July 24, 2024 • 37 mins
What does it take to become a surgeon in Australia? Join us on Aussie Med Ed as we navigate the rigorous and rewarding journey of surgical training with Dr. Blake Fidock, an Orthopaedic registrar. You'll learn the ins and outs of medical school, internships, and the various roles like intern, resident medical officer (RMO), and principal house officer (PHO) that shape a surgical career. Dr. Fidock shares his personal experiences and invaluable insights, making this episode a must-listen for anyone considering a future in surgery or simply curious about the process.
We also shine a spotlight on the key institutions that play a crucial role in Orthopaedic surgical training. Hear about the journey from internship to fellowship. Discover the importance of diverse surgical experiences, research engagement, and recognised courses in shaping a competent and skilled orthopaedic specialist.
Ever wondered what a day in the life of an orthopaedic registrar looks like? Dr. Fidock provides a detailed glimpse into his daily routine, from early morning ward rounds to on-call duties and surgeries. Learn about the evolving nature of on-call work, the significance of continuous learning, and the impact of a supportive team environment. Offering a comprehensive guide to navigating the demanding yet rewarding field of orthopaedic surgery. Listen or watch for an enlightening episode that blends expert insights with relatable anecdotes, offering a clear pathway for aspiring surgeons, medical professionals as well as anyone interested in medicine.
Aussie Med Ed is sponsored by -HealthShare is a digital health company, that provides solutions for patients, General Practitioners and Specialists across Australia.
Aussie Med Ed is sponsored by Avant Medical Indemnity: They state that they offer holistic support to help the doctor practice safely and believe they have extensive cover that's continually evolving to meet your needs in the ever changing regulatory environment.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Gavin Nimon (00:00):
From the first day of medical school to
becoming a fully qualifiedsurgeon.
The journey is both challengingand rewarding.
Just the nomenclature of thedifferent training positions is
confusing and, for theuninitiated, quite daunting.
Today, we're going to explorethe pathways for surgical
training in Australia.
Joining us today is Dr BlakeFidock, a surgical trainee, who
will share his first-handexperiences and valuable
(00:20):
insights into the steps involvedin this rigorous training
process.
We'll discuss the differentstages of surgical training,
including the transition frommedical school to internship,
the various pathways availableand the importance of research
and continuous learning.
Whether you're a medical studentconsidering a career in surgery
or a GP interested inunderstanding the surgical
training process better, thisepisode is packed full of
essential information.
(00:40):
G'day and welcome to Aussie MedEd, the Australian medical
education podcast, designed witha pragmatic approach to medical
conditions by interviewingspecialists in the medical field
.
I'm Gavin Nimon, an orthopaedicsurgeon based in Adelaide, and
I'm broadcasting from Kaurnaland.
I'd like to remind you thatthis podcast is available on all
podcast players and is alsoavailable as a video version on
(01:01):
YouTube.
I'd also like to remind youthat, if you enjoy this podcast,
please subscribe or leave areview or give us a thumbs up,
as I really appreciate thesupport and it helps the channel
grow.
I'd like to start the podcastby acknowledging the traditional
owners of the land on whichthis podcast is produced, the
Kaurna people, and pay myrespects to the elders, both
past, present and emerging.
Well, today we're joined byBlake Fidock, currently an a
(01:22):
registrar, who stems originallyfrom Newcastle in New South
Wales.
He's been living and workinghere in Adelaide as a South
Australian orthopaedic traineesince 2020.
He's just about to finish hissurgical training in August and
will be commencing a fellowshipin hip and knee arthroplasty in
Brisbane, Queensland.
Welcome, Blake.
Thank you very much for comingon.
Aussie Med Ed.
Dr Blake Fidock (01:41):
Hi, thanks, Gavin.
Dr Gavin Nimon (01:45):
Thanks for having me.
It's great to have you on here.
First of all, it's reallybrilliant to have someone who's
just gone through the wholeprocess.
It's a long route for you andcongratulations on finishing
your pathway.
Dr Blake Fidock (01:51):
Thank you.
Thank you.
It is a long road, but it'salways.
It's coming very close to theend now, which is good, so, yeah
, very excited.
Dr Gavin Nimon (02:05):
Well, it's great to have you here.
I thought we'd start off with,first of all, talk about the
nomenclature of different areasof medicine.
There's obviously RMOs,registrars and other areas are
called housemen, particularlyoverseas.
Perhaps we'll start off withwhat we're called here in South
Australia and then talk aboutdifferent states difference in
naming.
Dr Blake Fidock (02:14):
So when you finish medical school, the first
thing that medical students areemployed as are interns in the
public hospital, and internsessentially have provisional
registration with AHPRA, whichmeans that they are still under
supervision of consultants inthe hospital and they have
various sort of learningobjectives they have to tick off
throughout the year in order tobe deemed safe and suitable for
general registration.
So everyone sort of starts asan intern and they have 12
(02:36):
months as an intern.
They then progress to being aresident medical officer and it
varies depending on state tostate.
So I actually did my medicalschool and junior years in New
South Wales and we were affordedtwo-year contracts to start
with and we were then recognisedas junior medical officers or
RMOs, as we are down here inSouth Australia.
That position is essentiallywhere you have general medical
(02:58):
registration but you're doingsome more focused specialty
terms.
So in South Australia thatdivides into medical streams or
surgical streams, depending onwhat your interest is.
Further down your career path.
After you've done one or twoyears of RMO, then people often
progress to being a registrar.
There are various terms forregistrars and this is where it
(03:19):
can be a little bit confusing.
In South Australia the termservice registrar is commonly
used within the surgicalspecialties and that is a
position where someone is moreof a junior registrar and
they're not on an accreditedtraining program.
So they are providingessentially service to the
hospital in a position of aregistrar, but they are not
formally recognized as part of atraining program.
(03:39):
Yet In other states thisposition has slightly different
terminology.
So in New South Wales it's anunaccredited registrar and in
Queensland I think the term isprincipal house officer or PHO.
Nonetheless, the positions arerelatively the same.
They really denote like ajunior registrar position and
again, someone who's not on atraining program.
Once you've done a few years andit does vary based on the
(04:02):
surgical training program you'relooking to enter into once
you've done a few years as aservice or an unaccredited
registrar, then you can progressto a training registrar and
that requires a formalapplication to a recognized
training program which isgenerally overseen by the
college of surgeons in australia.
So within orthopedics thedesignated professional body
(04:22):
that oversees training is theAustralian Orthopaedic
Association and they have theright to oversee and facilitate
training that's designated tothem by the College of Surgeons
and your application is both toRACS and to the AOA.
So once you've been successfulin that application process, you
progress to being a trainingregistrar, which is really much
like an advanced trainingposition where you're then under
(04:43):
the formal training process andpathway of an accredited
training body and that trainingbody is accredited by the
Australian Medical Council andthere's a variety of criteria
that you then have to meet inorder to progress through that
training pathway.
And then, once you've been atraining registrar for a number
of years and you've completedall those requirements as now
(05:04):
I'm getting to the final stagesof doing then you can look to
exit your training and youbecome a fellow of a recognised
professional body.
So through the College ofSurgeons, the Royal Australian
College of Surgeons, you canbecome a fellow of them, which
denotes you're a fellow of theRoyal Australian College of
Surgeons.
You can become a fellow of theAustralian Orthopedic
Association as well, butessentially recognising that
you've finished your accreditedtraining pathway and you're now
(05:26):
moving to a position of fellow,which most people would then
recognise as being a consultantwithin a public hospital if
you're given a public position.
Dr Gavin Nimon (05:33):
Wow, for the average person listening to it,
let's say, gee, that sounds likea long route.
How many years do you thinkit's taken you to get through to
this pathway?
Dr Blake Fidock (05:45):
So I mean, I started as an intern in 2013 and
it's you know.
Now we're midway through 2024.
So it's over 10 years and, look, that is fairly standard.
There are people that might doit a couple of years faster.
There are people that mighttake a couple of years longer.
Everyone's got various periodsduring their training where
things may either be slightlylonger than they wanted, they
may happen slightly quicker thanthey anticipated, but at the
end of the day, I would tellanyone that's looking to enter
(06:07):
into surgical training today,particularly orthopedics, that
you're really looking at 10years and that's something I
think is fairly consistent.
One of my mentors when I was aresident back in New South Wales
described it to me asessentially the decade of
darkness, which is where yousort of enter into this decade
of surgical training in order toprogress to the other side.
I wouldn't say it's as bleak asmaybe that term would suggest,
(06:29):
but certainly it's around abouta 10-year period from completing
your medical training to maybegetting to the other side of
being a fellow and then startingas a specialist.
Dr Gavin Nimon (06:37):
And the question that would obviously come to
the layperson's mind is doesthat mean all that time you're
not earning any money?
Dr Blake Fidock (06:42):
Fortunately not .
So here in Australia, you know,particularly compared to a lot
of other countries, we are veryfortunate in our position as
medical officers through thepublic hospital system and we
are, relative to a lot of othercountries, very well compensated
.
So at the end of the day, youare earning money.
You know it is money you'reearned for time spent working
and there is also a significantadditional cost associated with
(07:04):
training.
So there are fees associatedwith training, which are direct
fees to the colleges, and thenthere are indirect fees in the
form of training courses,conferences that you're
attending.
So training is not aninexpensive process but
fortunately we are wellcompensated here and well paid
for that.
So you are working as a doctorthroughout that entire period
and that includes things likeworking weekends, working three
(07:26):
hours, doing overtime, doingon-call.
Fortunately, all of that iswell-paid here in Australia and,
yes, I wouldn't necessarilyworry about that.
You are earning an income forthat entire period.
Dr Gavin Nimon (07:36):
And this is down the pathway for surgery, which
is one sort of stream ofmedicine.
