31st August

This week I'd like to start by talking a bit about the Surgical Local Faculty Group and how we work to support you and your educational needs.

If you've worked in @HE_KSS before, you'll be aware of these specialty-specific groups of Educational Supervisors who meet three times a year with trainee representatives from all grades. These Faculty Group meetings are an important forum for issues to be aired and in the Surgical Faculty Group we have listened and redesigned rotas, developed on call structures, highlighted good and less good practice - all in real time to make sure trainees have a good learning experience.

Your Core Trainee rep is Sophie Wrigley, Urology CST @sophiehfwrigley here with her #ILooklikeaSurgeon selfie from this weekend on call (looking very smiley)

The next LFG is on Wednesday October 14th. Please let all your grade reps know ahead of this date of all issues you'd like discussed. 

In the closed part of this meeting we also go through all our trainees ISCPs so please ensure your logbooks and WBAs are up to date at that point.

Hashtag of the Week: #ILooklikeaSurgeon

(Me with Trauma Fellow Verona Beckles for our #ILooklikeaSurgeon selfie)

Three weeks ago, Heather Logghe @loggheMD a general surgery resident from North Carolina started a trend that has captured the imagination of female surgeons around the world. Here's (@DrEdFitzgerald) Dr Ed Fitzgerald's take on it: http://alliesforhealth.blogspot.co.uk/2015/08/what-does-ilooklikeasurgeon-really-say.html?m=1

With an immediate lack of face-to-face role models, it has been rather inspiring to see the sorority of surgeons let each other know they're there. 

I did a quick scout of the Consultant Directory @ASPHFT and totted up 8 female consultant surgeons, 11% of the total number of Consultant surgeons on staff. 

You might think that's a bit feeble, especially when some sub-specialities have zero female representation (Vascular, Urology, Colorectal, Upper GI) but in fact that's pretty much the same percentage as the average numbers of women in Surgical Consultant posts across England &Wales. 

Can we continue like this? I can't believe I'm actually referencing the Daily Mail (?!) but @maxpemberton made a rather punchy point on Saturday: http://www.dailymail.co.uk/health/article-3214852/Women-doctors-bring-NHS-knees-says-Dr-Max.html

Here's the RCPCH (@RCPCHtweets) source paper: http://www.rcpch.ac.uk/improving-child-health/better-nhs-children/workforce-planning/rota-compliance-and-vacancies/rota-com

If we can't make our specialities attractive to the majority workforce (women make up at least 55% of medical graduates) it is going to be challenging trying to maintain those unappealing services. It's not just a question of raising a media profile by putting up family-friendly role models, but making tangible, practical and quite radical changes to junior doctor training & consultant practice. 

I'd like to hear from you if you've considered even briefly pursuing a hospital based career (clearly the issue is not just with Surgery) and what made the 'cons' outweigh the 'pros', what factors have led to the career choices you've made or intend to pursue.

Surgeon of the Week

This week my top trainer is Prateesh Trivedi, Colorectal Surgeon, seen here with Sr Chris Tough. (I am so loving how my fabulous colleagues are embracing the ASPHug)

Teesh has links with the Royal Holloway co-ordinating pelvic floor research and supervises the training & development of our ward Clinical Scientist in addition to training our Core and Higher Surgical Trainees. It has been great to have his support & involvement at a Surgical LFG which with our many recent appointments is growing from strength to strength.

Forthcoming Attractions

Basic Surgical Skills is pretty much an essential course for Core Surgical Training applications, due in November. Not only is it a practical and helpful course to have at F2, for surgery and for A&E, but it also shows 'commitment to specialty' AND earns you one of the easier points on the checklist (max of 3 points in the Courses box)

Here are the local courses that still have places and will get you the point ahead of the closing date for CST applications:

***BREAKING NEWS***

Congratulations to former @ASPHFT T&O trainee Ritesh Sharma on getting his Consultant post at Epsom & St Helier @epsom_sthelier (WOO!!)

Ritesh was with us for two separate years in his training and I am so pleased for him, Cindy, and Simran, Sachin and Kiran that he has passed the final hurdle.

24th August 2015

The big news this week is that we have permission to continue with merger plans  with the Royal Surrey County Hospital (@royalsurrey). Whilst this won't impact on your training, there is great potential to expand educational opportunities and I'm looking forward to collaborating with my opposite number on joint projects. I'm particularly excited to forge greater links with MATTU @alisonsnook and their fantastic labs http://www.mattu.org.uk/ 

More info about the merger here: 

https://assets.digital.cabinet-office.gov.uk/media/55cdbb62e5274a5470000023/Provisional_findings_report_EXCISED_v3.pdf

Trainee Talk

You'll all know that in the first couple of weeks, apart from getting to grips with a new hospital, new culture, new colleagues and whole new specialities, it's also the time to build relationships with new supervisors. 

