Former Yarm School Pupil Sets His Sights on Becoming a Consultant

Former pupil Bola Ajekigbe has set his sights on becoming an Orthopaedic Consultant after rigorous medical and surgical training.

Bola joined Yarm Preparatory School in Year 4 and continued through the School to Sixth Form. Over his 10 years here he was involved in a vast array of activities, including rugby, rowing, drama, orienteering, skiing and French exchange. Bola studied Biology, Chemistry and French at A Level before moving to London to study at Imperial College School of Medicine for six years, including a compulsory BSc in the fourth year during which he attended Imperial College Business School.

Bola graduated with distinctions in Medicine, Obstetrics and Gynecology and merits in Psychiatry and Pathology. He also has a First Class Degree in Management. After graduating, Bola moved back to the North East where he carried out his postgraduate training.

We spoke further with Bola to hear more about his experiences at medical school and how he has found working in orthopedics so far.

When did you first consider applying for medicine and why?

I decided I wanted to apply for medical school when I was in Lower Sixth.

Whilst French was my strongest subject at A Level, I was among some hideously talented linguists at school (Mr Bridges included) and knew I wouldn’t be the best in that field. I always thought human biology was pretty neat and studying medicine seemed like an interesting way to apply that alongside all the requisite soft skills: leadership, communication, continuing professional development.

My dad and many of our family friends were also medics. Teesside wasn’t as multicultural 20-25 years ago as it is now, and if you see people from similar cultural backgrounds in positions of responsibility, then that career path naturally seems like a viable option.

Why did you choose to study in London?

I often visit family in London at Christmas and went on the occasional school sports trip there, such as Rosslyn Park 7s and the Head of the River race, and I guess those visits left their mark on me. I see it as a country within a country and if I hadn’t moved there for university, I would have likely applied to work there as a Junior Doctor.

However, Imperial and University College London also seemed really strong from an academic point of view which was attractive to me and I applied to both. I didn’t apply to Oxbridge as I didn’t particularly see the appeal for medicine specifically, though I did enjoy punting with Mr Bridges while he was there.

What did your surgical training involve and how long did it take?

The career pathway to becoming a surgeon is made up of 4-6 years at medical school, 2 foundation training years, 2 core surgical training years, 6 higher surgical training years, then at least 1 ‘fellowship’ year to help develop skills and develop expertise in a particular area. There are also optional years training for a Master’s (1 year), MD (2 years) or PhD (3 years) for academic interest, or just to give you a competitive edge in job applications.

There are also involuntary years out of formal training; trauma and orthopaedics (T&O) had six applicants per place last year. Equally, postgraduate exams can also be a stumbling block as you can’t progress without passing them.

Many non-surgical specialities such as cardiology can end up being of similar length, but surgery is generally longer than most. It’s also longer than the same training abroad, for example postgraduate training takes between 5-6 years in the United States, compared to 11 years in the UK.

As a higher surgical trainee, I rotate around different hospitals on six month placements. Our training region (Northern) spans from Carlisle on the Scottish border, to Darlington and Middlesbrough in the south. Some commutes are inevitably longer than others, but many other regions are even bigger than ours. Carlisle aside, everywhere is a trundle along the A1/A19.

When I’m ‘on call’ (emergency shift), then I take A&E/ward/GP referrals for people with broken bones, dislocated joints, spinal injuries, bone & soft tissue infection etc. When I’m not on call, then I attend clinics and theatre sessions. All of this is completed under the watchful eye of one or several consultants, with levels of supervision varying based on seniority and case complexity… until one day you’re the boss!

What were the highlights of your surgical training?

It’s a long, steep learning curve; but it’s nice being able to measure your progress along it, and you take the small wins as they come.

I remember being scrubbed for keyhole knee surgery as a fifth year medical student. I watched the Consultant stitch one keyhole closed at the end, then he asked me to close the other one. He walked off and said he’d be back to test my repair by squirting local anaesthetic around it and seeing if it held. The incision was only 1cm long, and it probably took me three minutes to do what I can now do in seconds, but he bunged the full syringe in – the repair was watertight.

I’ve done a couple of supervised keyhole knee operations this April, but I never take those little incisions for granted. I’ve also once been told that my wound repair looked ‘like a dog’s dinner’ and to start over again so yes, you take the small wins, but also have to stay humble.

Why did you choose to specialise in orthopaedic surgery?

Generally, orthopods are a pretty entertaining bunch and it’s a very sociable specialty… Musculoskeletal (MSK) pathology involves a large multidisciplinary team of nurses, physios, theatre practitioners, radiologists, microbiologists, paediatricians, anaesthetists, A&E doctors, other surgeons (Vascular, Plastics).

Fracture clinics give an interesting snapshot into people’s lives; sometimes you just have to laugh at the creative ways that people will try to injure themselves (those mini-motorbikes seem to be the latest craze). You’re not usually saving lives in T&O, but you do get people walking/golfing again, which is more my speed.

The ‘toys’ are also quite cool: power tools, joint replacements, bone fixation devices. It’s probably medicine’s most fluid interface in terms of industry, technology and engineering.

Have there been any challenges or tough moments during your studies or career?

Too many to mention but there were some key challenges I wasn’t aware of before I started my training, such as:

• The hidden financial costs: as of the last two years there is now a very generous study budget, however this explicitly excludes exam courses, exam fees and compulsory membership fees, which run into the £1000s.
• The hidden social costs: coming in on days off to gain more operating experience, and quickly becoming that ‘flakey’ friend that has to cancel plans last minute because of an overrunning theatre list. Also the competition for training posts can mean accepting a job in a new region away from family, friends and significant others (in common with many grads, in fairness, but at that point the average medic is in their late 20s/early 30s).
• Complications, or rather how to deal with them: they come with the territory no matter how experienced you are or how perfectly the operation seemingly went.

Did the pandemic affect your work in any way, and if so, how?

Objectively speaking, I would say that T&O has likely been affected more than any of the larger surgical specialties as the elective (routine) work, such as hip and knee replacements, stopped completely. Cancer work can’t be stopped and forms a large part of other surgical specialties such as general surgery (gastrointestinal), urology & ENT, but is actually very rare in T&O.

On the flipside, we’ve seen a lot of exercise and DIY-induced lockdown injuries and so the trauma side of things has been busy.

Ultimately, there is lots of operating to catch up on and the options are:
Somehow make up the numbers elsewhere in normal training time. Perhaps by making effective use of the post-Covid backlog.
Extend the length of training for everyone which, as discussed, is already 11 years long and would come at a cost.
Change the level of experience that everyone can accept of our future surgeons.

What are your long-term plans and how do you see your career developing?

Most of us combine general trauma with a subspecialty: foot and ankle, hand and wrist, shoulder and elbow, spines, paediatrics, arthroplasty (hip & knee replacements). I still need to rotate through a few more to decide which I’d like to do.

I would like to try and do my fellowship training outside of the UK (Canada, Australia/New Zealand) for a different perspective on things, but would like to work here as a Consultant.

Do you have any advice for anyone looking to go into this field?

I would suggest that anyone interested in this field should keep an open mind about other medical specialties and career paths. The best surgeons I know are also the most medically well-rounded.

I also highly recommend keeping up with extra-curricular activities, though you might only have time for one main hobby. Burnout among medics is common and achieving the right balance for you is crucial; I’d like to be a good surgeon, but I work to live, not the other way around.

Finally, surround yourself with a trusty circle of friends, family and mentors, who will help to keep you grounded and relatively sane.