There are various other streams.
You can go down the pathways,isn't there?
Dr Blake Fidock (07:43):
Yeah.
So there are a variety ofdifferent pathways.
So once you've finished yourinternship and then you're
working as a resident, that'swhen you sort of make that
decision about which directionyou really want to go.
So if you want to stay withinthe hospital for the vast
majority of your training, thenyou're either looking at a
surgery, you're looking atmedicine or you're looking at
critical care, and they'reessentially the three things
that happen within the hospitalsystem and they're largely
(08:05):
hospital-based training programs.
Medicine specifically looks atbasic physician's training and
then training to become aphysician, so a cardiologist, a
respiratory physician, ahaematologist.
Those training pathways, againfacilitated through the public
system but very much moremedically focused.
Then there's critical care,which I suppose you're looking
at, intensive care, anaestheticsand emergency, which again is
(08:26):
facilitated through the publichealth system.
And then outside of that, Isuppose general practice is
something where it's notparticularly through the
hospital system.
So they might do one or twoyears in the hospital but then
apply to an accredited generalpractice training program.
So the Australian RACGP is theRoyal College that facilitates
training for GPs and the reasonI'm familiar with this is my
(08:47):
wife is actually in generalpractice training and they have
various accredited sites acrossthe country and then you would
essentially apply to one ofthose training pathways,
depending on which state you'rein, and then you could train
through that pathway in thosevarious states.
So, yeah, so if you're notinterested in surgery, then
there are a variety of trainingpathways that are available to
medical students and juniordoctors.
It's just really about tryingto pick which one you know suits
(09:09):
you, suits your life goals,ambitions, your work-life
balance, what you want toachieve, and then trying to
really funnel your career movesand your rotations into being
able to pivot towards thosetraining pathways.
Dr Gavin Nimon (09:23):
Yeah, a few other thoughts came to mind as
well.
I was thinking of the peoplewho went through my medical
school many years ago and somehave become GPs, physicians,
obviously surgeons, anesthetists, obs and gynae, radiologists,
ophthalmologists, oncologists.
Yeah, so I missed a few, so yeah, Paediatricians, pathologists,
(09:43):
public health and administration, and someone in my gear has
gone into one of those differentareas.
So it's actually quite excitingthat years down the track you
actually see these people indifferent positions.
You mentioned the RACs, orRoyal Australasian College of
Surgeons, and the AustralianOrthopaedic Association.
They're the different bodiesthat we're under the auspices of
.
Can you explain how, say, ageneral surgical trainee may
vary from an orthopaedic traineein that they actually are
(10:06):
purely under the College ofSurgeons?
Is that right, as opposed toorthopaedics, who are under two
different areas?
Dr Blake Fidock (10:10):
Yes, the overarching organisation that
facilitates medical training orthe oversight of medical
training in Australia is theAustralian Medical Council and
then, from a surgical point ofview, it's the Royal
Australasian College of Surgeons.
So the general surgeons arevery much under RACS.
Racs there's a bit of traditionassociated with RACS being
predominantly general surgeons,then orthopaedics being a
relatively newer specialtycompared to general surgery, and
(10:33):
then, as things have evolved,the Australian Orthopaedic
Association has essentiallydeveloped as a separate
organisation outside of RACSthat essentially represents the
interests of and lobbies for theinterests of Australian
orthopaedic surgeons and thensubsequently has then gone into
being able to facilitate anddevelop training for upcoming
and future orthopaedic surgeons.
And that's been a big focus ofthe AOA, I think, probably in
(10:55):
the last 10 to 20 years isreally developing that training
pathway.
So as an orthopaedic trainee,we are certainly recognised
surgical trainees, which is whywe are still under the
supervision of RACS, but ourtraining is very much
facilitated and organisedthrough the Australian
Orthopaedic Association.
(11:16):
And our examinations to thatextent are done through the
College of Surgeons.
The College of Surgeons stillcontrols the process by which we
are formally examined at theend of our training and then
enter to be a recognised fellowor specialist within an area,
but the training pathway thatyou undertake in order to get to
that point is essentiallydeveloped by the airways.
What I would say to anyonethat's looking at this process
(11:37):
is necessarily to get tooworried or try and look too much
into there's a larger sort ofhistorical relationship that
exists between these very largeorganisations.
It's's just about recognizingthat as a surgical trainee, you
are certainly a member or anassociate or a trainee of both
organizations and there arebenefits to both.
So it's just recognizing thatthat, yeah, there are two
(11:57):
organizations that represent youas a trainee as well in the
public hospital and of coursethere's also other organizations
that also we're.
Dr Gavin Nimon (12:03):
Then the also itself is actually something
like the Australian HealthPractitioner Regulatory
Authority.
Then we've also got otherorganisations that people become
members of, like the AustralianMedical Association or in South
Australia the South AustralianSalaried Medical Officers
Association, which are sort ofinterest groups.
Dr Blake Fidock (12:18):
Yes, there's plenty of oversight and
supervision that exists whenyou're working as a doctor in a
public hospital and then whenyou are not, when you're still
going through your accreditedtraining process, you know there
are plenty of organisationsthere to represent you and to
oversee your development.
Dr Gavin Nimon (12:32):
So what do you reckon the routes are?
To get into surgical training?
Let's focus on orthopaedics.
What are the sort of routes tohead down this sort of way?
I mean, you've mentioned youcame straight out of internship
heading down this pathway.
Does everyone come down thatsame sort of route or do people
go off and try different areasin the first place?
Dr Blake Fidock (12:46):
So internship, you will get exposed to a
variety of things.
You'll do your medical surgical, your emergency terms, which
are really important, and Ithink it's probably important
that you then, as an RMO or as aresident, you then explore some
of those varying interests thatyou have as well.
I certainly had interests whichwere heading towards
orthopaedics as an intern, but Iexplored other things whilst I
was doing internship and myresident years, including
(13:08):
general surgery, vascularsurgery.
I did rotations in those beforeI decided to go down the
orthopaedic pathway.
So that's important.
I think exposure is important.
Don't try and pigeonholeyourself too much.
There are people obviously likethat, straight out of med
school who know exactly whatthey want to do and, regardless
of what you tell them, they'redefinitely going to go down that
pathway.
But it is important to makesure you do get some exposure to
what it's like, because whatyou see as a medical student is
(13:30):
very different to what youexperience when you come to work
.
Come to work and it's importantthat you get to know the team,
be part of the team when you'rea junior member and then see
whether this is the type ofenvironment and these are the
type of patients you want to belooking after ultimately when
you choose your specialty.
But I think so, to start with,from those junior years,
exposure is important.
Get some exposure, get someexperience.
The process to apply toorthopaedics is done through the
(13:51):
Australian OrthopaedicAssociation and the criteria
does change every year.
So it is important to keepabreast of that as you're
getting close to yourapplication.
But it does essentially comedown to what experience you've
had, the referees that youcollect along the way, any
research you've done as a resultof that, and then some
recognised courses andpublications or presentations
(14:12):
that you've done to aid thatapplication process.
So in those first couple ofyears, in those junior years,
doing some orthopaedics terms isimportant.
It's important to reaffirm yourinterest and then guide your
career.
But it's also important just todevelop some basic
understanding of orthopaedics,because it's not the easiest
thing to sit down and just readin a textbook.
It is a very experientialspecialty and it is
(14:34):
traditionally very much anapprenticeship model-type
training and the reason for that, I think, is because it is
something that you learnpredominantly by doing and you
know that's what those junioryears are really important for.
But once you decide you want todo that and you're sort of
guiding your career towardsmaybe doing a service or an
accredited orthopedic registraryear, then things like engaging
(14:54):
in some research so engaging indoing some either literature
reviews or joining a researchproject that's a clinical
project or, you know, speakingto your seniors and seeing
what's available, trying to jumpon board there to at least
experience what that's like andthen get your name on maybe a
presentation or a publicationthat can come as a result of
that work is important,recognizing the courses that you
(15:15):
do.
And then again, even though theapplication is through the AOA,
racs run a series of thosecourses.
So things like EMST, crisp.
There's another one, clear,which is again about evaluating
literature and research.
So there are a few courses thatare important.
Dr Gavin Nimon (15:28):
Just outline these abbreviations for us,
Blake, if you can.
Dr Blake Fidock (15:31):
Yeah, so EMST is the Early Management of
Severe Trauma, it's the onethat's the old ATLS system, so
Advanced Trauma Life Supportcourse, so that one is again a
very essential courseessentially to do prior to
applying to surgical training.
Crisp, I think, was the Care ofCritically Ill Surgical
Patients, and then CLEAR isCritical Literature Evaluation,
(15:52):
something, something I can'tremember the last two letters
for that one, and then ASSET wasanother one, it something
something I can't remember thelast two letters for that one,
and then asset was another one.
It's another surgical skillsone that's run through through
the College of Surgeons.
But essentially, if you go tothe application criteria on AOA
they'll tell you which courseswill grant you points and it's
when you come to apply to theAOA you're looking to generate a
reasonable number of points inorder to meet a threshold, to be
(16:13):
a suitable candidate to applyfor a training position and
subsequently be considered foreither interview or collation of
your references and compared toother applicants.
So doing those courses, doingsome research, doing some higher
levels of education.
So there are points of doing amaster's and there are some
master's courses that can bedone through many universities
around Australia and thenultimately you can do a PhD.
(16:33):
But a commitment to a PhD is abig commitment.
So I wouldn't necessarily tryand do that as a matter of
point-tacking for application,because you're looking to commit
a lot of time and years inorder to do that.
I'm not saying you can't do it,but just think about it if
you're going to try and get todo a PhD to apply for
orthopaedics.
