Ok… so this is a bit embarrassing. On last week’s Real Reflective Practice on the theme of ‘Creativity’, I opened the show with a story about a song I wrote to help me learn about leukaemia in med school, and I said I would share the full lyrics after the show. I’m now slightly regretting that promise, but I’ll keep word – here they are!
As I said on the stream, forgive any errors or outdated info – this was written way back in 2008 when I was just a baby pre-clinical student! I hope it gives you a giggle at least and er, don’t judge my poetry-writing skills on this, will you?
‘Leukaemia’
(To be sung to the tune of ‘Hallelujah’by Leonard Cohen)
Verse 1
These patients turn up really sick,
Cos this disease can kill you quick,
They’re breathless and they sometimes have anaemia,
So last week was mental health awareness week. I feel like this year it’s come at a particularly poignant time, with mental wellbeing taking a universal nosedive thanks to Covid-19. The UN actually released guidance this week around supporting mental health in the wake of this pandemic, so it’s clearly a significant issue. And in terms of how it’s affecting healthcare professionals… One can only begin to imagine.
What’s wild to me is that I’m still waiting. I’ve had my DBS check done now and Capita have told me I’m on standby still, whatever that means. It’s not that I want to be called up (I really don’t and I am making absolutely zero effort to chase work). But what gets me is the fact that we have doctors in GP surgeries and hospitals under immense pressure, working ridiculously hard, not being able to take leave and having to adjust to unprecented working conditions, while doctors like me are still on bloody standby. GP Online reported that 30% of GPs they surveyed reported “worse depression, anxiety, burnout or stress related to their work since the COVID-19 outbreak began”. The workforce planning here is like a cross between a unicorn and a hospital IT system – non-existent and shite.
Add to that the shambolic behaviour of our government over the last few days (trip to Durham, anyone?) and I just want to throw my hands up in frustration. It’s got to the point where reading the news makes me feel ‘corona-cussed’ – headachey, disorientated, stunned, dizzy and a bit sick. I am remedying this particular ailment by reading Matt Coyne’s Man vs Toddler, which has me laughing out loud. The laughter and respite from reality is very much needed and appreciated, because even as lockdown begins to ease, we’re still a long way off ‘normal’.
I’m worried about the schools reopening. We’ve taken the decision not to send our daughter back to nursery yet, which is the right thing for us but it does mean that my mad juggle between mothering and working must continue a little while longer. I’m working as much as I can at evenings and weekends, so I have never been more grateful that I love my job. It would add insult to injury to have to give up precious rest time for something I hated!
It’s funny, I’m doing more coaching than I did before this pandemic, and with my weekly Real Reflective Practices, I’m also generating a lot more content than I did before. It’s strange to think about the opportunities that this whole situation has created… I think we’ve seen than across many sectors – humans meeting this great challenge with great innovations, new ways of thinking and unexpected collaborations. I talked a bit about this in one of my reflective practices with Dr Amrita Sen Mukherjee – the idea that so many of the technologies we now enjoy and take for granted are born out of moments of great suffering, such as war. Again, it’s this idea that challenges that create solutions, and once we find the solutions, we often sort of gloss over the suffering that went into them. Because we must; it would be unbearable if we did not.
As much as work buoys me, though, I have to confess that when I’m not working, I often find myself struggling. My first instinct is to push back against my low spirits because ‘there are people who are so much worse off than me and I should be grateful for what I have’, but I don’t think that’s a helpful internal narrative. Your feelings are your feelings. No one else know what it is to be you or live your life, therefore your experiences – and your pain – are valid.
And let’s face it, this situation is suboptimal to say the least.
So that’s all my news, really. Sorry this post has been a bit depressing! I wanted to share it though because I know such a huge number of people are struggling right now, and if you’re reading this, you’re probably the kind of person who puts on a brave face just to get through; chin up, with a facade so brilliant that no one would think you were anything less than a fully functional human being 100% of the time.
And if that resonates, then I just want to say I see you. And I know it’s exhausting to put up a front when you’re crumbling inside. And I also know that, sometimes, that’s all you can do.
So it’s been well over a month since I got the email from the GMC to tell me they’d reinstated my licence. After that flurry of conflicting emotions, all the media coverage and the strained conversations with friends and family, it’s now all feeling like a bit of an anti-climax.
I’m still going through the process – they are processing my DBS check at the moment apparently. They initially said I wouldn’t need one, but since the contract for bringing back retired docs went to Capita (or ‘Crapita’, as they are affectionately known by the medical profession!) the goalposts have moved. In the Facebook for returning doctors that I’m part of, there have been multiple reports of having to fill out paperwork twice because it was lost, or being sent the wrong documents. Communication is slow and it’s all very confusing and disorganised. Surprise, surprise.
On the bright side, I’m being told my literally every single one of my currently practicing colleagues that it’s good that I’m not back yet because the PPE situation continues to be dire. And not only that, Trusts are continually changing the guidelines to limit the use of PPE. One example would be classifying CPR as a non-aerosol-generating procedure so staff performing it don’t have to don full PPE. Now, correct me if I’m wrong here, but I reckon jumping up and down on a person’s chest so hard that you could literally break their ribs might result in the forceful expulsion of a teensy bit of air from their lungs. Oh, and the Resus Council agrees.
I’m still really confused about what’s actually going on in hospitals. I know we’ve got speciality doctors being redeployed and non-essential clinics and surgeries being cancelled, so staffing levels appear to be better than normal (perhaps adequate, as opposed to woefully inadequate?) But it seems like it’s patchy – according to my contacts, some shifts are a lot busier than others, and their rotas are still brutal. It’s not sustainable.
As for me, I’m just carrying on with motherhood mostly. Being the sole source of entertainment for an 18 month old is absolutely draining and at times quite boring if I’m honest. I’m also much more anxious and strained than usual. Insomnia is plaguing me. I feel bad for feeling like this when I know other people have it worse – I keep reminding myself to be grateful for the things we do have, like our health, our garden, our daily walk… But I think everyone is struggling in their own way in this most unnatural of times.
