Ali Juma
Consultant Plastic & Reconstructive Surgeon, FRCS(Plast)
Lancashire Teaching Hospitals
Royal Preston Hospital
How did you train in plastic surgery, Ali?
I started my postgraduate training in London in General Surgery. Very soon I became interested in plastic surgery and took up a plastic surgery locum position in Billericay in the South East of England. This was an incentive to continue my postgraduate training as a plastic surgeon rather than a general surgeon as I had enjoyed the trial period in plastic surgery so much.
I started my first job as a senior house officer in Plastic surgery at the Royal Preston Hospital. I stayed in that position for one year. After that I was given a research post through the Duke of Kent Research Fund and took up research as a Registrar with on-call duties at Stoke Mandeville Hospital. The research position lasted one year. I then took on a job as a hand fellow at the Leicester Royal Infirmary for the next six months. This allowed the experience and exposure that I needed following my research.
My training continued in Scotland, in an SHO3 position at St John's Hospital in Livingstone. I stayed there between October '95 and February '96. On the 11th of March '96 I commenced my training as a registrar at Whiston Hospital in Merseyside, the post then became Calmanised as from July of that year. I was able to undertake a secondment from Whiston to Withington in Manchester for a six-month hand Fellowship. In my final year of my training I spent it developing my skills in breast reconstructive surgery as a senior SpR at the Countess of Chester Hospital. Following my passing the part three FRCS Plastic Surgery exam I was offered a consultant locum position at Chester for six months before coming back to be a consultant in Plastic Surgery and Breast Reconstruction at the Lancashire teaching hospitals based at the Royal Preston Hospital; I have been in post since 1st November 2002!
Is this the normal pathway for plastic surgeons?
The pathway I followed: SHO - research - SpR - Consultant is a recognised pathway. Research improves knowledge, broadens one’s horizon and improves the chances to progress in training. It is encouraged at an earlier stage of training. It is also necessary to gain the practical experience necessary to care for patients. Exams maybe difficult for a number of reasons; it took me seven attempts to pass the exam for the FRCS Plastic surgery. To be resilient, determined are important factors in success. The road is difficult but enjoyable, challenging but yet achievable.
Can you remember what attracted you to it?
I was attracted to plastic surgery because it is innovative and dynamic. It is a modern specialty that is still evolving at a good pace. In plastic surgery the surgeon's mind can be innovative - there are difficult problems to be tackled and we are always aspiring to perfection. There is also a flamboyancy about it that lends it an unstuffy feeling. In plastic surgery there are several sub-specialties: cleft palate, burns, hands, breast, skin cancer as well as general. Part of my training was outside the NHS, working closely with my consultant trainers at the private sector to obtain the necessary training in cosmetic surgery, which has become a prerequisite of the syllabus in the final exam.
It has become a very fast moving specialty and is going into different fields as it becomes increasingly more involving of other disciplines. It is helpful to remember the three main components of its use: Reconstruction of Appearance and Function. These sum it up nicely – “RAF”. Trainees in the North West are exposed to all aspects of plastic surgery. It is up to each trainee to decide on a sub specialty interest or whether to become a general plastic surgeon. This tends to happen in the latter years of training.
Are there any particular personal qualities needed for the job?
It is important for plastic surgery consultants to be good communicators and to be skilled with their hands and also the have the ability to integrate with other disciplines. Plastic surgeons look at people individually and need to have skilfulness in dealing and mixing with people. My way as a professional is to visualise the patient as a person first, then, as a doctor, to care for the patient and, then, as a plastic surgeon, to provide skilled surgical expertise.
What is the work like in terms of hours on-call and team work?
In my practice at the Royal Preston Hospital I am on call one week in five, this includes weekends. We always need to work as a team - it is a multidisciplinary specialty. For example, in breast reconstruction the team usually comprises the breast reconstructive plastic surgeon, the general surgeon, the oncologist, the radiotherapist, the breast care nurse and other members of the team. There are a number of women in plastic surgery and increasingly so. In the north west job sharing is possible.
Last but not least my partner and wife to be, Cliona, is a plastic surgery Nurse Clinician and a University of Liverpool Teacher of Clinical Skills, too. It is possible to have a normal life and provide a good caring service at the work place. The most important is to strike a good skilled balance between the two.