPMC Harrisburg Hospital in Harrisburg, PA, how he obtained a PGY-6 plastic surgery fellowship at Temple University in the Department of Surgery, Division of Plastic & Reconstructive Surgery in Philadelphia, how he became interested in plastic surgery and all the latest breakthroughs in this highly specialized and competitive area of media and more.

From baseball to med school

UMHS Endeavour: You grew up in New Rochelle, NY. Did you always want to become a doctor?

Dr. John Trangucci: I come from a family of no physicians, no lawyers. And initially my goal was to be a pro baseball player. I wanted to play center field for the New York Mets; that was my goal. I played throughout my childhood. Baseball was what I slept, ate, and breathed.”

How did you go from wanting to be a pro baseball player to considering a career in medicine?

After having realized that I was not going to get drafted to the MLB in high school, I started to pursue other options, and I wanted to play baseball because I wanted to continue to give myself the chance of pursuing major league baseball. So, a couple of colleges had looked at me and they said, “Well, why don't you come play for us in college?” And I got an offer from Concordia College in Bronxville, NY. It is a Division II baseball school, actually a pretty good baseball school. They produced several Major Leaguers, including Scott Lieus, who played for the Minnesota Twins and won the World Series with them. Mike Aviles who got drafted several years ago, played for the Boston Red Sox and was almost Rookie of the Year. So having once accepted my admissions there, I had to major in something I've always been interested in athletics, and the human body, and anatomy and physiology, so I decided to major in biology.

You were so into baseball that you wound up getting an athletic scholarship for college, right?

I played for my high school and ultimately got a scholarship to play for a Division II school in college. And shortly after starting college, I realized that I was good, but I wasn't great. And I wanted to pursue a career in medicine, and I forfeited my athletic scholarship and ultimately obtained an academic scholarship and began focusing my attention on pursuing my dream about becoming a physician.

On my street, two houses down are parents whose son is a general surgeon. And I had picked [his] brain one day just about the field of medicine and what he thought about it. And he said that he would never have chosen another occupation. He recommended that I work at Montefiore New Rochelle Hospital. Actually, we have it as one of our rotations for general surgery. I live right up the block. And he recommended that I worked there after the summers of my freshman and sophomore year in college, and I did that. The first summer I was in the ER, the second summer I was in the OR, and I would just transport patients, and I would clean their rooms, and I got to observe some surgeries. And I said to myself, “This is what it is. I love it. This is what I want to do, I belong here, the environment fits me.” And then I decided at that point that this is the occupation for me. And then I put all my attention and focus into a career in medicine.

You worked hard studying as an undergrad in order to have all the requirements, prerequisites and grades needed to apply to medical schools. You originally applied to several American medical schools and were either denied or put on waiting lists. So why did you consider applying to UMHS?

I always tell people UMHS is the one that gave me the shot to achieve my dream. I didn't know if my dream was going to come true—I didn't know if I was ever going to get an acceptance at [an] American med school. I was looking at doing some of those master’s degree programs, but then I was looking into some of the Caribbean medical schools and UMHS was very similar to my undergraduate school. Small classes, kind of personalized education, and the admissions director at the time who I met was incredible. And I said to myself, ‘This is where I want to be. These are the people that I feel would help me achieve my dream and seem like they would cultivate a good learning environment’ And that's why I chose UMHS, and they have been the ones who have allowed me to achieve my dream. And I'll never forget that. UMHS is an institution that will always have a special place in my heart.”

Why plastic surgery?

So how did you get into plastic surgery? What made you become interested in plastic surgery?

I've always been into surgery. Surgery was something that I've always had an interest in. And in the summers of my freshman and sophomore year of college, I actually had the opportunity to work in the operating room at the hospital in my hometown, New Rochelle. And I got to observe several surgeries. I saw a cystectomy, I saw a total body lift, and I just fell in love with surgery there. As I was going through medical school, I got to scrub in on a couple of plastic surgeries, including like an orbital floor blowout repair, a tummy tuck. And I said, wow. I mean, this is pretty interesting. In one respect, you're helping people look better when you perform a cosmetic surgery, in other aspects, you're actually performing reconstructive surgery, following trauma. And you're working from head to toe. You work on all parts of the body, every aspect, there's no limitation.

It's not like you're only working on the chest or the abdomen. You could work on any part of the body that needs to be repaired. You also get to operate and work with adults and children, which is unique compared to other types of surgery. And then honestly too, having had a cosmetic procedure myself, having had a hair transplant about six years ago, that also made me see the effect that it has on patients. And I said, well, who else could be a better advocate than somebody like myself who's had one of these procedures before, and has seen what it can do for your confidence? And that's what pushed me to pursue plastic surgery.

So, you actually had experience with plastic surgery having a hair transplant and it's a confidence builder. And I think that's so important because a lot of people just think of plastic surgery as something for vain people.

Exactly, and it's not.

There's reconstructive surgery after cancer or an accident. What are some of the things that excite you the most about the field of plastic surgery?

