First Incision

First Incision

A podcast about preparing for the General Surgery Fellowship Exam. Each year, Australian and New Zealand surgical trainees sit this exam in order to gain a 'fellowship' in General Surgery. This podcast follows one trainee doctor on her journey towards FRACS (Fellowship Royal Australian College of Surgeons). The series correspond to the different modules from the surgical curriculum. Series 1-Breast Surgery, 2-Exam Specific Episodes; 3-Upper Gastrointestinal Surgery; 4-Colorectal Surgery; 5-Hepatobiliary Surgery; 6-Endocrine Surgery; 7-Trauma; 8-Skin and Soft Tissue; 9-Vascular; 10-Anatomy (Limb); 11-Surgical Oncology; 12-Critically Ill Surgical Patient

Episodes

April 2, 2024 38 mins

This episode covers the topic of chest trauma, with the James Mckay, an incredible general surgeon, trauma surgeon, and dual trained intensive care physician.

Topics covered include:
- rib fractures
- flail chest
- blunt cardiac injury
- chest drains
- resuscitative thoracotomy
And more!   
 
Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the...

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This guest episode with colorectal surgeon Chris Wakeman focuses on the common familial cancer syndromes. For each we go through diagnosis, genetics, surveillance, management, decision making and more. Topics include:
- Familial Adenomatous Polyposis (FAP)
- Lynch Syndrome
- Serrated Polyposis Syndrome
- Oligopolyposis
Here are some resources Dr Wakeman suggested might be helpful when covering this topic:

Lynch s...

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This episode is the first  part of a series that has been produced in collaboration with the Australian and New Zealand Training Board in Colon and Rectal Surgery (ANZTBCRS). It has come out of work prepared for the Colorectal Fellow's Training Weekend held in Adelaide in August 2023.

Henry Drysdale won the Phillip Douglas Prize for his presentation on malignant colorectal polyps and is our guest for this episode.

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For this guest episode we are joined by Dr Simon Richards, as colorectal surgeon from Christchurch New Zealand.

This episode is a masterclass in Total Neoadjuvant Therapy (TNT) for Rectal Cancer. We cover:
- the traditional paradigm of rectal cancer management and how it's progressed to where we are now
- what is TNT
- what is 'watch and wait' and 'organ preservation'
- the main thr...

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On this guest episode we are joined by Dr Carla Gillespie, an UGI, bariatric and general surgeon from Sydney to cover the topic of bariatric surgery.

We cover:
- pathophysiology
- types of operations
- considerations when deciding what operation
- complications - immediate and late
- how to remove a lap band
- and some general exam and career advice!

Disclaimer
The information in this p...

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January 22, 2024 29 mins

From the vault (courtesy of Tara who found it).

This episode covers the topic of intestinal failure. It includes:
- definition
- classification
- pathophysiology
- prevention
- the three phases
- intestinal adaptation
- management
- complications (short and long term)

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery...

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In this week's 'Christmas Special' episode I am joined by Ashwini Pondicherry and Jamie Crichton to reflect on our first year of fellowship.
We discuss some of the good things about this transition, but also some of the more difficult and formative aspects and how we negotiated them.
The step from registrar to fellow/consultant is a HUGE one and we hope that by talking about some of these topics it will make ...

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Our first episode back (in a while - sorry!) is an incredible guest episode that is worth the wait.
We talk through a series of breast cancer cases with Ashwini Pondicherry, the current breast fellow at Christchurch hospital, to cover a wide range of topics in breast cancer. This includes some updates from the original breast cancer episodes (which were published over 2 years ago now).
This episode not only covers content,...

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This guest episode covers the essentials you need to know when talking about operative surgery in inflammatory bowel disease.
We are joined by colorectal and general surgeon Mr Michael Johnston who has significant experience in looking after these patients.
We talk about:
- ileocolic resections
- what to do with crohn's fistulas to the sigmoid
- stricturoplasty techniques
- how to handle the crohn'...

