Doctors Getting Coffee

#003 Dr Kaishin Tanaka - BPT and Training in Neurosurgery vs Neurology

Dr Syl

In this interview with Kaishin Tanaka we talk about his pathway and experience as a Junior Doctor in Neurology, Neurosurgery and Neurointervention terms. We breakdown the neurosurgery training pathway in Australia and also talk about how to become a neurologist. Including the basic physicians training program. I hope you enjoyed it as much as we did.
Please note we do not represent any of the colleges of physicians or neurosurgery. Double-check the details on their websites to ensure accurate information. Cheers!

Shout the next Coffee: buymeacoffee.com/DrSyl.AU   
Become a Member: youtube.com/channel/UCiOBkubL46VQT9mPqrnJlrQ/join
Become a Patron: patreon.com/DrSyl

Support the show

and this is it's very taxing exactly and


0:02

as a neurosurgery registrar you you do


0:04

work long hours obviously you make sure


0:06

you get your divorce before the training


0:08

because doing a divorce during your


0:09

training will be very


0:11

popular to get one after you finish


0:13

everything okay right


0:15

[Music]


0:19

hey guys and welcome to another video dr


0:21

still here junior doctor from sydney


0:22

australia and today i'm talking to dr


0:24

kaishin tanaka


0:26

he's the registrar on the neurology team


0:28

that i'm with thank you so much for um


0:30

having a chat to us


0:32

i feel like you've done um almost every


0:34

term that's related to brains you've


0:36

done neurology neurosurgery neuro


0:39

intervention and i thought it would be


0:40

great to talk to you a little bit about


0:42

the basic physicians training program


0:45

your pathway why you love the brain and


0:47

your story yeah so first off though i'd


0:49

like to know was there ever a patient


0:51

case or anything that you saw clinically


0:53

that made you like fall in love with the


0:55

neuro side of medicine


0:58

i i don't think there's a specific case


1:02

that made me


1:04

um think of like euros what i want to do


1:07

oh my gosh


1:09

this is a


1:10

realistic okay what is it it's going to


1:13

be in a stroke it's a stroke let's go oh


1:15

we're not the team in charge of stroke


1:17

right now so


1:18

there are there are doctors going to


1:20

that stroke call don't worry


1:22

um


1:23

what was i saying yeah so yeah there


1:26

hasn't been a specific patient um


1:28

there's been several patients along the


1:30

way which has


1:31

made me


1:32

or which has you know affirmed my


1:35

interests in the field


1:36

i think for me um my interest in euros


1:39

started


1:40

when i was probably when i was a medical


1:42

student um


1:44

as we were going through our rotations


1:46

in different specialties when i got to


1:49

my neuro rotation


1:51

just learning the science of everything


1:52

and learning how there's still so much


1:54

that we don't understand


1:56

how you could read a textbook and they


1:58

would have a name for an anatomical part


2:00

of the brain but they don't know the


2:01

function of it it just you know


2:03

fascinated me and


2:04

made me want to go into that field to to


2:06

understand it better


2:08

and also maybe to maybe understand


2:10

myself


2:11

better as well really so it's kind of


2:13

like you're using your own yeah to


2:15

discover your own


2:16

somehow i felt like that could


2:18

yeah that could satisfy that kind of


2:20

curiosity as well how much of the brain


2:23

do you think we actually understand


2:25

i think as a percentage i i think


2:28

that question


2:30

the answer that question changes every


2:32

year that we get more research does it


2:34

get bigger or smaller i think it gets


2:35

smaller it's like we we think we've


2:37

gotten somewhere and then we realized oh


2:38

it actually there's this whole other


2:40

side of things that we didn't


2:42

know about and um you know it just opens


2:44

up more questions yeah exactly i reckon


2:47

that begs the question like do you think


2:48

we would ever fully understand the brain


2:51

and if we go along that trajectory of


2:53

thinking i think that you start when you


2:55

start going to that it kind of ends up


2:57

being a philosophical discussion about


3:00

um


3:01

you know what is


3:03

the brain what is consciousness like


3:05

what is it what does it mean to


3:06

understand the brain well we deal with


3:08

that exactly you deal with that in


3:09

neurology all the time exactly so what


3:11

are some of the interesting cases you


3:12

saw


3:13

yeah so


3:13

[Music]


