Consultant Surgeon working in remote community

First hand feedback from a Consultant Surgeon working in remote community hospitals through Templars Medical

‘My interest in remote area work’

My interest in remote area work stems from my own view that medicine should be practised holistically, and that surgery is merely an extension of medicine. Remote work allows one to follow these principles, and also ensures a much closer and more satisfying relationship with patients and staff. One tends to follow a patient through the entire clinical encounter (and may also frequently encounter them and their relatives shopping or in the street) allowing you to feel much more connected to the community than one does in a large hospital setting.

The surgeon should be prepared to take responsibility for the patient throughout the entire clinical encounter. So the specialist needs to be a bit of a GP at heart. Common sense and kindness go a long way, and whilst the facilities and staff may be restricted the work is generally done at a more relaxed pace.

‘’It helps to be able to tackle a wide range of things’’

It helps to be able to tackle a wide range of things simply and safely using standard techniques. It is essential not to get carried away by hubris into undertaking surgery which is beyond the resources of the hospital or the nursing team. Major cases can come in at any time, and for them your role will be to resuscitate, diagnose, package and transfer.

Surgically, one must be particularly careful about procedures that are rarely performed, and one must never assume that kit or nursing skills, that one might take for granted in a large hospital, are necessarily going to be available. Just because you can do something does not mean the rest of the team will be happy to take it on; one needs to meticulously check the

kit and the staff beforehand. It is also essential to get on amicably with everybody, no role for prima donnas. You are not just going to work with them; you are going to bump into them in the pub afterwards.

‘’What makes the work different’’

What makes the work different is that you need to hit the ground running and be organised to deal with a new system whilst at the same time dealing with the personal administration aspects of life such as feeding oneself, doing the laundry and keeping fit. I find it helpful to have a series of large boxes containing things like medical books and kit, sports kit, personal comforts etc. Then you simply load up the car and you are ready to go. Certain bits of stationary are useful: a list of logins and passwords, codes for combination locks and patient lists for example.

I find the adventure of all this is very refreshing, although it can seem a little daunting at the outset. The great thing is to always keep the same stuff in the same place so you can always find your mobile phone charger or comfortable pillow.

‘’I do a certain amount of work in Scotland which is delightful’’

Nowadays I do a certain amount of work in Scotland which is delightful. There are opportunities for fishing, walking, skiing, climbing and canoeing. I leave a bicycle and sometimes a car up there and commute on the train. The skiing and climbing stuff and an inflatable Kayak are in the car. Last weekend I kayaked with a colleague down the Thurso River from Halkirk to Thurso. It was alive with wildlife and autumn colours and we ended up back in the pub at Halkirk in time for roast beef and Yorkshire pudding. In winter the skiing can be as good as anywhere. Last winter there was 3 feet of powder on the almost vertical side of the Nevis resort near Fort William. The climbing and rock scrambling in that region is excellent.

From the point of view of making the expedition financially worthwhile it is desirable to spend a certain amount of time on call. However there is almost always some free time available, and this coming weekend I shall be heading down to Aviemore for some climbing and a few good meals at the Cairngorm Hotel.

‘’Templars will, if required sort out your accommodation and travel arrangements’’

Templars will if required sort out your accommodation and travel arrangements. Last December I made some personal arrangements but fielded them through Templars to work in a teaching hospital to keep my skills up to date. The hospital accommodation was unsuitable, however after a short call to Templars it was amended and they booked me a room at a local hotel.

Templars is absolutely wonderful and I have a marvellous relationship with them, with a personal advisor who finds the jobs and makes sure I am happy as well as promptly paid. My fellow Templars doctors are all highly reliable, personable and competent. It is an honour to be part of the team.

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