How to Become a Surgeon: Your Questions Answered
Recently, MedicGuild wanted to hear your questions for our surgical registrar about surgical training pathways. And here, with the new medical year upon us, a time when doctors often set goals for the year ahead, she answers those questions.
Previous articles on MedicGuild have detailed how to set up your early career as a student and intern for surgical training, and the ins and outs of applying to the surgical education and training (SET) program through the Royal Australasian College of Surgeons (RACS). In this article, I’ll answer questions you have asked us about life and career planning, how to combine research and study with full-time work and whether or not becoming a surgeon is really worth it.
Find your ‘why’
One of my mentors once told me, “the time will pass anyway, you might as well spend your days doing something you really love, then it won’t feel like work”. This is something I now commonly share with medical students and junior doctors who are deciding what kind of doctor they want to be.
All training pathways are competitive in Australia, all require sacrifices, dedication, and hard work, but, if you find and focus on your ‘why’ then the challenges become easier, the wins become sweeter and the lessons you learn will shape the future specialist you become.
Everyone’s ‘why’ will differ. For me, surgery is my Ikigai – that is, the intersection of my passion (making a tangible and meaningful difference in people’s lives and getting them back to living their healthiest life), my talent (at the moment as a junior starting to master minor procedures and then, as I progress, major procedures!), what the world needs, and what I can earn an income from.
My strengths – I am a good communicator and think quickly on my feet, I have high emotional intelligence and love working in teams - are good for both the patients I serve and the surgical teams I work in. Because of this, as an intern, I was recharged and energised by the long days of surgery – the multiple moving parts, varied patients and colleagues, and the fact that no two days are the same.
After a long shift as a medical intern, however, I was fatigued by the lack of variation in my working environments and found my mood was lower and that my motivation to do anything outside work had disappeared.
I encourage you to listen to these subtle signs as you go through your rotations to help you find your strengths and which training pathway is the best fit for you.
What does it really take?
Many of the questions submitted to us centred around what it takes to become a surgeon. A practical and didactic place to start are the ten RACS competencies for selection and ongoing success as a trainee. RACS have also detailed the JDOCs Framework for juniors wanting to pursue a career in surgery. Further, as the previous MedicGuild articles (above) discussed, the RACS website and specific surgical colleges have outlined the selection criteria for applicants.
My biggest piece of advice from personal and collective experience is to try to generate research opportunities early in your career – which is a lot easier said than done! Research presentations and publications comprise a large proportion of the selection criteria for all surgical specialities and are often the biggest hurdle for applicants to overcome.
Talk to any surgical registrar and you’ll hear countless stories of research projects that never got beyond ethics applications. In the past, I have chosen some research questions that were neither interesting or unique to my supervisor or I or the wider medical community. Though I have learnt numerous lessons so far from misfired research projects, time is the scarcest commodity you have as a junior doctor, and it’s important to keep in mind how valuable yours is.
For me, the best and most productive research questions were ones for which I had supervisors who shared my passion for the topic, and who had extensive previous research experience.
Also, it’s worth starting small. The large, randomised control trials are the cornerstone of evidence-based medicine, but, as a junior garnering research experience, sometimes the best place to start is learning about the publication and presentation process with a case series or small retrospective cohort study – at least, it was for me!
Flexible Training Options
I can’t speak to how flexible training options work for doctors who combine family planning, caregiving, other commitments with surgical training as I haven’t undertaken flexible training to date.
From discussions with colleagues, I’ve learnt that flexible training options vary widely. It could be working one half of the week or working a week on and off roster with another trainee undertaking flexible training.
What I can tell you is that RACS does support flexible training and has provided a toolkit for hospitals to work through when implementing flexible training options. Hopefully, someone who has lived experience with flexible training can write the next MedicGuild article!
Full-time surgical registrars are contracted to work 43 hours a week (including five hours of training time). More typically they are rostered 45-55 hours a week, depending on if you're also working an evening shift or weekend on-call.
From my full-time experience, I’ve found it is easier on some days than others to find a balance with all your competing interests. In recent years, I have been managing a part-time research degree with my work, building my CV for my SET application, personal commitments, exercise, nutrition, sleep, hobbies….the list goes on.
While others may have a different philosophy, I don’t think achieving the perfect 50:50 work-life balance is possible with many careers including medicine, but that doesn’t cause me grief or stress. I prefer to think of my competing interests and commitments as rubber and glass balls that I juggle – I know what the glass balls are in my life, the people or commitments that, if I drop them, will shatter and never be the same. The rubber balls in my life are commitments that, if I drop them, will bounce and I can pick them back up another day. Some weeks the scale weighs more heavily on the side of work and research commitments, other weeks it is heavier on the side of my personal life, but, overall, I have found that being clear in my priorities helps manage the crazy hours in surgery.
The other thing I consistently do is a thorough handover between shifts, because surgery is a team sport! This allows me to mentally hand over the responsibility and care of patients and switch my mind off and to other aspects of life – so take your half days and your rostered leave, it will make you a better doctor and teammate.
Best of luck to all those starting new rotations in the first week of February – and happy goal setting to all those dreaming of speciality training pathways!
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