After we graduate, we all go through the same mix of medical, surgical and now, more commonly, general practice placements through the training programme called Foundation Programme. This is meant to equip us with all the necessary basic knowledge and skills to deal with common emergencies and the acutely unwell patient.
Now I've chosen the Surgical career path (or maybe it chose me!?) which means my knowledge of management of "common" medical presentations become more distant. Rarely now do i get called to see a breathless patient, or chest pain. Do i keep up to date with modern protocols of heart failure? No.
However, no matter where I work, medical doctors are territorial and have to be dragged by the ankles to our patient if we deem them to require formal medical input purely because medics work on only their territorial ward. Whereas, we surgeons will jump to any place in the hospital to see a patient, relatively immediately.
Why is this the case? Well surgeons are doctors, and should know how to manage "basic" heart failure and diabetes and COPD, apparently. Therefore, there is a reluctancy for medics to step out of their safe zone onto Surgical wards. I imagine the array of stomas and drains intimidates them. On the other hand, screaming dementia patients, the smell of stale urine and diarrhoea on bed linen intimidates me too.
Where does this leave us? Well, perhaps surgical trainees should be expected to cover the ad-hoc medical on-call to keep up to date with acute medical management, including running cardiac arrest calls. The result? We might eventually harvest the surgeon who dually fills out the role of a medical registrar.
