Case study

Consultant paediatric ENT surgeon — Ian Street

Although working as a consultant surgeon can be demanding, Ian stresses that it's entirely possible to combine the career with a normal family life. Find out what he enjoys most about this rewarding profession

How did you get your job as a surgeon?

After graduating with a Bachelor of Medicine (MBBCh) from the Royal College of Surgeons in Ireland, I spent a year as a house officer in Ireland, two years as a senior house officer (SHO) in Singapore and two-and-a-half years as a Singapore Army medical officer. I then came to the UK and spent two years as an ear, nose and throat (ENT) SHO. I worked for two years as a locum ENT registrar before receiving my National Training Number in ENT on the six-year South Yorkshire rotation, including a year as the paediatric ENT Fellow in Sheffield Children's Hospital. I then started my current role as a consultant in a children's hospital in Liverpool.

What's a typical working day like?

My department works to a four-week rota so I do have some structure to my days. A day might start with a general ENT clinic, which may present me with a new-born baby with airway and breathing difficulties or a teenager with recurrent tonsillitis and upcoming GCSE exams.

Alternatively, I might spend the day in theatre, operating on patients that I've seen in clinic. There's a lot of variety injected into the job by the emergency work I do, which necessitates working with patients, their families and my hospital colleagues to get the best outcomes we can, often with limited time.

What do you enjoy most about being a surgeon?

Surgery offers a wonderful mix of intellectual stimulation and hands-on practice. Seeing an ill patient recover after a surgical procedure provides great emotional satisfaction, as does building good relationships with patients and their families.

What are the challenges?

All health services work within the limitations of the resources available and the NHS is no exception. Trying to temper the expectations of an ill, uncomfortable and anxious patient or parent can be a very taxing aspect of the job.

In what way is your degree relevant?

My medical degree taught me a large number of useful facts, which I still use on a daily basis. Less obviously, medicine teaches a more disciplined and systematic way of thinking a problem through. Counter-intuitive, methodical and slow thinking often solves problems faster than flashes of genius, which can’t be relied upon.

How has your career as a surgeon developed?

As I've progressed up the medical hierarchy, I've been given more clinical responsibility for formulating the medical management of my patients, whilst fewer of the ward-based duties make up my daily schedule. An important part of a consultant's job is management and teaching, both of which contribute towards the long-term successes of the healthcare sector.

What's your advice to someone wanting to become a surgeon?

  • Surgery is popular and it's important to be able to deal with disappointment and bounce back from failure. It's also extremely useful to have the ability to appraise yourself in a constructive manner when things go well or badly.
  • It’s entirely possible to enjoy a normal family life in surgery, although realistically your family will need to be understanding as unpredictable moments do occur, which may mean a late return home.
  • I would also recommend reading Atul Gawande's books Complications and Better, Henry Marsh's Do No Harm, and Gabriel Weston's Direct Red.

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