I recall when I was a surgical trainee being thrown into situations in which I felt completely out of my depth. It was my very first day as a general surgical registrar in 2001 when I received a call from the emergency department about a trauma that was coming in. It was an impalement injury. A chap had been working up on a ladder when he slipped and impaled himself on a shovel below.

I rang my boss and explained the situation. I was expecting that he’d drop what he was doing and rush in to receive the patient. He was a very experienced surgeon and simply said, “have a look at him and give me a call”. Although these moments in training were challenging and confronting, there were enough senior members of the emergency team present to make the situation safe and protected for a junior surgical registrar like myself.

Trauma medicine is all about first principles and priority of urgency and severity. Airway, breathing, circulation, spine are all assessed rapidly, immediately and treated simultaneously. Although his injury appeared ghastly on the surface, all of his vital signs were in fact normal and his injuries were not life threatening. After making that initial assessment, the rest of his management was up in the operating theatre, extracting the shovel handle, cleaning him up, and sewing him back together!

The training program is a wonderful example of skill acquisition. Initially, trainees are taught basic skills and as these are accomplished more and more responsibility is handed over. Ultimately, in the final year of training, most surgical trainees are competent to operate independently with the supervising surgeon being available for advice. All of this happens within 4 or 5 years. Being thrown in the deep end is confronting but once accomplished, it gives great confidence in one’s own abilities and expertise. It helps you to step up and grow into the role of a fully fledged surgeon.

Looking back, I’m very grateful for all my surgical teachers, trainers and mentors who patiently helped me gain the skills that I have.

Be well!

In Health and Wellness