3:15

from when i was


3:17

working in intervention there was a


3:20

a case with a


3:22

child about seven to ten years old


3:26

he came into our hospital


3:29

[Music]


3:31

after he had played he was playing on a


3:33

see-saw and he'd just fallen off and


3:36

became completely unconscious after that


3:38

um


3:40

he he came to a hospital we found that


3:42

he had um


3:44

a lot of blood in his brain um and after


3:47

they did a contrast scan they could see


3:49

that he had this enormous aneurysm that


3:51

was taking up like a third of the size


3:53

of his the space in his skull


3:55

essentially yeah it was huge huge


3:57

aneurysm so we think that that was


3:58

obviously there before the the fall yeah


4:00

it was just no one obviously hadn't he


4:03

hadn't had scans for whatever reason i


4:05

mean he wouldn't have had to he was fine


4:07

until that point


4:08

um and he's obviously this aneurysm is


4:10

obviously ruptured so he's been living


4:12

with this aneurysm the size yeah his


4:14

brain yeah his whole life he falls off


4:15

the scene


4:17

it's popped and yeah so he's had this


4:19

massive hemorrhage into his brain so


4:21

guys aneurysm is when a blood vessel is


4:24

dilating so someone had an anatomical


4:26

abnormality so big a big blood vessel


4:29

and then it's weakened because it's so


4:31

dilated and it's popped after a fall


4:33

yeah yeah so


4:35

he came to our hospital um


4:37

because he was in the area he would have


4:39

otherwise gone to a children's hospital


4:40

because it was such a critical


4:43

case


4:44

he came to us um and then that's when i


4:46

i was involved from the morning he came


4:48

in the morning and we were basically


4:51

trying to figure out what to do with him


4:52

for the entire day so he he went to the


4:54

interventional department first


4:57

we tried to coil the aneurysm and


4:59

stabilize the the bleed


5:02

he and just to kind of break that down a


5:05

little bit for like medical students and


5:06

people who don't do medicine coiling an


5:07

aneurysm yeah you're basically also then


5:10

filling up that kind of


5:12

uh enlarged blood vessel with a bunch of


5:15

metal coils so it just physically blocks


5:17

blood from


5:19

flowing out through that right side


5:22

stops the blood yeah right right by


5:24

filling it up with something else


5:25

essentially yeah


5:26

um so we tried to do that um and it was


5:30

it seemed to be somewhat successful but


5:32

he was still


5:34

very uptuned and and obviously unstable


5:36

so unconscious and yeah unconscious so


5:38

he needed to have surgery to decompress


5:41

that um which i also got the privilege


5:43

of discovering in for as well


5:45

and so i got to see them decompressing


5:47

this child's brain so how do they do


5:48

that so opening up the skull essentially


5:51

just making an incision a rather large


5:53

one taking out a piece of bone and just


5:56

letting the brain relax and so when they


5:58

take the bone off is it a circle that


6:00

they just they kind of pull up and do


6:02

you see the brain you see the brain


6:03

swell right i see the brain swelling out


6:05

and you can see how tense it is you can


6:06

see the blood as well that's it in the


6:08

brain do they remove some of them yeah


6:10

you generally kind of wash it off um you


6:13

know trying to release some pressure but


6:14

you're basically just trying to take out


6:16

the skull so the brain can just