I had the chance to get to know one of my new supervisees, Dr Phien Vo, South Thames F2 in T&O (@STFS1) at our Initial Educational Supervisor's Meeting. Here's Dr Phien Vo with Mr Monk (@jonny_monk) and here's what we talked about:

Phien: "the first couple of days of T&O were a bit overwhelming, finding out where we had to be and what we had to do. Once the Service Plans* started that really helped a lot, giving us specific teams and roles and we now all really know what we're doing and what our responsibilities are.

"The staff are all really nice and the nurses have been so friendly, helping with things like all the new codes - everything seems to have a code!

"I've been really looking forward to the step up from F1 and in particular I want to experience theatres and scrubbing in. I have already been in clinic with Mr [Jon] Monk, he is so enthusiastic and such a great teacher. He's asked me back to his Fracture Clinic tomorrow and I'm really looking forward to that. I've already sent him a CBD!"

So terrific to hear from someone whose professed interest is a career in gastroenterology throwing herself into our speciality and taking every opportunity to learn new skills. 

As surgical trainers, we're well aware that the majority of Foundation doctors assigned to us are 'conscripts' not 'volunteers'. It makes an enormous difference to us, especially to the quality and quantity of advice and teaching imparted, if we have trainees who engage & want to learn as many transferable skills as they can.

*Service Plan

We're trialling a new way of working in T&O harking back to the firm structure and traditional one-to-one training. A weekly plan gives every junior doctor a very structured week with opportunities to lead, have protected time in theatre and go to clinics. Early feedback is very encouraging: watch this space for updates on how it rolls out.

Surgeon of the Week

This week my education superstar is Orthopaedic Surgeon Arshad Khaleel, seen here with Sr Leyni Lugtu (she gets in on all the free hugs going around):

Arshad's enthusiasm for imparting knowledge is legendary. A trainer with unsurpassable energy, Arshad has been running the Chertsey FRCS Revision Course for 15 years and has supported the careers of a legion of South West Thames registrars. He is our research and audit project generator and publishing powerhouse and is my absolute most favouritest person to go National Selection interviewing with: here's our Leeds Thai restaurant selfie (Note to T&O colleagues: Chaophraya, it's totally brilliant and the single biggest reason to make the loooong trip to Elland Road to do the interviewing http://chaophraya.co.uk/) 

Forthcoming Attractions

Since we're talking about our upcoming civil partnership with RSCH @royalsurrey, it seems appropriate to highlight local courses at the Minimal Access Therapy Training Unit (MATTU):

Basic Surgical Skills Course

http://www.mattu.org.uk/course/basic-surgical-skills-course/2/

Registrar Ready

http://www.mattu.org.uk/booking/577/

Laparoscopic Suturing

http://www.mattu.org.uk/course/laparoscopic-suturing-course/22/

Hand and Wrist FRCS Revision

http://www.mattu.org.uk/course/frcs-revision-hand-and-wrist-course/34/

17th August 2015

As I was away last week, this post is a little generalised so I apologise. I hope Changeover Day nerves have given way a little bit to excitement and interest in the challenges your new posts bring.

This week, rather than a Surgeon of the Week, I though I'd hit you with a whole department: the Rowley Bristow Unit.

Before I left we welcomed our new cohort to the Unit, and I gave them a little background to the legacy of Orthopaedic training that lies with our Unit's name.

Walter Rowley Bristow (1882 - 1947) was a St Thomas's graduate who seems to have spent most of his undergraduate life playing water polo, golf and driving fast cars supplied by the Bank of Dad. He passed his exams "with an apparent absence of effort" http://www.bjj.boneandjoint.org.uk/content/30-B/1/200 and by the start of WW1 he had a private practice in problems of the Locomotor System. He served as a Medical Officer at Gallipoli and on return joined the Military Orthopaedic Centre where he came to the notice of that giant of Orthopaedics, Sir Robert Jones, who became Director at the very first Orthopaedic Centre set up at St Thomas's in 1919. Strange that less than 100 years ago an Orthopaedic Specialist Centre was a novelty: a seemingly young speciality but to date the largest speciality group of surgeons on the Royal College register.

He was a founding member of the British Orthopaedic Association (@BritOrthopaedic) and past President, but his connection with Surrey is his appointment as Honorary Orthopaedic Consultants to two Childrens' Homes moved form Tooting and Surbiton to Pyrford, looking after 130 patients with surgical tuberculosis, infantile paralysis (polio), congenital deformities and ricketts. Rowley Bristow brough his entire team down there for two days a week, and was a legendary teacher http://ezitis.myzen.co.uk/rowleybristow.html

Whilst the Hospital partially burned down, and then was formally closed in 1990, the reputation for Orthopaedic training continues and remains the name of our peninsula next to A&E.

