Thirty years, remembered. Career milestones and memorable cases — braided into one continuous story.
1986
Milestone
Commandant Prize: Royal Military College
Before medicine, there was discipline. I was awarded the Commandant Prize as the Most Outstanding Student at the Royal Military College in Sungai Besi, Malaysia. RMC teaches you things that medical school doesn't: how to lead under pressure, how to make decisions with incomplete information, and how to take responsibility. Those lessons stayed with me through every operating theatre I have ever walked into.
1993
Milestone
Barker Anatomical Prize
The Barker Anatomical Prize was the first formal recognition of what would become the central thread of my career: a deep fascination with neuroanatomy. Understanding the three-dimensional architecture of the brain and spine, the tracts, the nuclei, the vascular territories, is what separates safe neurosurgery from guesswork. The prize was an honour, but what it represented was more important: anatomy is the surgeon's map, and without a map, you are lost.
1996
Milestone
MB Bch, BaO, LRCSI, LRCPI: Royal College of Surgeons in Ireland
I graduated from the Royal College of Surgeons in Ireland in Dublin. The RCSI is one of the oldest surgical training institutions in the world, and its curriculum emphasises clinical examination and diagnostic reasoning from day one. I emerged with dual licentiates from both the surgical and medical royal colleges of Ireland, LRCSI and LRCPI, a broad foundation that has served me through every phase of my career.
2000
Milestone
MSc in Trauma Surgery: University of Birmingham
The MSc at Birmingham sharpened my understanding of trauma as a systems problem, not just a surgical one. Trauma surgery sits at the intersection of rapid decision-making, applied anatomy, and multidisciplinary coordination. The principles I learned there apply every time I manage a patient with a head or spinal injury, whether from a road traffic accident, a fall, or a bleed inside the skull.
2000
Milestone
Neuro-oncology Research Fellow: University of Liverpool
Between 2000 and 2002, I served as the Walton Neuroscience Research Fellow at the University of Liverpool and the Clatterbridge Cancer Research Centre, working under Professor Peter Warnke and Dr Carol Walker. My research focused on molecular neuro-oncology, the biology of gliomas, the radiological response to radiotherapy, and the prognostic factors in low-grade and high-grade gliomas. This was the period that made me a neuro-oncologist, not just a surgeon who removes tumours. I learned to think about the disease at the molecular level.
2002
Case
The First Depressed Skull Fracture Series
That same year, we published our five-year study of surgically treated depressed skull fractures in the Annals of the Royal College of Surgeons of England. It was my first peer-reviewed publication, and it taught me that every surgical case contains a lesson, if you are disciplined enough to collect the data, analyse it honestly, and publish it. The patients in that series were mostly young men, victims of assault and road accidents. Their outcomes taught me that timely surgery, meticulous technique, and good post-operative care can return someone to their life.
“Every case contains a lesson. The discipline is in collecting the data, analysing it honestly, and publishing it, even when the results are humbling.”
2003
Milestone
Landmark Glioma Research Published
Our work on phenotype versus genotype in gliomas displaying histological heterogeneity was published in Clinical Cancer Research. This paper addressed a fundamental clinical problem: gliomas that look heterogeneous under the microscope. Do they behave as one tumour or multiple? The answer, we found, was that different histological areas within the same tumour often share the same genetic signature. This has real implications for how we sample, diagnose, and treat these tumours. It remains one of the papers I am most proud of.
2004
Milestone
Specialist Registrar in Neurosurgery: UK National Training Programme
I entered the UK neurosurgical training programme as a Specialist Registrar, rotating through major centres in Liverpool, Manchester, Leeds, Edinburgh, and Aberdeen. Over the next six years, I would be exposed to the full breadth of neurosurgical practice, cranial, spinal, vascular, oncological, paediatric, and trauma. The training was demanding by design. It had to be. No two brains are the same, and no textbook fully prepares you for the first time you hold a scalpel above someone's motor cortex.
2009
Milestone
FRCS (Surgical Neurology): Royal College of Surgeons of Edinburgh
The FRCS in Surgical Neurology is the exit examination for neurosurgical training in the United Kingdom and Ireland. It tests everything: anatomy, pathology, operative strategy, clinical judgment, and the ability to think clearly when questioned aggressively by senior examiners. Passing it meant I had met the standard to practice independently as a consultant neurosurgeon. It was the hardest examination of my life.
2010
Milestone
CCT in Neurosurgery & Consultant Appointment: NHS
I received my Certificate of Completion of Training (CCT) in Neurosurgery and was entered onto the General Medical Council specialist register. I was appointed Consultant Neurosurgeon and Clinical Lead in Neuro-Oncology at Aberdeen Royal Infirmary, Scotland. For the next four years, I managed a busy cranial and spinal practice, led the neuro-oncology service, and founded the Aberdeen FRCS (SN) Viva Course, an intensive preparation programme that has since trained neurosurgeons from the UK, Europe, Asia, the Middle East, and Africa.
2014
Milestone
Co-author: Neurosurgery: The Essential Guide
The first edition of 'Neurosurgery: The Essential Guide to the Oral and Clinical Neurosurgical Exam' was published by CRC Press / Taylor & Francis. The book was born from the realisation that there was no single, practical resource for candidates preparing for the FRCS examination. We wrote it to fill that gap. The second edition followed in 2023, updated to reflect advances in the field and the evolution of the examination itself.
2014
Milestone
Contributor: Landmark AVM Study in JAMA
I contributed to a major multicentre study on the outcome of conservative management versus intervention for unruptured brain arteriovenous malformations, published in JAMA. The findings challenged prevailing assumptions about the benefit of intervention for unruptured AVMs and changed practice internationally. It was a reminder that, in neurosurgery, doing nothing is sometimes the bravest and best decision.
2014
Milestone
Return to Malaysia: Sunway Medical Centre
After nearly two decades in the United Kingdom and Ireland, training, researching, operating, and teaching, I returned to Malaysia. I joined Sunway Medical Centre as a Consultant Neurosurgeon and Spine Surgeon, bringing with me the techniques and multidisciplinary approach I had developed through the UK system. The move was a homecoming and a new beginning.
2018
Case
Awake Craniotomy for a Young Professional
A young patient, a professional whose livelihood depended on language and fine motor control, was diagnosed with a glioma in the dominant hemisphere, near the areas that control speech and hand function. An asleep operation would have carried a significant risk of permanent deficit. We performed an awake craniotomy with intraoperative mapping, and while I resected the tumour, our speech therapist tested the patient's language in real time. The tumour was removed. The patient walked out of the hospital with preserved function and returned to work within weeks.
“The goal is not just to remove the tumour. It is to remove the tumour while preserving the person.”
2023
Milestone
Second Edition: The Essential Guide Published
The second edition of our textbook was published, updated and expanded to reflect the latest evidence and examination standards. It continues to be used by neurosurgical trainees around the world preparing for their exit examinations.