6:18

expand out have room to expand it


6:20

doesn't


6:20

um get constricted in the confined space


6:23

of the skull because that's the main


6:24

concern if if uh


6:26

if a brain is um got too much pressure


6:29

inside um and you don't believe the


6:30

pressure then it damages everything in


6:33

that just leads to permanent deficits


6:35

basically what happened after so after


6:38

that he


6:39

stayed in the icu for just just


6:41

overnight just because um they wanted


6:43

him to be stable for transport to a


6:45

child's children's hospital um and he


6:48

was subsequently transferred


6:51

um following on from that um we did a


6:53

review of his imaging um on our end


6:56

um and we found unfortunately that he


6:58

actually suffered


7:00

had suffered a stroke another stroke


7:03

whilst he was having um the


7:05

interventional procedure which we


7:06

couldn't see the time


7:08

because he was being brushed off to


7:09

surgery and everything


7:11

and


7:12

it was one of the reasons why the


7:14

children's hospital was actually having


7:15

a lot of difficulty


7:16

waking him up from his um sedation


7:20

so unfortunately what actually happened


7:22

we had found is he had um


7:24

he had developed an ischemic stroke so


7:26

there was actually a clot that developed


7:27

in one of his other blood vessels


7:31

it's a complication of having had the


7:33

having to trying to do the coiling


7:35

procedure right yeah because that's one


7:37

of the risks of coiling procedures so


7:40

you're fixing one problem that saved his


7:42

life that day yeah because causing


7:43

another problem yeah yeah yeah yeah they


7:45

have a very much longer term exactly


7:47

yeah so he just i mean just this kid had


7:51

everything that could have gone wrong


7:54

which is yeah very unfortunate


7:56

um


7:57

but i think for me it just showed me you


8:00

know how much we can do


8:02

um it showed me how much um care needs


8:05

to be taken within this specialty and


8:06

within um treating someone from a


8:08

neurological quantity yes and what i


8:10

remember like i did a new research term


8:12

as a student yeah and that was the one


8:14

where you would see people go from very


8:16

unconscious to very conscious very


8:18

quickly if you if if anything you can do


8:20

but then if things don't work out like


8:22

things can go bad so quickly and it's


8:24

all about the like you just have to be


8:25

so careful very very sometimes you can't


8:27

control it obviously of course yeah yeah


8:29

complications can happen without your


8:31

control and i mean that's one of the


8:34

other sides of it i suppose just having


8:35

um


8:37

consideration of the fact that you're


8:39

when you're the one who's doing these


8:40

procedures


8:41

um you know a lot of um


8:44

responsibility is placed on yeah it's a


8:46

lot of um privilege but it's also a lot


8:47

of responsibility and it's a privilege


8:49

to have that response yeah exactly


8:51

exactly


8:52

yeah yeah um so what what so how were


8:56

you and did you always want to do


8:57

medicine or what was your pathway into


8:59

the medical world and then into


9:00

neurology did you were you born in


9:02

sydney no no i've had a very complicated


9:06

backstory i was born in the u.s


9:09

born in the u.s grew up in the uk


9:12

came to australia around high school


9:14

just before high school


9:17

wanted to do medicine i'd say from


9:19

[Music]


