In it to WIN it

In our late November gathering, the second of the year, about 20 attendees, both WIN faithful and some fresh faces gathered at the Grand Hotel in Richmond to hear two fantastic talks alongside a great meal. Personally, it was a much needed break, being one of my first solo outings since giving birth to the youngest WIN member, Ava Louise. Though my absence from clinical (and academic) medicine for some 4 months was evident in my difficulty concentrating (coupled with my newly acquired low tolerance for alcohol!), both talks left me enthused and with a little more respect for the humble kidney – but more on that later.

Dr. See presents data on AKI in ICU

First up was Dr. Lucy Modra, who updated the crowd on WIN’s goals and our achievements for the year, including our formal collaboration with ANZICS, our proposal for targets for female representation at ANZICS affiliated fora, our first official meeting as a new ANZICS committee and more (a round-up of our 2018 achievements to follow).

The first of our advertised talks was delivered by Dr. Emily See, nephrologist and critical care nephrology fellow at Austin Health. Dr. See delved into the mysteries of the kidney, particularly, what happens to patients who end up in the ICU with an acute kidney injury. First, the sobering data that showed even small changes in creatinine could have lasting effects for patients admitted to the ICU - outcomes which may manifest long after the injury has resolved. For patients who are dialysed during their ICU stay, their chances of remaining on dialysis in the long term is significant. AKI has not only been associated with an increased risk of CKD and ESRD in the long term, but, unsurprisingly, death, cardiovascular disease and heart failure too.

In addition, many patients who develop AKI in ICU are never referred to a nephrologist or are referred and not seen, with a significant portion lost to follow up. This was surprising news to me; I would think that most patients that I see in my unit with AKI are seen by a nephrologist at some point in their stay, but this is simply not true. Dr. See presented some interesting Canadian data which showed that there was a significant disparity between what nephrologists think they are doing and the actual proportion of patients with AKI that are actually seen (spoiler alert: only 18% of patients were seen despite the nephrologists thinking they had a 91% strike rate!) The benefits of nephrologist involvement, both in the inpatient and outpatient settings, will be the subject of a new clinical trial taking place in Australia in the very near future. Dr. See is part of a multicentre team who will investigate the benefits of post AKI nephrology outpatient clinics.

The last speaker of the night was Dr. Carolyn Vasey - surgeon, mum and researcher. Dr Vasey spoke about her important work examining the challenges facing parents who are undertaking the surgical training program. As part of her masters of surgical education, Dr. Vasey interviewed a number of surgical trainees on their views on part time training. Interestingly, there was a large mismatch between the percentage of respondents working part time (0.3%) and the percentage interested in flexible training (41.6%). Most of these respondents were women (65.2%). In addition her research has uncovered a large discrepancy between attitudes shared between men and women, with some women reporting that they felt a career and surgery was incompatible with parenthood, while these thoughts simply had not even crossed the minds of a significant proportion of the male respondents.. Dr. Vasey’s work is attempting to dispel this myth, as she leads by example, being a parent and surgeon herself and through her work with the RACS.

Parenthood and surgery - can we navigate the divide?

All in all, two very diverse talks which provided much food for thought and some robust discussion. Be sure to be on the look out for next years events - we've got some amazing speakers lined up!


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