Still learning on the job

There's more to a career in orthopaedics than healing broken bones, writes Josh Jennings.

Orthopaedic registrar Aaron Buckland vividly remembers a couple of patients emergency services recently delivered to the Royal Children's Hospital. The two girls (aged 7 and 11) had multiple injuries including neck fractures, lower-limb fractures and abdominal injuries. Their parents were absent and they were petrified, he says.

"I suppose I remember it because they were just very vulnerable and frightened children. It was difficult for them to engage in the environment because their parents weren't there, but we had a team of people in the emergency department - emergency doctors, surgeons, anaesthetists - and the hospital worked together to make sure they felt safe and secure and their pain was controlled.

"The thing that took me back was just the way these complete strangers come in and trust us to do these things for them . . . It was a pretty humbling job in that respect."

Buckland, who is about to commence his final year of training to become a surgeon, is at present an orthopaedic registrar at the Western Hospital. He typically spends his working days, which normally begin at 7am, visiting the hospital's 20-30 inpatients and assigning jobs for the junior doctors to undertake for the morning and afternoon. He also spends the morning or afternoon seeing patients in clinics or operating in theatre. After hours, he will attend emergencies and complete after-hours operating.

"It can vary between a seven-five job to, at the very worst, not going home until the following afternoon, when you're on call," Buckland says. "But usually you'll be leaving the hospital while on call, probably around 10pm to midnight."

Buckland completed a bachelor of medicine/bachelor of surgery and a bachelor of medical science at the University of Melbourne in 2005 and basic surgical training at the Royal Australasian College of Surgeons in 2009. It's difficult to overstate the level of dedication that's required to train to become a surgeon, he says.

"I think a lot of people who go into surgery are naturally very energetic and competitive and have always worked hard. But there's definitely another element you need to develop . . . I think we can all stay up late and get up early in the morning but it's another thing to be under that pressure for that time and that's what they really teach us over those years."

Buckland combines his role with his other one as president of the Australian Orthopaedic Registrars Association, a branch of the Australian Orthopaedic Association (AOA) comprising surgeons and others who volunteer their spare time and expertise to shape the future and training of orthopaedic surgeons. "Surgical training taught me how to look after my patients, whereas my president's role has taught me how to look after my colleagues and my profession. There is a lot of satisfaction in doing both."