JAP Volume 7 Issue 1 Feature
Crossing the Blood-Brain Barrier
For a young doctor, finding an ideal specialty is no simple task.Dr Seetal Patel tells of interviews and applications, the busy life behind the surgical mask and crossing over to the pain-free world of anaesthesia.
M
y journey began in a busy teaching hospital in Stoke- on-Trent, Staffordshire. At the time, I was a PRHO in General Surgery. My previous House job had
been in General Medicine: a 12-bedded, sleepy geriatric unit. It was run so desperately well that I was not to have an ounce of an impact on the provision of services during my time there. General surgery, on the other hand, was a chaotic jumble of five consultants, 120 patients, nine wards, two bickering registrars and me… yes just me, to ‘house-manage’ all of them. Before the privileged days of EWTD, I could not go far wrong if my day spanned an unhealthy 14 hours, working flat out everyday. Crazy as it may seem, it was the sole inspiring experience to mould the next four years of my life. I was totally gripped by the specialty that was Hepatobiliary and Upper Gastrointestinal General Surgery. I wanted to be part of the elite, to be able to be the hero of the day, to go where no surgeon would dare, to conquer the realm of females in this tough, harsh reality of surgery. The team I worked with was awe-inspiring. They were simply remarkable. I was bowled over by the heroics and wanted to be a general surgeon; more than that, I wanted to be a general surgeon in upper GI and hepatobiliary surgery. My path had been set. I expressed interest, keenly attended
courses with registrars, went to theatre to hold a retractor for hours, began studying for my post graduate exams and all the while duly continued with my bitter schedule of blood, forms, requests, cannulae and TTAs. The team spirit and camaraderie back then were strong.
We had regular nights out, shared highs and lows in the mess on weekdays and in the residences on weekends. Consultants through to juniors would go out and party hard only to wake up bright-eyed and bushy-tailed the next day and have to work twice as hard. The throughput was incredible and all the while I was getting more and more inspired.
Let the applications begin The applications were submitted for SHO jobs in the field of surgery
or related. I underwent many interviews: some funny, some utterly exhausting and some just bordering on ridiculous. I had no skills, no knowledge and no way of getting a job as a surgical SHO. So instead, I got my first SHO job in gastroenterology and A&E, telling myself that I would use the experience I’d gain here when I was a surgeon. The following year, I did get a surgically orientated job. I
began as an orthopaedic SHO. By this time I’d gained my MRCS parts I and II. I loved this job and applied my all to it, and thus began my intense application to everything surgical from then on. I then went on to a rather privileged job, SHO in Coloproctology at St Marks Hospital. This, I enjoyed the most. I felt like I was finally there. The following year I began application under the new MTAS system.
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www.japractice.com MTAS
This was the beginning of a period of great tumultuousness. MTAS was the biggest disaster to hit the medical profession and all involved were to suffer. The implementation of this trainee appointment system as the sole method, led to wide-spread criticism from both inside and outside of the medical profession. Repeated apologies were made by the Secretary of Health at the time, Patricia Hewitt, and the independent review of MMC, led by Professor John Tooke, revealed gross and substantial errors. It did however lead to everyone who had applied for a job being offered an interview. This, for confident, well-versed me, meant a job as an ST1 in surgery.
Surgical training established My first year as a surgical trainee was amazing. I moved from
simple stitching to doing appendicectomies un-supervised. It was, however, a very busy world, and a very cut-throat environment, where the competition to get into theatre and operate was immense. I continued in my relentless pursuit, doing all the courses known to Man, getting my postgraduate exam and operating until the early hours, but to no avail, I could not secure a further job in higher training. There were several reasons, which would take years to correct, including the lack of research, lack of peer-reviewed journal publications and the widespread lack of jobs at this massive well-established bottleneck.
I had no chance of getting a post that year. I had to work and continue the chase simultaneously. So applications went out to every allied specialty in the hope that I’d widen the opportunity enough to be chosen. One of these was anaesthetics. I thought a little time working in ITU, fine-tuning my physiology knowledge, learning about what goes on behind the curtain and brown- nosing could only add to my appointability. I had many friends in anaesthetics and they helped to convince me that this was a fail-safe move on the surgical chess board. Bar doing three years of arduous research resulting in less than appealing results, which could not be applied to any real population, I was constrained to applying with all my literary might.
Anaesthetics, here I come I genuinely jumped for joy when the long-listing led to short-listing,
led to an interview, which finally led to a substantial offer of Core Training in Anaesthetics. I was delighted. I was sure this was the making of great things. I couldn’t have been more right. I started in Anaesthetics in a fabulous department in a world-
leading institution. Hampstead was just beautiful, the job was awe-inspiring and the people were very welcoming. Gone was the bitter competition, the relentless CV buffing and the endless fight to be the best. Now, everyone around me was the best. After all, that is why we are the best specialty in the hospital
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