Surgery Post-Mortem

Surgery posting finally ended last Friday.

It was certainly the toughest posting I've been through so far, though it was only my second posting and I should be expecting much tougher times ahead. It was tough both in terms of the academic content and the working hours. A typical day in surgery required me to wake up at 5.30am, be at the hospital at 6.30am and the day would only end at 7pm. Added to that was the amount of content to be learnt everyday. With only 8 weeks to cover all that we had to learn in general surgery, there was certainly no time to waste. Despite reaching home almost dead tired, there was still much reading up to be done every night. Perhaps the only consolation was being to fall asleep almost immediately after having such a tiring day!

Many learning opportunities only came by infrequently throughout the posting, and it was up to us to make full use of those limited chances we had. For example, those of us not posted to the breast team only had 1 clinic day allocated to us to learn all about breast cases. Some of us never got to see the colorectal or urology procedures first-hand, which was certainly quite a pity. However, it must be said that SGH is the best place to learn about surgery. The huge number and variety of cases it receives meant that most of the time there was no lack of cases to learn about. The tutors were also of top-notch quality - despite the individual tutors being extremely busy, there was certainly more than enough tutors to get tutorials from! It would have been better if we had the chance to rotate through more teams, but understandably there were logistical and administrative difficulties. It all then depended on our own initiative and our colleagues' goodwill to broaden our exposure.

Night calls was the other new element I first encountered in this posting. Strictly speaking for my level the effort-to-benefit ratio could not be considered high most of the time, but it was a new experience that I quite enjoyed. The benefit derived from night calls mostly depended on who you were following. If you want to do all the work and have little rest, follow the HO. If you want to have a tutorial follow the MO. If you want to go home follow the registrar. From my night calls I saw quite a few interesting things: acute abdomen, appendicectomy, upper BGIT, and even a HO quarrelling with the sister. It was also through night calls I got the chance to practice some of the procedures like taking blood, setting plugs and catheterising patients.

About the people, my first mentor was perhaps one of the best mentors among the lot. In my first week I found her style to be a bit 'tekan', but soon after I realised she had painstakingly polished my presentation skills, diligently ensured I had learnt my basics well and proactively invited me to watch some of the operations. She was friendly, helpful and caring most of the time, though as like many other surgeons, when the workload became unbearably high her tone could become less than comforting. My second mentor was substantially busier most of the time, but she made a less helpful mentor as she was less forthcoming in teaching. Nonetheless it was still a fruitful and highly rewarding experience learning under them.

Other members in the team: most of the HOs and MOs were really nice and helpful. Though they could not be expected to give us full length tutorials like their peers in some other hospitals, due to their excessive workload in SGH, they certainly made the effort to ensure our questions were answered and helped us whenever we needed. Not forgetting the SIP seniors, they were extremely extremely awesome people! Karen from Duke-NUS, Edwin and Fairuz from YLLSOM, they patiently taught me many invaluable things and shared with me many insights which I would never get to hear from other seniors. The time spent with them was certainly a great source of fun and comfort amidst the immense working pressure.

Throughout the posting I was asked the question of whether I would become a surgeon on many occasions. My reply was always the same: I have not made up my mind and I would at least wait until I have done my internal medicine posting. I have found surgery to be challenging and highly rewarding but the working hours can approach the threshold of insanity at times. That said, my options are still open.