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Medical Women Talking Podcast
Hosted by: Professor Dame Jane Dacre DBE, MD, FRCP
Dame Jane Dacre is the former Director of UCL Medical School and an honorary consultant rheumatologist, at Whittington Health in London. A physician and educator by background, Jane is currently special advisor and Chair of the Expert Panel for the Health and Social Care Committee. She is the past president of the Royal College of Physicians (the third women to be elected in 500 years) and was also vice chair of the Academy of Medical Royal Colleges, medical director of MRCPUK examination, academic vice president of the RCP and a GMC council member. Her research is in medical education focusing on assessment and equality.
Access all episodes on Apple podcasts, Spotify, Soundcloud, Amazon Music or your favourite podcast app.
Season Three: Rising Stars
Episode 1: Dr Ruth Law
Dr Ruth Law FRCP DPMSA is a consultant physician in geriatric medicine and general internal medicine at Whittington Health NHS Trust, London where she is Associate Medical Director for Quality and Clinical Effectiveness. Her work in integrated care resulted in her being awarded the British Geriatrics Society Rising Star Award for quality in 2018.
She is currently Honorary Secretary of the British Geriatrics Society. She was selected to participate in the first cohort of the Emerging Women Leaders Programme at RCP and elected to College Council in 2019. She has been an RCP censor since 2022.
Episode 2: Dr Becky Cox
Becky is a GP specialist working in gynaecology and an academic GP with an interest in violence against women. As a survivor of domestic abuse as well as sexual harassment and assault at work she advocates and campaigns to end the culture of misogyny in healthcare.
From lecturing at Oxford University to medical students on domestic abuse, writing and publishing scientific papers, national and international speaking, and charitable work she has worked to bring a focus to violence against women in the healthcare sector. From sharing her own experience of sexual violence and abuse she recognises the power of survivor stories in bringing forth change.
Episode 3: Dr Chelcie Jewitt
Chelcie is an Emergency Medicine trainee, interested in health inequalities, particularly those faced by women. Throughout her training she has been a victim of, and witness to, multiple incidences of sexism and misogyny. This prompted her to found the Sexism in Medicine project, which has led to the hard-hitting report published with the BMA in August 2021.
Chelcie campaigns for equality in the workplace, speaking at national and international conferences, collaborating with multiple organisations in order to tackle this issue. This latest campaign, focuses of giving victims of workplace misogyny a voice, bringing about change through the power of their testimony.
Episode 4: Dr Patrice Baptiste
Patrice Baptiste is a double award-winning portfolio GP, medical educator, entrepreneur, writer, author, visionary and champion for diversity within the medical profession. Dr. Baptiste holds various roles alongside her main role as a GP. She is focused on supporting others with their career development especially with creating a portfolio career.
Dr Baptiste enjoys juggling multiple careers and interests. In addition to her work as a general practitioner she also works as a senior lecturer at The University of East London. She is also the founder of Medschool Xtra a new and innovative medical education platform, a writer for GP Online and speaks at various conferences and events.
Episode 5: Dr Jess Morgan
Jess is a clinical fellow at the Royal College of Paediatrics and Child Health, leading a national project to improve the wellbeing and working lives of paediatricians. She spent 11 years as an NHS doctor, specialising in paediatrics and undertaking research in neonatology. Burnout and mental illness led her to leave medicine in 2019.
During the subsequent few years, she developed a passion for improving wellbeing and retention, speaking and writing about our humanity as health professionals and ways in which we can provide inclusive and compassionate working environments. More recently, Jess has embarked on a journey of returning to the NHS, with the aim of combining her leadership work alongside clinical paediatrics.
Episode 6: Dr Kate Ordidge
Dr Katherine Ordidge is a Consultant Radiologist at Barts Health NHS Trust, London and Honorary Senior Clinical Lecturer at Queen Mary University of London, UK. She graduated from University College London (UCL) Medical School in 2007, with an intercalated BSc in Medical Physics and Bioengineering.
After completing foundation training, she joined the UCL Centre for Advanced Biomedical Imaging on a Medical Research Council Capacity Building PhD Studentship, completing a Master of Research (with distinction) and then a PhD in 2014. Dr Ordidge specialises in oncological imaging and PET/CT, with a focus on gynaecological imaging, uro-oncology, endocrine and haematological diseases.
Episode 7: Dr Rahel Odonde
Rahel Odonde is a consultant obstetrician and gynaecologist. Her special interests include the safe practice of abortion care, sexual and global health, having completed a MSc in Global Health in Sweden. This was followed by an internship at the Sexual and Reproductive Health Unit at the WHO Regional Office for Europe.
Rahel is the first Equality, Diversity and Inclusion council officer for the Medical Women’s Federation, and as a member of the executive committee of the UN Association Women’s Advisory Council, UK. Alongside these commitments Rahel is a guest blogger for the Swedish NGO ‘My Period is Awesome’, and volunteers with the King’s Global Health Partnerships.
Episode 8: Dr Rosia Shah
Dr Rosia Shah is a Locum consultant Obstetrics & Gynaecology and Medical Lead for VCTC, a UK-based clinical trial site that specialises in running patient centric clinical trials. Rosia reflects on her journey from a deprived background to medical school and the challenges she faced as a women of colour.
Rosia also shares what inspired her to pursue leadership roles and her advice for younger women to say yes to opportunities and embrace hidden value to help acheive personal growth and success.
Episode 9: Professor Lesley Regan
International Women's Day special
Dame Lesley Regan is Professor of Obstetrics and Gynaecology at Imperial College's St Mary's Hospital Campus, and Honorary Consultant in Gynaecology at the Imperial College NHS Trust. She is also PI of the Recurrent Miscarriage Tissue Bank, co-director of the UK Pregnancy Baby Bio Bank and she chairs the Department of Metabolism, Digestion & Reproduction People and Culture Committee (Athena SWAN).
Professor Regan was awarded a DBE for services to women's health in the 2020 New Year's Honours List.
Episode 10: Dr Parveen Jayia
Parveen Jayia is a physician who is passionate about developing high performing medical teams that are strategic, collaborative and externally focused to improve patient access to therapies that can improve clinical outcomes and quality of life. Dr Jayia has held a number of medical leadership roles both within NHS, where she practised as a surgeon, and within pharmaceutical industry. Integrity collaboration, excellence, creativity and compassion are dear to her heat which she uses to lead by example empowering people to reach their full potential as well as taking personal accountability for her actions and deliverables.
Currently working in oncology, Parveen is keen to embrace new ways to optimise healthcare and determined that working in partnerships is the way forward.
Episode 11: Dr Abi Patel
Abi is a Consultant Colorectal Surgeon at University Hospitals of Coventry and Warwickshire NHS Trust. She graduated from University of Cambridge in 2004 and completed higher surgical training in the West Midlands, some of which was as a less than full-time trainee. She is co-founder and chair of the Midlands and Oxford IBD (Inflammatory bowel disease) regional network which brings together clinicians to help develop patient pathways, teaching and research. She is a NIHR CRN Research Scholar and believes in patient centred research, being involved in several research projects as principal and chief investigator. She is the vice chair of Early Years Consultant Network, helping deliver mentorship schemes and supporting trainees as well as early years consultants.
Abi has recently joined the emerging leaders program at the Royal College of Surgeons of England, recognising the power of mentorship and peer support in empowering you to become a more effective leader.
Season Two
Episode 1: Professor Dame Clare Gerada
A practising GP in South London, Dr Clare Gerada initially trained in psychiatry at the Maudsley Hospital. As a specialist in mental health in primary care, she focuses on substance misuse, homelessness, and supports mentally ill doctors. Leading Europe's largest physician health service for a decade, she has aided over 5000 doctors and dentists with mental health issues. Clare led the Royal College of General Practitioners from 2011-2013 - the second woman to hold this position. In 2019 Clare was elected the Co-Chair of the NHS Assembly.
Episode 2: Dr Celia Bielawski
Celia is a consultant geriatrician, working at Whittington Hospital in North London. She is also Deputy director of the London Foundation School and clinical lead for assessment at the Royal College of Physicians (RCP). She has been a Foundation training programme director and Director of Medical Education at Whittington Trust. She has also been a RCP Censor and is a senior examiner and chair of examinations for RCP, in the UK and internationally.
Episode 3: Professor Gozie Offiah
Dr Gozie Offiah practised medicine (with a background in Surgery) for over 15 years in the Health Service Executive (HSE). Dr Gozie Offiah is a Senior Lecturer and Director of Curriculum at the Royal College of Surgeons in Ireland. She is also the Clinical Lead for the National Intern Training programme in the Health Service Executive, the chair of the cross-cultural group of tEACH, the International Association of Communication in Healthcare and the Non- Executive Director of the Medical Protection Society for Ireland.
Episode 4: Dr Fiona Cornish
Dr Fiona Cornish was senior partner of a Cambridge GP practice and has successfully combined clinical practice with active roles as an appraiser, GP trainer, undergraduate teacher, school doctor at King’s College School and member of the University Health and Wellbeing Committee. She has been a senior member of the Medical Women’s Federation (MWF) for many years, serving as President from 2012-2014. She was the MWF representative on the General Practitioners’ Committee of the BMA.
Episode 5: Dr Sarah Clarke
In July 2022 Dr Sarah Clarke was elected the 122nd president of the Royal College of Physicians. Only the fourth female president of the RCP.
Previously clinical vice president RCP, president of the British Cardiovascular Society and Joint National Lead for Cardiology for the Getting it Right First Time (GIRFT) programme. She is clinical director for strategic development and an interventional cardiologist at Royal Papworth Hospital in Cambridge.
Episode 6: Professor Meghana Pandit
Meghana trained in Obstetrics & Gynaecology in the Oxford Deanery and was Visiting Lecturer in Urogynaecology at University of Michigan, Ann Arbor, USA. Meghana was a Consultant Obstetrician and Gynaecologist, Clinical Director and Divisional Director at Milton Keynes University Hospital before joining University Hospitals Coventry and Warwickshire where she was Chief Medical Officer from May 2012 to December 2018 and Deputy Chief Executive from 2014. Meghana completed an MBA at Oxford Brookes University (Distinction) and the Innovating Health for Tomorrow Programme at INSEAD, Fontainebleau. Meghana has been Chief Executive Officer at Oxford University Hospitals since July 2022.
Episode 7: Professor Scarlett McNally
Professor Scarlett McNally is a Consultant Orthopaedic Surgeon in East Sussex, Deputy Director of the Centre for Perioperative Care www.cpoc.org.uk and President of the Medical Women’s Federation. Previously elected Council member of the Royal College of Surgeons of England (2011-2021, the ninth woman). She speaks and writes a lot about Exercise the miracle cure to fix health and the economy, diversity, bullying, workforce, education, sustainability and perioperative care. BMJ columnist, mother of four adults, cycle campaigner, electric-cycle convert, living with myeloma and cardiac amyloidosis.
Episode 8: Professor Averil Mansfield
Averil Mansfield CBE was born in Blackpool in 1937, where she grew up in a council house. Even in becoming a doctor, she was achieving against the odds. But her desire from the age of eight was to go further still and work as a surgeon; a goal she was delighted to achieve in 1972. Based in Liverpool, Averil was the UK's first ever female vascular surgeon; she went on to become the first female professor of surgery too. She has since been awarded a number of honorary titles and prizes, including a CBE in 1999 and an NHS Lifetime Achievement Award in 2018. Now widowed, she lives in London.
Episide 9: Dr Jeanette Dixon
Jeanette Dickson was elected as Chair of Council of the Academy of Medical Royal Colleges (AoMRC) from July 2023.
Jeanette graduated from Glasgow University and trained initially in general medicine in Glasgow and Eastbourne, obtaining MRCP. She returned to Glasgow to begin her training in clinical oncology at the Beatson West of Scotland Cancer Centre. After obtaining FRCR, she undertook an MD investigating intrinsic radiosensitivity at the Paterson Institute, Manchester. She completed her oncology training at Mount Vernon Cancer Centre (MVCC), where she remains as a consultant clinical oncologist today. Her main practice is in the area of multi-modality management of thoracic malignancies.
Episode 10: Professor Dame Jane Dacre
Jane trained as a doctor at UCH Medical School, qualifying in 1980. She undertook her postgraduate clinical training in General Internal Medicine and Rheumatology at St Bartholomews Hospital in London. She completed her research training at St Bartholomews Medical College, developing digital imaging methods for the evaluation of radiological joint space size in patients with osteoarthritis.
She was Women in the City Woman of Achievement in medicine and healthcare in 2012, and was in the inaugural HSJ list if inspirational women in healthcare in 2013. In 2014 she was elected President of the Royal College of Physicians. The third female president in its 500 year history
Episode 11: Professor Faye Gishen
Faye Gishen is Professor of Medical Education and Palliative Medicine. She is the Director of UCL Medical School. She is a Doctor of Medicine and a Doctor of Education, with a mixed clinical and educational research portfolio. She has a specialist interest in cancer survivorship. Faye has led innovative work including diversifying the undergraduate medical curriculum, and mapping undergraduate medical curriculums. Her introduction of reflective practice Schwartz Rounds to healthcare students has now been adopted by over 20 UK Higher Education Institutions, with impact on learners and patients.
Faye has three children and worked less than full time until taking up her current post. She enjoys travelling, cooking and is a bit of a book worm.
Season One
Episode 1: Dame Clare Marx
In this first episode, Jane is joined by Dame Clare Marx, the first woman to chair the British Orthopaedic Association, the Royal College of Surgeons of England and the General Medical Council.
In this particularly poignant episode, Jane and Clare discuss Clare's career, from what it was like to be one of only a few women working in surgery and chart a successful path though that field, to leadership styles and the most important things doctors can do for their patients.
Episode 2: Dr Suzy Lishman CBE
Dr Suzy Lishman CBE is a consultant histopathologist and lead medical examiner in Peterborough. She has held many local roles, including Medical Staff Committee Chair, Clinical Governance Lead, Postgraduate Clinical Tutor and Clinical Lead. Her previous national roles include Registrar, Vice-President and President of the Royal College of Pathologists, through which she championed member, public and political engagement. Suzy is currently President of the Association of Clinical Pathologists, and chairs the Medical Examiners Committee of the Royal College of Pathologists. Suzy was awarded a CBE in 2018 for services to pathology.
Episode 3: Professor Dame Parveen Kumar DBE
Emerita Professor of Medicine and Education at Barts and the London, Queen Mary University of London. She qualified at St Bartholomew’s Hospital Medical College and worked in the NHS as a gastroenterologist and physician .Her research was in small bowel disorders, particularly coeliac disease.
Professor Kumar co-founded and co-edited the textbook, Kumar and Clark’s ‘Clinical Medicine’, which is used across the world. She has been President of the: British Medical Association, Royal Society of Medicine, Royal Medical Benevolent Fund, and the Medical Women’s Federation.
Episode 4: Dr Jennifer Dixon CBE
Dr Jennifer Dixon joined the Health Foundation as Chief Executive in October 2013. Jennifer was Chief Executive of the Nuffield Trust from 2008 to 2013. Prior to this, she was Director of Policy at The King’s Fund and policy advisor to the Chief Executive of the NHS between 1998 and 2000. Jennifer was appointed as a non-executive board member of the UK Health Security Agency in April 2022.
Originally trained in medicine, Jennifer practiced mainly as a paediatrician prior to a career in policy analysis. She was awarded a CBE for services to public health in 2013
Episode 5: Dame Carrie MacEwan
Professor Dame Carrie MacEwen is Chair of the General Medical Council (GMC), appointed in May 2022. Carrie has been a member of Council since January 2021 and served as Acting Chair from August 2021 to May 2022.
Carrie is a consultant ophthalmologist for NHS Tayside and Honorary Professor at the University of Dundee. She served as Chair of the Academy of Medical Royal Colleges until 2020 and is Past-President of the Royal College of Ophthalmologists.
Episode 6: Professor Henrietta Bowden-Jones OBE
Professor Henrietta Bowden-Jones OBE is a medical doctor and neuroscience researcher working as a consultant psychiatrist in addictions. She is current Vice President of the Royal Society of Medicine. A regular advisor to the UK Government on matters relating to gambling disorder, gaming disorder and mental health, she was appointed NHS England National Clinical Advisor on Gambling Harms in September 2022.
As well as pursuing a clinical career, Henrietta has a Doctorate in Medicine in the field of Neuroscience from Imperial College and is Honorary Professor at UCL in the Faculty of Brain Sciences.
Episode 7: Professor Geeta Menon
Professor Geeta Menon is a Consultant Ophthalmic Surgeon at Frimley Health NHS Foundation Trust in Surrey. In addition to high-volume cataract surgery, she has developed a major interest in medical retina, particularly novel treatments for age-related macular degeneration (AMD).
In 2016 Professor Menon was awarded the joint Royal College of Physicians (RCP) and NIHR award for ‘Outstanding Research Leadership in the NHS’.
Episode 8: Professor Dame Helen Stokes-Lampard
Helen Stokes-Lampard is Professor of GP Education at the University of Birmingham and was Chair of the Academy of Medical Royal Colleges (AoMRC) from July 2020-23. Helen is a GP Principal and Chair of the National Academy for Social Prescribing (NASP). She held the title Chair of the Royal College of General Practitioners (RCGP) until Nov 2019. She was awarded a DBE for services to General Practice in the New Years Honours list January 2022.
Episode 9: Professor Wendy Reid
Professor Wendy Reid is medical director of Health Education England (HEE). Professor Ried was previously appointed the dean of postgraduate medicine at London Deanery in 2003. She is a consultant gynaecologist and became an associate dean in London in 2001, leading on anaesthetics and paediatric training and sector development across north Central and north east London. Professor Reid has recently completed her term as vice president at the Royal College of Obstetricians and Gynaecologists.
Episode 10: Professor Cathryn Edwards
Professor Cathryn Edwards is a consultant physician and gastroenterologist and Registrar of the Royal College of Physicians (RCP). Her main clinical interest is inflammatory bowel disease (IBD). Professor Edwards was the first female secretary of the British Society of Gastroenterology (BSG) and its second female president. As part of her work with the BSG, she promoted mentorship as a means of personal development, instigating the BSG Mentorship Programme launched in 2018.
Season one transcripts
- Episode 1 Dame Clare Marx
Medical women talking podcast - S01E01 Dame Clare Marx
Speakers: Clare Marx, Jane Dacre
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. This podcast is particularly poignant. I'm interviewing Dame Clare MarX. She has been an inspiration to many and is well known for being the first woman to chair the British Orthopaedic Association, the Royal College of Surgeons of England and the General Medical Council. Sadly, she died from pancreatic cancer 10 days after we made this recording, in spite of her illness, she was determined to leave her voice for future generations of medical women.
Clare Marx 01:40
Well, my name is Clare, Clare Marx, although I am married: Clare Fane. And I've been very lucky in that I've been awarded the honorific of damehood - Dame Commander of the Order of the British Empire, which is a bit of a mouthful. So. And I regard that as a particular honor, because I'm very, very aware that for a very long time, women were not recognized in the same way as men were in the Honors system. And to be one of the ones that had been recognized as particularly pleasing.Jane Dacre
Oh that is one of a number of pretty amazing contributions that you've made. So how about your career? How did it start? Why did you decide to do medicine?Clare Marx 02:34
It's very difficult when you look back that really long haul. But I mean, some people would say it was because I cut my finger when I was age seven, some people would say that I saw my father being ill when I was sort of a medical student. But of course, by then I'd already decided to do medicine. Undoubtedly, I think that my mother gave me some work experience with a local surgeon made me think about not just doing medicine, but doing surgery. And I think that was a really important part of my career. And I think it's just that wonderful combination of art and science, of being able to care, being
able to compute being able to be endlessly fascinated in other people's lives and trying to work out what makes them work and what doesn't work, being able to offer them compassion and, and kindness throughout their lives. So all those things that are all part of every medical career.Jane Dacre
Are you the first doctor in your family?Clare Marx
Yes. So my father was an international research chemist, my mother, teacher, maths teacher, and my grandfather, a high court judge, so very much not a medical family. So I don't know where it came from. Don't know where it came from.Jane Dacre 03:48
Fantastic. So you, you talked a bit about always being keen on surgery. So that's quite a tough career path, particularly given what you've said earlier about women not being recognized. I think surgery is one of the last bastions, is it not?Clare Marx 04:06
Yes. I mean, part of that is that actually any career in medicine is a tough road to hoe. And I think that's something that people would do well to reflect on now. There isn't an easy route through medicine, because it's that combination of learning, acquiring knowledge, giving a bit of yourself when you least want to that altruistic intent. But then when it comes to something like surgery, there is a technical part of it. And I think you have to you have to give it a go and try very early on. And if you're no good at surgery, it's no there's no point in saying I want to be a surgeon because I want to be a surgeon and you think it sounds sexy or whatever, you've got to actually be really honest with yourself and say I can't cut it. There is there is an element of surgery which is intensely practical. It's about organisational, it's about team leading. It's about decision making. And often decision making, followed by more and more decision making. Because if you get one little decision a little bit wrong, you've got to tweak that. So you've got to be you've got to know yourself and recognize when you're going to be good at it, and when you're not going to be good.Jane Dacre 05:19
But what you've also done, though, is started to take up leadership positions, or continued to have the most amazing leadership positions, often the first woman to have done so. So what how did that come about?Clare Marx 05:32
It's sort of hard to, to know exactly. But what I suppose I often did was I looked around at the situation in which I was finding myself and I was thinking to myself, some of these things have to be done, they have to be organized, they have to be led. And if no one else wants to do it, why shouldn't I offer my thoughts and what's more, it's always better to be led than to be being dragged along by the nose. And, and you can only blame yourself if you get it wrong. So that's where I think it started. But it also started around the whole area of professional behaviors. And there were so many unprofessional behaviors in surgery, the very often one of the ways of getting change for the benefit to everybody was to actually try and lead that change. And often if people would say to me, how on earth are we going to get people to change things? The answer is, you actually have to lay it out in front of them, you have to hold the mirror up, and you've got to be brave enough to actually just be still holding it when they they let off steam, because they don't like what you're saying. So, I mean, there are some particular stories that have moments in my leadership role, which I have one of which I'll share with you. But a previous president of the College of Surgeons asked me to go to an event that that was organized to try and get more women into surgery. And when we got to the event, it was one of these typical events where there are post-its on the wall, and you know, pink ones, and blue ones and all these other things. And we had to all the women amongst us, and indeed a few men had to say what free things we were going to commit our colleges to, to improve the chances of there being women in surgery. So I, we set off, and we posted things everywhere. And at the end, I got these three things. And my three things were number one was to have a 50:50 leadership programme men and women, so men and women could grow together and learn how to their leadership styles and begin to appreciate, take some from some people styles and take some from others. I thought that was really a very nice sort of thing. And the second one was that we should stop swearing in theaters. Now that that was a little bit more aspirational. And the third one was that we should have a woman president elected as a College of Surgeons. Anyway, when I got back at the end of the day, and I went to the president, he said, What have you committed us to? So I said, well, I've committed us to having a 50:50 leadership programme for men and women. He said, well, well. And then he then he said, What else? And I said, well, we've I've committed us to stopping people swearing in theater, and he said, ‘Oh, no, we could never do that.’ And at the time, I was just rewriting the good medic good surgical practice guide. So I said, well leave it with me. And in fact, eventually what I did was I put into that guide, a piece that said that one shouldn't use undermining or pejorative behaviour. And of course, when it was done in front of everybody in front of Council, no one could stand up and say, I think it's a good idea that we do this, you know, so that was, and he said to me, anything else? And I said, No.Jane Dacre 08:50
So of course, you did go on to be the first female president of the College, didn't you?Clare Marx 08:56 I did.
Jane Dacre 08:57
How was that? Tell us about that?Clare Marx 08:59
Well, there are some wonderful male colleagues in life. And there are some absolutely dreadful people, both men and women. And I have to say, I don't think I've ever been as undermined and bullied as I was when I was president, the College and but for some really wonderful friends, yourself included, I think it would have been very tough to get through. And that really taught me a big leadership lesson, which is you can't do these things on your own. You have to have really good solid sounding blocks and friends and people to help and people to give you a sense of when actually, yes, this is right or no, actually, you're pressing too hard on that button. So I think it's really, really important to be able to share that with sensible friends. But the old boys, and there's no other way of describing it, because they were mainly boys. Were just at times utterly, utterly outrageous. And you can laugh at it now but it At the time, it wasn't nice.Jane Dacre 10:03
So just tell me some of the things that you achieved. There are some fantastic things, what did you achieve?Clare Marx 10:10
We did, we did, of course, start the first emerging women's leaders Estelle Wolfson program. And that was immensely successful and has continued to be with the really wonderful support of Estelle Wolfson and her and her foundation. And then then we then we had the whole area of, of professional behaviors, learning from professional behaviors, publishing about what people were doing, and why things were going wrong in poorly performing areas and poorly performing units. And sometimes this is about putting the holding the mirror up to the profession. And very, very important when the profession itself says this, this stuff isn't it's not good enough. And I think it's really that's a really important thing for them. Then, of course, there was the whole rebuilding of the building, the knocking down of the building, and the starting again, which shortened my life, I think, probably but now when you see it resplendent, and I think most people would say it is resplendent, and fit for purpose and available for the next generations. I think it's you know, people, most people can see that it was the right thing to do. But, but there were lots of other things that are just starting some of the leadership fellowships, both of the college and subsequently, the GMC, starting to get women recognized as, as actually being able to stand in the footprints of the people who had come before not being lost in those footprints, but actually having other people who are making the footprints a bit smaller. So the next lot of women who came along, we'd be able to step into them and move on. And just feeling that the very positive impact of the life enhancement of people who want to do things, but when perhaps a little bit afraid of putting their head above the parapet, and they felt emboldened by having someone else ahead of them, just to push them along. So definitely, they're feeling that there's been a positive impact for the future, which I hope will never go away, now.
Jane Dacre 12:25
I don't think it will. I think it's an extraordinary position to be a role model. But then you moved on to be a role model somewhere else, too, didn't you?Clare Marx 12:34
Then, of course, there was the GMC. And, you know, no one loves no one loves the regulator. No one ever thinks they will get it right. But actually trying to change the conversation, so that it's done with compassion, and understanding and caring, and equality, because of course, you have to remember this is a system that essentially was built by men for men over hundreds of years. And women's needs. And what they do are very different. That doesn't mean that people should behave differently in terms of their professional behaviors. And I think there is a really, there's a really big problem now, which is that some women think that they should they should be treated differently, because they're women, not because they actually are women with a problem. But just because people still understand that they're different. They, men and women are different. But the reality is that we all have professional duties, and we have to fulfill them to our patients and our colleagues. And when people start stepping out of those patterns, then then there's trouble for everybody.Jane Dacre 13:43
Absolutely. So if you were to reflect on your leadership style, what would you say? That's what people get taught on courses like the Estelle Wolfson course,Clare Marx 13:54
I’ve never been quite sure about my leadership style. But I'd like to think that it was, it was a bit of learning from the people around me. It's a bit about caring for the people around me. And it's a bit about having fun with the people I've tried to lead. And I think I've managed to have all of that in my life.Jane Dacre 14:14
And so now more recently, you've become a patient. Does that well make a difference to how you reflect on what it's been like as a doctor?Clare Marx 14:27
Yes. And what I really, I mean, this, I think that on the whole, doctors are caring and compassion. And I think that but sometimes they have gotten themselves into a mind frame about what can the system can do for me rather than what can I do for the system? And I think it's a really tricky place because when one is being pushed in a very, very pressurized system, you know, of course you don't have that last milk, bit of milk of human kindness left, and you want someone to look after you and so on. But that that is when actually being a true professional shows through because that's when you actually have to dig really deep and find that altruistic moment, to be kind to the person in front of you. And to look out for them and to advocate, to advocate for the patient. I think that's probably the most important thing.Jane Dacre 15:22
Fantastic. Well, you've been incredibly clear and helpful and have again, shown yourself to be a fantastic role model for the women and of course, men who are coming through medicine, is there anything else that that you would like to share?Clare Marx 15:39
Well, I think that there's no career that's entirely milk and honey. And I think that the most important thing is to remember what it is that you can do for your patients. Because one can do so much for the patients and the teams around them. Just by that those acts of kindness and fun. And as the leader of a team, which you certainly are, as a doctor, people look to you for that leadership, what you do is reflected across the piece. And I think I think that's just, it's a really, really privileged role to carry in life. And once you just sort of hold on to it and enjoy it.Jane Dacre 16:24
Fantastic. Well, it's been really lovely to talk to you. And I'm sure a lot of doctors coming through and actually all health care professionals will be inspired by your words. So Dame Clare Marx, thank you very much.
Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.- Episode 2 Dr Suzy Lishman
Medical women talking podcast - S01E02 Dr Suzy Lishman CBE
Speakers: Suzy Lishman, Jane Dacre
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Today, I'm talking to Dr. Suzu Lishman. She's a pioneering history pathologist, and has been a female president of the college of pathology, she has a number of outside interests, and will be an inspiration to listen to. So, Susie, can we start by talking about your career? So do you want to give us a summary of your career journey, which includes when did you decide to become a doctor and take us from there.Suzy Lishman 01:37
So, I always wanted to be a doctor. And I come from a medical family. And I just always thought that's what I wanted to do, even before I really understood what it meant to be a doctor. But I always liked health, and was very interested in the body. And I would you know, I was the three year old wrapping my grandmother in bandages. And so I always knew that's what I wanted to do. I had a big thing at sort of 14 when I was choosing O levels, and 16 Was there anything else I might want to do? I thought about law. The only other thing I really ever considered doing seriously was art history, always been really interested in art, and the history of how art how and why art is produced. My grandfather used to take us on holidays to Italy, and I got to learn about the Renaissance and Romans and I loved all that sort of thing. So art history was really the only other thing that I considered. But having decided that I’d probably have a better quality of life if I was a doctor with an interest in art history than the other way around, I decided to do medicine. I went to a mixture of schools, but my last six years my secondary education was all in a comprehensive school state school. And I went from there to Girton College, Cambridge, did three years there, and then did my clinical at the London Hospital, did my house jobs and then was fortunate enough to get onto a seamless training programme at UCL, which in those days was quite unusual. You used to have to apply through your SHO job and then a registrar I got a six year training program,e. And so I did my histopathology at UCL and the Whittington and then went straight off into my first and only consultant job first working at Hinchingbrooke Hospital in Huntington and then moving after seven years to Peterborough City Hospital. And the two have since merged to form a single trust. So essentially, I've been 23 years now working for what's now called Northwest Anglia Foundation Trust. So it sounds like I haven't actually done many different things, but I've had different phases to my career. And that's really reflected some of the things I do outside my main job as a full time diagnostic histopathology, just as you alluded to, so I'm...Jane Dacre 03:50
sorry, can I can I just interrupt you to ask you how you chose pathology.Suzy Lishman 03:56
I when I was a medical student, I enjoyed almost everything I did. Considered doing obstetrics at one point I love delivering babies, I realised pretty quickly that wasn't what you did. As an obstetrician wasn't all the happy moments of delivering babies. I liked almost everything. And so I had an I intentionally kept a really open mind about what I might do. And it was really during my house jobs when I was doing surgery. And I could see that some of the more senior trainees in surgery were studying for their exams. And they talked a lot about pathology and the relevance of it. And I think I just always liked always been curious about how things work. And I liked understanding the sort of cellular and molecular mechanism for disease. And I think I just I just wanted to understand more about why diseases happened and why they responded to treatments or surgery in the way that they did. So it's really curiosity. And so I just started looking into it. I went to see a post mortem on one of my patients who died I went into the lab to look at the histology from a specimen that had been removed from one of my patients, and just realised how relevant it was to actually caring for patients and how interesting it was to understand what was happening happening down the microscope and how that related to it. And so I started looking around, I actually had a gap between finishing my year of house jobs and starting pathology training of about four months or so. And during that time, I applied for jobs and was fortunate enough to get the one at UCL. I think in in retrospect, I really didn't quite know what a job as a history pathologist involved at that stage. Obviously, I'd gone and have looked around labs, and I've spoken to people who were doing it, but it's not something you really have exposure to found the first six months really quite tough. It's so very different from anything else I'd ever done. And then something just clicked and I have never looked back and never regretted it for a second. I always say if you put my personality type into a computer, it would come out and say that I should be I was born to be a histo pathologist.Jane Dacre 06:07
A lucky break, I suppose that some some would say. I mean, in every career, there are highs and lows. How about you tell us about some of your highs and some of your lows.Suzy Lishman 06:21
There have been many, many more highs than there have lows. You know, I think I've really I've been very fortunate that I haven't come across very many barriers along the way. Lows, I suppose doing, doing house jobs with very little sleep. And you know, it was the days when you were doing 120 hour weeks, and you never went home and didn't see my family, I found that really, really hard. And I couldn't imagine how I could keep that up for another 30 or 40 years. And of course, at that stage, I got very little training, you were just sort of running around trying to keep things going. And I worry about today's junior doctors with the pressures at the moment that training falls by the wayside when you're so busy actually delivering care. But I found that tough. As a pathologist, I failed my FRC Patho exam part one, I just took it too early. I I've been so used to being good at exams throughout my school days and not really struggling with them. And I think I didn't quite appreciate the I hadn't got I'd read lots of books and lots of papers. And I just hadn't quite got the clinical experiences as a diagnostic pathologist. So that was a low and pretty devastating, you know, I'd gone into pathology, I thought I was doing quite well at it. And then I failed the first part of the exam. But I did what you have to do pick myself up, took it again, six months later passed it and never so far failed anything since so my profit, my department said, you know, it was it was a good thing. That good thing taught me a bit of humility. And it hasn't hasn't held me back. But at the time that felt pretty devastating. Being president at the college, although it was, you know, the most fantastic thing I ever I've ever done in my career really, really had its low point. So it's quite tough at times. And trying to juggle the meeting the needs and representing your members while trying to influence and inform politicians and policymakers. And trying to get that balance right can be quite tough. And you can't please everybody all the time. And that's quite difficult. And probably the hardest thing for me was balancing presidential life, college life, work life, because I still had my consultant job. And, you know, had work to do and home life. And that was really tough, and I think unfortunately, was my home life that that suffered a bit, My poor husband missed out and bore the brunt of that. But getting that balance right was was a real struggle. But you know, as long as go, I can't really complain about those and, and, you know, as you find careers, things change, and they go up and down and our careers are long. And you get through the tough bits. And then there's some highs, the highs, there's the landmark days where I can sort of pinpoint that day that marked a change in the direction of my life without which it would have been quite different, you know, getting into Cambridge, you know, I remember getting the letter that said I got a place at Cambridge and that undoubtedly going to get and you know, undoubtedly changed the direction my life took getting onto that UCL histopathology training scheme. You know, if they had if it didn't happen to have had that scheme now I could have done one year there and then gone somewhere else. And I could have ended up somewhere who knows where but that that gave me some security and six years. I didn't go very far. The Whittington was the furthest I went on that scheme so I wasn't rotating around the country. I was very fortunate with that. Getting my consultant job obviously I've been there 23 years now that's defined how might the later part of my career Um, has evolved, been elected president of the college clearly has had a big, big impact. And then probably the final other day, but my wedding day, that's been really important was getting my CBE from Prince Charles now the king, that was a wonderful day. So they're they're, they're really big days of my life. But I think the real highlights the highs of my career have been the things where I've been able to make a difference. Supporting trainees and mentees. Seeing them succeed is interesting. Now, I've sort of moved on towards spending a lot of my time outside pathology on medical examiners. But actually, for a good decade or so my thing was public engagement. I introduced national pathology week in 2010. And got psychologists around the country out of their labs and out to talk to the public about what they do. And it was going to be a one off, but now it's an annual event. It's been happening now for for 12 years, and we've now gone international. So we have international pathology day. And so we have pathologist from 42 countries doing the same thing. So that's really one of the things that I've been proudest of during my career. But yeah, as you mentioned, introducing this whole new specialty of medical examiners, now it's evolving to be a separate specialty from everything else. And being able to work through that develop training materials, deliver the training, work with people who are making the legislation about how that might go forward has been really fascinating and interesting, and really successful. So far,Jane Dacre 11:34
quite a battle No?Suzy Lishman 11:36
Yes, but only only in the way that you expect it to be or you know, you don't expect to get your way, all the time. And certainly in the NHS you learn that things don't happen quickly. You know, there's an IT system that goes with this, this is not going to happen overnight. So I think that's one of the things I learned along the way is around finding ways around things, finding compromises. So one of the, you know, I don't take full credit for this myself, but one of the things that was holding up implementation of medical examiners was the funding. And it was initially the government intended that families would pay in the same way that you pay for a cremation form, you would pay 100 pounds for the medical examiner to issue a certificate so that your loved one could be buried or cremated. And obviously, this didn't go down very well with many communities. But the government was adamant that that was the way it had to be done. However, it was recognized that you could possibly get funding from other places. And so as an interim measure, before it became static tree, it was decided that cremation for money should be used to fund the system. And so medical examiner's started to do the second part of cremation forms, and then that money would go to fund their job rather than going into their own pocket. And so that was a huge compromise. But it was rolled out nationally that that funded the medical examiner system and that was starting to work and the pandemic came along. And the Coronavirus act easements got rid of that second part of the cremation form. So during the pandemic, it had to be funded centrally, which it was, and to my great joy. At the medical examiner's conference in May, last year, the Department of Health announced that it would be permanently funded centrally, which is what we wanted in the first place. So you know, we could never have thought, you know, it was the pandemic that did that. So it's finding workarounds, and, you know, looking at different ways of approaching things, and I think sticking at it, I'd been working on medical examiners for over a decade, and there are people who were working on it long before me, I can't take the credit for starting this all up. I just picked up the baton at one stage. So you know, being persistent and carrying on and believing that it's the right thing to do. And it's likely to become statutory this year. And every single death in England and Wales will be reviewed by a medical examiner. And I just find it amazing that you know, what we started discussing on a piece of paper, you know, 10 years ago is actually happening.Jane Dacre 14:01
Fantastic you must, it must make you feel very proud. So what inspires you to do all of these things? A lot of people don't go into leadership positions in medicine, a lot of people find it all quite tough. What inspires you, or drives you?Suzy Lishman 14:17
Yeah, I mean, I like making a difference. I like to feel that I'm making things better than they were, you know, not entirely selfless. It makes life better for me, too. So I like to improve things. And I think being a hysto, pathologist, you just get a different view of the world than you might do in other aspects of medicine. And so I started to, you know, I worked with the coroner, and I do post mortem examinations, and then, you know, I'd explain the findings to the public. And I think people often say, Oh, I wouldn't have thought you'd be a hero. You'd look like a histopathology is to me. And people have this idea of pathologist of sort of sad people with no, no people skills who are locked in the mortuary sort of thing from telling me vision. And I think what I did was was bring the love of communicating with people into pathology and try to merge the two. And so I love going out and talking to people, I go and talk to schools regularly about what pathology involves, I talk to the public, I do all these sorts of things. I've always worked hard, I'm quite focused, and I get things done. And as, as I'm sure many people who are watching this will know, if you do things well, and you get them done, then people will come and ask you to do more things. And so really, a lot of what I've done and the sort of extracurricular things that I've taken on, have come along by chance, rather than me actively going looking for them. And I've just seen it as an interesting opportunity. And thought, oh, yeah, I'll give that a go. That sounds good.Jane Dacre 15:49
Have you got any role models, who's who has perhaps inspired you to do these things?Suzy Lishman 15:55
I mean, I think my first role model and many people's first role model is a mother, my mum was a nurse, and was very keen on the importance of education, and good grammar. So I always think of my mother when I can't remember if it's less or fewer, or I have to spell things really hard on English. So yeah, I mean, I think my mother was my first role model. And she really brought me up to believe I could do anything that I set my heart to. And to get there, I just have to work hard, which is, I think, you know, stood me in good stead role models within medicine. There are so many brilliant role models. And although they've been some inspiring men, I have to say the majority of my role models are women. People like Professor Dane Carroll black, Afro Mansfield, Professor Mansfield, and in surgery, then Claire marks Parveen Kumar, you know, these amazing women, and it's not just that they've done fantastic things, which they clearly have, what's inspired me has been really their generosity to share that with people like me, you know, to act as mentors, to be so encouraging, and so open and friendly and helpful. And I've found that really inspiring and they do make you feel, you know, I'll spend an hour chatting to Carol black, for example, and I come out feeling I can do anything, because because, you know, having someone who believes in you and has done great things is, is good for the soul.Jane Dacre 17:34
And pairing and pairing. So you mentioned that a little bit earlier how you had some concerns about your family life, when you were so busy by being president of the college. Do you want to, to talk a little bit about how being a successful woman medical leader the impacts on on family life?Suzy Lishman 17:56
Yes, I mean, I don't do everything I do in 40 hours a week. So there's a limited number of hours in a week, and you have to divide your time up. And my husband recently described me as a workaholic, which, you know, probably would come as no surprise to other people. But actually, he'd never said that to me. And I, it's hard because I do work hard. I do work every night and every weekend, and there are no hours to my working day, I go into the hospital and work 10 hours, and then I'll come home and work in the evenings on something different. And I'll be reading papers for a meeting or writing a review or reviewing a case. So I do all these different things. So it's difficult. And I do have to remind myself that, you know, I'm not the only one in this family. And I have to give some time to working on relationships and just having fun. So we're quite good at getting holidays in the diary and making sure that they are completely worth three, phone goes off. And no look at the emails at all. So quite good at that. And just try to plan nice things and get them in the diary. So that so that they happen. I think if our if our social life, and the time we spent together was just was less was more casually arranged. Let's see how we feel on Friday night. Well, I'm Friday night I'll be sitting working. So I need to know that that's going to be a time when we go out. So for me for us, it works well to plan things and to know, and then I can, you know, I can plan my week and I can plan what I need to do around other things. And obviously, that's something I want to do is to spend that time with my husband with my family. But it is really difficult. It's difficult when work doesn't stop when work doesn't have boundaries. It's very hard to draw the line because there isn't a natural one.Jane Dacre 19:49
So being organized. Maybe it's something that you'd suggest well, just coming towards the end now. You're clearly a role model. For other people in pathology and all other branches of medicine, what advice would you give to those women who are aspiring to be medical leaders,Suzy Lishman 20:10
I mean, I always say to people, be yourself, you can't be somebody else. And I suppose you know, you can, you can grow yourself. And I would say, look out for opportunities for leadership courses, I went on the Athena program course at the Kings fund, I should probably have mentioned that as one of those big life defining moments, because it was going on that course, that helped me reflect on myself. So you do quite a lot of sort of psychometric testing, and you understand what drives you, and how you react under pressure. They recommended that I get a mentor and a coach, which I have done, I've had a mentor throughout, and I've had a coach at various points in my career where it's been helpful to do that, I would say, don't be afraid to ask for help. And that's one of the things that I found is, you know, asking a very busy, very important person, if they'll be your mentor is quite a scary thing to do. But actually, people are pleased to be asked, they, you know, in the same way that I enjoy helping other people and supporting them, you know, they people like to do that. And so don't be afraid to ask, they can only say no. So I would say don't be afraid to ask for help. find like minded people that you can compare notes with, have a mon, you know, having the group of past presidents that we went through that phase of our careers with, as has been an amazing support, structure, and resource for all sorts of things. And it's really helped, you know, with my career going forward, I say, do something that you love and that you're interested in. I mean, you do have to do some things that you're not so keen on along the way. But do be choosy, be picky about what you say yes to, as I said, the more you do, and the more you do it, well, the more people will ask you to do and you only have a finite amount of time. So pick the interesting stuff, see what comes out, look out for opportunities, I would say don't put things off thinking that one day, there'll be a perfect time to do it. Because there really is. And if the opportunity is there now, think about what you can do, what you can rearrange how you can organize things so that you can take that opportunity when it arises. Being yourself doing the find supportive people to surround yourself with, you know, there'll be enough negative people out there, but you know, have your team and supportive people follow your heart. And finally, I'd say probably pace yourself. Actually, careers are really long. When I think of it the beginning and how daunting it seemed developing that first national pathology week. And here we are 12 years later, and it's gone international and I you know, I do a few events, but I don't run it at all. It's got legs of its own. massive changes can happen over a decade and our careers are several decades long. So you don't have to do everything all at once. But look out for those opportunities and grab them with both hands when they come along.Jane Dacre 23:02
Suzy, that's wonderful. Thank you very much. And thank you for your thank you for your time.Suzy Lishman 23:07
You're very welcome. Thanks for talking to me.Jane Dacre 23:10
Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.
- Episode 3 Professor Dame Parveen Kumar
Medical Women Talking podcast S01E03 Professor Dame Parveen Kumar
Speakers:Parveen Kumar, Jane Dacre
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Today, I'm talking to Professor Dame Parveen Kumar, Praveen Kumar has become a household name because of her book, Kumar and Clark. She is an inspirational woman who's had an incredible career. She's also had an incredible life, with a childhood, starting as a refugee moving around the country. Please listen carefully. There'll be several pearls in this podcast.Jane Dacre 01:34
Tell me about your career journey. When did you decide to become a doctor?
Parveen Kumar 01:39
I suppose I always thought I'd be a doctor, probably, I suppose the age of about 12 or 13. I think the things that really intrigued me about medicine was first of all, the caring aspect. And the other was the fact that a lot of it involves science. And at that stage, I wanted to do both.
Jane Dacre 02:01
So you had quite an interesting childhood, didn’t you. youTtell me about that?
Parveen Kumar 02:06
So rather a strange childhood. So I was born in Lahore, which then was in India it was that long ago. And then during the partition, I remember the British came across and Mountbatten was there. And they decided to divide Pakistan from India. And everybody expected Lahore to go into India. But in fact, they drew the line the other way around. And that, caused , a huge amount of problems in the people who had to cross the border, millions lost their homes, they were killing people. And if you were in a train, or you wanted to cross the boarder by train, as the train comes out of the tunnel, they would blow it up. And I remember standing i at the bottom of garden, watching hordes going past saying ‘blow it up’ Pakistan's in the… long live Pakistan. So we were three of us, my, two brothers, and myself and my mother, we were actually in Lahore and had to get across to India. And the only way that my mother who was a remarkable lady to control this, the only way to get across was she got some places in an army convoy, which was going across. And I think for two days, we travelled in the convoy into Delhi. And of course Dehli wasin turmoil. And luckily, I think for the first few days, we stayed with some friends. But then, I think because of the army, and so they're in the army, you know, that these particular friends, but so we then got a place in a refugee camp, rather odd having a refugee camp in your own country, and you're staying in refugee camp so we were there for quite some time until my mother managed to contact my father. Because remember, we didn't have phones and telephones that you could just phone up.And my father had been sent by Neru to China, for the United Nations, so he’d been seconded to the United Nations. So eventually, my mother, so we went then from Delhi to Calcutta by another two day long train trip, got onto a plane and it was actually all fun for us really, we enjoyed all that, seeing all these strange things. These are the old planes, the old American clippers where you actually had a room with a curtain so we quite enjoyed this. I think we went to Bangkok, Hong Kong and then eventually to Shanghai, where we met up with our father and he then had to find somewhere for us to stay so we stayed in a hotel with the Americans in Shanghai, and then we went to Nankingas it was called in those days. had a lovely house and my brother was old enough to go to the American School, . so he would have been about five, say say 5-6 ,I was a couple of years younger. So then instead of ayahs, we had ahmas, nannys, who looked after you, we had nannies. That is, and they sort of looked after us, although we didn't speak Chinese. And then so first. whammy. ., the second one for my poor mother and my father was that we were in nationalist China with, obviously, United Nations and Americans. And then was making Mao huge progress was coming down through China. And we have to leave very, very quickly. So my father got us onto a plane and sent us back to India. And I think he must have gotten one of the last planes leaving Shanghai and came to India. And then now my father was working, you know, so we were back now, because we’d lost everything in both places now,so we had to to start again, from the reasonably well off family to having actually nothing. But now we were all sent to boarding schools, a new English boarding school in the foothills of the Himalayas, or the Himalayas, as we should call them. And so we were brought up by the English really. And then the third tragedy for my poor mother was that my father then lost his eyesight. And he just been appointed as economic adviser for the whole of the Punjab, which is a big County. So my mother, who was never brought up to work, as women didn't, those days, I had to take on the mantle of being the breadwinner. And luckily, my grandfather, my mother's father, believed in education, and education, not just for the sons, but the daughters as well. So she was sent off, obviously, to College, which was the college where everybody went, and then to government college. So she did a bachelor's degree first in economics, and then did a master's, I think she must have been one of two or three women with 1000s of men in the college. So really remarkable in those days. So we were talking about the 30s, I suppose the 1930s that it's where, you know, women just didn't go to university and you didn't. So really, it was great, really on the part of my grandfather. So then she decided, well, you know, what can I do? Well, you know, when my father lost his eyesight, she couldn't afford the fees for the boarding school. So she decided to bring me across to England, where she started working, and we went to a school here. And then my younger brother came across and my older brothers came across. And I'd always wanted to do medicine, there was a slight problem, you know, would wel be able to afford it. And, but amazingly, my mother managed to send us all to university and get good jobs.
Jane Dacre 08:16
So you you've talked about internal drivers, were there people around you or role models that influenced you at that stage?Parveen Kumar 08:25
I think at that stage, I think really only from books really, I remember reading, I don’t know why I suddenly remember this but I remember reading this book on Damien the leper, I heaven knows, , I must have gone into the library and picked up this book and thought of it and it was about again, in fact, I think it's probably a month but it was actually about giving and looking after people and I think my mother always also told me you can do anything you like, even as a woman and I think there's been a sort of mantra to my life that you know, mantra to my life that I would whatever I wanted to do. I’llhave a go at it, ok so we going to get disappointments. But I've got to have a go. Let me get on and do it my way.Jane Dacre 09:15
See when to Barts medical school so,Parveen Kumar 09:20
Si I appliedapplied. And my older brother, he got into Imperiall to do aeronautical engineering. I apply that got into cambridge but couldn't afford it and got into Barts, I applied to all the medical schools in London, and Barts is wonderful and then my younger brother went to Oxford. So I think my elder brother probably would have done medicine but he had to do something that could support the family or he felt he ought to be thereJane Dacre 09:51
So they can't have been that many girls in medical school when you were there.Parveen Kumar 09:56
No there wern’t, The first year they were about eight of us. So I don't know how many boys so I mean, it was very few but I then did a BSc a physiology BSc. So stayed back a year So the University suddenly said that unless Barts had with more women that would take away the grant. So the following year, I think they're about 25 women.Jane Dacre 10:22
So how many how many?Parveen Kumar 10:25
There would have been 150 Something I can't remember the numbers were from the boys point of view. But there weren't too many boys, too many girls around. So in everybody said so you know to do plenty sports with the answers you had to because there weren’t enough girls. So I captained thethis hockey team. I think I played lacrosse, netball tennis, you know, and I Oh, sorry, I used to fence so started the fencing club which was enough which I could have done at university level but I stayed with the medical school because I was a started it so I had pursued to fence for Barts but occasionally fence for the university.Jane Dacre 11:10
And you chose to become a physician and a gastroenterologist.Parveen Kumar 11:14
Yeah, so I think I, I always wanted to be a physician. I think surgery didn't really intrigue me in any way. And the reason I think I chose gastroenterology was this amazing chap called Tony Dawson, Sir Anthony Dawson, , who came down from, I think, from the Royal Free. And he, in a way it was a role model, because he was incredibly bright. had done a lot of research and also was a great physician. So I want into gastroenterology .Jane Dacre 11:52
Amazing. And you've had a long career in gastroenterology.Parveen Kumar 11:57
Yeah, no, that was the other problem because I was the only girl for 20 years.Jane Dacre 12:03
So how was that? What's it been like?Parveen Kumar 12:06
I’m sure you’ve been through the similar sort of thing? I mean, so all the jokes were on you, you know, you call Flossy, you know, whatever they said. And it was just like, you know, water off a duck's back. But the one occasion when I felt I had arrived, was when I’d better not mention the name when they were one of the boys said was telling a rather risky joke. And another boy said, You can't do that because the lady present and it kind of looked around and said, Oh Parv, she's a chap and carried on ttelling the risky joke. And I think, because I was the only one, they did look after me, so I never felt, you know, okay, they would say things about women. But so what?Jane Dacre 12:50
he wasn't bothered he told me. And, and it sounds as if they treated you with respect?Parveen Kumar 12:57
Well, yes. I mean, I had to turn up to the the football and the rugby, turn up to watch them all. And now we have great fun. And you know, they treated me with resepectJane Dacre 13:10
I think not, not only that, though, in the generation that you came through in, it's quite remarkable that not only were you a woman in a quite intense specialty, but you're also married and had children. So how did how did you handle all of thatParveen Kumar 13:27
Well just the same as you did so, but you know, it was a compromise. I mean, you had to compromise onsome days. And I was really lucky to have married David because he understood. And I remember when just sort of an aside when I wanted to do an MD in those days you did MDs rather than PhDs My supervisor said, you don't need that if you're a woman. And that goes like a red rag to a bull. And I was going to have anybody say that to me. And David supported me. So we were very lucky that we were both working so we could get care, we had nannies and then au pairs. But you know when a child was ill, you just felt awful leaving a child. But yet you had to go to see the patients. And it was a compromise. Maybe I got it wrong. Maybe I was concentrating more on the medicine and looking after patients than the family that we had but had a great time in holidays. We saw each other obviously saw each other much more.Jane Dacre 14:39
Well, you're still a close family now.Parveen Kumar 14:41
very closeJane Dacre 14:43
So you can’t have got it that that wrong, can you?Parveen Kumar 14:44
Well, I think they probably the girls when they were young resented that a bit and particularly over the book, because that was holidays weekends. Every night and you know, we've, you know, we’d go on holiday and say go skiing. And I would be sat in front of a window with a piece of paper and wave goodbye to them as David took the girls off skiing. And it was awful that you couldn’t be there.,Jane Dacre 15:21
The book has been a fantastic success, hasn't it? Kumar and Clark. How did that all come about?Parveen Kumar 15:32
Well, I was doing my MD at the time. So doing research, but we had this rather sort of... Hammetsmithonian type of way. We did research for three of the six months, then you were on the walrds and you did endoscopy, then you did outpatients. So you sort of over five years would do everything you get..., as trained as a gastroenterologists, as a physician, and in research. And one day, a letter arrived on my desk and it was asking me to write a book or a writer chapter in gastroenterology, I'm guessing probably for a book that somebody had startedstarted. And in those days, all the letters were put out because they were typedwith carbon copies. And I would just go in on a table by the Secretary, I would just go to look at mine and sign it. The boys obviousy went in and read everybody else's as well. So my supervisor Mike Clarke stormed into my room and said, What's this? And I said, someone’s asked me to write a chapter and are you going to do it? I said, Yes. as you've obviously read my letter, thanking them and say, I'm delighted. And he said you can't do that. And I said, I don't see why. So you know, nothing about gastroenterlogy ? I said Im in gastroenterology . And then he said, You can't do it because I own you. And I thought, because he was my supervisor. He said, You haven't written those papers, and you've done the work. Get on and write the papers. You don't want to do anything rubbish-ey like this. And of course, it was another little red rag. So anyway, when he realized he was determined to do it, he said he'd help. And that's ho w Kumar and Clarke started.Jane Dacre 17:14
So just as a chapter in gastroenterology, now, chapters in everything is thenParveen Kumar 17:18
rising the whole thing.And, you know, we asked, we told to keep it locals, we asked all the people at Barts , and they were so nice. I mean, we rewrote the chapters 16-18 times. And there's one person I remember who said, Parveen , would you be putting my name on it? And I said, of course, you know, you wrote it, you only recognize the word and, as mine. Because we, and they were so good to let us do it. And I remember, you know, people who taught me Jim Malpas, who taught me everything I knew. And you know, he went back and said, and he said, Look, you know, the gaffer, if it fails, you take the plan,
Jane Dacre 17:58
but it's been phenomenal success, hasn't it worldwide?Parveen Kumar 18:02
Well, due, in a way otherwise I’d top myself. But you know, we, the problem really Jane is remember, the original Davidson was just page after page of black and white. And it just prose and they wasn't really succeed. You know, they'd say, you might consider giving that as well. If you consider it and you've got it wrong and kill the patient. That's not the drug you need. And I wanted it fun. I wanted to easy to read. I wanted bullet points. So all these bullet points of whatever we said, we actually looked back at original data. It's a huge amount of work. And often people will say, you know, like headaches they would say all headachesare hypertension, but they're not. You know, certainly, if you've given the Link , so really, that you might get a headache. So I mean, lots of stupid things. But the sort of mantra of medicine, we had to redo and get the data and say, No, it wasn't true.Jane Dacre 19:05
So but at the same time was doing that you're also rising through the hierarchy.Parveen Kumar 19:11
So that was going on in the background, including bringing up some kidsJane Dacre 19:15
and being doing a lot of medical education, the students loved you.Parveen Kumar 19:19
Yeah, like you. I love teaching and, I mean, it's just, I'm very lucky. It's such a privilege to teach. I just love doing that. And, you know, I sort of did go around looking to say other people to remember you weren't appointed as a consultant for your teaching abilities. It was for what research you did Well, must be one of the few people that I took myself off for a weekend course on how to teach. It didn’tadd much to what I was doing already. But it was worthwhile knowing that what you were doing was correct. And I went to go to McMaster to look at PBL and how they taught them and bring up the They had the data here. And then they started to remember you had clinical or college representatives.Jane Dacre 20:11
So yes, for the RCPParveen Kumar 20:14
RCP. So I was at the RCP, regional deputy regional advisor that and then I became – that was the college- and then there was a clinical, which was run by the postgraduate medical education. And then, it was, Jack Tinker came around and looked around what I've been doing. And then he said, he sacked the other person who was doing a postgraduate and said, I want you to take this on, I want to, you want to model the director of postgraduate education on you for what you're doing. So to be the first one in the country, and very kindly said, here's a budget. And, you know, , I think the college gave me a second postgrad . And I always do things in teams. And she and I just said, Right, okay, let's actually do this. And so I set it up for Barts and the Hommerton and got somebody to help me, you know, to be the deputy head, so that they saw what I was doing. We all did it together. And then when Bart's and the Hommerton split, we joined with the London and then the London director said that I take on London and Barts . And that was phenomenal thing because we overnight, remember this is doing an all new job as well. Overnight, we have to change the programs and the rotas of several 100 junior staff and registrar's and also consultants because they were… so anyway, we set it all up and we set it up in a, I walked around the London I never been there and said, you know, what's that building. And then there was one which had been lights on that Whats that building. And it's sort of owned by the trust or something. And I said, I’ll have that. Then I got them to refurbish, and we did it. And then if you remember, you and I were the first female teamJane Dacre 22:26
we were, we were quite unusual. The purple ladiesParveen Kumar 22:30
That’s right,they had color schemes for firms that I think then if you remember what we did was because they all had to have to consultantward rounds, and you and I were both doingdoing something different. So I did Monday morning where the general medicine, gastroenterology and rheumatology and you did Thursday's where you did general medicine, rheumatology and Gastroenterology and all the really ill sick patients we obviously visited every day. But while doing that you set up the amazingly the first clinical skills of laboratory here.Jane Dacre 23:08
We mean, it feels like a bit of a golden age. And if you look back, how does that all make you feel?Parveen Kumar 23:16
Well, I think in a way, in retrospect, I mean, we did what was needed to be done, then in retrospect rather pioneeringreallyJane Dacre 23:25
Funny it didn't feel like that we did what we needed to do, didn't we? It was some it was. So in all careers, there are good bits and bad bits. So what would be what are your best bits and what maybe hasn't gone so well. start off the good bits.Parveen Kumar 23:43
But I think there's so many good bits. I mean, I have to say, I love getting out of bed to work for the NHS. I mean, I have to say that because I just love the NHS. And I think the good bits were the best bits were when patients got better, really. But on top of that was the teamwork. We all did it, we all did it together. And then there's wonderfulspirit, which then of course, also, you know,it fed down to the students, because your students that you were given were your students and you would make sure that the 6-9 weeks or whatever they were given to you, you made sure that they were okay. And they were looked after and in to their CVs and you know, what would you like to do and how can you help you and so, there was a lovely spirit, which I think I miss I think like doing endoscopy the team you know, you've got a patient there and the whole team worked like a well-oiled machine you know, to get a happy and live patient at the end of it, which is lovely.Jane Dacre 24:47
And I'm all about times when maybe it wasn't so good if you got some lows that you might want to share?Parveen Kumar 24:54
Do you know I don't get low but I think I do I did find that it was a lot of pressure. And I look at the junior doctors now they don't have that lovely team system, that firm system to fall back on and in anxiety and depression, but I’m trying to think of lows . I don't know you just took everything in your strideJane Dacre 25:25
maybe you just always moved on.Parveen Kumar 25:27
I think it was very lucky. Come on, I must have been lucky because the double whammy of being a female andforeign. But it didn't affect me. I didn't think funny I don't think being Indian made any difference. But one did get a bit of a stigma of being a woman.Jane Dacre 25:45
Interesting. So what over your career, what's inspired you, you've clearly been quite driven to achieve so much. What or who has inspired you to?Parveen Kumar 25:58
Well, I think certainly my mother must have inspired me. And I always regret not having said thank you, because you never do to a mother do you. But also, I think the support I had from my husband, which was amazing. And then I think in terms of medical things, a lot of people in often my role models are now I think Tony Dawson was one Mike Clarke because he obviously, you know, helped me with my research and was a supervisor, a quite a male chauvinist supervisor, which in a way taught me how not to do things. And God, I hope he won't be listening to this. But you know, to write the book. There was just process to just the minute you met, you just sat down and wrote and then the minute you finished, you went and you know, had a different life. So I think they will no, no major downs. I’ll probably think of one afterwards.