We’ve transitioned into a new normal of sorts. My husband and I have our new roles (he is now the official food-shopper!) We’ve got projects on the go, like the veg patch and a bemused attempt at a sourdough starter. I’ve also got my Real Reflective Practices every Monday, which are brilliant fun and hopefully are proving useful, and every Saturday we treat ourselves to a takeaway. It’s a quiet, contained sort of existence physically at least, if not emotionally.
So as bored as I am, in some ways I’m dreading what comes next. Will they need me? When? What will they ask me to do? And will I say yes? Futile questions to which as yet I have no answers. I guess all I can do for now is just enjoy this safe cocoon and try not to think too much about whatever’s ahead, because one thing’s for sure – if there was ever a time to make plans, this is not it.
Happy Wednesday all! Just a quick note to tell you I’ve got another THREE Real Reflective Practice livestreams confirmed! After the Guilt themed one went so well I’ve been asked to do more, so…
On Monday 20th Apr I’ll be talking to Coach and Career Consultant Sally Beyer about Imposter Syndrome. Sally’s an expert in this subject, with a special interest in Imposter Syndrome in doctors, so I’m looking forward to an in-depth chat.
On Monday 27th Apr I’ll be tackling the theme of Disillusionment with my long time friend Dr Gyles Morrison who is an ex-doc turned Clinical UX Designer.
And on Monday 4th May I’ll have Chris Hafner with me who is a Business Strategist, Entrepreneur and Investor with a special interest in the Health Tech and Wellness industries. He’ll be looking at the theme of Leadership with me.
All sessions will be broadcast from 7.30 – 8.15 pm BST on my YouTube channel. Check out my Facebook event page for more info and links to join the livestreams and please like my page to keep up to date on all the latest Disillusioned Medic events!
Day 19 of lockdown. I had a bit of a ‘moment’ today. I’d had a tough parenting day and it just felt for a brief moment that I couldn’t see an end to this situation… It was depressing. But then the clapping for carers started and I went out to join in. I know this clapping thing is making some doctors feel a bit uncomfortable, and I completely get that. It does feel like too little too late, and I am as cynical as anyone about how long post-crisis this feeling of goodwill will actually last. But despite all that, I still think it’s a nice thing to do. At the very least, it gives the nation a way to do something at a time when there is, quite literally, nothing else to be done.
I had an ‘interview’ with the ‘Bring Staff Back’ campaign last week – the people organising the return of ex-docs to the health service. It was a brief, informal phone call with a very nice lady to talk about my background and experience, as well as my availability and what I’m willing to do. I said I’d prefer something remote if possible. They said they’d send me potential roles soon, but I haven’t heard anything yet.
Despite being really conflicted about this question over whether to go back, I decided to get in touch with them in the end because I realised that it wouldn’t hurt to look at the options. If they offer me a position that seems acceptable and feasible, and my situation at the time allows me to do it, then fine. If not, then I’m not going to beat myself up about turning it down. At the end of the day, my daughter’s welfare is my priority. Oath or no oath, she comes first. Always.
But I would gladly go back and help if I could honestly believe that the NHS would behave with an ounce of decency towards me, i.e. treat me like a human being and not a robot. Current evidence is not looking good…
A friend shared a post on Facebook from a retired doctor who’d been offered a job recently – they posted a copy of the contract they’d been sent. It was ridiculous. Essentially it said things like “we decide where you work”, “we decide how much to pay you” and “you might be sent to another hospital, and if you do not comply you will be penalised”. It made me so angry to see it – another prime example of the demeaning way the NHS treats its staff.
And then there’s the news about NHS staff being prevented from speaking out about working conditions and PPE supplies. In this Guardian article there’s an extract from a memo sent to staff at Southend hospital, where I once worked:
“The posting of inappropriate social media commentary or the posting of photographs of staff in uniform who are not complying with IPC [infection prevention and control] standards and social distancing requirements is unacceptable. Such behaviour will be considered under the disciplinary policy.
“Now, perhaps more than ever, NHS staff are in the public eye and we have a responsibility to convey a professional image and to role model positive messages about social distancing. It would be very sad for moments of inappropriate or unprofessional behaviour to undermine the respect that we and our colleagues have from the public.”
I can’t even begin to describe how much this bullshit makes me fume. It’s cold, hard, psychological abuse. It’s basically saying what an abusive partner would say in a toxic relationship – ‘don’t you dare ruin my image by showing other people how hard I’m hitting you’. Also, it makes zero sense – how would highlighting PPE shortages be in any way setting a bad example? The public are very much in support of staff having adequate PPE since it might actually mean the diffierence between life and death for them and their loved ones. And what the fuck does it have to do with social distancing?
The Trust should be thanking the staff members who show the public what it’s really like, because it’s images of staff wearing bin bags and pleas from the frontline that have spurred charities and businesses into action – like those behind Med Supply Drive UK, who are getting PPE donations and delivering them to the frontline. All of this also puts pressure on politicians to do more about PPE. Trusts should be working with their staff to highlight the shortage, not trying to cover it up.
I’ve heard it myself from former colleagues and friends who have been silenced – their managers throwing hissy fits because they’ve dared to voice concerns over personal safety, jobs being put on the line because someone refuses to toe the party line, referral to the GMC once again being used as a threat to those disobediant doctors who dare to use their brains and speak truth to power. Isn’t it funny how, in the midst of a global pandemic, with tens of thousands of people dying, the system is still more interested in covering its own arse than actually saving lives?
I’m disgusted.
And then there are other things that don’t make sense – I’ve heard from locum doctors that they’re struggling to find work. I realise that, with elective and non-urgent work being cancelled, there might be less demand, but it seems odd to me that Trusts aren’t gearing up their local locum community at the moment. We’ve got trainees and permanent staff within hospitals working ridiculous hours at the moment, with no prospect of leave or a break any time soon, yet outside of hospitals we’ve got locums offering to help but left twiddling their thumbs. Seriously, what is going on? Oh yeah, NHS leadership is too busy stalking doctors and nurses on social media to bother with little things like innovative rota coordination during a national emergency.
