"Watching trainees develop and gain surgical skills is another rewarding aspect of the job."
Miss Kathleen Fan is consultant in oral and maxillofacial surgery (OMFS) at King’s College Hospital and is also an honorary senior lecturer at King’s College London.
During sixth form I decided that dentistry was the career for me, after being inspired by an enthusiastic dentist during some work experience. I liked the fact that dentistry involved contact with people and also involved working with your hands. I’d always enjoyed practical things like baking, cooking and art. But at this stage a career in OMFS had not crossed my mind.
After my dental degree I got a house job (the equivalent of dental foundation training) which included the surgical aspects of dentistry. This gave me a taste of OMFS and oral surgery.
I continued to gain more surgical experience and it was meeting an inspirational OMFS consultant that was a turning point for me. He was very kind, patient and encouraging which gave me the self-confidence to see that I could become a surgeon. I performed operations such as the removal of wisdom teeth, surgical treatment of facial fractures and jaw cysts and found I really enjoyed the work.
Before embarking on my medical degree (you need degrees in medicine and dentistry for OMFS) I decided to do a PhD, where I conducted research into photodynamic therapy and head and neck cancer. I really enjoyed the PhD, with the opportunities it gave to present the results of my research to international conferences and be on expert panels.
My medical degree followed, which was shortened to four years for dental graduates. At the same time I worked as a junior doctor in OMFS during evenings and weekends to help fund my medical training.
After graduating in medicine I took the normal route into OMFS – one year of the equivalent of foundation training (I trained before this was introduced), a further year of core surgical training and five years of higher specialist training. After this I was awarded the Certificate of Completion of Training, CCT and I became a consultant.
My work as an OMFS consultant surgeon at King’s College Hospital includes the following areas:
- craniofacial trauma
- orthognathic surgery (the correction of jaw disproportion)
- skin cancer removal
- temperomandibular joint dysfunction (TMJ) (problems with the jaw joint)
- salivary gland disease
- dentoalveolar surgery (teeth)
I gained experience in all these areas during my sub-specialty training in OMFS, which is part of the higher specialist training. The main areas I don’t work in are surgery for head and neck cancer or cleft palate surgery, but had been trained in these sub-specialties.
On average I operate for just over a day each week. My surgical lists are very varied, most of the surgery in facial deformity takes a few hours but complex facial reconstruction can last up to six hours for following trauma - if someone falls off a roof for example. Other operations such as removing a wisdom tooth may take a few minutes or skin cancer cases might be performed under local anaesthetic and usually take around 30-45 minutes.
I also see patients before and after surgery in outpatients’ clinics. I usually have one general clinic and one multidisciplinary clinic each week, lasting half a day each. Leading ward rounds, which is an important part of the training for junior doctors is also part of my working week.
For me, providing my trainees with support, coaching and encouragement is central to what I do. When I go to national and international conferences I always take my trainees along, and encourage them to give presentations about our research.
When you become a consultant teaching is an important part of the job. I teach medical and dental undergraduates, foundation dentists, core dentistry, core surgical and higher specialty trainees.
Research is another key aspect of my work. I am our academic and research lead and I encourage our team to be involved in surgical projects which will improve patient outcomes. I co-supervise one PhD student and one postdoctoral research student.
I am particularly interested in research into tissue engineering, as well as some of the psychological aspects of our surgery. We are currently looking at the kinds of psychological and psychiatric support that will benefit patients who have suffered facial trauma.
My surgery days are long, and usually start at 7.30 am with a pre-surgery ward round and finish at around 8 pm. Most other days I work from 8 am to around 6 pm.
I love my job as it is very varied and I equally enjoy surgery and research. Operating is so rewarding and surgery on the face can really make a difference to someone’s life. People sometimes tell me they have been bullied because their jaws don’t meet properly, and that their lives have changed dramatically after surgery.
In OMFS we really are part of a large multidisciplinary team. We work alongside neurosurgeons, ophthalmologists, orthodontists, dermatologists, physiotherapist and other medical and dental specialists, which is very enjoyable.
Watching trainees develop and gain surgical skills is another rewarding aspect of the job.
The hours in surgery are long and working in trauma and infection can sometimes be unpredictable but you learn to pace yourself. But I do have to plan my personal life around my surgical lists – this means an early night the day before surgery. You have to be very focussed during your work as a surgeon, but your training prepares you for this.
It’s really important to strive for a good work life balance and find time for relaxation. I enjoy spending time with my husband and young son, and we enjoy playing tennis together and travelling. It’s also important to have a good network of supportive and family and friends and to have good childcare in place.
I want to continue to push forward the development of OMFS surgery via research and to continue to encourage OMFS trainees.
- follow your dreams and keep focussed on your destination even though there might be occasional detours
- plan your career at each stage and continually set your yourself small achievable goals