Jane Dacre 27:07
Okay. Well, I think that's all that's all good. That's all very positive. So you've talked about people that have helped you along the way, one of the things that's clearly been important to you has been your family. And the balancing act that you must have learned to do. Is there anything that you want to say about that, for people who maybe are embarking on a similar journey?Parveen Kumar 27:36
I think, I think possibly I got it wrong. I think your family must come first. They came first with me. But I would make sure that they were alright. So I could go and see, you know, you're on at nights and you didn't want to leave them. But you know, David and I, we were a team,Jane Dacre 27:52
You've been extraordinarily successful. You are now a Dame you're very well known in medicine and to those women who aspire and maybe are slightly worried about how they might achieve similar success. Is there anything that you would say to them any piece of advice that you might give to those coming through?Parveen Kumar 28:13
I think the business biggest piece of advice is the success comes in different ways. Now, you know, is a Dame a success? I think it's a success for the people around me. You know, I would say that the PAs and the secretaries, I’ve kept up with them all these years. And I'm so lucky, I think I've had over 30-40 years. And we're team and they really should be given the Damehood andnot me. And I've never really because they pushed me around doing whatever I did. So success is different. And success is really what you want to do. And what you want. And Advice for the next. Advice is be yourself and be honest, and be self-critical, I think as well to make sure that you're not doing the wrong thing. And I think be kind to everybody. And I've just been incredibly lucky. I think if you smile, it's there is one thing I'd say if you're leading a team. Remember it's a first morning Hello. If you can smile and say hello everybody you know, now you have a good evening or something in that mood from the head really translates all the way down. And then it'll be a happy day for everybody. So I think it's the way you lead your team. That's important.Jane Dacre 29:41
Praveen Kumar, thank you very much.Jane Dacre 29:43
Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you- Episode 4 Dr Jennifer Dixon
Medical Women Talking podcast - S01E04 Dr Jennifer Dixon CBESpeakers: Jane Dacre, Jennifer Dixon
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Today, I'm talking to Jennifer Dixon. She's the Chief Executive of the Health Foundation, she qualified as a doctor, but has had a career in policy. This is something that some people may want to do, because clinical medicine isn't for everybody. She had been hugely successful in that, but has done things differently. So I commend her approach to you. Please listen and learn. Can we just start off by you talking about your career journey so far? So why did you decide to become a doctor?Jennifer Dixon 01:41
Well, I suppose two reasons really. One was, I really liked science, I was quite fierce about it, and really interested at the right time that you choose your own levels. And I also, you know, like many people, it's sort of a cliche, isn't it, I kind of felt I wanted to do something with purpose and help. So I think those are the two main reasons but the other thing was, I was very interested in at that point in international travel. And in particular, I was very interested in East Africa, for various reasons. And so I thought that if I trained in medicine, that I might be able to travel a bit, but particularly might be able to contribute to, to health somehow in East Africa, I had no idea how but I nevertheless, that was, so those three reasons I think were the main ones.Jane Dacre 02:31
Thank you. And so how did you go about that?Jennifer Dixon 02:34
Go about theJane Dacre 02:36
getting through your career and getting to achieve your aims?Jennifer Dixon 02:41
Yes. Well, I think the I think the first thing to say is that my aims were sort of blown off course, pretty early on. I think the first thing was, I did actually take a year off between School and University and I went to Kenya and I, I taught chemistry and physics in a bush school, right on the Kenya Uganda border. And actually, to be honest, I was still deciding whether to do medicine or not. I was in two minds, because one part was very arty. And the other part was very science-ey. But nevertheless, I went there. And then I decided, well, I perhaps ought to do medicine, in before I figure out what else to do with the arty side. So I then went to medical school, Bristol, which was fantastic. And, and part of the detour started when at medical school, I just got really interested in Student Union politics and got elected onto the Student Union Council. And I just got very interested in party political port, you know, the just politics more generally, and why the country was run as it was, what was the role of the state? Why was the health service constantly underfunded, it seemed. So yeah, as I was going through medical school, I was particularly interested in those things. And over time, my interest in the science was still there, but it got superseded by domestic considerations about politics. So then, that that set up a kind of almost a conflict in my own mind as to whether medicine itself and enjoyable though it was with the science and the patient's was, was going to fulfill this other need, which was really to consider the state of the country at this sounds rather grandiose, doesn't it? But, you know, the, the state of the country why we set up the health system as it was, why the public sector was as it was why we made certain political decisions about state. So there was that kind of tension, but I carried that throughout and finished medicine. And then went on to do housetops. But that tension grew and grew, and at some point later on, which we can get on to it, it became too difficult to sustain and I had to jump way and one way or the other I'm actually I then retrained into policy analysis.Jane Dacre 05:03
So that's a really, really interesting thing. And something that I think I can see now in quite a lot of young people coming through medicine at the moment, that they that they have the opportunity at University and beyond to look at the system and say, well, this isn't right. How can we? How can we look at it? How can we make it better? It sounds as if that was the kind of thing and there are I think there are lots of people. Now, given the NHS that we currently are working in, or health systems that we currently work in, probably think the same way. But there isn't a proper career track or is thereJennifer Dixon 05:37
So it's a good point there, Jane. And I was just reflecting on this point recently, because I am in a nice position of being able to select Harkness Fellowships, I don't know if you know, this fellowship program. For those listening, it's a really interesting opportunity to spend a year in the United States. It's sort of mid career, year, for a year, and we are in selecting, you know, lots of candidates, a lot of whom are doctors. And what's absolutely clear is they are doing Masters, these are people around 2930. And they have been clinical fellows at the Department of Health at NHS England, they've been Darzi Fellows, they've gone to NICE and had all sorts of attachments to different parts of the system, in the way that it just simply wasn't possible for somebody like me, I mean, you were considered slightly weird if you veered off the clinical track. But now it's much more acceptable, which is fantastic progress. And, I mean, at some point, I mean, there's no doubt that young people have a wider, some have a much wider purview, and really don't want to be just boxed into clinical medicine, some really do. And that's completely fine. But some really don't. So I think it's more and more possible to forge a path to combine both of these things. And I think that's really, really healthy, it does mean that we might lose some people from the clinical coalface to, to work in sort of the system more widely, so to speak. But I think that's really how it healthy. And I think what we need to do in the future is to enable a kind of almost revolving door to happen between people who are on what wants to do clinical work, and also want to have this other purview. So that's, that's progress made, but there's still a lot more progress, I think, to allow more flexibility for people to stretch the other talents that they have, you know, in my my generation, which was a long time ago, now, it really was quite binary, you either did clinical medicine, or you jumped ship and find out found some other landing spot that allowed you to develop these other things. And in my day, the real jumping off point was public health that allowed you to do that. And so that's one of the reasons why soon after I did five years of clinical medicine, and then I realized that I needed to stretch this other bit. And, you know, taking a year off to do the MSc at the London School of Hygiene in public health, being exposed to public health, did help me get off the wards to enable myself to think about which channel was best to sort into, was it really medicine? Or was it public health? Or was it something wider? So I need to say public health was the only route that almost tried to, to, to examine that, and, and, and think and to sort yourself into different realms. Now you can do it much earlier. So that's fantastic. And I really encourage people to do that where they can.Jane Dacre 08:37
I mean, I agree, I once heard somebody say that if you're interested in patients, you can sometimes have a much more positive impact on the patient in front of you by standing back and pulling policy levers than you are by just treating the person with diabetes. So presumably, it took me a long time to realize that you must have realized that earlier on, I suppose.Jennifer Dixon 09:00
Well, I suppose what what I felt you know, there's the psychologists have this really sort of phrase of it, there's a bit of pathology called splitting. And and I think I probably exhibited the split so that there's sort of, on the one hand, there was the science sort of side and the other side, there was really a completely different side, which was really interested in policy and economics. And I couldn't see then how these two things could fit. Now, as I say, it's much easier, but actually, with the medics that I see who quite a lot come to me around the ages of around 2930. They they've achieved a lot they've got to a particular position, and they look thinking to themselves is this, is this what all there is? Is there something more that I can do? So it's a classic, and that's when these people apply generally to this fellowship program and other things. And I think it's really important to pause at that point and just reflect because there's still a lot of working life ahead. How are you? Are you sorted into the right time? Know, you're doing the right blend of things for you that given your talents, and how best can you forge your way to combine things that really would work. And a lot of medics in my experience, actually are not really interested in the politics or the economics side of things as I was, but they are interested in bigger service changes how best to make improvements across services, for example, that's closer to home, or they might be interested in nice and what nice does. So there's a number of sorts of channels that you can take, which aren't directly patient care, but nevertheless are linked to it. And it doesn't have to be on the one hand, you're on the wards dealing with your patient with diabetes. And the next minute, you've got an attachment to the Cabinet Office, it doesn't have to be quite so stark, it could also be something that's related to your work, but you want to run, you want to be part of say, a National Collaborative to improve diabetic diabetes care across the country working with one of the Clinical Directors. So that's see that's there's a whole range of things now. And if it doesn't exist, I think you just just go out there and make try and make it happen. And you know, just forge a path as people before have done. And it's all to go for I think if you've got the energy.Jane Dacre 11:21
So I mean, it sounds as if that's what that's what you did. When you you say you decided to jump ship, but in fact, maybe you're just driving the ship in a different direction. So how did that feel at the time, because that strikes me as being quite a brave thing to do. And sometimes, particularly as women, we don't really feel terribly brave about our careers. How did that feel? What was it that drove you on to do that?Jennifer Dixon 11:51
Yes, well, I kind of what happened was, so I did five years of pediatric clinical medicine, I was doing pediatric medicine sort of neonatal a lot, actually. And I decided to keep a diary. And I said to myself, if my diary on reflections doesn't change much in the next year or two, I've really got to do something about it. And the diary was, was mostly, it was mostly about how am I what am I learned? What am I kind of, Am I moving forwards, not in a career way, but in intellectual way am I and in pediatrics, I wasn't really. So. So then I decided to apply to do public health. I didn't know what I was doing, to be honest. But somebody did say if you do this public health course to, you know, to become a consultant in public health. If you start the training course, then you can have a year off to do an MSc at the London School of Hygiene. So that's what I did. And that was that what that did for me was it expose you to all sorts of things to be able to sort yourself more fully so you were exposed to statistics, Epidemiology, Communicable Disease Control, sociology, policy and economics, etc, etc. and it soon became obvious it was like catnip, but I was clearly quite surprised. The the policy and economic side was just like, I suddenly felt alive. And so So I then thought, Okay, I'm this is back to my student union roots, there's obviously something there that really is the basic denominator of which science was grafted on to the top. So I better I better take this seriously. And so I basically pursued that Jane and was lucky enough to do a heartless fellowship in the United States just after the MSc. So I really wallowed in you know, health care reform us style, and got into Capitol Hill interviewing all these senators and congresspeople and in the, in the center, and then in the various states, and really did a political study about why healthcare reform was so blocked in the United States. And then I came back, I just thought this this is the thing for me. So I ended up doing a PhD at the London School of Hygiene not on policy, actually, but on quantitative analysis, because I thought if I'm a policy analyst, I'm really going to have to understand the quants. I taught myself Bayesian, Bayesian modeling, multivariate analysis, all that stuff, just to just to be able to feel that I was tooled up it's almost like retraining after medicine up to the same standard that I had felt I had got to in medicine, so I really felt as if I was retrained not not additionally trained as a medic but retrained and and so that's what happened. And then I was all set for an academic life. But then I got a call to the to, I mean, the Kings fund just tweaked me in there. And then as soon as I was in the Kings fund, it was just an environment that really suited me. So so so I was at the Kings fund it working in their policy department really loved it, and how there was a very famous moment where you If you don't know if you'll allow me a little anecdote, I was talking to my good my lovely boss that at the time, Nick Mays, who's still a professor at the London School of Hygiene, and we read written an editorial about the state of the NHS and what needed to be done about it. And he was so grandiose, really? And I said to Nick, why don't they ever listen to us if only they ever did this? And at that time, I received a phone call from the Department of Health we would I like to go and work in what I would consider a job to be the policy adviser of the chief executive of the NHS Alan Langlands. It was just, it was just priceless moment. So, anyway, so and then I went into deployment for a couple of years before then coming out and then continuing the policy analysis route. So me Sorry, that's rather a long winded way. But that's, that's, that's what happened, really.Jane Dacre 15:49
So the passion for what you do comes through, have you had highs and lows would have been the best bits and would have been the worst bits?Jennifer Dixon 16:01
I think they've, I think what happened just to link that back to your last question, which I failed to answer, Jane, which was it didn't feel like a risk, all of this, jumping off clinical medicine was a bit of a risk. But I always felt I could go back to me to things really felt if I fell flat on my proverbial, so I had a kind of insurance policy. But to be honest, once I'd really got into the, the groove that I was to have describes, it was so energizing, and so fulfilling, that I didn't feel that there was any risk involved at all, and I still had my GMC registration number, I could still go back if the worst came to the worst. So there have been a lot of highs, I guess, is the answer to the problem. I haven't felt as if there have been enormous barriers at all. I'm the highest have been where we've done a piece of analysis and really influence something. And there are quite a lot of examples of that, that I think we've I think at least I hope we've made a difference. But I think helping people I think helping my main contribution, my main interest is not to, dare I say it, that there are people who are really motivated by making change. And and for me, I shouldn't confess this game. But that is, that is a secondary thing. For me, the primary thing is that we we have more insight in order to act better. So it's what Rudolf Klein used to say Rudolph Klein was the doyen of policy analysis really, for many years. Wonderful writer and academic. And he wrote a book called only dissect. So it what he meant by that was if you just dissect the issues more fully and gain the insights, then you can act more appropriately. And so I think I'm in that camp, which is much more of an academic orientation. So send me the highest would be insights would be landing analysis would be helping, helping to the NHS just just strengthen its arguments for more money. It's quite a significant sort of groove that I've been on. And, and helping to them to learn from other countries. So lots of lots of examples there. The lows, I don't think they've been many lows, really, I mean, I had a moment where early in my career, I produced a piece of an analysis with some colleagues on GP font holding, which, if you remember, was very contentious at the time and Virginia Bottomley, who was the Secretary of State at the time, stood up in Parliament and referred to this paper quite a lot. And she said, this was not the best paper that BMJ have ever published, she said because it was counter to what the person said that wasn't really a low but I got a bit paranoid that I might be followed around by a black Moriah at one point. But but know that I do think there have been lows. I think it's I think the lows are more when you've got a political environment where no one's listening, and it's just really disappointing and depressing. And we've had a lot of that recently, haven't we? So I think that's more generally it.Jane Dacre 19:18
Okay, that that's great. So you've talked very much about what inspired you and driven you and your your sort of your academic approach, really, to policy, which I have to say is welcome, but it is rather depressing when it feels like nobody's nobody's listening. I think we, we all get that. So. So along the way, who's been helpful to you how or where have you found your inspiration?Jennifer Dixon 19:47
Well, I think, you know, everyone is helped by a lot of people. And and so I suppose lots of people have influenced me along the way. I think I've done I've never I've never had a mentor. I've never, I've always, probably totally erroneously felt I could figure this out. But, and I think that's dangerous to think that but nevertheless, that's what I have thought. But there are a couple of people I think, who, along the way have really been very, very insightful in different ways. One of them is Alan Langlands, who was my, who was the Chief Exec of the NHS when I was working with him at the Department of Health, and I think I've learned most from him because he's just so very wise and insightful and deeply human. And coming from a different tradition to me, you know, obviously male, older a manager, but seemed to have a really all around intelligence and was very, very interested in very strategic and very interested in people. And I just learned a lot from that because someone like me is can be quite early on in my career is quite fierce and almost quite robotic about science, you know, really, you know, as you as you are, you know, you're quite humorless, aren't you, when you're, you're kind of fiercely driven. And, and I think he helped me to sort of sit back a bit and think much more widely about a variety and, and, and, and working through people, as opposed to totally working through abstract evidence and science, or whatever it is. So he's very, very helpful. And I think the other person who I mean, he'd probably roll his eyes and step back a few miles to hear me say this. But I do think that I found Simon Stephens, very inspiring. And as a as a peer, and it's nothing like someone who's around your age, he's a bit younger, to to really inspire when you see someone who is so gifted. And I've never so anyway, I find that inspiring. And then there have been other people who've helped. And I think Carol black as my chair at Nuffield trust also has been incredibly generous, and again, deeply human, at a very personal level. So I think they've all collaterally not direct indirectly, have been people who I've, I've thought about and have been inspired by, and I'm very grateful. But but many, many other people, indeed have been very, very helpful.Jane Dacre 22:35
It's great to hear it's interesting. In the women that we've been talking to, there are some names that that come up more than once. And certainly Carol is one of those people that's inspired an awful lot of people at the next of the next generation.Jennifer Dixon 22:51
So generous. She's very generous. I love that quality, I think. And it's something that I've had to think about over time not not that I feel ungenerous, hopefully not, but that I would like to contribute more as time has gone on and, and to other humans, as opposed to focus on the issues the whole time, which is where you can often focus,Jane Dacre 23:10
yes, yes. It's kind of easier sometimes, isn't it to focus on the issues or the data? So can I move over to the human side of things, because you've had a stellar career. Often, for women, particularly who've had a fantastic career, there have been some difficulties, some ructions ups and downs in their in their family lives. So so how have you balanced all of that? That's something that the the the young women coming through, when they're early on in their career, and maybe they have their first child, or maybe they have caring responsibilities, it's, it appears to be a big struggle, maybe more of a struggle now for different reasons than it was for us.Jennifer Dixon 23:56
Yes, it is a real struggle. And I have to say, for me, having children was far more difficult than anything of work. I mean, I just some, some women find it much easier. And I found it really, really hard to do the whole. All of it was so different. Very, very, very wonderful, of course. Well, I think what happened to me was that I had my children very late. So I'd already established quite a lot before I had them, which I think helps because I wasn't kind of forgotten about when that aside, I'd set up a secure perch. So I had my first child when I was 41, and my second child at 46. And, by the way, in brackets, please don't leave it that late to close brackets. Because it's very, very risky. I just was lucky and lots of people are not. But anyway as a result of having it late two things. One is, as I said, you achieve more you're slightly known you have a secure platform ad, you have a bit more money. So that meant that I could afford a nanny who made it all possible. And also that, so it because I had the nanny, and I was then able to go back. So what I did was with both of them, I had six months off, to have maternity leave. And then I went back full time after that. And I was very, very lucky to have a very good nanny, the same nanny throughout, but for nearly 10 years. And so she made it all possible. But even have even with a nanny who was not living, she was in it until six or 830 till six. It's just a long, it's a long graft, because you know, we all know about working evenings, we all know about is a you come in, deal with the children, feed them, read them to them, give off and put them to bed and then go back to work, which is what I did, until about 10 3011. And you're exhausted, of course when they're when they're ill. But I just sort of I don't know how looking back now how it was done. But you just you just do that. So that so that's how I did. My husband is also working full time. He's an academic. So what was good about that was that he he didn't tend to work away very much. So he was at home and he had regular hours. So he but he like me, you had to work in the US because he's writing papers and all that, but it was a regular predictable style of jobs. So our household was very, very evenly balanced in terms of domestic contribution. I can say that with hand on heart. So I was very lucky. So solid support from the nanny and solid support from from the husband and both evenly distributed. So it so that it kind of worked that way. But it was a lot of effort. Like and my my experience is no different to other women, I'm sure in terms of you know, it's it's a lot of hard graft, you have to keep moving forwards, though. But the other thing I learned was it even if you feel you feel half dead, when you turn up to work, no one notices. So don't apologize too much.Jane Dacre 27:18
I feel so feel that with my children, I felt as if they had a few years where I neglected them terribly. And quite frankly, now they didn't seem to noticeJennifer Dixon 27:30
that I stopped I did ask them questions early on, you know, and in the sort of between the ages of 13 to 15. Particularly these are girls, of course they trowel it on you. But after they kind of forget and then they sort of sort of liked the idea. It's a sort of badge of honor that their mum works, you know, because a lot of so so yes. So it's you can't win either way. So just don't burn yourself. And just you'll you'll be as Winnicott said, a good enough mother, that's the most important thing.Jane Dacre 27:57
fantastic that's fantastic. And and now also what what do you do to what do you do to relax? And also what are you going to say to these young women that are coming through that will keep them going and inspire them so relaxing? First?Jennifer Dixon 28:13
Well, I suppose I mentioned early on that, that I had this arty sort of side. So it's my way of I wouldn't say it's relaxing, it is what it is to paint. So I do do quite a lot with my spare time if I've got something at the weekend, as always with the brush in hand or some some projects or other. And it's been so fulfilling to be able to do more of that as time has gone on. So if you feel that I guess the obvious point is if you feel you've got some things there that you know are part of your identity, and that Perforce will be stifled a bit because medicine is so all consuming and always on. And indeed childcare is always on. But but try to give some oxygen to those things. Because that that That way lies some kind of contentment. And otherwise, things can just get too grim. And it can bite you if you don't if you just deny this this stuff. So permission to enjoy permission to pursue. However, whatever it is, and I've been it does keep me going fat extra thing. And I suppose the other thing is I run I kind of I say run it running is probably to overclaiming, it's probably jog every day. So and that really does help.Jane Dacre 29:34
Well, fantastic words of words of wisdom. Any more advice to the next generations coming through? I think you've actually probably already given them quite a lot of pearls.Jennifer Dixon 29:47
Well, I think one thing if you don't mind me saying that I was Jane, you and I recorded the podcast last week and we had three women of different generations speaking and the generations of doctors and the youngest generation, the person who was in their 20s, I found really inspiring. And that's because she, what was interesting there is that people of my generation, I think I don't whether you think the same thing had to super adapt in order to, you always pull yourself out of shape in order to, because you felt you had to behave in a certain way in order to, you know, make progress or, and actually, what's really nice to hear is that I think some, some of the younger generation don't want to do pull themselves out of shape in that way, they actually want to give respect and airing to other parts of their experiences and identities, which matter. And this is much more of a modern phenomenon, which I think is really healthy. So I would encourage people to, to do that, clearly everyone has to adapt. But but not to pull yourself out of shape is very important. So I'm really so please keep going younger people if you're hearing this and and you don't have to compromise the ground has been made made. The running has been made by earlier generations. So So hopefully, you are able to give some more oxygen to other parts of your character that brings more of yourself to the to the work situation and so that you don't have to deny things that are actually really quite important to you.Jane Dacre 31:20
Thank you. So that's wonderful advice. So So whoever's out there remain You be you don't allow the world to move you out of shape. Exactly. Fantastic. Well, Jennifer, thank you so much. That's been really inspirational. I'm sure people will really love listening to whilst they're multitasking. So thank you very much for joining me today.Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.
- Episode 5 Dame Carrie MacEwan
Medical Women Talking podcast - S01E05 Dame Carrie MacEwen
Speakers: Jane Dacre, Carrie MacEwan
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Today, I'm talking to Professor Dame Carrie McEwan, Carrie has had an extraordinary career in medicine. She started life as an ophthalmologist and became the president of the college of Ophthalmology. From there, she went on to the Academy of Medical Royal Colleges as its chair, and has become the second woman chair of the General Medical Council. That's a job she's currently in. Listen to what Carrie says, because Carrie has also got three children. And so she's combined a wealth of experience with a very full life. Listen and take note. When did you decide to become a doctor and whyCarrie MacEwan 01:52
I have always wanted to be a doctor as far back as I can remember, it was always things I was doing playing with very traditionally playing with dolls, and trying to fix them and pottering around and trying to fix the dog. My father was medical, but he was from a very modest background. And he recognized that medicine was a really a huge privilege. For him. He was the first person to go to university in his generation, the only person in his generation to go to university. And he absolutely loved his job. And he loved helping people. And he really inspired me to see what a privilege it was, and how wonderful it was to be able to help people.Jane Dacre 02:38
So how did you set about realizing those aims?Carrie MacEwan 02:43
Well, I was at a school that wasn't necessarily hugely academically inclined, but I was very clear that I was going to choose the right subjects to get onto medicine, which rather tediously involve things like Latin and these days. And so I made sure that I was doing the right things. And I worked as an auxiliary nurse, as they were both before I went to university, and actually during all my university holidays. And that gave me a little bit of income, but also gave me insight into what it what it was. And when I appliedfor university, I was able to give some of these insights as to what healthcare involved. So I was pretty sort of kin from from very early on. And obviously, you know, I worked hard at school and fortunately managed to come up with the grades. But it was difficult, more difficult, I think in some ways, but it was easier and others. There were fewer women, there's a cap and women going to medical school in these days. And so you're smaller chance of getting in, but you didn't have to jump through all the different hoops, I think that people do nowadays in order to fulfill their personal statement. And so it was slightly different easier in many ways. But harder and others.
Jane Dacre 03:54
Okay, and so where did you Where did you go to university and what was it like?Carrie MacEwan 03:59
I went to a the University of Dundee medical school, Ninewells hospital was a brand new medical school and hospital when I went to a university, and that was fantastic. I was really, really keen to go somewhere. That was that was innovative and different. And we had a fantastic and medical education. Dundee frequently comes out as up there for student experience. And it didn't these days, and we had a very diverse group of students that came from all over the UK. And that itself was actually quite insightful as to how life was for very many different people. But I had a fantastic undergraduate experience. I learned a lot and I enjoyed it. Um, soJane Dacre 04:43
you said there was a quota. What was the quota of girls in your year? Do youCarrie MacEwan 04:48
think? I think it was between 25 and 30%. And I mentioned diversity in 1975, which was the year of the Sex Discrimination Act. And so just after that they had to change it they couldn't discriminate against women following Got, and so quite rapidly it went up. But it had it had slowly crept up over the preceding years. And I think it was somewhere between 25 and 30%.Jane Dacre 05:09
Or so it's changed a lot till now, hasn't it? So you then you've become an ophthalmologist, very eminent ophthalmologist, how did that happen? Why did you choose that specialty.Carrie MacEwan 05:23
I always wanted to do surgery, I had a feeling that that's what I wanted to do as a student. And when I did house jobs, we did two six month post jobs. And these days, I much preferred and surgery to to medicine. So what I did was I started my surgical primary, which was a generic primary. And at that point, was trying to decide what I wanted to do. So I did an accident, an emergency job, which meant I saw a whole variety of different things coming in and interacted with, with everybody, medical, surgical, obstetrics, the whole works. And at that point, I thought I really quite fancy doing ophthalmology, rather than one of the bigger surgical specialties at that time. And so I applied and I got in, and that was me really on the road to becoming an ophthalmologist.Jane Dacre 06:11
And have did you have highs and lows along that road? What were the good bits and what maybe could have been better?Carrie MacEwan 06:20
Well, it is interesting, actually, that that you you do have you do have highs and lows. But I think I'm quite good actually, at trying to forget the lows, and trying to remember the highs. I mean, obviously passing my fellowship exam was an enormous high in that that meant that I actually had a qualification on paper, which couldn't be changed. And that meant that I didn't exactly have a passport to move on. But without that I couldn't have I couldn't have gone any further. So to me that that was an enormous a high in my time. And one of the some of the laws involved. Well, I was bullied on by, by one consultant. And that was a miserable experience. And I've got huge regard for people who believe in it totally 100% against any form of bullying, it undermines people and it actually can almost destroy somebody who's confident and able to take it on. And it really throws you despite the fact you you think or you know, you've got the skills and the talents, but they're just constantly getting whipped away from underneath us. So very bitter experience.Jane Dacre 07:27
So can you do you mind just giving us the gist of of what of what happened just in case it happens to other people who are listening to this and help them to, to see their way throughCarrie MacEwan 07:38
it. I think it's it's difficult. And I think, again, things have changed, I didn't really feel I could go to anybody because it was the in the time when you didn't speak up, you just especially as a woman and a surgical specialty, you just kept quiet and you kept your head down. And I would recommend that people didn't do that. I recommend that people went and spoke to their educational supervisor or their postgraduate Dean or whoever it was to raise to raise flags. I mean, is generally the thing is to try and try and see trying to be realistic about thinking this is not actually genuinely the truth of what's going on, I'm actually able to do what I'm supposed to do. And this person is trying for some reason to make it difficult and undermine me. That's that's hard, though. And it's all very fine. Looking back now and seeing that's what I should have done. Obviously, I spoke to, to the person who became my husband, and he was hugely, hugely supportive. But I think you don't and I think you should get help from from friends from from relatives from family. But really, I think you really do need to address it fully and speak up and not not let it happen to you.Jane Dacre 08:47
It's interesting, isn't it? Because I think back on my career, and I had said it's quite hard to make that diagnosis. Hang on a minute. I think I'm being bullied here. Yes, isn't it? Particularly when you're trying to fit in and you're you makes you think you're doing a bad job, doesn't it?Carrie MacEwan 09:04
It does, because you're keen, you're eager. You're learning and it was exactly around the time that I was sitting my fellowship exams. So it's a time in your life probably quicker, but it's agenda and all the information as you possibly can be because you've read all the books, you've done all this stuff. And I just kept being taken away from me. And I kept thinking after sitting this exam, and I'm, you know, this person doesn't think I'm up to it. And it was it was actually it was difficult. But again, I had I had other good colleagues, especially about my peer group. And they helped and in fact, speaking to some of them was quite interesting because he believed them as well in different ways. And that was quite helpful to know that I wasn't actually being singled out.Jane Dacre 09:42
Interesting, interesting. Well, let's move on to something a bit more positive. So what about the inspirations? You've talked about your husband, your friends, your family, tell us who inspired you? Who did you think okay, I'm going to I'm going to do this.Carrie MacEwan 09:56
No, it is it is an interesting thing. And I always think about inspiring because it at the time, I don't think you'd necessarily recognize you're being inspired for something. I think it's often in retrospect that you see that. And it's undoubtedly the case that my father was a fantastic inspiration to me. He was a man who I saw studying at his desk in early morning before he headed off and did full day's work and came back and was sitting exams and was absolutely passionate about what he did. It worked long hours, we used to our holidays used to be him doing locums in other places, so that because doctors weren't paid as well as pletely junior doctors in these days. And he had a small family, family of young children to look after. So I was very much inspired by that, by that work ethic by that by the pleasure he got from the job. And he he again, was very realistic. You know, he said, being a doctor, as a woman has got huge challenges. And, you know, you have to look at these and address them, having children and being a doctor in the 70s. And 80s, was really a very difficult thing. And most of the women who had been in his year, and there were very few of them, and had actually given up medicine because they couldn't juggle both of the things together. And I think that was very sad. But he felt that times were changing. So I was very, very much inspired by him. And I think that that went on, he died just at the beginning of COVID. And I think that, you know, that's been a huge mess for me.Jane Dacre 11:23
Gosh, yes, it's, it's sad, but he's leaving his legacy and new is that right?Carrie MacEwan 11:30
I'd like to think so. And my mum always says that he's looking down, and he does see that. So it's okay, I'm the only one I've got three brothers. And I'm the only one in the family who did who did anything medical.Jane Dacre 11:41
Interesting. Interesting. So I'm being an opthamologist was good. Clearly, it was something that you excelled at. But you moved into doing leadership roles. How did that happen? What was it that made a change?Carrie MacEwan 11:55
Well, first and foremost, I'm absolutely primarily a clinician, and I was a full time clinician until my to my mid 50s. So you know, so it was definitely something that I that I loved. But tied in was being a clinician or all the other roles that you do. For instance, I recognize the difficulties that women were having, and progressing in their careers, and I became the very early on less than full time associate Dean's so that gave me another insight into to life and give me an insight into the other aspects of other specialties as well, and how difficult it was to make that work. And I was also very keen on medical education and assessment. And I became involved in the college, ablest training. And also assessment, I became senior examiner for the college, and interesting enough for Sport and Exercise medicine, the faculty of Sport and Exercise medicine as well, which was something that was always a passion of mine, a home medicine and sport fit together. So I was I was doing all these things. And with that in mind, I became vice president of the college. And then I became senior vice president. And then I was elected as president. And so that kind of was the the way that my my leadership role evolved. And having become leader, a president and leader of the college, I recognized that there were things that I needed to do. But I only had one opportunity to do it as I could see that. And I had to get on with some of the things that we'll do. And I and I enjoyed it. And I enjoyed interacting with people, I met the most inspirational group of fellow presidents. And I know you're one of them, Jim. But that is I mean, I'm sure that you'll feel the same that we had, we had a really a good group of people who were able to help one another. And that demonstrated how valuable it was to be a leader and to be able to share and to be collaborative. So yeah, so that was sort of really how I got into leadership roles.Jane Dacre 13:53
But it didn't just stop there. Did it. KnowCarrie MacEwan 14:00
that? Yeah. So having been college president, I was then going to go back to be a clinician again a full time. But then other things happen. One, we have a real shortage of pediatric ophthalmologists and what can utilities specialist which is my area of specialism and one of my fellows, was ready to take a job and was good to go to one of the other areas in the country. And so I thought I need we need to keep her here. And it's time for me to move on. So I decided at that point that I would overtake early retirement not that early, but a little bit early. And I would carry on doing some work. But I was looking for something else. And I was persuaded and what I was persuaded to apply for the the role of chair of the Academy of Medical Royal Colleges, and quite honestly, you could have knocked over for the failure when somebody phoned me and said actually, you've just been elected Chair of the UK had me. But that again took me on to another level of leadership, which was much more multi disciplinary, in the in its in its view about about a bit about medicine. And it didn't stop there either. No, no again. So when I came to the end of that, that's when I was definitely going to give up, I was definitely going to retire at that stage. But again, I was persuaded to stand for a council role at the General Medical Council, somebody who had an interest in medical education, an active clinician, and which I've still I was still doing, I still I still am doing clinical work, actually. And so that was fine. Being on the on the council of the General Medical Council was seemed attracted to me, it was, you know, one day a week. And so I stood, I applied for that I was interviewed in that, and I was appointed, but they sadly, six months after that appointment, the chair didn't clear marks, and was diagnosed with pancreatic cancer. And I was then approached by the Council to take over the interim chair post. So I was very happy to do that. Because, well, one, I think that what I did not want to do was prolong any agony for clear and make sure that she had she could get leave immediately and not have to worry about in any responsibilities there. And during that time, I became aware that the gentleman who became much more involved with Jen Medical Council, obviously, and recognize that this is an organization that isvery constructive, it's really keen to change. And it's got an excellent highly skilled staff. And therefore I applied for the sheriff when a lamppost came up, was appointed.Jane Dacre 16:52
The GMC isn't everybody's favorite organization, it must, it must be quite a bit of it a bit of a change from an organization that feels as if it's everybody's friend or organizations where you're helping colleagues to organizations that maybe don't have such a rosy reputation amongst our colleagues. Does that has that? What do you what, what are your reflections on that,Carrie MacEwan 17:23
or being a regulator is not a job that's necessarily going to make you be loved by everyone, because at the end of the day, regulation means that you have power. And that power is it actually benefits the registrants because it means that only people who fulfill the appropriate criteria of educational training and qualifications are able to join the register. And if that wasn't the case, as doctors, we wouldn't like it very much. And we don't want people who don't have the right qualifications. But it also means that, that, at both ends, that the intermittently, people who are not able to either conduct themselves appropriately or have the appropriate skills, the need to be removed from the register or have some sanctions placed against them. And that's to protect patients patient safety organization, and to make sure that we're all working with was the right colleagues. Now, that inevitably engenders some anxiety with people and that, and in some cases, I recognize fear. That is something that's interesting enough, the people who work with the GMC closely think it's a good organization, don't fear it, and know that it works very well. It's the further away you get from the organization, the more likely that anxiety becomes. So what I want to do regarding that is to make the GMC first of all, the best health care regulator that there is nationally and in the world. That's That's my my plan. And I think that everybody is on board for that to take it forward. And part of that is to make it into really a much more compassionate organization. And we're already moving towards that by becoming an upstream regulator making sure that we're working with registrants to make sure not only do you have the plate, that they're set for the job, that they've got the right skills, qualifications, to feel confident to do the job. But we're working with employers and trainers now to make sure that the environment in which they're working, allows them to do that job fully and properly and with confidence, and that they're allowed to progress as best they can and not be held up for unexpected reasons. And that includes our EDI policy. And we've been very, very clear about that, that that either from the point of view of racism or sexism More, or disability, everybody should be allowed to move move on and not be held back in any way. But in addition, we're reviewing the way that we deliver our regulatory actions. But we're slightly held back by the out of date medical act, which is 1983. And we're we're pushing for medic for regulatory reform, which is coming through. And as part of that, we are making sure that we are making sure that the any interactions we have as registrants and complainants are are improved so that people feel that they are being given support, and they do not they should not be feeling an organization, what we don't want to do is compound harm. If somebody isn't fair to us, it's difficult. We don't want to make that any worse.Jane Dacre 20:49
Absolutely. A lot of a lot of work work to do. But I'm sure I'm sure you will. You'll go for it with gusto, Carrie, like you have with the other jobs that you've had in your career, can I just pivot a little bit? And and say that you've also had three children, you have an active family life? How did that all fit in? A lot of the younger women that we talked to are struggling at the moment, we're getting all of all of those pieces of the jigsaw to fit in? So little bit about that, and then any advice you might have for them?Carrie MacEwan 21:29
Yeah, it's, it's definitely a balancing act. And I don't think there's a right way to do it. And I think everybody has to look at their own way of doing it. And there really wasn't flexible training or less than full time training in my day. And I waited till I became a consultant effectively to have my children I, I had the first child, sort of between senior registrar and consultant. And I think it would have been very difficult for me to have been any other way. But that was a choice that I made based on thecircumstances at the time. And I really don't think people have to do that. Nowadays, I think there's far more flexibility in a system. And I wouldn't encourage anyone to wait, do it at the right time. That's right for you. Having children, and when you get three under the age of four, and your husband is working in another city, because that's again, how sometimes it works out, it really is quite difficult, and especially if you do have any family nearby. So there was a few things that came in to practice. And first of all, although my husband was working far away, he was highly, highly supportive. And we we managed to work out a route or some way that managed to get together, I was very dependent on support. And that involve, unfortunately, and I know that people are very aware of this, paying a lot of money out in order to make sure that you could continue to work. And sometimes you really weren't working for as much money because you were you were what you were doing as you were investing in your children's future, and you're investing in your own future. And you just had to look at that for a few years. And being organized was absolutely, you know, batch cooking at the weekends to make sure that everybody had good homemade meals during the week, but didn't get you know, chicken curry every night, whatever it was, and making sure that you you could perceive what was happening in the future. And that meant often working with friends who also had children, and arranging runs and making sure that people could be picked up and and making sure that you could you know, perceive what might become a problem and keeping Bay friendly with your neighbors and friends so that when disaster struck, you could call them and ask for some help. But it's a really, really difficult thing. And I think that that investment in the future for you and your family is something you've got to keep your eye on because it's expensive. And you sometimes feel you're you're doing it for nothing but you are you're doing it for your future.