Well, my wobble appears to be well and truly over – I am back to being gloriously disillusioned and wonderfully cynical, woo hoo! I would still go back and help if I’m needed and if it works for me and my daughter, but perhaps they wouldn’t want me after all… It’s dawning on me that I may just be a tad too outspoken…!
P.S. My Reflective Practice for Doctors pilot on Monday went brilliantly! I’ve been asked to do more, and I will try my level best! It’s tricky with my toddler at home, but I’m keen to do more, so watch this space!
Forget your e-portfolios for a moment. Reflective practice might be a mandatory training requirement, but rarely does it give doctors the opportunity and skillset to truly process the emotions that surround their work. And with concerns in recent years over the confidentiality of those reflections, it can feel like being authentic and honest is not an option.
That’s why I’m doing this livestream – to practice some real reflection, i.e. take a deep dive into the mental, emotional and spiritual realities so unique to the medical profession. And on Monday we’ll be looking at the theme of Guilt.
Guilt a familiar feeling to a lot of doctors (me included…) but now, in this unprecedented situation, ‘doctor guilt’ is taking on new forms… Are you self-isolating and feeling guilty for not being there for your frontline colleagues? Beating yourself up because you can’t be faster, cleverer, less exhausted than you are right now? Perhaps you’re a retired doctor feeling bad for not coming back, or not helping as much as you think you should be? Or maybe you feel you don’t deserve the public support and generosity being shown at this time?
Join me as we explore:
Why doctors experience guilt and how it’s different from other professions
The impacts of guilt on our personal and professional wellbeing
How we reframe those narratives in a more healthy way
SPECIAL GUEST: I’ll be joined by Dr Amrita Sen Mukherjee, a GP with a special interest in Occupational Health, Wellbeing and Positive Psychology. She’ll be sharing her own perspectives on how doctors experience guilt, as well as her research around the powerful impact of positive emotions.
Hope to see you there! Just click on the link above to join 🙂
With everything that’s been going on lately with Covid-19 – the insane rotas, the failure to protect staff, the appalling lack of leadership and the battlefield the NHS has turned into, I’m not surprised that we’re now seeing doctors seriously considering a change of career.
As much as the political rhetoric tells us we’re ‘all in it together’ and that camaraderie in the health service is back, it feels like too little too late. So many brilliant, hard-working doctors out there are feeling lost, exhausted, and just plain fed up.
When I first considered quitting medicine, I found the whole idea deeply distressing, and I felt really alone. I didn’t know where to start, what to do, or even how to find out more information. It also felt like such a taboo to even talk about my feelings – socially isolating, you might say… (Too soon?)
Anyway, in honour of my old colleagues, and anyone else out there who has doubts, I’ve updated my guide for what you should do if you’ve had it with medicine.
* * *
1. Find some head space
As much as our beloved eportfolios bang on and on about the importance of ‘reflection’, working as a doctor rarely gives you the chance to actually reflect on your life. I got my chance to do this completely by chance – in October 2015, I was called up for jury service, and as all those who have done it before will know, you spend a lot of time waiting around. The hours I spent sitting in a tiny room outside the court with a bunch of strangers forced me to think, and in the end, the inefficiency of the justice system served me well, because five days later, I wrote my resignation letter.
Whether it’s getting away from normal life for a while (admittedly tricky right now), or talking to someone who’ll respond to your concerns objectively and not critically, spend some time exploring your doubts and feelings.
2. Know that you don’t have to leave medicine outright
I’ve had doubts about medicine since my first year of medical school, but one of the reasons I held back from doing anything about it was that I genuinely didn’t realise that you could be more than a doctor.
It seems like such an obvious thing to me now that I’ve done it, but the medical schools rarely tell students how they can diversify their careers. As a medical student, you’re led to believe you’re on a non-stop train to consultancy. You start to believe medicine is all you’re trained to do, all you know how to do, indeed all you can do.
But it’s not true. I’ve discovered that you can get off the train. You might change trains and go via a different route. You might ditch the train for a while and drive a car to the next station, where you get back on again. I’ve met people who have had several career breaks over the course of their lives, doing both medical and non-medical things. For these people, their experiences have enriched their lives and have actually helped them when they have returned to their medical careers. Don’t believe the old-school naysayers who will tell you that career breaks will damage your chance of making it in your chosen field; if you do something interesting that will help you grow as a person, it can only be beneficial.
You may not even have to take a career break in order to pursue new interests. I for one firmly believe that things like sabbaticals, ‘F3’ years and part time practice should be the norm in the medicine, not the exception. It is such a demanding and all-consuming job that we should be championing those who recognise that prioritising their mental health and their emotional wellbeing by balancing their lives with other things, be it side-hustles, non-clinical roles, their own businesses or hobbies.
Here are just a few examples of incredible doctors, some still practising, some not, who have diversified their careers:
UK-trained and/or based
Evgenia Galinskaya, Production Associate, Coulter Partners (Life Sciences)
Joseph Liu, TEDx Speaker and Personal Branding Consultant
3.Remember who you were
While on jury service, I went out for a drink with one of my dearest friends, who happens to be an old teacher of mine. She taught me French at high school and we stayed in touch after I left. Whenever I see her, I feel a strong connection to my high school self: the girl who was a brilliant linguist, but didn’t appreciate or realise it at the time; the girl who loved poetry and prose better than covalent bonds and the Krebs cycle; the girl for whom English, French and German held such a fascination, that studying them hardly felt like real work.
My wise friend listened to me so understandingly, and told me of her own search for happiness in life, and suddenly the right thing to do became blindingly obvious to me: I didn’t just like languages – I was madly and irrevocably in love, to the point that life without some linguistic aspect would always feel incomplete.
So who were you before medicine eroded the passions you once had, and drove out the hobbies, interests, talents and little personality quirks that once gave life that spark? The coronavirus pandemic may be closing doors at the moment and making things like career changes more tricky, but it may also be an opportunity to reflect on who you really are.
