Getting Into…Neurosurgery

An important part of our mission here in the APH is to demystify the world of work and careers. We often take for granted how difficult it can be to access information about what is required to succeed in a particular discipline.  This is why we routinely interview aspiring professionals and share their personal stories of the steps they took to excel in their careers.  Recently, Amara had the opportunity to interview Dr Andrew Alalade, a neurosurgeon with a subspeciality interest in skull base tumours and discuss his #MyCareerStory of building a successful career in Medicine in the UK as an international medical graduate. 

APH: Please can you tell us about your educational and professional background? 

AA: My  school education started in the United Kingdom but I moved back to Nigeria and studied Medicine at the University of Ibadan. I returned to the UK to work on rotation as a Foundation Year 2 doctor.  My neurosurgical residency training was done in the London North Thames rotation and I had the privilege of training in some of the United Kingdom’s top neuroscience centres. I am a Fellow of the Royal College of Surgeons, England (FRCS SN) and a Fellow of the European Board of Neurosurgical Societies (FEBNS). On completion of my training, I obtained my Certificate of Completion of Training (CCT) in July 2016. The CCT confers the title of specialist Neurosurgeon at Consultant level, which gives permission to practise as one in the United Kingdom.

APH: Why did you choose Neurosurgery? What were your biggest challenges to achieving your goal?

AA: A bit of a weird story, that one. In a science class as a 13-year-old, I was extremely fascinated by the brain and the spinal cord. I kept thinking of the intricate networks within the central nervous system and decided shortly afterwards that I wanted to become a neurosurgeon. A lot of people find it riveting that someone could decide that early in life on a career.  At my 30^th birthday party, a former secondary school mate brought our school year book to the party and showed everyone what I had written as my future ambition – “To Be A Neurosurgeon”.

In my second year of medical school, my Dad was diagnosed with a brain tumour. The episode consolidated my decision, and left an indelible mark as I still vividly remember the turbulent experiences my family faced at the time. Fortunately, I have learnt to draw from the memories of that bleak period when interacting with my patients. There is nothing that beats having a surgeon/doctor who has encountered the same experience(s).

While my dad was on admission at the time, I sent a letter to the surgeon who operated and asked for advice on becoming a neurosurgeon. We kept in touch via email correspondence for a few years. He was extremely impressed when we met about 15 years after when my Dad had a follow-up appointment with him. By then, I had become a Neurosurgery registrar.

The biggest challenge for me was meeting people who told me it would be impossible to train as a neurosurgeon in the United Kingdom. There was no black senior neurosurgeon to look up to in my junior doctor jobs, and the few I heard about were not in the formal neurosurgical training programme. Several colleagues made it clear that not having done my medical school education in the United Kingdom would be a demerit of some sort. I was determined to succeed, and would stay up late reading my neurosurgical texts and spending time in the neurosurgical theatres.

APH: What are the essential skills and attributes required to succeed in Medicine and Neurosurgery in the UK?

AA: A lot of my early experiences have in some way or the other contributed in making me succeed as a doctor and Neurosurgeon. I have always had a good memory, especially the “fine details”. My military school education gave me a steely “inner strength” and my time at the University College Hospital, Ibadan taught me ‘giving up wasn’t an option’.

Our job is patient-centred, so apart from the attributes I have already mentioned, good communication skills, brilliant team-work ethic and the determination to pull out all stops for the sake of the patient are obligatory.

APH: What advice do you have for anyone considering Medicine/Neurosurgery as a career in the UK?

Personally, I believe that knowledge is available to all worldwide. However, opportunities are not equally available to everyone. To succeed and get the right opportunities, you need to painstakingly do your research, plan way ahead, know what all your possible options are and then implement what you have learnt. Speak to people who have already done what you intend to do, and get loads of advice from them. Try your best not to be dissuaded by the naysayers, and just focus on your goals.

It does not hurt to monitor international or national events closely e.g. new government policies, guidelines, forthcoming changes etc to have a good grasp of events and why they are happening. It also means you will most likely be “at the right place at the right time”. It doesn’t always work, but one can as well try.

APH: What does a typical working day look like?

AA: I am usually up by 5:30am before the rest of my family get up. I aim to get to work by 7:30am or even earlier if I am operating. Patients appreciate the surgeon’s reassurance before their procedures. The operating lists usually last through most of the day, and I also do my best to see my patients and their family members after the surgery. The discussions after surgery are as helpful to the patient and their family as the surgery, and I do not underestimate the benefits of this at all.

On other days, I review patients in clinics or see them on the wards. Clinic consultations are mainly for elective patients or patients who have had surgery, so I do my best to discuss elaborately in layman’s terms and I often use drawings which makes it more interesting. On other occasions, I engage in academic and/or administrative responsibilities e.g. teaching junior colleagues, writing papers and keeping up-to-date with the latest neurosurgical innovations.

