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Career Focus

What opportunities exist in organ transplant surgery in the United Kingdom? What are the pros and cons of a career in transplant surgery?

BMJ 2004; 329 doi: (Published 20 November 2004) Cite this as: BMJ 2004;329:s206
  1. Zain Khalpey, honorary specialist registrar and clinical fellow in cardiothoracic surgery
  1. Imperial College and Harvard Medical School


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Many opportunities exist for organ transplantation (liver, pancreas, heart, and lung) as the need is growing in the United Kingdom and there is increasing demand for organs. However, this is coupled with dwindling resources and a frayed infrastructure.

One way to get experience would be to develop a rapport during a senior house officer job in a surgical rotation linked to a tertiary centre that performs such surgery and which has the supportive infrastructure and experience for liver and pancreatic transplantation, or in a standalone job. Another way of getting an opportunity in organ transplantation surgery would be via the research route. Doing an MD or PhD in stem cell research in pancreatic or liver transplantation is quite exciting and may give you adequate clinical exposure, especially if you choose a translational (bench to bedside) research project, as these are well funded in Europe and the United States.

Competition remains high as the people in these fields are dedicated and quite determined to do what they believe in—the specialty can be quite unforgiving to one's personal life. But it's what you make it that matters, and if you have the qualities and dedication then you will succeed.

The pros can be on many levels: satisfying and technically challenging surgery, integral involvement with multi-disciplinary care and teams, transplantation immunology and new evolving technologies which breed the innovation and creativity required in surgery, emotional rewards and personal satisfaction.

The cons can be balanced, depending on your perspective and your resilience. One has to work in an overstretched and underfunded NHS, which can be demoralising and is applicable to many specialties. Also, the hours may be longer than you expect, depending on your dedication level, and they will not comply with European Working Time Directive should you want to learn and deliver the best possible continuous care for your patients, which would be crucial in a specialty like transplantation.

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