4. Ask yourself: is it medicine or is it the NHS?
This notion came from an unexpected corner: my dad. Although he expressed doubt as to the wisdom my leaving the profession, he made a very pertinent point: debate is important when you’re making big decisions, and while the medicine referendum was going on in my head, my dad represented the ‘stay’ campaign.
Working for NHS England can make it very difficult to like medicine at times, and it can be really hard to know if it’s medicine itself that is making you unhappy, or whether it’s just the system. Would it change things for you (if we’re ever allowed to travel again…) if you were working in a different country? Could a different speciality, part-time work, or a year or two abroad give you that sense of perspective? What about the private sector? It’s a taboo subject I know, but you’d be surprised to know that even junior doctors can find roads into it. The co-founders of Doctify, Drs Stephanie Eltz (mentioned above) and Suman Saha, set up their independent health tech platform partly because they felt stagnated in the NHS, and setting up a business has been their way of getting that spark back.
It’s a really hard question to answer, but I guess, if you don’t ask it, you never look into it.
5. Do your homework… in the right way
If you’re like me, you’ve probably spent hours googling thing like ‘alternative careers for doctors’, and seen unhelpful lists of other careers that are vaguely related to medicine. But I stopped when a friend of mine, Dr Evgenia Galinskaya (also mentioned above), who used to be a Dermatology reg, told me not to do this. (Her exact words were: “stop googling alternative careers for doctors!”) In fact, she’s just updated her excellent blog post about this very issue, so check it out.
Those lists are bullshit written by people who have only a vague idea of what the job market actually looks like. You are not limited to those lists. When was the last time you sat down and thought about what you wanted to do? Years of medical school and postgrad training give you a plethora of skills, but it can make medics forget that they have other facets to their personalities.
You might also – and there is no shame in this, because I was like this too – have certain prejudices and ideas about certain professions. I had a massively negative and distrustful view, for example, of the media and also of the pharma industry. It’s a doctor thing – we can get locked into a pretty narrow view of the professional world. Cut to five years later, I’ve worked in the media industry and advised the pharma industry, and loved both and at no point did I have to compromise any of my personal values. Also true of both those roles is the fact that I could never have even conceived of either of them at the time I left medicine – I didn’t know they exsited, and I certainly had no idea I’d enjoy them.
Remember that it’s an incredibly diverse world out there with a tremendous amount of variation between companies, and there are good bits and bad bits of every industry, just like there are good people who work in the health service, and people who are morally bankrupt, corrupt and self-serving.
So give yourself the chance to rediscover your natural skills, weaknesses and goals, and be open-minded. It might not come straight away, because you aren’t used to asking yourself what do I actually want. But it’ll come in time. Finding your sense of purpose and direction is a journey – start it now.
6. Evaluate your own health
The GMC estimates that 10-20% of doctors suffer from depression at some stage, but more recent studies suggest that the real figure is much, much higher than this. I suspect that, after this pandemic is thorugh with us, the percentage will be even higher.
Of course, not every doctor who questions their career will be experiencing either mental or physical health issues, but I think the risk of this happening is greater, because changing career just isn’t something we do. As I said before, it’s classically been a bit of a taboo – you work so hard and invest so much personally; leaving could naturally make you feel that a lot of time and effort has been wasted. Then there are the wishes of your family or colleagues, and their investment in your career, plus the horrible, awful guilt many doctors feel about leaving. When all of this was added together, for me, it made the misery so intense that I honestly began to wish I could go to sleep and not wake up again.
Please don’t feel alone if you find yourself struggling. You know what the signs and symptoms are; if you were your own patient, would you be worried? Don’t suffer in silence: contact the Professional Support Unit in your Deanery or NHS Practitioner Health. Or reach out to support wellbeing groups on social media like Tea and Empathy. Or get yourself a licensed counsellor or therapist – again not something doctors do, for some reason.
Physical health is also an important consideration. How is being a doctor affecting your body? Do you have a condition or disability that, if given more attention, could allow you to continue practising? Doctors are really good at feeling guilty and ‘weak’ compared to their colleagues, and therefore not asking for what they need. But knowing your own body is not weakness, and you’re allowed to be a human being.
7. Get yourself a person
Even if it isn’t health support that you need, people who are having a career crisis generally could use a little help. Having someone who specialises in careers guiding you, such as a coach or a mentor, was a critical part of my successful transition out of medicine.
When I was considering leaving, I contacted the Professional Support Unit in the London Deanery. They gave me four free career coaching sessions (that was five years ago – I’m not sure what they provide now). I was linked up with a coach who wasn’t a doctor, but a writer by profession. She did all sorts of things with me, like personality tests, a CV overhaul, a skills analysis, non-medical interview practice and lots more. As she worked with me, it became a bit clearer to me why medicine wasn’t the right career for me.
My mentor was (and, in fact, still is) Dr Gyles Morrison (mentioned above). He left medicine about a year before I did, and was therefore able to relate to me in a very specific way, as he knew exactly what I was going through – he understood on a level that even my most supportive non-medic friends never could. His support and advice became a lifeline to me as I felt my way through a strange, new, non-medical world.
That was an informal mentorship, but there are also a lot of professional career coaches, life coaches and mentors out there, like me, who specialise in helping other doctors. We all have different backgrounds and niches, so have a look around and find someone whose style and story reonates with you.
Formal or informal, having a person to specifically discuss these issues with you can bring you empathy and new perspectives, as well as helping you to set goals and holding you accountable to them. Remember, engaging a coach doesn’t mean that you’re definitely going to end up quitting medicine – it just means that you’re exploring your options.
If you’re interested in mentorship with the Disillusioned Medic, click here.
8.Explore opportunities to take time out
For you doctors with a specialty training number, it could possible for you to take an Out of Programme experience (OOP). This can be related to training, research, or something completely non-medical altogether. They can be hard to get, but they are definitely worth exploring. I’ve met many OOPers, Dr Azra Chang being one of them. Like her, many have stepped out of medicine into something completely different, like management consultancy or health policy. I don’t think a single one of them regrets doing it, for the experience has allowed them to learn something totally new. Some don’t return to medicine, but some do, and from my experience, those who do feel empowered to come back on their own terms.