So apart from, yeah, research,doing terms and then doing
courses, they they're sort ofthe main things that you're sort
(16:53):
of looking to get as part ofthat are always really in the
application process.
There might be one or twopoints here and there that pop
up.
There is a big sort of pushtowards rurality recently.
So you know recognising peoplewho go to rural terms.
So there are a lot of ruralhospitals that need service in
the form of, you know, juniordoctor and then registrar
service.
So you know, working in ruraland remote locations like Alice
(17:15):
Springs is looked quitefavourably.
Dr Gavin Nimon (17:18):
And also give you a lot of experience as well,
from different areas.
Dr Blake Fidock (17:21):
Yeah, it gives you a lot of experience.
Yeah, exactly, I think I workeda total of about 16 months in
Alice Springs, so I cancertainly be one to say that it
is an excellent opportunity togo rural and work in some of
those remote communities,particularly when you're looking
to apply.
I did that pre-training.
I certainly think that not onlyhelped my application but just
helped me all round when I wasready to apply.
(17:42):
So, in essence, there's thosethings.
There's quite a few things toconsider, but yeah, they're the
broad strokes.
Dr Gavin Nimon (17:49):
We talked about applying for advanced
orthopaedic training and thispathway.
What's the role I mean?
Does it still exist, the basicsurgical training program that
you have to do after an RMO yearbefore you apply for?
Dr Blake Fidock (18:00):
advanced orthopaedic?
Yeah, no, there was, and I haveheard of this and I think it
existed just prior to my time.
There was basic surgicaltraining, but that doesn't exist
anymore.
When you're a resident, you canget surgical RMO terms that
will allow you to rotate throughvarious surgical specialties,
but there is no basic surgicaltraining pathway.
That's facilitated through RACs.
Essentially, the colleges nowreally only facilitate
(18:23):
accredited training programs andthere's no pre-vocational
training pathways that I'm awareof.
Dr Gavin Nimon (18:28):
And are there any exams you need to do before
you apply for the AustralianOrthopaedic Association?
Dr Blake Fidock (18:32):
Yes, that's probably the one I forgot as
part of the AO application.
Yes, so there's the GSSE, whichis the Generic Surgical
Sciences Examination, which isnow a prerequisite in order to
be able to apply and be eligiblefor application, which is
essentially an examinationthat's conducted over two days.
It's a written exam, it's allmultiple choice, but it
essentially comes down toanatomy, pathology and
(18:54):
physiology and it is aprerequisite in order to apply
now and you have to meet theminimum threshold in that
examination in order to progress, to be suitable as a candidate.
So I think historically it wasactually delivered during
training, so people had tocomplete that examination prior
to maybe their third year orsomething.
But that has since changed inthe last maybe five or so years,
(19:14):
where it is now a prerequisiteprior to getting onto training.
And I think that's probably agood thing because there are
more examinations once you're ontraining, but it also acts as a
really good barrier.
You know, the GSSC is a lot ofinteresting facts about anatomy,
pathology and physiology, butit is a barrier to see who is
willing to sit down and studysome of these random facts that
may appear in a multi-choiceexamination prior to wanting to
(19:39):
commence surgical training,which in itself is arduous and
long and requires a significantperiod of commitment.
So whether you can sit and dothis exam is the good sort of
first hurdle to see whetheryou're a suitable candidate.
Dr Gavin Nimon (19:52):
It says hard work and I remember from my days
.
I still have dreams about doingthe exam, so that's many years
ago.
Dr Blake Fidock (19:57):
I don't think that ever, having just done my
fellowship exam in the last well, 12 months ago now, I don't
think it will ever leave mybrain.
Yeah, you still wake up withnightmares sometimes.
Dr Gavin Nimon (20:09):
Now people often say look, you know it's very
competitive and it's hard to getonto these sort of pathways,
but obviously people do.
What's your advice?
Would you ever try and talkanyone away out of doing
orthopaedics?
Do you think it's worth a grind?
Dr Blake Fidock (20:20):
I wouldn't try and talk anyone out of it.
I mean, I think that it's likeanything it is competitive, it's
hard work, but it is also ahighly rewarding career.
So you know, if you were tolook at other areas outside of
(20:40):
medicine and you were sayingsomeone they were going to
invest in building a, building abusiness and trying to have you
know professional fulfillmentin another area, telling them
it's going to take ten years ofhard work but you'll get there,
most people probably tell recordyeah, willing to give that hard
work and willing to commit.
So I try to tell people that itis not an easy process but it
is a rewarding process.
It's one that requires a lot ofcommitment.
There's, you know, commitmentand there's a bit of luck at the
end of the day, like everythingin life, particularly during
(21:02):
your application process.
Sometimes it can be your year,sometimes it can't be your year
and it can be the numbers andwho's around and you know who
you're competing against forthat time.
But I think that if you aregenuinely interested in
orthopaedics as a surgicalspecialty and you enjoy the work
, you enjoy your colleagues, youenjoy treating patients,
looking after them and beingable to make a difference in
(21:23):
their lives, which I think isone of the biggest advantages of
orthopaedics, is that you getto actually see that improvement
in your patients when youfollow them up and that impact
that you've made.
Then I would say the commitmentis worth it.
But it's not an easy commitmentand it is someone that has a
family or also has a partner.
It's not an individualcommitment either.
(21:43):
It's very much a familycommitment and that's maybe one
of the main bits of advice Igive to people now, because if
you are at a later stage of lifeand you're looking to enter
into orthopaedics, then by allmeans go for it if you've got
the drive, but make sure youhave the conversation with your
other half, because it is awhole family commitment, as I'm
(22:04):
sure my wife would certainlyattest to.
Dr Gavin Nimon (22:06):
Look, what about a typical day in orthopaedics?
And what does it look likealong the pathway?
What's it been like along theway?
Dr Blake Fidock (22:13):
Yeah, so I mean , it depends on which hospital
you're at, and some arecertainly busier than others and
some rotations are busier thanothers, but in general you start
at around 7 to 7.30 in themorning, somewhere between that
time.
The first thing we do every dayis ward round, and an
orthopedic ward round is notlike a medical ward round.
It is a quick hello and woundcheck and make sure there's no
(22:36):
significant complications ormedical adverse events that have
happened in the past 24 hoursthat we need to be aware of, and
we're essentially do a quickward round in the morning.
Then, depending on the siteyou're at, again, you'll
generally attend a meeting whichwill discuss the new admissions
plans for the day, includingthe plans of attack for various
operating theatres that you'rerunning, so that we can be
appropriately staffed andeveryone's on the same page
about what we operating theatresthat you're running, so that we
(22:56):
can be appropriately staffedand everyone's on the same page
about what we're doing, and thatis particularly the case in
larger hospitals.
They will have these regulardaily meetings to address these
and then, depending on where youare sort of in your career,
your day could be broken into, Isuppose, being on call, which
is taking call for any of thenew referrals that are coming
(23:16):
through the emergencydepartments.
They're going to the ED andassessing patients and then
deciding who needs to beadmitted and discharged, who can
be followed up in theoutpatient clinic, going to the
outpatient clinic and seeingpatients in the outpatients or
being in the operating theatre.
And in the operating theatrethat can be in the emergency or
the elective list and those aresort of the main things that you
can be doing sort of and thatwill run essentially we break it
(23:38):
into half days generally.
So morning session, afternoonsession, someone could be there
all day.
They could be, you know, halfday in clinic, half day in
theatre, depending on what'srunning.
Most days generally finisharound about five o'clock In the
public hospital.
You know that's the time thattheatres will generally shut.
As with all things, sometimesthings can run late, sometimes
they can finish early.
It's more commonly they'll runlate than finish early, but
(24:00):
generally you can always seehopefully finish around 5
o'clock.
If you're on call you may staylater.
So if you are holding the phoneor on call for that day, those
shifts generally can run alittle bit later, so maybe 8 or
9 o'clock.
Fortunately there's been a bigshift in on-call, particularly
in busy hospitals now whereorthopaedics are running 24-hour
services, so recognising theimportance of having day staff
(24:21):
and night staff.
So you'd be handing over to anight registrar now, as opposed
to doing 24 hours of on-call andthen expected to front up the
next day.
That is certainly what used tohappen in the old day and I'm
sure you would attest to that,Gavin, that that was what you
did during your training.
But I think I'm fairlyfortunate enough to say now that
in this generation that we aremoving away from that,
particularly in busy hospitalswhere that doesn't happen
(24:42):
anymore, and that you know youmay be on call for a period of
12 hours, but if you're in abusy quaternary or tertiary
level centre, you're probablygoing to go home and sleep, you
know, quite comfortably thatnight, because you're not going
to be woken up overnight and sothey're not expected to, you
know, to work more than 24 hoursin a row.
So that's the general sort ofoverview.
Even if you're not in anaccredited training program,
(25:04):
we're all training, we're allworking towards something.
So at the end of the day andthroughout the day, there's
always reading, there's alwaysthings that you want to be doing
.
There's always thatextracurricular stuff that
you're trying to build your CVfor, You're trying to enhance
your knowledge.
You've got a list the next dayor the day after You're trying
to work out.
You know, read about some ofthose cases, do the prep for
that to make sure that you'reprepared.
So that certainly adds up.
(25:24):
I'd say there's probably atleast an hour of that every day
where you're doing somethinglike that.
And you know we often do thatsubconsciously.
I think a lot of us.
We come home now and we'realways looking at, because it's
so accessible, we're looking atour phones, we're looking at our
Microsoft Teams, we're goingthrough the cases that we have
for the next couple of days tomake sure everything's all right
, that everything's beentemplated appropriately, all the
(25:45):
investigations have beenordered.
So that sort of admin timecertainly adds up.
And then, if you are in yourtraining years, there's periods
of study, there's periods ofworking on your formalized
teaching.
