From Sri Lanka With Surgical Skills

Vicky Ilankovan interviews her father

Since I was eight I wanted to be a doctor. I still remember using pencils as injection cylinders and giving people sachets of powder from the kitchen to make them feel better. The concept of doing something to help people has always fascinated me.

However, the year that I was to enter medical school in Sri Lanka was the year the policy of standardisation came into force. This meant that Tamils needed substantially higher marks than Sinhalese in order to get into university. For example, Tamils needed 250 points to get into medical school whereas the Sinhalese needed less than 200. I got 249 and was therefore unable to qualify. I was heartbroken but decided to go to dental school instead. A highly underdeveloped specialty at the time and one that I was not at all happy in. Then one day I met a man who had been educated in England. He introduced me to the practice of facial surgery for dentally qualified people and stressed the importance of this speciality in treating head and neck cancer patients.

At that time, oral cancer was prevalent among tea plantation workers. He also spoke of the specialty’s involvement in deformity cases. These sorts of treatments interested me because they meant I would be able to help people who were otherwise be getting treatment because of a lack of money.

In order to do this, it was necessary to be qualified in both dentistry and medicine, and have surgical training. I became determined to do just that and, since there was no way of doing a second degree in Sri Lanka, I sat for a fellowship examination that was held by the Royal College of Surgeons of England every year. I passed part one of the exam and came to England to do part two. I couldn’t get a job for 6 months because there was discrimination in the UK at that time against foreign graduates. I was able to get an incredibly junior job in Edinburgh. After another six months I passed the second part of the exam and managed to get a job in South Wales. Getting into medical school at that time for a foreigner with a temporary registration was particularly difficult. I applied to all the medical schools that first year and didn’t even get a reply. The second year I got into Cardiff. The next few years were full of visa issues, paying the Sri Lankan government who were refusing to renew my passport and let me stay in the UK, and prejudice. I became a registrar in Glasgow but, despite having more publications and presentations than my peers, along with fellowships in dentistry and medicine, I couldn’t get a position as a senior registrar. I went to elocution lessons to improve my presentations and even shaved off my moustache as an interviewer told me that I didn’t look like a senior registrar but still got nowhere. I finally got it on my twelfth interview. All these things made me even more determined, so I made a point to use all my annual leave to go overseas to India and China to learn and become competent in all aspects of our surgical discipline. Then life became easier. Within two years, I was headhunted for a job, and I have been a consultant for twenty years.

After six months of being a consultant, I realised there were many shortfalls in my field. First, I had to set up a head and neck cancer service in Dorset – which hadn’t been there before. Secondly there was nobody trained to look after these patients – so I trained the staff. What I found most difficult however was the patients; when they were diagnosed, there was no facility for them or their families to be supported in the community. I realised that this was a very important part of patient care. So 19 years ago, we set up a small charity called About Face which has blossomed over the last five years. We have now raised money for a house where we give one-to-one counselling support. We also have a laboratory where young surgeons can practise their skills, as well as one of the best head and neck libraries. It’s great for people to know that when they’re going through a rough patch, whether they be a patient, friend, family member or carer, they can pick up the phone or come and visit us and there will always be someone to listen.

When I became a consultant, I also put aside 18-20% of my income to go and work in various centres in the Far East. I set up three Cleft Centres in South India as well as centres to train surgeons in oral cancer surgery and treatment. Last year, the Peking Medical School granted me an honorary professorship for my work. So for twenty years I have been helping on established units and helping patients at no cost to them. I would love to be able to continue this and do more.

Over the years, young trainees and surgeons have seen what I have contributed to the speciality and suggested that I put my name forward to become the President of the British Association of Maxillofacial Surgeons. I was successful for the year 2013-14. This is the first time a non-Caucasian has been given this position and I am immensely grateful to those who have supported me. I hope that I can make people proud of this field and can provide better support for our speciality.

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