That advice brought him to West Virginia University and led him to claim a spot in the School of Medicine’s history. A third-year resident in plastic and reconstructive surgery, he’s the first native West Virginian and, so far, the only WVU alumnus to enter the program.
“I always knew I wanted to be a doctor of some sort, and that goes back to the fact that a lot of women in my family had been diagnosed with breast cancer and had medical illnesses and formed a special relationship with their doctors and medical team,” Koenig said. “I wanted to be just like them, be able to pay it forward and treat others just as they treated my family.”
To begin his education, WVU was a natural choice. Both his mother, Beth Koenig (’89), and aunt, Melissa Faris (’93), are graduates of the School of Pharmacy; however, Koenig wanted to make sure it was the place where he could reach his goals.
He still remembers the winter morning when he traveled from his home in Charleston to meet his future academic adviser Jeffrey Petersen, professor emeritus in the C. Eugene Bennett Department of Chemistry in the Eberly College of Arts and Sciences. That encounter sealed the deal.
“He gave me some great advice. He said, ‘You can make the most of your experience here at WVU and accomplish just as much as you can anywhere else.’ That was something that resonated with me. Being born and raised in West Virginia, I really wanted to be able to stay in my home state and attend a state institution as well.”
Koenig found Petersen’s insight accurate. When it came time for medical school, WVU was his clear choice. “I could not imagine a better place for myself to train and learn,” he said. “I feel really lucky to have been surrounded by such phenomenal people throughout my entire time at WVU. We really are the average of the people we spend the most time around.”
While he studied and worked as an intern, Koenig had to start thinking about his future as a resident. Again, he needed some good advice. This time it came from a doctor who had treated one of his family members for reconstruction surgery following breast cancer. He suggested Koenig might want to set his sights on the plastic surgery field.
“As I progressed throughout medical school, I became more and more interested in it and set a high bar for myself,” he said. Apparently that tactic worked well. In 2022, Koenig opened his Match Day envelope to find “WVU School of Medicine plastic surgery” printed as his residency placement.
The highly competitive, six-year training program admits only one resident per year. Since
receiving accreditation in 2017, two physicians have graduated from the residency.
“We have four faculty members in the Division of Plastic Surgery, so it's one of the things where you really feel like all eyes are on you, and they're really pushing you to be the best version of yourself,” Koenig said.
Although many people may associate plastic surgery with facelifts and nose jobs, Koenig points out there’s much more physicians do to enhance their patients’ appearance and improve their quality of life.
When it comes to restoring function, Koenig and his team have helped amputee patients relieve phantom limb pain and regain range of motion with a prosthetic device.
“On a regular basis we do a procedure called targeted muscle reinnervation that redirects nerves to different muscles,” Koenig explained. “In turn it prevents phantom limb pain by preventing what's called a neuroma from forming. That sets in place an avenue for what’s called a myoelectric prosthesis – ones that are able to actually move.”
Other common procedures include craniofacial surgery to correct deformities and abdominal wall reconstruction for hernia and scar repair.
If Koenig had to name his number-one surgical interest, it would be breast reconstruction, a procedure that harkens back to his family members’ experiences with breast cancer and the treatment they received. Specifically, he wants to learn more about microsurgery techniques.
“It’s basically doing surgery under a microscope. We connect super-small blood vessels that are difficult to see with the naked eye,” he explained. “It involves highly precise maneuvers and really, really long operations, but the results are phenomenal. Regardless, I'm really passionate about every aspect of plastic surgery,” Koenig said. “I feel like there's so much variety in what I get to do, and that's something that just excites me even more about the field.”
After completing his residency, Koenig anticipates a one-year fellowship and then hopes his career stays firmly rooted in WVU.
“I want to still be involved in academia, and I would absolutely love to be able to come back and practice here in West Virginia alongside of my same faculty members that I'm working with right now,” he said. “I would just love to be able to contribute to the next generation of people who come through this program.”
At any rate, WVU hasn’t heard the last from the Koenig family. Zack’s brother, Nick, (Chemistry, ’20) earned his MD from WVU in 2024 and will soon begin his residency in anesthesiology at the WVU School of Medicine.
