Doctors in the past were perhaps not as professional in certain aspects of medical practice. Certainly if one looks at past records, comments were added that would not be acceptable today. Whilst these were at one point considered harmless pranks for the amusement of doctors, this is no longer the case.

Simon Bramhall, 53, was a prominent liver surgeon who no doubt saved countless lives. He used an argon beam machine to write his initials on the organs of anaesthetised patients in 2013 while working at Birmingham's Queen Elizabeth Hospital.

There was no medical reason to do this and it was not part of any treatment plan that would benefit the patient. The ‘branding’ did not harm the patient. 

A case of ‘assault by beating’ was brought against the surgeon. There is no suggestion that the surgeon actually did ‘beat’ any patient in the violent sense of the word. He was fined £10000 and also sentenced to a 12 month community order at Birmingham Crown Court. He was also suspended from his post at the hospital. 

I think medical schools are less likely to ask you directly about what you know about Simon Bramhall but they could frame a scenario, ethical or factual, about elements of the case. 

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There are a few take home messages from this case which you also use a reference to answer similar questions in your medical school interview

• During the trial the judge considered and accepted his defence that he was stressed and tired and this impaired his judgement.

• However act was considered ‘arrogant’ and strayed into criminal behaviour

• General opinion has been divided. Some felt this was an abuse of power. Two of his victims claimed they had felt violated and suffered long term psychological harm.  

• Others happy to have the ‘branding’

• An important point here is that it was done without consent and not for any therapeutic value for this patient. His patients were more vulnerable as they were under anaesthesia

• Another point that was raised is that his ‘branding’ would have remained hidden if one of his patients had not been subsequently followed up by another surgeon who discovered the ‘branding’

The General Medical Council in the United Kingdom said that his actions did fall below the standards expected of a doctor. The council concluded the case by issuing a formal warning. 

There was a similar case in the United States where Dr Allan Zarkin used a scalpel to carve his initials on the stomach of a patient on whom he had just performed a caesarian section. In contrast to Dr Bramhall, the ‘branding’ was visible externally. The patient claimed this had deprived her of intimacy with her husband as another man’s initials were visible when she undressed. Zarkin was found guilty of second degree assault and barred from applying for a medical licence for 5 years. 

Try this question:-

‘You are a medical student who is watching a world leading surgeon perform life saving surgery on a patient whilst on placement. The surgeon near the end of the operation uses a laser to etch his name on the metal implant he has used in the operation before closing the wound. What do you do?

Learn how to approach and answer similar questions on our medical school interview course. Take the hot seat.

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