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First Incision

Amanda Nikolic

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A podcast about preparing for the General Surgery Fellowship Exam. Each year, Australian and New Zealand surgical trainees sit this exam in order to gain a 'fellowship' in General Surgery. This podcast follows one trainee doctor on her journey towards FRACS (Fellowship Royal Australian College of Surgeons). The series correspond to the different modules from the surgical curriculum. Series 1-Breast Surgery, 2-Exam Specific Episodes; 3-Upper Gastrointestinal Surgery; 4-Colorectal Surgery; 5-H ...
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This episode covers the topic of chest trauma, with the James Mckay, an incredible general surgeon, trauma surgeon, and dual trained intensive care physician. Topics covered include: - rib fractures - flail chest - blunt cardiac injury - chest drains - resuscitative thoracotomy And more! Disclaimer The information in this podcast is intended as a r…
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This guest episode with colorectal surgeon Chris Wakeman focuses on the common familial cancer syndromes. For each we go through diagnosis, genetics, surveillance, management, decision making and more. Topics include: - Familial Adenomatous Polyposis (FAP) - Lynch Syndrome - Serrated Polyposis Syndrome - Oligopolyposis Here are some resources Dr Wa…
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This episode is the first part of a series that has been produced in collaboration with the Australian and New Zealand Training Board in Colon and Rectal Surgery (ANZTBCRS). It has come out of work prepared for the Colorectal Fellow's Training Weekend held in Adelaide in August 2023. Henry Drysdale won the Phillip Douglas Prize for his presentation…
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For this guest episode we are joined by Dr Simon Richards, as colorectal surgeon from Christchurch New Zealand. This episode is a masterclass in Total Neoadjuvant Therapy (TNT) for Rectal Cancer. We cover: - the traditional paradigm of rectal cancer management and how it's progressed to where we are now - what is TNT - what is 'watch and wait' and …
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On this guest episode we are joined by Dr Carla Gillespie, an UGI, bariatric and general surgeon from Sydney to cover the topic of bariatric surgery. We cover: - pathophysiology - types of operations - considerations when deciding what operation - complications - immediate and late - how to remove a lap band - and some general exam and career advic…
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From the vault (courtesy of Tara who found it). This episode covers the topic of intestinal failure. It includes: - definition - classification - pathophysiology - prevention - the three phases - intestinal adaptation - management - complications (short and long term) Disclaimer The information in this podcast is intended as a revision aid for the …
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In this week's 'Christmas Special' episode I am joined by Ashwini Pondicherry and Jamie Crichton to reflect on our first year of fellowship. We discuss some of the good things about this transition, but also some of the more difficult and formative aspects and how we negotiated them. The step from registrar to fellow/consultant is a HUGE one and we…
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Our first episode back (in a while - sorry!) is an incredible guest episode that is worth the wait. We talk through a series of breast cancer cases with Ashwini Pondicherry, the current breast fellow at Christchurch hospital, to cover a wide range of topics in breast cancer. This includes some updates from the original breast cancer episodes (which…
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This guest episode covers the essentials you need to know when talking about operative surgery in inflammatory bowel disease. We are joined by colorectal and general surgeon Mr Michael Johnston who has significant experience in looking after these patients. We talk about: - ileocolic resections - what to do with crohn's fistulas to the sigmoid - st…
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In this episode we go into some of the pathologies that can affect the salivary gland, as well as the different neck infections we need to know about. Topics covered include: Salivary Gland Pathology - Salivary gland calculi (sialolithiasis) - Infections / Inflammation including sialadenitis - Plunging ranulas Cervical Infections - Compartments of …
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On this guest episode, we talk to Anthony Payne, a financial and tax consultant with DPM Financial about some of the financial changes we will face transitioning from being a registrar to fellowship and consultancy. Some of the topics we cover include: - Transitioning from employee to sole trader, and the implications on this for Tax, Super, Insura…
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In this first episode from the Head and Neck module of our curriculum we touch on salivary gland pathology. Including: - Salivary gland anatomy - including the parotid and submandibular glands. As part of this we cover the important anatomical relations and the parasympathetic supply (highly examinable!) - Common tumours of the salivary glands and …
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This week we are joined by the incredible urologist Dr Anita Clarke to talk about all things urology! We cover: - the benefits of multidisciplinary surgical approach - putting in a ureteric stent - the diagnosis and management of bladder cancer (for general surgeons) - management of intra-operative ureteric injuries - the difficult urinary catheter…
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Welcome to this guest episode with A/Prof Phil Carson. A/Prof Carson is a general surgeon from Darwin and the most recent ex-censor in chief of RACS. We are lucky enough to have him for this special episode to cover a range of topics filled with pearls and insights from his varied and interesting career. We cover: - some background into his life as…
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We are lucky enough this week to be joined by the incredible Kellee Slater - HPB and hernia surgeon from Queensland. In addition to being an incredible surgeon, researcher, published author and presenter, A/Prof Slater has been extremely generous and joined us to cover topics from the hepatobiliary and transplant modules. I hope you enjoy listening…
