Crippled before the race begins: how the med students are feeling

Hello all, I wrote this yesterday after I went to Birmingham medical school for the day to represent Medic Footprints at a national conference hosted by BAMSoc (Birmingham Academic Medicine Society). As well as academic presentations and poster displays, there was also a focus on career development and mentoring. One of their committee members, Lauren Quinn, was telling me how they were inspired by the Medic Footprints ACW (Alternative Careers and Wellbeing for doctors) conference last October, and wanted to bring something of it to their own university. It was pretty interesting to hear what current med students have to say about their medical careers…

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I’m sitting on a train on my way back to London from Birmingham New Street, and thinking about the experiences I’ve just had at the BAMSoc conference.

I was there with fellow Medic Footprints team member Dr Jogisha Kukadia, an orthopaedic registrar who’s taking a break from the classical training path and locuming while she does other things and tries to figure out what she wants to do – such a common story now. I was unsurprised to see the recent government statistics confirming that only half of FY2s continue into speciality/GP training – there seem to be more reasons to leave than to stay these days.

Anyway, it was a very interesting day. I used to wonder whether it was ‘too soon’ to be discussing alternative careers with medical students – after all, they haven’t even started yet – but then we’ve had a few medical students come to events over the years, and indeed many of the doctors in our network started their journey while at medical school. As Jogisha said, it’s never too early to set an example and ‘sow the seeds’, as it were.

The general feeling from many of the medical students we spoke to is that they are really feeling the strain of what’s going on in the NHS, and questioning the future of their careers. Already they’re planning F3 years and thinking about leaving, and a couple of them were even thinking about quitting medical school before finishing. I felt keenly for one student who came up to me and told me how a friend ‘couldn’t bear the thought of doing the clinical years, but felt she couldn’t speak to anyone about it ’. And there was another who found medical school was eating into every aspect of life, and becoming so stressful, that hobbies and interests were no longer fun. I remember feeling these things at medical school. I thought I was alone, but in reality I think that a lot of people probably felt that way – we all just hid it very well.

A really lovely moment today was when three final year students came to us and told us how ‘refreshing’ our talk was. It was actually brilliant to meet them, because they seemed so impressed with the ethos of Medic Footprints, and so amazed that this whole world of possibilities existed. I’ve got used to it now, but I mustn’t forget that, just a short time ago, I too was ignorant of any path but the well trodden one of continuous, relentless training until consultancy. We spoke for a long time about various things – dealing with the guilt of leaving, having little to no access to alternative careers information at medical school, the tendency of medicine to make everyone conform to one ideal, like robots rather than thinking, feeling , individual human beings.

We told them numerous stories about doctors were know who have done things differently, like Gyles Morrisson, Evgenia Galinskaya, Stephanie Eltz, Sandeep Bansal and many more. They seemed so shocked – the expression on their faces must have been exactly as mine was the first time I went to the ACW.

They told us how they felt they were losing who they really were. On their first day at medical school, they were told by a lecturer that ‘half of them would be GPs’. This is, of course, the government target that the med schools are clearly pushing, but it made the students feel as if they had no autonomy over their careers and were just there to do as they were told. They told us about the Situational Judgement Test, and how even the exam itself was designed to imply that, though work-life balance was important, work was the ultimate priority.

When did medicine become like this? It’s a vocation, to be sure, but that doesn’t mean it should come at the price of your happiness and enjoyment of life. We are breeding a generation of miserable doctors, shuffling onto the wards to do their duty rather than loving their job. What good is that? Who does that benefit? Certainly not the patient, for whichever way you put it, an unhappy doctor is never going to be as effective a clinician as a well-rested, emotionally supported doctor who is happy with their life.

It was also absolutely fascinating to hear a talk by Peter Minnis, who is training to be a doctor in the Royal Navy. Jogisha and I looked at each other in astonishment when he told us how much they earn. Not only are school fees paid for, but they are also salaried while they are at medical school! Think of that! To be paid for studying! It seemed unreal. And then the fact that, as a naval FY2, you could earn £56k! Madness! That’s more than double the normal FY2 salary! And just when Jogisha and I were thinking it was probably a man’s world, he told us that about 50% of naval doctors were female! Apologies for the overuse of exclamation marks, but my mouth literally dropped open during this talk.

