Interview by Sarah Polzer

Dr. Simõ⁠es, you are currently working in Birmingham in the United Kindom. Birmingham is also the central headquarter of the COVIDSurg network. How did you become part of the team and what do you like about working with it?
I moved to Birmingham around six months before COVID-19 started to get pandemic. It was cheering to join research that is globally relevant. Personally, I have interest in having the best data on COVID-19 research. I am conducting the research as part of the full-time PhD programme. To be part of COVIDSurg was a team decision. Everyone came together to do something. The potential of global collaboration was available. Issues are that implementation of guideline medicine is partly lacking. For example, operation A was always done, therefore recommended to patients, although operation B would now be the gold standard. Gold standards must continue to improve. The goal is to build up evidence-based medicine.

How would you sum up COVIDSurg in two sentences?
Recognition to the whole association and not individual names on the paper. People who participated in it are part of something bigger.

In your opinion, how do you evaluate the work in such a large network, which includes around 15,000 participants all over the world?
In an international network, you get a lot of inspiration. Sure, it is also time-consuming, but you gain valuable insights. There are also challenges like logistical problems. All in all, the advantages outweigh the disadvantages. Research in different locations is possible as well as a look at countries in the low- and middle-income field. This is how we work step by step for fair access to health care.

How much time do you invest in COVIDSurg projects?
It is a full-time job.

Which approach is chosen to achieve the network's goals?
A working group has been funded for research in low and middle wage countries. It is important that representatives from there, do participate in these studies. What is true for developed countries does not necessarily translate to these nations. The research infrastructure in locations that do not have such facilities will be improved by this global research, so that they can do more independent work. The only way is to build a clinical research network that can be accessed in the future. Laboratory research is another area of interest. There are student research communities in Europe and around the world in this area as well.

Do you think there are also positive effects of the pandemic?
Certainly, scientific knowledge became more accessible to all. The pandemic has shown us how important medical studies are. By learning how to make the most of online conferences and not always having to travel across the country for conferences, there are also environmental benefits. We needed fewer flights, which has an impact on the climate. People started to think about it and it also raised awareness about some aspects of science, the importance of research and evidence-based medicine.

You describe surgery as your great passion. Has it always been your strong wish to work in this field?
At the beginning of my medical studies, I mainly wanted to know how the body works and understand biological processes. Moreover, you do something useful and help people who are in vulnerable positions. I wanted to focus my life on the main things in life and to have a reliable position. In the beginning, I wasn't keen on pursuing surgery. Little by little, I became more and more enthusiastic about the versatility and necessity of surgery. Above all, I loved facing new challenges. The step into surgery has proven to be the right decision for me - it has become a life's work.

How do you encounter these challenges you speak of?
These are technical challenges. This includes redefining and developing technologies to help people with your own hands. The most difficult thing is proportionality: the more people you save, the more patients you will lose.

The question of who is to blame for a failed operation accompanies every surgeon at some point in his or her career. What is the best way to deal with these fears?
Oh, that is a good one and really important as well. Ask yourself: What could have been done differently? In surgery, this topic is still often kept quiet. Surgeons often must deal with it alone. There is a risk of developing fear of getting into such a situation again and being overcautious, which is not always good. One way to deal with this is to become cold in some way. Try to get distance, a kind of emotional distance. Break the rules of silence. Share your suffering with colleagues, exchange ideas with your mentors and peers. All in all, be brave to share experience. Accept that you cannot control everything. The challenge of our generation is to bring about a mindshift, based on evidence and communication.

What is your personal balance?
I do a lot of yoga, meet up with friends and try to find a balance to work. I advise everyone to find something away from work to calm down and recover from the often exhausting experiences of your day-to-day work.

You're still in training - what stages have you been through so far?
I am originally from Portugal. I completed my medical studies there. This included one year of general training and four years of general surgery. I have also done extra short internships in Italy, in Messina and at the Hospital Principal in Sao Tome and Principe. I have been in Birmingham for almost two years and am doing my PhD there.

What are your hopes for the future – and - what is your main message to others?
It is in the hands of everyone. Collaboration is the only way to bring about change and development, because only when we work together can we achieve something.