We are UHB: Shahzada Ahmed, Consultant Rhinologist and Skull Base Surgeon and Deputy Medical Director

University Hospitals Birmingham NHS Foundation Trust runs Good Hope, Heartlands, Queen Elizabeth and Solihull hospitals, the Birmingham Chest Clinic, and Solihull community services.

I'm currently Deputy Medical Director for Division 2b, which involves supporting the medical director looking after cardiology, cardiothoracic surgery, liver medicine, liver surgery, renal medicine and renal surgery. I support the operational team to improve clinical care delivery across all our hospitals, but specifically take the lead in chairing the quality and safety meetings and supporting colleagues in incident reviews.?I work with the management team and clinical service leads (CSL) to achieve the Trust’s strategic aims and objectives.

My NHS time is still as a rhinologist. I'm an ear, nose and throat (ENT) consultant, but I solely do rhinology in my elective work. My super specialist interest is going through the nose into the brain, and going through the nose, or through the eye, into the nose or brain for tumours that are at that junction between the roof of the nose, the skull base next to the eye, or through the back of the eye; that means a lot of my work is collaborative. I work with oculoplastic surgeons, neurosurgeons and endocrinologists, because I do pituitary surgery, so most of my work is multidisciplinary and this gives us the best outcomes that we can for our patients.

I was born in a small village in Northern Pakistan, and before I was born my father moved to England as an economic migrant in the early 1970s. He worked for British Telecom in a factory, making telephones. In 1976, when I was four-years-old, my mother, brother and I came over and joined him. I went to school in Sparkbrook in Birmingham and then a comprehensive in Kings Heath. When I came to the UK, I couldn't speak a word of English. Birmingham is great because it’s very multicultural. It has lots of green spaces, which I like. I travel a lot for work (mainly teaching), so that’s much easier living and working in a big city, where there’s an international airport close by.

Going through my schooling I was OK at most things. I came up to my GCSEs and my father was quite keen for me to pursue medicine, and at the time I didn't have any strong desire not to, or to, do anything else; so I kind of fell into it more by following my parents’?wishes. Looking back on it, I certainly wouldn't change any of my education, or my training.

I started off in medicine, then i wanted to do vascular surgery; undertaking another degree and some research with a well-known local vascular surgeon, Malcolm Simms. I then came back to work with the same consultant as his fourth- and fifth-year medical student, then progressed to be his houseman and a desire to be a vascular surgeon.?He was a great role model and mentor and was the reason I picked a career in surgery.?His house job consisted of three months at Selly Oak Hospital doing vascular surgery, which was linked with three months of ENT at the Queen Elizabeth Hospital; that was my first real taster of ENT and I immediately fell in love with it.

I then followed general surgical training in the region. I was in the Worcester Basic Surgical Training Scheme and rotated through cardiothoracic surgery, neurosurgery, plastic surgery, and burns, and then got onto the West Midlands ENT surgical training rotation. Towards the end of my training, I realised that I enjoyed rhinology and sinus surgery more than otology and head and neck surgery, and I think it was partly because I was exposed a lot more to it early on and I felt that I was naturally much better at rhinology, than ear surgery, or head and neck surgery.

During my registrar training, I travelled a lot. I spent six months in Cape Town learning rhinology and skull base surgery. I spent a year in Nottingham on a fellowship in a large specialist unit, again learning the same, and I did a travelling fellowship for three months between Pittsburgh in America, Zurich in Switzerland and Hanover in Germany, trying to learn things that were at the forefront of endoscopic sinus and skull base surgery at the time.?I then ended up, thankfully with, a permanent consultant job back with UHB and have been working here ever since.

At UHB, we currently have 31 ENT consultants, but you don't have 31 people all doing ear, nose and throat. Everyone is emergency safe and we'll do the generality of ENT, but we all super specialise so that we can provide a tertiary and quaternary level service for complex rhinology skull base surgery, complex otology, lateral skull base surgery, robotic head and neck surgery and laryngeal surgery. This is where a lot of the integration in a large hospital with multidisciplinary colleagues really comes into its own and has allowed me to flourish here, and within a short time frame, develop endoscopic skull base surgery as a much bigger discipline within our ENT department.

I do a lot of surgery with neurosurgeons and a lot of interdisciplinary work with endocrinologists, oculoplastic surgeons, neuro-ophthalmologists, neuroradiologists and I'm learning all the time – that's the joy of working in a department, and within a hospital, where we've got lots of likeminded consultants who will go that extra mile for their patients. Whether it's getting a different scan, finding some other time, which might be out-of-office time on weekends or evenings, to come together to find a date for an operation that we need to do or a different intervention, we do it. For everyone who I work with to be in the mind-set of?“how can I make it happen” rather than?“the system says no”, is a joy.

Currently I visit Pakistan about twice a year to teach. I go back to operate, I give lectures and run courses. I enjoy going back and giving back whatever I can, to try to do my bit to help a country which is decades behind in terms of its healthcare and social state.

I’ve?been a consultant since 2010, so I’m 13 years into practice now. I still thoroughly enjoy patient interaction, listening to patient stories and their journeys, and I still get a lot of job satisfaction from seeing how my intervention changes their lives. Whether it's cancer surgery or surgery for inflammatory nasal disease for benign?nasal polyps,?I can make a huge difference in symptom control, and for tumours, we’re making more and more of a difference in life expectancy as well.

If you enjoy what you do, then when you fall out of bed in the morning, it's not work. It's a privilege to be able to do something that you enjoy day in, day out and to look forward to. I am privileged to be able to be in that position and to be working in a place which still makes me want to come to work; a place that allows me to innovate and continuously try to improve my own practice.

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