A DAY IN THE KNIFE: “Surgical training isn’t a sprint, it’s a marathon.”

25 February 2026

Raiyyan Aftab, 29, born in India, grew up in Newcastle, Based at Salisbury District Hospital, Raiyyan is an ST5 plastic surgery trainee, President of the Association for Surgeons in Training (ASiT) and is on the Board of the Confederation of British Surgery (CBS). He tells us of his experiences as a trainee;

“My specialty is plastic surgery. At my stage of training, you’d call me a registrar, the stage before becoming a consultant. Surgical training is long. You do five to six years of medical school, two years of foundation training, two years of core surgical training, then five to six years of higher specialty training.”

Becoming a plastic surgeon is a journey measured not in years, but in decades of preparation. And despite the length and intensity of the training, plastic surgery remains widely misunderstood. “Most people think plastic surgery is cosmetic surgery. People often assume all I do is breast surgery and cosmetic procedures. Even colleagues outside plastic surgery don’t always understand what we do. As a specialty, we sometimes have an image problem, unless you work in it, people don’t see what plastic surgeons actually do day to day.”

Raiyyan originally wanted to go into politics, international relations, possibly working for the UN. Raiyyans parents encouraged him towards politics, but he made the decision to pursue medicine. This decision marked the beginning of an academically challenging but professional road, one that did not start smoothly. “I wasn’t the most studious medical student. I struggled early on because the first years of medical school focus heavily on basic science, which can feel far removed from patient care. I failed my first year of medical school. I was given the opportunity to resit exams, and that was the moment I had to decide whether to continue. I decided to work harder and give it a proper go. Medical school didn’t become easier, but it became clearer. I wanted to finish because the reward would be worth the journey.”

For surgeons, there is no “typical day”, something Raiyyan considers one of the specialty’s greatest strengths. “The variety is the beauty of plastic surgery. You do a bit of everything. I arrive around 7:30am. I see the patient, read their notes, answer questions, and take them through consent. Reassuring the patient is as important as the operation. Patients are often anxious, sometimes it’s their first surgery. If you reassure the patient and build trust, they tend to do better. In theatre, surgery is a team sport. Anaesthetists, scrub nurses, and theatre staff are essential, without any one of them, the operation fails. In one day, I did hand surgery, elbow surgery, and finished with a leg amputation for a patient in chronic pain. That’s the reality: there’s no typical day. You never know what will come through the door. That unpredictability keeps surgery fresh and exciting. Some people prefer predictable careers in medicine, but unpredictability is a big part of what draws people to surgery.”

However, the unpredictability comes with great tension. “The workload creates constant pressure. Some cases leave a lasting impact. One case that stays with me was a child with a significant burn who became very unwell. Paediatric cases carry more emotional weight. Children don’t always understand what you’re doing. You can be causing short-term pain for long-term benefit, and you can’t always communicate that clearly to them. It’s emotionally charged. Parents are frightened, and the child may be very unwell. After a case like that, you need time to decompress, even if it’s just having a coffee with a colleague. Not every part of the job is brilliant. Tough days happen. It’s important to understand what stresses you out, and what you carry with you. It’s also important to have people around you, colleagues, friends, partners, who you can talk things through with.”

Raiyyan often performs hand tendon repairs regularly, they may sound routine, but they represent the core principle of plastic surgery. Restoring function in a way the patient can see and feel almost instantly.. “One of the operations I do regularly is repairing a cut tendon in the hand. The patient comes in unable to move their finger. We often do the operation with the patient awake. You repair the tendon, close the wound, and they can move their finger straight away. They can see the result immediately. You take something that wasn’t working, and you make it work again.”

Beyond the operating theatre, Raiyyan is equally thoughtful about the future of the profession he is working so hard to join. For a specialty built on teamwork and shared experience, that loss has been significant. Raiyyan has a clear message for those considering a career in plastic surgery. The pathway is demanding and at times exhausting but deeply rewarding for those who understand their reasons for pursuing it. Raiyyan concludes,

“The leadership of CBS is motivated, future-focused, and cares about both patients and trainees. After COVID, surgery lost some of its sense of community. Surgery is a tight-knit profession. Surgeons share a common language and a shared professional culture. COVID eroded that. CBS has the opportunity to rebuild that sense of national surgical community. If you choose surgery, you’re making one of the best career decisions you can make. The most important thing is understanding your personal motivation for doing it. Motivation is what gets you through the hard moments. Surgical training is long, difficult at times, and often antisocial. If you know why you’re doing it, it will carry you through. Surgical training isn’t a sprint, it’s a marathon.”

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