Courses Don’t Make Experts, Practice Does
There is a quiet but persistent myth in modern professional life: attend a course, receive a certificate, and emerge somehow transformed into a competent practitioner. … Read more
ReadThe blog
Notes from both theatres.
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Trauma education, medical school guidance, and reflections from twenty-five years at the sharp end — written the way he teaches: plainly, and from experience.
What Future Conflict Will Really Look Like
We tend to imagine the next war using the language of the last one. Frontlines. Forward operating bases. Evacuation corridors. Protected rear areas. Helicopters lifting … Read more
ReadExpertise Is Earned With Your Hands
There is a particular confidence that comes from having done the thing yourself. Not read about it. Not watched someone else do it. Not quoted a … Read more
ReadThe Resource We Keep Forgetting
There is a great deal of conversation at the moment about prolonged field care, about evacuation denial, about scarce skill sets, high-value clinicians, and the … Read more
ReadWhy the Four-Person Expeditionary Surgical Team Is No Longer Optional
For decades, military medicine has been built around a comforting assumption: that there will always be a place behind the fight where casualties can be … Read more
ReadVomiting Blood: When the Gut Bleeds Loudly
There are few sights in medicine that still silence a room. A patient vomiting blood is one of them. Bright red or coffee-ground, slow or … Read more
ReadChange in Bowel Habit and Rectal Bleeding: When the Gut Changes Its Mind
Few symptoms unsettle patients more than a change in bowel habit or the sight of blood where none should be. Stools, after all, are deeply … Read more
ReadAbdominal Swelling: When the Abdomen Is Trying to Explain Itself
Abdominal swelling is one of those presentations that looks deceptively simple. The patient points to their abdomen and says, “Doctor, it’s getting bigger.” What they … Read more
ReadEvery Curve Ball Is Still a Ball: Lessons From the Trauma Table
In trauma, unpredictability is not an anomaly, it is the environment. You can be as prepared as any human being possibly can be: your drills … Read more
ReadNever Become the Monday Morning Quarterback
There is a particular kind of behaviour that appears after every conflict, every kinetic deployment, every traumatic event where clinicians and medics have intervened under … Read more
ReadBlue-Sky Fantasies and Battlefield Realities: Why Drone Evacuation Will Not Save Us
Every few years, a new generation of technology arrives with great fanfare and an even greater promise: this time, finally, war will become cleaner, safer, … Read more
ReadGroin Hernias: When Anatomy, Gravity, and Bad Luck Collide
The groin: small region, big problems Few areas of the body punch above their weight like the groin. It’s a crossroad of vessels, nerves, muscles, and … Read more
ReadAnterior Abdominal Wall Hernias: When the Gut Decides to Step Outside
The great escape… The abdominal wall is a masterpiece of engineering, layers of muscle, fascia, and peritoneum that hold back the constant pressure of life: … Read more
ReadThe Most Important Resource: The People Beside You
There comes a moment in every career, sometimes early, sometimes far too late, when you realise that the most vital resource you will ever possess … Read more
ReadLarge Bowel Obstruction: When the Colon Says “Absolutely Not”
The day the colon stops cooperating If small bowel obstruction is the frantic traffic jam of the gut, large bowel obstruction is the motorway shutdown, slower to … Read more
ReadThree Worlds, One Team: Preparing for Contingency, Humanitarian, and Kinetic Deployments
There is a quiet truth that every experienced deployable clinician eventually comes to understand: we do not train for one type of world, but for … Read more
Read“When the Bowel Hits a Dead End: A Night on Call With Small Bowel Obstruction”
It always starts with a sound… A low, hollow gurgling echo drifting across the ward. If you’ve been a surgeon long enough, you learn to … Read more
ReadFrom Frontline to Killzone: How Modern Warfare Has Erased the Middle Ground
Because the battlefield has changed, and pretending otherwise gets people killed. The Frontline We Used to Know There was a time, and it’s not ancient … Read more