9.Network your socks off
Doctors – especially junior doctors – are not used to the concept of networking. Generally, you know where to find the people you need (even if they’re not always available!) and as jobs in the early years are dished out using some strange algorithm that puts the SJT on a par with six years of med school, you don’t really need to get out there and meet people in order to find work.
However – and I cannot emphasise this enough – this is not how it works outside medicine. Meeting people and knowing people can mean everything. I’m not talking about nepotism; it’s more about being in a position to take opportunities. How can anyone become your mentor, your new boss or even business partner if they don’t know you exist?
I’ll give you an example: my mentor Gyles walked past a health tech start up’s PR stunt one day, and stopped to ask them questions about what they were doing. The Head of PR ended up introducing him to the founders of the company and they paid him for some UX consultations. Some months later, I met Gyles by networking at the Medic Footprints Alternative Careers and Wellbeing event and he became my mentor. Gyles then asked me to assist the same company in another PR stunt they were doing, and I just went along out of curiosity and to be helpful. In the process of doing this, I got to know their Head of PR and I guess he saw something in me, because the company then called me in for an interview and hey presto, I become their new Head of Content and Marketing.
When I left that job, I met the CEO of my next company at a GIANT Health event. I heard him speak, loved his perspective on the way companies hire, and went to talk to him about it afterwards. He gave me a job on his marketing team, but because the company was a management consultancy, I learned about the consultancy world and then I became a consultant myself.
Now I know that right now, it’s impossible to go to networking events, personal development events and careers fairs (thanks, Covid-19…), but there are still ways you can be curious and keep your eyes and ears open. We’re currently seeing a surge of people work remotely and attending events online, so get researching. Looks also at social media – there are alternative careers groups for doctors on Facebook, there are videos of ex-doctors talking on YouTube, and then there is THE major professional platform… LinkedIn.
10. Get on LinkedIn
This ties in with networking, and is a must for medics who want to explore new professional territory. Make yourself a profile, put some effort in and make it look good. Write a decent bio about yourself and put up a good, professional-looking photo of yourself. You can go further by putting up blog posts as well.
Another benefit of networking is finding that peer support. When I first started discovering the alternative careers sphere, meeting other people who thought differently was just the most inspiring and comforting experience.
I know LinkedIn can seem a bit befuddling if you’ve never dealt with it before, as doctors don’t tend to use it, but if you’re serious about exploring the non-clinical world, take some time to learn about it or even get your coach to take you through it. Because I guarantee that when you meet people in a professional capacity and they want to know more about you, the first thing they’ll do is Google you, and unless you have your own website, the first thing to come up in search results will be your LinkedIn profile.
11. Think about when you’ll be in a good position to leave
It’s not a nice subject, but I used up a lot of the money I had saved working as a doctor while I was unemployed. It didn’t feel great – especially when I was considering unemployment benefits – but I felt it was a necessary investment in myself. I was extremely lucky to have the support of my fiancé as well.
Dr Roger Tackley made headlines when he left his post as a Consultant Anaesthetist to open up his own hair salon. A career change is always a financial burden, but for him, setting up a new business at the same time made it even more challenging. However, he told me that he was so glad he took the plunge, and his advice to anyone who has a passion to do something alongside a medical career is to give it your best shot. He said it’s a good idea to experiment and sample it before swapping careers, and to make sure that you are secure enough to survive if it doesn’t work out.
12. Remember that the door is always open
Dr Lafina Diamandis (mentioned above) is a testament to how varied a doctor’s career can be. She took several career breaks to try different things, including setting up her Boutique Property Services in Spain, and founding Eurekadoc, the only UK publishing house dedicated to printing ‘niche’ career guides for doctors. In December 2015, it was she who organised the ‘Medicine: Stay or Go?’ conference. Lafina went in and out of medical practice, and is now returning again to complete her Paediatrics training. So if someone tells you that once you leave, you can never come back, ignore it; it’s simply not true.
And even if you do completely cut ties and tell the GMC to well and truly fuck off, a global pandemic might end up pulling you right back in (case and point: yours truly).
13. Free yourself from guilt
When I spoke to Dr Sabine Fonderson, CEO of HelloDoc, about switching careers, getting rid of the guilt thing was her number one tip.
I too was racked with this terrible feeling, but Gyles put it this way for me: if you did a degree in history, would you feel guilty about not becoming an historian? Probably not. Yet doctors continue to feel this sense of shame and guilt when they consider leaving medicine. I felt like I was letting everyone down and I felt that I owed the NHS all the money spent on my training.
Do remember, though, that the government subsidises every single degree in this country – medical students might get a bit more, but the difference is not as big as people believe. Also think of all your fees, exam costs, the free overtime you do, the quality improvement projects, the audits, the teaching and everything else you do completely out of your own pocket and your own time. You’ll probably find that the NHS owes you more than you owe it! Also your value is not just monetary – you are more than just a pay check. The fact that you’re a doctor makes you extremely valuable to other sectors – health policy, for example, like Dr Harpreet Sood. People who harangue you for wasting taxpayers’ money are ignorant of these things and therefore not worth listening to.
Ultimately, you have to do what is right for you. If you are miserable, you and everyone around you will suffer, including your patients.
14. Turn down the volume of negative influences
It can be hard to avoid negativity. When someone close to you expresses a strong aversion to the idea of a career change, it can make it very difficult to make the call. I also had a bad experience with my educational supervisor, who simply told me I was wasting my life.
Having said that, I did notice, particularly in the wake of the junior doctor contract fiasco, that more and more senior doctors are willing to talk about the realities of working in medicine than they were before. I was surprised at how, as well as those consultants who have urged me to go back, there were a considerable number who were open to discussion about other careers and who helped me – by providing references, for example.
At the end of the day, people will always have an opinion about what you should do with your life, but I now try to take advice only as it empowers me.
