TBBB Podcast: Recent Episodes
TBBB Podcast
Top bunk bottom bunk podcast. Discussing hot topics in urology and surgery, aiming to capture both trainee, consultant, and wider MDT perspectives. Hosted by Mr Marcus Cumberbatch (@marcuskwesi) and Miss Samantha Conroy (@s_conroy91). Supported by Mr Sanad Saad on sound (@ssaad205) and Dr Rachel Hubbard on social media (@drrachelhubbard).
On TBBB this week, we go 'pink flamingo' with our two esteemed non-urology colleagues: James Tomlinson (consultant spinal surgeon and human factors lead at Sheffield Teaching Hospitals) and Peter Brennan (Professor of Maxillofacial Surgery and PhD in Human Factors). Both are leaders in the field of human factors and non-technical skill research and join us to discuss their role in surgeon performance and operating room dynamics.
We kick-off by discussing how Peter and James first became involved in human factors research/leadership, why they feel this is such an important concept to embrace as a surgeon, and how understanding human factors can help us to optimise performance. Peter highlights the HALT (Hungry, Angry, Late, or Tired) mnemonic and how surgeon awareness of these physiological/psychological issues can assist in error reduction. In the remaining discussion, we deep-dive into operating room hierarchy, training in human-factors, lessons from other professions, the role of simulation, and the GMC's stance on human error.
Don't make your operating room like a Monty Python sketch!
NOTSS Website: https://www.rcsed.ac.uk/professional-support-development-resources/learning-resources/non-technical-skills-for-surgeons-notss
CAP737 Handbook: https://publicapps.caa.co.uk/docs/33/20230222%20CAP737%20Flight-crew%20human%20factors%20handbook%20E2.pdf
In this episode of TBBB, we are joined by two key opinion leaders in endoluminal endourology. Mr Daron Smith from University College Hospital London and Mr Jake Patterson from Sheffield, who both give up 'one-unit' of time to discuss all things stone related.
Our discussion starts with current landscape of acute stone care in the NHS. We touch on the NICE and GIRFT guidelines and debate whether the 48h target is achievable in the current climate. We deliberate challenges and potential solutions towards delivering this target for stone patients, and models throughout the country that have been successful.
Daron and Jake then talk us through how to build the optimal acute stone service, in terms of logistics, equipment, and personnel required to make it happen. Finally, we discuss the challenges of centralised services - in particular, issues around access to specialist stone care and interventional radiology services. In a doubles tennis debate, Daron and Jake take a tag team, walking us through individualised strategies for stone networks, as well as, the future potential of hub and spoke working.
“The best strategy is to fix the problem”
In this week's TBBB episode, we are discussing the hot topic of surgical fellowships. However, this is not just your standard 'how to' guide for trainees looking to acquire a fellowship position, we also delve into the world of how to establish and run a fellowship programme from the perspectives of surgical mentors and the host institution.
To provide world-class insight, we are joined by two guests who run uro-oncology fellowship programmes in the UK and Internationally. First, Mr Jim Adshead, consultant robotic surgeon at The Lister Institute and RCS England-accredited fellowship programme host; and secondly, Prof Peter Black, consultant uro-oncology surgeon from University of British Columbia and associate director at the Vancouver Prostate Centre.
Our two established surgical mentors discuss the benefits and challenges of setting up a fellowship programme, the infrastructural requirements, where to find help, and how to generate excitement about your fellowship. We dig deeper into finding the right balance between training and service provision during a fellowship, which can often be a tipping point for maintaining interest in the programme. Both our guests provide food for thought on how to establish whether a trainee is right for their fellowship - particularly when coming from overseas - and the embedded processes of assessing the fellow when they first arrive. Finally, we discuss two controversial topics: whether fellowships should be advertised as fixed and part-time to be more inclusive; and how to recognise and act upon a fellow that is falling short of the mark.
Fantastic listen!
In this special episode, we welcome Prof Declan Murphy - Consultant Urologist, director of GU Oncology at Peter MacCallum Cancer Centre, and co-host of one of our favourite podcasts - GU Cast. As well as, Dr Ayo Akinwolere - BBC presenter (Blue Peter, Commonwealth Games and Winter Olympics) and founder of Milk-First production company.
