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A view from the coffee room…my message to newly qualified [insert your specialty here] surgeons 

Authors: Virve Koljonen M.D. PhD.
Department of Plastic surgery
Helsinki University and Helsinki University Hospital
Helsinki, Finland

Today I am going to share you with my speech to newly qualified plastic surgeons, I have been thinking about the tradition of speaking in surgery and medicine, in general, and usually it involves Powerpoint slides, and bloody pictures. Personally, I have nothing against PowerPoints or blood, but I feel that we need to revive the art of giving speeches. A good speech is inspiring and captivating, a good speech has clear message and is supported by facts, a good speech is basically telling a story suitable for your audience. Based on this I would grade my speech 3/5 – there is always room for improvement. If your professor is not as eloquent as yours truly and you need reassurance, just imagine that this speech was made by your professor to you. 

And here we go:  

A specialist degree – including a specialist degree in  [insert your specialty here] surgery – is an exceptional university qualification.  The bulk of a specialist’s degree is spent in hospital working on what, at least in our hospital district, is irritatingly and dismissively referred to as service production or health-care production. In day-to-day work on the service-production side, one learns to perform specialty-specific procedures on specialty-specific patients through an increase in the number of n. And if you’re really, really lucky, you also learn to perform unusual and rare techniques on patients with unusual and rare diagnosis. That’s good. 

I have noticed that the significance of the university and academia has, if not disappeared, at least diminished as the service-production has been in full swing and has severely limited participation in academic activities and initiatives. Not good.  Indeed, mere technical achievement is not enough – not for personal professional growth, nor to move our field of [insert your specialty here] surgery forward.  I would argue, somewhat simplistically, that anyone can learn to do a trick and do it well, history has examples of this, BUT not just anyone can adopt the tradition of our field, apply, and individually select the right treatment or procedure for that particular patient. And this is what academic education gives us. Academic expertise is the ability to think scientifically, to generate new knowledge and to learn continuously. Academia gives us the skills to build professional expertise.  For me personally, the key words are generating new knowledge based on tradition and continuous learning. What are your key words? 

One threat that I want to raise here is the uncritical deployment of new health technologies. Health technology can be your best friend or your worst enemy, depending on who you ask. If you ask me, I can’t say that dichotomously. But what I can say is that health technologies, i.e. new devices, robots, wound care products, AI, they are not toys for us surgeons, but a powerful tools to help the patient. Therefore, we should actively and critically do research – where the outcome is the health benefit to the patient and society.  How health benefits are defined is not the focus of this talk, that is another talk. 

A few years ago, a series of photographs was displayed in the corridor of the intensive care unit at [insert your hospital  here] Hospital to illustrate the history of our hospital. All the pictures showed a patient in their sickbed and a doctor next to the bed, from different decades. When you actually stopped to look at the series of photographs, it became very clear that the closer you got to the present day, the more beeping and flashing devices were in the picture. And it also became clear that the fewer devices in the picture, the more the doctor looked at the patient and, conversely, the more devices, the more the doctors gaze was turned away from the patient – to the device.  Amidst all the beeping, buzzing, colour-lit equipment, let’s try to remember the tradition that was important to my predecessors and is important to me; we are here because we want to do the job of a doctor – to help our fellow human beings through surgery. 

Finally, dear graduating [insert your specialty here] surgeons, never forget that you are the crème de la crème, cherry on top. I know that there are many different paths to get here to this celebration of new [insert your specialty here] surgeons, each one’s story is precious and worth telling. But to put it simply – each of you was admitted to medical school out of hundreds of applicants, you passed medical school successfully, then you were selected to specialize in [insert your specialty here] surgery because you performed excellently in the screening period, you passed two exams; written and oral. You have passed a screening that most of the medical profession would never pass. Be as proud of yourselves as we are of you.   


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