9:20

first year uni did you have an english


9:22

accent when you got to australia i did


9:24

very very strong i'm i'm wondering if


9:25

now i can actually kind of just if


9:27

that's yeah


9:29

it was much stronger yeah it was much


9:31

stronger when i first


9:33

was in australia and then it kind of


9:38

um but yeah i'd say i think i wanted to


9:41

do medicine from


9:43

from when i did my first year of


9:44

universities and what did you do at


9:46

university uh i just did a bachelor of


9:48

science as my undergrad okay and you did


9:50

a bunch of different science courses i


9:52

majored in um medicinal sorry i mean


9:54

majored in medicinal chemistry


9:57

so i had some exposure to biomedical


9:59

sciences


10:00

and that's really what i think made me


10:02

want to pursue medicine as a career and


10:04

so then did you do post-graduate


10:06

medicine yes whereabouts university of


10:07

sydney you said yeah how did you find


10:09

that


10:10

um overall it was fine people find it


10:13

very overwhelming when they've done a


10:15

like you did a science undergrad which


10:17

gave you a bit of a footing yeah but


10:18

still people find it like super that is


10:20

true yeah i mean there are definitely


10:23

parts of doing the course which were


10:24

difficult um and i mean


10:27

medical education is something that i


10:29

think is still an ongoing process of


10:32

improvement for all you know educational


10:35

institutions around the world there's


10:36

probably no perfect way of doing it but


10:39

um you know it's it was definitely a


10:40

help having the science background


10:43

um definitely had some difficulties um


10:45

with you know ongoing clinical learning


10:47

as well like it's difficult i understand


10:49

from a


10:51

from an educational institution's point


10:52

of view it's difficult to always have um


10:55

you know clear


10:57

guidelines as what to learn because it's


10:59

you know it's always changing and


11:00

there's lots of things


11:01

um but


11:02

you know i suppose that was what i found


11:04

difficult sometimes was just knowing


11:07

what i needed to know and how much i


11:09

needed to know and it's difficult for


11:12

anyone to kind of define that as you go


11:14

along as that so do you think that's why


11:15

it's so hard to


11:17

like


11:18

teach medicine like you're saying how


11:20

like it's a process of improvement which


11:21

is a very nice way of saying like it's


11:24

it's imperfect globally there's no


11:26

perfect medical course yeah but like why


11:27

is that why is it so hard


11:30

yeah i think yeah like i think um


11:33

definitely


11:35

the fact that there's just so much stuff


11:36

in medicine


11:38

um


11:39

knowing


11:40

as a medical student what you need to


11:42

know and what you


11:44

can sort of maybe just know roughly


11:46

about is difficult


11:48

um especially when you get thrown in


11:50

textbooks from every single direction


11:52

and then you're everything i need to


11:53

learn all of a sudden one of my pet


11:55

peeves of medical school is like when a


11:57

niche


11:58

like um


12:00

specialist comes in to do a niche shoot


12:02

and gives you a textbook to read like


12:04

the whole textbook it's like that's


12:06

unrealistic we can't read a textbook on


12:07

every specialty yeah guys like just be


12:09

realistic what do we need to know when


12:11

we call you for help that's what we


12:12

exactly yeah yeah yeah so it it can make


12:15

things difficult when you're trying to


12:17

study for exams if you hadn't really had


12:19

that kind of


12:20

framework to begin with


12:22

you may have been kind of


12:23

reading things which may not have been


12:25

um what they wanted you to know about in


12:27

the exam


12:28

yeah um they're clear


12:30

exactly yeah everything about everything


12:33

that's how it felt yeah exactly so i


12:35

think that was one of the main


12:36

difficulties i found


12:39

okay so then you made it through medical


12:40

school congrats yeah that's that's not


12:42

easy for anyone


12:43

um and tell me about your junior doctor


12:45

years


12:46

yeah so i did internship at royal north


12:48

shore hospital uh and then i was a


12:50

resident there as well and then i did an


12:52

sr mario which is a senior resident here


12:55

after that that's what i'm doing next


12:56

year so this year i'm a resident yeah


12:58

yeah


12:59

um


13:00

i really liked working at royal north


13:03

shore hospital i think it was a great


13:04

hospital for me to train at and learn


13:06

the basics did you do any neuro or


13:08

neurosurgery yeah yeah absolutely


13:11

i did a neurosurgery and a neurology


13:13

term oh wow and i got also


13:17

some exposure to other terms i did a lot


13:19

of cardio related things as well well


13:21

that's good because um the heart and the


13:23

brain the two most important organs some


13:25

might argue yeah a lot of strokes of


13:27

course because of the bad hearts yeah


13:29

yeah


13:30

i was also very fortunate that royal


13:32

north shore is a hospital that does


13:34