APH: What do you wish someone else had told you before you started?

AA: That formal neurosurgical training in the United Kingdom takes a long time (compared to equivalent programmes in other countries). After medical school, it takes at least 10-11 years to get to the CCT stage. To be honest, with all the factors that affect medical training these days, it is worth it as you come out very competent.

Just after high school, I also feel that if someone had mentioned getting a student loan to study at Harvard was possible, my career pathway might have been different. Somehow, I persuaded my parents that I wanted to write the SAT exams after completing my secondary school education. I went for the examination, and did very well. Months later, the admission booklets for pre-med at Harvard were sent to my home address. Unfortunately, the annual fees were over $30,000 and my parents could not afford it. Years later, I learnt from some friends it could have been possible if I had applied for a loan but we had no idea of these options at the time. We did not even think of it. If only someone had told us.

Looking back now, I still became a neurosurgeon, albeit through another route but I still can’t help but think of what could have been if I knew what all the possible options were. That’s definitely ONE LESSON LEARNT!

APH: Is a mentoring relationship  something you recommend or have found valuable? Why?

AA: I have had the awesome opportunity of learning from some of the world’s best neurosurgeons. Having a mentor is absolutely important. More senior colleagues like Prof. Temitayo Shokunbi, Dr Nelson Oyesiku, Mr Neil Kitchen, Dr Theodore Schwartz, Prof. Michael Gleeson and Prof. Ben Panizza have all been helpful to me at different stages of my career.

I would definitely recommend having a mentor as they are more experienced and their invaluable advice helps to keep you on the right track. A smart mentee would gather positive learning points from several mentors and put them to some compelling synergistic effect.

APH: What achievements are you most proud of? What have been your most profound learning experiences aka mistakes that you are happy to share?

AA: Like I suggested earlier, one of the main challenges for international medical graduates (IMGs) in the United Kingdom is the difficulty of getting into formal residency training. Fortunately, I was one of 9 successful candidates at the national neurosurgical interviews in 2010 and got appointed to the third year of the neurosurgical training programme in London. I still remember the disbelief on the faces of colleagues when they learnt I had my medical education outside the UK. Completing my neurosurgical training without any extensions was also a big achievement for me.

Holding key responsibilities is a ‘big deal’ for me, as I always want to serve and contribute, rather than be a bystander. Being a member of the British Neurosurgical Trainee Association (BNTA) Executive Committee from 2011 to 2014 taught me so much, and I hope to consolidate on this again in the future.

Neurosurgery on its own is already a very busy job. Combining that with other responsibilities could be overwhelming, so I usually have to remind myself to take breaks and check my target objectives regularly.

APH: I know you are active on social media – how important do you think social media tools are to professionals trying to develop their careers or businesses? What are your top tips for building a LinkedIn profile?

AA: Social media has become an integral part of our lives. It has definitely come to stay. A lot of junior colleagues have contacted me via multiple social media platforms, for advice or even to ask me to mentor them. I have never even met many of them – this won’t have been possible without the social media, and would not have been possible years ago. Connections and network systems previously unimaginable are now easily accessed, and the amount of information is unbelievable.

A LinkedIn profile is somewhat like an online CV. Take time to show your outstanding qualities and achievements. I know a few friends, who have been head-hunted via LinkedIn, so having a well written profile definitely helps. Make sure you upload a picture too – humans are visual beings, and a large chunk of the brain is devoted to processing visual details.

APH: Finally, how do you maintain a sense of balance while juggling your different roles – both personal and professional? 

AA: This has been one of my biggest challenges. I am married to my medical school sweetheart, and we have got the world’s two cutest children. I still get eerie memories of when my daughter (a 5-year-old at the time) asked me why I never dropped her off at school like the other Dads. Months later, when I had some time off and went to pick her up from school……. you should have seen her face. I don’t think I have ever seen her as excited as she was that day.

The secret is to try to make every second count – whatever you do and whenever you do it, make sure it’s done well. I work very hard when I am at work, and equally I do my best to be a good family man when I am at home. Having a supportive partner helps too. There have been several times when I get inundated, and it’s my wife’s support and trust in me that keeps me going.

About the author: Andrew F. Alalade FRCS (SN), FEBNS is a Neurosurgeon with a subspecialty interest in skull base tumours. Andrew has occupied key positions within several surgical trainee national organisations – he was an executive member of the British Neurosurgical Trainee Association and council member of the Association of Surgeons in Training (ASiT) from 2011 to 2014. An author of multiple publications, he has also won several surgical training awards. He tweets @AFAlalade.

Thank you Andrew for sharing your #MyCareerStory with us. If you enjoyed reading this article, please share and subscribe to our network! Would you like to share an article in The Hub? We would love to hear from you. Please get in touch – info@aspiringprofessionalshub.com.