So your bone schoolpresentation.
So every week the orthopedictrainees have half a day
dedicated to teaching.
So bone school is our formal,recognized training session.
So one training will presentthat every week so you might
(26:07):
have a bone school coming up oncervical spine injuries.
So you're sitting there workingon your bone school
presentation that evening.
We've got a journal club comingup the following week.
You're working on that journalclub presentation.
So there's always that sort ofstuff outside as well.
That's the general day of anorthopaedic registrar, certainly
.
And then on top of that you tryand squeeze in some time to
(26:27):
exercise and some time to spendtime with family and all that
sort of stuff as well.
Dr Gavin Nimon (26:32):
I think one of the things you've passed over
quickly is actually theenjoyment of being in a hospital
scenario too and having lots ofdifferent people you meet and
being exposed to differentpeople.
Have you found that as well?
Would that be your experienceas well, Blake?
Dr Blake Fidock (26:44):
Yeah, I mean 100% working orthopedics.
I said to a lot of peopleorthopedics is a team sport.
So you know we work in teamsand that is our team.
The team that we have whenwe're working as a unit, that's
the.
You know the senior registrar,the training registrar, the
junior reg, the rmo.
You know when you're onorthopedics you're in our team.
And then there's also the teamsthat you work with every day.
(27:06):
So you know the theater teamyou're working with.
You know getting to know thetheater staff is really
important the clinic staff thatwe.
It's very much a teamenvironment and certainly it's
one of the best things aboutworking in the public hospital
and during your training years.
And you know, even when youhave those rotations that are
really busy, really hecticrotations that are very full-on,
(27:27):
long days, hard work, the thingthat makes it worthwhile is if
you've got a good team.
If you're surrounded by a goodteam, then that becomes so much
easier because every day you'refronting up and you've got your
mates there and it's like you'regoing into bat together.
You're all trying to just getthrough the day together and
there's a lot of banter that canbe had there as well and that
(27:49):
is one of the most enjoyablethings.
That's probably one of the mainreasons why, ultimately, when I
was trying to decide surgicalspecialty is orthopedics,
because when I looked around,you know, at the teams, the guys
there would, and guys and girls, the guys, all of them were
having fun.
You know.
They were all enjoying it,despite the fact that it was
organized chaos some days and itis organized chaos some days.
(28:10):
Everyone was enjoyingthemselves and there was, you
know, good banter and at the endof the day, you know, it was an
enjoyable workplace.
So, and I think that that hascertainly been my experience as
well, like my experience overallhas been, you know, every
rotation I've done and I'veworked with, I've found people
that I've really gotten alongwith and you know, we have a
(28:30):
good time when we come to workand it's hard work and some days
are worse than others, but butoverall it's good fun brilliant.
Dr Gavin Nimon (28:38):
One of the questions medical students might
ask is how do you actuallystart surgery?
You don't come straight out ofmed school and start opening
someone up and doing a procedure.
How do you actually become asurgeon?
What's your recollection ofyour first operation and how
you're exposed to it?
Dr Blake Fidock (28:52):
yeah, I mean I alluded to it slightly earlier
that it used to be a bit more ofan apprenticeship model, and I
think there's some truth in that, in that you are learning a bit
of a you know don't tell theanesthetists or the physicians
but you're learning a bit of atrade.
Really, you're learning how touse your hands and there's a
higher degree of dexterityrequired maybe than some other
things, but at the end of theday, you are, you are learning.
(29:13):
So we have to go and you haveto see, you have to see people
do and you have to learn aboutwhat they're doing, and then you
have to try and replicate whatthey're doing.
And that is essentially theapprenticeship model that we're
trying to follow.
Now the AOA has very much movedto a competency-based model.
Now we're trying to tick offvarious things that we're good
at, but in essence, what we'restill doing is, you know, by
going with our supervisors andby operating with our
(29:35):
consultants, we're watching themdo a procedure.
They're then watching us do aprocedure, and then we're trying
to get to that point oflearning how to do a procedure
independently.
And I think when I was aresident in this was when I was
back in Newcastle.
I remember I was about secondor third year I got rostered to
a list with an upper limbsurgeon.
I'd seen plenty of distalradius fractures and I thought I
was getting pretty close tobeing able to fix a distal
(29:56):
radius fracture.
And then I sat down at theoperating table and I just
thought, as I was sitting atthat side I was like, what do I
do now?
What's the first step?
And it's like when you take theknife in your hand, you have to
.
You're then starting.
The whole thing changes.
So it's not innate Sur.
It's not innate.
Surgery is not innate.
You would never expect someoneto be able to enter into a
(30:16):
surgical pathway that they knowexactly how to operate.
And anyone who comes in andsays that they can do this and
they can do that and isoverconfident is often more of a
red flag because it is a taught, it is a trained skill.
So I would say to anyone thathas concerns about how they're
going to learn it is.
That's the benefit of doing thejunior years and the service of
(30:37):
the unaccredited years is thatyou get exposure, and the more
exposure you get, the more youpick up and whether you actually
like this process, you like theprocess of trying to learn how
to do something or replicatesomeone.
Do something well, and youenjoy the challenge and then
trying to do that yourself, youknow, for the betterment of a
patient.
That's the part that you shouldreally aspire to, and if you
(30:58):
don't like that, then youprobably shouldn't do it.
But that is the model we followand there's reading behind that
, there's understanding, allthat knowledge of anatomy and
structures at risk and thingsyou don't want to cut.
Really, it boils down to whatdon't you want to cut and how do
you want to fix this cut andhow do you want to fix this or
how do you want to do this.
And there are crucial stepsthat you should always do and
(31:19):
there are crucial steps wealways should not do.
But being able to recognize thatis all part of the training
pathway and or I'm still doingthat now and towards the end of
my training, I certainly stilldo that now.
If anything, I look for it more.
Now you learn how to look forthose people that you want to
watch, you want to emulate andyou want to develop skills from,
and I think surgeons still dothat.
You know they go and visitpeople, go on visitations all
(31:41):
the time.
So it's very much a lifelongskill.
So don't be deterred by theidea of having to learn how to
do surgery.
That's the job of training isto learn how to do that.
And once you learn how, you canconstantly sort of be trained
in doing that then you're on theright path.
Dr Gavin Nimon (31:57):
Yeah, generally it's a group of little steps
along the way.
You might learn how to sew upthe skin or how to do the
incision, and eventually theyjoin together.
That probably leads me into mysort of segue sort of question,
where you say where do you thinkthings are heading for you in
the future?
I mean, where do you thinksurgical training is going?
Dr Blake Fidock (32:17):
Where do you think you know?
What do you think you'll see inthe future from what you've
already seen so far?
I must say I think the model ispretty good at the moment.
I like the way that as much asI've again, as I've said, it is
an apprenticeship model I likethe way that the AOA has
certainly formalized the processand they've taken away this
time-based, rigid apprenticeshipmodel and turned it into more
of a competency-based, flexiblemodel, which I think is
certainly in keeping with thedemands of modern society and
(32:40):
having a more diverse andequitable workforce.
So I think that they've got thebalance right there.
The biggest challenge that I see, probably with surgical
training in the future, is justmaking sure that, as we increase
the number of surgical traineesto service the increasing
demand within Australia throughan ageing population and this
(33:01):
particularly applies toorthopaedics that we still have
the capacity for people to trainappropriately in the public
system.
And I don't think you have tobe from South Australia to know
that the public system isundergoing a lot of challenges
at the moment.
In every state there areincreasing demands across
multiple domains in every singlestate and then, along with the
increase in cost of living andthe strain that's then put on
(33:23):
people that have private healthinsurance.
It's really hard.
So we have to try and balancehow we can still train the right
number of people, how they getadequate exposure for that
training in order to service thefuture, and we can't just
increase the numbers withoutmaking sure that everyone's
still getting the appropriatelevel of exposure.
So that's probably the biggestchallenge I would see.
(33:44):
But I think that this challengeis known and it is certainly
discussed.
They're always addressing that,which is why I think that
having the formalized structureof training that we have at the
moment, in its capacity tomeasure the number of cases
we're doing, the exposure thatwe have, the feedback we're
constantly getting, is a greatway of being able to tick off
whether we're competent atsomething or not, rather than
(34:06):
just relying on sending peopleout there for five years and
going okay, you've done yourfive years, you're good.
Now you're good to go.
So overall, I think it's goodat the moment.
I mean, there are going to bechallenges.
Dr Gavin Nimon (34:19):
It's up to the organisation to sort of adapt to
those as they presentthemselves, and do you think
there's any role for technologyto help in that sort of process,
or do you think some of thisnew virtual reality and AI sort
of information is going to be ofany use to us in the future?
Dr Blake Fidock (34:31):
Yeah, I mean the augmented reality stuff is
interesting.
To be honest, I don't have muchexposure to it.
Again, being in the publicsystem, we're flat out getting a
robot for robotic surgery inthe public system, so I don't
have any exposure to augmentedreality.
I don't think there's anysubstitute for actually doing
surgery.
As much as you can make as manynice 3D, 4d models as you want,
(34:51):
until you're there with a bladeon skin or a saw in hand
cutting bone, I don't think youknow how it feels and that's
probably the biggest difference.
That's probably the biggestchallenge that there is.
These technologies may help,but I don't know how they're
going to replace actually doing.
Dr Gavin Nimon (35:09):
Well, look, it's been fantastic spending this
evening with you discussing thesurgical pathways and how
students aspire to be someonelike yourself, Blake.
I really appreciate your timegiving up this evening to
discuss it.
Thank you very much for comingon.
Aussie Med Ed.
Dr Blake Fidock (35:21):
No, thank you, Gavin.
Thanks, I really appreciate it.