Jane Dacre 23:56
Fantastic. Well, listen, Carrie, we've taken enough of your time you've given us some fantastic insights of a long and very successful career. So thank you very much for for talking to me today. Thank you, Carrie. Thank you for listening.There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.
- Episode 6 Professor Henrietta Bowden-Jones
Medical Women Talking podcast - S01E05 Professor Henrietta Bowden-Jones
Speaers: Jane Dacre, Henrietta Bowden-Jones
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Today, I'm talking to Professor Henrietta Bowden Jones, known as Esther, Esther, as a psychiatrist, and she's a specialist in addiction disorders and also gambling. She's had an extraordinary career, having started life in Italy, and has lived between Italy and England. She has two children, and is now on the board of trustees of the Royal Society of Medicine. So she organizes a huge number of events for women and others in medicine, listen and learn. If you could start by giving me a kind of summary of your career, let's talk our talk our way through your career.Henrietta Bowden-Jones 01:50
Well, my career really began at the Chelsea and Westminster hospital, when I arrived as a junior doctor, and I was the only full time woman in a in an office with 12 other young psychiatrists. And I fell in love with the hospital immediately. It was a Charing Cross rotation that I that I was that I belong to. And it was, there were a couple of part time. Flexible trainees, as they used to call them, who were women, but really, I ended up navigating my way into a room full of rugby playing, you know, very nice colleagues, male colleagues. And so it was an interesting beginning, because it wasn't just about navigating a new subject training in psychiatry, with wonderful, wonderful consultants there, who were supportive and who had great academic sessions, etc. But it was also navigating, I suppose the gender issues, it started very early, you know, I arrived and someone said, Welcome to the rotation of the golden boys. And I said, What about the golden girls? And they said, oh, there aren't any there are only a couple of part time people here. So that was a sort of thing. And yet, and yet I will say that I have remained in the same trial. So I did, I trained on the Charing Cross rotation for the St. Joe years, then moved to these Charing Cross and St. Mary's specialist registrar rotation for those years. So manage still to do my jobs around the Charing Cross, and the Chelsea and Westminster in some areas. So it was really very much, I loved it, I loved it. And, and it felt just right in terms of the connections. I'm a very people person. And I tend to keep my friendships, not just with people outside of medicine, but very much my colleagues too. So it was a great delight for me that I could continue being in the same mental health unit that I knew the nurses, I knew the OTs and that my colleagues kept on, rotating around, but they'd always be people I knew. So I love that.So it's now been, I guess, it's been 25 years in the same trust, and I'm still enjoying it. And of course, you know, the CN WL central northwest London, at trust does tend to keep its workers and so there are many of us are going who are just getting old together, which is lovely. Some of the managers I work with I've known since we were very young. So that's really and so when I was there, I had a fantastic consultant in addictions called William Shanahan had spoken to about him before when I was interviewed for a career interview by the BMJ and I said, you know, he really was inspirational. And so I, I ended up choosing addiction psychiatry very, very much because of his teachings and, and he would be talking to us in our training, academic training afternoons away before I had to make a choice when I was a specialist registrar about what CCSD to choose. But it was very much about his trips to Colombia and the drug cartels and what people were using when, you know, those were things that really influenced me in relation to trade. There were other things too to do with my life. And people I had known who had ended up using drugs, some had died, some had ended up in rehab. I did know many people from I'm half Italian. So my Italian by from my Italian life, I knew people during the heroin epidemic who had become heroin users and, you know, had suffered the consequences.
But I do think William Shanahan was really the person who then who he was then a medical director for a long time for addictions. And so really inspiration. When I, when I started my consulting job, I knew because I loved film and art so much, I thought, well, I can't think of anything better than being an addiction psychiatry and psychiatrists in Soho. And this was like, my kind of, you know, Dream thing. And then one day, I got a call saying, there's a junk going, it's an addiction psychiatrist in Soho, and I said, Well, are you joking? You know, and they said, no, no, I mean, you've got to apply for it. But there is a job going. So I applied and, and I ended up inside the old Hospital for Women on Soho square, which had been turned number one for history, which had become on health center, and I ran from there, the server rapid access clinic, looking after the homeless drug injectors in drug users in, in Soho. And, and at the same time, I also used to look after the people injecting drugs at St. Mary's from a porter cabin. So it was all very frontline, and very different from the work I do now, Jane, but it was extreme. And what I will say about those years, was that after the comfiness have the lovely training on these two rotations. And after all the research I had done, because I had applied for research fellowship side one research prizes at Imperial College young researcher, you know, and stuff like that arriving as a consultant in the homeless Addiction Services was quite intense, the people had suffered everything, they had started life, without any winning chance of doing anything very much other than survive. And I've never forgotten that, really, how some people, you know, just starts start fighting from when they're born really. And that's, I suppose, one of the things that made me realize how much I love my job was that I never gave up. You know, I later on I was running the inpatient unit in Westminster, for all detoxes for Chelsea Kensington and Westminster. I did that for several years, any detox was NHS was coming through me. And, you know, and you could have given up, of course, because these were miserable stories, and people were coming back and back and back, you know, unfetter men and dry in all sorts of, you know, alcohol, and yet, I just kept on feeling, you know, positive about treating them. When I eventually moved on to dealing with behavioral addictions.
I never missed doing that job, I felt I had given as much as I could probably, it was such a miserable, you know, it was difficult. But I was really pleased that I had done that. So if I take a step back and talk to you, because, as you know, I've had parallel lives, I've had a clinical life, but I've also had a very research based life and my research informed the rest, it really informed everything I ever did, really, I was very fortunate when I was as as a junior doctor at the Chelsea and Westminster. They advertised Imperial College advertised for a six month research fellowship. And I thought, actually, you know, I'm not feeling very taken seriously here. There are too many golden boys and no one seems to sort of take me for you know, how important I feel about being here becoming a psychiatrist. What am I supposed to do about this and I couldn't work it out. Really. Um, And then I realized, actually, if I went for this research fellowship, I might be taken more seriously. You know, I used to swan around, I was young, I, you know, I wore heels and you know, slightly flared trousers, and I swung around being half Italian. And I think people thought, well, this woman, you know, does she think about medicine? Or does she think about shopping, you know, it was that sort of thing a little bit. And I went to the cinema a lot, I loved art, I could see how easily they might have been mistaken about me. And I thought, I'm just gonna put them straight. So the time came for this interview. And I was due to go to New York taken by my husband then or my boyfriend, I think he was still my boyfriend, I can't remember anyway, my now husband. And, and I was due to go to New York. And I said to him, I said, Look, there is a big issue. I'm gonna go for this very serious research fellowship, unfortunately, I'd like to go, unfortunately, is during it's the same time as you've, you're taking me to New York, you know, for this big treat that we've been waiting for, for many for many months. And to his credit, and this is why I chose the right husband, he said, you know, this is such a big thing for you, I can tell you really wanted and I said, but I just want you to understand that I probably won't get it because there are quite a few of these, you know, colleagues, male colleagues going for it and they said but yet but you will always look back and you will know that you had a go at it.
And so, you know, I did one of those things that I've known for which is to totally go nuclear on the academic side. And I you know, and I got I got the post and it started a very different life for me a because people were like, blimey, here's a, you know, this woman in high heels who was swanning around is now doing a research full time research fellowship at Imperial on the rental ventromedial prefrontal cortex. You know, that's changed our perception a bit. And so I was taken out of clinical work for six months, I had to do my on-calls at the Charing Cross, which I loved. So I spent nights in A&E Looking after all the emergency psychiatric emergencies once a week, but the rest of the time I was free to do what initially was a research fellowship. And later became my medical doctorate. I needed to change my supervisor because I needed someone in fact, it was Professor Eileen Joyce's who then moved moved from Imperial to the to Queen Square, about and I work very closely with the Cambridge with neuroscience department because Barbara Sahakian are one of the greatest neuroscientists in the country in decision making was a great inspiration.
And later, when I did all my later doctoral research, she was indeed the person whose tests I use new neuro psych battery of tests I used. So there Yeah, and then I won this prize young researcher, again, Imperial College. And yeah, and then of course, when I ended up choosing behavioral addictions, for the second part of my career as a medical doctor, as a specialist in addictions, I chose it because it was the findings from my doctoral work that pointed to me that there was a bit of the brain that really wasn't working as well as it should in a population, which turned out to be a population of people with gambling disorder. At a time when in England, no one knew about gambling disorder, you know, I had been fortunate to be on one of the best addictions rotations in the country, and no one had ever mentioned gambling to me. So it really didn't exist. You know, the Royal College of Psychiatrists knew nothing about it. So, again, I spent, I think I spent six months writing, I would say to you, maybe 1000, if not one and a half 1000 index cards on gambling. I collected information from all over the world. And there wasn't a single thing I didn't know about gambling disorder at the time in 2000. No, by then it was later it was the early 2000s. But it was no it was maybe 2006 2005 When the Royal College of Psychiatrists said to me, Westminster is having to make decisions about gambling. And there is no one in the country other than you, who knows about gambling since you're obsessed with it, would you become our spokesperson? And I said, Absolutely, yes. You know, and then I was inundated with, of course, what I didn't realize was that a spokesperson meant I had to speak on behalf of the college to all the media with whom I for whom I hadn't, I'd had no training so I end Did up, you know, with my public engagement side, evolving very, very rapidly, with much anxiety initially on my part because I went from looking at index cards knowing what I knew I can dynamically that I'd been very carefully sort of collecting to having to convey the importance of various things to journalists who then wrote about it often, you know, I anyway, I, it was a steep learning curve, Jane, but one that suited me well. And, and, and I enjoyed a gradient. Of course, as you know, now, I'm national clinical advisor for the NHS England, on gambling harms.
And I my clinic that I first set up in 2008, and my clinic that was the only one the National Problem Gambling clinic, was the only one for over a decade is now has now been replicated 15 times across the whole of the country. And I spent much time in Westminster advising politicians and the House of Lords. But it was a journey that started very much with a college, to whom I'm extremely grateful for giving me the psychiatrist of the year prize award and lots of other things, for recognizing the help and all that I've done. But they were always there supporting me as we're the comms department in my trust, because, you know, of course, these demands came thick and fast when Gordon Brown wanted to open more casinos. And you know, and things were happening quickly in relation to what products could be allowed and not allowed. And I wanted to protect, you know, the whole population, not just people who had a problem, it wasn't just so my focus shifted, and I started thinking, Okay, I need to think about the wider population and about prevention, not just about people with problems and how to treat them. And I suppose that's a story radio of the last few years. And I thought, well, now there are other people helping me to treat patients. Of course, I want to triple numbers in treatment. And we are trying to do that by opening more clinics. But ultimately, my job now when I am in Parliament, so regularly is to try and prevent harm, to stay, try and stop people from having harmful products and reaching, you know, and reaching vulnerable people and reaching the Young, who are seeing adverts and, you know, being impacted by social media and and encouraged to gamble and spend money that no one has. So So I suppose that's a story in itself.
Jane Dacre 17:42
Fantastic. So So I mean, it's interesting to see how you've become so impactful in relation to that, and what why, what do you think it is that that made you be able to do that?Henrietta Bowden-Jones 17:56
I think so. You know, not I don't think I've ever actually been asked this question before, but but I have an answer for you immediately. I think that it's a combination of the having had, you know, an incredibly studious mind and an analytical and rather at times, people laugh at me for my precise nature. So if I'm going to learn something, I have to know, all there is to know about it. In order to feel that I really grasp it. So in the way that you know, the 1000 index cards are, you know, are an example of that, which could be deemed to be slightly obsessional. But if you are going to do your, if you're going to describe yourself as an expert, then you know, of course, then there's a key. So there is that side, coupled with a very extroverted nature, and a people nature. So the communication side, so my comms department, have always been very happy because they've got someone who can do public engagement by conveying all the stuff they know, without having the problems of not being able to have a dialogue, let's say. So that's been fortunate, and people often say, psychiatrists may be fortunate in the sense that sometimes we tend to be slightly more, you know, extrovert, right. You know, my, my role model, one of my greatest role models is Simon Wesley, who is probably the only person I know it was more extroverted than I am. And, and he, we bow to each other in terms of how much you know, how much we sort of enjoy people and company and communications, etc. But he really, he really is, you know, our guiding light always has been one of the absolute best psychiatrists of our generation the best I think. Yeah, yeah. And so I think if you've got the skills to know the staff, retain the clinical and the neuroscience sorry, that's the other thing more seriously, because I think the reason why I was able to convince people to gave me the funds to continue building and building and building on this national expansion is because I had an understanding of evidence base and science. And I think one of my greatest bits of advice I could give to people listening to this is, please don't shy away from the word research, research all research is is evidence base. And you can choose whether you want to do more neuroscientific research or more clinical work. But essentially, if you want people to take you seriously, if you want people to really build on what you've started, you need to show them that it works. And you need to show them that what works lasts. And you can't do that if you can't expect others to do the research that you need to give evidence on what you're doing. And so and so when I hear people, and by the way, the thing that really worries me is that there are a lot of female colleagues I know seem to sort of defer, you know, oh, I'm no good. I'm no good at research. I just want to say to them, Well, of course you are. Otherwise he wouldn't be assigned, you wouldn't have done sciences, he wouldn't be in this position. So I think there's a big job we have to do, Jane, in breaking down these walls that are often actually present, put there by I don't think this people are putting up the walls themselves. I think there's some society still some societal label that allows people to be excellent clinicians as women, but are they really excellent researchers? Are there enough role models out there? Are we speaking enough about what we can do? Well, so there's a lot of that.Jane Dacre 21:38
Yeah, no, maybe? Maybe not. I'm interested that you started your story, when you'd already decided you're going to be a psychiatrist. Yeah,Henrietta Bowden-Jones 21:46
yeah. Yeah. SoJane Dacre 21:47
how did you get to that stage? Why did you go to where did you go to medical school? How did it how did you get inspired at the early stages of your career?Henrietta Bowden-Jones 21:58
Well, it's a it's a, I'm so glad you asked me this. So I was born in Italy, and raised as an Italian child, by an Italian mother, and an English father, who was very English, she, you know, was a Cambridge undergraduate, graduated there, and then left for Italy almost immediately. And he only ever spoke Italian to me, and so did my mother. So so we were raised three children, as Italians really. And it was during some very difficult political years, where as I was growing up in Milan, when the Red Brigades were blowing up everything and shooting people we knew, murdering people, we knew that my parents suddenly thought, you know, I think we need a change of tack here. But by then, you know, I'd finished my primary school was finishing primary school very happily without a word of English seriously without a word of English. And then they said, well, actually, you've got to go to boarding school now. You know, take a year, a year and a half, and then you've got to go, we've got to teach you English. And I was very, very studious. And I, you know, I had my desk in my bedroom, I had index cards at the age of eight, I was making notes and, and I was cataloging things. Goodness knows what initially, they were just toys, and then it ended up being flowers, but I already had that need to assimilate knowledge, and to tidy it up in an orderly fashion and to be able to, to come in and I think part of it was the chaos that was going on around you know, I had very socialized parents that didn't work who, who had, you know, they were just at parties every night, etc. So I had a very different personality, you know, I needed my, my school, my school was, you know, really special for me. And so suddenly, you know, that I was being told I had to, yes, I could carry on being at school, which is what I love, but I had to do it in a different language. It was very traumatizing very doJane Dacre 24:08
did you come to the UK thenHenrietta Bowden-Jones 24:11
eventually I did. Eventually, I had a horrendous year and a half being taught English. And of course, it was all done so quickly, because they had to get rid of us, you know, they had to leave get us to leave Milan. And with me, my lot of my generation with Expat parents were sent away to America to France to Switzerland to boarding schools because it literally was you know, warfare out there and with a Red Brigades against you know, so anyway, so So I was then very anxious trying to learn a language that I knew nothing about in an environment that I didn't like the children and in English school in Italy that I didn't feel any affiliation with. And then after that, to sort of complete the picture. I was sent to boarding school to a boys school in Wiltshire. Now I I do. Having said that, you know, it was traumatizing for me to be leaving my family. I was very much an Italian girl, you know, very attached to parents and had no intention of leaving home. And suddenly I was sent away for months on end to our country where we never went. And it was very difficult. The school were wonderful. You know, I still go back now to reunions. But it was a boys school. And there were 600 Boys and about 810 15 Girls, you know, I mean, it was nothing. When I started in 1977. At that school, there were almost no girls. They got them eventually through the sixth form. And eventually in the middle school, they started coming in, but it was, you know, looking back on it, you wouldn't wish that on anybody, though. It took me You know, I arrived at medical school. So then my brother and sister escaped back to Italy as soon as they could, and I did too. And we, you know, I went to, you know, eventually I went to medical school in in Italy Impervia. But realizing when I was there that my English background by then had been quite formative. And I had loved my time in England. And so I was stuck, you know, as many children of two cultures are, without really quite understanding where you should be doing what. And so luckily for me, during medical school in Italy, I had come to the Charing Cross. And I had sat in and I had participated in many, many ward rounds. And I had been taught by people like George Ecosse, who are iconic psychiatrists of our, you know, contemporary times, he had been instrumental in making me see that I, that I should train psychiatry, and I shouldn't do it. Yeah.Jane Dacre 26:50
Well, you came back.Henrietta Bowden-Jones 26:51
Yes. Yeah, I came back. I came back. But you know,Jane Dacre 26:55
why psychiatry, because of the role models there.Henrietta Bowden-Jones 26:58
I was always interested, always interested in the mind. And I really felt as if everything that had come before had not really been right. You know, psychology had not wasn't right. Psychotherapy wasn't right. Because I was very, very studious in a kind of analytical way. It was really neuroscience that really was important to me. And I remember, I was doing some training in in my early 20s, trying to learn about psychotherapy because I thought maybe that was what I wanted to do as psychoanalytical psychotherapy, and I was sitting in a tree and Barnet in some of the medical training sessions there with the psychiatric trainees, I ended up managing to get their full professor man from the institute, who had kindly invited me and Klaus Fink, who used to be one of the people teaching psychotherapy there. And both of them said to me, at a, you're made to be a doctor, you have to you have to go to medical school. And that's how it all ended up working out so well for me, psychiatry and neuroscience were very psychoanalytical in Italy. And I knew therefore that if I was going to do that, I would explore this country's educational possibilities in terms of training. And so I've ended up in a crazy way with my brother and sister in Italy was when we all left, because none of us, you know, we felt we'd had we've been forced to come to England, whereas I now hear out of my own love for England, and everything it means to me, it means so much. So I'm more English than anyone my husband's always laughing. They're going, Oh, you're such a royalist, and you're such this and such that and I say, Yeah, I always feel like I've earned it, you know, because I had to sweat for it for so much.Jane Dacre 28:57
So can I can I sort of move you You've talked a bit about some difficult times when you were when you were going through school and and getting to medical school, but once you once you did that, as a an Italian English woman going through the system in the NHS working as a psychiatrist, you're very, very positive about it. Are there things that you might share with people that maybe were more difficult times and how you got through them?Henrietta Bowden-Jones 29:31
You know, probably the hardest thing and, and I will say that I did take upon myself that moment when I decided I needed to be taken seriously. I did feel somehow that there was racism, frivolous. So that was a moment but it wasn't very difficult. It was just that if I needed to change things, a very difficult moment came when I was pregnant and and I really wanted to do some research and I was Someone very kindly at the mental health unit at the Chelsea and Westminster hospital said Well, yes, I can. I can definitely include you in some research. Here is a list of suicide notes written by people who have killed themselves on the London Underground. And why don't you use your maternity leave to catalog them into? I'm not making this up to catalog them. There's a whole shoebox there handwritten notes, you will do a great job and that will be wonderful. And and I said, Fine. I wanted to please Abul I'm always a pm enables all authority for me has always been there since I was little. I'm like, you know, I really want to, you know, please, people. And so I was like, Yes, of course. And I found myself at my desk late at night in the office crying and crying and crying, thinking I must be because I'm pregnant. And eventually dawned on me that actually, I'm pregnant. And I'm reading suicide notes all day long in any spare time, I've got before work after work to try and cut. So eventually, I have to go back and see this person say, Look, you know, I'm not Do you know what I said? I didn't say I don't think you've offered me the right research. I said, I don't think I'm made to do any research. I mean, yeah, so that wasn't easy. But um, generally speaking, I only you know, for I, personally, I have found psychiatry, almost sort of gender blind. If I could say that. I have not, I found it the most meritocratic of places. If you wanted to work, you could work. And if you worked, and you work well, you were absolutely rewarded for it. And I know, because as you know, I was president of the medical Women's Federation, in recent years, how difficult a story that was for other colleagues of ours, female colleagues in other professions. But personally, you know, I didn't have any problems at all with anybody in relation to my gender. I think maybe early on at the beginning, when I arrived with a, you know, a bit more of an Italian accent, I felt I remember doing my part one membership exams and thinking to myself, I mustn't fail this, I mustn't fail this. Because if I fail it, people will see me as someone who can't who's not good enough to be in this country. And then I think, goodness, if I thought that then imagine what people must feel, you know, anyway, luckily, there were four of us during the exam. And I was the only one who passed and all the others trained in England. So that did that jet very well, at the, you know, at the Chelsea and Westminster that day, but, but, you know, I did have those thoughts. And it's only now that I'm older, old, and I can talk like that. So with such clarity about what it meant to pass that exam, it meant that I would be accepted. And then, of course, the senior consultants were like, Ah, well, we always knew you had it in you. And I thought it took an exam for you to see, you know, something like that. But anyway, so that's I think England was more xenophobic, then in terms of letting it you know, sort of maybe, amongst, you know, the older colleagues. But it was never, it was always very subtle. It was never very,Jane Dacre 33:29
but also being married and having children and working within the health system. Some of the some of the people who are listening to the podcast might be interested in, in how you coped with all of that. Did you? For example, did you work part time? How did you fit it all in? And how did you make it work?Henrietta Bowden-Jones 33:46
So again, because of my personality, I would, I didn't allow myself to work part time because I didn't think people would take me seriously. And that again, remember, this is many years ago now. And they didn't take people seriously. I was in the office with 12 of them. I knew they didn't take the flexible trainees at all seriously. So things, thank goodness are so very different now. But in those years, they were, you know, they were just I think, overlooked could be a good word to you. They were certainly not seen as serious, you know, competitors, that things and I want it to be seen as a serious competitor. I was not going to let this stop me. So I you know, and when I look back, I think Did I really do that? But you know, I did what a lot of people of my generation and previous generations, probably not, not after me, you know, doing the on calls and you're about to drop your baby, despite, you know, the risks that that involved. Doing the 70 hour weeks with newborns. I went back to work six weeks after my first child, I think it was six, six weeks, something like that eight weeks. I mean, it was just ridiculous. Ridiculous. And And the second child, I was in the middle of a, I was I was doing quite a lot of the end work then and I had, you know, protected time for that. So that was easier. I also was a bit more organized in knowing what to expect. So I had a nanny to help. But I will say my parents who had been great, as I said, Great socialites, when I was little, and not really as present as they might have been, they were very present as grandparents and I relied on the enormously because I look back, and I think I was just exhausted all the time, I was very hard on myself. I never let myself do less because of the pregnancy or the newborns. And and that, you know, again, that I'm sure that wasn't healthy. And it's not what I would suggest others should do. But it's how I lived it. And when I look back on it, I kind of, you know, deep sigh and think thank God, I got through it. But it wasn't a healthy way of doing it. And so my parents moved house and they moved closer to here. So because by then they'd moved to England for half a year. So they were around a lot. And and then I often now, and again, when I was president of the medical Women's Federation, I would sometimes talk to young colleagues who didn't have parents near them, some of them didn't have parents at all. And I remember, you know, this empathy. Empathy is the other thing, I've got probably a lot probably too much of sometimes I, I kind of empathize so much. I'm almost like, you know, on the verge of feeling emotional for people sometimes. And that's why it's helpful to be a psychiatrist, I suppose. But sometimes I would feel for these young colleagues, you know, who didn't have that support? Because I would think to myself, you know, how, how's it going to work out for you, which is why I am so passionate about the idea of childcare in hospitals, if I had had that life would have been so much easier. I was fortunate, like most M WF precedents to have been married to a medical person. For some reason, we've worked out there, nearly all of us had marriages to medical colleagues, and Owen took half of the childcare at every step, you know, and if if a child was ill, I was very clear that one day was him at home and one day was me unless anyone else could help. And that was very helpful. I don't think it was just me insisting I think I married someone who truly believed in equality. And so that was, you know, that worked. Because again, you know, you don't go once you don't go twice a third time, you don't show up to seeing your patients, you know, when you're a junior doctor, because your child is at home that cannot be easy, in relation to one's work anxieties. So yeah, no, I,Jane Dacre 38:05
those things are very difficult and and people people deal with it in different ways, don't they? So in terms of your personal life, do you think you had to make sacrifices to to carry on in your career? Or did it all just come together?Henrietta Bowden-Jones 38:23
Well, remember, they were never sacrifices, because I felt so privileged to have had finally found my life's mission, the first day of medical school, when they said to me, you're going to be here, eight hours a day, every single day, for the next six years, you're not going to have any time to do anything else. I thought, bring it on, I'm ready. You know, and, and so and so everything after that. And now, you know, I, I mean, to be honest, even now, every day I wake up, and I feel grateful for my profession for my sense of identity linked to my work. And now of course, again being 60 Next year, for the ability that I have now to influence change at a population level, rather than just at patient level,Jane Dacre 39:18
a huge a huge achievement. So were coming to the to the end of our time now. So are there messages that you that you want to give to maybe some some younger women who are listening to you for you to be an inspirational role model, what would you say were important things to those aspiring medical leaders.Henrietta Bowden-Jones 39:39
So I've got two or three things really, Jane, I think the first thing remains. You got you got to become an expert at something. You've got to have your niche you've got to be you've got to work out what it is you've got to offer to your profession. So just going in and being You know, a jobbing doctor, I don't think that's good advice, I think you really should choose what really makes you tick what you're passionate about and become an expert in something the world needs experts and recognize as experts. But if you're going to be an expert, then as I was saying earlier, I think you need the skills to be able to deliver what you know. And so you need the public engagement skills, you need the research skills, it doesn't mean you've got to do a doctorate. I'm not in any way suggesting that. But I think you do need to know how to convey these things. I think women often shy away from being competitive. And this is a I could talk for hours about this. I personally have thrived, receiving and being recognized for things I have done. I would say to you that the OBE that i i received changed the course of my career fully because people started listening to me, instead of telling me to shut up, they started to notice what I was saying might be something of value, maybe worth implementing, it needed an OBE for some people to listen to be honest, a government level. And I will say to my female colleagues, do not shy away from competing for awards for prizes. From being at the top really and being a leader rather than to being led. I think too many people are quite happy to be senior enough and being led rather than to say, right, you know, I'm going to change things. Always for the good of others. And And lastly, the person before me so I had the pleasure of being sandwiched as president of the medical Women's Federation between, between Pavan Kumar who came before me, and Nina moody who came after me and I always say, you know, how lovely to be that sort of jam in the middle. But Parveen taught me whereas Simon Wesley taught me how to speak truth to power and not to stand down if you need to fight for it. I think Parveen taught me kindness, and how to support and continue to be kind to all whoever they might be in whatever situation and I saw her in the most difficult situations, continuing to retain her professional integrity. And I would say, I would say, I mean, if you need a guru followed Povey, rather than me for sure, but but if I could give you some advice is do the same that I'm doing now following Parviz advice, and it seems to work.Jane Dacre 42:40
Well, fantastic. So kindness is of course, something that then Claire Marx, who's now sadly died also tried to promote in her in her chairmanship of the General Medical Council. So it's something that seems to be coming into medicine via the via the women route, which is which is lovely to hear. It's been fantastic to talk to you. Thank you so much for your time, and I'm sure that the listeners to the podcast will be absolutely inspired by your words of wisdom. Thank you very much. Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.- Episode 7 Professor Geeta Menon
Medical Women Talking podcast - S01E07 Geeta Menon
Speakers: Geeta Menon, Jane Dacre
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order so that you can listen and be inspired whilst doing other things. Happy listening. Today I'm talking to Professor Geeta min on, she has had an extraordinary career, which has spanned both India and the UK. She reached consultant status in India, but then came to this country and had to start all over again. She's been through several career grades, and is now working as a postgraduate Dean for NHS England. Geeta, welcome. And thank you very much for joining me.
