Abigail Durston – A letter to my younger self

By Abigail Durston
Specialty Doctor in Trauma and Orthopaedics, Royal United Hospitals Bath NHS Foundation Trust 

After a smooth run at Foundation and Core Surgical Training, I was pleased to secure an ST3 LAT. Surely that meant that the following year I’d get a number. I busied myself with solo projects and built up a beautiful portfolio, neglecting collaborative working and verbal interview practice. That approach did not pay off, and it took many years to realise why. By now I was married, and my husband knee-deep in a PhD. We had a family in an efficient way (three babies in four years). Failing to secure a number in my deanery, and lacking appetite for crazy commutes with three toddlers to adjacent ones, I decided to leave training.  It was wonderful to be offered a non-training job in a nearby DGH, where I worked part time for five years until my youngest started school. My ambition still burned strong, and with the support of my department I decided to sit my FRCS Orth exam. This time I followed wise advice and prepared thoroughly with a motley crew of trainees. We passed first time. Now I am preparing my CESR application with a view to a consultant career in foot and ankle surgery.

• You want to do your best at everything. This is great, but you cannot be full time in every role in your life at once! Unrealistic expectations cause pressure which can steal your joy. Pace yourself. Sometimes the focus needs to be on the kids, sometimes on the career. Nurture good friendships so you have someone who has the guts to tell you.
• It is a massive privilege to have kids. Not everyone has that option. Those kids need you more than work does, so treat them with care. Training can take as long as it takes, but kids are only little once; enjoy them.

• There is no convenient time for women (or men) to have children. Some young kids make you feel good; most do not. Instead they wake you up multiple times a night for ridiculous reasons and replace most of your brain with cotton wool. If you have kids early, training is a team endurance feat. If you choose to have them late, fertility is reduced, and you may well have more responsibility by then, when it’s less acceptable to have cotton-wool in your head instead of brain. This being said, you’ll emerge from this period with new skills and experience which are invaluable in your career!

• It is a massive privilege to have a career. Most children’s mothers don’t. Talk about work in this positive framework and embrace being a role model. Also, you get to talk to adults, use the thinking part of your brain, (which shrinks the cotton wool component), and get paid!

• Partners make/ break a career in surgery. Treat them with care, and be thankful! They will make many sacrifices for your career. It is good to be in the habit of making sacrifices for them, and keep articulating your gratitude (and how lucky they are to have you!).
• Whenever someone offers useful help, always accept. Don’t be British about things. If they didn’t really mean it, they will not offer next time!
• When you face a hurdle, tackle it with all the energy and determination you can, seeking out and following wise advice. Be collaborative as often as possible. Your time is short, and can’t be wasted on half-hearted attempts.
• Approach CESR in the same way you would a cabbage. Swallowing it in one go is unpleasant and unnecessary. It has a finite number of requirements which must be digested in small portions over six years. Anyone can eat a cabbage in six years!
• Realise your place as a trainee. Your route may be different but the destination’s the same. After all, CESR is awarded by identical criteria to CCT. So, turn up to each theatre list prepared to do the operations, and you will be rewarded.
• Relish life as you go; living in the here and now is such a valuable skill. Remember God, consider exercising and eat less chocolate!