Peter then went on to describe the other benefits of being a navy, army or RAF doctor: the camaraderie, the great social life, the sense of belonging, the problem solving, the autonomy, the hands-on approach in which skills like wound closure, intubation and other aspects of advanced trauma life support were taught routinely – all of these things were exactly what I imagined life would be like when I applied for medical school, and I was so disappointed when it was not. Junior doctors nowadays are massively deskilled because their exposure to all this practical stuff is so minimised. I couldn’t believe this way of doctoring still existed in the armed forces! Clearly, the medical students didn’t know either, as some of them sounded annoyed that they had never been given this option before.

In the navy, you are also, by default, obliged to step out of medicine every so often, as you are a naval officer first and a doctor second. You are expected to muck in and assist with the other jobs to be done on the ship, and you travel the world while you do it, so the very nature of the job protects you from that dangerously unhealthy state in which medicine becomes omnipresent and all-encompassing. Of course, there is a risk involved – you may pay for it all with your own life, and I don’t pretend that doing such a job easy, with the long missions away from home and the ethical implications of the job. But you could argue the NHS has its own risks – the rates of physician suicide are that much higher than the average person, and both mental and physical health problems are growing increasingly common. I would die a thousand deaths before going back to being the mundane, bitter shell of a person I became as a doctor.

Someone asked me if I would still recommend medicine as a career. That’s a tricky one. I recently turned down an opportunity to speak at an event that was aimed at helping college students to get into medicine. I couldn’t do it – given my background, I couldn’t reconcile myself to the cause. Having said that, a medical degree is a valuable one, and medicine itself is a wonderful profession if you remove all the inane obligations thrown at you by the system.

I think I would still recommend it, I just don’t think it’s right that medicine should be done full time. When I say full time, I mean it in a junior doctor’s terms, where every hour of every day is spent either working clinically, working at home on projects, papers or portfolios, or worrying about work. I think cultivating interests outside of medicine should be encouraged and applauded, because it is simply unhealthy and unwise to do this kind of work without respite and relief.

What struck me most today was not so much that these students were already disillusioned before even beginning their careers. It was that they were so disempowered. So often we heard from those who were unable to share their fears for fear of censure, ignorant of the many forms a medical career can take, and pressured to ‘complete’ their training as fast as possible. These are the reasons why medicine can feel like a prison. Without a way to address these issues, what happened to me will happen to them – they will get to a point where they just can’t do it anymore and quit. I hope that we can make a difference by intervening sooner, and showing them that you truly can achieve a balance between medicine and life. I hope we can also show them that it’s OK to ask questions and have doubts, and that their wonderful, high-functioning individuality is their greatest asset, not something that should be stamped out of them.

 

 

 

12 months older, I must admit…

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So here it is, New Year’s Eve, and 2016 is coming to an end. It’s been a bit of a disastrous year for the world in many respects, but for me, I can truly say this has been the best year of my life. As well as getting married, this was the year that took me away from my life as a doctor and threw me onto a less comfortable, but much happier path.

“I can picture myself sitting exactly where I am now, one year ago, my mind racked with anxiety and guilt, my confidence shaken and my direction lost.”

When I think about myself this time last year, I wish I had a Tardis – or some such other time travelling contraption – because I can picture myself sitting exactly where I am now, one year ago, my mind racked with anxiety and guilt, my confidence shaken and my direction lost. I sat here crying, in the wake of my resignation, terrified of what I’d just done but too repulsed at the idea of going back to even consider locuming. It was also around the time that the new junior doctor contract stuff was kicking off, and I couldn’t imagine returning to the ever increasing frustration and uncertainty.

I was traumatised, I think – not only from my experiences as a doctor, but also from the illness that gave me a seriously big reality check earlier that year. I was still recovering from it in body and mind, and I didn’t feel equal to coping with the changes in my life, even though I had been the source of them.

The last pay cheque had been spent on Christmas and rent, and I was living off my savings and what seemed like borrowed time. I felt like a failure. I felt that I had let everyone down – a burden to my fiancé, a disappointment to my parents, and worst of all, a disappointment to myself. I listened to the same songs over and over again – holding onto my reasons for leaving (Gotta Go My Own Way), trying unsuccessfully to convince myself I would succeed against the odds (Hall of Fame) and waiting desperately for some distant day when I could look back and say I survived (Survivor/I Will Survive).

