This is probably the biggest dilemma facing surgeons of all grades, stages and demographics; how do we juggle the knife and our life? Let's call it what it is...we need to have a life-work balance. The job is all-consuming and will devour your very essence if you let it, so how do we straddle both domains successfully? In the first of this three-parter (because, let's be honest, this is a huge topic worthy of time), we discuss:

• Good habits that can set you up to maximise your day and stop admin encroaching on your free time.
• Balancing the different roles we occupy.
• Making time for your hobbies and pursuits, whether those are smashing out ultra-triathlons, going outside to touch some grass or even just binging Netflix.
• Pearls of wisdom given to us by the wise old trainers of yore, warning us to capitalise on youth and freedom so that we're left with more than regret when we finally put the scalpel down.

Remember....get busy living or you'll be too busy shivving!

Walking Britain - finding walks close to you: https://www.walkingbritain.co.uk/

Ramblers - even more meandering: https://www.ramblers.org.uk/

D.A. Parry, R.S. Oeppen, M.S.A. Amin, P.A. Brennan (2018). Could exercise improve mental health and cognitive skills for surgeons and other healthcare professionals? BJOMS 56(5)367-370. https://doi.org/10.1016/j.bjoms.2018.03.005.

Balancing a personal life with a surgical career | The Bulletin of the Royal College of Surgeons of England (rcseng.ac.uk)

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As we discussed in the previous episode, sometimes life and the job sticks the boot in, and kicks you when you’re already down. Picking ourselves up is easier said than done.

Psychology is a vital aspect of any high-performance industry because we need to believe we can do it; not just for us, but also for the people who rely on us. Sometimes we need extra help to find the right headspace.

Today we’re joined by Nicola Forshaw, counsellor, therapist and professional coach and we talk about how coaching and/or mentoring can get you back in the zone.

What’s the difference between the two? How does a good mentor mentor? What benefits does it bring? How do we combat performance anxiety? How much time do we really need in the stretch zone? Is it bad if we like wallowing in the comfort zone? Are we on the highway to the danger zone?!

Look, stop asking questions and just listen; all will be revealed. Now drop and gimme 20!

You can't say 'danger zone' without listening to Kenny Loggins: https://www.youtube.com/watch?v=siwpn14IE7E

Nicola's endeavours - Nine Coaching, Teaching and Wellbeing: https://www.nineteaching.com/

Gagnon, L & Abbasi, N. (2018). Systematic review of randomized controlled trials on the role of coaching in surgery to improve learner outcomes. The American Journal of Surgery, 216(1), 140–146. https://do.org/10.1016/j.amjsurg.2017.05.003

Lin, J & Reddy, R (2019). Teaching, mentorship, and coaching in surgical education. Thoracic surgery clinics, 29(3), 311-320. https://doi.org/10.1016/j.thorsurg.2019.03.008

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So you’ve got into specialty training? Made it to the promised land? You can turn it on to autopilot and cruise your way to the end right…?

Wrong.

Buckle up and strap yourself in! This is where shit gets real.

Many trainees will be absolutely fine, but what if you’re one of the ones who aren’t? Complaints? SUI? Complications? Failing FRCS? All these things knock your confidence which is essential for both survival and progression in surgery? So what do you do? How do you go on?

As eminent Gotham city physician Dr. Thomas Wayne once rhetorically asked his son: “Why do we fall Bruce? So we can learn to pick ourselves up again…”

Granted, even though we’re a) surgeons not physicians, b) not billionaires and c) not Batman…the sentiment still holds true.

Today we’re joined by local lad, orthopod extraordinaire and all-round top bloke Rich Unsworth (Health Education North West) as we talk about the journey from the highest highs to the lowest lows, and how you pick yourself up, dust yourself off and find the will to carry on.

It's a long slog to the end, you might end up broken, and like the name of the episode suggests, 6 weeks in a plaster cast sometimes just isn't enough....

Pinto, A & Faiz, O & Bicknell, C & Vincent, C. (2014). Acute traumatic stress among surgeons after major surgical complications. The American Journal of Surgery. 208 (4). dot: 10.1016/j.amjsurg.2014.06.018. 

Dean, E. Surgeons and mental health support. (2020). The Bulletin of the Royal College of Surgeons of England 102 (6). dot: https://doi.org/10.1308/rcsbull.2020.169

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As the unstoppable bullying endemic wreaks havoc, bringing surgical trainees to their knees with widespread anarchy and chaos, one man must face his greatest challenge to battle injustice. However, is the @orthopodreg prepared to walk the fine line between defender and avenger, hero and vigilante?

Whilst that is just the synopsis of The Dark Knight (with a few names/details changed), it rings true for detailing the mammoth scale of the problem. In Part 2 of our look at bullying, we're privileged to be joined by the shining beacon of justice that is Simon Fleming.

The self-described misfit who has long been the target of bullies, starting as a fat kid, and then joining a speciality with the worst reputation for bullying. He made it his British Orthopaedic Trainees Association (BOTA) campaign pledge to tackle bullying at its root, and then dedicated the last decade of his life to doing so, being met with scorn, criticism and vitriol. He’s been the proverbial lightning rod for the wrath of the establishment, and the metaphorical shield for trainees to hide behind, despite constant threats to his training, career, and even his life.

