Tips for Locuming in a New Specialty – General Surgery
You may have chosen to do an F3 year for lifestyle reasons, to try out different specialties you didn’t get during your Foundation rotations, or to gain more experience in a specialty you’re particularly interested in. Of course, if you’re a current F2 or F3, you might've missed out on rotating on to different specialties because of the coronavirus pandemic.
Whatever the reason, at some point you may find yourself working in General Surgery for the first time having no previous experience in it!
This can seem like a daunting prospect, so to help you with the challenge this article will explain what the daily workload will be like and share some tips to ensure you’re prepared for starting the job!
Where Will I Cover?
Most hospitals have a similar spread of clinical areas you’ll likely work in as a General Surgery SHO:
Accident and Emergency (A&E).
Theatres, for elective and emergency procedures.
Surgical Assessment Unit (SAU), where most patients are admitted to from A&E for investigations and initial management.
Surgical Wards which, depending on the size of the hospital, may include colorectal and upper.
GI and/or Hepatobiliary Clinics, which you may or may not spend time in as an SHO. If you do, it will be well supported by senior colleagues so the rest of this article will focus on your on-call role.
What’s the Day-to-Day Like?
Your Daily Role
You will most likely be assigned to a particular base ward. You may be asked to lead ward rounds independently, or participate with the Consultant or Registrar.
You’ll then be assigned to either clinics or the theatre lists during the day, and potentially ward cover as well if your ward is short on Foundation Year 1 (FY1) cover that day.
Ward cover will include requesting and chasing investigations, managing unwell patients on the ward, and discharge planning.
Examples of theatre cases you may assist with (or start to learn independently, if you’re keen) are abscess drainage, cholecystectomy, hernia repairs, and bowel resections.
Your On-Call Shifts
This will often involve assisting in theatre with emergency cases like appendicectomies and laparotomies for bowel obstruction or perforation. You’ll also be tasked with clerking new patients in A&E or SAU, and reviewing unwell patients on SAU or the surgical wards.
Depending on where you work, you may also be asked to cover other surgical specialties during these shifts, for example breast, plastics, or ENT. We’d recommend checking this before you agree to on-call shifts, as the Registrar for these specialties is often non-resident, so you’re unlikely to have direct supervision.
You’ll also be attending trauma emergencies. If you’re working in a major trauma centre, you may hold a bleep for the trauma team and attend trauma emergencies. Usually your role in these situations will be to cannulate and take bloods, or to provide general support like scribing, gathering equipment, or checking observations.
Our Top Tips
1. Get some taster experience if you can to try it out beforehand
2. Practise assisting in theatre if you can, as all surgical skills are relevant!
3. Check which specialties you’ll be expected to cover for on-call shifts and make sure you’re comfortable
4. Use the Trust guidelines to help you for clinical conditions, and antibiotic guidelines
5. Don’t be afraid to ask for help if you need it!
If you want to do any reading beforehand on common surgical conditions you might be tasked with managing, there are plenty of resources out there. For example, Pulsenotes and also TeachMeSurgery are both very useful.
Most importantly, though, remember that your seniors and other colleagues will be a great source of support once you start, especially if you’re working in General Surgery for the first time. Always speak up if you’re being asked to do something you’re not comfortable or confident with, and they’ll be able to help you out.
By following the above advice, the process of working in General Surgery for the first time should become far less daunting, and you’ll be well prepared to hit the ground running when you start. Good luck!
We've also written guides for each of the main specialties, giving you tips on how to settle into those departments. These are especially useful if you haven’t rotated through that specialty in your Foundation Training rotations.
Tips for Locuming in a New Specialty – Emergency Medicine (Coming soon)
Tips for Locuming in a New Specialty – Trauma & Orthopaedics (Coming soon)
This article is part of a wider series, supporting doctors like yourself with a comprehensive set of guides to ensure your F3 year is a success. These guides cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience. Click here to visit our F3 Resource Hub to explore the full list of guides and articles.
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