• Adewale Kukoyi

Dr Jude Interview Part 3: Working Abroad, Family, and General Advice

AK: You spoke about that inspiration you got from going to Yale for an elective, which is incredible by the way! How did you then take that inspiration into your Foundation Programme Training?

DJ: Well, the big thing for me was the early starts! I had to do ward rounds at Yale at 5:30 am and I remember struggling to get in for 8 am at medical school! After you do 5:30 am ward rounds, everything else becomes easy. When I got back to London, they would tell me they need me in for 7:30 am, and I would be like "say nothing", and I would be there at 7:15 am with my coffee, patient notes, getting my list ready and by the time the boss walks in, I'm like "Boss, I've done this and this, let's go, we're good for the day!" So, the early starts in surgery became really easy for me.

Secondly, having pride in your work is so important. You need to commit yourself to what you are doing, and you cannot be haphazard as every decision you make has another person on the end of it - even if it's a small decision. So, I'm deliberate and evidence-based in the actions I make. In surgery, you have to read a lot, and on my commute to work, I find myself reading for those 45 minutes. We all tend to fall into the trap of using Instagram and Spotify for those 45 minutes, but you can use it to read up on the cases you got for the day. Alternatively, if you've got a book that you're working through, then you can read it and set yourself a goal of "by the end of this rotation, I wanna learn everything on X". That's what I used in my training, and I remember being a junior registrar in one of the central London trauma centres and I knew that the consultants were trying to use me as an example (because I was junior at the time). So, in trauma meetings, they would ask me questions and try to 'expose' me. I knew what they were doing, and I liked it (it was funny) but what I would do is come in before them. I'd look at the list before the meetings, and I'd read the cases for the day. I'd get my coffee, sit down with my iPad and 30-45 minutes before the meeting, I'd be reading everything so that by the time the bosses came in, and they'd be like "Obi, tell us about this pelvic fracture", and I'd step up with that swag and confidence and answer. All the seniors would be surprised and assumed I was just knowledgeable, and in their defence, I was, but it was about me being prepared. For example, I would text my boss the day before and enquire about the cases for the next day. I would prepare beforehand so that by the morning, I'm fully prepared.

Ultimately, [working in the US showed that] it was about showing up early, being knowledgeable and reading, and being prepared. They are the basics! The earlier you get them nailed down, it becomes part of who you are.

AK: So you spoke earlier about doing your fellowship in Canada, how did you get that opportunity, and why did you take that next step?

DJ: As I mentioned earlier, I went to Yale for my elective, and I always wanted to go back at some point in my training. Unfortunately, I never had that opportunity because my training was going too smooth, so I never had a gap where I could do my USMLE and go to the States for a short period. When I got to the end of my training, going to America looked less attractive for several reasons: Donald Trump, police brutality and having to sit the USMLEs with kids. I actually spoke to a surgeon, who was a mentor of mine (and spent some time in Canada) and he was the one who first put it [working in Canada] on my radar. Interestingly, a lot of the orthopaedic literature comes from Canada, and a lot of great surgeons practised there. So I did my research and found that the University of Toronto was the major centre there. I emailed one of the fellowship programme directors and said I was keen on going there to spend some time. He outlined the application process, and again, networking was key here. I mentioned my mentor and how he spent some time in the unit there, which made me stand out.

Nonetheless, I applied through the formal process and was successful! I moved to Canada and its amazing because they have a huge fellowship programme, there must have been about 200 fellows split between six hospitals (all different specialities). I think everyone should experience that North American grandeur, it's definitely a unique experience.

AK: I think people from the UK are looking towards the US, and some of the medical students in my year group are already planning on taking the USMLE! I think there's a change in the narrative towards going to the US, and more people are looking to enrich their experience.

DJ: I had a few colleagues along the way who took the USMLE, I was supposed to join them, but I was too busy in my surgical training. Most of them had personal motives as they had Americans in their family, and if you have that as an option, it's not a bad one. Personally, I don't think America is the "be-all and end-all" at the moment. You get a better quality of life as a doctor - a lot of my friends who practice there are incredibly well-paid, live in a nice home, and educate their children to a high degree. You get a great [quality of] life, and I don't think you necessarily get that in London as we are public servants. However, if improving your quality of life motivates you, I don't think going to the US is a bad option.