I think that it's always on the leading front of advancing technology and the fact that they're always trying to push the limits. Right now, one of the new big fields within plastic surgery is gender-reassignment surgery. That's a newer field within medicine, and Temple University actually is doing a lot of that right now, so I'll be able to have some experience with that and again, being able to help change people's lives and make them feel whole. People always say, “oh, plastic surgery” is like you said, “it's for those who are vain and they just want bigger lips or they just want that change,” but that's not necessarily the case. Cosmetic surgery for those particular patients is a very, very small percentage patients wanting cosmetic surgery.

With gender-reassignment surgery, with patients who have breast cancer, and who have had their breast removed have a mastectomy and had breast reconstruction, that's [also] plastic surgery. Craniofacial surgery, like cleft lips and cleft palates is also done by plastic surgeons, craniofacial trauma. So, like I said, people that have had special accidents, injuries to their orbit, fractures to their orbit, plastic surgery deals with nasal fractures. So, it's very broad and as you get an idea from, you work on every aspect of the body. And that really, really attracts me to the field. Personally, I think it's the best feel out there and I will glad to go into it.

Is there anything else that you'd like to say about plastic surgery?

I think to all the prospective students, you might hear that it's out of your reach. You might hear that it's impossible to get into, especially coming from the Caribbean, but I want to tell you guys that it is possible and never forego your dream. If this is what you want to do, you work at it as if it's the air that you need to breathe. Don't give up—always try to network, work your hardest, make connections, and don't listen to all the naysayers because I will tell you, if you tell people that you want to do plastic surgery, you're going to hear it from a lot of them.”

Plastic Surgery Fellowship at Temple University

What about UMHS helped you achieve your goals and helped you get where you are today— about to start a fellowship in plastic surgery at Temple University?

First and foremost, I always tell people UMHS is the school that gave me my shot. When I was in college and I was applying to medical school, I applied to American med schools and some I got rejected from immediately, some I was put on the waitlist before. And at the time, I didn't know if my dream of becoming a physician, a plastic surgeon was going to come true. And I was considering doing some of the master's programs that are out there and available. But then I started looking at the option of going to the Caribbean for med school. And UMHS had actually come to my undergrad school for a career fair. And two of my friends had met the admissions director at the time. And they said, “John, you have to meet this guy. He's great. He's an excellent guy”. So, I gave him a phone call and was telling me about the school. And as he was explaining to me how the school was set up, and how it's designed, it reminded me a lot of my undergrad. Smaller classes, personalized education. And I said to myself, this is where I want to be. So first and foremost, how did UMHS achieve my goal? They gave me my shot. They gave me my shot to achieve my dreams, to achieve my MD and I will forever be grateful for that. Going forward, once I started at UMHS, the teachers on the island were phenomenal. I don't think that you'll find better basic science education and any other med school than UMHS. The foundation that is laid for you by these professors is second to none. I think if you have a great basic science foundation, you're going to excel through med school and you're going to be a fantastic doctor.

And, of course, you're going to do well on your USMLE, which of course is needed to get into a competitive residency. No doubt about that. So, I think that UMHS offers you an incredible opportunity to become the position that you want to be and get into whatever specialty you so choose. And people will tell you that there are certain specialties that are too competitive to get into out of the Caribbean. Typically, those tend to be more surgical-based, but dermatology would fall into that too, and I think that that is not true. One of my classmates actually, Kareem, I think has matched into ophthalmology. There is another graduate, I think, who is actually currently in plastic surgery fellowship as well. I think he was a semester or two ahead of me. So many of us have gone into general surgery, so it can be done.

And again, I'm very much about positive vibes and always focusing on your dream and never giving up on that. And I want all the prospective students to know, and all the students who are actually applying to residency, if you are looking at going into something competitive, don't give up, work hard. You create your opportunity. So, you network, do as good as you can on your exams, get involved with research, and don't let anybody tell you that it can't be done because it absolutely can. And many of us here are a result of that and are proof that you can certainly achieve your dream.

Positive experiences at UMHS

Were there any professors or staff members, both in St. Kitts or Maine that you recall were especially helpful or inspiring to you?

There are so many. When I was on the island for the first semester, in my anatomy class, Dr. Feras Yamin— he was one of the anatomy instructors, who's actually, he just finished his plastic surgery fellowship. He trained with the Long Island plastic surgery group. He's actually out in Beverly Hills right now. He's amazing. I became very close to him because I knew I wanted do plastic surgery and so did he, so we developed a good bond. But I looked at him as a mentor. Dr. Mungli was and is amazing. And is amazing. I mean, everybody loved him.

