One day Diary by Frank McDermott
Frank is a newly appointed Consultant Colorectal Surgeon based at the Royal Devon & Exeter Foundation Trust, and is currently undertaking international fellowships in Barcelona and Denmark, he lives with his wife and two sons in Devon. Twitter: @mcfark
I completed medical school at Imperial College London in 2004 and following house officer jobs spent a year working in Perth, Australia. I was appointed as a run-through surgical trainee in Peninsula region in 2007 and completed my surgical training as a consultant colorectal surgeon in 2017.
I´m responsible for...
As a consultant surgeon, I am responsible for the elective management of colorectal patients and I am part of the emergency general surgery rota.
I got my job
After my CCT in 2017, I spent 6 months as a locum consultant in the Royal Devon and Exeter Foundation Trust. I have recently been appointed to a substantive position but I am developing my sub-specialist skills further by working for 3 months as ESCP Travelling Fellow in Bellvitge Hospital, Barcelona and RSM Ellison-Cliffe travelling fellow to Aarhus University Hospital in Denmark.
My typical day
Typically, I am in work before 8 am, below outlines a standard ‘clinical’ week i.e. weeks when not doing emergency general surgery on-call. In the mornings prior to other clinical activities, I review patients under my care on the ward.
- AM: Mainly admin, weekly surgical meeting to discuss morbidity and mortality/ planning and teaching.
- PM: weekly colorectal MDT to discuss management of colorectal cancer patients, review imaging and post-operative histology and consideration of other adjuvant therapies.
- Academic day, I am completing a Masters in Genomic medicine and one my responsibilities is to increase recruitment to the 100,000-Genome Project locally.
- In addition, I work with other clinicians and scientists involved with genomic and epigenetic research. Two of my current projects are on rectal cancer epigenetics and the epigenetics of diverticular sepsis. There is a weekly journal club and review of on-going quality improvement projects.
- Day case surgery: There are several community hospitals in Devon that are used for outpatients and day case surgery. I commonly do benign proctology cases and hernia surgery in these peripheral hospitals. In the afternoon, I have colorectal outpatients and review a mixed group of patients presenting with colorectal disease, cancer and complex abdominal wall issues.
- Main theatre operating: I have all day operating sometimes 3 session lists that finish at 9 pm. The operative lists include operations for benign disease, minimally invasive and open colorectal cancer resections and abdominal wall.
- I work closely with other consultant colleagues including Ian Daniels and Neil Smart. I am currently being mentored to operate on more challenging patients with intestinal failure and the management of advanced pelvic cancers.
- I perform weekly colonoscopy lists on Fridays.
We run a colorectal consultant of the week system as a 1:7. This involves reviewing all specialist colorectal referrals Monday to Friday and two 24 hour on-calls on Tuesdays and Thursdays. The post-take day consists of a post take ward-round and operating on the emergency CEPOD list.
Worst part of my job…
A large of part of colorectal surgery is the management of colorectal cancer. One of the most challenging parts of my job is informing patients (and their loved ones) that they have cancer and sometimes incurable disease. Doing this compassionately is professionally rewarding and a skill that I continue to develop with experience. I am very fortunate to work with some excellent healthcare professionals some of whom include colorectal nurse specialists, the nurses on the colorectal ward, oncologists and palliative care team that help support patient and their families.
Best part of my job
The best part of my job is variety with a combination of clinical work, academia and quality improvement projects. I really enjoy education and training and spent many years on the council and executive of the Association of Surgeons in Training (ASiT). In addition, I have the privilege of managing the care of a wide range of patients presenting with a spectrum of disease from benign proctology to complex cases e.g. intestinal failure, complex abdominal wall, advanced cancer, and emergencies. I am fortunate to work with many experienced and dedicated healthcare professionals who support me!
What do you see as the future of colorectal surgery?
There are many exciting initiatives and is it is difficult to mention them all. I believe in our goal of better connected personalised care and we need to be thinking as global surgeons. This will require better data and I.T. systems to integrate the patient pathway in primary and secondary care along with advancements in genomics. Better technologies e.g. robotics, targeted drug therapies along with better prevention such as tackling the global obesity epidemic are all integral to improving health and focussing on what matters to our patients i.e. patients reported outcome measures (PROMs).
Other specialist interests
I have several specialist interests including genomics, advanced pelvic disease and medical publishing. I am currently a BJS editorial assistant. I am very excited about genomics and the future prospects for patients with the rapidly advancing field that can only be improved by the 100,000-genome project. In addition, I have a sub-specialist interest in advanced pelvic disease, an area that is continuing to develop helped by initiatives like ACPGBI’s ‘IMPACT’ and the international collaborative ‘PelvEx’.
How do you unwind?
I love travelling both in a professional and personal capacity to learn from international colleagues and cultures. In addition, I play hockey for a team in Exeter. Devon is a beautiful part of the world and I enjoy exploring places like Dartmoor with my wife and young family.
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