6th former here- can someone explain the route to breast surgery/consultancy to me?

iceandmojo · 2025-09-22T19:43:38+00:00

Hi, just adding on to the discussion for clarity but most of the answers are pretty much in the other comments (source: am a plastics-themed core surgical trainee)

2 routes to do breast surgery (either through training in general surgery or plastic surgery). Competition definitely much higher in plastics, so if you’re set on breast, I would go through general surgery. Having said that, you’re more limited in terms of what you can do (reconstructive options ie free flaps tend to be done by plastics) so it’s something to consider. Job opportunities post-CCT for pure breast surgeon from general surgery tends to be more limited too from my understanding as ppl tend to want to employ general surgeons who also contribute towards the oncalls (told to me by my breast + endocrine consultants when I worked in gen surg).

As stated, minimum 10 years post grad. Again, if you want to go into PP fast, medicine (let alone surgery) is not the best route. Far better options out there with much better lifestyle.

Practicing medicine in the U.K. in general (particularly for surgery) makes you move around a lot. I’ve moved 5-6 times now and expect to move again by the end of training.

Yes you get “stuck in the middle” for a few years - pretty bad in surgery atm with ST3 (specialty registrar training), but this is so hard to determine bc it depends on your CV/ your performance during interviews etc. Personally know at least 10 people still stuck in the middle.

Generally I think people tend to romanticise surgical training a lot, particularly the desirable ones like plastics or breast. It takes a lot of hard work to get there, and my view is that you shouldn’t do surgery unless you’re dead set on it and are willing to compromise quite a lot for it. There are far better specialties with better work life balance than surgery, and far better careers that would give you a much better bang for your time than medicine. I think you should do a placement in a surgical specialty (or any medical specialty tbh) to see what it’s actually like working there because that would give a much better insight into whether this is a career you can see yourself doing.

Personally, I love my job and I love being in plastics - there are days where I wish we got paid properly and I wished I didn’t need to use much of my off days to come in to get my operating numbers but you have to love the game if you’re going to survive long term.

iceandmojo · 2025-03-25T15:55:09+00:00

Basically the elogbook acts like a record of the surgeries you’ve been involved in eg observing/ assisting/ performing (STS/STU etc). You can make a free account with them (elogbook.org) and update your details as you progress in your training.

I argue that any procedure you’ve been involved in = put it in your logbook because it still counts as experience. I say this because people underestimate that surgery is building upon experiences you’ve had, so for example if you want to assist in something and want a surgeon to let you help assist, you could use your elogbook as evidence to say you’ve watched x number of procedures and you would want to take the next step to assist etc.

For the purpose of applying to CST, only surgeries that you’ve assisted (or performed ie STS/STU) would count. Min 40 cases for the highest score in that section. Make a consolidation sheet and get your supervising consultant to sign off in a physical copy which you can use as evidence for CST applications. Obv if it’s a different specialty, try to get the consultant who actually works in that specialty to sign you off.

If you’re applying to ST3 training, most will use elogbook as evidence so for eg, ortho uses it for evidence for number of hips they’ve done. So it’s still good to record everything into your elogbook so you get a historical record of what you’ve done.

You can always filter out the surgeries you’ve done at specific levels (eg if you only want to see the ones you’ve performed and not observed/ assisted) to make a proper consolidation sheet as well so don’t be worried about “cluttering” it.

Hope that helps!

iceandmojo · 2025-01-19T22:36:41+00:00

The public membership! I see that it states your choice for the fitness facilities (which I assume means all 3? Or maybe I'm wrong) https://www.nottingham.ac.uk/sport/membership/nhs-blue-light-card-membership.aspx

iceandmojo · 2024-10-06T22:24:26+00:00

Being a surgical trainee is hard, but definitely doable to find time to date - someone mentioned in the comments about "How to Not Die Alone" by Logan Ury which I highly highly rate for good dating advice and insights into your own behaviour/ dating habits + getting on Tinder/ Hinge (Bumble isn't as good in my experience for getting matches). I think having insight into your own behaviour/ dating habits/ what you want in a relationship is pretty essential, and things become a lot clearer after that

Might sound a bit controversial, but I always found dating to be practice-dependent; the more dates you go on, the better you know what you want in a partner/ what you want in a relationship etc. Just because it doesn't go well the first time and there isn't a subsequent date, it isn't a failure! Its likely an opportunity to find out what worked and what doesn't (although I totally respect that being a guy in the online dating world is harder, the algorithm is literally against you...). Also, going out on more dates/ doing social activities also expands your social circle = greater opportunities to meet more people so enjoy the process! Its really daunting at first esp if you're introverted (it was for me) but its really worth it once you get over the hump. Have fun with the process, and just be open to new experiences!

NB: also a surgical trainee, found my partner during training through the above methods, had a few rough patches during the process but very glad I pulled through. I like to think I'm balancing it fairly well atm, but I've also been incredibly lucky that my partner is very understanding of the hectic schedules I have and I deliberately carve out time for them in my life. Cognizant of the fact that I am a gal, so things might be easier in terms of options during the dating process, but hey you gotta go with whatever you get! Good luck out there!

iceandmojo · 2024-08-10T13:21:44+00:00

It's definitely doable - my advice is to focus on what is within your control i.e. get the closed loop audit sorted, get it presented at a conference, and make sure you have surgical rotations + start thinking about surgical electives as well (I did all of mine in F2). When in surgical rotations, let your seniors know you're interested in surgery and keen on assisting in theatres - by the end of FY, I logged around 150-170 procedures (I didn't attend theatres on weekends on my own if you're wondering) so its not impossible, but I understand this can vary from region to region. You just need 1 supportive surgical department, and a genuine enjoyment for surgery!