Geeta Menon 01:35
Thank you very much, Jane for inviting me to talk about my career. So I actually was born and brought up in India, in western India, in a place called Gujarat, state of Gujarat, in Ahmedabad. I did all my primary and secondary schooling there, and always wanted to become a doctor. And so
Jane Dacre 01:58
hold you when you decided to become a doctor. That's something I'm asking people, it's surprisingly young.Geeta Menon 02:04
Yeah, I think probably the age of eight or nine. And that's just stayed with me. It's interesting, because my neither of our parents are doctors, and probably the first doctor in the family. So it was just, you know, our family physician used to come to you know, in those days, we used to have family physicians either come home if we were to ill, or we could go there. And he was such a nice guy. I mean, you know, and every time you know, Dr. Pandit came, he could just get rid of my illness so quickly. And I was like, you know, that's what I want to be. I just don't do that. I think. Yeah. So So but, yeah, you went to medical school? Yes. No, that's fine. So yeah, so I was lucky to get into medical school, it's quite difficult in in India and Ahmedabad. There are two medical schools, I went to one of them. And whilst I was in my second year, we had our clinical placement in ophthalmology. And I remember going into theater and seeing this female surgeon operate on a patient for cataract surgery. And that just kind of, I was hooked on it. I just loved ophthalmology. I love the way you know, the intricacies of surgery, but at the same time, the clinical bits as well. So it had both medicine, medical and surgical aspects to the job. So I decided that was what I wanted to do. But it's not very easy to get into ophthalmology because you only had like two seats in the college that I was studying in two postgraduate seats. So, you know, while once I finished my medical school, I remember my parents friends sitting down with me and saying, I take pediatrics. And you know, that's much easier because the more seats you know, and you wouldn't be disappointed if you didn't get fit, but I was absolutely sure that the only thing I wanted to do, so I managed to get into ophthalmology. And I completed my training in ophthalmology while I was actually doing my training, I got married and my husband was training to do is to do radiology, he was doing postgraduate training in radiology in a place near Bangalore. So, we were quite, you know, we got married but we had to kind of finish off our postgraduate training before we then settled down in Kerala. So, I started working in I hospital there in Kerala, quite a cultural shift from going from Ahmedabad to Kerala because Ahmedabad is one of those states which has prohibition, which means you're not allowed to drink or sell alcohol. It's very, very safe. You know, so girl as a girl I used to be, you know, as a female, I could go out 12 in the night and be really safe. Whereas Kerala was totally the opposite. Um, everything started to kind of shut down by seven o'clock in the evening. So in this hospital that I worked in, one of the things that was happening was the retinal patients who had retinal detachment surgery and needed surgery would come and they would have to then go to the neighboring state to have surgery because there was no retinal surgery available in Kerala in those days. So my director of my institute was very keen that I go and specialize and do a fellowship in retinal surgery. So I then went back to Ahmedabad. Again, I was lucky to get a place because initially when I was finishing off my postgraduate training in ophthalmology, I remember this professor who was in you know, the retinal surgery giant didn't in that, in that space at that time, come to me and say, Okita, you know what, I think you should do a VR fellowship with me. And I at that time, or I would think of, you know, I finished my postgraduate degree and then go and join my husband. I said, No, no, I'm not interested. And so when I called him up to say, oh, I want to actually do a fellowship. I remember him first. His first response was, I'm sorry, I've got a waiting list now. And you know, you can come in five years time. And then of course, I explained to them what was happening, these people were going blind. And, you know, it was really a sad thing, because they couldn't afford going to the neighboring state. So he said, Okay, somebody dropped out, and I let you know. So in 1989, I went and did my retinal fellowship with Dr. Nopal professionals in Ahmedabad, and then came back and set up with retinal surgery in the hospital, I was 10. And it was an interesting journey, because there weren't very many females with retinal surgeons in those days. So it was, you know, people used to always look at me and say, Why are you training to do a retinal surgery? I mean, you know, you're a female, why don't you go and do ocular pathology, that's more, more your, you know, what females should be doing. But anyway, I survived and thrived in that place. I didn't give up I went and then, you know, like I said, Separate set it up in Kerala. And I thought I was living a dream because I was, you know, doing a lot of research, I was, you know, presenting lots of papers at conferences. And then suddenly, we had a bit of a tragedy where I lost, lost my baby. So things then started to kind of not be very great because my patients and others didn't know that I lost the baby. So they would come in ask or is it a boy or girl kind of thing. And I just felt I needed a change. My brother was in the UK at that time. So he said, Oh, you know what, you need to come here. You need to come and you know, work over here and do the fellowship exams. It's really you know, something that will really be great for your career. So, one of my professors had done a Commonwealth fellowship in the UK. So she did help them sponsor me to draw College of ophthalmology, because in those days, there was a double sponsorship scheme. So she sponsored me to come and work. And so I got a job at Luton and Dunstable hospital. It was a very interesting period at that time. So being from being a consultant with to retinal surgeon in India, I came down to becoming a senior house officer, as we were called an sho in ophthalmology at Luton and Dunstable hospital. And the other bits of my journey they have was also interesting that I came to the country on my own, my husband had to stay back to sort his visa out. So he and my son joined joined me only a month after I came to the country. So I was on my own in India and later absolutely sheltered life. I, you know, got a chauffeur a cook, I had never thought the bank account of my life, let alone actually look for a house. So I had to do all of those things whilst actually trying to get my head round working as an essential in a very new environment. And I remember the first clinic and they will forget that where you're sitting in the clinic, and you're told that you've got 17 patients to see and there's the phone constantly ringing from the GPS or trying optometrists are trying to contact you at the same time. And I think the thing that sticks out in my memory of that period in my life was standing at a payphone. In those days, you had to pound coins. I'm trying to talk to my son of definition my clinic because the time difference, it was quite hard to kind of find the time to actually talk to them when he was awake. And wait, you keep talking until the pound coins ran out. And that was really hard. How old was seven? He was seven. He mistake factory six.
Jane Dacre 10:22
And I'm really sorry to hear about that the baby that you lost to so that was a it was after it was after the baby was born.
Geeta Menon 10:31
Yes, that guy. So it was a premature delivery at eight months. And yeah, it was quite the I thought was quite so as
Jane Dacre 10:41
we come to the UK after that, leaving your family. And also, essentially having a bereavement from a consultant job as well must have been so tough.Geeta Menon 10:53
Yeah, but I think I didn't actually find that I had made the decision to come to the UK. So I wasn't in that space, where I was thinking, Oh, my God, and now coming to do all these things. And at times, it was interesting, it was interesting more than anything else, because you were actually assisting with your retinal surgeon. And you know, and it was interesting, she the vitreoretinal surgeon I was working with was a female from New Zealand. So she was a New Zealander. And she was quite engaging in trying to understand see what my opinion was that she was doing surgery. So that was quite okay. I mean, it wasn't, of course, it was hard going. But I only did the essential job for six months, because then they decided that I had, you know, like, they might give me a registrar post, they said, you've got all the qualities you need to do, you know, take on a registrar job. So then I became a registrar there. But then, of course, I again, decided to change change tactics, because my son was getting to the age where he needed to get to secondary school. And what I had got was this retinal fellowship in Liverpool, and one of the very famous VR surgeons at that time. And at the same time, I also had a job that had come up at frimley Park Hospital, which was much more of a fan of job where you can stay in one place, because you know, moving around with our son, and then my husband was working in London at that time, so we going to Liverpool was never going to happen. So I decided to take a step back from my career, and take up the specialty doctors staff, great job, as it was called, at simly. And I remember my brother, not talking to me for a whole week, because he was so upset. My brother, I must add, he's a hepatobiliary, surgeon, a transplant surgeon. So you know, he was absolutely he said, How can you do this? You know, you just kind of ruined your career, why are you going into that job, there is no kind of progression in that space. And you're given up your registrar job to do that. And I said, Look, I need to give my son like stability he needs, you know, it's really important. So I don't I eat till today, I don't have any regrets about having taken that step back for six years, I think that really helped my son to get to where he is today. And I'm very proud to say he's a interventional radiologist, a consultant at Portsmouth. Wow. So, so you know, and at that time, what I did, I was, I was in an art department with only male consultants. So that was interesting. But I must say that they were all really supportive and brilliant, I was really lucky, for me was really a great place to be in that kind of middle grade space. They gave me the freedom to do what I wanted to do. And if you're done the line, they called me in to say that, you know, they thought I wasn't, you know, working to my potential here that, you know, I was meant for greater things, and they were ready to give me give me a registrar job. So I could go back into training and become a consultant. And I said, No, I didn't want to do that. Very happy in this post, you know, because this is what I need at this point in time. And then what happened was that we had the Mac macular degeneration, which is my specialty area, medical retina, has started getting a new treatment called photodynamic therapy. So I might one of the consultants basically said to me that why don't you go and actually look at what that requires and the training it requires. So I was then the person who set it up in frimley, so I set up photodynamic therapy, it was we worked on on the first NHS hospital to actually set it up in the NHS, because most places, setting it up privately. And that then gave me that niche that I needed. And so I then, you know, set up the whole of the medical retina service at Wembley, in my staff grade job. It was very interesting, because I had was the person who had trained in that. So I was running training programs, nationally, and I would have consultants come to me and say, you know, not listen to my opinion, because they were like, you know, you're not a consultant, your staff grade. So I ut telling me what that fluorescein angiogram should look like. But you know, what, what was happening on the other side was my height, like, the doctors were acting as allies. I didn't know at that time, that white ally thing you know, but then governor who used to be, you know, very prominent figure in, in ophthalmology. He used to come and say, you know, ask me out in front of all these people. So, you know, it was like, you know, if this person is the expert, she knows what he's talking about. So, you know, he was kind of trying to true to these people who were trying to kind of put me down. So it's all of the along the way, it helped me develop a lot of resilience, I must say, from all the different, you know, things. And then I think it was in 2002, that they decided to make me a local consultant that firmly and then pushed me to put in for the excellent training.
Jane Dacre 16:40
Did you do the whole CESR route?
Geeta Menon 16:43
Yeah, yes, that's right. Yeah.
Jane Dacre 16:45
So you didn't you didn't have to go back and take royal college exams and things you've got. SoGeeta Menon 16:50
I'd already taken the exam. Yeah, so sorry, I had already had taken the exam. And so I had done my FRP at Edinburgh exams in as soon as I joined frimley, actually. And they looked at all my experience that I had in India, and decided that it was equivalent to what a CCD is in the UK, as an
Jane Dacre 17:14
example of that working well, then, yeah,
Geeta Menon 17:17
yeah. Yeah. The only thing is Jane, that, you know, in those days, the reason I was really reluctant to actually put it in was, in those days, most people were, most applications are rejected. So you know, they would say, oh, there's a problem, that problem, very few applications would go through. So I was really lucky, I must say, to get that. And then my ex chief exec, Sir Andrew Morris, then I remember him coming down to the eye clinic to congratulate me when I got my CESR, and then he said, Okay, now we need to create a substantive post for you. And that's exactly what he did. So you know, so yeah, so I'm really, really lucky. And yeah, so that's how I became.Jane Dacre 18:01
You've talked a lot about the ophthalmology side of things. And then you've mentioned that you did training, but now you're a postgraduate Dean. So how did that transition happen? SoGeeta Menon 18:13
I was so done, I became a consultant. I was quite busy with, you know, doing all the clinical stuff. And then DME at Finley came to me one day, Dr. Allison Keatley, she came to me and she said, Geeta, the foundation program director job role in family is coming up, be heard so much about trainees coming and telling us how good you are as an educational, clinical supervisor. So I'd like you to consider applying for that role. And I was like, I was already like, inundated with the clinical work I was doing because I wasn't doing you know, setting up diabetic retinopathy screening in the region, as you know, setting up the whole Macklowe service with all the new treatments, etc. So when she said that, I thought, Okay, let me think about it. And I love teaching, I absolutely always loved you know, training and teaching people. So, I applied for that role. And I got it. And that's when I realized I absolutely loved you know, working with the foundation trainees, and you know, really getting them to understand about the different faculties, the journeys, etc. So when Alison retired, I applied for the DME Director of Medical Education role and got that so a year down the line. The dean Bucha, Dean of cancer in Sussex called me and said, Geeta, we are we are planning to separate from London, and we want to set up a school of Ophthalmology in kiss, and I want you to actually lead on it. So we're going to be putting out an advert for the Head of School of Ophthalmology. So do You know, I would want you to apply, but I don't want you to give up your DME role. So, so that's how I went into the head, head of school. So I basically remember it was quite, it was quite what should I say? It wasn't great at that time, because all the college students in London had a meeting where they sat down and decided that, you know, they couldn't understand how I, an international medical graduate was no idea about how training in the UK happens, could actually had the school of Ophthalmology. And I only came to know about it through one of my friends who would call it YouTube basically came to her and said, Oh, you know what, somebody called this Geeta Menon. Is that line to be the Head of School of Ophthalmology? Can you imagine what a crash is going to be? Because she doesn't even know how training happens in the country. So it was upsetting? Of course, it was upsetting to hear things like that.Jane Dacre 21:02
That sounds like open discrimination, doesn't it? Yeah.
Geeta Menon 21:06
I know. And, you know, can you imagine having a whole group of them sitting there, of course, they were, you're part of me know that they were all upset about the separation, they didn't want to kiss to set up their own schools. So that was there as a part of that thing, but and so. But anyway, I decided, you know, there are people who think I can do it, so I need to try it. So I applied for it, and they got the job. And, and I have my way of dealing with these kinds of situations is usually by saying that, you know, I will show these people with my action. If they think that I'm not good enough, I'll show them with my actions that this is what I can do. And that's exactly what I did. I set up the school of ophthalmology, which actually had the best induction program for SC one trainee, which was then taken by the Royal College across the country. So you know, I thought, and so then the Associate Dean for study came up, which is then when I went to apply for that, and while also the Associate Dean, the postgraduate Dean in South London came up. And I remember that time Graham Dewar, the postgraduate Dean for kiss, at that time, calling me too often Sangeeta, I think you should apply for this role. And I was like, Graham, it's in London. I've never worked in London, how can I apply for that? And he said, No, I think you know, it's a good opportunity, and you should give it a try. And I remember ringing up my Andrew, because Andrew used to be kind of my mentor. And I said, Andrew, what should I do? And he was like, Geeta, is this in your five year plan? I said, Yeah, I think my five year plan, but not now, you know, where you suddenly have to give up a lot of your clinical work and, you know, go into education. He said, No, these opportunities only come that you don't come very frequently. And important thing I want to understand from you is, are you saying you're not applying? Because you think you don't get you won't get the job? Because that's the wrong reason? You know? You don't actually. So I remember then coming to the interview, and J, and I'll never forget that up. So you know, I've got this little bag here. Thing leaving boomin? Yeah. So I ended up coming quite early. As I was the case, I'm always early for things like this. And I was sitting there, it was very cold February morning. And somebody came and gave me one of these badges. And I said, Oh, what is this? So he said, Oh, you know, we're celebrating 150 years of women and education. And I wasn't nervous. And I can you know, I'm always nervous. Before interviews, I hate it. So I said, Oh, wow. So he said, If you want to learn more about it, we've got all these posters just at the back. And so I thought, okay, so I went to look at those posters. And in there was the three women. One No, sorry, one in was a Japanese costume. And another one in, I think, from Iran. These are three people who had come 150 years ago, and you know, studied here. And I thought, my God is dope. People can do it 150 years ago, kita. Come on, you can get thisJane Dacre 24:24
interview. And of course you did. Yeah.
Geeta Menon 24:30
Yeah. So that's why you don't need to report
Jane Dacre 24:33
brings you back up to date. So just a couple of questions. So you've moved around a lot and you've obviously been very passionate about your career, but you've also got a family. So how does that work? How do you make that works? I think a lot of people who listen to these podcasts are struggling really to work, how to work out how to make career and family sit alongside each other. Well,Geeta Menon 24:59
you Yeah, so I think that the, the important thing is that I did take that step back for six years, because I absolutely wanted to be there for my son. And I don't think I would have done it any differently. Even, you know, going back again, over that journey, I also have an amazing husband, really lucky, who's very supportive, and absolutely supporting me in everything I do that that's important to have that family that, you know, because family always comes up. That's what I always say. And even today, you know, I've got two grandchildren. And so you know, even in my busy life, when they are there, they take priority, and I absolutely need find time for them. Life doesn't stop does it. So you need to make sure that you don't miss out on all those moments that you're with your family. And I'm lucky now that at the moment, I took that six years, step back. And that has really helped me because now I have this is my time, this is a time that I can actually do what I want to do. And it doesn't mean that I have to, you know, compress everything into the into Kenya's into, you know, all of what I want to do. Research is something that I'm really passionate about as well. So I do, you know, split into new doing personal research, as well as work in the NIHR. But I think family is important, Jane, and you know, there are times when you have to take a step back from your career. And, you know,Jane Dacre 26:36
you're obviously a role model for others. What do you what would you say to those women coming through? Is there any message that you might want to give to women who are listening to this to inspire them?
Geeta Menon 26:51
I think that if you actually have that, get that perseverance for what you want to do, then you'll always get there. Secondly, I always feel that you should take on things where you think you can make a difference. Because that really helps you. And you know, never listen to somebody who tells you you can't do something just because you're a female. Yeah, just absolutely make let your actions speak for themselves. Don't want to argue with them. Don't do anything to say that, Oh, you know, you're wrong. Just let your actions speak for themselves. And AnkitaJane Dacre 27:27
finally, who are your role models?
Geeta Menon 27:32
Gosh, I've got so many of them, then you're one of them. You are and I think I think I along my along the way. I've had a lot of people who have been amazing role models in my during my medical school, my postgraduate training, but all along, I think my mother is probably the most amazing role model I can ever have. She's one of those people. So I think I've learned on my resilience from our amazing women. Yeah.Jane Dacre 28:03
Fantastic. Well, Gita that was a wonderful story. Thank you so much for sharing it with us.
Geeta Menon 28:10
Thank you. Thank you, Jane. Thank you so much for asking me to do this. I really enjoyed it.
Jane Dacre 28:16
Thank you for listening. There are many more medical women talking in this series of podcasts.Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you
- Episode 8 Professor Helen Stokes Lampard
Medical Women Talking podcast - S01E08 Helen Stokes Lampard
Speakers: Jane Dacre, Helen Stokes-Lampard
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening.Today, I'm talking to Professor Dame Helen Stokes Lampard. Helen is an extraordinary woman who started in medical politics as a student, and then went on to become the chair of the Royal College of General Practitioners. She's currently chair of the Academy of Medical Royal Colleges, and is able to balance being glamorous, being articulate, being high profile in the media, and also having an extraordinary career in academic general practice. So just to start off, Helen, could you take us through your career journey, and we've edited highlights? So tell us how it started and how you how you got on maybe start by by saying, Why did you choose medicine?
Helen Stokes-Lampard 01:59
Okay, lovely. Well, I'll try and give you the truncated version. And so you'll pick up from my accent that I'm from South Wales, originally, I'm brought up in a reasonably tough area, it was a former mining community. But my parents were both teachers. So I'm not pleading poverty. But I went to the local, pretty tough, comprehensive school. And I knew I was reasonably bright and reasonably good at science isn't the fact my dad was a chemistry teacher was probably a good indicator that sciences would be of interest to me. But as I was growing up, I didn't really think I was bright enough to be a doctor. And I remember conversations when I was quite young, and but thinking at the time that actually dentistry sounded like great fun. We had a close family friend, but somebody would be my babysitter, in fact, who was a dentist, and she was five and glamorous, and that looked like a really great career. So by the time I did my own levels, because of that generation that did level, I was thinking of a career in dentistry, got an extremely good crop of results. And when I went to Sixth Form College immediately my a level science teacher started talking about medicine, I had to suddenly start doing my homework, then there were no members, my family were doctors. Although, of course, like anyone, I'd seen my share of friends and family have serious illnesses. So I really thought decided to go for medicine on the basis that if that didn't work out, dentistry will be a great second option. But then I realized the incredible potential of medicine would offer. I ended up going to St. George's medical school in London, which was just amazing. I was determined, being a teenager in South Wales in the 80s that I wanted to get out of Wales, to see the world broaden my horizons. And so London fitted the bill beautifully. I was incredibly happy at St. George's medical school in London and got very involved in Student Union politics. But when I'd entered medical school, I thought that what I would want to do would be gamey oncology. So Guinee cancer as part I mean, in retrospect, it was clearly because of the experiences that we've had a family friends as I was growing up with women's cancers. And nothing in medical school dissuaded me from that I was, I realized that I was definitely a people person. That was very social, I realized that I was somebody who got stuff done, hence my involvement with students unions. But as long as I was working with patients, I was pretty happy. I knew I wasn't going to be a lab scientist either. So I chose options that would help for that. I did my elective in gynecology work out in the Middle East, and started as a junior doctor. life got in the way and instead of staying in the London area, I moved back to South Wales because I was married to but I'm married to an engineer who got his first professional job in South Wales. And so suddenly, I was back close to home doing gynecology, and very happy. But then, of course, life's deal to a series of blows and swerves. And my husband had a very severe accident when I was a junior doctor, and was in a wheelchair for quite a long time, and also it was the time where there was a real chaos in medical training, particularly affecting gynecology. So we're talking now the late 1990s. And so combination of factors Made me re-examine what I was doing. And I think, probably the nail in the coffin we got a letter from the College of Obstetricians and Gynaecologists. All trainees say that there would be a five year hiatus before there would be any career progression. And that Belgium and Canada were looking for trainees, and we might want to consider options. And I realized the thought of staying five years doing what I was doing was going to be intensely frustrating, I was already getting frustrated, where I was itching to go further and go faster. And then my husband, I just decided to do something different. And he got a job in the Midlands, I think he was afraid of being the man and would have the accident and wanted to be known for something else. And I decided to retrain in Public Health Medicine, which is a little ironic, given I just told you what I love is being with people, but I was determined at this point, if I wasn't gonna fix them, one by one, I fixed the whole flipping lots of them in one go, hence public health medicine. But on my way to getting a training number in public health medicine, I accidentally found myself in an academic GP training post, the people who are looking to give me a number said, Do you need some experience in general practice, and there are these amazing, innovative academic posts coming up in Birmingham, they're piloting them, something like that, that'd be fantastic. And I generally, I just found my happy place, I started that academic post. And within weeks, I knew that I'd come home. So that was how I ended up as a GP. So the rest we can talk about, again,Jane Dacre 06:23
it's interesting that it was a set of circumstances rather than some particular role model, or inspirational, singular, or whatever, which is, which is actually quite unusual in the people that I've been talking to.Helen Stokes-Lampard 06:37
Yeah, I mean, I've skipped over so many other influences, and people I mean, I had some amazing educators in general practice in medical school, and then subsequently, and I was surrounded by a bunch of brilliant GP trainees, when I was doing ops and gaming in South Wales. And they all seem to have such fantastic perspective on things. And I remember some powerful moments and how they seem so much more knowledgeable about general medicine than many of my colleagues did. However, it was actually feeling as having a go at it that transformed it for me. And I think that brilliant balance of doing some academic work doing some teaching work, as well as that wonderful richness of what I would call traditional general practice where you could follow up patients over time, you could get to know their extended families and the society in which they're based. And it probably opened up in me the realization that I really care about people in their entirety. The body parts are fascinating, but it's whole people and whole communities and systems that really interests me. And that probably shaped my career direction, for a long way to come. But yet, serendipity played a big part in my career. And I have to be very honest about that. And it has continued to do so. But I suppose if I've done anything in that, it's to allow space for serendipity. I'm a very organized person. And, you know, I'm certainly not certifiably obsessive compulsive, but I'm very organized. And so I have to consciously make space to allow serendipity and and chance to factor in what happens to me can't plan everything.Jane Dacre 08:03
So you got involved with the college GPS at a relatively early stage in your career, how did it how did that happen?Helen Stokes-Lampard 08:12
So I mentioned involvement with students union when I was a medical undergraduate, and I ended up doing a sabbatical to run the Students Union at St. George's, and then 24, which is really interesting time. And during that it made me realize that because that also involved working with the Trans Union as well, because you're the BMA medical student rep as well. And I made a conscious decision. I was asked, I consider standing for the National Union of Students nationally, having finished my post and decided not to, because I realized that I wanted to focus on the quality and standard sides of college work as opposed to the Trades Union bit subsequently. So I'd always had in my mind, thinking I was going to opt and go, I knew that I'd reach out and try and get involved in the college Obstetricians and Gynecologists because what happened is I got into my training practices a GP, and discovered that one of the doctors there was involved in the local faculty and they they asked me to come along to meet him and said, it'd be a great way as somebody new to the Midlands to get to know some local doctors, make some new friends. And of course, before I knew it, I was co opted onto the board and asked to sort of help out and they encouraged me to stand as a national rep of the Royal College of GPS. And so suddenly, I found myself learning very fast about medical politics and the GP Lab, which opened my eyes to possibilities. And I think because of my previous experiences, I realized the power of doing things by committee the need to be very patient when naturally but internally, I'm a I'm a rabble rouser. I'm a pulpit Thumper to get things done. But actually, I've learned to dial down my energy and enthusiasm and passion to control it and use it by playing the game playing you know, doing it by committee and influencing from the inside. But that was a decision I made probably subconsciously to start with and then subsequently I've continued on that route because it seems to work for May,Jane Dacre 10:01
which is and so you then continued your career in parallel, really in the College of GPS. So why did you decide to stand to be chair?Helen Stokes-Lampard 10:12
Well, I think I didn't, I didn't set out to be chair of the college GPS and because the GPS is different from the other colleges, and that they have a chair and the president, but the chair being the equivalent of the President and other colleges, I so what happened was I originally was sort of I did some regional stuff having been trainee rep. And then I was asked, Will I be regional treasurer. And a great way to know any organization is to learn about the money. So I became regional treasurer and be through that I got to know national financial stuff with the college and a position came up on the audit committee nationally for the college. And my husband was an engineer. And he'd been a national quality auditor. And I remember talking about him say, you've been really good at this and said, you can this is a despite your energy, you can be very analytical and you need to be, he said, it'd be good for them to have somebody who thought about auditors more than the way you medics generally do, which is often just tick boxes about patient care to think about auditing the true sense. So I stood for it and got it and I think they were a little surprised that this relatively young female and appeared from nowhere. And certainly I stood out in the rooms when I attended the early meetings I made my face was unlike other people in the room. My accent was like other people in the room, but they were incredibly welcoming. And I think perhaps the enthusiasm abroad landed well, and then in time, I was encouraged to stand for national treasure to the first. There were many jokes about being the first woman with a college checkbook at her disposal. But it was an amazing time because the college had just purchased its new headquarters, we had a financial model that needed to be fulfilled in terms of taking a conferencing and hotel facilities, estates management, I'd actually enjoyed learning about different things met all these amazing people. And suddenly I was working closely with these incredible inspirational role models, both within our college and then starting to see them from around the wider landscape. So no plan. Gerardo was chair of our college when I was first elected as treasurer we had our president was Iona Heath, we had amazing people like David Housel, Mr. Mike Pringle and Steve field were around me. And then Maureen Baker became champ people started tapping me on the shoulder and say you should go for this, you should think about it. And it was when Maureen Baker was chair, she encouraged me to have a go at the media side of things. Because because of the flexibility of my academic job, I could do media on Mondays, which they were the GPS could do. And suddenly, I started doing media things and realizing I could explain things fairly clearly in an hour. So that's all good general practice is about explaining complex things in ways that are accessible. And it just took off. And I think I wouldn't have stood if people hadn't tapped me on the shoulder. And I think that's a lesson I've taken forward in life that if you don't encourage some people, or hold a mirror up to them and say, you know, you could do this, people won't think it for themselves. And those are often the people you want to be doing these roles. And then the morning I woke up having been elected by a very narrow margin, it was a very strong field. I remember lying in bed thinking this overwhelming comp, you know, this sort of insecurity and inadequacy, poring over me thinking, What on earth am I going to carry this off? But I guess if people don't have those kinds of complexes, they're probably more the ones we have to worry about than the ones that do.Jane Dacre 13:31
Well, and absolutely. So how was it then being the chair of the College of GPS, it was? Well, we were we were around a little bit together, we overlapped together, it was quite a turbulent time. And so I suppose it always is, how was it?Helen Stokes-Lampard 13:45
Oh, you're very kind, generous to me, Jane, and very supportive. And I shall never forget that. So thank you. It was an amazing time. I mean, I'm not everybody enjoys leading a college, I think that's fair to say. I certainly did. And I, when I came to the end, I remember reflecting that 80% That it was the most amazing job I could ever have wished to have done and probably the best job in the world. And 20% of it was hell on earth. And it was truly awful. And I think those extremes and that passion and response to that brings out for me and gives you a flavor of it. You know you are so when you are the very visible leader of your tribe, a very big tribe in both our cases, and you become personally attacked and personally vulnerable. But you are also in such a privileged position to get stuff done to influence and also to inspire and encourage those who need it. So certainly general practice was in the doldrums at the time I took over when people told me I was completely mad to entertain the prospect of standing. But you know, during those few years we did turn around the tide of morale. We did something again passing up swinging people being prepared. To apply for training places in general, we couldn't fill the jobs back in 2015 16. And suddenly, all the training posts were filled and we were filling more than ever. And by 2019, we got the government, the government, sorry, NHS England, plus the government to agree to the biggest single cash injection into general practice in the history of the NHS is part of the long term plan. Of course, now, a few years on, those things quickly get forgotten as so many other trials come along. But I do feel that I made a positive difference in some ways. I learned so much, I met so many amazing people. So best time in my life, probably.Jane Dacre 15:38
I think I probably agree with you about my time at the College of Physicians, I'm a great fan of being involved in Medical Royal Colleges, there's something about having somewhere else to go to when life at the coalface is a bit is a bit difficult. But as a glutton for punishment, you went on to the academy, and then had to deal with COVID didn't you. So tell us about that. Yeah.Helen Stokes-Lampard 16:00
You know, Jane, as we look at our careers, it's back to this serendipity thing, and we don't know what's going to come up and what's going to happen. And when you get to senior roles, as we both well know, some things go your way. And some things don't and you apply for some things and don't get them. And it's always interesting. I think when talking to junior colleagues, they seem shocked that when you're quite the senior position, you don't get everything you go for, but it's it's just part of the landscape. It's whose fit face fits at any one time and I went for one senior role. I didn't get it. But it was hugely supported by recruitment agents. And it helped me learn more about myself and what I wanted to do. So I stood for charity Academy for people not aware to head at the academy, it has to be somebody who's headed up a royal college previously. So there are at any one time only 20 or so people who are really eligible to stand.Jane Dacre 16:49
But of course, the sorry to interrupt just a quick sentence or two about exactly what the academy is not sure everybody knowsHelen Stokes-Lampard 16:58
that the Academy of Medical Royal Colleges is probably the most important medical body that most doctors have never heard of, and certainly in the wider public has never heard of, but it's the umbrella body that brings together the 24 Royal Colleges, colleges and faculties that set the standards for people to become consultants at any one discipline, other sort of rough, loose sort of way of defining it. So it includes all the Royal Colleges, which which there are colleges in Scotland, and Ireland, as well as the ones we know are called based in in England. But there are faculties and we've got faculties and public health medicine and rehabilitation as well as colleges, Royal Colleges of Ophthalmology. So there's a whole breadth of medicine is in there. And those colleges in turn represent over 220,000 doctors in the foreign nations of the UK and Ireland. A lot of our work as an academy is behind the scenes on education, so ensuring sharing of information about education standards, and so we work with bodies like the GMC. But also a really important role is collaborating to put a unified voice all about big decisions. So sometimes that's clinical matters. So the standards for diagnosing death, for example, are owned by the Academy of Medical Royal Colleges, something that cuts across all disciplines. And there are others where we collaborate in the common good. So of course, when the COVID pandemic came along, suddenly all the colleges all the disciplines need to work together in new and innovative ways. The Academy played a massive part now, I came into the academy and as chair in officially in July 2020. Well, of course, we were well underway with the pandemic by then. So it was my predecessor Karen McEwen, who got the ball rolling in terms of setting up structures. But it has been a remarkable few years subsequently, keeping the college's together at times when their members have wanted to pull apart you can imagine the tensions that there have been across different disciplines, some not able to operate when they wanted to. Others completely overrun whether it's a a&e or intensive care, community feeling forgotten about and abandoned with a huge upswing of demand and a huge negative tide from the media. So they've been lots of different challenges. But you know, working with the leaders of those disciplines is the biggest privilege. They are phenomenal individuals, when rightly so you'd expect colleges to intellect and select some of the brightest and best. But 24 individuals are the brightest and best don't always work well together. And what's been brilliant is how they have done so for the good of their colleges and the good of the public.Jane Dacre 19:30
That's fantastic. So we've talked about your career and your career to date, what what helped you along the way and what happens? How do you deal when things are maybe not going quite so well?Helen Stokes-Lampard 19:45
Great fast. And so, you know, I always say that I learned more from failures more often when things go wrong than you do from the successes because those are the times when you really have to stop and think about what's happened. So how do I deal with it when things go wrong in lots of Whereas with a small, little irritations it's you know, it's a personal hygiene fantasies, what do we do to keep ourselves safe and well, I love my garden. But if I, if I need to sort of do something physical and get outdoors, I love being outdoors. Many years ago, that came to the realization that if I don't get some fresh air every day that I'm a bit like a plant, and when wilt. So mind you, I did use that as an excuse to buy myself a convertible car at the time. But I've never been without a convertible sitting. So you make of that what you will actually, friends and family are so important to me. And I have very strong groups of friends, but different groups of friends, you know, so GP friends, some old university friends, some friends far away from medicine, and a very close group of friends who've gone through senior medical leadership experiences that I have. And knowing that you've got people who've got your back, who genuinely care about you, and are in competition, or they've got no reason to be anything other than support that is very powerful. I'm very lucky I've been I've been married many years, and my husband is wonderful. We don't have kids. And that's an interesting one, as all female leader, we didn't have children by choice, that there's no tragedy behind that. And at certain stages of my career, that's felt like I've been a bit of an odd one out. And nowadays, I think it's much more acceptable just to say it's just not right for us and our relationship. But the pressures that it brings both directions are significant. And I think we do need to be quite open and talking about those because, you know, my many friends and colleagues who had children have had to make sacrifices that are particularly acute for a few years, and that's fine. But it's not that it has changed their career, because it's merely slowed things down a little bit for a few years. And I think, being quite open about that with one another is important. And what else do I do to deal with really no, and when it's really difficult, and I am upset, I'm lucky, I am naturally resilient. So I, when you do the sort of in depth personality profiling, I know that I am very empathic and sensitive. So I feel things very hard, I feel things very keenly. But I am lucky, my natural resilience is that I bounce back quite quickly. So if people are mean to me, or I fail at something, I take it very hard, either go away, lick my wounds, and bounce back relatively quickly. And I think realizing that about myself. So I think that how you benchmark yourself against others was helpful. Because sometimes you see situations where you couldn't understand why others weren't as upset as you were. And yet, two weeks later, they were still in a bad mood about something. Whereas I did that for 4872 hours and feeling really wretched. And it was all over from behind me. So I think there's a big thing about getting to know yourself and taking feedback, and using it to build a picture of who you really are, as opposed to who you think you are, or indeed who you want to be.Jane Dacre 22:52
That's very good advice for people coming through. So Helen, you are moving on from the Academy in the in the summer, any idea about what we might? Well, we might expect to see you next or is that secret?Helen Stokes-Lampard 23:08
I genuinely don't know, myself, Jane. And I do know there'll be no more places in colleges for me because I have there is nowhere to go. I have loved my time working with the Royal College of GPS of the academy has been incredibly fulfilling. But it's time to move to something different. You know, theoretically, you know, I'm still a GP part I've stayed a partner in by surgery throughout all things that I've done. And I've stayed a professor at the University of Birmingham, although I think they've had a pretty poor daylight to it, as they haven't seen a lot of me, of late. So far a will be back working with them. But I am open to see what the future brings my passion. You know, we haven't touched on the work I've done setting up the National Academy for social prescribing, which is now quite a big, thriving, independent charity, looking at all the stuff that's good for our health and well being was out with what the NHS and social care offer. So the advice, the guidance, the green spaces, the sport and exercise, and all those things that help us live more fulfilling lives. I'm a trustee of Macmillan Cancer. And the stuff that really excites me is about through whole person care and building better society. So if somebody can offer me a job with bundles that lock together, I'd be all ears.Jane Dacre 24:17
Well, you never know, you never know. So as we're coming towards the end. Now. Is there anything that you would be able to say to maybe people who are listening to this podcast who might want some pearls of wisdom for you about what you think is important in having a successful life and career in medicine?Helen Stokes-Lampard 24:41
So I think that first point to reflect what I've said a few times is about getting to know yourself, how do you work what, what what lifts you up and what drags you down? And so making space for the things that lift you up and being aware of the things that drag you down and compensate for them, having great support systems around you. So that's friends, family, whatever it is. so that when you need it, you know where to go, making space for serendipity. So being open to opportunities, and when you know that you've got a gap, or you're looking for something actively going looking, because whilst things will land in your lap, as a doctor, we're really lucky how many opportunities do come up, we certainly have to have our eyes open and ears pinned back to look for them. I've always been nice. I think that served me very, very well. And I have a mantra, which I often use with students and training, which is that work on the assumption that everyone you work with is lovely. Some people will hide their loveliness. And this applies to patients just as well as it does to colleagues. But fundamentally, it's not a bad starting point, because it really does put you in a positive frame of mind at any interaction. Always keep confidences, people will never forget if you breach their confidence or lie. And I think at the end of it, you've got to be true to yourself. If you're being asked to do things that really undermine your personal values. You won't sleep at night, and only you know what your personal values are. But so, yeah, know your red lines and don't cross them.Jane Dacre 26:13
That's wonderful advice. So, Helen, thank you very much for talking to us today. I'm sure people will love to listen to you.Helen Stokes-Lampard 26:21
Thank you, Jane. It's been a pleasure.Jane Dacre 26:23
Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.- Episode 9 Professor Wendy Reid
Medical Women Talking podcast - S01E09 Wendy Reid
Speakers: Jane Dacre, Wendy Reid
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening.Today, I'm talking to Professor Wendy Reed. When she started her career in obstetrics and gynecology. She went into this because she was so overwhelmed at seeing her first baby born when she was a medical student. And since then, she's continued to have an interest in obstetrics and gynecology. But she also moved into education where she felt that she could do more. And she rose to being the medical director of health education, England. So she managed and organized the education and training for countless trainees. She's now working for NHS England, and is going to tell you about her career story. Wendy, thank you very much for joining me. It's a pleasure. And what I'd like to do is to just ask you to take me through your career journey so far. So over to you.
