"Working as part of a friendly team is fantastic and my specialty has a great camaraderie."
Edward works at Lancashire Teaching Hospitals NHS Foundation Trust as a specialty registrar. He is also an honorary research fellow at Southport and Ormskirk Hospital NHS Trust.
By the age of 15 I’d decided on a career in medicine. It was the combination of working in science and being able to help others that really appealed. I’m the first doctor in my family.
During medical school I enjoyed surgery and was exposed to some inspiring surgical role models. I also chose a student-selected module in trauma and orthopaedic (T&O) surgery, which involved a research project.
After medical school I progressed to two years of foundation training, FY1 and FY2. I deliberately applied for jobs that included surgical rotations - ear nose and throat (ENT), urology, general surgery and T&O. I also gained useful experience in A&E and diabetic, renal and endocrine medicine.
During foundation training, surgical experience mainly involves ward-based care of patients before and after their operations, rather than being involved in the operating theatre. The opportunities to learn about surgery during foundation training do exist, but you have to make things happen for yourself. I tried to make life easier for the surgeons, by working hard on the wards and ensuring the patients were looked after, then making time to get to theatre. In return I gained some early experience in operating.
After foundation training I applied for general core surgical training (CST), which lasts a further two years. After six months in CST I’d decided that T&O was for me, I contacted the training programme director, requesting to transfer onto ‘orthopaedic themed’ CST and I was lucky enough to be accepted.
It’s important to make contact with people and ask for help if you are interested in surgery. The competition is intense, but many people helped me along the way and without them I might not have been successful in gaining a place on the higher specialist training programme.
Before commencing higher specialist training I had already gained some research and teaching experience. CV building is tough and there are many hurdles, mainly a lack of knowhow. Initially I helped other doctors with the more mundane aspects of research, conducting literature searches and referencing to gain experience. I set up teaching programmes for medical students to help them with their final exams, and demonstrated anatomy in my spare time.
Higher specialist training in T&O surgery takes six years and involves six-month placements in the different sub-specialty areas. I’m currently working as a spinal registrar and see patients with degenerative spinal conditions, spinal cord compression, nerve entrapment, and those who have injured their backs.
I normally have three half-day clinics each week – two spinal clinics and one fracture clinic. At the fracture clinic I see around 30 patients (children and adults) with broken bones and making decisions this quickly is challenging. Most need their fracture setting in plaster by the technician, but some fractures require re-positioning or surgery.
I am on-call for 24 hours once a week at Royal Preston Hospital, which is the major trauma centre for our region. We form part of the trauma team with A&E doctors, anaesthetists, general surgeons and specialist nurses. We are pre-warned for a big trauma and I am bleeped before ambulances, including the air ambulance, arrive. This could be any time of the day or night.
We aim to carry out emergency (trauma) surgery during the day, but there are times when operations must be done at night, in which case I always keep in touch with my consultant.
I also have about four or five sessions of planned surgery each week (orthopaedics). One of these is a triple session where I operate for up to 12 hours a day. Some operations are very quick, for example a spinal injection, whereas other operations, to stabilise someone’s neck or straighten a spine, may take up to five hours. I also see patients before and after surgery on my regular ward rounds.
I spend one day a week undertaking research. I fit in my admin during lunch breaks or at the end of the day. I also teach medical students and junior doctors.
I love T&O surgery, as you often have the opportunity to immediately improve someone’s life, whether you are fixing a broken bone or replacing a knee or hip. Working as part of a friendly team is fantastic and my specialty has a great camaraderie.
Along with managing my time effectively, another challenge is moving around the different sub-specialties, as you have to become competent in a new area quickly. I make time for reading whenever possible, as there is so much to learn. My working day can be as long as 12 or 24 hours and is often fairly ‘full on’, but you get used to that. It’s important to have supportive and understanding family and friends.
This job can be stressful and physically demanding so I try to keep fit and healthy. I go to the gym, play golf and enjoy socialising with my other-half, family and friends.
Hopefully, I will reach the end of my higher specialist training in three years and be awarded my Certificate of Completion of Training (CCT). After this I plan to do a specialist fellowship for a year, before applying for consultant posts as a hip and knee surgeon.
- find out what makes you tick early on, and make steps in your chosen career direction
- be efficient and keep your portfolio up to date
- stay humble and be gracious to your bosses, training you is hard work
- think what you would like your references to say – then be that person. You’ll need to be likeable with a capacity for hard work