An Out Of Programme Experience (OOPE) in adult general surgery
As paediatric surgical trainees in Bristol, we have a very close working relationship with the adult general surgeons locally. Every 6 months a new adult trainee rotates through our department and, as well as being good fun, they often bring a fresh perspective and useful skills, particularly with conditions more commonly seen in the adult population. Having seen first-hand what a useful training opportunity this was, I decided to arrange a 6-month OOPE in adult general surgery.
The process of arranging the OOPE was straightforward and took less than 6 months to complete. My TPD contacted the Severn deanery TPD for adult general surgery, who approved the placement. I had identified a local DGH which had excellent feedback from the general surgical trainees and my TPD contacted their head of department. I was slotted into their next rotation as a fellow.
My 6 months were spent working for a team of lower GI consultants, with a 1 in 8 on call rota. I was also lucky to have regular upper GI day case training lists as I had expressed an interest in improving my experience with laparoscopic cholecystectomies. From the offset I was treated like an adult trainee with, at first, what felt like a daunting amount of independence. I can say coming from paediatric practice, that the volume of patients seen on call, in clinic and on ward rounds was higher. This fast pace contributed to the biggest thing achieved in my OOPE which was surgical confidence.
If you are interested in minimally invasive surgery, the adult perspective seems to be “laparoscopic until proven otherwise” and who wouldn’t want to improve their suturing skills with a 3D stack! The volume of work and team set up meant a standard week had 3 to 4 operating lists with my logbook numbers higher than a comparable time-period in paediatric surgical training. Most on call shifts included at least one emergency laparotomy and this higher volume allowed me to improve both my decision making and technical skills. I gained lots of exposure to gallstone disease, pancreatitis, pilonidal disease and IBD just to name a few conditions which are managed more commonly in adult practice. Alongside clinical exposure, I also had great departmental teaching and journal clubs which I hope will prove useful not just in future exams but also future practice.
Most importantly it was great fun and really good to get out of my comfort zone.