“Let me start with a moment every cardiac surgeon remembers. It's not your first solo case. It's not passing exams. It's not even the first time you hold a heart. It's the moment just before you make the incision and the room goes quiet; the lights seem brighter and you realise something very simple and very terrifying. There is no undo, no reset, no pause button, no second draft. If your hands are steady at that moment, that's good. If they're not, that's good too.

“Because at that moment, the one where you feel the full weight of responsibility, is when your legacy starts. Not years from now, not at the end of your career, but right there with a scalpel in your hand and a life trusting you completely.”

The legacy you leave – a reflection for young surgeons, was the title of this year’s Syme Oration, delivered at the Convocation Ceremony at the ASC in Perth. The presenter was Professor Mark Edwards, Emeritus Consultant cardiothoracic surgeon at Royal Perth Hospital and chair of the Medical Board of Australia.

Speaking candidly about legacy, Professor Edwards challenged the idea that it is defined by titles, accolades or technical perfection. Instead, he reframed legacy as the lasting impact surgeons have through their judgement, integrity and behaviour, particularly in moments of uncertainty or failure.

Drawing on personal experience, he described the profound responsibility surgeons carry from the moment a patient places their trust in them. He reminded the audience that professionalism begins not at the end of a career, but at the very first incision when accountability becomes real and unavoidable.

“Your legacy isn’t built on your victories. It’s built on how you carry your failures. As surgeons, we are placed in a position of incredible privilege.”

Central to his  message was that surgery is never a solo endeavour. Professor Edwards emphasised the importance of humility, teamwork and creating cultures where honesty is valued and people feel safe to speak up. He noted that surgeons are remembered less for flawless cases than for how they respond when outcomes are not as hoped.

“Your legacy lives in whether people feel safe to speak up, where the juniors dare to question you, whether the quiet voice in the room is heard. How you speak to people who have no influence on your career … Your Trainees won't remember every word you taught them, but they will remember how you made them feel. They'll remember how you treat people when no one is watching, how you speak to the scrub nurse at 2am, whether you say thank you when the case is done, whether you learn people's names, whether you blame or protect your team.”

The Syme Oration honours Sir George Adlington Syme, the College’s first president, and has long been a cornerstone of the Convocation ceremony. His support for the establishment of an Australian and Aotearoa New Zealand College of Surgeons was an important influence on surgeons in the two countries.

Read the full Syme Oration. (PDF 94.48KB)


 

About Professor Mark Edwards BSc; MBBS; FRCS; FRACS, Emeritus Consultant cardiothoracic surgeon, Royal Perth Hospital, Chair Medical Board of Australia (WA)

Born and schooled in Perth, Professor Mark Edwards graduated in both science and medicine from the University of Western Australia. His early ambition was always surgery, obtaining his FRCS in London in 1977. Returning to Perth, he began cardiothoracic training at Royal Perth Hospital, followed by Royal Prince Alfred Hospital, and attained his FRACS in 1982

Returning to London, he worked with legendary figures Donald Ross and (later Sir) Magdi Yacoub experiencing every conceivable aspect of cardiac surgery. He was subsequently appointed consultant surgeon at Royal Perth Hospital where he was head of department until the unit moved to Fiona Stanley Hospital in 2015. He was granted Emeritus Consultant status on completion of his service.
With a strong interest in teaching and training, he was appointed by College Council as an examiner in Cardiothoracic surgery and indeed spent six years as Senior Examiner. He was then elected by his peers to Council where he spent nine years serving with distinction as inaugural Chair of BSET, Chair of the Court of Examiners, and finally as Censer-in-Chief.

At the completion of his time on Council, he was awarded the Louis Barnett Medal “for outstanding contributions to education, training and achievement in surgery”. In 2024 he was given ‘The ANZSCTS President’s Award for lifelong contribution to Cardiothoracic Surgery in Australia. Always passionate about education he was a teacher, trainer and mentor to literally hundreds of surgeons throughout Australia, Aotearoa New Zealand and overseas.

Later, he developed an interest in medical regulation and was appointed to the WA Medical Board in 2016, subsequently becoming Chair of the Board in 2022, a position to which he has just been re-appointed for a second term.