Editor: Eamon Merrick
What advice can I give you about travelling along this long and winding road to specialty practice?
The best approach I can think of is to start with ABC…
As a basic trainee, you are in a very unique position where you are exposed to all sorts of amazing learning experiences and no one expects you to know the answers. Contrary to how you might feel, it’s ok to say I don’t know. In fact, it’s expected! So ask lots of questions and learn as much as you can. As you get more experienced, it gets much harder to ask. I remember a Paediatrician taking me aside when I was the registrar and asking me to explain the new anticonvulsant medication that our patient was on. She said she was embarrassed to ask but I remember thinking how honest she was that she was willing to ask the question. Asking for help can be hard at any time in your career, but it certainly can get harder as you get older and you are “supposed” to have the answers.
When you become an advanced trainee you feel like you have earned your stripes and it’s time to stop asking questions. I remember one shift I did in ED where at the end of the day I was so proud when I realised I hadn’t asked for senior advice about any patient. I felt so grown up. Until the next day when I found out I had sent a patient home who then came back with meningitis. Luckily the patient outcome was ok, but I certainly learned the hard way that pride comes before a fall.
You are never too experienced to ask questions, and there is no better time than when you are a trainee. That’s what TRAINEE means. You don’t want to be annoying and question every sentence, but think about how you can make the most of the learning experience. As well as asking about diagnoses and management, take the time to learn other professional skills – like how did you find the way to reassure those parents? Or how did you break that news and help the patient understand? Or harder questions like how do you balance caring for your patients and caring for yourself?
We covered this already, right? There can be lots of pressure during training to do what everyone else is doing and to make some really big decisions about your career. The only person who knows what is right for you is you. And you are all different. There is no one right answer about how to get through a training pathway, what rotations are best, what courses to do and whether to do a PhD. But there will be an answer that works for you, so back yourself and do it. Ultimately, if you seek experiences you enjoy, you will end up working in an area that suits you. Be yourself and be kind to yourself.
I think your training years represent some of the best years of your life, both professionally and personally. Aspects of training can be tough, and we sometimes see it as a rite of passage that needs to be endured. Remember, though, that there is no magic light at the end of the training tunnel when everything suddenly becomes easy, so make the most of the time that you have and choose your path wisely.
Take a break, do something new or challenge yourself in a different way. Particularly before you commit to a consultant post, you have the flexibility to do something that matters to you and to balance your training with other experiences. Why not do something outside the square – something that is not related to the “medical expertise” that you have learned about every day. There are many different things you could choose where you could learn important skills like leadership, teaching, research, health advocacy or any one of the non-technical skills that make up a “good doctor”. Or, you could do something that has nothing to do with medicine. The right choice is up to you. Study, travel, learn a language, be a DJ, have children… the options are endless. And the choice is up to you.
One of the most important skills you can learn is to surround yourself with a support crew who will help you to get through. Next time you are at work have a look around the room – the people sitting next to you are very likely to be the people you become senior registrars and Fellows with, Consultants and Professors. They may all look like little ugly ducklings now but one day you will be asking each other for consults and referring each other patients. It’s a very small world and the medical family is very close. Look after yourselves and each other. Find a buddy and a mentor – most people are only too happy to help and there is nothing more flattering than being asked to be someone’s mentor. Don’t be afraid to ask. We all remember the scary things that keep you awake at night.
I will never forget the first time I had attended a resus call. It was in the good old days when an alarm rang across the whole hospital and you had to run to the ward that was illuminated on the call system on the ceiling. I ran up 4 flights of stairs and arrived feeling flushed, puffed and distinctly like an ugly duckling. In fact all the junior doctors there were very much the same. And just as we were all panicking because we didn’t know what to do – in came our Swan. The emergency doctor who took stock, took control and ultimately saved the day. I think that was one of the first days I felt like I recognised my flock – doctors who could keep calm in the face of adversity. And now I am – or I am at least closer – to being a Swan.
As times go on I find medicine gets harder in some ways and easier in others. It can still be the best of times and the worst of times and sometimes it seems that can change even by the hour. A medical career can be tough, there are many sacrifices and many tears. But it’s also an incredible privilege to care for our patients and be part of a healthcare community that laughs and cries and travels the road together. So be true to yourself, kind to your colleagues and enjoy the ride.
Follow Sarah on Twitter @DrSarahDalton