Next week I'll be back on track with what's  up to date and happening @ASPHFT but for now it's 'ciao!' from sunny Italy

7th August 2015

Early posting this week, as having settled the new teams in I will be on holiday next week, but I couldn't let Changeover Day pass without a mention. Here's our 5th August new starters, raising the energy towards the end of a long and wordy Trust Induction to give us a wave...

This week it was the turn of Everyone Else to go through Trust and Departmental Induction. We've really taken note of your comments made in the GMC Survey so I hope we've done better but please let me know if you can spot ways to improve it further. There is so much mandatory stuff we have to cover that clinical topics (eg managing speciality-specific scenarios) have to be left to teaching into the post but you can always access Clininet via the Trust Homepage for support on all major topics, including fracture management and Up-to-Date (much more reliable than Dr Google)

Surgeon of the Week

This week please meet Pasha Nisar seen here with Sr Renuka Sasikumar. Pasha is a Colorectal Consultant with a fantastic track record of training and engagement. 

His major interest is in pelvic floor and cancer and is the Trust Lead on NBOCAP and the Emergency Laparotomy Audit. He is Head of the KSS Collaborative Research Project, linking trainees with Consultants in the region to facilitate high quality research. And he's a sweetie.

Forthcoming Attractions 

Foundation Teaching starts on Monday. You need to have attended at least 70%: inevitably you will miss some through annual leave and all the sessions are valuable so get to every one you can. 

Think ahead: this course @rcsnews is aimed at Foundation Drs thinking of T&O as a possible career choice. Contact mailto:education@rcseng.ac.uk to register interest

https://www.rcseng.ac.uk/courses/course-search/so-you-want-to-be-an-orthopaedic-surgeon

The Chertsey FRCS Course is coming up: read up and pass it on

3rd August 2015

Well here we go... The new academic year. Welcome to all new starters @ASPHFT, hope you have a wonderful experience with us.

Thursday was #NewDocsDay with 48 F1s starting with us. Welcomed by Director of Medical Education Peter Martin ... 

... and Foundation Programme Director Tayo Johnson, the week of shadowing begins

The Surgical Programme has undergone a radical restructuring over the summer and now it swings into action. It's inevitable that some glitches will surface as it rolls out so if you do identify any issues please let me know for T&O and talk to Mr Sachin Agrawal for Urology/General Surgery. I'm very grateful to our CSTs Sophie Wrigley @sophiehfwrigley and Young-Seok Cho for helping design the rotas.

If you're starting on nights, this might be helpful:

https://www.rcplondon.ac.uk/sites/default/files/documents/working-the-nightshift-booklet.pdf

(Courtesy of Sophie Bishton @twitfrg)

Surgeon of the Week

This week our teaching superstar is Trauma Surgeon Mr Kevin Newman, @newman_kevin, seen here with the Rock Of Fracture Clinic Sr Ann Fletcher. 

Kevin is @ASPHFT's current Trainer of the Year and is past South West Thames/HEKSS T&O Trainer of the Year. His legendary enthusiasm to support our trainees is firmly rooted in the principles of delivering the best patient care. Top bloke, our Kevin.

Forthcoming Attractions 

"Are You Cut Out For It?"

We will be holding the regional heat of this competition in November, so if you are currently a CT2 get practising with your knot-tying, suturing and triangulation skills. National Final at the Royal College of Surgeons @RCSNews in February 2016

http://surgicalcareers.rcseng.ac.uk/trainees/foundation-core-trainee/prizes-and-competitions 

October Regional RCS Courses

27th July 2015

Goodbyes and good wishes

Good luck to our trainees moving on this week. Just as you get to know them, they're off to pastures new. But if our T&O department is anything to go by, with 7 of the 15 consultants having been registrars here previously, it'll be good to see them back in the future. Clearly Paul Trikha @surreyknee is going to miss Zu Nawaz...

The last week of the training year is as good a time as any for me to go get re-energised and excited about the Surgical Tutor role again. I was lucky this week to hear Anne Richards speak (@AnneRichards16) at 30 Euston Square (@rcgp), which is a utterly stunning College by the way - but then it's not a building I totally associate with exams like Lincolns Inn Fields.

Anne is Chief Investment Officer at a FTSE100 company, another environment with an imbalance between men and women, though at 25% they are better than Surgeons (10% women) and T&O (4.2%).

Discussing the gender gap, she highlighted that without encouragement, it's easy to fall into the 'girls can't do that' mindset and believe it.

