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I didn’t like what i had become, I was grumpy, stressed, my health was shot. I was inpatient. Snappy. My head which had used to be full of stories, and images was now concerned only with getting enough sleep to make it through the next on call cycle.

But unlike my friend Halaina over at the D word, change came quick, I guess the signs were there but I was fixated on the idea of becoming a plastic surgeon and ignored it until I was forced to confront them
The consultants had not made time to see me to discuss my future, but assured me that they would have me in my current job and not to worry.
I didn’t (rookie mistake. Don’t trust them as far as you can throw them.) and a few weeks later got a generic health department telling me I was unsuccessful in my application for my current job.
This was a bit of a kick in the balls, as I had no negative feedback, and no heads up this was on the cards.
But this was the big kick I needed. Looking back over this blog, I was always torn between my need to do my art and my love of medicine. The last few years was an experiment in subsuming my art for medicine and I didn’t like it. I wasn’t me. I missed being creative, I missed collaborating, I missed moving and dancing.
I had forgotten these things and this kick was what I needed to reassess.
I took the time to step back and get in touch with what I wanted out of life, I looked forward to what I could expect if I wanted to pursue plastics and I found no joy in that.
I took wise counsel from trusted friends and decided to step back in 2015. reconnect with my art practice and take a different path.
So in 2015, I’m dancing again, teaching, doing a Masters in Sports Medicine, a Dip in child health, making films, riding my bike badly. Its going to be good.

Follow your bliss’ (Joseph Conrad)

a lecturer once told me this and it stuck in the back of my mind until recently and it seems apt.

I did manage to make a small film at the end of last year which re-enforced how much I missed being creative.

Us Right Now (120mb. NSFW)

LakeWanakaTree

Lake Wanaka 2013

I was asked about advice for advice about undertaking Plastic Surgery training in Australia, so I thought I’d write it down.

The process goes Internship -> Residency (1-2 years) -> Unaccredited registrar (numerous) -> Accredited Registrar (5 years) -> fellowship (optional 1-2 years) -> Boss

Now the problem is that it is pretty competitive at all levels, very uncertain and often unsupported.

With the medical student tsunami well underway, competition for residency position is heating up, no longer can you expect to simply wander into a residency job of your choosing post internship. Further more if you want something as competitive as Plastics then you’ll need to score plastics rotations so you can meet the bosses. You also would benefit from an ICU, ED or anaesthetics term (my advice is to try and schedule this late in your residency career as you have to have done one of these terms within 5 years of applying to the SET program and you don’t want to break up your unaccredited registrar time with a residency ED/ICU/Anaes job if you can help it)

you need research, in plastics, published in certain journals.
You need a masters at least
you can now do your primary surgical exam before applying to the program (~$3000)

So you’ll want to start angling for unaccredited jobs. These are competitive (FYI there are 9 unaccredited jobs in NSW. people tend to stay in them till they get on or quit, and only 7 get onto the program per year IN THE COUNTRY).
Be prepared to suck up, hard. 1 guy i know spent every weekend and every morning pre round, hanging out at a different hospital to the one he was working at chatting up the bosses.

So while tootling around in unaccredited land, getting your masters and publishing like a mofo you will start thinking about applying for the SET program. The privilege of applying will cost you some $1200.
People are getting on somewhere around around 6 years post graduating uni, and it is not unheard of getting in at 10 years post.

Now, its probably true that if you really want to get on, you will eventually. The thing you have to ask yourself is how long you are willing to wait and how much you are willing to put up with.
As a registrar your time is not your own, you will have surprise shifts all the time, you will work 110hrs in a week +, we still do the Friday 11pm to Monday 8am (and expected to work all Monday as well) on call. (for those non surgeons, consider that on Monday your surgeon may not have slept since Thursday night). Almost everyone in the hospital will hate you, because while you’re operating you’re not in clinic, and ED has been waiting for hours, and that patient on the ward needs a review, and no they will not get someone to cover the other 2 registrars who are off. And certainly don’t expect love from the boss who has called the sole remaining registrar off to help them in the private.
As an unaccredited registrar you can’t even think about the light in the end of the tunnel because you aren’t even in the tunnel yet. Do consider what happens if you don’t get onto the training program – GP is increasingly competitive with the vast numbers of students coming through, CMO jobs are slowly being phased out as young consultants come out the other end. Surgical positions are tightening down from a high of 14 entries/year to 7 now.

