Operation Launch Asclepius

How does surgical training compare to astronaut training?

By Samantha Pillay

As I researched what it takes to become an astronaut for my latest kid’s picture book, When I’m an Astronaut, I realised there were some similarities (and differences) to my own surgical training, beyond being a woman in a male-dominated field.

I don’t just mean whilst operating; you can’t eat, drink, pee or scratch your face. As surgeons, we learn to avoid drinking too much before scrubbing for a long case, and we haven’t resorted to wearing adult diapers.

For many astronauts or surgeons, it starts with a childhood dream inspired by a book, person, media story or another event. A love of STEM is a key ingredient. Although getting selected for surgical training might not be as competitive as astronaut candidate selection, it can still take years to get selected, and many never make it.

Surgical training includes understanding and sometimes conducting scientific research, a significant component of an astronaut’s work.

Astronauts spend most of their careers practicing on earth and have better training simulations than surgeons. Although technology has advanced surgical training, there is still no simulation quite like the real thing when it comes to operating. We spend most of our careers operating, constantly refining our skills. Much of surgical training relates to preventing complications and preparing for every possible scenario, like astronaut training. If you’ve ever had surgery, you know by the number of times you get asked your name and birthdate that we check everything several times too.

I fear the food in space is a similar standard to hospital food. Unfortunately, the long work hours of a surgeon often means not getting enough natural light or exercise, and on-call rosters can disrupt normal day-night patterns. When you finish the gruelling demands of surgical training, it can take some time to acclimate to the real world. When it comes to survival training, we get years of it as surgical trainees.

As a surgeon, you need to think on your feet, usually with no one to call for help, and we need to solve life-threatening problems under time pressure. For an astronaut, it’s their life at risk rather than someone else’s, and they’re technically floating rather than standing on their feet. Still, we don’t need to take that expression literally.

With the extra PPE and face shields we now wear as surgeons in a world with COVID, we even look more like astronauts, but we desperately need some space-grade antifog for our face shields. Hey - our scrubs and jumpsuits were blue first. I suppose they’ll be wearing green next. Except when surgeons get scrubbed, they are ready to launch into an operation. Unlike a scrubbed mission, that’s back to the drawing board.

Whether in the operating theatre or space, a successful mission takes teamwork. We try not to mix or ignite the explosive gases in the operating theatre. As a urologist, I’ve removed kidney stones that may have resembled moon rocks. We might not have to learn Russian, but we do need to learn a whole new language of medical terminology and instruments. I wonder if using that robotic arm on the International Space Station is like driving the Da Vinci robot. If you need to know how to tie knots up there, we can help.

Astronauts are exposed to high levels of radiation in space. As surgeons, we have worked with radiation in theatre for years and wear lead gowns for hours on end, under all our gear. Try doing that in gravity!

Being a surgeon takes courage, and your work is for the benefit of all people, although more for the present generation rather than the future generations who will benefit from space exploration.

When you have cut someone open and seen people from the inside, it gives a perspective that we are all created equal, and surgeons can see humanity as one. I wonder if this is a similar feeling to looking back at the earth from space.

Being able to operate on someone is a privilege and something that few people will ever experience in their lifetime, although many more than have visited space – but maybe not so in the future.

Find out more about "When I'm a Surgeon".

Find out more about "When I'm an Astronaut".