ReadThe Calm in the Storm: What Trauma Really Demands of You
Because when everything is falling apart, someone has to hold the centre. Trauma Is Noise – Deafening, Unforgiving Noise Alarms blaring. Monitors screaming. People rushing. … Read more
ReadKeeping a Level Head: Lessons I Learnt the Long, Hard Way
If I’m honest, controlling my temper was never something that came naturally. Not at the beginning. Not even halfway through my career. It has taken … Read more
ReadDoing the Right Thing vs Doing Things Right
Because perfection without purpose is just noise. The Subtle Difference That Changes Everything It sounds like wordplay, doesn’t it?Doing things right versus doing the right thing.But in trauma, … Read more
ReadPeptic Ulcer Disease: When Acid Bites Back
A small sore with big ambitions The stomach, that muscular bag of acid and appetite, is built for abuse. It churns, digests, and disinfects, bathing … Read more
ReadChronic Pancreatitis: When the Fire Never Quite Goes Out
A smouldering rebellion If acute pancreatitis is an explosion, then chronic pancreatitis is the slow, relentless fire that follows.The pancreas, once inflamed, never fully forgives. It heals, yes, but … Read more
ReadAcute Pancreatitis: When the Pancreas Goes Rogue
A fiery organ with a short fuse If there’s one abdominal organ that holds a grudge, it’s the pancreas.You can neglect it for years, overload it … Read more
ReadThe Edge of Hope: How to Speak When They Might Not Survive
Because sometimes, you have to hold someone’s hope without lying to them. The In-Between There’s a particular kind of silence in trauma, the one that … Read more
ReadThe Hardest Words: Breaking Bad News in Trauma
Because all the training in the world doesn’t prepare you for this. The Longest Walk There’s a moment, after the adrenaline, when the monitors have … Read more
ReadThe Hidden Wound: Managing Duodenal Trauma
Because when the duodenum is injured, it doesn’t bleed, it waits. The Quiet Saboteur The duodenum sits there, tucked away behind the liver and stomach, … Read more
ReadThe Third Kingdom, Obstructive Jaundice: When the Bile Can’t Get Out
When the pipes are blocked, pressure rises… In the First Kingdom, bilirubin production was too high.In the Second, the liver cells were under attack.But in the … Read more
ReadThe Silent Killer: Understanding Blunt Abdominal Trauma
Because sometimes, the most dangerous injuries are the ones you can’t see. The Calm Before the Collapse Blunt abdominal trauma rarely announces itself.There’s no arterial … Read more
ReadThe Hollow Fury: Managing Gastric Trauma
Because a hole in the stomach is never just a hole. The Setup Blunt trauma loves the liver. Sharp trauma loves the stomach.And when the … Read more
ReadThe Second Kingdom, Hepatocellular Jaundice: When the Liver Itself Falls Ill
When the gatekeepers go on strike… In pre-hepatic jaundice, the liver was overworked but otherwise innocent.But in this Kingdom, the liver itself is the problem. Hepatocellular jaundice … Read more
ReadThe Quiet Traitor: Pancreatic Trauma and Its Deadly Neighbours
Because the pancreas doesn’t shout when it’s injured, it whispers, waits, and then destroys. The Lie of First Impressions Pancreatic trauma rarely looks bad at … Read more
Read“The First Kingdom: When the Blood Turns Against Itself”
There’s nothing wrong with the liver… yet. When you see a jaundiced patient, most people (students included!) immediately point to the liver and say, “Aha! … Read more
ReadWhen Pressure Wins: Post-Trauma Abdominal Compartment Syndrome: With and Without Laparotomy
Because sometimes, the abdomen becomes the enemy. The Silent Strangler Abdominal Compartment Syndrome (ACS) is one of trauma’s cruellest tricks.The bleeding stops. The repairs are … Read more
ReadDamage Control Laparotomy: When Seconds Save Physiology
Because sometimes the victory isn’t closing, it’s coming back tomorrow. Start With the Truth Definitive surgery is a luxury.Damage control is survival. By the time … Read more
Read“Why is My Patient Yellow?” A Surgical Take on Jaundice
When yellow tells a story There are few things as striking in medicine as jaundice. A patient walks in, and before they’ve even said “hello,” … Read more
Read“When the Gallbladder Loses Its Temper: A Surgeon’s Take on Acute Cholecystitis”
