Q&A: Toby J Gemmill on specialising in small animal surgery (orthopaedics)
As part of a series of articles on veterinary specialisms, My Vet Future is talking to vets about their route to specialisation, with the aim of helping vets better understand how they can become specialists.
Name: Toby J Gemmill
Job title: Clinical director, Willows Referral Service; RCVS and ECVS specialist in small animal surgery (orthopaedics)
- 1996: Graduated from the University of Bristol
- 1996-2001: Worked in mixed and small animal practice
- 2000: Obtained RCVS Certificate in small animal surgery
- 2001: Started residency in small animal surgery at the University of Glasgow
- 2005: Became ECVS specialist in small animal surgery
- 2005: Obtained Master’s degree (MVM) for research into canine elbow dysplasia
- 2005: Became RCVS specialist in small animal surgery (orthopaedics)
- 2005: Joined Willows Referral Service (Willows) as an orthopaedic and spinal surgeon
- 2016: Became clinical director at Willows
Did you have a career plan?
Following graduation, I worked in mixed practice for a few years. This was an experience I thoroughly enjoyed, but my main interest was always small animal surgery; in particular small animal orthopaedics.
When did you decide to specialise?
I knew from the day I graduated that I wanted to take a certificate in small animal surgery, and I started working for this in my spare time immediately. I found that the more I studied, the more I wanted to know. I was lucky enough to work in a practice which gave me plenty of surgical experience and I obtained the RCVS Certificate in small animal surgery in 2000.
Within a few years of graduating, I was determined to follow a specialist career. Following a short stint in another small animal primary care practice, I started a residency in small animal surgery in 2001 at the University of Glasgow.
Being a certificate holder in practice prior to completing a residency was satisfying and reassuring for me - it gave me the confidence to take on some of the more challenging cases. However, I soon realised that the gulf in knowledge and technical skills between certificate level and diploma level is huge. As I always had a desire to be the best surgeon I could possibly become, progressing to specialist status rather than stopping half-way along the journey was an easy decision for me.
How long did it take to specialise?
Using the CPD time available to me and putting in a moderate amount of my own time, I obtained the RCVS Certificate four years after graduating. This timescale was not particularly onerous - as a young vet in my 20s, I was keen to indulge various other interests outside of work.
"Progressing to specialist status rather than stopping half-way along the journey was an easy decision for me"
I started my residency the year after obtaining my certificate. The residency was a three year programme and I obtained my RCVS and European specialist status in small animal surgery the year following the residency. In total, this added up to nine years from graduation to becoming a fully-fledged specialist in small animal surgery.
Can you describe the commitment involved?
Personally, I never felt I was making a huge commitment or sacrifice. Following graduation, I loved being a vet and was only too happy to stay late to operate on interesting cases or study in my own time – I was indulging my main interest and passion!
Although the residency involved long hours of clinical work and study, I was part of a fantastic team of motivated, like-minded individuals doing work we loved. I also really enjoyed living in Glasgow and had a very supportive wife!
I took a year following completion of the residency to study for board exams alongside working at Glasgow University. Looking back, this year was hard, and actually taking the board exams was one of the least pleasant experiences of my life. The emotion I felt when finding out I had passed the exams was definitely one of relief rather than pleasure!
How do you maintain your specialist status?
Working in a busy referral practice with our own residency training program means it is not too difficult to collect ‘points’ for re-accreditation every five years. Points are awarded for seeing clinical cases, training residents, engaging in research, provision of CPD and involvement in professional committees.
What’s it like working in private practice?
I love the fast-paced nature of private practice and the ability to make decisions quickly. At Willows, we have a residency programme and engage widely in clinical and occasionally pre-clinical research; this is something I find very satisfying.
As a specialist in a relatively technical discipline such as orthopaedics, it is clear that maintaining a busy personal caseload is essential to achieving the best possible patient outcomes; this is relatively easy to achieve in private practice.
How do you maintain a good work-life balance?
There is a definite need to balance time spent at work with time spent doing other things in life.
However, I do feel the tone of the debate can sometimes be unhelpful - work is often portrayed as something that is negative and must be minimised, whereas anything else is seen as positive.
"I am passionate believer in wellbeing at work, but this should come from being part of a motivated team doing great work"
I am passionate believer in wellbeing at work, but this should come from being part of a motivated team doing great work, rather than just trying to stay away from work as much as possible. We’ve given a lot of time to our wellbeing programme at Willows to reflect this.
For me, it is maybe more helpful to see work as part of life, along with other activities such as spending time with family or indulging in hobbies. There is no reason that all of these can’t be seen as positives.
Personally, I still thoroughly enjoy my work, whether that’s taking on orthopaedic operations, giving CPD or managing people in my role as clinical director of the hospital. If I have a busy day at work, I have no problem staying a little later than usual to get things finished up. I know that on a quieter day, I can usually get away earlier to spend time with family or walk our dog. I also love sports and physical activity, particularly CrossFit – this allows me to clear my head when I have been thinking too much.
Why would you recommend a specialist career?
Being a specialist can be very satisfying on a clinical level and can also open up huge opportunities such as involvement in professional organisations and academic colleges.
I have been fortunate enough to be involved in the AO Foundation, which is a global organisation dedicated to improving patient outcomes in musculoskeletal diseases.
The foundation has given me amazing opportunities to travel and give CPD around the world. I have also been involved in the AO Board of Trustees which oversees work in human healthcare as well as veterinary medicine. This has been truly fascinating – trauma is a far larger cause of death and disability in working age people than infectious diseases such as HIV, malaria and TB; this is a particular problem in developing countries. Directing resources to improving management of trauma patients has the potential to make a huge difference to people’s lives.
I never imagined I would have the opportunity to take part in these sorts of discussions. This is what a career as a specialist can provide!