It seems that I’ve spent my life being told to adjust who I am.

That my hair is too big and curly. That I say “please” and “thank you” or laugh too much. That I’m too small or too soft-spoken or too female to do my job.

I am a fourth-year plastic surgery resident. To reach this point, I completed four years of undergraduate pre-medical training during which I studied for a little test called the Medical College Admission Test (MCAT) and then underwent a grueling application process. This resulted in four years of medical school during which I studied for another little test called the United States Medical Licensing Exam (USMLE) and underwent another grueling application process for a plastic surgical residency spot. The tests and application processes, however, were trivial compared to what lay ahead.

It’s barely worth mentioning that surgical training is rigorous: it should be, as rigor is a minimal requirement if we are to train and earn the right to safely cut into people's bodies. We start our days prior to 0600 and put our needs behind those of our patients, our bosses, and our hospital systems, without a thought. A little over halfway through my training I am still working out what the culmination of this effort is, but ultimately being in charge of managing surgical problems will be a terrifying and beautiful privilege.

It is well-described that in this purgatory between medical school and full-fledged surgeonhood, residents experience an “imposter syndrome” wherein they question their place in the hospital. You feel like a fraud on the verge of being caught. Part of this is the process of training: confidence is not a personality trait but a phenomenon that is earned by experiencing an unfamiliar, challenging, or scary situation and learning how to manage it.

But there is a part of the imposter syndrome that is not rational. Multiply this arbitrary self-doubt for the surgeons who are by default referred to as “nurse” when they are seen in scrubs. Who have been called “babe” by their patients. Who are classified as catastrophically unprofessional if they shed a tear at work while their male counterparts can yell, stomp their feet, and otherwise express their anger in a number of ways that are considered traditional for a surgeon.

Of course, everyone has hobbies and interests outside of their job. One of mine that will never make it onto my CV happens to be makeup. I have found the glitter and colors therapeutic since I was about 10. I watch makeup tutorial videos, revel in a thoroughly excessive collection, and even had the honor of doing wedding makeup for one of my friends from undergrad.

It has been suggested to me that this particular hobby is at odds with my job. I have wiped the glitter off of my face or nails in hospital bathrooms to seem more conservative for my bosses. Again: adjust who you are. But as I have advanced in my surgical training I have worn plenty of glitter to the hospital because I have realized that something silly like makeup is simply not surgically important. So how does one wear glitter makeup to the operating room?

1. Realize that OR lighting is much more flat and bright than most; hence, glitter will appear less holographic and more one-dimensional. This is less forgiving for heavy-handedness, sloppiness, or errors in application. Brush some of the makeup off on the back of your hand before applying so that you have more control over how much makes it to your face. Apply even layers in symmetric shapes bilaterally.
2. Because your makeup has to last for the long hours that you spend at work, utilizing a primer can be very helpful. I use a translucent powder on my face and eyelids before applying the rest of my makeup.
3. You can frame your glitter however you like, but in my hands well-groomed eyebrows and a quality mascara are optimal.
4. Excellent glitter requires an excellent canvas: wash your face every night, drink plenty of water, and exercise as often as you can. Remember that twenty minutes of exercise or any other investment in yourself are better than no minutes at all.
5. Read for your cases after your 18-hour days and never lose sight of developing your surgical skill. Again: confidence is earned. What anyone says about your makeup carries much less weight if your are delivering an excellent product to your patients. Conversely, you can never wear glitter to the operating room with confidence if you are underprepared.

We are inundated with “Women in Surgery” panels advising us as to how to balance our career with our families while men for centuries have seen no problem achieving such an allegedly tenuous balance. We are offered salaries tens of thousands of dollars lower than our male counterparts for the possibility that we will shortchange our careers to procreate. I am grateful to the men in our specialty who have opened their minds to a new generation of surgeons and who treat us with fairness in their mentorship and teaching - but we cannot deny that issues continue to exist.

The truth is that there is no appearance, color, or gender that excludes one from being an excellent surgeon. Wage equality and the fair division of domestic tasks seem to be imminent, albeit far into the future. In the meantime, professional women everywhere cannot internalize the message that their personal characteristics render them unfit for their career. My proposition is that we are not just women in surgery, we are surgeons, and the path to becoming an excellent surgeon remains the same rigorous one that it always has been. Adhering to this path is what reassures me that I can do surgery while remaining exactly who I am - glitter included.

Ayesha Punjabi is a plastic surgery resident at University Hospitals-Cleveland Medical Center.

Illustration/GIF by April Brust