• clinical neurology
• neurosurgery

One of my teachers observed that 50% of understanding medicine involves first learning the language. Thereafter comes the accumulation of facts, alongside development of technical skills. It may be all too easy, during this protracted process, for the young doctor to lose sight of our fundamental purpose. This was summarised by another of my teachers as: ‘the duty of a doctor is to relieve suffering’. There is certainly more to surgical practice than just deciding whether or not to offer an operation. Increasingly, we need to explain why surgery may not be needed at all, or why it provides just one management option. We require a broad, holistic approach, rather than a narrow surgical perspective.

Passing the Fellowship of the Royal College of Surgeons examinations, after years of study and training, gives a young surgeon an immense lift in confidence. Yet, it marks just the beginning of a challenging future, in which this painstakingly accumulated knowledge will be put well to the test. Soon, consultant experience will start to build and, whereas factual knowledge is generally devoid of attachments, clinical experience inevitably brings with it some emotional content. This may be a sense of …