I wonder if it's just a girl thing though. Why have the numbers applying for Core & Higher Surgical posts tumbled? Can it all be down to the constant media hammering? The perception that medicine is underfunded, undervalued and unrewarding? Or are we as consultants not encouraging enough as we too become jaded? This was definitely my note-to-self to start the new academic year more positive and communicate my love of this amazing job to my team & trainees.

Tweet of the Week

As the row continues in the media between the Secretary of State for Health and healthcare professionals, what has become clear is that our patients value what you all do and that is what we're here for. Many patients made a point this week of telling me in clinic how much they appreciate the care they've received @ASPHFT and the NHS. Make the most of every clinical and educational opportunity your time @ASPHFT allows. Karim Brohi @karimbrohi put it best this week... no matter what maelstrom surrounds education, training and the actual work itself, Be Excellent. 

Surgeon of the Week

This week I'm showcasing Jonathan Trickett, Consultant Colorectal Surgeon @ASPHFT, seen here with the fabulous Sr Leynie Lugtu

Jon is the current Medical Undergraduate Trainer of the Year (whoop!) as for voted for by @StGeorgesUni. He is also the Regional Lead for Enhanced Recovery for @HE_KSS and is Lead Supervisor for our Physicians' Associates programme.

Forthcoming Attractions

As promised: RCP Leadership Workshop information

https://www.rcplondon.ac.uk/cpd/non-clinical-cpd/leadership/doctors-leaders-accreditation 

https://www.rcplondon.ac.uk/cpd/non-clinical-cpd/leadership/individual-leader-workshop

https://www.rcplondon.ac.uk/cpd/non-clinical-cpd/leadership/organisational-leadership-workshop

September Regional RCS Courses

20th July 2015

Higher Surgical Training Interviews - Get Ahead

The above article came out last year, but I think it's still pertinent:

http://careers.bmj.com/careers/advice/view-article.html?id=20016622

Building a portfolio takes time and one achievement, such as a closed loop audit, can really earn its keep for you gaining points in a number of categories (poster, presentation, meeting, service improvement). 

How to get a closed loop audit in a four or six month post? Work together. David Ricketts, a Consultant at BSUH (who as Research Chair was famously 'encouraging' to SpRs at RiTAs - obviously for our own good) told me I should think of projects as pots on the stove (stay with me here) moving each one along as they progress but when you take the first one off, you'll need to get someone in behind you to keep the fire going and keep the pots moving along. So buddy up. Talk to the trainee coming behind you. Talk to the trainee leaving ahead of you. Each start your own audit (first author) and help close the loop for the one ahead of you (second author). And present the hell out of all of them. Maximum productivity in a short time.

The 'L' Word

Leadership. My personal view on how laboured this topic is at all grades is very jaundiced. I was unimpressed at how the Portfolio Station at National CST Interviews was hijacked by an unhelpful five minute candidate's speech when it is a whole section to be discussed in the body of the station*

*clearly a very individual & highly personal view. I support trainees to jump whatever hurdles are put in front of them regardless of the value I place upon them.

However, the requirement is that we ALL demonstrate leadership. Leading a Ward Round or Trauma Call does not shout out 'INITIATIVE'. There are a few one or two day courses, which not only give you a certificate but may also be the trigger for a leadership project you can really get behind. Identifying a need and creating a solution from scratch will always impress more than past glories as captain of the 2nd Eleven at school.

Not a natural place to look, but the Royal College of Physicians website is a good resource for these courses. As I see them coming up I will put the links on here.

The idea for this blog came from a brainstorming session with @zelly43 and Kayo from @ASPHFT Communications (thank you!). What I wanted was a newsletter - to share messages on teaching sessions, celebrate successes and hopefully lower the gradient between junior and senior staff. 

With that in mind, here comes the first of some consultants' profiles 

Surgeon of the Week

Who better that to start this segment with than Mr Humphrey Scott, Consultant Colorectal Surgeon @humphrey_scott (here with the fabulous @mykesinocentes).  

Mr Scott is not only a previous ASiT Silver Scapel award winner but also HEKSS Head of  School of Surgery and a top bottom surgeon. Also surprisingly good at negotiating twitter, discussing holidays and handbags, and very much 'in the know' on all matters educational.

Forthcoming Attractions

Keep an eye on the RCS England website for local courses - often easier to get shorter notice places on than London.

https://www.rcseng.ac.uk/courses/course-search/regional-courses/regional-search?letb=Kent,%20Surrey%20and%20Sussex

I will try and add courses with places as I find them

Basic Surgical Skills (Intercollegiate BSS) Course

24-25th November

https://www.rcseng.ac.uk/courses/course-search/bss.html

Advanced Trauma Life Support (ATLS) Provider Programme

2-4th September St George's Hospital robert.colson@stgeorges.nhs.uk

(Still has places)