2. Episode 2

Overview

Episode two in the series follows trainee surgeons Anita Mohan, Smitesh Patel, Onur Gilleard, Rosie Johns on one of the most competitive surgical training programmes in the world. Out of the 110 trainees on the course, 26 year old Onur Gilleard is one of the very top students. He’s in the Accident and Emergency department at Hammersmith Hospital and is having to make critical decisions when he gets an urgent call. A woman who is 15 weeks pregnant has had a pain in her side for several days and Onur’s instinct is that she may have appendicitis. If he’s right, she will need an urgent operation, but it’s difficult to diagnose and general anaesthetic is a serious risk for both mother and baby. His advanced diagnosis was correct and following the operation, Onur says: “She did have appendicitis, the appendix was quite clearly inflamed, taken it out and now she’s better, and, you know, it’s a huge relief for her, it’s a huge relief for us, the baby’s doing fine, so it’s a perfect result.” Smitesh Patel has just started in the orthopaedic department fixing broken bones. Like all of the students he’s trying hard to get to do an operation on his own, but as part of a large surgical team, it’s often more senior trainees who get the chance to operate. He’s invited to a hip operation, but the senior trainees are given the chance to operate and by the end of the procedure, Smitesh has done nothing but watch. He says: “There’s a hierarchy in your training and rightly so, the further along you are the more that you’ll get to do more complex procedures.” Eventually, he’s given the opportunity to do an operation on his own; removing metal pins which held a broken arm together while it healed. He completes the whole operation without help and receives praise from his consultant for making it look straightforward and easy. This valuable operating experience has put him back on track to pass the year. Anita Mohan has her sights set on becoming a plastic surgeon and is keen to impress her new team at Guy’s and St.Thomas’s. She’s given the opportunity to assist in a complex operation with a top reconstructive surgeon. The patient is Jane, a lady who is allergic to the sun and continually develops cancer. The operation is to repair her damaged nose with a skin graft and it’s Anita’s job to cut the surgeon’s fine stitches. But a tiny slip means she knocked the surgeon’s reconstruction and upset the new piece of skin. It’s a bad mistake and Anita knows she can’t afford to make errors if she’s to succeed as a plastic surgeon, one of the most competitive specialties. But she manages to prove to her superiors that she has learnt enough to do delicate operations herself and is going to remove scar tissue on the back of a seven year old patient’s head to allow her hair to grow normally again. A successful operation is a much needed boost for Anita and afterwards she says: “That was really good, it’s very exciting and it’s really good for me when I get to be more involved in the procedure. I hope I’ve made some progress in the way I handle the instruments now.” 27 year old Rose Johns has had a shaky start to her training. In her first four months she missed a lot of chances and has had to develop more confidence to ensure she gets all the opportunities she can. During the week she lives in London, and is only able to spend two days a week at home with her fiancé Adam heading back to London at 5am on Monday mornings. After eight months of training she should be tackling bigger operations, but instead she’s decided to pack her bags and leave London, quitting one of the most renowned surgical schools in the world to train closer to home instead. As she heads back to spend more time with her fiancé Rose admits: “It’s got some of the sort of biggest teaching and best teaching hospitals, certainly in the country, and possibly in the world as well… and it’s difficult to think you won’t be part of that any more.”