Tuesday, July 28, 2015

The Long Road Home

6 month between posts, you could be forgiven for thinking this blog had gone on permanent hiatus. Just been bust moving house, starting yet another new job and trying to look after our newly minted  2nd child.

I started this blog in 2009 to chart the time of being an  FY1 doctor straight out of medical school. Initially I chronicled my worries and flip flopping about what specialty I wanted to do for the 40 odd years. It regularly changed but by the time my foundation training had finished in 2011 I had narrowed it down to either Surgery or Obstetrics & Gynaecology. Usually, you enter specialty training straight after completion of foundation training.

Next week, 4 years later, I finally start Obstetrics & Gynaecology training.

Firstly, I am very happy to be finally on course in a training program which ends in CCT and my next interview is potentially for a consultant post. Especially in a specialty I have long wanted to join.

So why did I take so long?

2 reasons really.

Firstly, I wanted to gain experience in both before embarking on one or the other. Other than a 1 week taster course I did not do any O&G as an FY doctor so went abroad to work in O&G in Australia for a year. This firmed up my decision to proceed with O&G as I loved  both the medical and surgical aspects of a job as well as the intense emotions on the labour ward. This accounts for a 1 year delay and leads onto the next reason for it taking so long.

I'm terrible at interviews. Absolutely so. I have had many and had lots of practice and courses to improve the problem. My CV wasn't bad and neither were my clinical skills yet my communication skills, which when measured in work based assessments as good crumbled to terrible in a job interview. I don't know why, perhaps I've always had a problem with getting nervous around people in authority.

I had 3 interviews in 2012, 1 for O&G, 2 for Surgery which was more a second choice to ensure I moved back to the UK.

*aside* I know one should never embark on a career like surgery as an alternate choice, but at the time moving back to UK was more important. *end aside*

I failed 2 of them on communication skills and passed a surgery interview but not well enough to get a post outright and was placed on the reserve list. 10,000 miles away I anxiously waited for other candidates to reject the job I wanted. I got it and moved back to the UK.

I still wanted to pursue O&G so in 2013 applied again. Failed again, worst than the first time. Made many of the same mistakes and despite knowing them seemed unable to resolve them. As I had the job in surgery I resolved to go wholeheartedly into general surgery. I could be and proceeded be the best core trainee I could. I did all the courses and log books and exams and assessments and publications and teaching and management degrees and interview prep and in 2014 applied for a higher surgical training job. The same thing happened. Completely froze in the interview and despite getting the clinical skills and portfolio right failed on the communication skills. I get into knots as I try and 2nd guess the interviewer and then hesitate to find the correct words.  This led to me having to get a staff grade middle grade surgery job somewhere at short notice. Which is why I spent 2014-15 in the furthest reaches of Yorkshire.

Which is where I had to make another decision. 3 years in surgery and I had learnt to do a lot but still had the confidence issues and still not able to secure higher training jobs. Do I continue a 3rd time at surgery or cut losses and do something else entirely. I had failed O&G twice, did I want to go through it again now I was 3 years from my last experience in it? I wasn't enjoying the lifestyle away from family and friends and with 2 kids to look after we needed some roots. I love operating and working with families on the labour ward so tried again to get an O&G post back home, which is what I had wanted all along. Was it difficult to give up 3 years after starting surgery. Yes it was. A part of me will always run the "what if" scenarios in my head. Perhaps I would have got the training job with more experience, but I doubt it as I was away from an academic centre as a non training doctor. Maybe I would have had a rewarding career as a surgeon. I get the feeling I made the right choice. Many colleagues told me "You're far too nice  to be a surgeon." Which may well be the case, but it also meant I wasn't ruthless  or hardheaded enough to get on,so perhaps it was for the best.

  Now I write this from my  house in the East Midlands about to start run through training with my lovely larger family! I think the year as a registrar gave me the confidence to finally pass a communication skills exam. 4 years late via Queensland, West Yorkshire and about 100 appendicectomies, but I'm where I want to be finally! Are there still worries? Sure thing. I have got used to some of the benefits of being a registrar and will have to go back to being a novice and probably a lot of admin and mundane work. I'm worried I'll blur the line between my old role and new role. I'm worried people may expect too much from me, having been a surgical trainee in the past.

Is there a lesson to be learnt from this?

Perhaps, stop dithering and make your mind up earlier? I don't know, I think it is possible to love 2 specialities and researching will only get you so far. I think if you are equally happy in either, then persuing either is fine.

Prepare more intensely for interviews and work on flaws harder? Perhaps, but how much can you iron out an inherent flaw in your technique, stumbling over  words. Sheer bloodymindedness worked eventually as I passed the interview on the 3rd attempt.

Be flexible and open minded about your options? Medicine is an incredible career and its variability is what makes it so interesting.

So I think finally if there is anyone struggling to figure out what they want to do in medicine, it is OK to go a circuitous route if you can justify your decisions and it makes you interesting. You don't have to flow smoothly from one MTAS designed program to another. I honestly feel my 3 years in general surgery are going to come in mighty useful in the next few years. You'll get there in the end. Or not, and you can do something else equally interesting and fulfilling.

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