“Become a Doctor!” – hundreds of proud, ambitious parents and teachers shout throughout the UK. The medical professional is seen as one of the most successful career paths an individual can choose, but for a young person it is also one the hardest to be accepted into and the longest to complete training within. We catch up with a young Junior Doctor to discuss the realities, blockades, ups and downs of breaking into the medical industry.
Only a few months ago Lucy completed her final few months of medical training after an intense six year course at the University of East Anglia. She was one of the few girls, who knew exactly what career she wanted from the age of 10 and is now ready to take on the NHS by storm, as a fresh-faced Junior Doctor.
Her exciting journey, hasn’t been without its rocky moments, but despite every set-back, Lucy kept focused on her goal. At just 18, despite achieving excellent A Level results, well above the national average, she was just a few points off the results she needed to secure a place at medical school.
Many young people would have stumbled over this knock-back and let go of their dream. But as her school friends headed off to various Universities across the country, she stayed at home and retook her final exams to grasp those last few points to fight for her place. The course she was accepted onto included an extra year on top of a traditional medical degree – six years studying in total – but Lucy didn’t blink an eye, as she packed up her bags and headed up North.
The world of medicine provides a variety of different specialisms for a young trainee from psychiatry to paediatrics, surgery to anesthesia. Before starting your training at University, you had always wanted to become a General Practitioner. What was is that appealed to you about this specialism?
General practice is a unique speciality in that you never know quite know who will be walking in through the doors. GP’s serve a population of people allowing you to understand and get to know your patients, over a long period of time, more than you see in most other specialities. The doctor-patient relationship is a very unique and special one in that patients will often share with you their worries that they can’t even discuss with their partners or loved ones. No where else is this more evident than in general practice.
“The doctor-patient relationship is a very unique and special one in that patients will often share with you their worries that they can’t even discuss with their partners or loved ones.”
You completed your training at The University of East Anglia in Norwich. Can you describe how your course was structured over the six years of studying?
Medicine with a foundation year is split over 6 years, where you do a year 0 and if you pass this you can directly enter onto the 5-year undergraduate medicine course.
The idea behind the foundation programme relates to widening access to medicine. Doctors should be representative of the population they serve but in the past too often doctors came from the most privileged backgrounds. Neither of my parents went to University or work in ‘professional’ occupations, this gave me the opportunity to apply to the medicine with a Foundation Course and become part of the increasing number of first generation University students.
Year 0, was a year of basic sciences and introduction into medicine. It was a fantastic year as I lived and socialised with lots of people who did other courses which allowed me a life outside of studying and the ‘medic bubble’.
Over year 1-5, you cover every area of medicine and the basic sciences. The way they design the course, it starts of with fewer modules in the earlier years leading up to more modules and more complex specialities as you move through. We covered a long list with all the ‘ology’s’ – starting off with rheumatology and finishing in obstetrics and gynaecology!
I’ve absolutely loved the course – medicine is a fantastic course because it is applied and you spend all your time working with people. It’s hard though and you’ve really got to love it to get through the difficult times and the array of exams. I’ve done 17 practical exams, known as OSCEs, and 15 written papers over the past 5 years, not to mention the other coursework and presentations we have to do.
Which specialities did you like or dislike the most during your course?
I’m a generalist, I like to know a little bit about everything, which makes me perfect for a career in general practice. I really enjoy the clinical side of medicine and speaking to patients. Despite not wanting to work in a hospital, “Medicine for the Elderly”, did catch my eye as a potential career path as the patients tend to be so lovely and you just want to look after all of them like they are your Grandparents.
Psychiatry was one of the most challenging and frustrating placements I had, not because of the nature of the speciality but due to the vast underfunding in mental health, particularly where I study in East Anglia.
How would you rate the University of East Anglia over other Medical Degrees?
UEA has a fantastic medicine course, particularly due to the early patient contact and communication skills training we have. I spoke to my first patient in week 3 of the first year! Although this was incredibly daunting and, to this day, I have no idea what we talked about, it really helps to develop your skills and yourself as a person.
We also have a true integrated course, which means we see patients and learn about the clinical medicine at the same time as we do our basic sciences (physiology, anatomy, biochemistry etc.). This means from Year 1, we are able to understand the context behind what we are learning. It just makes everything a bit more meaningful.
What hands-on experience did you have during your training?
At UEA, we get a lot of hands on experience with placements and electives. We do a placement, of up to 4 weeks, in every speciality in medicine which gives you the time to see patients with the conditions you’ve spent time learning about in lectures.
In addition to this, we have two ‘elective’ periods where we can choose to spend time on a particular speciality that interests us. The first we do, in Year 4, is 4 weeks long and you can literally go anywhere and do anything. The world really is your oyster. I chose to spend my time in medicine for the elderly which I really enjoyed. I think students in my year must have been in almost every country in the world doing everything from research, to emergency medicine, to medical publishing.
We do another elective at the end of Year 5, I chose to do mine in palliative care, which is a speciality that is not extensively covered in undergraduate medicine.
In general, most staff in the NHS are willing to spend their time to help and teach you despite enormous pressures on the service and increasing workloads.
You spent a lot of time involved in the Junior Doctors protests in the UK – why did you get involved? What would you advice be to new Junior Doctors who have seen the protests?
I’ve always been interested in politics and medico-politics. A couple of years ago, I started to get involved with the British Medical Association (BMA) who are the biggest trade union and professional body for doctors in the UK. I’ll just throw in a bit of a disclaimer here – all views on the subject are my own and not representative of the BMA!
The BMA entered negotiations with the government voluntarily a few years before the industrial action to try to improve the contract that doctors were on at the time. There were many problems with the old contract but unfortunately, the Department of Health (DoH) took advantage of this negotiation to try to deliver their ‘7 day NHS’ without investing more money into the NHS and its infrastructure.
It frustrates me every time people talk about a ‘7-day NHS’ because we already have it! As they say on 24 hours in A&E, we are open ’24 hours a day, 7 days a week’, if you have an emergency you will be seen. Too many people now, including our own health secretary Jeremy Hunt, are using A&E and other emergency services as a secondary service for non-emergent problems because they feel they are unable to get appointments at their GP.
The NHS is vastly underfunded, and the only solution to changing that is to invest more money in infrastructure, not try to demoralise and take advantage of the staff.
A lot of newly graduated doctors will be demoralised after the industrial action that occurred last year but it is important to remember their have been some positive changes in the new contract. The BMA is still negotiating with the DoH and will continue to make positive changes to it.
“A lot of newly graduated doctors will be demoralised after the industrial action that occurred last year but it is important to remember their have been some positive changes in the new contract.”
What is the next stage of your journey? How does a Junior Doctor develop within the NHS?
Choosing a life in medicine means a commitment to lifelong learning. So many things change, at such a fast rate and it can be hard to keep up. Even in my 6 years at medical school, new conditions, treatments and even anatomy are being discovered.
In terms of the future, at the moment, it will take at least 6 years of full time training before I can become a fully qualified GP. After medical school, there is 2 years of foundation training where places are allocated based on preferences and a national ranking system. Followed by 4 years of GP speciality training.
I look forward to making those doctor-patient relationships and the satisfaction you get from doing an important job well. Not to mention, after 6 years of being a student, it will be nice to be finally paid!
What advice would you give your 18 year old self?
Don’t give up and don’t be disheartened when you hit an obstacle in your path. Mistakes are there to be made and to be learnt from.