We talk about his life’s work, his personal experiences of bullying, how far the movement has come, where we are as a profession now, and how he will continue in his crusade as a consultant.

He is the hero that we as trainees deserve, but not the one we need right now. So he will be hunted. Because he can take it. A watchful protector. A not-so-silent guardian. Wait… is he actually Batman?

Simon's Twitter account: www.twitter.com/orthopodreg

One of Simon's most visible TED talks: https://www.youtube.com/watch?v=aVkGiziPY1o

Simon Fleming: I launched an anti-bullying campaign to change culture in healthcare (2019). BMJ: 365:l2325 doi: https://doi.org/10.1136/bmj.l2325 

Fleming, S. and Fisher, R.A., Sexual assault in surgery: a painful truth (2021). The Bulletin of the Royal College of Surgeons of England, 103(6), pp.282-285.

https://doi.org/10.1308/rcsbull.2021.106

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Time for some real talk! Bullying and surgery go together like drink-driving; historically seen as no big deal, not uncommon and frequently resulting in disaster. That is of course until some brave souls step in to permanently alter the landscape. Surgery is typically dominated by strong personalities and we as trainees have to learn directly from, and form close relationships with these individuals. It’s also a tough career fraught with challenge and adversity, so resilience is necessary.

However, when does it become too much? Where is the line between 'having a laugh' and 'bullying'? How much 'character building' do you need? Is bullying detrimental in surgery or is it turning you into a capable independent operator who can stand the heat in the kitchen? Do trainees just need to take a joke and get thicker skin?

No surgical trainee will have Patrick Swayze standing up for them like he does for Jennifer Grey in Dirty Dancing, but we’ve got the next best thing; (former) trainees advocating for trainees ✊.

In the first episode of this two-parter, we're joined by Dave Riding (Consultant Vascular Surgeon, previously Health Education North West) who spearheaded the Royal College of Surgeons of Edinburgh anti-bullying campaign.

We talk about the subtle beasts that are bullying, undermining behaviour and harassment. Does bullying actually result in patient harm? Have we been bullied? Who do we report this to? Should we report this? Wait, so have we bullied someone???! Are we the baddies?!

Lots to unpick…

RCSEd Anti-Bullying Campaign: https://www.rcsed.ac.uk/professional-support-development-resources/anti-bullying-and-undermining-campaign

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'Build Me Up Buttercup' is the seminal song from The Foundations and is a tale as old as time. It portrays the story of unrequited love, lovesick fools pining after the object of their desires, constantly being let down and messed around. And just like The Foundations, foundation doctors across the land endure a similar experience trying to claw their way into Core Surgical Training. And worst of all, HEE never call when they say they will!

Today we're joined by Helen Cashman (Health Education Yorks & the Humber) and Kaso Ari (Health Education East of England) and we talk about how they cobbled together an application, the abusive relationship you strike up with Oriel, practicing presentations to the point of police intervention, and their tips and tricks for avoiding the heartbreak getting in. We had a great time doing this episode talking about CST applications, because to be honest, if you don't laugh, you'll cry...

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Once we started ranting; we couldn't stop! The frustration, emotions and pop-culture references came pouring out. We had a lot to talk about and plenty of leftover audio after we actually finished recording. So we've got some bonus audio for your listening pleasure. Or not. Whatever you like!

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To err is human; to remediate divine. No that's not an actual aphorism; we just conceived that now to sound smart. Surgical training is HARD. Whilst there are those who excel, there are also many amongst us who find it a struggle. Today we're rejoined by Nadeem Khwaja (Deputy Postgraduate Dean for Health Education North West, and Consultant Plastic Surgeon) and he's brought along Jon Ghosh (Associate Head of School for Health Education North West and Consultant Vascular Surgeon). We talk about the grind, the telltale signs it's wearing you down, the support that can be provided to you and that there's no shame in saying you need help. Even the people we'd least expect have...

JG's mad skills at work: https://www.dailymail.co.uk/news/article-2604367/Heavily-pregnant-woman-forced-birth-coma-21-year-old-speeding-driver-smashed-taxi-undertaking.html

Melton, W; Benjamin Jackson III, J; Koon, D et al. Orthopaedic Resident Remediation: Frequency, Intervention, Outcomes. JBJS Open Access. (2018) 3(4). doi: 10.2106/JBJS.OA.18.00011

To, H; Cargill, A; Tobin, S et al. Remediation of Underperformance in Surgical Trainees - A Scoping Review. Journal of Surgical Education (2020) 78 (4). https://doi.org/10.1016/j.jsurg.2020.10.010

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Do you remember your first time? The first time you thought 'I fancy a bit of this'? Well today we have a natter with the future of surgery! We have Jacqueline Howard from Surgical Scousers (University of Liverpool undergraduate surgical society), joined by Orlane Foucault and Jacob Tan from Scalpel (University of Manchester undergraduate surgical society) where we talk about the first time they 'caught the surgical bug', and the experiences they've had that have fired up their interest. In return (powered by their enthusiasm), we lift the lid on what they can expect from surgical training, swap our undergraduate horror stories and do our level-best to not....talk them out of the profession and exacerbate the workforce crisis....

Surgical Scousers (https://surgicalscousers.weebly.com/)

Scalpel (https://www.scalpelmanchester.com/new/)

Surgery School (https://www.youtube.com/watch?v=md2k5BD4qfs)

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