AK: So you've spoken about your career and training, how did you balance this with having a family and making sure that you're also looking after your mental wellbeing and enjoying life?

DJ: That's a good question and people actually ask me that all the time! What I say is that I'm an "all-or-nothing" kind of guy. As I got more senior and my following increased, the hardest thing for me was saying no to things. Before, anything that landed on my desk, I used to jump at the chance to do it, but I can't now, as my work would become haphazard. I like my work to be the best that I can do, some may call that a dangerous trait, but it's a trait you need to have as a surgeon. It does mean you can get consumed with things like if I'm doing YouTube, I can get locked into the point where I can be up till 3 am editing! Alternatively, if I'm writing a paper, I'm entirely focused on that. If I have an exam coming up, for a month or two, I'm focused on that and not talking to anyone, but the way I find that work-life balance is by understanding there will be "peaks and troughs". There are times in the year where I'm super-busy, I'm taking on projects, doing exams and practicals and that'll go on for 3-4 months but after I'll just take a month and unwind. In that month off, I'm taking the kids on holiday or taking the wife to Dubai, and I'll chill. I'm still "working", but I'm not taking on any extra projects. My months off are usually around Christmas and summer, and those are focused around spending time with family and friends and ultimately, enjoying everything you've worked for. That's how I do it, but it may not be the right way!

AK: In terms of medical students who wish to practice abroad, what type of advice would you give to them?

DJ: My advice is to do it! You have one life, and any decision you make is not permanent. As doctors, we become averse to risk because we don't want to disrupt what we have worked for. However, I personally do not think anything is permanent, and if you want to go to America or Canada, I think you should scratch that itch and go there! That itch won't go away and some point in your career, you'll end up regretting it. Your career is going to be 40+ years, and so it's about enjoying your time. If you want to go to Canada or the US:

  1. Speak to people who've done so, reach out and find out what it's like.

  2. Do your due diligence and understand that nothing is impossible. If you want to become an orthopaedic surgeon in New York, it may not be an easy task but find out the steps to get there.

  3. Do what needs to be done, and you'll set out to achieve your goals.

AK: If you were able to do medical school, all over again, what things would you do differently?

DJ: I would do absolutely nothing differently because as I said, I thoroughly enjoyed my time at medical school, and that was partly due to me having such huge social and extracurricular commitments. I think that's what makes you grounded and be a well-rounded person. I went to medical school when I was 18 years old! I cared about Air Force 1s, watching Arsenal on the weekends, going into the SU and making it into the football first team! I managed to keep up with my studies while doing so.

You tend to see that there are many mental issues amongst medical students partly because we can be hard on ourselves, set high expectations, and become so consumed by the workload. Hence, I wouldn't do anything differently, but I would advise students to form these support groups and participate in societies. Once you're in medical school, you have to pass, but your career is waiting once you come out. I often get medical students asking to partake in audits and studies, and although they have the best intentions, they never finish it! That's mainly because they've spread themselves too thin and are taking on too much, I wouldn't worry about doing these extra projects, focus on passing, getting out into the world with enough energy and vigour to attack what it is you want to go for.

AK: What are some of your personal finance tips to medical students and doctors?

DJ: First thing I would say is to read! A few books are mandatory to your journey such as "Rich Dad Poor Dad" and "The Richest Man in Babylon", they provide you with a foundation to understanding money that never gets taught at med school. Secondly, over the years begin to think about how you would like to supplement your salary. This may be through doing other things in Medicine or outside Medicine, such as building an investment portfolio and building additional income streams. The most powerful thing students have in their favour is compounding interest, so I would start a savings portfolio really early. You have to take charge of your finance, and not rely on the paycheck.

Check out Dr Jude's YouTube and Instagram for a more in-depth look at some of the things we've spoken about!