I was sitting here thinking that I was ‘nothing more than a doctor’, with no other skills or abilities, not realising just how many superhuman capabilities one has to develop as a doctor. I was wondering who on earth would employ, what on earth a failure like me had to offer. My mind was toxic and I just wanted to withdraw from the world, too ashamed to raise my head again. It may sound melodramatic to me now, but those feelings were real at that time. I was in a dark place.

And yet , despite being so down, there was something inside me that was determined to fight. I almost can’t believe it still – I walked into another job with a good salary and a senior position. I picked up my new skills from scratch and did my job well l. I remembered that I had other talents. I grew as a person. I healed. I felt special, unique, proud. I had the time and space to be there for my best friend as she got married, and to plan my own dream wedding. And I learned – my goodness, did I learn! It was an educational kaleidoscope. I discovered a world of things I had no idea existed, and finally jumped out of the box I had been sitting in for so long.

I once again attended the Medic Footprints ‘Alternative Careers and Wellbeing  for doctors’ event that I went to last October. It was just before my wedding, but I was determined to go, because last time I was there as a frightened and unsure delegate, and this time I went as a mentor and team member, with a spring in my step and the desire to give some inspiration back, after having received so much.

My husband and friends tell me now that they’ve ‘got me back.’ I am sad to think that I ever let my career take away any aspects of my personality, and I think that if I had my time in the NHS again, I would do things differently. But it’s so easily done – when you’re in that bubble, it’s hard and sometimes too exhausting to change things.

I think there’s part of me that will always miss being a doctor. It was such a fundamental part of my life, and I can’t deny that I still sometimes wish that I could have made it work. But I have no intention of going back. I see now that I just didn’t belong there – it didn’t suit me – and that’s OK. It’s not for everyone. You can’t change who you are, you just have to embrace it. Of course, things aren’t all plain sailing and rosy at the moment, but I am happy notwithstanding. I feel more in control and that things are more as they ought to be. I went into medicine because I wanted to help people, but this year has taught me that there’s more than one way to make the lives of others better, and I am finally using the gifts I have been given to do just that. If nothing else, this blog has helped other doctors, and for that I am profoundly grateful and humbled.

I have also been learning a particularly hard skill – not to be too hard on myself. The side effect of being driven and diligent is that there is a strong tendency to become complacent about one’s achievements and dismiss little progressions and successes as unimportant. The ‘good’ things don’t count as much as the failures, and this leads to the deeply dissatifying feeling that you’re never quite good enough. Self-praise is hard for people like me, but I’m going to do it now: while I was learning my new trade, I didn’t have the brain space to work on my novel. But now that I know what I’m doing at work, I’ve smashed out another 20 000 words or so. It might never get published, but it’s a project that is important to me and that is taking a lot of work to produce, therefore it’s something to take pride in.

If only I could go back to my last year self and give her a glimpse of the things to come. If only she could see that the outlook is not so very bleak, that she will harness all her resources and that the risk will pay off. I won’t say that I’ve ‘made it’ – my high ideals and expectations of myself continue to push my ambitions in a different but equally demanding direction – but it doesn’t matter. I’m doing things my own way and learning to trust my intuition.

And perhaps more importantly – I’m not just surviving. I’m living too.

Tying knots and unravelling tangles

Dear Readers, I can only apologise for my radio silence for the last couple of months. I do have a very good excuse, however… I got married three weeks ago and my new husband and I have just got back from our honeymoon! We had a perfectly elegant wedding day in Essex, and a splendiferous time in Sri Lanka and Thailand. I must publicly thank my excellent parents for pulling off such a wonderful occasion, and at present I am so happy that I have a mind above career troubles.

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That’s not to say I wasn’t able to make some interesting job-related observations in the process of getting married. I think I may have said before how lucky I was, not only to be free of on call rotas and late shifts, but to be working only part time in the lead up to the wedding. I feel even luckier now thinking about it afterwards, and I can’t imagine how doctor couples manage to plan this sort of thing while working full time (especially Asian weddings, with their huge guest lists and numerous functions!) Some of my married doctor friends have told me they were obliged to rely heavily on friends, family or paid assistance to pull off their big day, and many ended up doing things last minute. Of course, we too relied on my family and did things last minute, but I felt I could be mentally more involved with the process than I could have been before.

One of the biggest gripes about working as an NHS, for me and I think many others, was the ‘life event’ factor. How many of us have missed the weddings, funerals and other important moments in the lives of loved ones, because we couldn’t swap our shift, or because we had an exam or an assessment coming up, or even just because we were too exhausted to go?

