So you work in general surgery?
- Name: Ewen Harrison
- Age: 31
- Trained: University of Glasgow Medical School
- Current role: Specialist Registrar in General Surgery, Royal Infirmary of Edinburgh
- Career plans: Hepatobiliary and transplantation surgery
What do you enjoy about your job?
I rarely find it hard going into work in the morning. I am privileged to be working in a close team with great colleagues and consultants dedicated to training. General surgery is a fantastic job, providing variety, challenge and a real sense of achievement.
Why did you choose it?
General surgery was the first clinical attachment I did in medical school and I loved it. Surgery is for doers: those who like taking a specific problem and providing a solution that is often technical in nature. That’s the easy bit, though; the art is in knowing when not to operate.
How do you cope with the late nights?
I’m not sure I do! I saw a very unwell patient at 5am recently. He looked up and said: “Doctor, you look terrible!” Top tips for night shifts: do some exercise and get a good sleep the day before, take plenty to eat and drink, and snatch some sleep any time you can.
What has been the most difficult aspect of your career?
When a patient has a complication following an operation you have performed, it is difficult not to feel personally responsible. Adopting a no-blame culture and discussing complications in an open forum definitely helps.
What misperceptions do people have about general surgery?
The stereotypical surgeon of the past was arrogant, impersonal and uncaring. This can still occur, but is often the result of stress, poor team-working and inadequate training. Nowadays, surgeons are better trained and working patterns allow for more supportive environments. These personality traits are no longer acceptable in the modern surgeon.
How will the introduction of the European Working Time Directive affect the training of new surgeons?
The introduction of the 48-hour week will have a profound effect on training. Surgeons of the past would typically work for around 30,000 hours prior to consultant appointment. A training surgeon will now work 15,000 at most. Can today’s improved training compensate for this massive difference in time “at the coal face”? Possibly, but a great deal of work remains to be done to make this happen.
How has the training changed since you started? Is it becoming more sub-specialised?
Training has improved with the introduction of the Intercollegiate Surgical Curriculum Project (www.iscp.ac.uk). A trainee will now sit down with their consultant and plan exactly what training is to be targeted over a given period. This is essential in a world of shift rotas, where training will be delivered by a number of different consultants.
Is future surgical training going to be more evidence-based?
Surgery has been criticised for not being evidence-based enough and a great deal of work is being done to rectify this. However, the greater variation inherent in surgical procedures makes the job of showing differences between treatments more difficult than in other areas of medicine.
What has been the most important landmark of your career?
I have recently completed a year as President of the Association of Surgeons in Training and a PhD in Transplantation Biology, both of which were satisfying in different ways. They represent the two things I’m passionate about in surgery: maintaining and improving the quality of training, and the continued development of surgical science.
How do you maintain a life outside work?
Relationships with family and friends require dedicated time and it is easy to let work take over. I try not to take any work home with me – there should be a clear separation of work and family time.
Where do you see yourself in ten years?
2018 still seems a long way off! Hopefully, I will have been working for six years as a consultant surgeon in a nice hospital somewhere in the UK.
Top tips to success
- Download the specialist training application form in general surgery and fill it in – where are your gaps?
- Do a Foundation Skills in Surgery course (www.asit.org)
- Get involved in a research or audit project and present the results at a hospital or national meeting
- Plan to sit the MRCS exam
Typical week
Monday
08:00 – 16:30 - Theatre (majors)
17:00 – 17:30 - Ward round
Tuesday
08:00 – 08:30 - Ward round
09:30 – 11:00 - Teaching
11:00 – 17:00 - Research
17:00 – 17:30 - Ward round
Wednesday
08:00 – 08:30 - Morbidity and mortality meeting
08:30 – 09:00 - Ward round
09:00 – 12:30 - Endoscopy
13:30 – 17:00 - Administration
17:00 – 17:30 - Ward round
Thursday
08:00 – 16:30 - Theatre (day-case)
17:00 – 17:30 - Ward round
Friday
08:00 – 09:00 - Multidisciplinary team meeting
09:00 – 09:30 - Ward round
09:30 – 12:30 - Outpatient clinic
13:30 – 14:00 - X-ray meeting
14:00 – 15:00 - Educational meeting
15:30 – 16:00 - Ward round