From a very young age I wanted to be a doctor. I think this was because I had a lot to do with doctors and hospitals during my early years. When I was a baby I contracted osteomyelitis in my left femur and spent a lot of time in and out of hospital, having long courses of tetracycline and penicillin and multiple operations.
At school I worked hard and was awarded a place as a medical student at Christ Church, Oxford in 1978. I qualified with a BM BCh from Oxford University in 1984. After my pre-registration house officer posts at Oxford and Plymouth I taught for a year at Cambridge University. My basic surgical training was undertaken at the JRII Oxford, Frenchay and Southmead Hospitals, Bristol and the Princess of Wales Hospital, Bridgend. I became a Fellow of the Royal College of Surgeons in 1989 when I started work as a research fellow at University College Los Angeles School of Medicine. My research was into the pathogenesis of acute and chronic pancreatitis and pancreatic infection which lead to being awarded a Doctor of Medicine degree from Oxford University in 1991.
Higher surgical training started at the Norfolk and Norwich and Frenchay hospitals, and finished on the South West Senior Registrar rotation when I worked in the Bristol Royal Infirmary and the Royal Devon and Exeter Hospital. In 1995 I was awarded a Hunterian Professorship and a British Journal of Surgery European fellowship and obtained my UK an dEuropean Certificates of Completion of Specialist Training. On the 1st November 1995 I was appointed Consultant General Surgeon at the Royal Cornwall Hospital (RCHT). I initially specialised in General, Laparoscopic and Upper GI surgery but from 2005 I specialised in complex abdominal surgery and laparoscopic colorectal surgery. I always worked full time and participated in the emergency on call until I retired .
I have supervised, trained and mentored medical students, surgical trainees, newly appointed consultants and allied health care professionals throughout my career. Senior educational responsibilities included Honorary Peninsular Medical School Lecturer; Clinical and Educational Supervisor; Royal College of Surgeons (Eng) surgical tutor; Deanery Advisor and Associate Post-Graduate Dean; RCHT Clinical Tutor; Lapco trainer. I was awarded a Post Graduate Certificate in Education in 2002 and an ILM Level 3 coaching qualification in 2017. I have supervised MSc trainees, trainees and medical students undertaking research, and allied health care professionals undertaking specialist training. I have published more than 40 original articles and presented at numerous national, regional and local meetings. I have held many senior management posts including RCHT Clinical lead to develop a new Electronic Health care record; Chairman of the hospital audit committee; Surgical governance Chairman; Surgical Specialty Lead and Divisional Director for Surgery, Trauma and Orthopaedics, and Head and Neck Surgery.
During my career I noticed that the perceived value of the consultation among trainees has declined and the reliance on guidelines and tests, and, latterly, AI has increased. This trend is self-fulfilling because, as the perceived value of the consultation has declined the quantity and quality of the information learnt from the consultation has declined, so that it is often little better than a box-filling exercise. Paradoxically, as IT clinical aids and tests have become more available, and as patients have become more knowledgeable and opinionated, the importance of the consultation in the care pathway has increased. As trainees gain experience and expertise, they realise this and learn how to maximise the value of the consultation to ensure it is meaningful: meaningful for both the patient and the clinician. This led me to ask, what is wrong with the current format and what can be done to help trainees bridge the divide? This blog will help you become a better clinician. It will help you bridge the divide between the traditional history and examination format taught to trainees and the methods used by experienced clinicians, and to bridge the divide between a “textbook” knowledge of medicine and the basic sciences, and the clinical reality.
A blog to help trainee clinicians become experts
The Expert Clinician 