Dr Gavin Nimon (35:23):
Yeah, it's been brilliant.
Thank you very much.
I'd like to remind you that allthe information presented today
is just one opinion and thatthere are numerous ways of
treating all medical conditions.
Therefore, you should alwaysseek advice from your health
professionals in the area inwhich you live.
Also, if you have any concernsabout the information raised
today, please speak to your GPor seek assistance from health
organisations such as Lifelinein Australia.
Thank you very much forlistening to our podcast today.
(35:46):
I'd like to remind you that theinformation provided is just
general advice and may varydepending on the region in which
you are practising or beingtreated.
If you have any concerns orquestions about what we've
discussed, you should seekadvice from your general
practitioner.
I'd like to thank you very muchfor listening to our podcast
and please subscribe to thepodcast for the next episode.
Until then, please stay safe.
From the first day of medical school to
becoming a fully qualifiedsurgeon.
The journey is both challengingand rewarding.
Just the nomenclature of thedifferent training positions is
confusing and, for theuninitiated, quite daunting.
Today, we're going to explorethe pathways for surgical
training in Australia.
Joining us today is Dr BlakeFidock, a surgical trainee, who
will share his first-handexperiences and valuable
(00:20):
insights into the steps involvedin this rigorous training
process.
We'll discuss the differentstages of surgical training,
including the transition frommedical school to internship,
the various pathways availableand the importance of research
and continuous learning.
Whether you're a medical studentconsidering a career in surgery
or a GP interested inunderstanding the surgical
training process better, thisepisode is packed full of
essential information.
(00:40):
G'day and welcome to Aussie MedEd, the Australian medical
education podcast, designed witha pragmatic approach to medical
conditions by interviewingspecialists in the medical field
.
I'm Gavin Nimon, an orthopaedicsurgeon based in Adelaide, and
I'm broadcasting from Kaurnaland.
I'd like to remind you thatthis podcast is available on all
podcast players and is alsoavailable as a video version on
(01:01):
YouTube.
I'd also like to remind youthat, if you enjoy this podcast,
please subscribe or leave areview or give us a thumbs up,
as I really appreciate thesupport and it helps the channel
grow.
I'd like to start the podcastby acknowledging the traditional
owners of the land on whichthis podcast is produced, the
Kaurna people, and pay myrespects to the elders, both
past, present and emerging.
Well, today we're joined byBlake Fidock, currently an a
(01:22):
registrar, who stems originallyfrom Newcastle in New South
Wales.
He's been living and workinghere in Adelaide as a South
Australian orthopaedic traineesince 2020.
He's just about to finish hissurgical training in August and
will be commencing a fellowshipin hip and knee arthroplasty in
Brisbane, Queensland.
Welcome, Blake.
Thank you very much for comingon.
Aussie Med Ed.
Dr Blake Fidock (01:41):
Hi, thanks, Gavin.
Dr Gavin Nimon (01:45):
Thanks for having me.
It's great to have you on here.
First of all, it's reallybrilliant to have someone who's
just gone through the wholeprocess.
It's a long route for you andcongratulations on finishing
your pathway.
Dr Blake Fidock (01:51):
Thank you.
Thank you.
It is a long road, but it'salways.
It's coming very close to theend now, which is good, so, yeah
, very excited.
Dr Gavin Nimon (02:05):
Well, it's great to have you here.
I thought we'd start off with,first of all, talk about the
nomenclature of different areasof medicine.
There's obviously RMOs,registrars and other areas are
called housemen, particularlyoverseas.
Perhaps we'll start off withwhat we're called here in South
Australia and then talk aboutdifferent states difference in
naming.
Dr Blake Fidock (02:14):
So when you finish medical school, the first
thing that medical students areemployed as are interns in the
public hospital, and internsessentially have provisional
registration with AHPRA, whichmeans that they are still under
supervision of consultants inthe hospital and they have
various sort of learningobjectives they have to tick off
throughout the year in order tobe deemed safe and suitable for
general registration.
So everyone sort of starts asan intern and they have 12
(02:36):
months as an intern.
They then progress to being aresident medical officer and it
varies depending on state tostate.
So I actually did my medicalschool and junior years in New
South Wales and we were affordedtwo-year contracts to start
with and we were then recognisedas junior medical officers or
RMOs, as we are down here inSouth Australia.
That position is essentiallywhere you have general medical
(02:58):
registration but you're doingsome more focused specialty
terms.
So in South Australia thatdivides into medical streams or
surgical streams, depending onwhat your interest is.
Further down your career path.
After you've done one or twoyears of RMO, then people often
progress to being a registrar.
There are various terms forregistrars and this is where it
(03:19):
can be a little bit confusing.
In South Australia the termservice registrar is commonly
used within the surgicalspecialties and that is a
position where someone is moreof a junior registrar and
they're not on an accreditedtraining program.
So they are providingessentially service to the
hospital in a position of aregistrar, but they are not
formally recognized as part of atraining program.
(03:39):
Yet In other states thisposition has slightly different
terminology.
So in New South Wales it's anunaccredited registrar and in
Queensland I think the term isprincipal house officer or PHO.
Nonetheless, the positions arerelatively the same.
They really denote like ajunior registrar position and
again, someone who's not on atraining program.
Once you've done a few years andit does vary based on the
(04:02):
surgical training program you'relooking to enter into once
you've done a few years as aservice or an unaccredited
registrar, then you can progressto a training registrar and
that requires a formalapplication to a recognized
training program which isgenerally overseen by the
college of surgeons in australia.
So within orthopedics thedesignated professional body
(04:22):
that oversees training is theAustralian Orthopaedic
Association and they have theright to oversee and facilitate
training that's designated tothem by the College of Surgeons
and your application is both toRACS and to the AOA.
So once you've been successfulin that application process, you
progress to being a trainingregistrar, which is really much
like an advanced trainingposition where you're then under
(04:43):
the formal training process andpathway of an accredited
training body and that trainingbody is accredited by the
Australian Medical Council andthere's a variety of criteria
that you then have to meet inorder to progress through that
training pathway.
And then, once you've been atraining registrar for a number
of years and you've completedall those requirements as now
(05:04):
I'm getting to the final stagesof doing then you can look to
exit your training and youbecome a fellow of a recognised
professional body.
So through the College ofSurgeons, the Royal Australian
College of Surgeons, you canbecome a fellow of them, which
denotes you're a fellow of theRoyal Australian College of
Surgeons.
You can become a fellow of theAustralian Orthopedic
Association as well, butessentially recognising that
you've finished your accreditedtraining pathway and you're now
(05:26):
moving to a position of fellow,which most people would then
recognise as being a consultantwithin a public hospital if
you're given a public position.
Dr Gavin Nimon (05:33):
Wow, for the average person listening to it,
let's say, gee, that sounds likea long route.
How many years do you thinkit's taken you to get through to
this pathway?
Dr Blake Fidock (05:45):
So I mean, I started as an intern in 2013 and
it's you know.
Now we're midway through 2024.
So it's over 10 years and, look, that is fairly standard.
There are people that might doit a couple of years faster.
There are people that mighttake a couple of years longer.
Everyone's got various periodsduring their training where
things may either be slightlylonger than they wanted, they
may happen slightly quicker thanthey anticipated, but at the
end of the day, I would tellanyone that's looking to enter
(06:07):
into surgical training today,particularly orthopedics, that
you're really looking at 10years and that's something I
think is fairly consistent.
One of my mentors when I was aresident back in New South Wales
described it to me asessentially the decade of
darkness, which is where yousort of enter into this decade
of surgical training in order toprogress to the other side.
I wouldn't say it's as bleak asmaybe that term would suggest,
(06:29):
but certainly it's around abouta 10-year period from completing
your medical training to maybegetting to the other side of
being a fellow and then startingas a specialist.
Dr Gavin Nimon (06:37):
And the question that would obviously come to
the layperson's mind is doesthat mean all that time you're
not earning any money?
Dr Blake Fidock (06:42):
Fortunately not .
So here in Australia, you know,particularly compared to a lot
of other countries, we are veryfortunate in our position as
medical officers through thepublic hospital system and we
are, relative to a lot of othercountries, very well compensated
.
So at the end of the day, youare earning money.
You know it is money you'reearned for time spent working
and there is also a significantadditional cost associated with
(07:04):
training.
So there are fees associatedwith training, which are direct
fees to the colleges, and thenthere are indirect fees in the
form of training courses,conferences that you're
attending.
So training is not aninexpensive process but
fortunately we are wellcompensated here and well paid
for that.
So you are working as a doctorthroughout that entire period
and that includes things likeworking weekends, working three
(07:26):
hours, doing overtime, doingon-call.
Fortunately, all of that iswell-paid here in Australia and,
yes, I wouldn't necessarilyworry about that.
You are earning an income forthat entire period.
Dr Gavin Nimon (07:36):
And this is down the pathway for surgery, which
is one sort of stream ofmedicine.
There are various other streams.
You can go down the pathways,isn't there?
Dr Blake Fidock (07:43):
Yeah.
So there are a variety ofdifferent pathways.
So once you've finished yourinternship and then you're
working as a resident, that'swhen you sort of make that
decision about which directionyou really want to go.
So if you want to stay withinthe hospital for the vast
majority of your training, thenyou're either looking at a
surgery, you're looking atmedicine or you're looking at
critical care, and they'reessentially the three things
that happen within the hospitalsystem and they're largely
(08:05):
hospital-based training programs.
Medicine specifically looks atbasic physician's training and
then training to become aphysician, so a cardiologist, a
respiratory physician, ahaematologist.
Those training pathways, againfacilitated through the public
system but very much moremedically focused.
Then there's critical care,which I suppose you're looking
at, intensive care, anaestheticsand emergency, which again is
(08:26):
facilitated through the publichealth system.