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I'm back! After a nice break holidaying around Italy I bring you an introduction to the transplant module! Hopefully this covers enough background to get started with the module including transplant immunobiology, immunosuppressive medications, criteria for organ donation and complications of immunosuppression. Disclaimer The information in this po…
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I know I promised you all a series on urology but I'm taking a break this week and releasing a bonus episode from the vault! This episode covers all the appendiceal pathologies from the 'emergency' module of the curriculum: - acute appendicitis - appendiceal tumours including adenocarcinoma, mucinous adenocarcinoma, mucinous neoplasms, goblet cell …
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This episode continues our foray into the urology topics we need to know for our general surgical exams. We cover: - testicular tumours including the presentation, subtypes, workup, radical inguinal orchidectomy and management - Varicoceles - Hydroceles (including some operative points on Jaboulay and Lord's procedures) - and epididymal cysts Discl…
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From the abdominal wall, retroperitoneum and urogenital module from the curriculum I bring you the first in a series of podcasts covering urology! We have to know quite a few urology topics for our exam, but where better to start than by covering anatomy and embryology. In this episode we cover the clinically relevant anatomy of: - the kidneys - ur…
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This episode is number 3 in our series of pathophysiology quiz episodes. We cover pathophysiology topics from the following modules: - sepsis and critical care - nutrition - skin and soft tissue - trauma - vascular, and - abdominal compartment syndrome Disclaimer The information in this podcast is intended as a revision aid for the purposes of the …
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This episode is number 2 in our series of pathophysiology quiz episodes. We cover pathophysiology topics from the following modules: - Upper GI - Breast - Colorectal - Emergency - Head and Neck Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This information is not to…
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After the success of our Genetic Syndrome's Quiz episode, we bring you the first in a series of Pathophysiology quiz episodes! This episode is in a question and answer format - where I ask a question and give you time to think of the answer before giving it to you. We cover a variety of pathophysiology questions from the endocrine, small bowel, bar…
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After a short hiatus First Incision is back! This episode goes through the definitions of all the conditions which may affect our critically ill surgical patients. It also goes through the pathophysiology of these conditions. We finish off by talking a little bit about some of the medications that may be used by the ICU for these critically ill pat…
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Hi everyone! We're trying something different this week with a new format for the podcast. This episode covers a range of genetic syndromes that we need to know for the exam. The format is a 'call and respond' or 'question-answer' type format where I ask a question and give you a chance to see if you know the answer before telling you myself! You m…
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Spoiler alert - We Passed! In this week's episode we reflect on the exam and the whole process of preparation for and actually sitting the exam. We are joined by Ben Finlay (circa the trauma podcasts) to share his experience as well! We discuss: - exam preparation - study group - tutorials and other resources - the written exam - the viva exam - pr…
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This week's episode covers retroperitoneal sarcoma. Another difficult sarcoma topic most trainees wouldn't see during their training. This episode covers the presentation, subtypes, workup and management of these tumours. It also features a discussion with Dr Julie Howle, a medical oncologist from Westmead Hospital who has been so helpful discussin…
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This week's episode covers everything we need to know about soft tissue sarcomas. There are so many sarcomas it can feel a bit overwhelming, so this episode breaks it down into what we need to know as general surgeons, and for the exam. It features some of my discussions on this topic with the incredible Dr Julie Howle - a surgical oncologist from …
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This week's episode finishes our series on limb anatomy! This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes covered the anatomy and also the clinically and surgically relevant anatomy for each area. Disclaimer The information in this podcast is intended…
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This week's episode continues our series on limb anatomy. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Also happy birthday to me! :) Disclaimer The inf…
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This week's episode completes the upper limb component of our series on limb anatomy. Limb anatomy is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Good Luck to everyone sitting their clin…
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This week's episode is the second in our series on limb anatomy. This week we cover the anatomy of the forearm and cubital fossa. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant…
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This week's episode kicks off a series on limb anatomy. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Disclaimer The information in this podcast is inte…
  continue reading
 
This episode covers the topic of aneurysmal disease from the vascular module of the general surgical curriculum. We cover: - definition - classification - pathogenesis - risk factors - natural history focussing on abdominal aortic aneurysms - management Disclaimer The information in this podcast is intended as a revision aid for the purposes of the…
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This episode covers what we need to know about the diabetic foot - a favourite topic for the general surgical exam. - background - pathophysiology - workup and important factors to consider - classification systems - management - some information about charcot neuroarthropathy Disclaimer The information in this podcast is intended as a revision aid…
