Posted by Evgenia Galinskaya on 17 November, 2014
With the NHS being in the state of flux, there have been fears about a medical “brain drain” (12% Increase In The Numbers Of Doctors Considering Working Abroad and 5000 Doctors Considering Leaving the UK). Yet the NHS continues to survive thanks to the altruism of the frontline staff who put their patients first, often before their own needs and to the detriment of own health.
I think there exists an element of conspiracy within the NHS that prevents doctors from expanding their horizons and learning more about their options. If doctors discover – heaven forbid – that a medical degree (and the transferrable skills that they can offer to other industries) opens countless doors, there may not be anyone left in the NHS to provide “the service”. In my personal experience as a former clinician (as well as from what I hear daily from my medic clients who come to me for career-related support), there are several obstacles to exploring alternative career options.
Deanery Career support is patchy across the UK. Where such services exist at all, many doctors are not aware of them. Wales and London appear to be at the forefront of career support for their trainees providing excellent free resources and one-to-one consultations.
There is a general lack of information about (and practical guidance on how to organise) career breaks and Out-Of-Programme (OOP) experiences. On many Deaneries’ websites information about OOP is scarce and confusing. Fearmongering during medical training that stepping off the beaten track equals career suicide makes most doctors feel that it is unfeasible to leave the treadmill even for a year, and hence there is little point to even try.
There are countless examples of doctors who make personal and family sacrifices to satisfy their employing Trusts. Dr Kate Emmerson, UKFPO Foundation Doctor Advisor, has spoken about this issue several times (for example, “F2 and Career Breaks”). Having a baby or wishing to train flexibly for another reason is often perceived as a lack of commitment.
I personally know many medical couples who train in separate Deaneries without a chance of ever being together (at least until the end of training). Most places have draconian rules on inter-Deanery transfers, even for those who have children. Having to choose work or family is not exactly a great encouragement for sorting out your “work-life balance”.
After my recent presentation about alternative careers for doctors, which included my own story of leaving medicine, I was asked by a senior clinician when I would come back into Medicine. I understand that some people may never be able to understand how someone (especially someone very successful) could leave such a noble profession. The thing is, being a doctor does not mean you have to be at the frontline treating patients for the rest of your life.
Your doctor title does not define who you truly are and what you stand for. I believe that doctors should have information about options and and should be empowered to make informed decisions about their careers. I believe it is not good enough to be doing a job without passion or because you’ve got a relevant degree and you need to pay your bills.
As a junior doctor, I felt very guilty when I was trying to find out about other options. Like a thief in the night, I would sheepishly type “alternative careers for doctors” into Google. It really did feel like a crime. I could not share it with anyone, and it felt very-very lonely…
I want doctors to know that it is not a crime to make attempts to learn more about other opportunities to regain a spark of creativity, enthusiasm and motivation. It’s doesn’t have to be about “leaving medicine”. It could be exploring options to do something ‘on a side’ or to have a “portfolio career”.
Those who say that you would be wasting tax payer’s money if you were to work part-time or to leave medicine should think twice. Unless these critics would personally like a doctor whose burnout means they are losing kindness, compassion and caring abilities (the latter ‘sequence’ was described by Dr Clare Gerada at Medical Women’s Federation conference on 7th November 2014). I agree with Dr Gerada who says “doctors should pull down their mask first” before attempting to save others. I doubt the tax payer will have lesser aversion to paying for the treatment of doctors with mental health issues or those who are off sick with stress and burnout.
Doctors have a very high threshold of tolerance for things that would not be tolerated in other environments. In fact, many doctors have masochistic tendencies bragging about their terrible work environments (but not doing anything about it): inhumane hours of work, lack of sleep, lack of “natural breaks”, and the list can continue. When I was an FY1 doctor, I made a note on my “Hours Monitoring” report that I was so busy on the ward that I did not have time to go to the loo. The next day I was told by the Medical Director that if I am ever to write this sort of thing again, they would arrange for me to have a urinary catheter! After that “lesson” I lied on all the “Hours Monitoring” forms for several years until I had my epiphany moment.
If you recognised any of the above 6 obstacles to exploring alternative careers, I have good news for you. You may not yet have had your epiphany moment but you can start building a well before you get thirsty. You can start exploring alternative options even if you have no immediate intention of working part-time or leaving medicine.
Knowledge is power. If you continue putting your life on hold in the hope that you will finally start living when you retire, than may be you should be more honest with yourself. If you explore options and get convinced that only medicine is right for you then at least you will have had that itch scratched. How else will you know?..