An Interview with Dr Raghbir Khakha, a Consultant Orthopaedic and Specialist Knee Surgeon
Dr Raghbir Khakha (left), operating with his colleague Professor Wilson (Middle) and his assistant Nuno (right)
Mr Raghbir Khakha is a Consultant Orthopaedic and Specialist Knee Surgeon based at Guys and St Thomas Hospital in central London. He completed his medical degree at St George's University Hospital in 2006, in addition to Bachelors and Masters degrees in Orthopaedics, from University College London and the University of Brighton. He then went on to complete his surgical training in the prestigious South East London Training Rotation, for which he is now the lead for knee surgery teaching and is involved with managing surgeons in training. He is the current Patron to the King's College Orthopaedic Society. He has also completed Trauma and Knee surgery fellowships at Massachusetts General Hospital (US) and North Hampshire Hospital. Find out more about his work here
Q: Tell me about your journey in becoming an Orthopaedic and Knee Surgeon!
I grew up in Southall, West London, which I love, spending most of my growing life and attending school there. It’s an interesting part of town, with a large working-class population, which my parents were a part of - working at the local airport and factories. Everyone in my immediate family was from a working-class background, so it was a real aspiration of my parents for me to go into a good profession. My parents put me in the right places, and I found my direction.
As I went through school, I realised I had a passion for science and really enjoyed it. Sport was also a major part of my growing up, doing Karate since the age of 8, competing internationally and winning heavyweight titles, it was a big part of my life. In addition to this, I enjoyed being around people and Medicine was thus something I was interested in. I was lucky enough to go to St George’s Hospital Medical School, University of London. The years I spent there were some of the best in my life!
Initially, my interests lay in Cardiology, because I was interested in the physiology of it. However, the more I got into it and the more sport I played at University, I realised Orthopaedics was completely up my street. While I was at university, I had a knee injury myself from a competition. One of the local Orthopaedic surgeons, Mr Martin Bircher, was the sole reason I eventually became an Orthopaedic surgeon. He was very dynamic, charismatic and incredibly energetic. Being in his presence was an inspiration and I knew he was the guy I wanted to be like.
In my fourth year, I decided to intercalate. My experience with Mr Bircher inspired me to apply for the Trauma and Orthopaedic BSc at University College London, allowing me to meet many people at the forefront of the field, way ahead of the time I would’ve normally met them had I not done the BSc. This cemented my desire to become an Orthopaedic surgeon. After my BSc, I went for an elective in Ghana, off the back of meeting a surgeon from there who was an anatomy demonstrator at St Georges, who set me up in the biggest teaching hospital in Ghana. I was able to experience many amazing things there like gunshot wounds and road traffic accidents. It was a life changing experience. I then went on to do my house job as an Orthopaedic House Officer at St George's University Hospital, working for Mr Bircher.
Q: What does a typical work week look like for you?
I’ve got a fantastic working life!
Monday: A private practice day, where I see knee patients in a clinic just off Harley street.
Tuesday: Fracture clinic, I see patients who’ve had injuries over the preceding week, such as wrist, shoulder, hip, knee, ankle or anything general. In my clinic, my colleagues also send me very specific knee injuries for me to give a specialist opinion. In the afternoon, I do trauma operating - General trauma, specific knee injuries or any fractures.
Wednesday: All day elective clinic. GPs refer patients to me with pain, knee instability or knee arthritis who either need surgical or non-surgical management.
Thursday: A private practice day, where I do private operating all day.
Friday: The highlight of my week! I operate on NHS patients all day from the NHS surgical list. (Pre-covid)
Q: What are the favourite parts of your job?
The kinds of people I look after. I look after the full range of the paediatric and adult population- kids, young adults, middle aged and elderly patients. That makes my work very interesting! In contrast to this, a lot of my colleagues either look after very old people or very young people. I also do lots of different operations, which makes my job exciting for me. The variety I have in my day-to-day practice makes my job a highlight!
Q: What are the most difficult parts of your job?
Trying to help people with problems that don’t require surgery. A common perception is that surgeons only operate, but the hardest thing for a surgeon is actually to make the decision not to operate. What separates an average and a good surgeon, is knowing when an operation will not help somebody. It’s tough and comes with time, experience and knowledge, reading and being involved in academia, but it’s key. That’s probably the toughest part of my job
Q: Can you tell me more about your involvement in Academia and Education?
