Medical

Q&A with Dr. Nikki Stamp, Cardiothoracic Surgeon

Dr Nikki Stamp is a cardiothoracic surgeon in Sydney, Australia. As one of only nine cardiothoracic surgeons in Australia, she is also a strong advocate for women in surgery and other professional positions traditionally occupied by men, and for doctors’ well-being and prevention and management of mental health issues amongst doctors. Dr Stamp is also a mentor and teacher to young doctors and other hospital staff.
Dr Stamp obtained her medical degree and graduate diploma in surgical anatomy from the University of Western Australia and has completed training in cardiothoracic surgery with the Royal Australasian College of Surgeons. She has a particular interest in cardiology and women’s heart health, and promotes evidence-based healthy living.
Dr Stamp has been published in ANZ Journal of Surgery; Heart, Lung and CirculationAsian Cardiovascular & Thoracic Annals; and The Journal of Arthroplasty.
1. When did you first decide to become a doctor? Why? 
When I was around 8, I used to see Australian heart surgeon Dr. Victor Chang in the news, as he was working on a mechanical heart. I had written in my school journal that when I grow up, I want to be a heart surgeon and finish the work of Dr. Victor Chang.
During high school, though, I wasn’t really that interested in medicine. In fact, I really under-performed academically and I was on track to study music or musical theater. My dad was trying to get me to have a ‘real’ degree first as a backup, and I was planning on becoming an accountant. I knew it wasn’t for me and my dad said to me ‘If you could be anything at all in the world, regardless of marks or prerequisites, what would it be?’ and I immediately told him that I would be a doctor. It was tough because I had to study science and then switch to medicine. (Medicine was studied as a 6-year undergraduate degree at that time).
The thing is that, during high school, I never thought I was smart enough to study the difficult subjects like math or chemistry. When I had this goal in mind, though, I surprised myself. I studied university level physics and chemistry and got excellent grades throughout medical school. I’m pleased with the way everything kind of worked out in the end, although it seems my 8-year-old self was much smarter all along.
2. How/why did you choose the medical school you attended?
I studied medicine at the University of Western Australia. In Australia, it wasn’t that common to travel for university. UWA is my hometown school and where my dad went, so that was kind of nice. UWA Medical School was an excellent institution, and I loved being there. We’ve even produced Nobel Laureate Dr. Barry Marshall who, along with Dr. Robin Warren, discovered the role of H. pylori in gastric ulcers.
3. What surprised you the most about your medical studies?
That I could do it! I spent a lot of my teenage years thinking I wasn’t good enough, wasn’t smart enough. I underperformed academically at high school and then, I was the kid getting the high grades, the one whose notes people wanted! It was a change but a powerful reminder to me that I’m smarter than I think and that when I put my mind to something, I can make it happen.
4. What information/advice do you wish you had known prior to beginning medical school?
Probably in the same line: that I could do it. I loved medical school and, aside from possibly psychiatry, I loved all of my clinical rotations. That would be the best thing for me to pass on, go into everything ready to adore it and you learn so much more.
5. Why did you decide to specialize in cardiothoracic surgery?
I was always going to be a surgeon. I loved anatomy and I was good with my hands, and had good spatial skills. Early on, though, I wanted to be a hand surgeon, either by specializing in orthopaedic surgery or plastic surgery. I was given a rotation in cardiothoracic surgery as a trade-off for a term in orthopaedics, and I loved it so much that I never left.
6. If you had to do it all over again, would you still specialize in surgery? Why or why not?
I think that I would still be a surgeon; however, would I still choose CT surgery? While I probably would, I would be much more mindful of some of the very significant drawbacks with my career which might have been reduced if I had chosen plastic surgery. That being said, I’m not really sure that I would be able to resist how amazing this job is, despite all of the wisdom that has come with hindsight.
7. Has being a surgeon met your expectations? Please explain.
I think I had a much more glamourous view of what it meant to be a surgeon when I was just starting out, but as I have progressed, my expectations have certainly evolved. I also think, as a junior, it was all about the operating for me. While I love to operate – I mean love it – I also realise that the other aspects of my job and of my personality are also important and very interesting. I think that as I’ve noticed my expectations change, I’ve learnt to keep a much more open mind about my career, my job and what I want from it.
8. Describe a typical day at work—walk me through a day in your shoes.
One thing about surgery is that there is no such thing as a typical day, especially in cardiac cases. You never know what’s going to roll through the door. In general, I start at around 7:00 am, do ward rounds and then start operating. In a normal day, we’d do two cases a day and I try to get finished by 6:00 pm. However, I work in a transplant center, so sometimes, we have big cases or transplants that can make all of this very fluid.
