The Long and Winding Road of Hand Surgery Training Pathway
From Exams to Excellence: Meet Mr Dan Morell, the Hand Surgeon
The hand surgery training pathway is a long journey. There are lots of exams and time locked away in a room away from family and friends with your head in a book. There are lots of sacrifices, missed birthdays, weddings, and festive seasons (you get the idea!).
Surgical subspecialty training in orthopaedics:
Towards the end of surgical subspecialty training in orthopaedics, most surgeons will take an exam which signifies their competency in that speciality. For Orthopaedic surgeons, that is the FRCS (Fellowship of the Royal College of Surgeons) exam. It consists of a written component followed by a 2-day clinical and viva exam that is conducted by trained examiners made up of senior Orthopaedic surgeons from across the country.
Everything up to that point is focused on the exam and it becomes like a heavy burden across your shoulders, weighing down every decision you make. The relief of success is one of elation and freedom, as for most surgeons, this will mark the very end of a long line of academic exams. Unfortunately, for a hand surgeon, this isn’t the case. One more exam looms the British Diploma of Hand surgery.
British Diploma of Hand Surgery:
Hand surgery is a combination of both plastic and orthopaedic surgery and the Diploma is designed to cover the entire breadth of the hand surgery curriculum. It includes approx. 1200 educational hours; 32 tutorials; a literature review – amongst other coursework; a written exam and this is all followed by a 2-day viva and clinical exam.
Challenges of studying while working:
I began studying for the Diploma during my fellowship in 2017/18 at the Pulvertaft Hand Centre in Derby. Studying whilst working is difficult, especially when the commute is long, and although I achieved the majority of the required tutorials, I soon realized that I wasn’t going to be able to complete the Diploma within the year. In October 2018, I succeeded in getting a job as a consultant at Doncaster and Bassetlaw Teaching Hospitals. The task of managing theatre lists, clinics and the endless pile of admin became my main focus.
In late 2019, I refocused on the exam, but the COVID pandemic disrupted everything, making exams seem insignificant compared to what the world and the NHS faced.
Fast-forward 2 years and I’d now become an established hand surgeon. I had a choice to make… The driving force for many to work toward the Diploma is the subsequent enrichment of the CV. With this additional feather in your cap, work opportunities become more accessible. Having been a consultant in post for 4 years altered the landscape for me. I weighed up my options and discussed them with colleagues, family and friends; they asked: “If you pass, will you earn more money?”…. “No.” So why are you going to put yourself through it then?”
I also had to consider the risk of failure, in front of peers whom I admire and respect. That would surely only do my reputation damage. On the flip side, I felt like there was something missing: a small niggling feeling called regret. I didn’t like this feeling and I wanted to be assured that when I see patients, I can confidently advise them that I have studied the entire breadth of what is known about the surgery of the hand. Although it was a gamble, I decided to go for it.
The Exam Experience:
Six months of studying later, coursework and more weekends locked away from my wife and daughter, I’m in Birmingham ready to sit the clinical. Waiting for that bell to ring to go into that room, where destiny awaits is a bit like sitting at the edge of an aeroplane preparing to leap out and skydive: heart racing at 100 miles per hour. Why am I so nervous? Because this is important to me. I want to succeed.
The results arrive the following day with a phone call from the exam supervisor. It’s good news. Suddenly all that stress is worth it. My family share in my joy; it’s not just my success but our success as they have been the ones to carry me through it.