This week Ms Stella Vig is giving us her insights into training as a surgeon. With a reputation as one of the most demanding specialties, we are looking to de-myth the specialty and understand more about what it takes to be successful.

Ms Vig is a Consultant Vascular and General Surgeon and Clinical Director at Croydon University Hospital. She has a strong interest in training as a Core Surgery and Higher Surgery Training Programme Director, JCST Chair for Core Surgery and General Surgery SAC member. She is keen to ensure that all trainees, whether male or female, are able to develop a harmonious balance between family and career. Stella has won number awards including the NHS Leadership Academy London Mentor of the Year 2015, National BMJ Clinical Leadership award 2015 and an award as one of the Women of the Year.

When and why did you realise you wanted to be a surgeon?

When I was 5 and went to see my grand aunty in India, who had just lost her sight, as she had undergone surgery which was not successful in saving her sight. Apparently, I vowed to be an ophthalmic surgeon to restore her sight! Sadly, I realized at Medical School, that eyes made me feel very uncomfortable but the desire to be a surgeon remained!

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What aspects of being a vascular/general surgeon have you enjoyed the most? What’s the worst thing about being a vascular/general surgery consultant?

I love the ability to improve a patient’s quality of life rapidly with surgery rather than the slower pace of medicine. Vascular surgery treats vascular disease, a chronic condition and so you get to know your patients and their families over a long period. This specialty also mixes surgery and care of the elderly allowing you to treat both surgical and medical complications of their disease.

The worst thing is that you are managing the symptoms of disease rather than the disease itself. And that patients will not stop smoking!

Could you share with us your most challenging moment as a surgical registrar?

I think the decision to amputate a leg is the most difficult decision. There is a quote that states that an amputation is the greatest gift when nothing else can be done, but the worst if salvage should be offered. When you amputate, you know that you are changing that person’s life forever. It’s always a very tough decision to take.

What was the best part of your training to become a surgeon? What inspired you to become involved in cutting edge treatment?

I was trained by fantastic trainers, who were not just role models with great enthusiasm and passion, but patient enough to take me through cases. I remember my first involvement of a thoracoabdominal aneurysm, where I was amazed by the anatomy. I also remember the thrill of my first aneurysm as a SHO!

What do you think are the most critical personality traits that a doctor should possess for a career in general surgery?

A sixth form student was with me recently, and said after we had finished clinic that he was shocked that we actually spoke to patients – he thought we just operated. The old myth is that surgeons are male and have no communication skills. You need resilience and people skills alongside the pure technical skills to be an excellent surgeon.

As a surgeon you’ve had to perform under immense pressure. Is that something that you’ve learned to deal with or have you always had this ability?

I am sure that there are ‘surgical types’ who enjoy the stress of surgical work.

I was told as a houseman that I needed to slow down as otherwise, I would burn out, but I am still going and still enjoy taking on new challenges. I think you learn how to manage your workload as you get older – especially when family come along.

A concern of many trainees applying for surgery is the work-life balance; how do you cope with a never-ending workload?

There are many trainers who now understand the pressures on young trainees and support their desire for a work-life balance. I think you cannot be excellent at doing everything and so each trainee needs to decide what their individual work-life balance involves. I wanted to be a good enough mum as well as a surgeon. I am lucky as I have a supportive husband and sister, and have two children who are now a university and have a great relationship with them.

As a trainer, how do you think that surgical training has changed since you were a junior doctor? Do you think surgical trainees have enough time in theatre to develop into consultants?

Surgical training has changed immensely since I started.

I enjoyed a great relationship with my trainers and worked hard but gained their loyalty so they pushed me into new opportunities. I think the biggest detrimental change has been the loss of the firm structure but we have managed to retain this at Croydon University Hospital, and we can, therefore, ensure that trainees follow a firm timetable.

Now, surgery has one of the biggest gender imbalances in medicine, with women making up 30% of all surgical trainees and just 11% of all surgical consultants. Do you have any advice to women considering surgery or suggestions as to how we can help close this gap?

Just do it! My very first boss asked me what I was going to do as my career. I said medicine, as there were no women surgeons in Wales that I wanted to emulate. He said ‘Try surgery, if you don’t you will regret it all your life and if you do, you’ll enjoy it!’ I took his advice and here I am.

I took 12 weeks for maternity leave for both my kids but young female trainees do not need to make these sacrifices today. The new contract does worry me especially as women might leave having children to later in their career and find their fertility takes a dip. We also need to remember that men need help too and may need adjustments to ensure they succeed.

Finally, what’s your number one piece of advice to junior doctors who are considering applying for general surgery training?

It is still an enjoyable career and remains competitive, although the competition ratios are much better. Core Surgical Training is an 18-month interview process into higher training of many different types and not just in surgical specialties. If you have experienced surgery at Foundation and loved it or know you want to be a surgeon, then do it. If you haven’t, then try it, you may be surprised! The paper portfolios are important, so start developing them and know them inside out and upside down!

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