Excuse Me, Doctor
I recently enjoyed the company of some recently retired doctors at a dinner near Birmingham, and it made me think about how interesting it is that life has so many phases, and that time flies so quickly between them. The older doctors were exiting General Practice, just as I get ready to enter it as a speciality. Others are becoming junior doctors, just as we prepare to leave that phase. Even more exciting to think of, are the students who have just started medical school, with all their training years, life and career choices ahead of them. Whether it is about medicine, other disciplines or life in general, the phases do come and go, so this one is for the young professionals just starting out in the big wide world.
I will start by saying thank you for not giving up on your medical career despite all the challenges of medical school and some negativity in the media. There would have been one less doctor on the team if you gave up, and I am not sure that there would have been arrangements to cover for that to avoid added strain on our very busy teams. It is true that the stresses of life and the challenges we face in medical practice can sometimes make us wonder why we chose this path, but I like to remind myself that becoming a doctor was once only a dream and a prayer. There are doctors who struggle to remember how eager they were to get accepted into medical school years ago or how excited they were to pass their final exams, so I want to congratulate you on this achievement and beg you to never forget that this life is a privilege some will only ever dream of.
You might feel like you are not contributing much, or you might be very confident and feel that your team could not function without you. Wherever you stand on the scale, please remember that no condition is permanent. Stay humble, remain willing to learn and focused on doing the best for your patients. Never lose your smile and empathy. There will be days when you feel like a superhero and want to spend your whole life in hospital. There will be other days when you will feel so down and tired that you consider leaving the profession altogether. Please do not make such decisions in a hurry.
Thankfully, there are so many career options in medicine. If you do not naturally like a speciality, be grateful that the rotation is only for a few months - do your best, learn what you can and feel free to tick it off your list of speciality options for the future, if you still hate it at the end. There might be a speciality around the corner, next year, or even not on your scheduled rotations, that you were made for. Take time to think about what you want out of life and medicine before choosing a speciality after foundation training, if you do. You might need to endure some tough seasons to get to what you really want, but there will be light at the end of the tunnel if you thread wisely and have a good attitude.
There is more to life than medicine and work. Please, do not lose the priceless things in life while building a career. Love, peace and joy cannot be bought. Good health is more than just the absence of disease - look after your mental health. Make time for your family as much as you can and do other things that make you happy. Don’t lose your friends, don’t lose your faith, seize opportunities to make new friends, laugh often, and remember that you are not defined by your achievements or the opinions of others. Look out for your colleagues - you will be surprised to find out that the other clever junior doctor, your ward manager, your Registrar and even your consultant also have problems that you might be able to help them with, just by listening. Your kind response to a struggling colleague might actually make the difference between a suicide and a good come-back!
I have only been practising medicine for a few years, but I know that we all have bad days. We need to recognise and handle them well to keep going. Try to learn from your mistakes and don’t let them hold you back. We all learn from experience and even the best surgeon was once new to medical practice. Ask for help when you need it, use the resources and support available, keep working hard but do not overlook your need for breaks or holidays. That way, you will last long and well in the profession, and hopefully have a good work-life balance. We are all rooting for you, even though we sometimes forget to be encouraging and thank you for being here. Keep your head up - the people need you.
WHO IS LOOKING AFTER YOUR DOCTOR'S FAMILY?
Nurses, doctors, pharmacists, opticians, radiographers etc are seen as people in the 'caring profession' - healthcare providers who make a difference and save lives everyday. Many have made great sacrifices to be in their profession, while others have chosen their careers as a safe option in today's world of massive unemployment. Some are still making sacrifices to reach greater heights in their careers, while others remain in their profession because they feel it would be a waste of time and money invested if they leave at this stage. Patients can be grateful, disappointed, angry, rude, but most are indifferent to healthcare staff as long as they get an acceptable level of care and professionalism.
While professionals pride themselves in providing good medical care for patients, making improvements to healthcare services and sometimes even contributing to better public health, how do these same professionals rank when it comes to the care given to those closest to them? Yes, the wives, mothers, sisters and daughters often deserted at home for a weekend shift. I mean the husbands, brothers, boyfriends, fathers and sons that hardly ever get their full attention. The medical profession has been accommodating in providing 'Less Than Full Time' postgraduate training options for doctors, but in reality, how does it feel to be a “part-time doctor”? What are the real consequences of choosing family over full time work?
As expected, some careers and specialties are better than others in providing working hours that suit family life. It can be argued that professionals should choose specialties or jobs that suit their family life, instead of complaining about shift patterns and rotas. On the other hand, should people be expected to choose specialties they do not like just because they want to have a social life too? People who do not have children might even feel that enough is already being done to accommodate family life for colleagues who are parents, especially if they themselves have sacrificed the option of having children in order to advance their careers. Indeed, it may seem a sensible option, especially as a doctor, to leave childbearing until specialty training is complete, to avoid childcare issues and career gaps, but this option is not for everyone.
Working in healthcare professions is a privilege and requires commitment, but does it mean that professionals' families should continue to pay the price until Daddy and/or Mummy retire? There was an interesting article in the British Medical Journal about the rate of divorce among doctors. The reactions to this topic range from a sad acceptance of life as people who are destined to have little time for their families, to a strong rebellion that leads committed professionals in full time training/jobs to consider staff grade and locuming positions as a way to take back control of their time. Even though the latter options may be stigmatised in some professions, this is the price some are willing to pay to build a good relationship with their families before it is too late.
Family life seems to be dwindling because professionals are spending most of their waking hours at work, becoming great at what they do and strangers to their own family. When they are not working, they are preparing something for work or feeling stressed out. The work-life balance has been reduced to meaning an occasional day out with family/friends away from hospital, paperwork and journals, expensive holidays once or twice a year and having 1000 friends on Facebook who never get a phone call. The most concerning part of it is that children grow up feeling that the little attention they get from Mum and Dad is normal and they end up with all sorts of psychological reactions and coping strategies. Children of many professionals are now being brought up by nurseries, childminders and babysitters. Some spend most of their time with grandparents and close relatives or friends, who one would hope have the same values as the parents to pass on to the children. Fortunately, or unfortunately, some spouses willingly sacrifice their own careers to stay at home with the kids because their professional spouse works all hours.
It is very unlikely that a patient coming into hospital at 8pm will even spare a moment to think, 'Who is looking after your children while you are here, doctor?'. Why should they? It is the responsibility of the parent to care about that. Thankfully, we have babysitting agencies, nannies, au pairs and childminders who can care for children outside normal office hours, when nurseries are closed. Some professionals are blessed to have spouses and relatives that can help, but what about the professionals themselves? Are they missing out on great and memorable years? No amount of money can compensate for that.
Are professionals and business people driving miles to work to find the satisfaction they can find at home if they put more effort into their relationships? Is this really the life they want or do they feel trapped in a profession, company or shift pattern they hate? Can people not be professionals while their children are in school, and relaxed parents at home when they are not? That is just wishful thinking, of course! We need people 24 hours a day in the emergency department, wards and laboratories. Not to mention the police officers, firemen, journalists and people of other professions who work round the clock to keep our country safe and strong. Business must go on. So next time you see someone working after 5pm, please show some appreciation, because they have probably left a beautiful family at home to come out and serve you.