That being said, your time actually operating is magical (provided that you were lucky enough that someone has taken the time to teach you, as an unaccredited the bosses are generally uninterested in teaching you, and you will have to settle for scraps of teaching. I was lucky in my first accredited year where I got superb training, but in my second year I can count on one hand how many times I operated with a consultant). (also as an unaccredited trainee you are NOT ALLOWED to go to any of the accredited teaching session) The extraordinary privilege of operating on someone and being able to restore function is unmatched, and while you are in theatre, its a bit like being on stage – its all about the operation, time loses meaning, everything else is forgotten, and you work.
And seeing people regain function in a hand, or saving someone’s sight is incredible. I got to see great things, I got to do great things and I certainly don’t regret doing it.

So it’s really up to your values. Surgery demands your everything, and it is rewarding. It is a noble cause (until you become a private cosmetic surgeon which I’ll rant about another time), and that might be for you.
And while I tell you all this, I was told all of this before. It will make not one iota of difference because you will need to experience it for yourself to see if its worth it for you.

Good luck, let me know how it goes.

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Basel 2014

Holy carp, Its march 2015. A lot has changed. I lost the last few years as a plastic surgery registrar (resident for you yanks), I haven’t created barely anything during that time so 2015, I’m stepping back, reassessing, reconnecting with my arts practice.
Its a bit odd, stepping back from a promising, exciting (lets face it glamourous sounding)¬†career and something I didnt’ think I would do, but I feel I should write it down, its something young medical students and doctors should think about before embarking on study/specialisation.

This is largely inspired by my friend over at the D word someone I knew as a young ballet student who became a gorgeous dancer with the Australian Ballet and has moved over to Germany and tackling new and greater challenges. Check it.

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we had waited 4 days for an interpreter and as we explained the procedure, she said nothing but nodded sagely. When we had finished we asked her if she could relay the information to our patient. With deep thought, she leant forward and yelled ‘hey, HEY! they wanna put a needla into your back-eh?’

For a week now, she has struggled to breath. Her lung is full of muck, so much that it has leaked out and is filling her pleural space with a cheesy crust. We’ve put a chest drain in – the underwater seal nearly as big as she is and it hasn’t really helped – she needs surgery.
So we take her in, and perform a ‘mini’ thoracotomy a massive operation for anyone, let alone our spunky little kid. I stayed with her till daddy came. The next day, she was still quiet and subdued, but the day after, she was all smiles giggling and playing with her many balloons and stuffed toys without a hint of the sickness and hurt of only a couple of days ago.

Sometimes my job is pretty awesome.

Unrelated photo

Not my story, but a good one nonetheless

About 9pm, orthopaedic ward

A Mr Jones has had a hip replacement which went smoothly, however has been vomiting enthusiastically for a few hours.
Bonnie, the intern, has been trying her best to sort it out, but running of of ideas and her Reg in theatre and the med reg uninterested, decides to call her boss known only as Prof, a very english professor of Orthopaedics.

Prof: Yes?
Bonnie : Hellow, excuse me Professor, its Bonnie, your intern. I have Mr Jones here who you performed a total hip replacement on earlier today. He’s been vomitting since 5pm, I’ve given him Metoclopramide and tropisitron, and xray didn’t show obstruction and
Prof :sorry, I’m going to interrupt you here
Bonnie : yes?
Prof : is he vomiting bones?
Bonnie : excuse me?
Prof : its a simple question, is he vomiting bones?
Bonnie : bones?
Prof : yes. Those white calcified structural things that I operate on.
Bonnie : uhh, no.
Prof : well then. Its not my problem. I suggest you call someone else. I dont care who.
Click

bones

The things people come into hospital emergency departments boggles the mind. The finest one of last week
‘Patient has concerns about mild red mark on arm. ? slept on it’

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