I was once shocked when a former colleague of mine told me how the management at her hospital demanded that she work the evening before her wedding! I guess, looking at it completely dispassionate way, there was no reason she couldn’t work that shift, but from a human point of view – how cold, how unfeeling it was! To deny her those sweet hours of anticipation and delight, to prevent her from making any final arrangements and preparing herself for this symbolic and serious moment in her life… It is easy to understand how doctors feel dehumanised and undervalued when their personal quality of life is so apathetically ignored.

I feel truly thankful that my current employers not only gave me a generous amount of leave, but were also kind enough to give me a card and present. Such kindnesses from the management can perhaps only be found in small companies, but they mean a lot.

It is true that not everything about my situation was ideal – my drop in income wasn’t particularly helpful in the lead up to one of the most expensive periods of modern life! But personally, it meant a lot to me to have the time. We got to spend lots of time with my mum and other family members and friends, planning and making a lot of things ourselves. For example, I spent six or seven hours scoring, chopping, hand-painting and hand-writing 300-odd place cards, and looking back, I am so glad that I did that. It was important for us to feel that our wedding had a personal touch, and it did. It was truly special.

Also, as weird as it sounds, since working in marketing, I’ve developed a bizarre need for ‘consistency of branding’, and I confess a secret satisfaction that we had standardised themes, colours, fonts and styles running across all our wedding stationary and decorations. Laugh if you will!

During the wedding there wasn’t much time to think or talk about my current occupational quandaries, but one thing that made me feel quite emotional was my dad’s speech. He mentioned how proud he and my mum were about my educational achievements at school, getting into medical school and eventually becoming a doctor. I know how much it means to them that I joined a profession that they both value so highly, and I felt a pang of sorrow and guilt that I couldn’t continue to make them proud in the same way.

I was expecting far worse, however, during the party in Sri Lanka. We went out there for what Sri Lankans call ‘the homecoming’. Traditionally it is the ceremony that takes place after the honeymoon, in which the bride is welcomed in the groom’s family home – but nowadays it’s more an excuse to have another big party post-wedding, and it was ideal for us because it meant all my family and friends living in Sri Lanka could be part of the celebrations.

My only concern was that it would be difficult to talk about leaving medicine with people there. It’s hard enough to discuss it with some of our Sri Lankan connections in the UK, and I convinced myself, perhaps irrationally, that I would see looks of shock and dismay on the faces of my relatives. The thought of the concerned questions and maybe the shaking heads of disapproval, made me feel faintly sick.

However, circumstance cut me some unexpected slack in this regard… As we went round the tables meeting and greeting everyone, I discovered that the fact that I was now a wife gave me the perfect cover. People seemed to think it quite understandable that I was no longer working as a doctor – I am a wife now, after all. Time to step back in my career, look after my husband and have children. It made me laugh inside to think that, having been such an earnest believer in feminism as a young woman, such a high-achieving, determined career-girl, I would now find refuge in these old-fashioned notions!

I was grateful, however, that I was let off so easily. It meant I enjoyed the party a lot more than I imagined I would!

I can’t deny that the idea of ‘relying on my husband’ is uncomfortable for me. My father has always impressed on me the importance of being independent.

My husband has a different view – he sees our marriage as a partnership, where the burden of support is about more than just finances, and fluctuates according to the situation. One day, the tables may turn, and he may rely on me – there’s no telling what may happen in the future. Unwavering and unconditionally does he look after me now, and I must find a way to make peace with this and be happy until I can regain my independence.

As much as I tell myself this vocational hiatus won’t last forever, it is difficult for me to think that I left medicine almost a year ago, and I still have not found a suitable replacement. It is hard, after following a path and a plan for the last twelve years, to suddenly feel adrift. At a time when patience, faith and belief in oneself are paramount, and I have discovered that I, despite all my attempts at courage, am grievously lacking in all these areas.

Having just been in Sri Lanka and Thailand, both majority Buddhist countries, I have reconnected with my religion somewhat over the last three weeks, and I have been reminded of the importance of the Buddhist belief in appreciating the present moment. We spend so much time regretting and reliving the past, and planning for or worrying about the future, that we forget that we live in the present – that everything we do happens in the present.