Wendy Reid 02:02
Oh, goodness. Well, first of all, it's a real pleasure to do this. And it's always interesting when you look back. And sometimes we talk about our careers as sort of when we became a consultant or something but, but actually, I think my career journey really started when I was back at school. I went to a very strict all girls school. I was quite academic, but I liked music and sport. I was a sort of one of those all rounders and hadn't really got much of a direction. Apparently, I'd always said to my parents, I wanted to be a doctor, but didn't have much idea what that meant. And I was really lucky, I went on a school's exchange program to New Jersey, just outside New York when I was 16. And first of all, it was the first time I'd ever seen boys, because it was a mixed High School. And I wasn't doing Latin and you know, history. I was doing film studies and philosophy with a very mixed school of three and a half 1000 in quite a deprived part of New Jersey at a time when it was the last draft for the Vietnam War. And it was just from Watergate has happened. And I traveled up and down the East Coast with my student friends and enjoined a march against the Vietnam War. One of the people in my year because we work with kids a couple of years older than us just has different schooling. He was killed in the last draft. And I came back after term and a bit to my English strict girl school, I cut my plaits off, I'd got a crew cut, and I was chewing gum. And my headmistress told me, I got two weeks to lose the American accent. But it made me realize that there was a different world out there. And I was different. And I then I think it gave me confidence to sort of decide what I wanted. And I wanted to be a doctor. And I was made head girl, which was my first leadership appointment. And I had no idea I was going to be head girl. I think if I'm really honest, I probably wanted to be, but again, I had no I didn't articulate the reasoning behind this. But as head girl, I was really keen that you were a girl school and what did that mean? And I remember starting to understand feminism, starting to read things that this was way back in that, you know, Andrea Dworkin days and that sort of thing. And feminism was was exciting, but quite quite scary. We could be very safe. But I think having been to the States, I was prepared to speak up for that. I didn't do very well in my levels. And I had a place at Barts and they wouldn't give it to me because I hadn’t got a good enough grade in my physics. I remember being completely distraught, and having great parents that said, Do you want to do this, if you do redo your physics on apply, again, just completely straightforward. And I ended up with the Royal Free, which was unbelievably lucky, because they're all free in those days, still had a very strong female history to it. I met the brilliant professor anatomy. And she was the first really influential person apart from my headmistress at school. And Ruth just decided we could do anything. I wasn't terribly good at medical school, in the sense of exams, I had an awful lot of fun, did lots of music, lots of sport, met my husband. After three weeks, we got married in my final year. And then dean told me that first of all, my marriage wouldn't last because nobody wants to be married at that age. I was 23, the day I got married. And I want to be honest, just getting accomplished and that was useless if I was going to be married, and that my husband wasn't terribly good. He wasn't very impressive, he wouldn't make anything himself either. I'm very pleased to say that we're still married for three years. And he's a very successful GP, I think I've done it. Okay, so I prove that wrong. But it was Mexico wasn't. I wasn't really comfortable medical school until I did obs and gynae. I went to medical school to become a psychiatrist. I obviously loved psychiatry. But I hated the fact that everybody smoked. So quite a facet of reason. But I find it really uncomfortable. You come out stinking of smoke. I absolutely hated the postcode lottery. I couldn't believe that the first thing you did was look at somebody's address to decide whether you would accept them as a patient or not. I found that really challenging. And so I spent the first year and a half of clinical training, very anxious about what was I can do. I wasn't terribly coordinated. I couldn't hear very well. So stethoscope, it all said all a bit confusing. And then I remember sitting in the pub, opposite the Royal Free which these people might know that hospital it's very close. And it was at one point where all the doctors used to hang out. I remember sitting there as a student that day before doing obs and gynae thinking, God, this is going tobe absolutely awful. You have to do things you have to be practical. And on the first day, I was being shown around the Labor Board as well as little tools of scared medical students. And this midwife called Vicki Cassidy came out of a room said I need some help and grabbed me. And I ended up putting gloves on badly and again, those either tried, you know, when you're stressed, you can't put the surgical gloves on. You look ridiculous. I helped deliver a baby. And it was genuinely a Damascus Road experience. And I honestly never left labor ward after that. I don't think I did much more in medical school. I hung around labor ward. delivered babies did locums for house jobs in Guinee as you could do in those days. And I just knew that this was something I wanted to do. I had no concept of what the career was. I didn't know there was a royal college and I didn't look into it logically at all. I just knew that delivering a baby was the greatest thing on earth. And actually I still think is so I did my sort of my training at the Royal Free one of the consultants says wise man said you're a woman. They weren't think you could operate going get a general surgical job and prove them wrong. So that was probably the first career advice I'd had good advice personal delivered in the way we would these days, but it was good advice. So went to Brighton and did a year surgery, vascular surgery, cataract surgery and plastics, which is brilliant fun. And then I got on to what was then the rotation of choice of the Queen Charlotte's rotation at that point. 80% of consultants south of Birmingham been through Queen Charlotte. So it was a production line. And so this was an unbelievable experience because you were there with the best of the best. I mean, the people I was in all of my colleagues, they were just brilliant. The teaching was fabulous. And it was relentless. You weren't allowed any leave. And you were six months. Their annual leave was the end of your job. You got three weeks off at the end. That was it. We worked shifts, really intense shifts. But I learned the trade. And I had the opportunity of working with a dozen or more consultants or men of course. And so you saw different styles and different approach Choose. And then I went to the hostel for women's Soho square, to do my gynae. And that, again was a gynae factory. And by then, I was lucky, I realized I got a good pair of hands and operating I could think three dimensionally. So I love that did all the rotations ended up at the Royal Free as a senior registrar and got a consultant post at the Royal Free. And then I sort of looked around the thought, what's next? And indeed, the night I got my consultant posts, my mum and dad and husband were in my flat and we were celebrating, and my father, who knew me quite well turned round and said, what are you going to do after this? I was like, I've just got a teaching hospital consultant or dad in what else is that he was quite right, because actually, very soon, I realized that that wasn't enough, I wanted something more. I'd always been interested in teaching. In fact, I sought an ethics teaching program, but they're all free, because there wasn't any. And as an obs and gynae senior registrar, you know, we deal with ethical issues all the time. But I'd never formalized that thinking. And I got involved in some college work. And it struck me that even knowing more about this was really important. And then I met a couple of really influential people, one of them was Ujjain, and started to understand the academic structures behind assessment. And the so what is the purpose of the education that we're offering people, and it was the so what that really got me interested, and the fact that education is so much more than doing things, and much of my training has been about doing a procedure. Well, having managed this having seen that, when in fact, of course, the job, particularly upset isn't going to college is about communication and empathy and understanding and kindness and all the things that make a professional.Wendy Reid 12:00
And I then had a decision to make because I was very kindly offered a senior lecturer, I suppose as long as the Senior Lecturer anyway, I was offered to see who he was posed, or to say in the NHS. And that was, that was a decision that was quite hard to make. But I have academic leanings, but I'm not an academic. And the senior lecturers role was not something that I felt would give me the breath that London teaching us to do. And in those days, we have our own research fellows, we have our own systems. So that time a teaching job in London, I suppose most master's degrees to PhDs did active research, and teaching caring, we we weren't divided into academics and service, it wasn't like that. So I stayed in the NHS and went up the college ladder, regional advisor, got involved in the exam committee. And I remember the first exam committee asked me a question about how we set the pass mark, which I think you know, I've shared with anecdotes with colleagues like you in the past day, but you're setting the pass mark was in those days, just when it's always been 75%, or whatever it was.
And so being able to bring in evidence base to something as venerable as the membership exam, was really quite important, and I don't think I looked at is as a leadership role, but it most definitely was, I think it started to cement in other people's eyes, the fact that I was prepared to do something quite difficult. I was prepared to work with others to get it done that collaborative approach. And when I said I'd do something, it would happen. And I think that's partly how you build your reputation is going to somebody's going to do and do it. Makes sure you deliver. And then I was telephoned one afternoon and asked why I hadn't applied for an associate postgraduate Dean's job in London. And I was like, Well, I hadn't really thought about it. And actually, when I didn't think about it, I realized that that was sort of what was missing from my consultant posts was that chance to influence on a bigger scale. I've always been interested in systems and a wider approach than just my team. And so I went for the interview. And it was one of those job interviews where as a candidate, I realized that I really wanted to work with these people. I'm not sure about my performance, but I was appointed to the job. And then that was where I really started to learn differently. So I had to learn about different specialties. I had to develop my negotiating skills because there were no there's no law levers. If you want to change things with a royal college, you've got to be able to make the case. I was lucky enough to manage pediatrics and anesthetics nationally. And of course what that gave me was a whole new cohort of friends and colleagues, both in specialties that are quite forward looking in terms of assessment and structures and learning. And of course in pediatrics, women as leaders were quite common and it was fantastic. And likewise anesthetics and suddenly I met presidents of colleges who are women. And at that stage I had never worked for a woman until I went to the London deanery. So despite the fact I'm obstetrician gynecologist and had had a career in London, I had never had a female boss nothing. So my first female boss was surely heard in the London deanery. And Shelley was one of these she's a polymath. Yes, she'd been the chief executive of McHugh trust, she's a microbiologist, she's got a PhD. I think her Master's at university America is in philosophy. I mean, she's just extraordinary. And she was the person who introduced me to workforce planning, and workforce planning, it does sound a bit dry. But when I got my head around, the data is suddenly occurred to me, this was about patient care. And I didn't think I'd really quite put all of the bits of my career together until that point that I'm passionate about the individual patient delivery of that baby, the most important moment in that child's life for that month. And then the team worker, if you're setting up education, processes, that sort of thing. And then you academia, I didn't quite put it all together as about the system of how we care for patients and how we learned to do that better. And workforce planning, quite strangely gave me that insight that if you don't understand your workforce, you don't understand its choices, you don't understand how you get them to the right point, how you attain them, how you encourage them to do differently, you really aren't going to impact on patients positively at all. So I got very interested in that. At the Royal Free, we were struggling with the cover at night, because we had 6570 young doctors sleeping in law school at night, or being called for different things randomly. And we were facing the reduction in doctors hours called the Working Time Directive. And I thought, well, yeah, we have five different medics sleeping in hospital night to do in five separate things on the same patient. So we developed a concept called hospital night, which has become a brand really. And we tested it out, again, massive support from people like Margaret Johnson, who was the medical director at the Royal Free, another really impressive woman in my life. And we tested it out there. And I didn't know how to run a change program in that sense at all. And so I learned on the back of that, that it isn't enough just to have the meeting and have everyone agree, you've got to then chase them down the corridor and say, Are you sure you know what you've agreed to? Are you actually going to follow it through? So that's a lot about program management in the real world then. And then, because of that work, got lots of invitations to speak, mobilizing an agency, as it then was, which is part of that. So I'm saying to the Department of Health, took it on, I got to go and speak to those people. met one of my old friends from medical school, then Hillary Cass, who was at Great Ormond Street as a consultant and then became president Royal College of Pediatricians and child health. Hillary was trying to implement hospital nights at Great Ormond Street. So it was really interesting, sharing that learning and working across those professional boundaries. And then, um, just before Christmas, I got phoned up by somebody from the Department of Health, and you get these sort of slightly strange phone calls. And they said, would I consider being an advisor to the government on the Working Time Directive, I said, Don't be daft. And they sort of will do think about it. I put the phone down. And it rang again the next day. And they said, we really think you do want some CFLs and we've spoken to all the colleges and they'll think you'd be great. If they never believed that, okay. But something in me said, yeah, actually, tired doctors, kill patients and themselves. And we're not different to anyone else. I don't care that, you know, maybe surgeons think they're different. They can do 100 hours a week. It's not right. And I've done it. I've worked those punishingly long weekends with no sleep. I don't think I did any damage, but I don't know. And the evidence is that we are not safe. And we're that tired. I also had a great friend of mine who after a long bank holiday weekend in Brighton, driven his car home and flipped it on the 23 lost a leg, much of his brain. And he had two young children at the time. And we were summoned to Chief Executive, it wasn't called that managing director at that time in the hospital, and told if we felt tired, we should stay in Brighton we shouldn't drive home. I remember the time thinking. That's not right. That's not how you fix these things. So actually, the Working Time Directive for me was much more about safety, and the safety of my colleagues and our patients than it was about the hours that we work the government, Europe or whatever it might be. And that was a lonely job, very lonely, because actually, the profession didn't want to change profession read, professions don't change. That's not their job, their job is to be conservative. But this was going to be the law of the land. And we had to do something. And so I learned how to work with Department of Health, and made some really good friends. They're really, really hard working public servants. I also like to work with politicians, some of whom were fantastic, sort of who were more challenging. But I have actually got considerable respect for politicians, because they put themselves out there, they have a job to do. And our job as the experts or the advisors is to speak the truth to them.
Wendy Reid 21:44
And to help them see how they can deliver what is their public mandate. It's not about taking sides or, or ruling over for them all over the terms we use, it's actually about being true to the purpose of your role. So there's a huge amount of fat that had great fun going off to European Commission presenting English data and realizing that Koto to Europe would do the same, but it was a very interesting experience. And then I came back into my postgraduate Dean job as I was there in London. And London was reorganizing. And I wasn't very happy actually. It wasn't it wasn't where I wanted to be. I was really thinking, do I go back to clinical work? Do I look for a role in a medical school, I wasn't really sure what I wanted. But I felt it was much more to be done in the postgraduate space. But London was taking the approach of a lead provider, which was you one big organization would run training for others. And I I, that didn't feel quite the way I supported apps, except it was what London wants to do. And I was the square peg in the round hole. I was lucky enough to be elected vice president, the College of obviously, at that time. And that was fantastic. Because first of all, it gave me that professional sense of belonging again. I love colleges. There are times to he when they've driven me crazy. But I love the thoughts of coming together for the good of the patients we serve. And yeah, all of that stuff that goes with that. And I had a really very happy few years there as vice president. And in that time, the outside bodies were formed after the 2012 reorganization, the NHS known as the Lansley reforms, Health Education England came along. I was in India on holidays. And my phone rang again. And it was a chap called Chris Well, she said prime you apply to medical director, he has autism, he goes eligible, and it goes get your application. So I sat in a lobby of a hotel, or one of these businesses, he's sending my CV and if any of you ever applied for a job to finish his job, you know, the trial that is I was lucky enough to be appointed first medical director and he. So I joined he is the medical director, and then became the director of education quality, which was important because that was a multi professional role. So for the first time I was responsible across the healthcare professionals, which is really exciting because much of the work elsewhere might have been about a wider clinical team, understanding workforce, etc. Don't work in isolation as doctors. So what's the point of being like the medical workforce if you don't have some clinical team context, so it was perfect. And this was the first time we'd ever brought all of the processes together in England, they'd always been separated either in two regions or locally. And there was a chance to change things and that's what I wanted to do. So, building the organization took three or four years. It was really quite difficult because not everybody wants To be put into a huge system. And working with the postgraduate Dean's and colleagues across universities, there had never been a single organization that said, what we want from medical schools was regulation. And there were individual medical schools for the be no NHS voice saying, Oh, actually, we want this. And the way the oversight bodies were constructed was that we have an annual mandate from the government. And our first mandate was that 50% of UK graduate, English graduates should go into general practice. Well, I had to think about how on earth we'd have those conversations.
And indeed, my first conversation with the very venerable dean of a very Federal Medical School did not go well. And so just being the right thing wasn't an argument that we could make. So what I like to do is to build a team and I have a fantastic team around me of real experts, and they range from data analysts, people that really understand quality people that really understand human factors and decision making all those sort of things, I've learned a huge amount from them. But we have to live a quite significant change. Big stuff from 5g Medical Schools, a source of around changing how women in medicine can take time off. And if you take time off, having funded returned, that you can go and practice your skills, you can check in and make sure you're ready to come back, and you're confident. And none of these things can happen without funding. And negotiating that funding is always challenging, but that's been my job. It's also been fantastic working across all the colleges, all the regulators, all the medical schools that have some big picture stuff I've really enjoyed. I think we were lucky in that we had a very consistent political message, because we had Jeremy hub, a sector safe and much of my time, although I have now worked with 13 sectors of sacred health and various national roles. But I have to say that the one thing about chairing that was the ALC really difficult questions. But you could have that discussion with him and say, I can't do that. But we can do this. And as a politician, that's his job is he's there to ask these difficult questions. But that consistency there, and the support from Department of Health colleagues, I think made he successful. And during that time, you know, my own personal skills have developed significantly because I've, I've learned a lot more about the other professions.
And we all have different cultures in our professions. And it's been fascinating working, particularly with Suzanne westrich, who's the chief professional Officer of ours, healthcare professionals, he's unbelievably impressive. But she has to work in a very different way to me with medics, and yet we're trying to achieve the same end. So we've both supported the advanced clinical practice work. And that's now delivering hugely, not only better careers for people with aspirations, but actually really important elements of ServiceNow. And see how Suzanne did it how I did it. That's been a really fantastic way to build things.Jane Dacre 28:28
So just a question for you, you must have had, you've talked about some of that a lot of the lovely people that you've dealt with, not everybody comes across as lovely. How have you dealt with the refuseniks? And the tricky customers?Wendy Reid 28:40
Well, I think, yeah, you in the room to send his healthy, you know, it may not be what you want, it certainly isn't often what I want. But actually, if you're in a room where everyone agrees with you, you're not you're not doing the right thing, you're asking the right questions. And dissenters often based on fear, lack of knowledge, a sense of being pushed into something you don't want. So we go back again, and we get back again, and we get back again and again. And I think sometimes you have to realize that it might actually be your style, but isn't working. And that's why I've got such a fantastic team around me because we can put someone else in that space, they might do better. So it's about not bringing your ego into those conversations, being clear about why you want something. And that amazing word that gets things done called compromise. And nobody has the right answer. There are a number of ways in which you can get to a right answer. And that's something I've learned through two years about working with and through and round and accepting that there are some things that are a great idea at the time, but you'll never get landed. So don't hang on to them move on, to cling on to the one thing and that's why these retrospect So looking back, you think, Gosh, I haven't thought about this for ages and need to think about that I'm not involved in it. Lots of other people are doing it. So I think it's Be generous with your, your ideas. Don't hang on to them because nobody owns ideas. Let them grow and flourish and be prepared to put them out of their misery if they're really not going anywhere. And that's how we've worked. We've had to work that out. We don't we don't have, you know, we're not we're not an organization that can buy things we don't we don't buy our way into things, what Rich, we have public money. So we've got to make sure it's really well, us. And in the public sector, there are people with very strong opinions, but also with brilliant ideas. So dissent is difficult. And sometimes, frankly, you just have to wait it out and say, We're not going to get this done in this area. This individual does not want to work with us less think again.Jane Dacre 30:57
So he has been incredibly powerful and hugely effective. And is now going to be merged into NHS England.Wendy Reid 31:06
Yes, so it's interesting. So yeah, I've always got some personal sadnesses because if I could have written my job description, when I was 15, I'd probably have written the one I'm in now, because it's just brilliant. I've been very happy and enjoyed successes and challenges and everything. But I actually think it's the right time, I think sometimes organizations continue too long. And what we did was show that education and training was a key enabler of patient care and patient safety. No one's gonna go back from that now. Everyone is now talking about workforce, quite rightly. And so I think now is the time to knit together that service planning, financial planning and workforce planning. If I had any worries, it's that it becomes workforce planning for the short term. Whereas my businesses workforce planning for the long term. But I think that we've created a cohort of individuals who've either been in he or worked with us or understand us, who know that if you don't invest in the future, you can't buy the present. So I'm confident that those relationships will survive whatever the structure is. And remember, it's not just us merging, it's a new NHS England being created. And I think, along with the risks, there are massive opportunities to actually say, what is it we want from a single national body? In the NHS in England? And those are questions I think everyone needs to ask as we shape it for the future.Jane Dacre 32:49
So actually, you've got to keep changing in order to keep keep thriving.Wendy Reid 32:53
I do I think, new people say, Oh, we've got colleges and medical schools have been around since the 12th century. Well, yes, they've all changed. You know, BARTs is not teaching medical students that we taught them in 30, whatever it was 23. Okay. So what changes is the lifeblood of a healthy system. Not change for change sake, but change that we lead. That's not in response to disasters, but it is about preparing for the future. I think it's this is the right turn at this time.Jane Dacre 33:34
Okay, so looking to the future, what's what's next for you what's on the horizon.Wendy Reid 33:40
So I've been very lucky to have the support of my husband over the last 40 something years. He's a GP, he's one of the few happy GPS apparently, but he loves his work. And over the last few years, we've been thinking about what we want to do, I certainly don't want to stop contributing. But I'd like to do it from a different perspective, I'd like to actually be in more of a support space to think differently, to have a bit more space to think through things I'd like, at one time with my family. I've daughter, I'd like to use some of my other skills in a slightly different ways. I'd like to sort of spend a bit more time thinking about the role of the humanities in health care education. I'd like to understand why we will not seek caring for people with learning disability and autism. I'm involved in a charity called Art books, where these are artists with learning disabilities and autism, and they're phenomenally skilled. But we're a charity. And we're tiny, and we're often all these artists have. So I'd like to do a bit more campaigning and passionate about what Men's role in society. I think we're at a dangerous time. Now I remember my father as a vicar campaigning for the abortion act in the 60s because he'd seen what happened to women who had backstreet abortions. While I was training, we still had women coming in with septic abortions. So passionate that women's rights need protecting. I'm involved in some women leadership stuff in medicine, I want to continue those sorts of roles. Because I think it's time to give back, you know, I've been very lucky, I want to give back some of us in support in those ways.Jane Dacre 35:38
So just coming to the end. Now, just one more area to ask you about is, is you've clearly had an incredibly impressive and successful career which has lasted for a long time, and often with women that results in them having to make compromises in their in their personal life. So can you just tell us a little bit about how you manage that work life balance and what's worked and what hasn't worked?Wendy Reid 36:05
Well, goodness, yeah, the compromise word again. So we have compromised, you know, I, I have never worked less than full time because it just simply wouldn't have be acceptable in my professional time. So I, I have one child, I think we might have liked more. But I'm very happy with what we've got. I spent a huge amount of my salary nearly all of my salary on childcare. At one point, I had a nanny, because there wasn't, there wasn't a nursery that opened the hours I worked. And I was a surgical gynecologist. So if an operation went on longer, you couldn't suddenly leave pick up your child. So lots of compromises financially that none of which I regret. And indeed, I don't think I would have done it any differently at the time. But part of what I've done in each year's campaign firm, much clearer support for people that want to work less than full time, and to be valued equally as the colleagues who are working full time. And I'm absolutely clear that, you know, if you've got your child's kindergarten play, that's where you should be. The NHS is big enough to cope with that. And we shouldn't have rules around that we should have a human approach to it. So those were compromises. I suppose the other compromises been, you know, I've stopped singing in playing an orchestra. Isn't that something music, I get huge pleasure watching my very talented daughter do these things. But I stopped being in a choir, because I just didn't have time. And does an awful lot of work happens over weekends. So things like just saying maybe it's my turn to take the dogs for a walk. And maybe it's my turn to do this. I'm quite tempted by trying to finally prove to the world that I have absolutely no artistic tendencies by doing something like a lot, of course. But yeah, just just living a bit and just taking a breather. We're massive opera fans in my family. And I can't tell all the times I've arrived at the opera, straight from a really challenging day. And it's only halfway through the first act, I realize what I'm watching and I've taken a breath, and then I've gone home, and I've switched on the laptop to finish off what I was doing beforehand. And actually see to spend time in the genius world of music or art without feeling that because I'm brushed off and finished something that that will be a real gift.Jane Dacre 38:39
And having had that experience and that successful career looking back now, is there a piece of advice to maybe younger women who are listening to this podcast?Wendy Reid 38:50
So I wasn't very good at taking advice, to be fair, I think often came slightly sideways about what you shouldn't do. And I think that's an awful thing. So I think where I've settled, is it some be curious if something feels that you might be interested in it, be curious and grab it and do it? And don't let anyone tell you can't do the job? Because, you know, why would they be even thinking that? So be curious and take some risks, because the worst that happens is that you are you're a doctor, that's the hardest thing you've done is becoming that thing called a doctor. And then we persist in saying to people you can't do that. And that's a bit dodgy and you won't get that next. Don't Don't, don't look at the status quo. Be curious and take your opportunities. I think that's all I'd say.Jane Dacre 39:51
Wonderful advice. So Wendy Ried, thank you very much for talking to you today. Thank you for listening. There are many more medical We've been talking in this series of podcasts please have a listen to some of the other inspiring women you'll definitely find something to inspire you.- Episode 10 Professor Cathryn Edwards
Medical Women Talking podcast - S01E10 Cathryn Edwards
Speakers: Jane Dacre, Cathryn Edwards
Jane Dacre 00:06
Hello, my name is Jane Dacre. Welcome to this Medical Women Talking podcast. Medical Women Talking is a series of recordings of informal interviews with a range of women doctors from different specialties and backgrounds who've had successful careers in medicine. I'm a proud physician, and I've had the privilege of a very fulfilling career. As I get older, and have reflected on my own journey, I've become increasingly passionate about helping other women to achieve their potential in medicine. Combining life and career can be challenging, and it sometimes feels extremely difficult to keep going. The women in these conversations have all found a way to thrive and have achieved great things. I hope that you will be inspired by their stories. The podcasts are available to download in any order, so that you can listen and be inspired whilst doing other things. Happy listening. Catherine Edwards is the first female Registrar of the Royal College of Physicians. She's a gastroenterologist by training, and she combines her work at the Royal College of Physicians with an honorary visiting professorship in South Africa. She's had an extraordinary career, and is going to be sharing some highlights from that with you today.Cathryn Edwards 01:32
Well, I think my career journey is like many other women's is quite serendipitous and accidental in in some ways, I, I once wrote something for the RSVP when I was a newly appointed consultant. And I think I called it the accidental gastroenterologist. And I guess I still think that was a very genuine and authentic title for a very short and piece which I did at the time, right, rather as a spoof, I think along the lines of the Bridget Jones diaries. But looking back, I think this back began as young as the age of 16. So at 16, I was very much Arts Humanities orientated. And I was naturally a good linguist. I enjoyed history, I enjoyed English literature. I was a bit of a musician. I had this flirtation with the idea that I might be an opera singer, which I can laugh about now. A lyric soprano, so that at the age of 16, my sick form, insisted on community service as part of Wednesday afternoon activity. And so I trotted along to my local hospice in Sheffield St. Luke's that was one of the first hospices after Cicely Saunders and London was an amazing, amazing place. And I was thought very quickly asked whether I would consider volunteering as a nurse in a nursing capacity. So I've gone as T bar, assistant. And there was a fantastic female nursing tutor called Adele Martin. I remember her very fondly. He said to me, we think you'd be quite good at nursing. Would you like to be a nursing volunteer instead of we will help you be an nursing volunteer. And I think I would say that was the first the prize of my very embryonic career that somebody had actually said to me, we think you might be good at this, because we like the way you talk to patients. And therefore, we want to offer you an opportunity. And I have the most transformative experience, working as a nursing vol, as we call them, supported by registered nurses, and over a period of the first two years before I went to uni, and then subsequently a further eight or 10 years, I think it was, I continued to work in the capacity of effectively what we now call a healthcare assistant, but learnt massively about clinical practice. But you became a doctor.Jane Dacre 04:34
So how did that transition?
Cathryn Edwards 04:37
So the transition was gradual, so I still went to university to read off, I went to read history, offering two languages to fit in with that skill set that I had been almost conditioned to. But I continued to read enjoy the practical vocational aspect of a skill set that I was surprised to acquire. And it became obvious to me that whilst I had originally thought I might end up I don't know, doing diplomatic service or, or teaching academic, you know, academic teaching or even simultaneous translation, all these sorts of Korea sort of crossed my mind, it became very obvious to me that actually, I wanted to do a vocational career. And I thought very seriously about doing nursing, but then suddenly had a Damascus moment where I realized that all the senior nurses I knew who were, you know, really inspirational in the context of the hospice actually got less than less patient contact, and more and more administration, whereas all the senior doctors that I observed, seem to maintain their clinical contact, despite their seniority in the hospice.Jane Dacre
Okay, interesting.Cathryn Edwards
So on based on that observation, I, I basically read medicine as a second degree after graduating. And with the intention, of course, that I would end up as either an oncologist of some kind or potentially a palliative care physician. So first surprise was that I learned that I could do science and I could do a vocationally based career. A second surprise then became when I ended up not being an oncologist. And I ended up being a gastroenterologist. And the surprise for that was about again, it's about self discovery, it's about learning about the fulfillment you can get from fixing something. So I always thought I was going to be a talking sort of girl. Maybe, you know, flirted with psychiatry, that sort of sense of communication and understanding, getting that getting under the skin of what we can offer a one to one making a difference. N equals one difference. But I also have this again, this experiences msho working on the gastro awards, and understanding the value of doing an intervention that could actually change a patient's journey. Originally, I thought it was the fixing itself that attracted me. I think I subsequently reflected that. It's not just the fixing itself. It's an IT being able to deliver an unpleasant test several unpleasant tests in a way that makes it easier. So you both fix and improve the experience. And it's, I can't quite decide the balance of those two in the in making it feel good. But it certainly became a valued part of my practice. And I've really enjoyed that aspect. And it surprises me to date that I still, if I've got a list, I think, Oh, good.Jane Dacre 08:09
That's an endoscopy list?
