Contact


Twitter 

https://twitter.com/The_surgi_reg



E-mail

thesurgicalreg@gmail.com



Comments

Post a Comment

Popular posts from this blog

When there is just too much trauma!

The hospital in which I currently work is unfortunately not a Major Trauma Centre, although the head of Emergency General Surgery tells me that the Big Wigs have aspirations to make it one in the next 10 years - so long as Neurosurgeons can be persuaded to work here. Nonetheless, in a typical on-call week you can currently only be expected to be dragged down to A&E once or twice for a trauma call and consequently trauma laparotomies are vanishingly rare! Last weekend however, my Sunday afternoon got a bit exciting! The Consultant was being supportive and hanging around unscrubbed in theatre whilst I attempted a somewhat troublesome Hartmann's for perforated diverticular disease that had been brewing on the ward for a little while before deteriorating that morning. As I was firing the Contour stapler to divide the rectum, the trauma bleep went off, so we sent the SHO off to investigate and the Consultant scrubbed in to help me. Not long afterwards, the SHO called back to excited
Read more

How to Pick a Subspecialty

The question of how to choose a subspecialty is an anxiety that has insidiously been creeping into the periphery of my consciousness over the past few months. I am now midway through my ST5 training year, and thoroughly comfortable with my identity as a surgical registrar. Unfortunately, my levels of self-regard have clearly not yet reached sufficiently lofty levels, and I am still utterly unable to imagine myself as a consultant. I am therefore at rather a loss as to how to answer my TPD’s recent enquiries as to my thoughts regarding a subspecialty, and have ignominiously left that particular e-mail unanswered for an unacceptably long time. But this is a big decision! Training feels preposterously long and arduous; but is actually only a trivial 8 years compared to potentially 30 to 40 years of sub-specialist consultant practice! Nonetheless, before the end of training, a declaration must be made as to which of the five sub-specialties is preferred; the major sub-specialties being Bre
Read more

Pause...and then whip out the gallbladder

Squeezing impatiently through the waddling crowd of the unhealthy and the overweight in a hospital's corridors and stairways (and the world in general), it is astounding to remember that that the lifetime prevalence of gallstone disease is actually only about 10% to 20%. It's even more difficult to keep this at the forefront of your mind in a General Surgery outpatient clinic or On-Call, when there is barely a patient who doesn't have abdominal pain that they attribute to their inevitable gallstones! Nonetheless, I assumed that the decision making was a foregone conclusion in these patients who present with typical biliary colic and have proven stones or sludge - of course we should just whip their gallbladder out! Whilst this bit is easy, the practical business of listing a patient for cholecystectomy is a little harder - particularly with the decimation wrought by the COVID-19 pandemic on waiting list times. Patients with uncomplicated biliary colic are extraordinarily fo
Read more