My main interest is young adult knee surgery, so I do a lot of joint preservation knee surgery, which has become a very hot topic in Orthopaedics. I’ve been very lucky to be trained by and work with Professor Adrian Wilson, who is regarded as one of the best knee surgeons around, bringing knee joint preservation to the forefront in the UK and the world. I’ve done a lot of research in this area; its techniques, how to do the surgeries, what works and what doesn’t, how to identify the right patient for the procedure, the results of the procedures we’ve performed and looking at different implants.
I’m also the Deputy Training Program Director for all the registrars in the South-East Region of London. I help them with their projects and training, guiding them through their career to become a consultant.
Additionally, I’m one of the members of ESSKA (European Society of Sports Traumatology, Knee Surgery) and am one of 10 that make up the Osteotomy committee. I’m also writing the UK consensus document on joint preservation in the UK. In fact, we recently had a meeting to finalise the document! These are the main areas that I’m involved in at the moment.
Q: What have been some of the highlights of your career so far?
1) Getting an Orthopaedic training number. This was a massive highlight, because when you get through your junior medical training, getting a number is getting you on the career ladder to being an orthopaedic surgeon and it was really hard work!
2) My entire training. I worked with some of the best knee surgeons in the country, learning many cutting edge techniques
3) Landing a job in a central London teaching hospital (Guys and St Thomas Hospital, where I am at the moment), with all the resource that comes with it, is a real highlight for me.
Q: Do you have any advice thinking of going into medicine and surgery?
Advice on going into Medicine…
There’s lots of things you can do to get yourself ready for getting into medicine. However, the most important thing is being certain that this is the career for you. The only way you can do that is in speaking to and meeting people who are in the medical field, getting work experience and finding out more about the career. Don’t just speak to people who have got into medicine and come out the other side but speak to people who have been doctors for 6 to 7 years, because they’re still young enough to remember what it was like to be in the position of applying for medical school, but also not too old to have a career too different than what will be expected of you.
It’s not important to identify exactly what kind of doctor you want to be yet but it would be good to have an idea of what you’d like to get out of the career. Medicine is an incredibly varied career and open to the interests of many people. In summary, It’s important to get work experience and get into contact with people who have been through the process. A lot of people have the notion of wanting to be a doctor but don’t have enough information about it, so don’t be set in your ways and have an open mind.
Advice on going into surgery…
Spending time with people you want to be like is very important. For example, in medical school after I met Mr Bircher, I knew I wanted to be an Orthopaedic surgeon, so I just spent all my time on the ward, learning orthopaedics, being around the people I wanted to be like. My advice would be to not think like a medical student but to think like someone in the next level above you. For instance, if you want to go into surgery, think like a first-year junior doctor looking to apply to be a surgeon. Look at what they must be thinking and how you’re going to get there. I also wish a lot of my trainees coming through had been told to get more experience. You can’t get experience from a book. It takes time, attending things and doing things in your own time.
Q: What are some things you wish you’d known before going into surgery?
The management side of things, where a significant chunk of your responsibility is non-medical. This includes the day-to-day management of the hospital and junior doctors and the administrative side of things that no one warns you about. Anyone applying must also know that the field of medicine is very competitive, and it attracts competitive people, particularly the field of surgery.
Q: What are some things you’d like to see in a new generation of medical students and surgeons?
From my experience, the emphasis on surgery is slightly reduced in medical schools. I would love it if new generations got more hands-on anatomy exposure, more time learning the intricacies of holding instruments, doing dissections, actually learning the physiology and being in a cadaver lab. It’s a real passion of mine, but people just don’t get that exposure anymore and it’s only a small proportion of overall marks in medical school.
Q: If you could turn back time, would you still have gone down the same career path?
I wouldn’t change anything! I really enjoy my career, the people I look after and the people that I work with. I work in a big team of not just doctors, but physiotherapists, occupational therapists and nurses. Every day still feels like university to me, because I’m always meeting new people, learning new things and making new relationships. That’s what keeps me young, active and my brain ticking over!
Bonus Question: What do you think of Surgical TV dramas like Grey's Anatomy as an inspiration to do medicine?
The thing about these programs is they don’t take into account the more mundane things involved in medicine. Being a surgeon is not just about picking up a knife and making someone’s pain go away! There are lots of patients who just need talking to and a little bit of advice and I don’t think medical dramas look at the other side of things such as spending time with patients and forming an emotional connection with them, which are equally, if not more important. Though surgery absolutely can be a very glamorous career, there’s a lot more to it which they don’t cover. In the end, these TV dramas are there to provide entertainment.