9. What do you like most about being a surgeon?
I think the technical challenge and skill really appeal to me and I enjoy that I can never stop learning. However, one of the greatest things I think about being a doctor in any area is that, occasionally, we as a team get to say that we saved someone’s life in a day’s work and that is incredible.
10. What do you like least about being a surgeon?
I know that my career has meant sacrifices in other parts of my life, including my own health, my family and friends. I absolutely underestimated how much that work would impact the rest of my life.
11. In your position now, knowing what you do, what would you say to yourself back when you started your medical career?
Despite all of the knowledge I have now, which is the power of hindsight, I think that I wouldn’t change a thing. As trite as it sounds, everything happened for a reason and it’s all worked out pretty well in the end.
12. What types of outreach/volunteer work do you do?
I was lucky enough to go to Fiji with Open Heart International where we operated on children and adults. It was far and away one of the best experiences of my career. I also have been lucky enough to be involved with an event called Sohn Hearts and Minds where we raised over 4 million dollars for medical research. I do a lot of work for the Heart Foundation, too, especially in the area of women’s heart disease.
13. When did you first get involved in advocacy for women in surgery?
In the last few years of my training, I did start to notice the differences in gender in medicine and surgery. I started to talk to my female colleagues and we realised that we had a lot in common in terms of stressors in our careers. As a minority in my specialty, I often got asked to speak at women-in-medicine events; from here, it really escalated. I started to learn the importance of visible role models and then the #ILookLikeASurgeon movement started, which has given me the opportunity to not only help others but to build supportive networks of my own.
14. What do you like most about advocacy work?
I love the opportunity to reach out and inspire someone to achieve their goals. It’s also been a wonderful opportunity to meet some incredibly inspirational people and make some wonderful friends.
15. What do you like least about advocacy work?
I think because people see you as a bit of a role model, it’s really hard to say no sometimes when people ask you to do things. However, I’ve learnt the hard way that saying yes, then doing a sub-optimal job or becoming resentful, is perhaps worse than disappointing someone who wants you to speak at an event. I also worry that when I’m at women-in-medicine events, a lot of the focus is about children and child rearing, or accounts of people who simply explain their success with the phrase “I got lucky”. We’re in danger of perpetuating the same stereotypes and it’s important that we bravely stand up together and change these.
16. On average, how many hours a week do you work? How many hours of sleep do you get per night? How many weeks of vacation do you take annually?
I think roughly around sixty hours a week, although it’s pretty variable. Some weeks maybe around fifty; others… well I stop counting! I sleep badly, although I’m getting more in tune with the importance of good sleep for my own health, so I try for around eight hours a night. Which I often fall short of! I’m terrible at taking leave, and most leave I take is to attend conferences or do other work (such as TV presenting, MCing events) so I would like to try and be a bit more organised to take proper holidays.
17. How do you balance work and your life outside of work?
Personally, I think balance is a bit of a myth and sets us up for failure. Talking about balance makes me feel like if I give too much to one area, I’m failing another unless it gets equal attention. What I prefer to think of is prioritising. So, for example, at some points, work comes first. At other times, exercise does. It’s about working out your own priorities and making them fit as best you can.
18. From your perspective, what is the biggest problem in health care today? Please explain.
I think health care expenditure is getting out of control and we don’t have endless resources, so we need to be mindful of what we’re paying for. For example, the expenditure on preventative care is only 5% of GDP and since a large number of illness is preventable, I’d love to see a move towards better funding of prevention.
The other thing that bothers me is that medical administrators or health care systems seem to see frontline healthcare workers as cogs in the system. Frontline healthcare workers are so well poised to improve service provision, yet sometimes we’re the last to be asked, or to be informed, about changes in the system.
19. Where do you see cardiothoracic surgery in five years?
Great question. It’s definitely going to have to evolve. I think the way vascular surgery evolved with endovascular therapy is a great example of how specialties should evolve with new technology. With TAVR ever growing, cardiac surgeons need to maintain a seat at the table and attain the skills for this procedure which will inevitably become applicable to other procedures. I also think that we’re going to see sicker patients with more comorbidities and heart failure which means that we’ll need to become better heart failure doctors as well as surgeons. It’s an exciting time, if we choose to take on the challenge.
20. What’s your final piece of advice for students interested in pursuing a career in surgery?
Go into all of your rotations with eyes wide open and ready to learn, because whatever you end up doing, it all helps. Listen to what people say, not just about the medicine, but about the lifestyle and career as well. When the time comes to choose a career, choose something that interests you and challenges you and fits with all of your life goals, not just with career goals. And never let anyone tell you gender is a reason not to pursue a career, because nothing could be further from the truth.