interventional neuro procedures as well


13:37

so i got exposure to that through


13:39

my hospital in a neurology term uh


13:42

neurology and as a senior resident as


13:44

well and did you so did you do a


13:46

specific neuro intervention


13:48

correct yeah so my my senior resident


13:51

here was focused on neuro intervention


13:53

okay and for people who don't know what


13:55

like for medical students who are


13:56

interested in the brain and want to kind


13:58

of understand what neurology versus


13:59

neurosurgery verse neuro intervention is


14:02

what's how do they split up and what's


14:03

the difference between them yeah i mean


14:06

it's uh


14:08

as with other specialties you can kind


14:10

of look at


14:11

the


14:13

organ systems as a split of a surgical


14:15

versus a medical type of thing


14:17

so neurology is the medical


14:20

side of the neurological system and the


14:22

disorders of it and neurosurgery is


14:24

obviously the surgical sign


14:26

um really the the split just comes down


14:28

to the types of pathologies that you're


14:30

dealing with so


14:32

if you're having tumors or other kinds


14:34

of lesions that physically need to be


14:36

cut out yeah there's no there's no pills


14:38

like you can move yeah


14:39

you can truly do much yeah


14:41

other than just going and doing


14:43

something about it surgically on the


14:45

other hand if you have something that


14:47

you cannot cut out


14:49

or you can't go in and do something


14:51

about like a stroke or


14:53

someone who has a myelin demyelinating


14:56

condition like multiple sclerosis then


14:58

you need to treat that with medication


15:00

and that's where the neurologist comes


15:02

in


15:02

okay


15:03

and so you did your residency in the


15:05

neuro intervention and now is is this pg


15:08

wife


15:09

this is my pgy7 euro yeah so you're


15:12

seven years out and we're up to your


15:13

fourth year of your junior doctor years


15:15

yeah yeah


15:17

so i did um two more years after that as


15:20

a neurosurgery registrar oh right you


15:22

did that as a senior as well yeah it was


15:24

a registered registrar yeah yeah so and


15:26

did you want to get on the program were


15:27

you trying to be able to i yeah i did


15:29

want to i mean neurosurgery and


15:32

neuroscience that was something i'd


15:33

always been interested in i wanted to


15:35

try um giving neurosurgery a go um


15:38

obviously it is a much more


15:41

difficult pathway to pursue in terms of


15:43

getting onto the training program


15:45

um and so my rationale was to give that


15:48

a go first and make sure i have like all


15:50

the


15:51

relevant experience to give it a proper


15:53

try


15:54

um because it's much easier to go from


15:56

something


15:57

competitive to something that's not as


15:59

competitive to get into if you didn't


16:01

want to you know change


16:03

specialties so from neurosurgery high


16:05

competitive high competition do your


16:06

best to get on and if it doesn't work


16:08

out or they expect too many years out of


16:10

you you can then go for a neurology in


16:11

your own intervention which is still


16:12

competitive which is so competitive but


16:14

the competition for that is not at the


16:16

training stage it's actually at the


16:19

consultant level and the sort of senior


16:21

level so okay um it just meant that i


16:23

could progress my training along as a


16:25

junior quicker and get to an area that


16:28

i'm interested in still want to work in


16:30

you know anyway yes you know


16:33

um and did you apply for the training


16:35

program and do interviews and what were


16:37

they like yeah yeah yeah you know


16:39

the surgical biosurgical institutions i


16:41

i only went through the application


16:43

process once okay um


16:45

the i basically just had to a student


16:47

exam and then go through with my cv and


16:50

references and everything um that year i


16:53

didn't have


16:55

the the curriculum or the cv points um


16:59

that they needed and so i was doing that


17:01

as a trial run right


17:03

um and then subsequent to that they


17:05

changed the


17:07

entry requirements for getting into


17:09

neurosurgery and so that would have


17:11

added on


17:12

two more unaccredited registrar years um


17:16

which i had considered doing um


17:19

and i was you know almost going to just


17:21

stay at my


17:22

um


17:23

other hospital that was working out as a


17:25

neurosurgery registrar previously


17:27

um and but then i sort of felt as though


17:29

like new intervention was something i


17:31

had done as a senior resident as i said


17:33

before


17:34

you know it was something i could see


17:35

myself doing as a career i was very very


17:37

interested in it anyway um and you know


17:40

i could go through it as i'm doing


17:41

physicians training as well and without


17:43

needing to all the unaccredited


17:48

yeah like you have to pay how much does


17:49

it cost to apply to it


17:51

yeah so the exam itself i think maybe


17:54

cost me about five thousand dollars five


17:56

grand for an exam is it multiple choice