There was a moment on my wedding day when my favourite Bollywood song came on, and I grabbed my cousins and spun them round on the dance floor. Before I knew it, there was a whole contingency of (mostly female!) guests around me, including my mum, copying my Indian dance moves and making me feel like we really were in a  choreographed Bollywood dance scene! For a moment, I stopped worrying about the caterers and the plan and whether things were running to time. The only thing I was thinking about was the next dance move, and for a few minutes, it was blissful and joyous fun.

It’s time to employ a new attitude. I can’t spend my time worrying about how to replace medicine. I just need to live, and maybe one day I’ll look within and discover that the hole it left has finally been filled.

 

 

So… what do you do? Part 2

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I’m having a bit of a nightmare navigating the delicate social quagmire of speaking to another doctor when you’re a patient who also happens to be an ex-doctor.

It’s always a bit strange being treated and cared for when your job is to treat and care for others, but now that I’m no longer working clinically, it feels even stranger. I was hoping that you, my loyal readers, could give me your opinion.

A few months ago, I wrote a post about the pitfalls of answering the “So what do you do?” question when you’ve just had a massive career change. Now I’m starting to get used to telling my weird I-used-to-be-a-doctor-but-I-left-and-went-into-content-marketing story. Sometimes I even miss out the doctor bit for the sake of ease, but what I’m still finding difficult and slightly bizarre is talking to medical professionals as a patient.

Just after I left medicine, I had to take my fiancé to our local hospital for a minor operation. I remember waiting in A+E, contemplating the mess that was my life, and then we were called into the triage room to be seen by a very nice orthopaedic SHO. I let him explain what was happening, even though I knew perfectly well what my fiancé’s diagnosis was, and exactly what would happen next. Somehow or other, during the conversation I let slip that I was a doctor myself, and the SHO looked surprised and slightly embarrassed as he said:

“Oh! You should have told me before! I wouldn’t have dumbed it down so much.”

I also felt a little embarrassed, but to be fair, my fiancé was the patient, so it was good that he understood what was going on.

But the other day, I went to see a consultant dermatologist. My mum accompanied me, but I was the patient this time. We shook hands and sat down, and he began to tell me about the layers of the skin – first dermatology lesson at medical school stuff -and after debating in my head for a few seconds as to whether I should say something, I remembered the orthopaedic SHO and ventured to interrupt him in what I thought was the politest way possible.

“I’m so sorry to stop you, but I thought I should just let you know – I’m a doctor too.”

Later, however, my mother told me that I’d been rather rude and she’d never been so ashamed of me in her life!

The consultant looked as embarrassed as the orthopaedic SHO, and took a hasty second look at the medical form I had filled in when I had arrived at the clinic. I had written ‘marketing manager’ as my occupation – no wonder he was confused! He then looked at my title – ‘Dr.’ of course. He hadn’t noticed that before. He apologised profusely, but I assured him that I wasn’t at all offended – he hadn’t known, after all.

I felt awful, because he was a nice man and I didn’t mean to make him feel that way. I wondered, as my ears grew hotter and hotter, whether I should have put ‘doctor’ as my occupation on the form instead. It wouldn’t have been strictly true, because I no longer work as a doctor, but to avoid major awkwardness perhaps a little white lie would have been somewhat justified.

I have thought about it many times since. Was my mother right? Was it so very rude to save him wasting time explaining things I already knew ? What if said time wastage had resulted in the consultation ending without my having the chance to ask more complex questions that I really did want to know the answers to? And if I had been inpatient, could I not be forgiven for wanting desperately to get to the point and discuss my treatment options?

I’m going to have to find a solution for this, because there are going to be other times in life when I’ll be a patient. I want to have kids in the next few years, and after the things I’ve seen, there’s no way I’d have them anywhere but a hospital.

So what do I do? Your help would be greatly appreciated as I try to figure out how on earth I, Dr Perera, former junior doctor, am going to explain myself.

From Medicine to Media: my first experience of TV

Production companies are always looking for attention-grabbing ideas and inspiration for TV shows.

TV advertising is incredibly expensive, so if your business can provide material good enough to be featured on a TV program, it becomes a win-win situation: the production company gets their show, and your business gets TV exposure that could be repeated for months and even years to come.

In the health tech world, we’re lucky because health tends to be a subject that interests people. Shows like Embarrassing Bodies, Doctor in the House and 24 Hours in A&E are just a few of the health-related series that have captivated audience after audience.