The focus of this podcast was to delve into the topic of the emerging skill of broadcasting in surgery. We debate the difference between presenting and broadcasting, the need for surgeons as broadcasters, the skills (+/- equipment) required, and the potential benefits for the individual surgeon and wider community. Declan and Ayo share personal accounts of how broadcasting has revolutionised their career paths, altered their perspectives, and presented opportunities to spark change. A truly inspiring listen!
Below, we document some of the amazing pieces of work discussed in the podcast - we hope you enjoy it as much as we did!
Books:
Lend Me Your Ears by Max Atkinson
Patting the Shark by Tim Baker
Podcasts:
GU Cast’s incredible podcast episode talking to Tim Baker about his experiences
- YouTube https://youtu.be/4zLrKZyhKfM; Audio https://gucast.buzzsprout.com/904063/11712882
Website links:
Cultural Agility sessions: https://www.culturalagilitysessions.com/
Milk-First production company: https://www.milkfirstproductions.com/
Swim Dem Crew: https://www.swimdemcrew.co.uk/work-1
“Multi-consultant operating is a tool to help us push boundaries in surgical practice”.
In this fantastic episode, we delve into the world of two-consultant operating joined by our two eminent guests: Miss Archie Fernando, a consultant urologist at Guy’s Hospital, London, specialising in open and robotic retroperitoneal surgery ; and Mr Paul Rooney, our first colorectal surgeon on the show, who is a complex pelvic oncology consultant surgeon at the Royal Liverpool.
Archie and Paul provide a welcome debate about the circumstances for which two-consultant operating is “essential” or “desirable”, both within specialities and in cross-speciality cases. We then probe further into the benefits and drawbacks of multi-consultant operating with regards to service provision, cost, consultant mentorship, skill attrition, and training opportunities. Archie and Paul share some handy tips and tricks to avoid problems during two-consultant procedures. We also briefly mention Paul’s beautifully written publication in the RCS Bulletin on the topic (link: https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2018.329).
“One person’s inoperable, is another person’s operable. That’s the beauty of teamwork.”
Finishing World Vegan Month, we are delighted to release our second episode exploring the impact of vegan diet on health with the BOSH TV superstars Henry Firth and Ian Theasby. BOSH! is one of the most viewed vegan-recipe channels, where they have racked up over 3 billion views of their delicious vegan recipe videos. On top of that, they have sold 5 million products, 1 million recipe books, and have over 3 million followers on social media.
In this episode, Ian and Henry share their journey to becoming vegan, the impact it had on their health, and how this led them to sharing their love of vegan food through their business BOSH! Not only do we explore the health benefits, but also how a vegan diet can help to support action against climate change. Finally, we discuss how BOSH! are trying to make vegan diets more accessible to everyone - even in a cost of living crisis that is affecting people worldwide.
Maybe we all need to take some steps towards “eating the rainbow”?
For more details about BOSH! and their most recent recipe books, visit their website using the following link: https://www.bosh.tv
In this week’s episode, we build on upon the theme of surgeon wellbeing by discussing the highly relevant topic of surgeon burnout. We were joined by two fantastic guests with expertise in this area: Firstly, Miss Alice Hartley - Urology Registrar and Chair of the RCSEd Anti-Bullying Campaign; and secondly, Dr Jonathan Houdmont - Assistant Professor of Occupational Health and Psychology at The University of Nottingham.
This spirited episode opened with defining burnout and ways of identifying burnt-out surgeons, before getting to grips with the data on the scale of this problem in our surgical workplace (J Houdmont paper “Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study” 2022, World J Surg (https://pubmed.ncbi.nlm.nih.gov/34704146/)), and also within the urological community (F O’Kelly et al. 2015 BJUI “Rates of self-reported ‘burnout’ and causative factors amongst urologists in Ireland and the UK: a comparative cross-sectional study” (https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.13218)).
We expand on - with particular concern - the issue that junior surgical trainees seem to be the most severely affected by burnout.After discussing the problem, it was time to brainstorm mitigating solutions. Miss Hartley describes the essential impact of workplace culture and environment on burnout, before exploring some of the practical solutions to combating this problem.
“Fundamentally, work should not affect our health”
Following on from the first of this fantastic two-part series, we speak to Mr Arjun Nambiar, consultant in robotic and reconstructive urology in Newcastle about his bespoke career. His unique reconstructive consultant post involves a combination of reconstructive urology and robotic pelvic oncology work. He describes the incredible breadth of skill he developed across his RCS-accredited female and functional urology fellowship in Newcastle, which provided an opening to explore robotic surgery. As a fellow, he trained with the pelvic oncology team to increase his case-load in robotic surgery that he was then able to transfer to the reconstructive space. ess to learn robotics led to the synthesis of an exciting and unique opportunity.
