Surgery School (2010)

Episode one follows junior doctors Rose Johns, Andrew Al Rais, Nicola Robertson and Rishi Dhir as they begin their first year in surgical training, in busy London hospitals. Rose Johns loves her job but is struggling to find the find time to get into theatre, as she juggles it with her training. She finally gets the chance to assist on an 11 year old boy with suspected appendicitis but offloading the rest of her workload onto fellow staff takes far longer then expected. Rose arrives 20 minutes late and misses the most important part of the operation. The consultant remarks that she will have to be more forceful in future if she is to make it into theatre on time. Rose has made big sacrifices to train in London. She spends every week alone in a hospital bed sit, leaving her fiance at home in their comfortable Portsmouth home. She admits that she often questions whether she is doing the right thing. Rishi Dhir has worked for five years for his chance to train as a surgeon and is extremely excited about the experiences which lie ahead of him. He scrubs in on a hernia operation and finally gets the chance to assist when the consultant invites him to stitch up the wound. With his nerves getting the better of him, Rishi cuts his stitches far too short and is ordered by the consultant to pay attention. It’s not a good start. Having struggled with basic surgery skills, he is a long way from doing his own operation. But Rishi continues to practice in the lab, determined to make his family proud. Nicola Robertson is a trainee spending her first year in a South London hospital. She admits that her patients often assume she is a nurse. As a straight-A student Nicola is used to performing well and is in luck when one of her patients needs an immediate operation. Watched by her consultant, Nicola successfully removes an abscess on the male patient and is off to a flying start. However, her next operation does not go to plan when she fails to run a tube into the bladder of her next patient. After several attempts her consultant stops the operation and takes over, leaving Nicola disappointed. Andrew Al Rais is following in the medical footsteps of his parents, a retired surgeon and nurse. He admits to idolising his father and sees him as a great role model. Andrew believes one of his strongest assets is his bedside manner and ability to get on with people. After watching Andrew on his weekly ward round, his consultant comments that his ward care is improving and that he’s getting more confident when dealing with patients. Andrew reveals that he loves being a doctor and only made the decision to become a surgeon a few months ago. He is hoping that he has made the right decision. During one shift, Andrew is asked to cover another department on top of his normal workload. This leaves him looking after all general surgery, vascular, urology, orthopaedic patients on the ward and the acute admissions. He admits that this happens all the time. Luckily Nicola is working at a nearby hospital and agrees to come and help out, despite having already working a long shift herself. Rose finally gets another chance to get into theatre and is determined to be more pushy if it means she gets her shot. She successfully manages to delegate her workload and her consultant is happy for her to perform a basic hernia operation. Rose is delighted to successfully perform the majority of the operation by herself. She has learned the lesson of being assertive and it has definitely paid off.

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.”

As the first year finishes, the trainees are facing their first year assessments. It’s a crucial time for them as they have to show they have made real progress in the year. Those who don’t make the grade will be asked to leave the course. As well as preparing for tests the trainees have to get as much experience as possible. Nicola makes a good start by getting in to some important operations. Yvonne is desperate to move away from treating old men in urology, and eventually gets a placement in general surgery. It gives her a chance to do her first leg amputation. Trainee Nick gets to help a gardening enthusiast who chopped his toes with a lawn mower. For trainee Ed in intensive care he faces the most seriously ill patient he has ever had to treat. It’s a hard week for Ed, despite the intensive treatment she receives his patient dies. Learning how to cope with life and death is part of their training. During the final assessment and interviews, all of the trainees get a harsh grilling, but for one trainee it’s a disappointing end to the year.