15. Learn to talk about yourself
Often I find that doctors who are leaving medicine are not very good at talking about themselves. Any professional confidence they had within medicine suddenly evaporates, and they don’t know how to communicate their skills and value to non-medics. They also often suffer from an aversion to boasting that is so severe that they’ll often downplay their talents.
This makes sense in the strictly hierarchical medical world – if you talk yourself up, chances are you’ll get put straight back in your place by your seniors, or worse, you’ll be asked to do something outside of your competency. Also, you don’t really need to say very much to another doctor to communicate your level of expertise. For example, if you were to say that you were a Paeds ST3, another doctor would have a fairly good idea of your professional aptitude just within those two words.
Not so in the non-clinical world. People won’t hire you or partner with you unless you’re able to explain why they should, so start prepping that elevator pitch. Your coach or mentor can help you with this.
16. Create a non-medical CV
Medical CVs are only understood by people within the medical field. They often are extremely long, due to the level of detail you need to go into about the competencies you gained in every post.
Non-medical CVs need to be short (two pages max), snappy and to the point. There will almost certainly be a number of superfluous details you need to get rid of, and until you reach a certain level of experience in a non-medical field, you will almost certainly need to tailor your CV to every position you apply for.
Also, don’t assume that your medical degree will open every door for you. People will often tell you that a medical degree is a ticket to anywhere, but this is a misconception.
It is true that, as a doctor, you will have a range of transferable skills. You will likely be very adaptable, fast to learn, flexible and extremely diligent. But people won’t necessarily understand that, or have the ability to see how you’ll fit into their team.
Remember, most people have no idea what doctors actually do, and they often have weird assumptions about the kind of people we are and the kind of capabilities we have.
I’m not saying this to dishearten you – remember, you ARE much more than just a doctor, and you DO have a number of transferable skills, whether you know it yet or not. I just want to prepare you for the probability that you will meet resistance, and therefore have to ‘sell yourself’ in a very particular way. It is undoubtedly true that medicine has opened up many, many doors for me, and I wouldn’t be where I am today without my MBChB. It just didn’t necessarily happen in the way that I expected.
Again, ask your coach or mentor for help.
17. Stop thinking so big
Now this might seem counterintuitive – what could possibly be bigger than leaving medicine?! You NEED to decide EXACTLY what you’re doing with your life now, right? You NEED to have a new pathway to success mapped out with precision, to know IMMEDIATELY what your new purpose is, what your career progression is gonna look like, what your salary’s going to be, what you’ll be doing in two years, five years, ten years. How are you going to do GOOD in the world, make a name for yourself, make a difference, make up for the fact that you left the most NOBLE profession of all?? Oh God, it’s overwhelming! Maybe you’ll just crawl into a box and think about it later…
I understand. This was me, once. I felt like I needed to have all the answers, and it didn’t help that people around me were asking me what the hell I was doing with my life. But if you think too big, you’re only going to feel more stuck. This is a gradual process, so take it one step at a time. You’re probably not going to land your perfect dream job tomorrow. But you can go to that art class, you can read that book, you can attend that webinar. The small steps will lead to big ones – just be patient.
18. Explore
This ties in a bit with my last point. Doctors are really bad at exploring. For many of us, having been on a conveyor belt ever since we were in our late teens, we never actually had the time to experiment. It’s almost like you got married when you were 15 and never had the chance to date. You never kissed any frogs, never had a fleeting romance, never figured out what you like and don’t like, never spent a year with that guy you knew deep down was a mistake, but hey, it was a mistake you needed to make.
I think it really boils down to fear. Medicine always gave me a goal to work towards, no matter what stage I was at. To suddenly be without that very specific goal made me feel like I was wandering around aimlessly. I had jobs that I didn’t like but had to stick out for a while, jobs that didn’t really seem to be going anywhere, and periods of not really knowing what to do. These things acutely stressed me because I felt like a massive failure all the time.
But I realise now, they were all an important part of me learning about what I liked and what I wanted to do. Let yourself explore.
This is one of the reasons why it’s easier to leave medicine when you’re younger. Quite frankly, leaving medicine now would be much harder for me than it was five years ago when I wasn’t a mother and we didn’t have a mortgage. But being further down the line doesn’t mean that you can’t leave. It might just have to be a slightly longer and more convoluted route, and you might have to be more creative about how you do it.
19. Don’t presume you have to do a Masters
Because medicine requires us to have formal training for everything and demands proof of it before we even set foot on the wards, doctors often make the incorrect assumption that, if you want to go into new field, you’re going to have to retrain. And most frequently in my practice, my mentees talk about doing a Masters degree.
However, in the non-medical world, academics are not the be and end all of everything. There are plenty of fields where your experience, your personality and your talent (as well as knowing the right people) are the primary drivers of your success, and I would argue, are more important than your qualifications. This is a bizarre concept for a lot of newly escaped doctors, and it can feel quite uncomfortable at first.
Now I’m not saying that you should never undertake another formal qualification – I’m just saying that timing is important here. Often, doctors put themselves under huge pressure, as I said above, to ‘decide’ what their new life will be, and this drives them to looking at expensive degrees they have no idea whether they’ll actually enjoy or find useful. It’s basically like medicine all over again.
So pull it back a bit – start by building your skillset on a smaller scale. It doesn’t matter if you don’t know what you want to do yet, or even if you’re not sure you’ll leave medicine yet. Just start looking at things that interest you. If you think you might want to set up a business one day, read some business books. If you think you might be interested in health tech, maybe do a coding course and see if you’re into it. There are so many resources out there, including free webinars, courses and educational platforms. Use those research skills and start researching what you’re into!
Once you have an idea of that, you can step it up – find a more in-depth paid course, get a ticket for an event in that area, geek out about it a bit more, and talk to people who are in it. Perhaps you’ll even get a job in your new field of interest so you can explore it a bit more.
And one day (not always), there might come a point where you realise that, to take this further, it might be useful to do that degree. You might realise you’re really interested in management consultancy for example, and to work for the Big Four, you’re going to need an MBA. At that point, you’ll be ready to take the plunge and spend that £10k. Or you might find a completely different route into your chosen field without doing a degree – there is almost always more than one way of getting where you want to go.
