Table 6.

Early independence with limited supervision

1	The first time I assisted a surgery, I felt dizzy like I was going to collapse. This first procedure I did went OK, I knew what I was doing because I had assisted a lot of C sections. I didn't know what it would feel like to be a surgeon.	MO
2	When you see procedures, you think they are simple but when you do them, you find some are simple and some are complex. Last week, I had to call an AC into the OR who has more experience than me.	MO
3	I was scared because I had to do the surgeries alone. Even anaesthesia said, ‘Where's the surgeon?’ I was sweating and nervous. At one point, I almost called my boss to help me but it went OK. I followed my first patients very closely. I even visited the patients at home. I am now an expert in hernia.	AC
4	Sometimes the procedure looks easy when you are assisting; when you perform you are really sweating, with time, your hands become flexible.	AC
5	I had a patient who bled after a C section and the uterus was torn. I was scared … I kept clamping things and they kept bleeding. I was fumbling and then I finally controlled the bleeding. I was afraid – I thought the patient might die.	MO
6	One time, I had difficulty and had to do a hysterectomy. The patient was bleeding but it went OK. I had never done that before and had only seen three.	AC
7	I started to operate independently. It was difficult. I came across a hernia and it was direct not indirect. I couldn't find the sac, and that was my first time to come across this. I had only read about it in a book and I didn't have anyone to ask. I just did a Bassini repair. I learned so much from that procedure – you think an operation is simple then it's different than you expect, and you have to be prepared.	AC
8	Only did C section in internship, assisted on lots of other cases … It takes a long time for someone to be qualified in surgery. MDs have more technical knowledge, ACs have experience.	MO

MO, medical officer; AC, associate clinician; OR, operating room.