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In this episode we go into some of the pathologies that can affect the salivary gland, as well as the different neck infections we need to know about.

Topics covered include:
Salivary Gland Pathology
- Salivary gland calculi (sialolithiasis)
- Infections / Inflammation including sialadenitis
- Plunging ranulas
Cervical Infections
- Compartments of the neck
- Different infections and neck absces...

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On this guest episode, we talk to Anthony Payne, a financial and tax consultant with DPM Financial about some of the financial changes we will face transitioning from being a registrar to fellowship and consultancy.

Some of the topics we cover include:
- Transitioning from employee to sole trader, and the implications on this for Tax, Super, Insurances and Leave. 
- What an ABN is and why you need it
- GST as a...

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December 19, 2022 53 mins

In this first episode from the Head and Neck module of our curriculum we touch on salivary gland pathology. Including:
- Salivary gland anatomy - including the parotid and submandibular glands. As part of this we cover the important anatomical relations and the parasympathetic supply (highly examinable!)
- Common tumours of the salivary glands and how to treat them
- Some operative tips and how to describe how you would...

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This week we are joined by the incredible urologist Dr Anita Clarke to talk about all things urology!
We cover:
- the benefits of multidisciplinary surgical approach
- putting in a ureteric stent
- the diagnosis and management of bladder cancer (for general surgeons)
- management of intra-operative ureteric injuries
- the difficult urinary catheter and inserting a suprapubic catheter
As well as other lif...

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November 14, 2022 45 mins

Welcome to this guest episode with A/Prof Phil Carson. A/Prof Carson is a general surgeon from Darwin and the most recent ex-censor in chief of RACS. We are lucky enough to have him for this special episode to cover a range of topics filled with pearls and insights from his varied and interesting career.
We cover:
- some background into his life as a rural generalist in Darwin.
- what to do to prepare for practice if yo...

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We are lucky enough this week to be joined by the incredible Kellee Slater - HPB and hernia surgeon from Queensland. In addition to being an incredible surgeon, researcher, published author and presenter, A/Prof Slater has been extremely generous and joined us to cover topics from the hepatobiliary and transplant modules.

I hope you enjoy listening to this episode as much as I enjoyed recording it. Once again I'm over...

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October 24, 2022 39 mins

I'm back! After a nice break holidaying around Italy I bring you an introduction to the transplant module!
Hopefully this covers enough background to get started with the module including transplant immunobiology, immunosuppressive medications, criteria for organ donation and complications of immunosuppression.

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the Ge...

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I know I promised you all a series on urology but I'm taking a break this week and releasing a bonus episode from the vault!

This episode covers all the appendiceal pathologies from the 'emergency' module of the curriculum:
- acute appendicitis
- appendiceal tumours including adenocarcinoma, mucinous adenocarcinoma, mucinous neoplasms, goblet cell adenocarcinoma, and neuroendocrine tumours.
- and...

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This episode continues our foray into the urology topics we need to know for our general surgical exams. We cover:
- testicular tumours including the presentation, subtypes, workup, radical inguinal orchidectomy and management
- Varicoceles
- Hydroceles (including some operative points on Jaboulay and Lord's procedures)
- and epididymal cysts

Disclaimer
The information in this podcast is intended a...

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August 22, 2022 26 mins

From the abdominal wall, retroperitoneum and urogenital module from the curriculum I bring you the first in a series of podcasts covering urology!
We have to know quite a few urology topics for our exam, but where better to start than by covering anatomy and embryology.
In this episode we cover the clinically relevant anatomy of:
- the kidneys
- ureter
- bladder
- testes
- vas deferens
- seminal ves...

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This episode is number 3 in our series of pathophysiology quiz episodes.
We cover pathophysiology topics from the following modules:
- sepsis and critical care
- nutrition
- skin and soft tissue
-  trauma
- vascular, and
- abdominal compartment syndrome

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This ...

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