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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...
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Code Red Induction

This week I have started a new job as a Surgical SpR in a Major Trauma Centre. I was assured by my service manager that I had be allocated a two week ‘shadowing’ period, as I am new to the hospital and therefore have no IT access, badge, any idea how the system works or any experience of working in a Major Trauma Centre. He then went on to say that unfortunately due to a rota gap, there would not actually be anyone to shadow and would I mind awfully holding the trauma bleep. I cannot say I was terribly surprised that, as in most new positions in the NHS, I would be starting very much in the deep end. Shortly after this less-than exhaustive induction, the trauma bleep went off for my very first Code Red trauma call. Time to start shadowing myself! As I couldn’t find my way to the Resus Bay from within the hospital, I walked out of the hospital and came back in the patient entrance to A&E from the street. The patient was just being wheeled into Resus by the Air-ambulance doctor at th...
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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...
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