Example: I’m a strategic marketing and communications consultant. My clients are small to medium sized enterprises and they pay me a pretty decent day rate. And I don’t have any sort of marketing degree.
20. Get ready for a massive personal learning curve
Before I left medicine, I didn’t realise how ‘doctor-y’ I was. It was in part because I’d been institutionalised by the NHS, and infantalised by a management culture that still speaks to you like you’re a toddler even if you’re in you’re a highly trained specialist in your thirties. But it was also partly because I’d never actually experienced the outside world myself. I had ideas and presumptions about it that turned out not to be true, in both good and bad ways. Certain prejudices and suspicions turned out to be unfounded, whilst in other areas, I realised I was desperately naïve.
And the spiritual growth! Blimey, I was not expecting that. I mean, I realised that leaving medicine would impact my emotional and mental health, but I really had no idea how it would change my entire outlook on life itself! It’s perhaps a rather hippy-dippy thing to say, but my soul has changed. And changed for the better. It’s really why I started doing my Real Reflective Practice livestreams – I have learned to think in a different way, and it’s been a deeply healing skill to learn.
It will take you a long time – months, maybe even years, to rewire the neural pathways that are keeping you stuck right now. And to be quite honest, it might sometimes be really painful. But if you embrace the process, it’s worth it. Bloody hell, it’s worth it.
* * *
I hope this article has been helpful to you. Just remember, you’re not alone. In medicine, always being in the same environment can make it difficult to see the bigger picture, but take it from me – there are other options out there, and there’s no harm in looking!
Dr Anjalee Perera is a former NHS doctor turned Marketing and Communications Consultantand Career Coach for doctors.
I’ve spoken to a lot of people. Including the Guardian, ITV News, my mentor and old friend Dr Gyles Morrison, my therapist, my husband, my friends, my dad, my whole fantastic community of ex-doctors, and some fellow coaches. I’m like a decision pendulum – one moment I’m so sure I’ll go back, the next moment, I’m certain of the opposite.
I even flipped a coin last night – and then again. And again. (Best of three!) And then I got the email informing me that my licence to practise had officially been reinstated (not because I had definitely decided to return, you understand – they did this automatically). Fuck. Way to pile on the pressure, GMC.
Here’s the thing that’s bothering me at the moment though…
We’re hearing about things changing. There are reports of PPE supplies finally slugging their way to the frontline, and today that testing for frontline workers has been started (no doubt because of the amount of media coverage that myself and other healthcare professionals have been pushing for in order to raise this issue – sad that it had to come to that, but hey, not surprising).
We’re also seeing the nation express gratitude towards the NHS like never before. I joined in on last Thursday’s Clap For Carers round of applause and it was truly moving. It’s also incredible to see that already, over 700 000 volunteers have joined up to help support care efforts, and uplifting to hear reports of restaurants dropping food off at hospitals for staff, and businesses giving up their time and space to help support staff.
BUT – there appears to be on thing that has not changed. One incredibly critical thing: leadership within the NHS.
From up and down the country, I’m hearing reports from friends, former colleagues and on social media groups about the culture of bullying, blame and sheer managerial incompetence that is pervading the health system, even at a time like this: F1s being bullied for wanting to wear PPE; PPE protocols changing every five minutes, causing mass confusion; SHOs being yelled at for raising PPE concerns; consultants being threatened with fitness-to-practise tribunals if they refuse to see a patient on the grounds of inadequate PPE; retired doctors being charged GMC fees before their licence is returned… The list, no doubt, goes on.
You know something is seriously wrong when the Lancet – The Lancet– one of the most impartial scientific journals known to the medical profession – call this situation a ‘national scandal‘.
Last week the Doctor’s Association spoke of how they feel like ‘cannon fodder’. All I can say is, thank goodness for the Doctor’s Association, because if they didn’t speak up, no one would. The BMA is being deafeningly quiet, now that there’s nothing in it for them, and my friends on the frontline tell me that managers have warned them that if they go to the media to discuss their local situations, their careers will be damaged. Professional blackmail, how classy!
I’m not scared for myself. If I go back (and that’s still very much an if), the system will have little power over me. What are they gonna do, strike me off? Be my guest! They’d be doing me a favour! I have no intention of returning permanently, and therefore I can’t be threatened in the same way.
But I’m angry. This, more than anything, is a time where great leadership is essential. And I can tell you, from my experience in the management consultancy world, that great leaders make the welfare of their employees an absolute priority. It’s not rocket science. As Simon Sinek said, if you look after your staff, they will make your customers happy, which in turn will make your shareholders happy – in that order.
And in these times, this leadership principle is even more critical than ever, because we desperately need NHS staff to be well cared for, not just so they can be there to run the health system, but also because if proper infection control measures are not adhered to, they risk spreading the virus even further! This snide, small-minded, power-centric attitude is killing people in real time.
This was always going to be a challenging time – no healthcare system in the world was ready for Covid-19 – but in war, it’s not necessarily the biggest army, or the army with the most guns who wins. It’s the army with the best strategy, the best tactics – in other words, it’s the army with the best leadership. And shitting on your troops is not exactly a shining example of that.
To get the best out of your men, they must feel that you are their real leader and must know that they can depend upon you.
It turns out I didn’t need to send that email after all.
Less than 12 hours after I posted my last blog about how I was debating over whether to tell the GMC I’ll to return to the NHS in this time of coronavirus crisis, I got an email from the GMC informing me that, because I had relinquished my license within the last three years, I would be included in their first round of callbacks.
I had completely forgotten about this. I knew about the three year thing from hearing it in the news, but as I stopped practising five years ago, I assumed I wouldn’t be in included. But I had totally overlooked the fact that I didn’t immediately give up my license to practice! I, in my infinite wisdom, kept a hold of it for two years after I left ‘just in case’.
I guess I simply wasn’t ready to let go at the time I left, which is fine, but the consequence now is that going back into the fray seems a far more real possibility – one step closer to returning than I had anticipated.