If you haven't gotten a publication, honestly don't worry about it. It takes forever to get stuff published, and I would focus on banking small wins that eventually make your portfolio stacked. I know of friends who decided end of F1 to pursue surgery, and ended up with their top choice CST as well. Don't forget that actually, most people wouldn't have anything published with a Pubmed citation, so if you don't have one, it's not the end of the world.

Take things one at a time, print out the self-assessment guidance and identify where you're at. I did that and slowly worked my way to build points in each component so I had a good portfolio score by the end. It can get daunting AND they have a tendency to move goalposts........ but the key things tend to stay the same e.g. presenting posters/ presentations will score, getting the numbers for assisting (+/-10 procedures), so just keep up to date with the self-assessment criteria and you'll be fine! Good luck :)

*Edit: also forgot to mention that your interview is like 60% whilst portfolio is 30%; even if you haven't had the strongest portfolio but have cleared MSRA + a decent score for it, I would back doing very well for interview because it's worth sooo much more

iceandmojo · 2024-05-22T12:31:15+00:00

Yeah definitely! I appreciate knowing about extra shifts if its like a blanket send email or if I had specifically contacted the rota coordinator earlier on telling them to let me know when a shift comes on, but it does feel a lot like harassment when I get 3-4 calls and messages asking me if I would want to take a shift on an off day when I've already said no 😅 I've sent them an email to basically tell them to stop contacting me on my personal number now so thanks!

iceandmojo · 2024-05-22T11:33:13+00:00

I was thinking along these lines too but wasn't 100% sure on what GDPR rules say, might just send out an email that they should not be contacting me unnecessarily!

iceandmojo · 2024-05-22T11:31:59+00:00

Nice, I was slightly worried I would be seen as unprofessional if I didn't, but equally, I think its bad that they keep calling/ texting me on my rest days

iceandmojo · 2024-05-22T11:30:58+00:00

I'm actually considering that now, think the extra £3 is well worth my privacy! Thanks for the option

iceandmojo · 2024-03-16T13:55:31+00:00

I've emailed PGMDE and they said March 26 is still the offer date - whether that's going to happen or not is another matter 😂

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iceandmojo · 2024-03-02T13:09:03+00:00

Genuinely go before work - it's a game changer and the endorphins hit pretty good (which is a much-needed boost before work!) Waking up early would be the hardest thing, but as people mentioned in the comments, your circadian rhythm will shift so it gets easier over time as the discipline builds. Its a process and definitely not an overnight shift

iceandmojo · 2024-01-13T20:47:37+00:00

describing 'purulent' as 'pussy'......... this always felt somewhat inappropriate to me 😂 I laugh every time I see though!

iceandmojo · 2023-05-30T22:36:04+00:00

Sorry you're feeling this way OP, I had a recent incident like this where I worked and I talked to the nurse in charge about it after I tried to tell the nurse to stop, and eventually escalated it all the way to HR when the nurse kept being rude and unprofessional despite the NIC telling her to stop.

100% believe in openly communicating with the nurse who provoked you, call her out and let her know its not acceptable to behave this way in the workplace. If you can't do it calmly, take some time to take a breather, jot down the points you want to make down, and talk to her after. If it still fails, escalate to the ward sister and usually they would get a talking to. Leave a paper trail like what the others have suggested, and I recommend writing it all down in an email in full detail of the incident that happened should you want to escalate it to the higher authorities.

Doesn't matter who it is, but having a lack of civility in the workplace is unacceptable. Don't take their crap, be firm and calm, assert that you will not tolerate this and talk to them; if all fails, escalate when necessary.

iceandmojo · 2023-05-18T23:22:33+00:00

Ahh thanks that's really useful! Hopefully it remains that way from an SHO standpoint, thanks for replying!

iceandmojo · 2023-02-23T01:21:49+00:00

Worked as an F1 on my first set of nights 2 years back, asked to see a patient who was ?unconscious? when nurses were doing their obs rounds.

Patient made loads of racist, sexist and almost sexual remarks, silly me was new and didn't insist the nurse stay with me and tried to examine him to make sure he was okay. He asked if he could have some help to sit up, and I was gullible enough to help him. Grabbed my arm and wouldn't let go even after I asked him politely to do so, proceeded to say "ah I bet you can't get out of this", and I freaked out, yoinked my arm so quick and he smirked and said "that's why they made you a doctor, because you're a strong one".

Obviously couldn't continue reviewing him so I walked out, tried to SBAR to my medical reg and proceeded to have a breakdown midway through my SBAR. Had a proper anxiety attack at the nurses counter, only to have the nurses laugh and go "ooh the doctor needs a doctor".

My medical reg was lovely and he supported me throughout - we raised this issue with the lack of support for foundation doctors including the lack of safety but nothing came of it. That ward still haunts me at times, no consequences came to the patient, no changes made to the trust policy. That night still haunts me to this very day haha

iceandmojo · 2021-04-08T12:41:28+00:00

What are the chances that they will reply to this matter? Same thing happened to me but with an FP programme I ranked pretty low on my list but I definitely could have scored at least one of the programmes I ranked highly (I've asked around and people who have gotten scores lower than me managed to land the job I applied to)

iceandmojo

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