Cathryn Edwards
Yeah, yeah.
Jane Dacre
And so you never thought of being a surgeon?Cathryn Edwards 08:16
No. And I don't, and I and again, that doesn't, that very clear answer that I've given you doesn't really fit with what I've just said about enjoying the fic. I think I'm naturally quite dexterous. But maybe it's because my perception of the surgical specialties came with a level of no talking. No, no, you know, just the doing perhaps that and perhaps that was me misconstruing that. And I suspect it's something to do with the fact that I've just reflected back to you that may be the enjoy the most enjoyable bit of the fix thing is making the experience good rather than the actual. Yes, yes, it's quite fun putting on clips when people have got bleeding ulcers, but actually, it's more the fact that I can do that in a way that a terrified patient feels good about afterwards.
Jane Dacre 09:10
That combination, yeah, of course, your patients are not completely asleep. Which means you can still talk to them, ICathryn Edwards 09:20
suppose. Challenges your skill.Jane Dacre 09:22
So, how did you get into gastroenterology? Then you you've talked about how you decided that that was something you might want to do. What track did you go through?Cathryn Edwards 09:35
I think this again, is very sort of serendipitous that it's about it's about people you meet and clinicians you work with. And just as somebody said to me, we think you might be good at nursing. Somebody said to me, we think you might be good at gastroenterology had you considered applying for this. So again, it for the second time in my career, somebody asked me Had I considered applying? And I've, I've often thought, you know, we, we rightly now encouraged people to put themselves forward for things in a transparent and equitable way. But I still think there is a value for more senior doctors encouraging others, near peers, to put themselves forward when we recognize skills in them. Because certainly in my career, that's been very formative for me.Jane Dacre 10:31
You know, a lot of the women I've talked to have said that, and a lot of the women have said that somebody has said to them, Do you think you would like to or be able to, which is interesting, I wonder whether I wonder whether that's the same for them. And I wonder whether they have clear ideas? I don't know. Just Just one quick question. Going back to your, your your first medical, your undergraduate medical degree, did you do a postgraduate course or did you do a full? Did you do one of the shorter four year courses or a full five year just as of interest? Now,Cathryn Edwards 11:08
I had to do a six year medical course, because I needed to do that extra first book was called first because because I was humanities. So I did a total of nine years at university on the Greenway, which was quite a challenge at the time.Jane Dacre 11:27
You can imagine I can imagine. So then you got in to your career and went through your training first consultant post. Where was that?Cathryn Edwards 11:38
How did that go? There? My first and only consultant post, though, was Torbay in the southwest. Again, another serendipitous moment though. I did my undergraduate med at Newcastle upon time, fantastic course very clinically orientated which really helped me from day one. I did my postgraduate medicine at Oxford, and on an Oxford rotation, and I guess, again, thirds the price, fully thought I would stay in the end for four and four and 40 corridor. I thought I'd probably work in a large tertiary referral center because that had been my major experience. And as part of my own validation, my need for validation of my endoscopy technique, dropped off to Torbay where there had been a very inspirational and endoscopy lead who had come from Liverpool, and set up Torbay as one of the regional training centers in colonoscopy. on a par with the National Training Center in London, and actually at the time was, was competing for national endoscopy training status. And this particular consultant was recommended to me by my then the Fill supervisor who said, I know x, go and see him. He will he'll, he'll tell you whether you're good or not. It was free the days of formal jet, you know, ePortfolio training and endoscopy. So I had this masterclass day down in Torbay where I had the most fantastic time scoping patients with this incredible, incredibly skilled and just the pistol in a unit, which was clearly so much fun to work in. And it was such a fun element. It was the fact that everybody in the team effort there was it was palpable. And I thought, Oh, this is nice. And halfway through my first golden Oscar P somebody, the guy concern said to me, you're looking for a job. And I said, Oh, yes, thank you, doctor, but I but I'm actually I need to be near London or Oxford because that's where my husband works. So a year later, I was in posts having business.Jane Dacre 14:08
What happened to your husband? While he was the oneCathryn Edwards 14:11
that persuaded me to apply? I think, I think he recognized the benefit of working in a place with a good culture. He's a not a medic. So but he I think he helped me see the value of the culture replaced being something that was sustainable and would keep you working in the same place. Very wise very, very lives very wide.Jane Dacre 14:40
So um, you then got into some leadership roles. So how does it How long did it take before you thought, well, I need to do something more something different.Cathryn Edwards 14:51
So again, I would say that I'm not certain I did think that I was busy being a, you know, full time NHS consultant, I think I'm naturally curious. And I had some very naive ideas that somehow I was going to set up a whole research, you know, having done my D. Phil, I was going to continue, I was going to set up research and, you know, say almost single handedly, you know, you think you're going to pioneer IBD research in your unit. And I learned very quickly that you needed to use existing mechanisms, but I did did set up, you know, an early DNA and library there by collecting, collecting, effectively, blood of all our IBD patients phenotyping them, and then having that as a sort of an early biobank resource, which we then are then collaborated with the Wellcome Trust consortium, offering our samples for large cohort we had about nearly 900 patients at that stage we collected and phenotyped. So I, I was busy getting on and doing that diversifying practice, specializing practice within my own unit. And because of that subspecialty interest and the challenges of delivering long term patient care is over. Because you know, the debate on how you do deliver good care for chronic disease has been ongoing for as long as I can remember in the NHS. And again, I got asked to come and give a view. It was actually in the Dorchester library at the college, would I come and present a view on ideal, you know, ideal care systems for patients with IBD, using IBD as a paradigm. And I don't know if you remember, Jane, it was back in the days of do ones and share. It's making me sound very old here. But and I remember, it was an all nighter. It was one of those things a bit like an essay crisis. I got asked to do this by a senior colleague, national IBD senior colleague, typically saying, Oh, I'm sure Katherine could do that. And with very little notice, and having been on call all weekend, I then decided to change my presentation at the last minute. So I did sort of all my essay crisis, presented at this meeting, feeling very out of my depth, and I kept thinking, what am I doing here. But as a result of that, other opportunities opened up, and people that we wondered, had you ever thought of standing for putting yourself forward for an I've always found that very difficult to put myself forward? It gets much help, I find it much easier if you're invited. But on this occasion, with a very light, you know, had you thought about it was the first time I actually sat down and and prospectively made myself go through a process of thinking about what I needed, what I felt I could contribute. And I remember having a conversation like this with senior colleagues, who knew me well, and might give me feedback perspective on whether it was realistic. So it's that classic coaching, ask, you know, why? How is this realistic? Neck debt? And I remember several of those conversations, which were extremely, extraordinarily helpful. And I felt, I think I felt most proud of myself by actually having the courage to have those conversations. Because one of the answers to those conversations would be that's completely unrealistic. CatherineJane Dacre 19:01
will have been told that of course.Cathryn Edwards 19:07
They go, right, Jane, that's there's something about a dual level of journey here, it's fine to have the external opportunity. But without the internal development, understanding self awareness, self emotional intelligence, let's just say that without developing that, I think in yourself and actually, you know, having those honest conversations with yourself, I don't think you can actually make good decisions. But this is the first time I've thought about actively doing it that way. What are my resources? Who can I speak to? Is this realistic? Those are the sorts of questions I really positively asked myself at that that first opportunity and it was it was Stanford's secretary of the British society of gastroenterology, which was my again A bit of a theme going on sort of first female registrar on the Oxford rotation then the first female Registrar of the, sorry, the first female secretary of the BSG. And subsequently the second female president and then first female registrar, the college. So there was a bit of a theme, which I have got a bit bored with over the years, because it's not the great it means that if you're still if people are still talking about it being the first that that worries me, because it should be the norm. Not, not the first.Jane Dacre 20:34
Sadly, though, we've got a few more firsts to go through until it until it reaches the norm. So when you became secretary, and then and then the female president of the of the BSG. How was that? Because presumably, that took you away from your clinical practice and from being at home. How, how did that all work out?Cathryn Edwards 20:59
So the secretary job, which, which is very operational, it's not dissimilar to the registrar job at the college, it's very much the stuff to do organizational part of the society was a great opportunity to learn how the organization ticked. And that's something I've really, really took on board I, in retrospect, I would never, I don't think I've been able to be president of the BSG. Without the four years, I did as secretary. And as the Secretary, understanding what made the organization tick, what made the membership group tick, it was really important learning curve. But you're right, it did take me up to London. But I was doing it alongside a full time clinical job, which I compacted. So I did a little bit of compacting into, into eight sessions. So I had a, I had a clear to SBAS that I was allowed to actually do offsite in London, it needs to be. And so my learning from that was that that's an impossible, unsustainable way of doing medical leadership roles. Because, you know, it was busy. Certain times of the year were busier than others. But even though it was a busy job, I didn't, you know, I was still doing my general medical on call on my GI on call. So I would say that the job that most impacted on on me and my family. I've probably, realistically, I was absentee for that for some key moment. One of my biggest regrets, I think, well, no, that's not quite true. I think it's important not to have regrets you do you make good decisions at the time. We're in good faith. But I did miss my late sisters daughters, who is my honorary daughter graduation, because I was busy at a BSG conference. And it was it was my it was my responsibility to deliver that conference. And it was a federated conference, surgical and medical specialties and it was a big call, but it was it was the plenary of the conference, which I was running. AndJane Dacre 23:29
you know, what you do what you think was the time? I agree with you, I think regrets are unhealthy. I think learning learning from experience is good, but I think regrets and something to move on from actually. Yeah, totally agree. Yeah. So, then, registrar. So what's that, like?Cathryn Edwards 23:56
It's a whole different asset. Registrar? Yeah, there's a whole different scale of organization to working for a specialty group. I think it's a natural progression in some, in many ways, because it allows you to draw on the breadth of your clinical practice. Right, as well as the your specialty practice, that sort of clinical level. At a organizational level, it has a very broad remit. As you know, as past president, the registrar has a very broad sort of light touch right across the organization, membership fellowship, committees, governance president
Jane Dacre 24:43
as president, absolutely essential, wonderful person, the
Cathryn Edwards 24:48
registrar,
Jane Dacre 24:49
that that working relationship between President and a registrar is just, it's absolutely crucial because you can't do it all on your own. Definitely can'tCathryn Edwards 25:00
And I thought long and hard. So again, is it's an appointed role. And I've, I've thought long and hard about applying, particularly under such sad circumstances because my predecessor, Donal Donahue, had died of COVID. Mid Term. And I recognize that the organization was very briefed. And I also recognized that I would operationally find it very difficult to find a starting point, you know, there's all this sort of classic, you know, you go in, you listen for three, three months, those 90 days of fence checking, that was just not going to be enough. Because there was a need to have a functional registrar, as you've just pointed out. But there was also a need to be functional in a way that would acknowledge the organization's grief, and individual bereavement. There, I think it's been one of my most challenging roles because of the environment. Having said that, I do you think as you move through different roles with different challenges, if you are to continue to develop yourself, it's being able to flex, flip and adapt, your style, your pace, and the timings of your interventions that marks you out as a good leader. Now, I'm not saying that I'm a good leader, I'm saying, those are the things that I think are important in medical leadership. I had you we all have these little Damascus moments, don't we. But understanding that it is perfectly fine to use all the tools in the wide toolbox that leadership management theory tells us about and you're you're offering on your course, UCL and previously emerging women leaders at the RSVP. A key is to be able to pick the one or two, but tools which are appropriate for the temporal positioning of, of any project or leadership role. And I've come to understand that what the beginning of a leadership role might require will change as you progress through that role into its middle, and later phases. And whether that's, and it's the same for any project management, whatever you're offering, in terms of leadership, whatever style of leadership, whatever toolkit, you're relying on, your ability to flex from one field to another, it's important that your ability to change temporarily with the project itself, depending on the maturity of the project, or the maturity of the organization, is also absolutely key. And that has been such a key learning for me.
Jane Dacre 28:13
Yeah. And and that she was very wise statement that not everybody, I think understands. So you've been incredibly successful and really positive? Are there any? Is there anything that's really made you think this is a barrier, this is something I need to sort out or or a low point that you've had to deal with? Because we often learn more from those than we do from the good bits?
Cathryn Edwards 28:38
Yeah, I think there are different there are different barrier levels of barriers here. So there's a sort of external barriers that we all talk about. And I would generally say that I have been fortunate, and I have had opportunity and support. So I have felt more supported. And in terms of career progression and personal development than I have felt blocked. Although there have been clear moments where being a woman has been a block I was I was definitely passed over for ERCP training. And I was put to the bottom of the list, but I was the only female at the time. So it was pretty inevitable. But there was this sort of sense where well, we use a lot of radiation deer, so you know, probably will want to let them so, but those those have been less. I think it's important to call it out when it happens. Yeah. Yeah. But you don't have to be aggressive about calling it out. There are there areJane Dacre 29:47
quite hard to call out though, isn't it? sometimes quite difficult to to say well, actually, that was a bit patronizing,Cathryn Edwards 29:56
or whatever. But you can flip it and I've often found you humor is quite a, it's quite a good way to, because it actually, it doesn't make you look like the problem. And there's something about taking the edge of things with a bit of humor, if you can probably been a bit flippant occasionally andJane Dacre 30:18
in responses. I'm sure that's I'm sure that's, that's good. So humor has helped you what else has helped you along the way?Cathryn Edwards 30:28
Well, I've had amazing support from my long term partner, then husband, and also from my children. And I use children in the in the in the sort of wider sense. My, my sister died 19 years ago. And so I have been very involved with her two children, and they are a joy. And they continue to be a joy just as my son, my budget, biological son is a joy. And they have you always wondered, worry, don't you that your career choices or your life choices impact on your, your children in a detrimental way? Or on your family? Generally,
Jane Dacre 31:19
I was going to ask about that. Yeah. AndCathryn Edwards 31:23
I think the biggest joy for me is being able to discuss that with them, you know, as as young teenagers as teenagers as young adults now. What is what is it meant for them? Where do they think the downsides of having a pretty busy working mom has hit and, and unbalanced as a family, we've come to the conclusion that it's been more positive than it has been negative.Jane Dacre 31:51
Now, I would agree my children didn't notice when I neglected them, thankfully, and I'm quite positive now. What I've really, yeah, reallyCathryn Edwards 32:04
appreciated from my son was the recognition that having a strong female role model role model, how important that has been in his life and in his relationship with women.Jane Dacre 32:18
Fantastic. Fantastic. So just coming to the end, now, is there any piece of advice or word or words of wisdom that you would like to give to women who are now coming through because certainly my experience on running the leadership course is that the younger women really value role models like you.Cathryn Edwards 32:39
I think advice is a quite a strong word. And what I would say is, I don't think people, few people set out to be a medical leader, I think we set out to make a contribution. So I would say, establish where you want to make that contribution. And this this, and it's such an individual choice. It's this understanding of what motivates you as an individual. And be prepared to find the opportunity to make that contribution in some of the least expected places. Because we can't design our careers. And I'm really reminded of it as a, this was a bit of advice from my primary school teacher. When I was a primary school teacher I really loved you know, how we all have our little crushes on. But she was an amazing woman looking back and one of the I've had lots of amazing women in my career. And she said to me, hold fast to that, which is good. Now, that is a biblical quote, I'm not going to I think it's good testimonials, but don't quote me on that, because I would have to go and check that. But it's that sense that good, that works for me at all levels, you know, what is good, what is good for you? What is good for your family? What kind of goodness can you bring to your contribution to your patient, to the system to the organization. And however challenging or however stimulating and however fulfilling all of that may be, you've got to hold on to that internal validation. Because at the end of the day, that's all we all have as human beings. It's the internal validation, not the external.Jane Dacre 34:31
That's what it's all about, really, isn't it? Yeah. Catherine, that's been fantastic. Thank you so much for talking to me today.Cathryn Edwards 34:39
I felt very honored to be invited and I always enjoy our conversations. Joan, always thank you.Jane Dacre 34:45
Thank you for listening. There are many more medical women talking in this series of podcasts. Please have a listen to some of the other inspiring women. You'll definitely find something to inspire you.
Season two transcripts
- Episode 1: Professor Dame Clare Gerada
Jane Dacre 00:07
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant. Listen, and be inspired. Clare Gerada is one of a small number of people who've been both the chair and the president of the Royal College of General Practitioners. Clare's family come from Malta. So she was an outsider when she came to this country, but was inspired by her father who was a GP, she has gone on to become a household name in medicine, and contributes enormously across a broad area of policy, and also politics. She chairs the NHS Assembly, and is to be seen often in newspapers and on the television. What I'd like to do is to just go through your career. So if I may, could you give me a summary of your career so far? And we'll take it from there?Clare Gerada 01:27
Yes, of course, well, I'm just completing my 35th year as a GP at the same practice. And before I became a GP, I did psychiatry, and actually got my membership in psychiatry. And before that, a few other specialties. So I've really, if you like, entered and been in that space between mental health and general practice ever since, more or less, I've qualified. And what that's meant for me is taking quite a few local and national leadership roles in mental health, primary care, mental health, but also, along the way, also becoming Chair of the Royal College of GPS and now President of the College of GP. So I suppose I've had the absolute boundary of being a GP, in South London with my partnership, but that boundary has allowed me the the pleasure, the ability, the the flexibility to do all sorts of other things along the way. So what was it about the GP psychiatry interface that attracted you in right at the beginning? Oh, the reason I I was always going to be a GP, I was always going to be a GP if the truth be known. My father was single handed GP and from a very, very early age, my one of my first memories is our home was the surgery was peering down and seeing patients in our front room and dad used to take me on home visits when I was about eight or nine to, to what was then the postwar slums of Peterborough. And I just loved it. And he used to talk to me about medicine. I mean, you know, as a nine or eight year old can understand, but I just really loved dad's position in society. I loved his interaction with patients. I love the fact that if you like he was respected, so I think I was always destined to be a GP, but I strayed en route I, during one of my first surgical house job, I used to spend lunch breaks, we had them in those days in the library, the Whittington, and for some reason or other, I used to pull out what was the green journal, which is a Journal of Psychiatry, and I used to read all about these interesting developments in the management of schizophrenia. God only knows why I was doing this. And I thought, Oh, I'd really like to do psychiatry. So I applied and got into the Maudsley telling them I was interested in Freud and schizophrenia. And whilst at the Maudsley on the psychiatry rotation, I realized that every job I did, I enjoyed every job from old age to children, to long term conditions to forensic. And what does that mean? It means I'm a generalist, so soon after I met my husband, Simon Wesley, I thought, well, you know, he's, he's on route to be a psychiatrist at an academic. My heart really lies in general practice. So I left a psychiatry at that point, which wasn't easy. It felt like a sort of secret. I couldn't ask people for references. I couldn't tell them because what you didn't do then was leave the Maudsley hospital to go into general practice. But I went into general practice and I've never looked back and it's been fabulous. So, got a bit involved in the old Snakes and Ladders did you, did you have to take a dip?Clare Gerada 04:44
Yes, I went. I went from being the equivalent of a senior registrar. It wasn't quite cool at its time to becoming an SHO in obs and gynae. So I went right down the ladder and did an SHO job at UCLH in the obs and gynae, which was actually very interesting to do it at a slightly more senior level. And I also knew more so I knew more about mental health, for example, so and we used to see drug users,Clare Gerada 05:14
pregnant ladies who were drug users, I sort of knew how to manage those conditions that I also think it gave me a maturity to become friends with, who were then the registrar and senior registrar, who have been lifelong friends ever since. So we shared the time I was married, and we were all trying to start a family and we would all compare notes. And so I think for me, it was actually really, it was really a good thing to do at that later stage, because I think it showed maturity had I been in today's world, of course, I'd have had to start from scratch because very little of my existing training would have been counted. And by this point, I had already done 18 months in medicine 10 months and accident emergency, two and a half years in psychiatry, but I would have had to start again, which I think is a problem for new doctors now who are trying to move around in their in their career development.Jane Dacre 06:10
Yeah, and lot of people do want to move around. So that does make it difficult if you talk to also a little bit about the firm, how you you felt as if you were part of a team. And I think that's something that's become a bit more difficult for today's doctors.Clare Gerada 06:27
Yeah, much more difficult. I mean, not only did we were we part of team, but we were talking about our own last menstrual periods together. And when we were all getting pregnant at the same time, it felt like we were a team, not just a professional team, but actually a team of friends that have sustained that. And I do think it's a big gap, that most doctors are now becoming or a lot of hospital doctors and are becoming part of the gig economy. They go in there do the job, they go home again. And if they're fortunate enough to meet somebody whilst they're doing that job, that they might then have another interaction and that's really good. But on the whole, you don't. And I think it's a real sadness.Jane Dacre 07:07
It is something that we've lost, isn't it, however, on you thrived? And went into your practice? Did you train in the practice where you eventually worked?Clare Gerada 07:17
No, I didn't I actually lost my training post because I became pregnant and that those times there was no provision for allowing people women to defer their entry to their training year. So I had a big gap because I lost my training post, and then had to reapply. And that gave me another year where I had to, if you'd like twiddle my thumbs, I didn't twiddle my thumbs, I went and got a supernumerary post, caring for intravenous pregnant drug users as one does. And then I applied and actually got a training post up the road from where my practice is, the reason I chose the practice was that it sort of had it had it it was a practice with potential it had all the right values caring for the homeless, drug users and alcoholics, but it was it needed. It needed more doing and it wasn't a finished product. It was also a practice that was when a stone throws of my home. And it was also practice that I was registered with at the time. So in my own GP sort of said, I she went she was giving me antenatal care. Said oh I'm retiring in 18 months, why don't you apply? So all these Zeitgeist was there for me to apply. And so I went to the practice, it was part of the space that I knew and well in Lambeth. And I've loved it. It's been an extraordinary partnership, where people only leave through retirement or sadly through death. And we have been like a good marriage a very coherent team.Jane Dacre 07:30
So that's, that's lovely, a lovely story. So at some stage in all of that, though, you got interested in the wider world, or were you always interested in policy politics, the way the service runs?Clare Gerada 08:59
Well looking back. And you can only say this as retrospect is, I sort of always had ideas. I'd be sitting in the consulting room, I just had ideas about how things should change. And the first idea I had was a doctor's bag, which wasn't fit for purpose. So idea of how we should change it. But the idea is that I brought the practice ideas around how we care for drug users, because I'd left drug users with an 18 month waiting time to get treatment. And this was the beginning of the HIV pandemic, and I just wanted to make it better. So it wasn't that I set out to be a leader. I mean, I often say that I no more expected to be chair of president of a college than to be the Queen of England. But I desperately wanted to change what I'm seeing in the consulting room by effecting change outside and I got myself involved in all sorts of things in our local commissioning groups in our local leadership groups. I became the sort of lead for primary care mental health careClare Gerada 10:00
And the more I did, the more I knew needed to be done. So I didn't get involved with politics, I got involved by just wanting to change things, which sounds grandiose now, but honestly, for about 20 years, I think I was a little bit a little dramatic in that I just always had ideas that needed to be that needed to be put in into action. And General Practice gave me the absolute footing for that. And I got a job as a Senior Policy Advisor at the Department of Health, in alcohol and drugs. And that sort of started my leadership journey, I suppose. And I became a very big fish in a very small sea. And so it became, it was easier than somebody saying, in a different area for me, to write papers to give talks to be noticed. So I didn't set out to be a leader, I set out to change what I've seen in the consulting room and sorting out my patients who are getting such a bad deal of services outside.Jane Dacre 11:03
It's interesting, quite a lot of the women I'm talking to feel as if they went into leadership, because there was something that needed to be needed to be sorted. So less driven ambition, but more Oh, my goodness, this needs to be sorted out.Clare Gerada 11:18
And I suppose Jane, we were lucky, because the system around us allowed us to do that, for me, general practice allowed me to do that my partnership, I could have been in a different partnership, who would have said you can't leave, you've got to do eight and a half clinical sessions. If you don't, you can't be a partner. So I think I was very lucky. And I have been lucky the whole way along.Jane Dacre 11:39
So practically, how did you sort it out? Did you as a full time GP, that's incredibly busy. How did you sort out your well beingClare Gerada 11:48
When I first went to the partnership, as applied for the job they wanted, and an eight and a half session a week, doctor. And by this time, I was already running, what I call the Barefoot service for the drug users in one of the local needle exchanges, I was sort of taking my doctor's bag and I wanted to carry that on. So I went to the application and said, I will only do seven clinical sessions, which was a big risk for me, because it's basically saying you're advertising for an eight and a half partnership, and I will only do seven, it's not that I won't bring the income in for the other because a partner is full time. So you have to do other things to add on. So I was fortunate to have enlightened partners, they they weren't frightened of me because they could have been frightened. I mean, imagine I'm bringing drug use into a partnership. And we were the only practice we were seeing something like 50% of all the local drug users. How did we I suppose I chose well, I chose my partners well, who felt the same as I did. We also had a an agreement that we would take an equal partnership share of income as an if one bit of it didn't bring in enough to draw us out. There could be a sort of dispensation if it was for the greater good as long as it was within a limit. So we had a very complicated Partnership Agreement, which allowed me to leave and do work outside the practice, but at the same time, not be overly financially penalized for that. And and so that, so it was about negotiation, it's like a good marriage, you talk to each other, you have arguments, you negotiate, and then you find a way through.Jane Dacre 13:26
It's interesting, because that idea of recognizing the added value of women is often is often not there. And frequently when women want to have flexibility in their careers, they compromise on career progression and, and salary progression. So an enlightened group,Clare Gerada 13:44
I mean, I'm sure you're talking to women, because of one thing, when I first wanted the partner, I was replacing the lady rose, did all the cervical smears and family planning. And at that time, remember, it's very unusual to have female GPS. And so they wanted me to do all the cervical smears and family planning. And I actually said, No, I don't want to be labeled as the woman's doctor, there are other things that I think my skills would be better to use. Now, a lot of women wouldn't be able to find a partnership that allowed them to do that they would be bolted in and so they wouldn't have been able to develop their career they wouldn't. So I think the message is choose your partners, all sorts of partners, your relationship partners, your friend partners, your work partners well and make sure that you don't have to compromise too much your your I won't say career aspiration Jane because I never expected to be a leader. But it's so it's more than that. It's don't compromise your own internal sense of where you want to go and what you want to do, because there's never a second chance.Jane Dacre 14:46
Yeah, no, absolutely. So you you then went on to be the Chair of the College of GPS. What was that like?Clare Gerada 14:55
It was very difficult. At the time I was the first female Chair for 50 years. So there wasn't a role model, very few of the Royal Colleges had female chairs or presidents at that time, I think there was only a couple. And so people didn't look like me, Jane, they didn't look short, female, and foreign, they just didn't look like me. And I was also entering at a time when there was a lot of problems with the Health and Social Care Act. And I had to negotiate my way through the I mean, I'll say I was assertive that people often call women who were assertive aggressive. And I wasn't, I was striving to be assertive on behalf of patients. So it's very, very difficult, not my college, my college was fabulous. But other presidents, others medical leaders, it just it was a difficult space to be if the truth be known. Because as a female leader, you, you just have to be much more assertive than a male leader. Maybe things are changing now. But you have to a bit like a I suppose a peacock just fluff yourself out, which is something that sits naturally certainly not with me. And I suspect not with lots of women, and there wasn't anybody or very few people that I could align myself with. And certainly, probably the days before, good social media before WhatsApp where you could actually have a support group really there. So I'm glad I did it, but it wasn't the easiest of jobs.Jane Dacre 16:25
So did you enjoy it in retrospect, was it a good thing to do?Clare Gerada 16:28
Gosh, being president of the college chair or the President is the most extraordinary job you can ever do, you will never ever, ever have as much influence, you will never have so much authority, so much power although you have to use that power properly. And it is the most amazing job at that. And somebody told me when I was coming to the end, it takes six months to get over the bereavement of stopping and I think it does.Jane Dacre 16:53
So whilst you were there, there were obviously some fantastic achievements. And I think your your contribution to opposition of the Health and Social Care Act in retrospect, it turned out to be very wise. There must have been some difficult times some lows, is there anything that you that you want to share? Just because other people have lows tooClare Gerada 17:13
Oh listen, there was lots of lows, the lowest of the low was this very technical, but it was coming up to the end of the Health and Social Care Act, and it was going through the House of Lords. And there was a very technical issue about regulation. 75. And the government had said that they had changed the regulations, because we were lobbying for change and, and my father was dying at the time. And in fact, I was in Norfolk and left to come to a meeting in London. And he died as I was travelling down. And I then arrived back at the college and saw that the regulation 75 hadn't really been changed at all. And I might have made an inopportune comment and said, you know that they were lying the government line, which isn't a term you should ever use. And I got such vitriol from that from from externals the college that when I rang them and said this isn't my father died today. I'm not it was still a blank wall. And I was so distraught at that point. And this, the bill went through the house was over the next week. And I remember the day the bill went through, I got terrible flu, really bad flu, and I made me realize that the psyche of the soma do work together. On this day, which was probably the lowest day of my chairmanship, I became physically unwell, which lasted for about three weeks. So but it's fine. I mean, in the end, this is what leaders do, they have to pick themselves up, start again, this is what the job entails. And you have life events in between. And so as I said, there were lows, and but most of it was an incredible high I don't think high in the sense of you know, drug related high but a real sense of excitement, and you must have felt the same Jane some days you'd be inside the House of Lords, you'd be seeing the Prime Minister, you'd be going to the House of Commons, you'd be seeing national leaders, and you think, oh my god, what have I done today? And it would be amazing.Jane Dacre 19:05
Yeah, fantastic. So a lot of the women that we've talked to have also talked about their family life and that and that home life what's it like living with Simon?Clare Gerada 19:18
Simon and I have always had parallel careers. Simon, is, was president of his college and is very successful. He's Regis professor. And we had a I'm sure he doesn't mind me sharing this. We had to we've got two children. And when they were little, we sort of had a big argument because he was out I was and we came to an agreement that if it's important enough as not to be with the children, which is the most important part of one's life, then it has to be important and we wouldn't ask each other questions, we would just make sure that we managed the situation. In other words, we spent all of our money on childcare and help at home and Simon's parents are wonderful would come down and help So that gave us the freedom really not. So why are you away next week why you're away for three days, if it's important enough that he needed to be away or I needed to be out, then it was important and Simon has been my greatest support he's, and I hope I have been of him because he understood by job, I've understood his job as president. So yeah, going back to choose your partner, choose your partner, well, if I do have one, regret, and regrets are always great, because there's nothing you can do to change it. If I was to change anything, I would want half a day off a week, just half a day, doesn't matter which half day where I could spend some time being a mother, because the bits that I missed out on were the mothering bits picking up from school the nativity plays, just to go into tea with with their friends. And maybe I've got a romanticised ideal of it. But I wish I'd had half a day a week just to down tools and beer have a different identity from that of a female leader.Jane Dacre 21:03
It's interesting, because I think some of the younger women coming through a clearer about that now than our generationClare Gerada 21:12
But Jane, you cannot be unless you're extraordinarily lucky, you can't be successful unless you work hard. There is an and working hard means making sacrifices. And, you know, unless you're extraordinary lucky, and maybe have, you know, you live with your parents, and they look after the children and there's no guilt or fear. It's it's sacrifices and guilt. I mean, as a working mother, I've always been had the feeling of guilt, but I'm not giving enough to the family not giving enough to work. And I think that is something that we just have to get to grips with. And you only feel guilty for something that you love. And it belongs to you, me as an individual, not to my children, who pretty stable, sensible people. So it's also about accepting what belongs to you and what you think you're doing to your children, your children, as long as you give them consistent love, then they'll be fine.Jane Dacre 22:08
Well, they both do seem to be doing doing very well, they're better than fine. So, you've talked about partner, partners, you've talked about your partner, what else has helped you to thrive?Clare Gerada 22:22
Well, again, it's the support around me. So very early on, probably during my chairmanship, I decided to get supervision so intermittently over the years, I will either individual supervision or group supervision. So with our teams and I also began a training as a group analyst, which means you have to go into twice a week group analytical therapy groups. So the you sort of be able to you can start to talk about issues that aren't in that are in a safe space, people often talk about safe spaces, but I would recommend anybody get involved in a support group be that abandoned group or Schwartz group, a reflective practice, group, anything where you can actually just share the complexity of what you're going through. Very early on in my career, I was in what was called a young practitioners group. So we used to meet once a month, and talk about the difficulties of being a mother and working as a GP and climbing up the greasy pole. So that's, again, what I recommend to people.Jane Dacre 23:18
Fantastic. And what do you do to relax?Clare Gerada 23:20
What do I do to relax, I'm beginning to learn to play bridge.Jane Dacre 23:24
That doesn't sound very relaxing to me.Clare Gerada 23:26
And it's, it's fabulous, because I'm making friends? Can you imagine making friends in your 60s, good friends, people that you can joke with and laugh with and go away with? And it's not the bridge? I mean, the bridge is a bit like saying, Well, I can ride a bike, okay, you can go around the park with friends. It's the fact that you could learn a skill, you don't have to be particularly good at it. And it opens up a whole new vist, of enjoyment of people of groups. And yeah, I love it.Jane Dacre 23:56
And finally, a word of advice to those coming through what would you tell younger women who have aspirations to be leaders?Clare Gerada 24:03
I think I would go back to go back to try and get the basics right, the love of the work and Freud said love means a partner that could be a work partner, but also work get something that sustains you. But fundamentally, for me, if you are aspiring to be a female leader of all sorts, don't think of it as a career progression up a leadership path. Just think about at sorting out what you see in the consulting room, but trying to affect change outside and just enjoy it.Jane Dacre 24:35
Lovely, very wise. Thank you very much. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one.