The company I work for recently got the incredible opportunity to feature one of our GPs, Martin Saweirs, in a new prime-time health series on ITV, and our Head of Media Anthony and I planned to go along to the shoot to supervise.

On the day before the shoot, however, a last minute change of plan meant that Anthony could no longer join me… I had to go and supervise the shoot on my own!

I was pretty nervous about this. As well as being totally brilliant at his job, Anthony has also done this kind of thing a lot, and I… well, I had never done it before! He talked me through everything, however, and assured me that I would be fine.

So, on the morning of the shoot, I got to our doctor’s clinic at 7.30 am (early starts in TV!) and explained the plan for the day to the clinic manager. When the TV crew arrived, they set up their cameras in one of the consultation rooms and we had a quick discussion with the producer and Martin before the filming began. I had to get Martin to sign a rather scary-looking waiver form before we could start though!

The first task was to film an interview with Martin. There was no presenter, so the producer just asked Martin questions and he had to frame his answer in such a way that the viewer would know what the question was (which is surprisingly difficult when you’re under pressure!)

I felt a little sorry for poor Martin during this bit, because the producer had a very long list of questions and it was also incredibly warm in the consultation room. (The air conditioning had been switched off because the sound guy said the humming noise it made was interfering with the boom mic!)

If I had been wondering what exactly my role was up to this point, I quickly found it out during this session. As well as making sure Martin had plenty of water to drink and mopping his brow to make sure he wasn’t shiny, I also found myself interfering quite a lot in the interview. The TV crew were very nice and very accommodating, but they had their own agenda and time limits, which naturally took priority over our agenda and needs. I realised I was the only person there who was representing Martin and the company, so it was important to speak up if our star seemed uncomfortable with a question, or needed a break. It was also my job to get Martin to make as many company references in as possible! After all, the deal was that we would let them film him in exchange for featuring the company name on the show. I got him to throw in statistics from the company’s research and describe the sector we’re in, as well as mentioning the name a lot.

I thought I was being annoying, but Anthony later told me that I’d done exactly what I was supposed to!

The next part of the filming was Martin at work. The production company had found two volunteers from a casting website to be ‘case studies’. The idea was that they would each have a GP consultation with Martin, and then they would all give their feedback on how they felt it went.

We had a few hiccups – we got halfway through the first consultation when the sound guy realised the boom mic wasn’t plugged in! It’s difficult to do things over without losing the authenticity and energy of the first take, but both doctor and patient did very well. It did mean, though, that we were running behind schedule, so before we could shoot the second case study, Martin had to see a couple of his actual patients. While we waited, the TV crew got more cutaways of the two patients sitting in the waiting room, talking to each other, walking in and out of the consultation room and up and down the street outside.

It was a long day, with a lot of standing around and waiting, but I was glad I was there. It was great to meet a real TV crew and see them at work, and I think Martin appreciated my presence.

I must have done my job right because the production company called the next day about doing further filming about the research that I had got Martin to mention! As I walked home, I thought about everything Anthony has taught me, and how much I enjoy this side of the job. It makes me wonder how I never thought of working in PR and media before…

I guess, when it comes to a career, you never really know if you’ll like something until you try it…

 

Check out my latest articles:

Daily Mail :http://www.dailymail.co.uk/femail/article-3733796/Bras-cause-health-problems-droopy-breasts-s-not-young-turning-against-them.html

NetDoctor: http://www.netdoctor.co.uk/healthy-living/wellbeing/a26806/wives-tales-healthy/

We Are The City: http://www.wearethecity.com/women-doctors/

 

 

 

 

Giving up my license to practice

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It felt so cool getting my full GMC registration. In a weird, geeky way it felt like the James Bond part of a medical degree – a Licence to Practice! I was strangely proud and excited.

But today I gave it up.

It was so easy to do – just a simple form to fill on the GMC website, and that’s it. It takes seven years to get that license, and seven seconds to let it go.

I’m still keeping my registration, because for some reason I still feel the need to have a connection with my old profession. I considered renewing my license for another year ‘just in case’, but I can’t really justify the expense as I’m not working clinically and have absolutely no intention of doing so any time soon.

I know it’s reversible. I know it doesn’t make any difference to what I’m doing now, and that it doesn’t take away anything I’ve achieved.

And yet, it still hurts.

It feels like signing the final paperwork in a complicated divorce. I hated Medicine, but I loved it too. As much as we didn’t suit each other, we were together long enough for it to become a huge part of my identity, and I certainly wouldn’t be where I am today without it.