17:58

it was multiple choices that's horrible


18:00

yeah there's nothing in that that should


18:02

cost five thousand dollars


18:03

that's so bad yeah but that's really


18:06

rough five grand for a multiple choice


18:07

exam


18:08

um okay and so


18:11

so what's the normal pathway so you do


18:13

uncr like for people who are interested


18:14

in neurosurgery uh training can you


18:17

explain the pathway to become a


18:18

neurosurgeon and compare that to the bpt


18:21

neurology yeah so neurosurgery


18:24

uh in australia basically you um you


18:27

just to get onto the training program


18:29

which is five years i think five or six


18:31

years


18:32

you basically just have to get into the


18:34

accredited um college um program so


18:37

that's the the neurosurgical society of


18:40

australia's college training program


18:41

yeah so you've done med school you're


18:43

you've done your intern and residency


18:45

and then you're a resident and then


18:47

you're applying then you're working as a


18:48

registered applying to this


18:51

the college yeah and then that's your


18:53

that's when you get on yeah five years


18:55

but it takes years to get up yeah


18:56

exactly that's your goal um at least


18:58

from


18:59

finishing as a resident to then moving


19:01

forwards


19:02

to neurosurgical training um is to get


19:04

onto the program basically and to get


19:06

onto the program you need


19:08

a combination of things so as i said


19:10

there's an exam that you have to sit


19:12

every year you apply


19:14

you have to get a certain score on that


19:16

exam it's just a neuroanatomy-based exam


19:19

you have


19:20

point requirements on your cv


19:23

and that usually consists of


19:25

things like experience as an


19:26

unaccredited neurosurgery registrar uh


19:29

things like publications presentations


19:32

posters


19:33

and also your references so


19:35

previous consultants that you've worked


19:37

with um you know vouching for you


19:40

and this is it's very taxing because you


19:42

have to work full-time like no part-time


19:44

applications really really like if we're


19:46

being honest get in


19:48

and then you have to do the research and


19:50

the audits and the


19:56

you're the one who's there in the


19:57

weekends exactly and as a neurosurgery


19:59

registrar you you do work long hours


20:01

obviously you make sure you get your


20:03

divorce before the training because


20:05

doing a divorce during your training


20:06

will be very


20:07

popular to get one after you finish


20:09

everything okay right


20:11

now it's much easier to get


20:13

or partner afterwards


20:14

it's harder to do it yeah fair enough


20:17

um okay and then once you're on with


20:20

those points then it's just for the


20:22

college yeah exactly requirements yeah


20:24

yeah then you just once you're on it's


20:25

usually smoother you just do what the


20:27

college wants you to do um it's not easy


20:29

either when you're on because you still


20:31

get you're still at the mercy of the


20:32

college because they they will they can


20:34

send you to whatever hospital needs


20:37

really they choose where you go they do


20:39

you put in preferences but they will


20:41

ultimately


20:42

say where you go and


20:44

it's because it's an australian and new


20:46

zealand-based


20:47

organization


20:48

so you can potentially be sent to new


20:50

zealand you can potentially be sent to


20:52

other states in australia as well


20:54

yeah


20:56

and then there's an exit exam because i


20:58

remember one of my registrars


21:00

when i was a student um doing


21:02

neurosurgery was that was a really tough


21:05

exit exam to becoming the final exact


21:07

big boss consultant fellowship exam


21:09

fellowship yeah yeah it's a


21:11

uh i only know roughly what it involves


21:14

it it consists of a written paper as


21:16

well as a an oral viper yeah the oral


21:19

virus yeah and that's when they grill


21:21

you on cases


21:24

of inflammation yeah and a lot of


21:26

pressure yeah and i'm sure that costs a


21:29

healthy bit


21:31

i'm sure because it involves real people


21:33

yeah so that's the neurosurgery pathway


21:35

what about neurology if i want to become


21:37

a neurologist what do i do so neurology


21:39

in australia so you


21:41

it's a


21:42

it's a medical specialty through the


21:44

college of physicians


21:45

you have to complete basic physician


21:47

training which is um


21:50

training which makes you go through


21:52

multiple different uh medical


21:53

specialties


21:54

um and it's what we call bpt


21:57

we use the term bpt it's basic physician


21:59

trainee so it's it's it's a registrar so


22:01

more senior than a resident less senior


22:03

than a more senior doctor yeah and you


22:05

do a lot of medic a lot of medicine so


22:07

you need to know your animals you need


22:09

to know your geriatrics exactly even if


22:10

you want to be a neurologist you didn't


22:12

know it all yeah yeah and then once


22:14

you've done all the required things in


22:16

bpt you sit your


22:18