And then outside of that, Isuppose general practice is
something where it's notparticularly through the
hospital system.
So they might do one or twoyears in the hospital but then
apply to an accredited generalpractice training program.
So the Australian RACGP is theRoyal College that facilitates
training for GPs and the reasonI'm familiar with this is my
(08:47):
wife is actually in generalpractice training and they have
various accredited sites acrossthe country and then you would
essentially apply to one ofthose training pathways,
depending on which state you'rein, and then you could train
through that pathway in thosevarious states.
So, yeah, so if you're notinterested in surgery, then
there are a variety of trainingpathways that are available to
medical students and juniordoctors.
It's just really about tryingto pick which one you know suits
(09:09):
you, suits your life goals,ambitions, your work-life
balance, what you want toachieve, and then trying to
really funnel your career movesand your rotations into being
able to pivot towards thosetraining pathways.
Dr Gavin Nimon (09:23):
Yeah, a few other thoughts came to mind as
well.
I was thinking of the peoplewho went through my medical
school many years ago and somehave become GPs, physicians,
obviously surgeons, anesthetists, obs and gynae, radiologists,
ophthalmologists, oncologists.
Yeah, so I missed a few, so yeah, Paediatricians, pathologists,
(09:43):
public health and administration, and someone in my gear has
gone into one of those differentareas.
So it's actually quite excitingthat years down the track you
actually see these people indifferent positions.
You mentioned the RACs, orRoyal Australasian College of
Surgeons, and the AustralianOrthopaedic Association.
They're the different bodiesthat we're under the auspices of
.
Can you explain how, say, ageneral surgical trainee may
vary from an orthopaedic traineein that they actually are
(10:06):
purely under the College ofSurgeons?
Is that right, as opposed toorthopaedics, who are under two
different areas?
Dr Blake Fidock (10:10):
Yes, the overarching organisation that
facilitates medical training orthe oversight of medical
training in Australia is theAustralian Medical Council and
then, from a surgical point ofview, it's the Royal
Australasian College of Surgeons.
So the general surgeons arevery much under RACS.
Racs there's a bit of traditionassociated with RACS being
predominantly general surgeons,then orthopaedics being a
relatively newer specialtycompared to general surgery, and
(10:33):
then, as things have evolved,the Australian Orthopaedic
Association has essentiallydeveloped as a separate
organisation outside of RACSthat essentially represents the
interests of and lobbies for theinterests of Australian
orthopaedic surgeons and thensubsequently has then gone into
being able to facilitate anddevelop training for upcoming
and future orthopaedic surgeons.
And that's been a big focus ofthe AOA, I think, probably in
(10:55):
the last 10 to 20 years isreally developing that training
pathway.
So as an orthopaedic trainee,we are certainly recognised
surgical trainees, which is whywe are still under the
supervision of RACS, but ourtraining is very much
facilitated and organisedthrough the Australian
Orthopaedic Association.
(11:16):
And our examinations to thatextent are done through the
College of Surgeons.
The College of Surgeons stillcontrols the process by which we
are formally examined at theend of our training and then
enter to be a recognised fellowor specialist within an area,
but the training pathway thatyou undertake in order to get to
that point is essentiallydeveloped by the airways.
What I would say to anyonethat's looking at this process
(11:37):
is necessarily to get tooworried or try and look too much
into there's a larger sort ofhistorical relationship that
exists between these very largeorganisations.
It's's just about recognizingthat as a surgical trainee, you
are certainly a member or anassociate or a trainee of both
organizations and there arebenefits to both.
So it's just recognizing thatthat, yeah, there are two
(11:57):
organizations that represent youas a trainee as well in the
public hospital and of coursethere's also other organizations
that also we're.
Dr Gavin Nimon (12:03):
Then the also itself is actually something
like the Australian HealthPractitioner Regulatory
Authority.
Then we've also got otherorganisations that people become
members of, like the AustralianMedical Association or in South
Australia the South AustralianSalaried Medical Officers
Association, which are sort ofinterest groups.
Dr Blake Fidock (12:18):
Yes, there's plenty of oversight and
supervision that exists whenyou're working as a doctor in a
public hospital and then whenyou are not, when you're still
going through your accreditedtraining process, you know there
are plenty of organisationsthere to represent you and to
oversee your development.
Dr Gavin Nimon (12:32):
So what do you reckon the routes are?
To get into surgical training?
Let's focus on orthopaedics.
What are the sort of routes tohead down this sort of way?
I mean, you've mentioned youcame straight out of internship
heading down this pathway.
Does everyone come down thatsame sort of route or do people
go off and try different areasin the first place?
Dr Blake Fidock (12:46):
So internship, you will get exposed to a
variety of things.
You'll do your medical surgical, your emergency terms, which
are really important, and Ithink it's probably important
that you then, as an RMO or as aresident, you then explore some
of those varying interests thatyou have as well.
I certainly had interests whichwere heading towards
orthopaedics as an intern, but Iexplored other things whilst I
was doing internship and myresident years, including
(13:08):
general surgery, vascularsurgery.
I did rotations in those beforeI decided to go down the
orthopaedic pathway.
So that's important.
I think exposure is important.
Don't try and pigeonholeyourself too much.
There are people obviously likethat, straight out of med
school who know exactly whatthey want to do and, regardless
of what you tell them, they'redefinitely going to go down that
pathway.
But it is important to makesure you do get some exposure to
what it's like, because whatyou see as a medical student is
(13:30):
very different to what youexperience when you come to work
.
Come to work and it's importantthat you get to know the team,
be part of the team when you'rea junior member and then see
whether this is the type ofenvironment and these are the
type of patients you want to belooking after ultimately when
you choose your specialty.
But I think so, to start with,from those junior years,
exposure is important.
Get some exposure, get someexperience.
The process to apply toorthopaedics is done through the
(13:51):
Australian OrthopaedicAssociation and the criteria
does change every year.
So it is important to keepabreast of that as you're
getting close to yourapplication.
But it does essentially comedown to what experience you've
had, the referees that youcollect along the way, any
research you've done as a resultof that, and then some
recognised courses andpublications or presentations
(14:12):
that you've done to aid thatapplication process.
So in those first couple ofyears, in those junior years,
doing some orthopaedics terms isimportant.
It's important to reaffirm yourinterest and then guide your
career.
But it's also important just todevelop some basic
understanding of orthopaedics,because it's not the easiest
thing to sit down and just readin a textbook.
It is a very experientialspecialty and it is
(14:34):
traditionally very much anapprenticeship model-type
training and the reason for that, I think, is because it is
something that you learnpredominantly by doing and you
know that's what those junioryears are really important for.
But once you decide you want todo that and you're sort of
guiding your career towardsmaybe doing a service or an
accredited orthopedic registraryear, then things like engaging
(14:54):
in some research so engaging indoing some either literature
reviews or joining a researchproject that's a clinical
project or, you know, speakingto your seniors and seeing
what's available, trying to jumpon board there to at least
experience what that's like andthen get your name on maybe a
presentation or a publicationthat can come as a result of
that work is important,recognizing the courses that you
(15:15):
do.
And then again, even though theapplication is through the AOA,
racs run a series of thosecourses.
So things like EMST, crisp.
There's another one, clear,which is again about evaluating
literature and research.
So there are a few courses thatare important.
Dr Gavin Nimon (15:28):
Just outline these abbreviations for us,
Blake, if you can.
Dr Blake Fidock (15:31):
Yeah, so EMST is the Early Management of
Severe Trauma, it's the onethat's the old ATLS system, so
Advanced Trauma Life Supportcourse, so that one is again a
very essential courseessentially to do prior to
applying to surgical training.
Crisp, I think, was the Care ofCritically Ill Surgical
Patients, and then CLEAR isCritical Literature Evaluation,
(15:52):
something, something I can'tremember the last two letters
for that one, and then ASSET wasanother one, it something
something I can't remember thelast two letters for that one,
and then asset was another one.
It's another surgical skillsone that's run through through
the College of Surgeons.
But essentially, if you go tothe application criteria on AOA
they'll tell you which courseswill grant you points and it's
when you come to apply to theAOA you're looking to generate a
reasonable number of points inorder to meet a threshold, to be
(16:13):
a suitable candidate to applyfor a training position and
subsequently be considered foreither interview or collation of
your references and compared toother applicants.
So doing those courses, doingsome research, doing some higher
levels of education.
So there are points of doing amaster's and there are some
master's courses that can bedone through many universities
around Australia and thenultimately you can do a PhD.
(16:33):
But a commitment to a PhD is abig commitment.
So I wouldn't necessarily tryand do that as a matter of
point-tacking for application,because you're looking to commit
a lot of time and years inorder to do that.
I'm not saying you can't do it,but just think about it if
you're going to try and get todo a PhD to apply for
orthopaedics.
So apart from, yeah, research,doing terms and then doing
courses, they they're sort ofthe main things that you're sort
(16:53):
of looking to get as part ofthat are always really in the
application process.
There might be one or twopoints here and there that pop
up.
There is a big sort of pushtowards rurality recently.
So you know recognising peoplewho go to rural terms.
So there are a lot of ruralhospitals that need service in
the form of, you know, juniordoctor and then registrar
service.
So you know, working in ruraland remote locations like Alice
(17:15):
Springs is looked quitefavourably.
Dr Gavin Nimon (17:18):
And also give you a lot of experience as well,
from different areas.
Dr Blake Fidock (17:21):
Yeah, it gives you a lot of experience.
Yeah, exactly, I think I workeda total of about 16 months in
Alice Springs, so I cancertainly be one to say that it
is an excellent opportunity togo rural and work in some of
those remote communities,particularly when you're looking
to apply.