This week, the new F1s take their first fledgling steps in their new jobs, and junior doctors all over the country rotate into new specialties. The turmoil of the last year seems to have had no effect on the numbers of people applying for F1 training – which doesn’t surprise me really. For many it’s their first ever job, and it’s a chance to explore the profession and get a full registration.

I’m floating away from that world. I feel the bonds breaking and the distance widening. I sometimes look back in nostalgia, with that uncomfortable feeling that you were never really right together, but at the same time, you found a way to shift along well enough, and you did have some good moments.

There are times when I catch myself missing it terribly, particularly when I think about how great it was to communicate with patients. I was good at that, and it was the best part of the job. I recently comforted a friend of mine after a scan showed an unwelcome diagnosis, and in her gratitude for explaining things more fully, she lamented my leaving the medical profession, and wished that her doctors were more like me.

It was kind of her to say so, but in reality, when I was working as a doctor I never felt I had enough time to spend with patients to explain, to comfort and to guide, and I was often so exhausted that I could barely muster the energy to care very much. I can only smile at the idea of being a better doctor now that I’m out of the profession, and it makes me ashamed to think of what I was.

I think, having been a doctor, it never truly leaves you. There are some things that, once learned, can never be unlearned. Medicine is strangely addictive in that way.

But I can’t deny that I’m much happier where I am. Looking back and romanticizing my former life simply isn’t sensible, and I am in danger of seeing things through the rose-coloured glasses of hindsight.

It’s time to hang up my stethoscope and move on.

 

 

 

 

 

 

From Medicine to Business: One doctor’s journey into the startup world

As someone who has left clinical practice, I always feel a sense of kinship with those who have done the same. In my head, I imagine that they experienced the same inner struggles and external disapproval as I did, as they took the leap into unexplored territory. Recently, however, I discovered that I have perhaps been a little too hasty in my assumption.

Earlier this year, I  interviewed Dr Sandeep Bansal, Founder and CEO of health tech company Medic Creations. His success has been noted by the release of a number of clinical apps, including ‘The On Call Room’, ‘Your Health Room’ and ‘Medic Bleep’. I asked him about his decision to leave Medicine, and how it impacted him and his family. His answers were, quite frankly, a bit of a surprise…

Profile

sandeep bansal

Name: Dr Sandeep Bansal
Childhood home: Bedford
Medical School: Kasturba Medical College, Manipal, India
Foundation training: Bangor, Wales Deanery
Languages spoken: English, Hindi and Punjabi
Hobbies: Photography and travel

 

Sandeep’s lifelong link with Medicine

Sandeep’s father was a Cardiologist, but his severe childhood asthma also gave him a lot of personal experience of the NHS.

“I thought it was amazing how the doctors and the team gelled so well, and I just couldn’t think of a better career to have.”

Medical School – sometimes it’s right to walk away

Sandeep chose to study Medicine in India because he liked the diverse and international character of Kasturba Medical College. At first, he absolutely loved his studies, and worked extremely hard, motivated in part by the fact that he was so far away from home.

“I was the first person in the library, and the last person out.”

But, as with so many medics, Sandeep began to feel a bit burned out by his final year, and found he couldn’t remember why he chose Medicine in the first place. What I really respect about Sandeep is what he did next: unlike many medics, instead of pushing on into further exhaustion, he took a six-month sabbatical to spend time with his family and recuperate. He then went back to finish his degree after that.

This fascinated me because it so directly contrasts with my own approach to medical school – I kept going even at points when it really would have been healthier and wiser to take a break, worried that I would labelled as ‘weak’. I admire how Sandeep was confident enough in his judgement to make that call.

Working 100 hours a week!

Sandeep’s first jobs as a doctor in India were by no means easy; as an intern he would often work over 100 hours a week, and the levels of responsibility were huge. Even the seniors had it tough – Sandeep remembers one Consultant who slept in the hospital for five nights in a row! Despite this, he enjoyed the experience, and cites the sense of community around him as his best memory of that time.

“When you’re working that much, the whole hospital knows you, and that feels amazing.”

The NHS culture shock!

When Sandeep moved back to the UK and started working for the NHS, he noticed the marked difference in the way doctors were treated. He told me that, in India, doctors were so highly respected that patients would actually part ways when doctors walked onto the ward!

