Ms. Louise Kelly, FRCSI MCh
Consultant General Surgeon, BreastCheck, CUH
As Consultant Surgeon, I work in both the Symptomatic Breast Unit CUH, and BreastCheck South, Infirmary Road.
I am one of two consultant surgeons in BreastCheck South, part of the national screening programme for women aged 50 -70. Women present for free mammographic screening to one of the many mobile units, or the static unit on Infirmary Road. When an imaging abnormality is detected the ladies are assessed and counselled for surgery in Cork University Hospital.
Patients are also referred by their GP's into the Regional Cancer Centre at CUH with breast lumps and other symptoms. Four Consultant Surgeons, including myself, run 'triple assessment' clinics for these patients, which involves clinical examination, imaging and biopsy of the breast as appropriate.
There are approximately 500 women diagnosed each year with breast cancer between the two units, making CUH one of the busiest providers of breast cancer care in the country. Thankfully though, many thousands of women are assessed annually and found to be well.
As one of eight General Surgeons in CUH I am 'on-call' for emergencies, anything from patients presenting with appendicitis to major trauma. I am also involved in teaching and research.
What does a typical working day look like?
Every day is different with its own challenges, but the structure of the day is constant.
The surgical day starts early, 7:30 am for teaching, journal club and case presentations, followed by inpatient ward rounds to plan patient care for the day. Theatre starts at 8am, typically morning clinic starts at 8:30am and afternoon clinic at 1:30pm. The day finishes when the work is complete, with an update on the evening ward round. Theatre days are clearly my favourite - not surprising for a surgeon!
What do you enjoy most about your job?
Operating, of course! Every surgical procedure is made up of a series of small steps, skills which can constantly be improved and developed, no matter how often a procedure is done. Mastering these steps (level-up in a computer game!) is incredibly rewarding, as it always relates back to patient experience and outcome. I deliver devastating news to patients on a daily basis when diagnosing their cancer. Doing the best I can for patients in surgery mitigates some of the distress caused.
Training the next generation of breast cancer surgeons, seeing them develop both surgical skill and decision making is another dimension I really enjoy.
Catching up with patients at their annual follow-up appointment and seeing them get their lives back on track is also hugely gratifying.
What level of patient care do you have in your role?
80% of my working day directly involves patient contact, 20% administration. Teaching is at the bedside and research an 'out-of-hours' pursuit.
What other members of the healthcare team do you work with?
The Breast multidisciplinary team is huge:
4 Consultant Surgeons
1 Lecturer in Breast Disease
7 Consultant Radiologists
4 Consultant Pathologists
2 Medical Oncologists
3 Radiation Oncologists
7 Breast Care Nurse Specialists
1 Social Worker
Clinical Trials Unit
OPD nursing staff
And for General Surgery:
All the medical and surgical specialties
My career path to here
I graduated from Trinity College Dublin in 1996 and interned in the Meath and Adelaide Hospitals, Dublin. In 1997 I was appointed to the Cork Voluntary Hospital Surgical Scheme. My first rotation was Cardiothoracic Surgery in CUH, with Mr Tom Aherne and the late Mr Aonghus O'Donnell. As a first year Senior House Officer it was the most exciting job ever. I'd never encountered Cardiothoracics as an undergraduate in Dublin and remember calling home to tell my parents I'd 'held the heart' in bypass surgery on my first day. The job was a perfect mixture of complete immersion in surgery four days a week, and post operative ITU care. I felt I had huge responsibility, but in fact there were many layers of support. While my friends in Dublin were abandoning surgery for the pharma industry, I was loving it.
When I went to work with Mr John Kelly and Mr Denis Richardson in SIVUH I was sold on Breast Surgery as a career option. It was my first exposure to a proper multidisciplinary team structure and the benefits to the patients. After that, career progression was 'easy' in that I knew what I wanted to be. My masters degree was about breast cancer metastases genes with Prof Arnie Hill, and Prof Niall O'Higgins in St Vincents Hospital. While in St Mary's Paddington, London I trained in breast reconstruction. On the Irish Higher Surgical Training Programme, I worked in predominantly 'breast and endocrine' jobs, with a brief flirtation with Vascular Surgery- always useful!
I was appointed Consultant General Surgeon to CUH in 2009 and to BreastCheck Southern Unit/CUH in 2012.