Rachael Nicholson never set out to become a surgeon—let alone a vascular one. In fact, her early ambitions had nothing to do with medicine at all. As a mechanical engineering student at the University of Illinois, she imagined a future designing cars, not caring for patients. Medicine wasn’t on her radar.
That changed during a summer break, almost by accident.
A former teacher reached out and asked if she’d be interested in volunteering with her hometown’s ambulance service. The idea sounded exciting, driving a big ambulance had a certain appeal, so she said yes without hesitation. What she didn’t anticipate was everything that came with it: EMT training, long hours and most importantly, direct responsibility for people in moments of crisis.
What began as curiosity quickly became something deeper. Helping others in their most vulnerable moments was unlike anything she had experienced. It was immediate, meaningful and profoundly human. That summer quietly redirected her path. Engineering no longer felt like the right fit—medicine did.
Her decision to pursue surgery came later, in a moment she still remembers vividly. As a medical student on a neurosurgery rotation at Southern Illinois University, she found herself in an unusually hands-on environment. The team was small, just one attending, one resident and one student. When the resident went on vacation, the responsibility shifted.
Suddenly, she was immersed. The pace was relentless, the expectations high and the experience exhilarating. She had never worked harder, and she loved it.
On her final day, the attending handed her the drill and allowed her to perform a burr hole procedure. That moment sealed it. There was no turning back. She knew then that surgery was where she belonged.
Vascular surgery entered her life more gradually, shaped not by a single moment but by a series of influences. Early exposure to mentors like Drs. Ryan, Barkmeier, McLafferty and Mattos sparked her interest. Their cases were complex and fascinating, their discussions intellectually rich and the longitudinal relationships they built with patients deeply compelling.
That interest solidified during her general surgery residency at the University of Iowa. There, under the mentorship of Drs. Hoballah, Sharp, Kresowik, Sharafuddin and Bjornsdottir, she found both guidance and inspiration. Their influence helped her see not just the technical side of vascular surgery, but its broader impact and purpose. It became clear: this was her path.
As her career developed, professional societies played a pivotal role in shaping her journey. Organizations like the Midwestern Vascular Surgical Society (MVSS), the Society for Vascular Surgery (SVS), and the American College of Surgeons (ACS) became more than professional affiliations, they became communities.
MVSS, in particular, provided opportunities to engage, contribute and grow. Through these societies, she met mentors, collaborators and role models who energized her passion for the field. Many of these advocates, especially women leaders, opened doors, encouraged her involvement and helped shape her trajectory in ways she deeply values.
Reflecting on this, she believes medical societies have a responsibility that extends beyond education and networking. They must actively listen to their members, evolve with their needs and create meaningful opportunities for engagement. Inclusion, representation and accessibility are not just ideals—they are essential to building a stronger, more resilient profession.
That perspective feels especially meaningful during Women’s History Month.
For Dr. Nicholson, it’s a time to recognize and celebrate the remarkable women who have shaped vascular surgery—and to ensure that future generations find a field that is welcoming, supportive and inclusive. Visibility matters. Advocacy matters. And initiatives like the SVS Foundation’s Voices of Vascular play an important role in elevating stories, creating connections and inspiring others.
At its core, Dr. Nicholson's journey is one shaped by chance, mentorship and moments of clarity. A reminder that sometimes the most meaningful paths are the ones we never planned but discover along the way.
When you donate to the SVS Foundation, you support Voices of Vascular and its mission to highlight the diverse voices leading vascular surgery and research. Learn more and make your gift today.
Rachel Nicholson, MD is Division Director of Vascular Surgery, Clinical Professor at Iowa Carver College of Medicine