More importantly, however, the patients there were deeply grateful for everything the staff did for them, whereas working for the NHS seemed a rather thankless task. However, the benefit of the NHS, in comparison to the Indian system, was that it could provide far better resources to those who could not otherwise afford healthcare.

The businessman behind the medic

sandeep bansal 2

Sandeep had always been interested in business. Impressively, during his gap year after his A levels, Sandeep assisted in the set up of his father’s successful care home business. Even in medical school, his interest did not waiver; he would read the Economist or the Financial Times for half an hour a day to keep up with the latest in the business world.

“It’s an Indian saying that Bansals have business in their blood!”

After completing his Foundation training, Sandeep considered doing an MBA, but he knew he’d have to do the GMAT, and the cost of a full time course, along with the loss of earnings, made it unfeasible at the time. He also hadn’t yet completed enough years of clinical practice to do an executive MBA – apparently you usually need at least three years, and for the very top courses, at least five years!

Not sure how best to proceed, Sandeep took a year out. True to form, he didn’t waste a moment, and furnished his time with a myriad of different projects, including helping his parents’ with their nursing home, locuming, taking the Royal College exams for Paediatrics, applying for GP training and planning his wedding!

He eventually decided that GP was the best route for him, as his wife at the time was a dentist, and he wanted to support her, as well as having a decent work-life balance. Even then, however, he simply couldn’t take his mind off business.

Business ideas begin to emerge

After being told by so many people that I was ‘wasting’ my medical training by leaving, I put this idea to Sandeep, and asked him whether he thought his 11 years in Medicine were worth anything. His answer was an emphatic affirmative.

“I built such a solid foundation in Medicine. I took all those teachings from professors, colleagues, nurses, patients – I learned the most from patients.”

Sandeep told me that Medicine has helped him to go forward in business because it provided him with problems to solve. Indeed, he got the idea for his app, ‘The On Call Room’, when he found that he was constantly getting bleeped out of Grand Rounds and MDTs. He began to think about how he could facilitate learning by making knowledge bases accessible, which then got him wondering how he could spread clinical expertise internationally.

In India, he saw amazing things done with infectious diseases, while in the UK, areas such as cardiovascular disease took precedence. He decided to put it all in one place, and had ‘The On Call Room’ app made in Chandigarh. He was still practising at this stage, but every four weeks, he would take a week of annual leave to manage the business.

Leaving Medicine for good

In December 2014, Sandeep decided it was time to do his business justice. He liked working as a doctor, spending time with patients and receiving thank you cards, but he realised what he really wanted was to help other doctors to get those thank you cards.

“It occurred to me that I was doing everything for the wrong reasons. I hadn’t been fulfilling my passions.”

Unexpected reactions from friends and family

Ever the people-pleaser, I struggled intensely with the reactions of other people to my career decision, so I was keen to know what it was like for Sandeep. Amazingly, he told me it wasn’t really that tough a decision!

“I had very supportive parents. My Dad even became the seed investor in my business!”

He admits it would have been harder if his parents hadn’t fully supported him, but says he still would have done it anyway. Other relatives thought he was ‘a bit insane’, but seeing how happy he is now, they have warmed to the idea.

As for his colleagues, some of them dismissed his ideas (‘Oh yes, another app!’), but many predicted that health tech would be big in five years and admired him for being able to take that jump.

No regrets

Sandeep’s path to success has had its difficulties. He’s been through a divorce, and setting up a company in India was logistically very difficult. Once he’d hired a COO and a full tech team out there, however, things started running more smoothly. He still continues to travel to India frequently.

Even in difficult times, Sandeep knew he would not come back to Medicine. He had no nerves about stepping out of the familiar because he fully believed in his vision.

“Even if you fall down and you fail, get up again. Have faith in your knowledge and your abilities.”

Sandeep was the first ex-clinician I met who had a relatively guilt-free transition out of Medicine, and it made me really appreciate the value of having familial, and specifically parental support. Whilst many of my friends and my fiancé supported my career change, my parents’ disappointment and despondency made the process feel somewhat anguished.

It’s true, however, that no one really know how you feel but you. Sandeep left me with some parting advice: don’t get too many opinions from other people – if you want something, just get on and do it.

 

 

From a figurative Marathon to a literal one!

wellchild logo

As if he wasn’t busy enough, Sandeep is running the London Marathon this year for children’s charity WellChild!

 

To find out more and donate to this great cause, check out his London Marathon page.