About me

To achieve full credentialling as a Colorectal Surgeon and a General Surgeon, a fully qualified doctor must complete a long journey of mandatory structured learning, research, apprenticeship and examinations through a College of Surgery. In some countries this can be as short as 7 years, but in others it takes a lot longer.

My training programme was under the Royal College of Surgeons of England and took 12 years to complete. This included:

3 years as Senior House Officer
2 years as Surgical Research Fellow
4 years as Specialist Registrar in General Surgery
2 years as Specialist Registrar in Colorectal Surgery
1 year as International Fellow / Assistant Professor

My area of research was a bowel disease called Ulcerative Colitis and my MD thesis, titled “Regulation of Neutrophil Chemotaxis in Ulcerative Colitis”, was sponsored by Nuffield Hospitals and an award from the Royal College of Surgeons. My General and Colorectal training was under the auspices of the Northern Deanery and culminated in a Certificate of Completion Specialist Training (CCST) after passing the “Board” examinations of the UK’s Joint Committee of Higher Surgical Training Boards.

To obtain even greater sub-speciality training, I was granted a Travelling Fellowship to gain more experience in bowel cancer operations done by laparoscopic “keyhole” surgery, spending one year as an Assistant Professor in Hong Kong which at the time had the world’s largest experience in this emerging technology.

I have 22 years of specialist experience and can add another 12 years of operative experience since my first operation as a trainee in 1996! Surgeons are required to keep a log of every operation that they perform, and my logbook now contains thousands of these. As a prospective patient, you may wish to know what really matters: It’s not just about the numbers of cases, but rather about how well you are trained and then the independently-verified quality of your work.

I have been an emergency surgeon on call in busy public hospitals, dealing with everything from acts of terrorism, to road traffic accidents to ruptured organs. Thankfully I no longer have to do this kind of work unless called in by a colleague to assist with something unexpected. All these major abdominal cases were audited by NELA (the National Emergency Laparotomy Audit) and peer reviewed to ensure that my outcome data (survival, complications etc) was within the country’s acceptable range for someone in my specialty. This emergency experience gives me a solid grounding in dealing with the very rare “unexpected” problems encountered in elective operations. I was also a faculty instructor on the national CCriSP courses (Care of the Critically Ill Surgical Patient), so I feel very well prepared to handle adversity during a patient’s hospitalisation should this ever occur.

In elective surgery, we are judged more harshly on how our simple operations go than on how our major ones go. Care and attention to detail are just as important in the smaller, low-risk procedures. For this reason I upskilled in hernia surgery to take on the more advanced and complex hernia work called Abdominal Wall Reconstruction (AWR) and became a faculty member training other specialists in these techniques under AWR (Europe). For bowel cancer surgery I sought out a Fellowship with the most reputable centres for minimally invasive surgery and I spent a whole year just focused on this one surgical aspect of my repertoire. Making good decisions is just as important as technical ability: Who? When? How? Why not? Accordingly, many of my bigger operations are pre-planned, with input from allied specialists in a Multi-Disciplinary Meeting (MDM). All pelvic prolapse cases and all complex bowel cancer cases are discussed before surgery within an MDM. A group of specialists who can bring many years of experience, differing perspectives and a comprehensive knowledge of the medical literature together ensures that you will be given the very best advice.

I work within a culture of accountability and learning from experiences, both good and bad. The Patient Reported Outcome Measures (PROMs) is a system whereby patients undergoing certain operations have an opportunity to complete questionnaires on their personal experiences of my surgery, submitting these to a National and Independent third party. My hernia surgery and gallbladder surgery were subjected to PROMs scrutiny. In bowel cancer surgery, a similar process is followed, although in the UK this is more rigid and independent than in New Zealand and Australia. These processes are called NBOCAP (National Bowel Cancer Audit Project) and BCCA (Bi-National Colorectal Cancer Audit) respectively. This database captures many key performance indicators in bowel cancer surgery, such as mortality, length of hospitalisation, formation of colostomies, leaks of the join made between bowel loops etc. and in the case of NBOCAP it ranked you against your local peers in the hospital and against your national peers. My operations and management of Inflammatory Bowel Disease and Pelvic Floor Disorders would also be uploaded to databases run by professional bodies advocating for patient welfare.

I keep up to date with the best international standards and guidelines in my speciality by CSSANZ monthly journal club meetings, by membership of professional organisations, by attending international conferences and courses, and by participating every year in the Royal Australasian College of Surgeons’ MOPS programme (Maintenance of Professional Standards).