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This week's episode covers the topic of venous disease. This includes varicose veins and venous hypertension (chronic venous insufficiency). - the epidemiology - anatomy of lower limb veins - pathophysiology of chronic venous htn and the consequences of this disease (haemosiderin deposition, lipodermatosclerosis and venous eczema) - classification …
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This episode covers everything we need to know about acute limb ischaemia. - definition - aetiology - risk factors - severity assessment - pathophysiology - presentation - workup - management Including how to perform embolectomy and fasciotomy Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General S…
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This week's episode starts us off with the vascular module of the general surgical curriculum. We cover chronic limb ischaemia, also known as chronic arterial disease. - definition - presentation - pathophysiology - risk factors - the rutherford classification - workup - severity classifications - management Disclaimer The information in this podca…
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This week's episode covers the sweat-gland related pathologies covered in the skin and soft tissue module: Starting with anatomy of the sweat glands and the autonomic nervous system. Hyperhydrosis including - presentation - primary and secondary causes - management Hydraadenitis Suppurativa - presentation - pathophysiology - diagnosis - classificat…
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This week's episode covers everything you need to know about basal cell carcinoma including - presentation - risk factors - histological subtypes - poor prognostic factors - management including topical treatments, surgery, radiotherapy and targeted treatments Disclaimer The information in this podcast is intended as a revision aid for the purposes…
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This week's episode covers everything you need to know about cutaneous squamous cell carcinoma. - presentation - risk factors - premalignant lesions - histopathology - workup and when to stage - grading - TNM staging - poor prognostic markers - management including topical treatments, surgery, radiotherapy, systemic treatments and nodal treatment D…
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This week's episode covers the topic of Merkel Cell Carcinoma - a favourite question in the exam. We have added the discussion we had with Dr Julie Howle onto the end of this episode. Dr Howle a surgical oncologist from Westmead Hospital who has an interest in these rare cancers. We cover: - background - risk factors - pathogenesis - presentation -…
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This week's episode welcomes our guest Dr Julie Howle who is a surgical oncologist from Westmead Hospital in Sydney. We cover a wide range of topics related to management of melanoma including: - precursor lesions - whether ulceration relates to the clinical or histopathological diagnosis of ulceration - when to perform systemic staging for melanom…
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This week's episode continues on from last week to discuss the management of Melanoma This episode covers: - wide local excision and the surgical margin - lymph node biopsy and when to perform it, as well as a summary of the MSLT 1 and MSLT2 trials - the role of lymphadenectomy - the role of radiotherapy in melanoma - systemic therapy including the…
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This week's episode introduces us to the topic of melanoma We cover: - Risk factors - Precursor lesions - Histopathology and important histopathological features related to poor prognosis - Melanoma types and their appearance including superficial spreading, nodular, lentigo maligna melanoma, acral lentiginous, and desmoplastic - Workup including e…
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This week's episode introduces us to the topic of 'skin'. I know it seems weird that I would do an episode just on this but bear with me! The topics covered include: - the function of the skin as an organ - histopathology of the layers of the skin - Fitzpatrick skin types - history and examination of a skin lesions - principles and pathophysiology …
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This week's episode covers the useful topics of topical haemostatic agents and anticoagulants. We discuss principles of haemostasis, the coagulation cascade, how topical haemostatic agents work, the different classes and when to use them. We also cover anticoagulants, the different types, how they work, when to stop them before surgery and how to r…
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This week's episode is co-hosted by Ben Finlay. We cover a wide range of topics including: Burns - initial resuscitation including the parkland formula - assessment of depth and extent of burns (rule of nines - burns management - frostbite Blast injuries - pathophysiology - management Extremity compartment syndrome and how to perform fasciotomy The…
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This week's trauma episode is presented with our guest host Ben Finlay. We cover hollow viscus injuries including: - gastric - duodenal - small bowel - colonic, and - rectal injuries We also cover pelvic trauma including: - pelvic fractures and the Young and Burgess classification - pelvic bleeding management including how to perform preperitoneal …
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This week's episode welcomes back Ben Finlay to help present abdominal trauma. We go through: - trauma laparotomy - liver trauma - splenic trauma - pancreatic trauma - renal trauma - and retroperitoneal haematomas and what to do with them! Special mentions include how to do right and left medial visceral rotations, and some operative decision makin…
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This episode explores blunt and penetrating neck trauma with special guest Ben Finlay. We discuss: Blunt cerebrovascular injury including: - the grading system - Denver screening criteria - diagnosis - management Penetraing neck trauma - zones of the neck - hard and soft signs of vascular and aerodigestive tract injuries - approaches to management …
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