With this unique "hybrid" consultant role, we probe Mr Nambiar on the benefits, challenges, available evidence, and scope for more widespread implementation of robotics in reconstructive urology, and what it will take for this to become better utilised. In particular, we focus on unique opportunities to engage in robotic cystectomy, and given the recent iROC results, the potential longer term impact on patients having robotic cystectomy for benign disease.
"You’re going to be a consultant for a long time, the most important thing is that you have the skills you need when you get there, to do it well."
This week, we welcome Mr Tim O’Brien and Professor Kevin Turner to discuss the important topic of surgeon wellbeing after adverse events. In this episode - titled: “Surgeons as the second casualty” - we explore a spectrum of engrossing personal experiences, from two distinguished consultant urological surgeons, to exciting new developments in surgeon wellbeing research.
We discuss the impact of both errors and complications on surgeons, mechanisms to better prepare surgeons, and the wider implications on the surgical team. We expand on Kevin’s recently published article (“Surgery Harms Surgeons. What Can We Do?” J Urol https://doi.org/10.1097/JU.0000000000002861) in some gripping discussion on the individual and systematic approaches to enhancing surgeon wellbeing when these events occur. We also reflect upon the RCS England recommendations for supporting surgeons after adverse events (https://www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-practice-guides/supporting-surgeons-after-adverse-events/), which aims to offer guidance to surgeons - and their institutions - in the better preparing for, and subsequently managing, the consequences of such significant events.
#pauseforgauze
This week we lure Professor Christopher Chapple away from his bee-keeping and fishing to deep-dive on his career and discuss some controversial topics in reconstructive urology, such as, the future of robotic training in reconstruction.
Prof Chapple is our first ‘in-studio’ guest and is an internationally renowned figure in urology. He is Professor Emeritus of Urology at Sheffeld Teaching Hospitals and Secretary General of the European Association of Urology. With over 850 publications and 30,000+ citations, his reputation as a world-leader in reconstructive/functional urology is irrefutable. His words travel and resonate with all of us in the field. Having recently retired from clinical practice, we probe Prof Chapple on his views of the current landscape of the specialty, future avenues of research, and highlights from this years’ EAU congress in Amsterdam.
As always, Prof Chapple delivers high quality information with that air of historic nostalgia and authority we have come to love. Furthermore, he gives his golden tips for trainees aspiring to positions within EAU, education, and functional urological practice. An episode not to be missed!
Today, we discuss the positive impact of an ‘all-plant’ diet in offsetting prostate cancer risk and perhaps even reducing prostate cancer progression with Prof Stacy Loeb of New York University. We centre the discussion around a recent publication by Natasha Gupta and Stacy’s academic group (https://pubmed.ncbi.nlm.nih.gov/35790788/) published in Prostate Cancer Prostatic Dis. This systematic review, containing 5 interventional studies and 11 observational studies, provides strong evidence that we as urologists should be discussing dietary patterns with our patients (in a way that occupational histories are taken in bladder cancer) and that much good and little to no harm can come from such lifestyle modifications.
We also tackle the tough question of “how” to implement interventional studies on such topics. Myths are dispelled about the challenges of going ‘all-plants’ including: cost, convenience, variety, the need for supplements, and much more. We briefly discuss educational resources available to clinicians and patients as well as documentary series.
The train seems to be leaving the station here! Listen as our co-hosts are welcomingly surprised to uncover the genuine carcinogenic risks posed in the everyday diet and how much we can do as a surgical community to help fight for sustainability.
During this inaugural episode of the Top Bunk Bottom Bunk podcast series, we interview the newly appointed president of BAUS (British Association of Urological Surgeons) Ms. Jo Cresswell and the president-elect of the RSM (Royal Society of Medicine) Urology section Ms. Nadine Coull.
Life stories, ambitions, mottos, successes and tribulations are exchanged, as we try to uncover what it takes to be a successful leader in modern surgery.
Through this episode we feel a renewed optimism for the future of our specialty and a sense that staying grounded, true to oneself, and having those listening ears on high-alert, are the key qualities in running an organisation. Afterall, “there is a humility borne of spending many hours surrounded by puddles of wee that makes arrogance and self-importance seem a little silly” (Jo Cresswell, 2020).