exit exams i guess for bpt which


22:20

consists of a multiple choice exam which


22:22

covers the whole of


22:24

internal medicine um it's basically like


22:27

a


22:28

medical school exam on steroids right um


22:33

yeah and then you do your clinical exams


22:36

and you just did what because you've


22:38

just finished some exams yeah i've just


22:39

done the written yeah okay and there's


22:41

also the ascii is that what we're gonna


22:43

do no i haven't done that one yet and


22:44

that's coming soon it's coming if i pass


22:46

the written fantastic so you have a


22:47

little bit of a time now you've finished


22:49

your your written you don't know your


22:51

results so you can be existential about


22:53

that yeah you can limbo but i'm not


22:55

obligated to do anything at this point


22:57

because


22:58

it's a little bit a little bit a little


22:59

bit yeah yeah yeah so once if i pass


23:02

these exams i will move on to clinical


23:04

exams which are the oscis right um and


23:07

again yeah that's just basically um


23:09

where they assess you on your


23:10

ability to examine patients and


23:12

formulate detailed plans and management


23:15

you know plans in them yeah yeah and


23:18

then you become what an advanced trainer


23:20

is yes and then after that you that's


23:22

when you break into your


23:23

chosen sub-specialization so for me i'm


23:26

gonna need neurology but yeah it would


23:28

be you could choose medical oncology you


23:31

could choose renal medicine um


23:34

cardiology you know whatever you want


23:36

whatever you want yeah yeah cool


23:37

um but yeah so


23:39

it's a marathon really isn't it like


23:41

you've been doing this you're eight pgy


23:43

seven seven yeah seven so you're like


23:45

seven eight years out of med school


23:47

almost um how do you balance the work


23:49

life


23:50

uh


23:51

balance like or do you have you like had


23:53

problems with burnout or is it been yeah


23:55

crazy right everyone's different right


23:57

yeah you can handle exactly different


23:59

intensities of workload everyone is


24:01

different i i i mean i think just me my


24:05

personality i think i am


24:07

drawn to kind of high pressure


24:08

situations and fast-paced kind of things


24:12

um


24:13

and so i


24:15

like i really loved my um time as a as


24:18

armor and uh neurosurgery registrar i


24:21

think i learned a lot and


24:23

even though it was hard work and long


24:24

hours um i i enjoyed everything i


24:27

learned a lot right so can you say that


24:29

you haven't had burnout like i don't


24:31

i've never felt burnt out fantastic


24:33

personally i i think my interest in


24:37

my specialty has kept me going yeah and


24:39

that's not that you know not everyone


24:42

can say that


24:44

um lots of people obviously don't have


24:46

the same kind of um feeling towards um


24:49

you know whatever training they do


24:51

um


24:52

and you know that's just everyone's


24:54

different yeah everyone's different yeah


24:56

all right thanks so much for chatting uh


24:58

okay i think that's we'll have to wrap


25:00

it up uh now because everything's


25:01

running out of battery again but um


25:03

before we go what's your favorite part


25:05

of the brain and why


25:06

yeah that's a very difficult question i


25:09

think um


25:10

because i i like i mean i think the


25:13

brain is just a single organ but i if i


25:15

had to say something yeah


25:17

um and it's not really a specific part


25:19

but it's


25:21

i don't know the gray matter of the


25:23

brain i mean i guess that's where the


25:25

cortex that's just


25:26

yeah the stuff happens yeah that's right


25:28

where so what is the gray matter give us


25:30

a little run yeah the gray master is


25:31

basically


25:32

as the name suggests it's the gray color


25:34

part of the brain which if you if you


25:36

see it in your um


25:38

you know textbook pictures of um


25:41

of uh you know cross sections of the


25:42

brain it's the kind of the outer layer


25:45

of of all the nervous tissue and it's


25:47

basically where all the nerve cells are


25:50

basically and it's where all the like


25:52

fun happens that's where all thought and


25:54

consciousness and stuff is really really


25:56

happening the rest of the brain is just


25:57

like uh circuitry it's just getting


26:00

information from point a to point b as


26:02

far as we know yeah as far as we know


26:04

yeah


26:04

if you look into it maybe we're wrong


26:06

and there's more questions to answer the


26:07

connections are probably just as


26:09

important as the cells themselves


26:10

nowadays yeah probably


26:12

thank you so much for the chat just for


26:14

the record we don't represent the


26:16

college of physicians or anything yeah


26:17

this is informal advice so make sure you


26:19

double check everything with the


26:20

websites thank you so much for the chat


26:22

um we've got to go back up to the ward


26:24

and i'll see you all in the next video


26:26

guys


26:26

don't forget to like and subscribe


26:28

see you guys yeah


26:31

thanks man


26:32

that was fun