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

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!

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Transcript

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