Pretty soon after that email dropped, a Whatsapp group of fellow ex-docs was set up and buzzing. They, like me, have a LOT of questions about how this would work, what exactly we would be expected to do, and how on earth we would do it safely. And they, like me, feel a deep resentment towards the GMC and the NHS about their treatment of doctors. Thanks to section 18a of the Medical Act (1983), it would seem the powers that be reserve the right to dig their claws into us long after we’ve told them where to go.
I’m sorry if I sound mean-spirited. I still do intend to help out in any way that I can, and any way that is safe, but I think the reality of this situation has just really hit me the last 24 hours. I’ve been in emergency mode the last few days just trying to keep things together as my family self-isolates, so I haven’t really had time to process what’s going on. But when I got that email, it was like reality slapped me rounf the face. Today I’ve just felt so tired and ill, as all of my repressed emotions welled up inside.
Everything has changed. In the last two weeks, I – like so many other self-employed people and business owners – have lost almost all of my clients. Two weeks ago, my business partner and I were busy creating a new podcast that we were absolutely loving, and that felt like the perfect project for us. Now, she and I are now both in full time mum-mode as schools and nurseries shut down. I loved my job – I loved it. And now, for the forseeable future, it’s gone. And in its place is the prospect of going back to a profession I didn’t feel I belonged to and a job that I hands down hated. People are being so kind and telling me I’m being selfless and brave for being willing to go back, but I don’t feel selfless or brave – I mostly feel anxious, scared and resentful. Meanwhile, the world as we know it is falling apart around us.
Of course, there are many things to still be grateful for – health, friends, family. And I am mindful of all that, but after a conversation with my best friend today, I realised we need to make space for grief as well as gratitude. One of my favourite perspectives on gratititude is the idea that, when practised too early, gratitude can make us feel guilty for the pain that we do have. When we are too precipitate to make meaning out of suffering, we suppress the grieving process that is so critical to our emotional well being. We shouldn’t take it so far that we end up depressed, obviously, but the paradox is that allowing ourselves to embrace our pain and be present with it actually leads us to a healthier and more authentic form of gratitude.
So this is me making space for that grief. So many things are changing, and change is hard, and right now, most of it sucks. I miss my old life. And I’m terrified of what the future holds.
It’s funny, even just writing that paragraph is helping me to feel more positive. Maybe in coming days I’ll be able to write a reflection on everything I am thankful for. But right now, I need to sleep. A war is coming, and if I’m gonna go in, best get some rest.
Never, ever did I think I would ever see the day that I would consider returning to medicine.
For the last five years, I’ve been thanking my lucky stars that I got out. My whole life has been completely tranformed – I am happier, healthier, professionally more fulfilled. Indeed, my work as a careers mentor for doctors is all about fighting what I see as an inherently abusive system that treats doctors without humanity, restricts their personal growth, and traps them in a state of obligation by effectively decimating their sense of self-confidence and worth. I am the Disillusioned Medic, for crying out loud!
And yet here I am, my finger hovering over the Send button of an email to the GMC, telling them I am willing to come back. As Covid-19 sweeps across our societies, condemning health services to a swift descent into crisis and taking healthcare workers with it, it seems inevitable that the time will come that extra support will be desperately needed.
We’ve heard today that the government is proposing emergncy legislation that would allow them to call retired doctors back. Of course, there are many issues with this plan – namely that a significant proportion of retired doctors will be in the age bracket most at risk from the novel coronavirus. When I first heard about it, the thought that immediately came to my mind what that I am essentially a retired doctor, but young. I realise that youth is not a complete protection, but would doctors like me be a safer option if (and, probably, when) the call goes out?
And then there are the issues of indemnity, revalidation… I’ve joined a Facebook group called Covid Returning Doctors Support which is keeping an eye on the situation, and it seems that temporary licenses to practise could be granted under emergency circumstances without having to go through revalidation, and NHS indemnity might cover people like us. I guess in this situation, rules might have to be bent, but I still can’t shake my sense of suspicion and distrust of the GMC. I would be completely unsurprised if, after this is all over, the GMC, in all their scape-goating goodness, were to pin failures and deaths on returning volunteers. It’s sad to have those thoughts, but given what’s happened in the last few years with doctors like Chris Day and Hadiza Bawa-Garba, I certainly am not the only one. Trust has been so broken down that I’m not sure even an apocalypse can bring it back.
I won’t deny, there is a sense of thrill at the thought of returning to the frontline. It’s similar to the naive anticipation I had when I was applying to med school, but now it’s mixed with real memories of things I liked about medicine – little things I was good at, like getting cannulas into tricky veins. Would I still be able to do that? It’s been five years since I did any sort of venepuncture, let alone any oher clinical procedure… On one hand I feel the need to offer the precious skills and experience I have, but on the other, I worry that it’s simply been too long. Would I be too rusty to be of use? Would I get in the way, or make things worse?
And what about the risk? We’ve all heard about the appalling lack of PPE and testing for healthcare professionals. We also don’t yet know why this virus seems to be killing young and otherwise healthy hospital workers… I’m a mother now, and it’s scary.
Of couse, it’s all still hypothetical – for now. The proposed legislation is due to be debated in Parliament next week, but the way the projections for this outbreak are looking, I can’t see the UK going into the peak of the curve without needing back-up from the ex-doctor community. I have a statistician friend who is currently working flat out on a report that will project the number of critical care beds we’re going to need, which in turn will influence the estimated number of clinicians needed, so it shouldn’t be long now. (Incidentally, are scientists not amazing?? I hope our species appreciates them more after this.)
I am struggling with the feelings of duty and obligation – the very feelings I worked so hard to rid myself of when I left, the very feelings that once left me with so much crippling guilt. And yet, when I see my friends and former colleagues post on social media about the unthinkable challenges they face and their bravery in doing so, I feel compelled to help. As Emmanuel Macron declared, this is war. And doctors are on the frontline.
I hated practicing medicine, and it definitely is not the career for me. That is not going to change. But this situation is so utterly unprecedented – a threat to human life like never before – so even if I could ease the pressure in some small way, it might be worth the risk.