I did that pre-training.
I certainly think that not onlyhelped my application but just
helped me all round when I wasready to apply.
(17:42):
So, in essence, there's thosethings.
There's quite a few things toconsider, but yeah, they're the
broad strokes.
Dr Gavin Nimon (17:49):
We talked about applying for advanced
orthopaedic training and thispathway.
What's the role I mean?
Does it still exist, the basicsurgical training program that
you have to do after an RMO yearbefore you apply for?
Dr Blake Fidock (18:00):
advanced orthopaedic?
Yeah, no, there was, and I haveheard of this and I think it
existed just prior to my time.
There was basic surgicaltraining, but that doesn't exist
anymore.
When you're a resident, you canget surgical RMO terms that
will allow you to rotate throughvarious surgical specialties,
but there is no basic surgicaltraining pathway.
That's facilitated through RACs.
Essentially, the colleges nowreally only facilitate
(18:23):
accredited training programs andthere's no pre-vocational
training pathways that I'm awareof.
Dr Gavin Nimon (18:28):
And are there any exams you need to do before
you apply for the AustralianOrthopaedic Association?
Dr Blake Fidock (18:32):
Yes, that's probably the one I forgot as
part of the AO application.
Yes, so there's the GSSE, whichis the Generic Surgical
Sciences Examination, which isnow a prerequisite in order to
be able to apply and be eligiblefor application, which is
essentially an examinationthat's conducted over two days.
It's a written exam, it's allmultiple choice, but it
essentially comes down toanatomy, pathology and
(18:54):
physiology and it is aprerequisite in order to apply
now and you have to meet theminimum threshold in that
examination in order to progress, to be suitable as a candidate.
So I think historically it wasactually delivered during
training, so people had tocomplete that examination prior
to maybe their third year orsomething.
But that has since changed inthe last maybe five or so years,
(19:14):
where it is now a prerequisiteprior to getting onto training.
And I think that's probably agood thing because there are
more examinations once you're ontraining, but it also acts as a
really good barrier.
You know, the GSSC is a lot ofinteresting facts about anatomy,
pathology and physiology, butit is a barrier to see who is
willing to sit down and studysome of these random facts that
may appear in a multi-choiceexamination prior to wanting to
(19:39):
commence surgical training,which in itself is arduous and
long and requires a significantperiod of commitment.
So whether you can sit and dothis exam is the good sort of
first hurdle to see whetheryou're a suitable candidate.
Dr Gavin Nimon (19:52):
It says hard work and I remember from my days
.
I still have dreams about doingthe exam, so that's many years
ago.
Dr Blake Fidock (19:57):
I don't think that ever, having just done my
fellowship exam in the last well, 12 months ago now, I don't
think it will ever leave mybrain.
Yeah, you still wake up withnightmares sometimes.
Dr Gavin Nimon (20:09):
Now people often say look, you know it's very
competitive and it's hard to getonto these sort of pathways,
but obviously people do.
What's your advice?
Would you ever try and talkanyone away out of doing
orthopaedics?
Do you think it's worth a grind?
Dr Blake Fidock (20:20):
I wouldn't try and talk anyone out of it.
I mean, I think that it's likeanything it is competitive, it's
hard work, but it is also ahighly rewarding career.
So you know, if you were tolook at other areas outside of
(20:40):
medicine and you were sayingsomeone they were going to
invest in building a, building abusiness and trying to have you
know professional fulfillmentin another area, telling them
it's going to take ten years ofhard work but you'll get there,
most people probably tell recordyeah, willing to give that hard
work and willing to commit.
So I try to tell people that itis not an easy process but it
is a rewarding process.
It's one that requires a lot ofcommitment.
There's, you know, commitmentand there's a bit of luck at the
end of the day, like everythingin life, particularly during
(21:02):
your application process.
Sometimes it can be your year,sometimes it can't be your year
and it can be the numbers andwho's around and you know who
you're competing against forthat time.
But I think that if you aregenuinely interested in
orthopaedics as a surgicalspecialty and you enjoy the work
, you enjoy your colleagues, youenjoy treating patients,
looking after them and beingable to make a difference in
(21:23):
their lives, which I think isone of the biggest advantages of
orthopaedics, is that you getto actually see that improvement
in your patients when youfollow them up and that impact
that you've made.
Then I would say the commitmentis worth it.
But it's not an easy commitmentand it is someone that has a
family or also has a partner.
It's not an individualcommitment either.
(21:43):
It's very much a familycommitment and that's maybe one
of the main bits of advice Igive to people now, because if
you are at a later stage of lifeand you're looking to enter
into orthopaedics, then by allmeans go for it if you've got
the drive, but make sure youhave the conversation with your
other half, because it is awhole family commitment, as I'm
(22:04):
sure my wife would certainlyattest to.
Dr Gavin Nimon (22:06):
Look, what about a typical day in orthopaedics?
And what does it look likealong the pathway?
What's it been like along theway?
Dr Blake Fidock (22:13):
Yeah, so I mean , it depends on which hospital
you're at, and some arecertainly busier than others and
some rotations are busier thanothers, but in general you start
at around 7 to 7.30 in themorning, somewhere between that
time.
The first thing we do every dayis ward round, and an
orthopedic ward round is notlike a medical ward round.
It is a quick hello and woundcheck and make sure there's no
(22:36):
significant complications ormedical adverse events that have
happened in the past 24 hoursthat we need to be aware of, and
we're essentially do a quickward round in the morning.
Then, depending on the siteyou're at, again, you'll
generally attend a meeting whichwill discuss the new admissions
plans for the day, includingthe plans of attack for various
operating theatres that you'rerunning, so that we can be
appropriately staffed andeveryone's on the same page
about what we operating theatresthat you're running, so that we
(22:56):
can be appropriately staffedand everyone's on the same page
about what we're doing, and thatis particularly the case in
larger hospitals.
They will have these regulardaily meetings to address these
and then, depending on where youare sort of in your career,
your day could be broken into, Isuppose, being on call, which
is taking call for any of thenew referrals that are coming
(23:16):
through the emergencydepartments.
They're going to the ED andassessing patients and then
deciding who needs to beadmitted and discharged, who can
be followed up in theoutpatient clinic, going to the
outpatient clinic and seeingpatients in the outpatients or
being in the operating theatre.
And in the operating theatrethat can be in the emergency or
the elective list and those aresort of the main things that you
can be doing sort of and thatwill run essentially we break it
(23:38):
into half days generally.
So morning session, afternoonsession, someone could be there
all day.
They could be, you know, halfday in clinic, half day in
theatre, depending on what'srunning.
Most days generally finisharound about five o'clock In the
public hospital.
You know that's the time thattheatres will generally shut.
As with all things, sometimesthings can run late, sometimes
they can finish early.
It's more commonly they'll runlate than finish early, but
(24:00):
generally you can always seehopefully finish around 5
o'clock.
If you're on call you may staylater.
So if you are holding the phoneor on call for that day, those
shifts generally can run alittle bit later, so maybe 8 or
9 o'clock.
Fortunately there's been a bigshift in on-call, particularly
in busy hospitals now whereorthopaedics are running 24-hour
services, so recognising theimportance of having day staff
(24:21):
and night staff.
So you'd be handing over to anight registrar now, as opposed
to doing 24 hours of on-call andthen expected to front up the
next day.
That is certainly what used tohappen in the old day and I'm
sure you would attest to that,Gavin, that that was what you
did during your training.
But I think I'm fairlyfortunate enough to say now that
in this generation that we aremoving away from that,
particularly in busy hospitalswhere that doesn't happen
(24:42):
anymore, and that you know youmay be on call for a period of
12 hours, but if you're in abusy quaternary or tertiary
level centre, you're probablygoing to go home and sleep, you
know, quite comfortably thatnight, because you're not going
to be woken up overnight and sothey're not expected to, you
know, to work more than 24 hoursin a row.
So that's the general sort ofoverview.
Even if you're not in anaccredited training program,
(25:04):
we're all training, we're allworking towards something.
So at the end of the day andthroughout the day, there's
always reading, there's alwaysthings that you want to be doing
.
There's always thatextracurricular stuff that
you're trying to build your CVfor, You're trying to enhance
your knowledge.
You've got a list the next dayor the day after You're trying
to work out.
You know, read about some ofthose cases, do the prep for
that to make sure that you'reprepared.
So that certainly adds up.
(25:24):
I'd say there's probably atleast an hour of that every day
where you're doing somethinglike that.
And you know we often do thatsubconsciously.
I think a lot of us.
We come home now and we'realways looking at, because it's
so accessible, we're looking atour phones, we're looking at our
Microsoft Teams, we're goingthrough the cases that we have
for the next couple of days tomake sure everything's all right
, that everything's beentemplated appropriately, all the
(25:45):
investigations have beenordered.
So that sort of admin timecertainly adds up.
And then, if you are in yourtraining years, there's periods
of study, there's periods ofworking on your formalized
teaching.
So your bone schoolpresentation.
So every week the orthopedictrainees have half a day
dedicated to teaching.
So bone school is our formal,recognized training session.
So one training will presentthat every week so you might
(26:07):
have a bone school coming up oncervical spine injuries.
So you're sitting there workingon your bone school
presentation that evening.
We've got a journal club comingup the following week.
You're working on that journalclub presentation.
So there's always that sort ofstuff outside as well.
That's the general day of anorthopaedic registrar, certainly
.
And then on top of that you tryand squeeze in some time to
(26:27):
exercise and some time to spendtime with family and all that
sort of stuff as well.
Dr Gavin Nimon (26:32):
I think one of the things you've passed over
quickly is actually theenjoyment of being in a hospital
scenario too and having lots ofdifferent people you meet and
being exposed to differentpeople.