A quiet organ that suddenly turns dramatic You know those people who are calm and composed until, one day, they just explode?That’s the gallbladder for you. … Read more
ReadAbove or Below the Line: Managing Stab and Ballistic Trauma to the Right Upper Quadrant
Because the liver isn’t always the only thing bleeding, sometimes air is rushing in where it doesn’t belong. The Trap of Focus Right upper quadrant … Read more
Read“Gallstones: Pebbles in the Machine”
The unassuming culprit It’s small, pear-shaped, and tucked quietly beneath the liver, yet it’s responsible for an astonishing number of admissions, operations, and late-night calls … Read more
ReadDamage Control Resuscitation: Beating the Clock and Bleeding With Plasma and Whole Blood
Because in trauma, every minute without control is a negotiation with death, and death doesn’t bargain. The Most Important Clock in the Room We talk … Read more
ReadBorrowed Time: The Story of Liver Transplantation After Trauma
Because sometimes the only way to save the liver is to replace it, and sometimes, even that isn’t enough. When the Liver Crosses the Line … Read more
ReadWhen the Spleen Leaves the Table: A Trauma Surgeon’s Guide to Splenectomy
Because sometimes, preservation isn’t an option, and hesitating costs lives. The Reality in the Trauma Bay The spleen doesn’t leak; it gushes. When it tears, the … Read more
ReadControl First: Pringle, Aortic Control, Mobilise, Pack, A Practical Playbook for the Bleeding Liver
There are two certainties in hepatic trauma: the liver bleeds like it means it, and physiology dies much faster than technique saves it. When the … Read more
ReadWhen the Liver Fights Back: Managing Post-Traumatic Bilomas, Necrosis, and Abscesses
Because the liver doesn’t forget, it just waits for its moment to remind you that trauma doesn’t end when the bleeding stops. The Morning After … Read more
Read“Layers of Pain: Why the Abdomen Hurts the Way It Does, and Why the Embryo Still Gets a Say”
Pain isn’t just anatomy. It’s history. Every time someone grabs their abdomen and says, “It hurts here,” they’re not only showing you a symptom, but … Read more
ReadWhen the Duct Fights Back: Managing Extrahepatic Biliary Trauma
Because even after you stop the bleeding, bile finds a way to remind you the job’s not over. The Wound You Don’t See Right Away … Read more
Read“When the Belly Talks Back: Understanding Abdominal Pain”
It usually starts with a face. You know the one, that grimace patients make when you ask, “Where does it hurt?” It’s a universal expression, … Read more
ReadThe Pentagram of Death: Where Physiology Turns on You
Because in trauma, the body doesn’t die from injury alone, it dies from its own biology spinning out of control. The Moment It Turns You … Read more
Read“A Stroll Through the Abdomen (and Other Adventures Beneath the Skin)”
A funny thing about abdomens… You’d be amazed at how many people, even those wearing pristine white coats, think of the abdomen as just a … Read more
ReadGhosts in the Parenchyma: Managing AV Fistulas and Pseudoaneurysms After Liver Trauma
Because sometimes, the liver heals, but not without leaving a few traps behind. The Quiet Trouble After the Storm The bleeding stops, the packs are … Read more
ReadRemember Who’s on the Table
A reflection on why the patient is never just “the patient.” The Numbers Never Tell the Story We talk in numbers all the time age, … Read more
ReadThe Persistent Bile Drain: When the Liver Won’t Let Go
A reflection on those maddening post-trauma bile leaks, the slow, sticky reminders that the liver heals on its own time, not ours. You Know the … Read more
ReadThe Atrio-Caval Shunt Myth: Why the “Heroic” Move Was Never the Hero
In the chaos of a shattered liver and a bleeding retrohepatic vena cava, the atrio-caval shunt has always been the stuff of legend, but legends, … Read more
ReadThe Spleen Always Gets the Last Word: Lessons from the Trauma Table
The Unexpected Invitation to Chaos No one ever schedules a splenectomy. It’s never on the calendar, never part of the plan.It happens when a car … Read more
Read“The Liver Has a Temper: Reflections from the Trauma Bay”
It always starts the same way. The trauma pager goes off, some garbled voice shouting about a “stab to the right upper quadrant” or “high-speed … Read more
ReadIs a Career in Medicine Still Worth It?
