Wednesday, February 3, 2010


Yesterday, one of my junior registrars (residents for those of you in the US) came up to me to thank me for an ad-hoc tutorial I had given her. What surprised me most was that she then said that she finds me quite scary. This came as somewhat of a shock to me since I like to think of myself as the "good cop." I have never yelled at a registrar, nor been (in my opinion) unreasonable to any of them. Yes, I expect them to do a good job, but I believe my teaching style is more collaborative than combative.

This got me to thinking about our trainees. On average, we get new ones twice every year. Some years there are many newbies, some years there are few. What doesn't change is that they are generally young. Man, I wish I was that age when I started. Some of the guys joining this year were in primary school when I left med school. Youth isn't necessarily an advantage in this game, though. Our best registrars are those who have done many things before joining anaesthesia. You can't have perspective on ward management of patients unless you have been a medical officer/junior on a surgical or medical ward. Working in casualties makes you hard, and sharp as a doctor - good qualities in an area where the brown stuff often enters the fan rapidly and without warning. My 2 years doing orthopaedics and my rural experiences have helped me to have a more holistic view of patient problems, and the lack of this in registrars who join straight from community service is very noticeable. We as consultants have to then fill this gap.

I have reached a point in my career where it has become necessary to decide whether to stay in the state sector or not. If we had no registrars, the decision would be easy - Go. But, despite the fact that occasionally they drive me mad, they always phone me after hours with pre-meds when there are 2 consultants on cover for the list and some of them are downright unteachable, I love teaching them. Call it intellectual puffery if you will, but nothing beats showing a junior a technique that works for me and having them say, "Hey, that worked well, I'm going to do that from now on..." There is no greater satisfaction at work than seeing one of the people I helped to train pass their specialist exams and become mature, confident and capable consultant anaesthesiologists.

As doctors who have been trained by our betters, we owe it to those who follow to train them to be as good as, if not better than ourselves. I know that when I am old, and not simply an 'old fart', I want someone who has been trained by someone I trained to dope me.