Scalpel's Edge

A surgeon's notes

Teaching surgery the hard way

My first real registrar job was a big step for me. Not in terms of experience, as I had already been acting as a registrar (supervising junior staff, first on call, some primary operating). But it was a change in expectation. A non-training registrar is out for cases, cutting, contacts and curriculum vitae. A training registrar is seen as a potential exam candidate, and more scarily, potential independent surgeon.

I enthusiastically got to know my bosses and patients, and started to run the unit. But I still saw opportunities to learn, rather than opportunities to prove myself. I expected to be taught each new procedure. I waited to see what cases and complications walked in the door, rather than knowing what to expect. I was acting like a resident in big shoes.

The unit I was working for had a reputation for foot-stampers: Surgeons who knew what they wanted, and were happy not to play at getting along. One of them, Dr M, was quietly spoken, but was well-known for facing controversy face-on.

Seeing my absolute failure at taking the next step, Dr M took me for a private coffee. Over polystyrene cups, she explained exactly what she expected me to do. She explained about pre-learning the operating list, learning surgeon preferences and taking the lead, anticipating complications, and looking for potential pitfalls. All in a quiet voice in the corner of the cafe, with my intern busy with other tasks.

The next day I was poorly rested, but a real trainee. I knew all the cases. I knew the steps of the procedures, and I knew what was coming next. Learning how to be a registrar was important, and let me get the most out of that and future jobs. However, I learnt a more valuable lesson from Dr M, who treated me with respect, and got me to become a different person without raising her voice, humiliating me, or making me feel stupid (much).

I still count Dr M as an important role model. And I remember her every time I sit down for a private coffee with a struggling intern.

2 responses to “Teaching surgery the hard way”

  1. Dragonfly says:

    I love teachers like that.

  2. […] and ensured I focussed more on my personal embarrassment and anger, than the lesson at hand.  So, in contrast to other great teachers, the main memory was how not to teach students.  Maybe she also turned me off (internal) medicine […]

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