My balanced perspective for prospective applicants This is a question I get asked more and more: “Would you recommend medicine as a career today?” It’s a … Read more
ReadThe Truth: No School Picks on One Factor Alone
Every year I meet anxious applicants who cling to a single number or achievement as if it were their entire destiny. “I’ve got a Band 1 … Read more
ReadWhich 4 Medical Schools Should You Pick?
Every year, thousands of applicants ask the same question: “Which four medical schools should I apply to?” It sounds deceptively simple. In reality, it’s one of the … Read more
ReadTop Mistakes Applicants Make When Choosing Medical Schools: Errors to Avoid
One of the most overlooked parts of the medical school application is choosing the schools themselves. Too often, students pour energy into their UCAT prep, their … Read more
ReadProfessor Khan’s Battle Plan: The Interview Day Checklist
Think of this as your field guide on the morning of battle. Calm preparation beats last-minute panic 1. Mental Preparation 2. Presentation 3. Essentials to Carry (or … Read more
ReadThe Interview is the REAL Battle
When it comes to medical school applications, many students obsess over their UCAT score, their GCSEs, or the perfect personal statement. And while these are … Read more
ReadUCAT Band 1 SJT: Is it a Gamechanger?
As prospective medical students, you’ve probably heard the whispers: “If you get Band 1 in the Situational Judgement Test (SJT), you’re golden.” But is that really … Read more
ReadThe Complete Guide: How UK Medical Schools Use GCSEs, UCAT, and A-Levels to Shortlist Candidates
Applying to medicine in the UK is competitive, around 20-30,000 candidates apply each year for fewer than 9,000 places. The first major hurdle is the … Read more
ReadMyths and Misconceptions About the Personal Statement in Medical School Applications
Applying to medical school is a competitive, stressful, and often confusing process. Among the various elements, UCAT, interviews, and academic grades, the personal statement continues to … Read more
ReadUCAT vs GAMSAT: The Great Medical School Application Divide
Greetings, my friends. Today, we embark on that treacherous yet fascinating journey known as medical school applications. If you are sitting there, coffee in hand, contemplating … Read more
ReadUK Medical Schools Shortlisting Emphasis Table
Here is a comprehensive reference table. This condenses everything into a clear school-by-school overview so you can quickly compare medical schools across the UK. Ping … Read more
ReadWhere to Apply to Medical School if You Have a Low UCAT Score
Every year, thousands of students face the same dilemma: “My UCAT score is lower than I hoped. Do I still stand a chance of getting into … Read more
ReadThe Application Sprint: Navigating UCAS, Entrance Exams, and Deadlines
You've laid the groundwork. Your grades are on track, your work experience is logged, and your passion for medicine is burning brighter than ever. Now, … Read more
ReadIntroduction: The Road to Medicine Starts Here!
Laying the Groundwork: Your Pre-Application Medical School Prep Everyone knows the medical school application has a formal start date. But the truth is, your journey … Read more
ReadYour Roadmap: How to Successfully Apply to Medical School in the UK
So, you want to be a doctor? It’s a calling that’s likely been growing in you for years, a mix of scientific curiosity, a deep … Read more
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