Sandy Feng has walked confidently through a number of diverse cultural worlds during her life -- Taiwan, the West Coast, the East Coast and England -- so it is not surprising that she was able to take the tough world of surgical training in stride.

"Surgical training was definitely a skin-thickening experience, but I don't take personally what other people say or do," says Feng, now a transplant surgeon at the UCSF Medical Center. "I knew it was male dominated and I was never going to be one of the boys. But that's just life. You have to push on."

Feng has been moving onward, pushing forward, most of her life. Born in Taiwan, Feng's family moved to Southern California when she was eight. Always interested in science, she started working in a lab at UCLA while still in high school, and then entered Harvard, studying chemistry and graduating in three years. Feng intended to go right to medical school, but a Marshall scholarship caused a swerve in that plan. Switching temporarily to what she calls "a non-professionally oriented track," the Marshall Scholar traveled to Cambridge University, where she earned a PhD, working in the laboratory that was founded by Watson and Crick.

"It was an exciting place with lots of exciting people," Feng recalls. "Five days after I arrived, my PhD supervisor won the Nobel prize." Feng found the pace of life and social behavior surprisingly different in England, though. "Students there might choose to spend the weekend at home by the fire, reading books and taking muddy walks with the dog, which would not be typical in the US."

Coming back to the states, she chose to attend Stanford Medical School and stayed an extra year to do postdoctoral research. For her residency, she returned to Boston to Brigham and Women's Hospital, which she preferred because it was not as "overtly hierarchical" as other programs. "In science if you have a good idea you have a legitimate voice, but in surgery that's not the tradition," Feng says. "There's a whole chain-of-command concept in surgery generally, but at Brigham and Women's they seemed to respect people as individuals even if you are a lowly first-year resident."

Finding her way

Feng also feels it is important for women to stay true to themselves and not simply become more like men. She liked the fact that one of the chief surgical residents at Brigham and Women's Hospital, another woman with MD and PhD degrees, looked like a model and did not hide her femininity in order to fit in. "That spoke to me, because it told me that here women don't have to be gruff and masculine to do their job," Feng says.

Her advice for female medical students now is to develop a strong individual identity and to have a thick skin. Most of all, they have to stand on their own competence, which in the end will earn them respect, she says.

It is also very important that students and trainees enjoy the process of training and not just view it as a means to an end. Feng points out that 19 years passed between the time she started college and when she got her first paying job, and she has enjoyed every part of it. "Your training takes too long not to enjoy it," she says.

As a UCSF transplant surgeon, Feng is actively involved in research that has the potential to revolutionize organ replacements. Like other scientists, she is interested in using pluripotent stem cells found in bone marrow to repair or even replace damaged organs in the body. In recent years, these stem cells have been shown to be part of the body's natural repair system, journeying out from the bone marrow and becoming new cells in the liver, brain or muscle. Feng wants to learn how these cells know where to go and what to become so that they can be cajoled into replacing damaged portions of a liver, for instance, obviating the need for a transplant.

Feng's research has shown an evolution, she says, from very basic research to research that has a more direct link with people and disease. "I was working on molecular structure stuff at Cambridge, then transitioning to understanding the control of HIV gene expression during medical school, then moving on to ways to prevent rejection of transplanted islets [insulin-producing cells] after surgical residency, to my current project," says Feng. "It's helpful to coordinate your clinical interests and your research interests -- it's much nicer to have some coherence in your life." Feng says that such coherence is made possible by the extraordinary support of her husband, a physician who has given up his clinical practice to help more with their three-year-old daughter. Although he continues to work in a high-powered environment as the medical director for a major insurer, Feng's spouse has a more predictable schedule. "It allows a modicum of sanity and routine to exist in our household." Feng also makes it a point to travel with her family to the many meetings she must attend. "Our daughter has been to so many liver meetings and transplant meetings that many people at the conference know her and have watched her grow." Indeed, Feng may be making surgery her new family tradition.