Views & Reviews Medical Classics

So You Want To Be A Brain Surgeon?

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2320 (Published 28 March 2012) Cite this as: BMJ 2012;344:e2320
  1. David Warriner, specialist registrar in cardiology1,
  2. Vipul Ramjiani, house officer in cardiology1
  1. 1Northern General Hospital, Sheffield, South Yorkshire S5 7AU, UK
  1. Correspondence to: D Warriner orange_cyclist{at}hotmail.com

Careers advice given at school is renowned for having a low positive predictive value and, being based on level five evidence (that is, expert opinion), often leads to the stifling of ambition, condemning teenagers to careers in which they have no interest. Careers advice at medical school was no different, at least until this book came along in the late 1990s. So You Want To Be A Brain Surgeon? is a humorous, factual, and well researched guide to careers in medicine for school leavers, medical students, and junior doctors. The book considers disciplines from sports medicine to surgery, and voluntary service overseas to virology, but it is not just about the nuts and bolts of each specialty. Interesting and useful points are dispersed throughout, such as the history of genitourinary medicine; what life is like working for Médecins Sans Frontières; and contact details or suggestions for further information.

The descriptions of various specialties are hilarious: intensivists are “over-cerebral gasmen”; cardiac surgeons are “balls of steel surgeons”; and dermatologists are “grease pushers.” But this is mixed with thoughtfulness—for example, how geriatricians must balance thoroughness and curiosity with realism and compassion or risk being labelled as either aggressively interventionist or too laissez-faire.

Some of the book’s advice applies more generally—for example, when considering a research post, “be sure that you are not being an extra pair of hands in clinic [for] a consultant who has no track record of supervising research.” This is wisdom that extends to fellowships, audit, and publication in general. Ward and Eccles, the book’s editors, predict that in palliative medicine “only the balanced will survive,” which is relevant for all considering this vocation. And the editors say that “colleagues and public have increasingly unrealistic expectations of what intensive care medicine can achieve,” which could increasingly pertain to all specialties.

The book was first published more than 14 years ago. Salaries have gone up, hours have gone down, but the one thing that hasn’t changed is that, “in the first two years after graduation, you embark on the steepest learning curve imaginable”—because there is nothing that prepares you for that first day on the wards.

The final and most important section, entitled “What do I do now?” gives some of the best advice in the entire book, namely when deciding on a specialty “talk to your friends at medical school who know your strengths and weaknesses” and if after everything you find yourself a “square peg (in a round hole) have the courage to admit it and start again.” After all “the determined and good will always get to the top,” and this book is an indispensable guide to how to get there.

Notes

Cite this as: BMJ 2012;344:e2320

Footnotes

  • So You Want To Be A Brain Surgeon?

  • A book edited by Chris Ward and Simon Eccles

  • First published 1997

  • Competing interests: None declared.

  • Provenance and peer review: Not commissioned; not externally peer reviewed.