Tuesday, September 2, 2014

7 months on.....I sound like a broken record!

So 7 months have passed since my last post, I bet you all thought I had disappeared for ever. No? Don't care? Thought not.

Well a lot has happened I say that much. I now have a very happy healthy one year old son, who is better than anything else so I'll mention him first. He still doesn't have a presence on Facebook which I am happy about and is still doing all the right things for his age.

I have also moved house. Again. Fortunately for my family it isn't quite as far as Queensland this time, but still a good 3 hours up the M1 to West Yorkshire. Once more this was necessitated by my damned need for paid employment.

You see, I didn't get a training number. Again. I am starting to see a pattern emerging here of poor communication skills and a lack of direction in the portfolio. I am going to have to focus more clearly on what I want to do as opposed to hedging my bets as I did this year. I have completed my core surgical training and attempted applications for ST3 in general and paediatric surgery. Having to plan for 2 interviews meant not planning for either enough. Suffice to say I hate interviews at the best of times and probably buried my head in the sand about actual preparedness as I hate practising interview questions and handing over built in answers. It is all so fake and makes my skin crawl, Yuk. It is something I need to get over as that is now 4 interviews I have messed up and it is starting  to affect me.

Anybody who wants a career in surgery should think very carefully. There is not enough spaces for everyone who wants to do it, even those who get into core training at CT1 as per the ASIT website. I feel the whole concept of core training is flawed as more than 2/3 of those in a post will not progress to the next level, as most people who go into it don't go in wanting to do radiology or A&E (or they could do that straight away). I feel it is just a way to save money and fill SHO rotas under the guise of training. What's worse is that ST3 applications now downgrade candidates who have been out of medical school longer (presumably to level the playing field and smooth the flow for candidates straight from core training).Therefore next year my portfolio score will be marked down as I have more experience. Again I wonder about the fairness of this as not everyone chooses to go into surgery straight away or is full time all of the time. Anecdotally from the 18 core trainees that entered my core surgical training deanery in 2012, 5 got training positions. More than 5 are doing some stop gap or research and more than 5 left surgery altogether. I'm doing a stop gap. ST3 posts were released on May 24th and I needed a job by August 5th. Panic stations set in and I knew I didn't want to be someone else's research monkey for 3 years.

I am currently working as a Specialty Doctor in General Surgery at Airedale in Yorkshire. It is essentially a non training registrar staff grade post and is in a wonderful part of the country. We live in a cheap, spacious house with rolling hills and farmland all around, charming towns a short drive and within an hour I can be in Manchester or Leeds. The job itself is pleasant and I'm not working with any egos or idiots. I get more responsibility and the chance to work as a registrar and do my own clinics, ward rounds and teaching (but not theatres yet butterfingers). This has its upside as in it is more rewarding and I'm acting like a doctor and not just a ward administrator and retractor holder but means I get my fair share of problems which I used to send up the chain as an SHO, most notably dealing with difficult patients or having difficult conversations.

I am nearing completion of my Post graduate certificate in Leadership (Mary Seacole Program). Whilst the contact days have been enjoyable, I have found the whole process a bit overwhelming with having a full time job. Some of the other candidates on the course get 8-12 hours protected time at work to work on it! No such luck for me. I'm sure that would get laughed at if I mentioned that applying to me. My department in Leicester were not exactly helpful in doing the practical project side of things going and I'm glad it is soon to come to an end. I really wish I had enough time to engage more fully with it and not move house 3/4 of the way through it as the programme I feel it is worthwhile.

So time goes on and the same things are happening  to me. I've had to nail my colours to the mast and go all out to be a general surgeon. I really like my current job and actually want to go in this direction as opposed to just being all "meh" and going with the flow. That is not to say I won't change my mind when I'm unsuccessful next year. My difficult to placate ego means I don't think I'll want to be a staff grade for ever, however it is very possible that my talent for surgery doesn't match my ego and I will have to try and climb the medical ladder in other areas. I have looked into the new alternative route of entry into emergency medicine training, which I am eligible for as a surgical trainee. It would suit my desire for action and immediacy but I might not like handing my patients off after 4 hours. I have put a lot of time, effort and money into being a general surgeon.

  • MRCS Parts A (£450) & B (£900)
  • ATLS (£600)
  • CCrISP (£700)
  • BSS (£400) 
  • Basic Laparoscopic Skills (£250)
  • Logbook (£200 per year) 
  • RCS fees (£300 per year)
  • Interview  course (£200)
  • Teaching Course (£180)
  • 6 audits
  • 5 book chapters
  • 3 posters
  • 2 regional presentations
  • 2 service improvements
  • 1 publication
  • 1 weekly teaching commitment
  • 1 mentoring programme
  • 1 post graduate qualification (£5000 - luckily bursary paid for) 
  • Not to mention all the annual leave and rest days I didn't take so I could do more operations.

And because I get nervous when interviewers ask me awkward questions, none of that was enough to get even within 200 places of a job. And my list isn't spectacular, in fact some might consider my CV slightly bare. So, again(!) we will wait and see. Hopefully I get a surgical training job, possibly accept a long term staff grade position, potentially change career entirely.

Or sack it all off and go back to Australia.

Oh, and I'm still really fat. More fat than ever. I seem to coincide starting diets with doing blog posts. I must give my fingers something to do when they aren't stuffing pies down my chops.


  1. Well i am here first time and found that this amazing site and informative which gives all reader many good

    USMLERX step 1 Qbank

  2. Hi, I found your blog after googling general surgery ST3 points!

    I used to work at Airedale, before I took out an OOPR from CT2. I like you're blog and will be following you.

    Carry on the good work.