Have you found that as well?
Would that be your experienceas well, Blake?
Dr Blake Fidock (26:44):
Yeah, I mean 100% working orthopedics.
I said to a lot of peopleorthopedics is a team sport.
So you know we work in teamsand that is our team.
The team that we have whenwe're working as a unit, that's
the.
You know the senior registrar,the training registrar, the
junior reg, the rmo.
You know when you're onorthopedics you're in our team.
And then there's also the teamsthat you work with every day.
(27:06):
So you know the theater teamyou're working with.
You know getting to know thetheater staff is really
important the clinic staff thatwe.
It's very much a teamenvironment and certainly it's
one of the best things aboutworking in the public hospital
and during your training years.
And you know, even when youhave those rotations that are
really busy, really hecticrotations that are very full-on,
(27:27):
long days, hard work, the thingthat makes it worthwhile is if
you've got a good team.
If you're surrounded by a goodteam, then that becomes so much
easier because every day you'refronting up and you've got your
mates there and it's like you'regoing into bat together.
You're all trying to just getthrough the day together and
there's a lot of banter that canbe had there as well and that
(27:49):
is one of the most enjoyablethings.
That's probably one of the mainreasons why, ultimately, when I
was trying to decide surgicalspecialty is orthopedics,
because when I looked around,you know, at the teams, the guys
there would, and guys and girls, the guys, all of them were
having fun.
You know.
They were all enjoying it,despite the fact that it was
organized chaos some days and itis organized chaos some days.
(28:10):
Everyone was enjoyingthemselves and there was, you
know, good banter and at the endof the day, you know, it was an
enjoyable workplace.
So, and I think that that hascertainly been my experience as
well, like my experience overallhas been, you know, every
rotation I've done and I'veworked with, I've found people
that I've really gotten alongwith and you know, we have a
(28:30):
good time when we come to workand it's hard work and some days
are worse than others, but butoverall it's good fun brilliant.
Dr Gavin Nimon (28:38):
One of the questions medical students might
ask is how do you actuallystart surgery?
You don't come straight out ofmed school and start opening
someone up and doing a procedure.
How do you actually become asurgeon?
What's your recollection ofyour first operation and how
you're exposed to it?
Dr Blake Fidock (28:52):
yeah, I mean I alluded to it slightly earlier
that it used to be a bit more ofan apprenticeship model, and I
think there's some truth in that, in that you are learning a bit
of a you know don't tell theanesthetists or the physicians
but you're learning a bit of atrade.
Really, you're learning how touse your hands and there's a
higher degree of dexterityrequired maybe than some other
things, but at the end of theday, you are, you are learning.
(29:13):
So we have to go and you haveto see, you have to see people
do and you have to learn aboutwhat they're doing, and then you
have to try and replicate whatthey're doing.
And that is essentially theapprenticeship model that we're
trying to follow.
Now the AOA has very much movedto a competency-based model.
Now we're trying to tick offvarious things that we're good
at, but in essence, what we'restill doing is, you know, by
going with our supervisors andby operating with our
(29:35):
consultants, we're watching themdo a procedure.
They're then watching us do aprocedure, and then we're trying
to get to that point oflearning how to do a procedure
independently.
And I think when I was aresident in this was when I was
back in Newcastle.
I remember I was about secondor third year I got rostered to
a list with an upper limbsurgeon.
I'd seen plenty of distalradius fractures and I thought I
was getting pretty close tobeing able to fix a distal
(29:56):
radius fracture.
And then I sat down at theoperating table and I just
thought, as I was sitting atthat side I was like, what do I
do now?
What's the first step?
And it's like when you take theknife in your hand, you have to
.
You're then starting.
The whole thing changes.
So it's not innate Sur.
It's not innate.
Surgery is not innate.
You would never expect someoneto be able to enter into a
(30:16):
surgical pathway that they knowexactly how to operate.
And anyone who comes in andsays that they can do this and
they can do that and isoverconfident is often more of a
red flag because it is a taught, it is a trained skill.
So I would say to anyone thathas concerns about how they're
going to learn it is.
That's the benefit of doing thejunior years and the service of
(30:37):
the unaccredited years is thatyou get exposure, and the more
exposure you get, the more youpick up and whether you actually
like this process, you like theprocess of trying to learn how
to do something or replicatesomeone.
Do something well, and youenjoy the challenge and then
trying to do that yourself, youknow, for the betterment of a
patient.
That's the part that you shouldreally aspire to, and if you
(30:58):
don't like that, then youprobably shouldn't do it.
But that is the model we followand there's reading behind that
, there's understanding, allthat knowledge of anatomy and
structures at risk and thingsyou don't want to cut.
Really, it boils down to whatdon't you want to cut and how do
you want to fix this cut andhow do you want to fix this or
how do you want to do this.
And there are crucial stepsthat you should always do and
(31:19):
there are crucial steps wealways should not do.
But being able to recognize thatis all part of the training
pathway and or I'm still doingthat now and towards the end of
my training, I certainly stilldo that now.
If anything, I look for it more.
Now you learn how to look forthose people that you want to
watch, you want to emulate andyou want to develop skills from,
and I think surgeons still dothat.
You know they go and visitpeople, go on visitations all
(31:41):
the time.
So it's very much a lifelongskill.
So don't be deterred by theidea of having to learn how to
do surgery.
That's the job of training isto learn how to do that.
And once you learn how, you canconstantly sort of be trained
in doing that then you're on theright path.
Dr Gavin Nimon (31:57):
Yeah, generally it's a group of little steps
along the way.
You might learn how to sew upthe skin or how to do the
incision, and eventually theyjoin together.
That probably leads me into mysort of segue sort of question,
where you say where do you thinkthings are heading for you in
the future?
I mean, where do you thinksurgical training is going?
Dr Blake Fidock (32:17):
Where do you think you know?
What do you think you'll see inthe future from what you've
already seen so far?
I must say I think the model ispretty good at the moment.
I like the way that as much asI've again, as I've said, it is
an apprenticeship model I likethe way that the AOA has
certainly formalized the processand they've taken away this
time-based, rigid apprenticeshipmodel and turned it into more
of a competency-based, flexiblemodel, which I think is
certainly in keeping with thedemands of modern society and
(32:40):
having a more diverse andequitable workforce.
So I think that they've got thebalance right there.
The biggest challenge that I see, probably with surgical
training in the future, is justmaking sure that, as we increase
the number of surgical traineesto service the increasing
demand within Australia throughan ageing population and this
(33:01):
particularly applies toorthopaedics that we still have
the capacity for people to trainappropriately in the public
system.
And I don't think you have tobe from South Australia to know
that the public system isundergoing a lot of challenges
at the moment.
In every state there areincreasing demands across
multiple domains in every singlestate and then, along with the
increase in cost of living andthe strain that's then put on
(33:23):
people that have private healthinsurance.
It's really hard.
So we have to try and balancehow we can still train the right
number of people, how they getadequate exposure for that
training in order to service thefuture, and we can't just
increase the numbers withoutmaking sure that everyone's
still getting the appropriatelevel of exposure.
So that's probably the biggestchallenge I would see.
(33:44):
But I think that this challengeis known and it is certainly
discussed.
They're always addressing that,which is why I think that
having the formalized structureof training that we have at the
moment, in its capacity tomeasure the number of cases
we're doing, the exposure thatwe have, the feedback we're
constantly getting, is a greatway of being able to tick off
whether we're competent atsomething or not, rather than
(34:06):
just relying on sending peopleout there for five years and
going okay, you've done yourfive years, you're good.
Now you're good to go.
So overall, I think it's goodat the moment.
I mean, there are going to bechallenges.
Dr Gavin Nimon (34:19):
It's up to the organisation to sort of adapt to
those as they presentthemselves, and do you think
there's any role for technologyto help in that sort of process,
or do you think some of thisnew virtual reality and AI sort
of information is going to be ofany use to us in the future?
Dr Blake Fidock (34:31):
Yeah, I mean the augmented reality stuff is
interesting.
To be honest, I don't have muchexposure to it.
Again, being in the publicsystem, we're flat out getting a
robot for robotic surgery inthe public system, so I don't
have any exposure to augmentedreality.
I don't think there's anysubstitute for actually doing
surgery.
As much as you can make as manynice 3D, 4d models as you want,
(34:51):
until you're there with a bladeon skin or a saw in hand
cutting bone, I don't think youknow how it feels and that's
probably the biggest difference.
That's probably the biggestchallenge that there is.
These technologies may help,but I don't know how they're
going to replace actually doing.
Dr Gavin Nimon (35:09):
Well, look, it's been fantastic spending this
evening with you discussing thesurgical pathways and how
students aspire to be someonelike yourself, Blake.
I really appreciate your timegiving up this evening to
discuss it.
Thank you very much for comingon.
Aussie Med Ed.
Dr Blake Fidock (35:21):
No, thank you, Gavin.
Thanks, I really appreciate it.
Dr Gavin Nimon (35:23):
Yeah, it's been brilliant.
Thank you very much.
I'd like to remind you that allthe information presented today
is just one opinion and thatthere are numerous ways of
treating all medical conditions.
Therefore, you should alwaysseek advice from your health
professionals in the area inwhich you live.
Also, if you have any concernsabout the information raised
today, please speak to your GPor seek assistance from health
organisations such as Lifelinein Australia.
Thank you very much forlistening to our podcast today.
(35:46):
I'd like to remind you that theinformation provided is just
general advice and may varydepending on the region in which
you are practising or beingtreated.
If you have any concerns orquestions about what we've
discussed, you should seekadvice from your general
practitioner.
I'd like to thank you very muchfor listening to our podcast
and please subscribe to thepodcast for the next episode.
Until then, please stay safe.
Popular Podcasts
Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com