73 things a surgical trainee should know 

1. Be kind to everyone.

2. Look after your mental health.

3. Be honest always.

4. Never put anything in writing you wouldn’t say aloud

5. Don’t trust everyone you meet.

6. Nobody cares about you more than you should care. 

7. Keep fit.

8. Keep a diary of operations and techniques.

9. Organise yourself.

10. Drink enough every day and never miss more than one meal.

11. Remember this is just work.

12. Forgive yourself your small mistakes and forgive others theirs.

13. Don’t walk away from the operating table with any regrets or concerns. Deal with them there and then and walk away happy.

14. People die.

15. The nurses should like you,  but if they all like you all the time you are probably going wrong.

16. You don’t have to justify your choices to anyone. If you walk away from this and do something else or if you decide you want to be professor of surgery, both choices are equally valid and worthwhile.

17. Don’t shit on your doorstep. Take it from me, it never ends well.

18. Your professional reputation will come from what you do and how you do it, it takes time to build but seconds to destroy it.

19. When you need help, ask for help.

20. There is no shame in not knowing something.

21. Always be truthful in your professional life.

22. Consent people with plenty of time and due care, preparing for surgery is important and consent should be done just as well and carefully as the operation is performed.

23. Sometimes your best won’t be good enough.

24. You won’t like all the patients you meet.

25. They won’t all like you either, recognise that when it happens and step back.

26. Be especially kind to yourself, be your own best friend.

27. Find people you admire and watch how they work.

28. Same for people you don’t like, pinpoint what you don’t like and avoid doing that.

29. You can still be you and be a surgeon.

30. Some patients will touch your heart and stay with you forever, remember them and the lessons they teach you.

31. Don’t trust the sigmoid for an anastomosis.

32. Don’t fuck with the pancreas

33. A cut blood vessel has two ends

34. The operation can’t be said to have gone well until the patient is discharged home and you have seen the pathology results.

35. When you feel like crying, have a cry and then wipe the mascara, give yourself a hug and carry on.

36. You are not as good as the last operation you did, so don’t crumble when something goes wrong.

37. The natural history of most things is that they get better with time.

38. Apart from appendicitis, that usually  gets worse.

39. You are more than just your work, don’t let it define you.

40. Be kind and nice to juniors, they might overtake you and anyway they will spread your reputation wherever they go.

41. Don’t dislike pretty female medical students, they are the future and need to feel welcomed.

42. Have a daily routine for where you keep your watch and rings, it’s unprofessional to flap about at work looking for lost jewellery and wastes time when you should be working.

42. Always, always have money on your person to buy food and drink. You don’t know how badly wrong your day can go and having change at 10pm can make or break you.

43. Caffeine. You will need caffeine.

44. Alcohol, this you don’t really need. Never drink when you are sad, or if you are operating next day.

45. You will never stop learning or improving, it’s a lifelong process. Enjoy it.

46. There is always going to be someone better than you.

47. Very few surgeons think that they are average surgeons, half of them are worse than average. Have insight into where you are.

48. Wearing makeup and pretty shoes and reading Grazia as well as the BJS are all perfectly acceptable.

49. Not wearing makeup is also acceptable. Your female surgeon friends should be cherished and respected for who they are.

50. Rise above the stuff that doesn’t matter.

51. You will carry with you and become a product of all of the people who train you and mould you. That’s a gift and a joy to be a part of.

52. Remember that being a trainee is a transitory role, don’t be a dick.

53. Don’t lose your temper, ever, in a professional setting.

54. Hospital politics requires years of practice, listen and watch but stay out of it until you are well established.

55. Organise the rota if you can, it is worth the hassle.

56. Don’t disrespect LTFT trainees or people on maternity/paternal leave, it might be you one day.

57. Stand up for what is right.

58. It should feel good and make you happy at least 50% of the time.

59. The purpose of a ward round is to make the patients feel cared for and safe, not just to ensure they are cared for and safe.

60. When you feel you’ve made a mistake or had a complication do a ward round, it makes everything better.

61. Don’t trust a surgeon who isn’t happy and relaxed in theatre.

62. Don’t trust an anaesthetist who never questions any of your decisions.

63. The anaesthetist is your friend.

64. Lead the team in a way that feels comfortable to you.

65. Don’t try and be someone else.

66. Don’t hide your intraoperative problems from the anaesthetist.

67. Remember that you are lucky to live in this world, in this time, to do this job and be so privileged.

68. Smile and enjoy it. You have worked hard.

69. Foster good relations with other specialists, you never know when you might need them.

70. Don’t do drugs, ever.

72. Treat your seniors with respect, even if you don’t respect them that much.

73. Be prepared to be the subject of gossip, you will be talked about; good and bad, accurate and inaccurate.


17 thoughts on “73 things a surgical trainee should know 

  1. Wow, great list, I will share this with my trainees 🙂 can I add two to make it up to 70?
    Don’t do drugs. Ever.
    Respect your elders, They have more experience, good or bad. Even if you think they are bad surgeons, you can still learn from them about dealing with bad outcomes and what NOT to do.
    It’s great to be back in the blogosphere, and missed reading your posts. 🙂

    • You’re reading the guardian? Great article. He’s not on twitter sadly so I can’t tell him about me. I have always felt I am like one of his book characters, apart from the smoking, all women in his books smoke.

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