The Terrain, the Weather and the Enemy

By Belinda Lim

10/11/2023 12:00:00 AM | Stories from the Heart (NHCS)

The article is contributed/written by

The terrain is the patient’s body, the weather are the co-morbidities, the enemy is, of course, the disease.

Associate Professor Victor Chao, Senior Consultant from the Department of Cardiothoracic Surgery, draws the above compelling analogy for the preparation of surgical operations to the “battle procedure” that the military uses in preparation for missions.

Like Assoc Prof Chao, many of us wear multiple hats at home and at work and can find similarities and synergies in our various roles. As do all Singaporean men, Assoc Prof Chao has the added responsibility of fulfilling national service obligations too. When asked how he toes the fine line between his many roles, Assoc Prof Chao shared, “Patients are our raison d'etre – our reason for existence – so all our decision-making should be centered around them. Once you put the patient as your priority, the other priorities fall into place.”

A surgeon and educator first and foremost

A heart surgeon for almost two decades, Assoc Prof Chao first became the Programme Director of the SingHealth Cardiothoracic Residency Programme in 2013. He reminisced, “Initially, I never thought I could effectively guide people through cases, but after many years of experience, I have honed my teaching skills, and I am grateful for that. Seeing things from the other side of the operating table has made me more comfortable with operating, and maybe even made me a better surgeon – an unexpected side effect!”

Assoc Prof Chao (with green gloves) guiding and supervising a resident to carry out a coronary artery bypass surgery.

Over the 11 years of teaching aspiring heart surgeons-to-be, Assoc Prof Chao has groomed many residents providing them exposure to procedures early in their training so as to build their experience and confidence before they transitioned to independent Associate Consultants (AC) roles upon their graduation.

“In the past, the faculty would wait for ‘good’ cases to involve the residents, which resulted in limited case experience and exposure for the residents which are crucial as part of their learning. Therefore we revamped the process to initiate residents into procedures from the start of their training, regardless of whether the case was ‘good’ or not. With this approach, every surgery contribute significantly to their growth and development as aspiring surgeons.”

This change reaped several downstream benefits such as a vast improvement in residents’ basic and in-depth surgical skills from the get-go and this created more opportunities for them to perform procedures. “All these resulted in a “virtuous cycle” – the residents received enhanced training in both quantity and quality over the years, resulting in improved surgical outcomes as they progress into new surgeons,” said Assoc Prof Chao.

Powering Through ORD to ROD

Wearing his other hat as an operationally ready national serviceman, Assoc Prof Chao rose through the ranks, from a Medical Officer to Senior Lieutenant Colonel. As he completed his reservist obligations this year, Assoc Prof Chao recalled how he had to juggle in-camp trainings and his commitments as a surgeon. “There were times that I had to reschedule my annual army duties and had to abruptly leave in-camp training to attend to patients.”

A proud moment for Assoc Prof Chao and his wife when he graduated from the Command and Staff College in 2013

Displaying immense passion, he shared that the NS role closely parallels the responsibilities of surgeons during a demanding surgical operation – it involves gathering of facts, studying the terrain and the enemy, and determining the resources available. Both require careful study, planning not just for the main task but also preparing for contingencies.

Regardless the roles he undertakes, Assoc Prof Chao admits that he is not immune to challenging periods and tough situations. “I draw strength from my Christian faith, and believe that no matter how difficult a situation may seem, it will eventually pass. Indeed, as the saying goes – Life doesn’t get easier or more forgiving; we get stronger and more resilient.

(L-R): Guess which is Assoc Prof Chao? – Route march in 1988; Assoc Prof Chao (extreme right) at an outfield training.

Did you know?

The SingHealth Cardiothoracic Surgery Residency Programme clinched the ‘Most Improved Award’ and the ‘Best JCST (Joint Committee on Specialist Training) Programme Award’ at the Residency in SingHealth Excels (RiSE) Awards in 2021 – the only programme to have a double recognition in the same year!

To know more about our Residency Programmes, click here for the Cardiology programme, and here for the Cardiothoracic Surgery programme.