He made biochemistry a class that maybe is not the most exciting to learn enjoyable and fun. Incredible teacher. Pathology professor Dr. Anoop Kumar Jalan—I mean, I don't think there is a more gifted teacher than Dr. Jalan. His theatrics and the way he lectures and his tones that he uses really makes the information stick with you. And he makes pathology fun. And pathology is one of the most important subjects. So, I think with regards to the actual island, I would say those individuals were probably the three that really had the biggest impact on my education. But I think everybody was great there. I mean, I really cannot say that there is a bad professor in the mix. But yeah, the education there is great. I mean, you really get a solid foundation of basic sciences laid down for you, and with a solid foundation in that, you carry that over to your clinical rotations. You'll do well on your steps and you're going to be a phenomenal resident and ultimately a great attending. So, it's very important that you have that.

Were you involved with any clubs when you were in St. Kitts?

When I was on the island, I studied all the time. So, any events that they might have had, I might have missed. My focus was just to do really well to get into surgery. I always tell people, I think I went to the beach one time in my year and a half that I was down on the island of St. Kitts. My focus was just to do as well as I can on the USMLE to achieve my dream.

Goals for plastic surgery fellowship

Let’s talk a little bit about your specialty that you're going into. What are some of your goals for your upcoming fellowship in plastic surgery?

So as of right now, I'm unsure in terms of what exactly I want to specialize in with the plastic surgery. So right now, I would say it's more or less a broad general plastic surgery practice is what I'm aiming for. Do some cosmetics, do some reconstruction. So, my goal is to just become as well rounded, and as knowledgeable within the field plastic surgery as I possibly can be. I want to make sure that I give my patients the best care and the best outcomes as possible. I just want to learn and dive into, and get as many cases under my belt as possible. Now certain things you have to further specialize in if you have a desire to do. For example, hand surgery. You typically have to do a fellowship after plastic surgery to do hand surgery.

What are some areas of plastic surgery that really interest you?

There's a fellowship in microsurgery. So, if you want to do more microvascular related procedures like deep flaps and things like that, that also requires an extra fellowship. Craniofacial is another fellowship. So, cleft lips, cleft palates, things like that. That's another fellowship beyond plastic surgery. And even gender-reassignment surgery—typically that falls into another fellowship thereafter, so extra training. I'm not really sure exactly what I want to do yet. As of right now it's more general. So just kind of going in, figuring out what I like and just trying to gain as much knowledge as I can within the field.

It sounds like there's a lot of specialization depending on what time of plastic surgery that you want to go into. Is there anything off the top of your head that you think you are possibly leaning toward?

I mean, I like cosmetics. Again, I think having had a cosmetic procedure in the past and having benefited from that directly and having seen what that has done for me and my confidence certainly has sparked an interest. So, I would definitely want to incorporate that somewhat in my practice. Not saying it would be a hundred percent of my practice, but definitely I want to be a part of it. So at least as of right now, just because of the exposure that I've had so far, that's something that I just certainly have interest in. But craniofacial, when I did do a rotation at Penn State Medical Center as a fourth-year general surgeon resident, and I did get to do a lot of craniofacial, that's what they're known for as a visiting resident and I loved it. Having to do ear reconstruction for kids born with microtia or small ears, malformed ears, having to operate on kids whose skulls fuse prematurely right out of the womb, it's called craniosynostosis, and taking all, taking the skull off the patient's head and remodeling it, and remolding it and putting it back on to give them a more natural look and to allow the brain to naturally and normally was really, really, really cool and one of the most amazing procedures I have ever taken part in. So cranial facial might be something too that I would be, I'll be interested in pursuing.

We spoke earlier about the misconceptions of plastic surgery. What do you think, I think one of the biggest misconceptions about plastic surgery that it's just for vain people—for people that want to have breast augmentation or nose jobs or whatever, what would you say to people that have that perception of plastic surgery?

I would say that's a very superficial and lack of knowledge on the field of plastic surgery, not to say that is certainly an aspect of it, yes. But if you truly look at the field, you will know that it is much more than that. It is much more, the patient that you're dealing with have a lot more behind their story. Breast cancer, facial trauma, transgenders who are looking to live a life where they feel whole, people that might have had their fingers cut off and need to be replanted. Plastic surgery does a lot more than just your basic bread and butter cosmetic procedures like breast augmentations and tummy tucks. I would encourage those people to kind of look at the field, read more about it, and just learn that plastic surgeons are some of the more talented surgeons in the field of medicine. They call plastic surgeons, the “surgeon's surgeon,” because oftentimes they're the ones who are called to help every other specialty within surgery, cover a wound, close a wound. If a neurosurgeon needs some help with a scalp closure, they call a plastic surgeon. If a colorectal surgeon needs help covering a wound after performing an abdominal per resection for a rectal cancer, they call the plastic surgeon. When a breast cancer is removed by a breast surgeon and the woman needs her breast reconstruction, they call a plastic surgeon. So again, plastic surgeons tend to work alongside every field to complete the goal of healing. It’s pretty amazing. And it's very exciting and I can't wait to start.

Contact Dr. John Trangucci via email at Johntrangucci@gmail.com

(Top photo)  John Trangucci, MD '16. Photo: Courtesy of Dr. Trangucci.

Video of UMHS Interview with Dr. John Trangucci '16