- Episode 2: Dr Celia Biewlaski
Jane Dacre 00:07
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days, but these inspiring stories show us that medicine can still be brilliant. Listen and be inspired. Today I'm talking to Dr. Celia Biewlaski. Celia is a geriatrician, a very passionate geriatrician who worked extremely hard clinically, including during COVID. During her interview, she'll share some of the experiences she had at that time. She will also talk about how she got involved in the Royal College of Physicians, and says she wishes that perhaps she'd done it earlier. So listen and see whether you might want to get involved with your royal college as soon as you can. Celia to start with, if I could just have a summary of your career journey.
Celia Biewlaski 01:21
Well, I went to medical school in London Kings, and then did a standard selection of SHO jobs, which actually included a job in geriatric medicine, and then went into a selection of registrar jobs, because in those days, you could do a registrar job in rheumatology actually I did a years rheumatology - and then go off and do respiratory medicine, which is what I did, and so on and jump around in a way that actually made it a lot easier and gave you a lot more time to kind of work out what you wanted to do, because I didn't really have much of a clue. rheumatology, great as it was, I learned a lot was very outpatient based and that kind of made me realize I needed an inpatient specialty. And I went back to my geriatric medicine, which I'd done, I can talk a bit more about why if you want and then ended up as a senior registrar in North London, at UCLH and the Whittington and geriatric medicine, did that for two years. And then a consultant job came up at the Whittington, I had just been working at the Whittington, and so bless them, even though I was far too young and really didn't have a clue I don't think, they appointed me, as I said, at the age of 32, to a consultant job. So it was my first interview. I can't believe I gave a very good interview. But I'm ever grateful to [name unclear] who was consultant colleague at the time, the only one really at the time, who, obviously, who believed in me and obviously was willing to give me a chance. So I've worked at the Whittington ever since I was really always really, for reasons I don't know, interested in education, maybe because my mom was a teacher, I don't know. And I set up the first undergraduate teaching firm in geriatric medicine at the Whittington, and then got involved in running revision courses for finals and then became undergraduate Sub Dean, and did that role for a number of years before jumping to postgraduate education. And I took on the foundation training programme director role at the Whittington. And then eventually after that, that Director of Medical Education. And actually I think probably quite late in my career, I then moved on to more external roles. It's actually something I kind of reflect on and slightly regret that I left it a long time. Maybe I was a bit daunted by it. And then eventually, I became a Deputy Director of the Foundation school for a HEE for North London. And subsequently, I've had a couple of roles within the College of Physicians. So as a censor for three years, and I'm now a clinical lead for assessment at the London college. So that's that's it in a nutshell.
Jane Dacre 04:18
Just a couple of things. Did you always want to be a doctor?
Celia Biewlaski 04:21
No, no, not at all. My dad always wanted me to be a doctor. I was the sort of only child of elderly parents I think my mum was 45 when when she had me so they were very doting. And it felt all you know a little bit intense. So whatever my dad suggested I didn't want to do perhaps parents do know best but I thought no, no, no, no way. Am I going to do medicine. And actually, I wanted to be a marine biologist. And that was really because there was a guy called Jacques Cousteau and he used to do these amazing documentaries on Television, about exploring the undersea world. And I just thought, you know, exploring remote places with wildlife sounds wonderful. But then I discovered you could only do marine biology in Bangor in north Wales or in Aberdeen and nothing against those two places. But I was really, you know, I'd grown up in rural northern Ireland in a small town in Northern Ireland, feeling that everybody was watching me in everything I did. And I kind of wanted the big city and the bright lights. So I'm afraid I didn't say any of that at my interview. But that's why I did medicine in London.
Jane Dacre 05:36
Fantastic and you've, I mean, you you've worked as a geriatrician on what people call the coalface or the frontline or whatever. You did a lot of face to face work during COVID, didn't you?
Celia Biewlaski 05:51
Yeah.
Jane Dacre 05:52
How was that?
Celia Biewlaski 05:53
Well, it was fine. I mean, I love clinical medicine, I kind of it's always the you know, I've loved my career in medicine, because I really, because I love clinical medicine and education. And I've been able to do both throughout it. And so sort of wards and inpatient work and seeing patients has always been what I've been all about. So, you know, none of us really hesitated when COVID happened and just rolling our sleeves up and working on the wards. So, yeah, effectively, we all got COVID, one after one after another. But yeah, effectively took my turn in running a COVID ward. So one of our care of all of our care, older people was at the Whittington all became COVID wards, essentially for months at a time. And now, we'll, the great thing was everybody pulled together, the team working, you know, the, the Whittington is a fantastic place. Anyway, it's got a great group of physicians all worked very collaboratively. And we came together even more collaboratively, you know, than ever, and everybody just did, went over and above. And, actually, I really quite liked it. And one, that in a weird kind of way. You know, it was intense. And it was knackering. And it was sometimes difficult, because there were some very difficult decisions to be made. But there was always somebody to talk to about it. And our department, particularly were very cohesive. And that's been one of the great things for me. And we always do kind of support each other and talk to each other. So and that continued, and, you know, was a great framework for, for getting through COVID. For us all. We did it, we did what we had to do, really,
Jane Dacre 07:49
Were you at any stage worried for yourself or your health?
Celia Biewlaski 07:54
Yeah, I remember saying to my kids, actually, just as you know, just as it was all happening, and lockdown was happening, and I was aware that I was going to be on the ward the next week, and there was almost no PPE. And I thought, you know, I remember saying to them, you know, something corny about how much I cared about them, and that there was a slight, there was a distinct possibility that, you know, I might get ill and as a possibility, you know, obviously a possibility that it could be fatal. And we just didn't really know. They were lost for words. And I think my husband was, you know, who's not medical was also kind of slightly daunted. But I used to sort of, he was at that stage working from home. So I just used I used to go off in the morning at the crack of dawn, come back, take all everything off, put it all in the washing machine, go upstairs shower, and then, you know, come back before I sorted, but I didn't, I'm afraid to say I did give him COVID as well, although he had an easier time than I did.
Jane Dacre 08:55
And were you, were you unwell
Celia Biewlaski 08:58
I was fine. I wasn't hospitalized, but I was, you know, I was, yeah, people from work would ring me and say what are your SATs? And I would say 92%. And they'd say that's fine and put that down. And I think she's not really fine. I was coughing and coughing and coughing for weeks. And I used to lie prone because I was thinking God what if I die in the night. But anyway, it took about two weeks actually, I wasn't well for about two weeks. Whereas Dave, my husband was slightly fluey for 48 hours and then bounced back.
Jane Dacre 09:31
It's amazing how it affected people differently.
Celia Biewlaski 09:33
It was it was bizarre. It was bizarre,
Jane Dacre 09:35
But sort of moving on from that you you say that you had parallel interests in education? Tell me about the education bit you say how you started?
Celia Biewlaski 09:48
Yeah, um, I don't know why but I was. I was always interested and I you know, as a trainee, it was something I always was involved in teaching students and I I and I really saw how good educators made a significant difference to, to engagement to your, you know, the engagement, you're in one's engagement and one's confidence, really people's confidence. And, and, and I sort of sort of saw and I've seen that really throughout my career, but, you know, I see it in our department, we've trainees who we've looked after and supported through their training, come back as consultants. We've got I was thinking about this the other day, six of the consultants in my department have passed through department, as you know, undergraduates, often well, mostly postgraduates, and some also as undergraduates. So you know, it, it's such a key part of what we do. And I've just always really believed in it. And I, you know, I got I was because you're, if you're keen and enthusiastic, the students love it, you get given more to do. And so the whole thing built up fairly rapidly in my undergraduate role. The Whittington built up really, quite quickly after I was appointed, how I then got engaged with postgraduates. I don't I'm not sure how it happened. I mean, I was obviously a supervisor of foundation doctors. These things are often opportunistic, aren't they? And I think somebody was, somebody was stepping down from the foundation TPD role and said, you know, you could do this, you might be good at this. And so I've kind of thought, Oh, well, maybe it wasn't something I'd really planned. But then most in lots of my career hasn't been very planned. And lots of it has been very opportunistic.
Jane Dacre 11:43
There is a kind of natural progression between being a good teacher. Yes, or a good educator. Yes. And then being involved in running educational programs, education stuff. So how did that? How did? Why did you make the move? And or did you know you were making that move?
Celia Biewlaski 12:03
I'm not sure how conscious it was at the time, really, I suppose use you. I suppose you see what you think is good. And you see what you think isn't done well, and you start wanting to influence it. I think that's just how it happened. Really. You know, I was always, I do get bored fairly easily. And I'm always keen, I've always been keen to sort of take on a new challenge, I suppose. I suppose that was it really. And I And and I just saw that as there were one or two people actually in leadership roles at the Whittington who, who did it very well. And were quite inspiring in fact of the directors of medical education, she was brilliant. And she just oversaw the whole of medical education that had really good structures, and inspired and developed all the educators very well. I kind of aspired to be like her, really. So it was natural that I would gradually build up to taking on her role. Several people after but I did it.
Jane Dacre 13:12
So there were the roles that you had in the Trust. And you mentioned earlier that maybe you got involved in external roles a bit a bit late. Tell us a bit more about the external roles. And what does that provide to your career?
Celia Biewlaski 13:26
Yes, well, I suppose the College of Physicians is is the obvious way to talk about I think I was perhaps daunted by the college, I became a PACES examiner, which was a common thing for people who postgraduate education to do and that was fine. And I do a lot of postings as examiner became a PACES chair and a PACES host. But the sort of wider college was somehow rather quite daunting to be. Yeah, actually, it was you who suggested that I it was you said why didn't I apply to be a censor and I actually applied once and didn't got it didn't get it? And then I thought about it and thought about it and though hmm, because I don't think I'm particularly a political animal. So and I thought the sort of wider college roles were for older men with many more letters after their name by me who moved in political circles, you know, but I kind of thought about it and talked to a few other people and then thought, no, actually, I can do this. And so I reapplied actually much better prepared the second time and got it and, and yeah, learnt a huge amount from that job personally developed huge about personally, from the diversity of things that go on on the college that, you know, lots of other things people as well don't really fully appreciate
Jane Dacre 15:02
What things, what sort of things did you take away,
Celia Biewlaski 15:07
I got involved in the student Foundation, Doctor network, which was an art fairly obvious thing for me to get involved in because I was by that stage of us were foundation school director. And I had lots of undergraduate experience and, and working with them and developing them to run, for example, their own careers conference was a huge hit. And working, particularly working with the amazing staff in the college who really, you know, the, the, the events, people, etc, who just I hadn't really been aware of their existence. I also got involved in the physicians Associates, and we set up a question bank for this physicians associates registration exam, and again, working with some great people within the education department at the college. And then I started to do more with the education department. So I kind of I learned from from a lot of non medical people, a lot of skills. And yeah, it was. Yeah. And was really realized how much added value they all brought to the college, as they almost silently work behind the scenes. And that's quite inspiring.
Jane Dacre 16:27
I've often have often felt that when times are tricky in your Trust, it's quite nice to have another orgnisation to call home yeah, it's quite. It sounds very busy. Yeah, one of the things people worry about is their is their work life balance. So any thoughts
Celia Biewlaski 16:51
Well, I'm rubbish, I'm not good at it, and I'm not good at managing it very well. I mean, I kind of have you have to work very flexibly when you've got lots of different roles. And you've also got to protect the core things that are crucial. So you know, diary management is really, really, really important. And you have to be very organized. So yeah, I've done that. I do take a lot of holidays as well, though, I do protect my leave. And, you know, I basically leisure time, there's leisure time, and that's a board. And I've always sort of made a huge effort to keep doing things outside work as well, because I think that's really important. So it is really busy. But somehow I managed to just about keep all the balls in the air, there does come a point when you've got too many things, and the balls stop dropping. And that has happened to me on a few occasions. And then I've had to sort of sit down and think rationally and divest myself of a few things. So yeah, yeah, to know your limits, I think as well and know when to stop. But, but the diversity of it is one of the huge pluses of it all really, as well, you know, and that's why I'm still working, I think it's kept me going because every day is different. So you know, and there's a challenge round every corner, which is fascinating.
Jane Dacre 17:24
And you've also got a husband, your children family. So when How did all that come about, did you have to make compromises work part time?
Celia Biewlaski 18:38
Yeah, slightly. I got married. Just before I became a consultant, actually, and then had that I've got two sons had them two, four years later, so quite late, you know, I was quite an old mother, I suppose. My mid 30s. And, and Dave, my husband has never been somebody who particularly sees traditional roles, you know, so he's always mucked in equally. And actually, what is really nice to see is the boys with their partners. There's no kind of traditional role play in the old fashioned way. My mother always worked here. So yeah, they have very my my sons and their partners are very equal sort of division of duties and both careers are equally important. And that's how it's been with us. And I'm grateful for Dave today that that's what he was like, we probably wouldn't be married otherwise. We had a, when my oldest son was born. We employed a full time live-in nanny. And I realized that that's so much more difficult for people to do now. But it was life saving really, and I'm I had a friend who said, you've just got to do whatever it takes. She had two small children in order to, in order to get you back to work. So I went back at three months with this full time living nanny employed. And we're still in contact with her now, actually, she was with us for between 8-9 years. So it got us through all of it, and really enabled me to work. And my kids, still, you know, still in touch with her as well.
Jane Dacre 20:27
And they still talk to you.
Celia Biewlaski 20:28
And they're still an amazingly they still talk to me. Yeah. Yeah. And, in fact, when she left, that's when I went slightly part time, I worked four days a week for a few years. Because I thought that one day a week, I ought to be school gates. And that kind of absolved my guilt slightly. It's a very hard balance and impossible to get right.
Jane Dacre 20:50
The guilt is something that people talk about. That's always, there. Do you think that you've had any particular barriers or anything that you that you maybe would have wanted to do but weren't ablr to do? Because of the because of having so many balls in the air?
Celia Biewlaski 21:09
No, not from having so many balls in the air. I think the only barrier was my perceived barrier to external roles, you know, that I didn't think I was good enough or important enough to do all the external things. And, and I slightly regret that now. And it took pushes from people like you to say you could do these things. Imposter syndrome, impostor syndrome. Yeah, I think that that's a perceived barrier, really, no female role models as a junior doctor coming up at all, really, but I had, there were a couple of people who just said things to me at the right time. You know, my parents always believed that I could do whatever I wanted, there was no nothing about never anything about me being female. You know, my, as I said, my mum worked. When I was a registrar. In fact, that was my respiratory medicine Phase I, my consultant was a guy called David Lever. And he and I was thinking about geriatric medicine as a career. And when I done it as an SHO, I'd gone into the sort of workhouse type hospital that was off the main main post teaching hospital site, found all these patients with all these amazing things wrong with them, not amazing to them, but amazing to me, and, you know, got various specialists down from the main teaching hospital to kind of look at them and help sort them out and then got the turnover, got them sorted out and the turnover, the ward got and dramatically well with the help of an amazing ward manager. And I always remembered that I that that I thought that had made a difference. And that sort of sort of came back to that time and time again, but I wasn't sure, at that time, geriatric medicine wasn't a popular career choice. It was something you did if you couldn't do anything else. It's changed so much since then. And I remember talking to David Lever about it and saying, I really thought I quite like to do it. But I was worried about my credibility as a clinician. And he said, that that was a load of nonsense, and that if you're good at your job, and he told me I would be, then your credibility will come from that. So he found I wanted to do so he really made a difference actually. And I can remember that as a trainer, you know, just you know, it's just something like small things can make a real difference to people's careers.
Jane Dacre 23:31
So maybe he's part of it. But what inspires you what, what drives you? What keeps you going What's kept you still working?
Celia Biewlaski 23:41
Well, I still actually love clinical medicine, I really do I really like and it's the thing about geriatric medicine, it's the clinical problem solving, people coming in, often very nonspecific and sorting out the diagnosis. And one, I still love that. And I love supporting trainees, actually, I mean, we all need to do it. They're our future. I love it. When I get actually this week, I got an email from somebody who was in trouble over seven years ago. It's a long and complicated story. But it ended up with a GMC hearing that I went and gave evidence at. And this person emailed me just a few days ago to say that they were about to apply for consultant jobs. And, and they will never forget, you know, the support they got from a few of us, you know, when they were going through a difficult time and were lost and unsure. And it wasn't very much really, you know, it wasn't a big deal for me to do that. But small things, you know, make a big difference to find out by and that's great. And if you could keep doing even small things, and it's worth doing.
Jane Dacre 25:01
So, obviously made a huge difference a small thing makes a big difference. So you've talked about a lot of positive things. Have there been times when you've just thought, you know what I, I've had enough because quite a lot of people, you hear about being burnt out or no longer enjoying their jobs. Does that has that ever happened to you?
Celia Biewlaski 25:22
Well when I went from full time to part time, the time was right, because so I, you know, yeah, I have not done full time clinical medicine for over five years now. And but I think that diversity and doing other roles as has kept me going, I don't think I could've continued with frontline medicine any longer than I did. I think as a new consultant, it was very difficult as well, you know, trying to do everything and you know, and when you get complaints, and something goes wrong, and yeah, I can remember the lowest point was when as a new consultant, I had a patient who committed suicide on the ward,they jumped out of the ward window of the Royal northern hospital that was on ward round. And he, this patient had come in for investigation of weight loss, and difficulty swallowing. And of course, we would do the GI investigation looking for oesophageal or gastric cancer, and failed to notice that actually, it was all severe depression. And there was a, there was a, you know, internal investigation afterwards, I remember being asked as part of that investigation, when I was completely wrapped up on what I done wrong, and what mistakes I've made, what asked what you had done to support the rest of the ward. And of course, I've done absolutely nothing. And that was such a wake up call for me. And I think, really, from then on, I've realized that however rubbish it is, if you talk to other people, it it. It really helps. And I've and that also that when things are rubbish for you, they're rubbish for everybody else. And you will have to kind of support each other really, and I've sort of hung on to that. Within our department. We have a Social Secretary. And he'll be we have we have to, we nominate a Social Secretary on rotation, and they have to organize some kind of gathering on a regular basis where we just all get together outside the hospital, and just having those relationships with people gets you through difficult times, I think..
Jane Dacre 27:37
I know, I think I think you're right, you do need to have colleagues to talk to were sort of chatty human communicative animals.
Celia Biewlaski 27:46
And we've Yeah, and you can lose it. You lose that very easily when you're under pressure, you know? And, yeah, when things are difficult, so, yeah, a few low points, but nothing less
Jane Dacre 27:59
So for people coming through for people that are at the beginning of their careers, or are thinking about a career in a physician specialty or geriatric medicine, do you have any thing that you think they perhaps ought to think about? Or some advice for people coming through?
Celia Biewlaski 28:19
Well, I know yourself, I think you know, yourself, but you're not always. You don't really, always verbalize or externalize it very well. And I know it took me quite a long time to work out, you know, what my priorities were and what was important to me, and then you've got to look for that in a career and there are so many careers in medicine, there's always I think, something for somebody. I think. Don't give up. You know, I think if you want to do something and you don't get it first time, keep going and try again. And if it matters enough to you, you'll get there in the end. Yeah, I think diversifying is really important and what you know, I mean, medicine gives you so many, so many opportunities to diversify, and take every opportunity that's thrown at you. Because there will be things in there that will kind of develop you and that you will you will love and keep doing. Don't be afraid of any of it. Really, and the imposter syndrome. I don't know how you get past that really. But yeah, just if you don't try to do things, then you'll never know really whether you could do them or not if it doesn't work out. It's not the end of the world. So just go for it. I think
Jane Dacre 29:46
So Sally Davies. You know, the Chief Medical Officer Sally Davies once said to me, you know, Jane, sometimes you've just got to hold your nose and jump. Yeah,
Celia Biewlaski 29:55
exactly that, exactly that.
Jane Dacre 29:58
Thank you very much for talking to me today. I'm sure it's absolutely inspirational to number of the people who are listening. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 3: Professor Gozie Offiah
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant, listen, and be inspired. Gozie Offiah is an Irish woman of African descent. Her family came from Nigeria, but she was brought up in Ireland and went to the RCSi where she learned her trade as a doctor and decided to become a surgeon. She has been extremely successful and has now moved into medical education so that she's inspiring the next generation of doctors, and hopefully, of women surgeons. So Gozie, thank you very much for joining me today. So we're going to talk about your career journey.
Gozie Offiah 01:17
Indeed. Thank you very much. It's been a pleasure been invited to be part of this. So thank you very much. And so I think let's start from the very beginning. Why did I go into medicine? Starting from there, I think when I was about 12, my grandfather was very unwell. And I remember vividly visiting him in the hospital with loads of doctors around him and trying to help him he had urinary retention, actually, he was in quite a lot of pain, very uncomfortable. And as a 12 year old, I must say, I was amazed to see how they put in a tube. And suddenly he felt so much better. And he was like, wow, okay, this is amazing. I would love to do that. And that's where my interest in medicine actually started up. My dad is a doctor, and he started off in surgery himself. And that inspired me as well. My parents are originally from Nigeria, and they moved to Ireland in the 70s after the Biafra war. So I was born in Ireland and was raised in Ireland ever lived all my life in Ireland, but obviously still have that traditional and cultural identity of being a black African. So I must say, growing up in Ireland in the 70s, it was great. There weren't many blacks in Ireland at that stage. And, you know, everything was so many opportunities for quite a lot of people at that stage. You know, my father, as I said, studied in Trinity College. So he was always an inspiration for me, because he worked so hard. And I saw him really doing what he genuinely loved. So about a few years later, I completed my secondary education. And I went into study science. It started in science, I really liked it. It was great fun, I met loads of people, but it wasn't really what I wanted. So I transferred into medicine at that stage. And I studied in the Royal College of Surgeons in Ireland, and I absolutely loved it. There were just people from so many different nationalities. I think the concept of being a doctor and helping and influencing patients health and life was just for me was just really key in what I wanted to do. And as a person, I'm a very skillful person, I'm very good with my hands. And, and hence, my rotations during medical school. I absolutely loved the surgical ones. And I actually went into surgery, absolutely loving surgery, because he was very skills based. I got to use my hands. It was really focused around the doing. And for me, that was there was a quick result at the end of it. So absolutely loved surgery for that reason, and and loved it. So studied, did my surgical training in Ireland. And I must say there were challenges to that. And I started off mentioning my ethnicity as a black African. That was challenging in Ireland studying and doing surgery because there weren't very many black females in surgery it was very unique to be a black female in surgery. So there were certain micro aggressions that were definitely there. Throughout my training, both for being a female, but also for being a black female,
Jane Dacre 05:07
really? So can you can you share some of that? I mean, it sounds as if you must have had to be quite resilient to cope with it.
Gozie Offiah 05:16
indeed. And I mean, I have two children. And I think for me, I think that's quite modest. But I vividly remember during my second pregnancy, my supervising consultant saying to me, gosh, you must be a baby making machine. How many kids do you possibly have? To which I responded, this is the second one. And I didn't think that was quite a lot. You know, coming from Ireland, where years ago, people used to have eight 9-10 Kids, I thought two was a pretty modest number. But to be referred as a baby making machine just didn't make sense. And I think that was his way of kind of saying, you're taking maternity leave when there's rotors to be covered and work to be done, you know? And, and I think several times I was kind of asked, Well, what exactly you doing in surgery? You know, for starters, girls don't do surgery. And, you know, you're black, and I'm going yeah, I am. But I'm in surgery, and it's about my skill, not really about my identities that I have. But several times. And I think one key one that I remember was going for my membership exams, and really ready anxious with exams and everything. And the one of the examiners coming to say, Oh, I think you're in the wrong section. And I said, Oh, no, I'm here for the exam. And they looked at me it went, really? And there's like, yes, like every other candidate. I'm here for the exam. And they went the surgical membership exams. And I was like, Well, yes. And I think they obviously assumed there was something else or somebody else or another role. But you know, and that put me off, you know, that was really...
Jane Dacre 07:08
i hope you passed.
Gozie Offiah 07:10
I did. I did, but you could imagine coming into exam really nervous and, you know, wondering, Am I in the wrong place? You know, have I turned up late or whatever. And getting that and they weren't just saying, you know, they're obviously referring your show possibly couldn't be a doctor, let alone the surgeon, and you shouldn't be here.
Jane Dacre 07:34
So people talk also about sexual harassment. There's a lot been alot in the papers recently about sexual harassment. Did you have to deal with that as well?
Gozie Offiah 07:44
Thankfully, no, I definitely didn't experience any of that. But I know that the you know, you hear stories, and they did mention this definitely been in the papers and all but I didn't experience any sexual harassment. During my training. I recently completed a PhD, my PhD, which was women in surgery, looking at gender issues and challenges as surgery. And my goodness, there was quite a lot of harassment, discrimination, sexual bullying, there was quite a lot of that that is happening within the system. And I think one of the main, one of the things I've always said to any doctor, be it surgeon or otherwise, is really to call it out and up, because I think that's really, really key. I think, years ago, when we put up with this, I don't think that's really the way to go anymore. But he just needs to be called out, you know,
Jane Dacre 08:41
Quite hard, though, isn't it quite hard to call it out? Particularly if there's a sort of power differential between you and your boss, for example? It's a hard thing to do. But you're also involved in education, aren't you? Tell me Tell me about that. How did you get into that?
08:58
Yeah, so I am indeed so I think it was. So after I had my second baby, I wanted to go part time. And unfortunately, Ireland is at that stage. This is a quite a few years ago, probably about 15 years ago. Weren't great with flexible training of flexible work. And it was there was just not heard of it, which is the thing that didn't exist. So I wanted to progress at that stage. And it was either one or the other couldn't choose both. So I decided to undertake a master's in medical education to see if that financial I would like and I started in the Royal College of Surgeons working as an education. And from there, I actually really built up my portfolio has an educationalist within the year over the over the last 1015 years. And that's how I got involved in education and I kind of roast To the different levels within the institution. In the latter years, obviously, I've been able to kind of keep clinical role as well, which has been really good to kind of keep a hand in and to educate into clinical work as well. So at present, I do a bit of education, with within the undergraduate medical school, I do some clinical work, just to keep a hand in. But that's really decreased to about one day a week at this stage. And the reason for that is that I've also been involved in policy and leadership. So in about five years ago, I got a role as the national clinical lead for Intern Training for Ireland, film that's been involved in medical workforce planning about junior doctors, about intern wellness and well being and aspects related to the education and training. So at the present, I have three, three hats and at any particular time, and that's definitely kept me busy. But I must say, I've absolutely loved it. It's been great to connect angles to go into. And I think that's one of the opportunities that you could do different things at different times, you know,
Gozie Offiah 11:16
No I don't no, I don't operate anymore. I just right I do clinics. So I have clinics within my local hospital, where breast surgery is what I was trained in, so I do breast like a breast physician role within the local hospital. And that was the choice that I made myself, I think, because I've been involved in so many different things. As I said, surgery is a skill, you need to keep up with this. And but in the last five years, I don't operate anymore.
Jane Dacre 11:16
So do you still operate. Do you still get to?
Jane Dacre 11:51
It's difficult to keep it all going to do you miss it.
11:56
I do, indeed, I absolutely method quite a bit. But I've also loved the new opportunities that I've been involved in, because it's worked for me, but I mean, it's led to opportunities both nationally and internationally, which has been quite great. And it's nice to kind of see it. And for me, I suppose the angle I take is, I'm in the position to be able to influence the future, the doctors of the future, and to see what they're doing to be part of that training up of new clinicians and new doctors and influencing policy. I think currently, the healthcare system is really under a lot of strain. And I think one of the challenges is really have those making decisions that haven't worked on the ground or experienced what it is like on ground. So having the opportunity to go in there with my clinical background, I think has been absolutely great. And we've been able to influence a few things as much as we could, you know,
Jane Dacre 12:59
and then it's an interesting concept, isn't it that when you're at the clinical coalface you focus only on the one patient in front of you. Whereas, if you stand back and look at policy things you can you can influence, you can influence much more. So, so will you get what's next? Will you carry on doing that?
Gozie Offiah 13:23
it's been, it's interesting, because it's been as busy as ever, I must say, and will I carry on doing that for the current time? Yes, I will. I really am enjoying that. So yes, I will continue to do that for the current for the present time and see how that goes. You know,
Jane Dacre 13:41
fantastic. So Can I also ask you about your family life? Because often the the women that that listen to these podcasts are younger than us, and are thinking about having family and career and and worrying about how to make it all hang together. So how do you make it all hang together?
14:02
I think that that's a really key one. And I think we talk about work life balance, and what exactly does that mean? And I always say to, to my mentees that it's not just about talking about like work life balance is actually about action and work life balance. So I have two kids that I mentioned already. And I must say it wasn't easy initially when I was working all the crazy hours and trying to juggle child care and move at all. But one of the things I suppose in the last while with my new roles, even though I do have three hats on is really about prioritizing life. And I think it was interesting when my my two kids now they're a bit older, but when they were five one of them going, Mommy, you must love work because you'd constantly have a laptop and your hands. Like no I don't. So For me, I like every other profession. Interestingly, after five, you leave the work in the office, and at the weekend, you leave the work in the office. So when you're not at work, leave the work in the office. And I think that's one of the things I've done over the last two few years that has really, really helped me. I used to bring my work home and constantly working. And it did me no justice, it did me no good. So I think it's really about making that conscious decision that once you get out of your scrubs, and you're leaving the hospital, that you are leaving all of that and that, you know, those that are there be on call or shifts or whatever we'll carry on the duty, and this is your downtime, so that you'll be better. One of the things that I suppose that that I heard that was really resonated with me is that, if you're unwell, you're unable to actually fend for your, for your patients. So a sick doctor is no good to patients. So you need to be well to be able to treat your patients. And I think that's something that we really don't do, as well as doctors that we don't look after ourselves as much as we should. And that's something I've started to really push across the board with anyone that I speak to, that it's really important that you look after yourself first. And that wellbeing is really key. And for me part of that is spending time with family being with your kids spending time with them having extra curricular activities. In my in my house, we always have an activity that we do together. Come rain, shine, snow, we always go out. And we always go climbing up in. We live in Dublin. So there's the mountains around us. So we go up and we have our walk, we do some hill walking. And that's been fantastic. Because the kids know, this is what we need to do it Saturday, this is it. And that comes first. And that has been amazing to actually clear the head, get a bit of reflection, but also spend time with the family, which is really key.
Jane Dacre 17:08
What about some childcare? Do you have a partner? Or do you have? How do you work out the childcare?
17:16
So I do, my husband, I must say is amazing. And I'm one of those who believe that it's equal share. So I'm not one of those that believe that it's all false, a mother or the mummy know it's equal share, and he does his equal share. So he's a medic, and he also worked in general practice. So when we share it between the two of us, you know, I dropped them to school in the morning and he collects them. Or we have a child minder, if she's away, then we both manage it. And that's the way we've done it. And it's worked quite well for us. It's sharing the load between the two of us. And that's really worked. And as I said, we do have a child minder, so that does help.
Jane Dacre 18:01
I bet you're super organized.
18:05
That definitely does help to manage yourself true that. Yes,
Jane Dacre 18:09
I'm so so what sort of what sort of advice and support might you give to your younger self thinking about the way that you've come through? Because you've actually been incredibly successful in achieving everything that you do? And people will be saying, Oh, well, what's the what's the key? What's the trick to being able to do all of that?
Gozie Offiah 18:32
Yeah, I think if I was to give advice to my younger self, I think I will pitch it in five ways, five key advisors. The first one is that change is constant, I think, be open to change my career obviously took a different turn. But I was open to that change when it was time to come. So to go into education from surgery, even though I was so passionate about surgery, I think it was time to make that change. And I think it be in knowing that changes that constant and being open to that I think is really, really key. I also believe and the second tip is to take the opportunity, I think that opportunities come ways in different ways. And we just need to be able and open to take that opportunity when that opportunity comes. So it's really being there and being open to take that opportunity. And one of the things that has really worked for me throughout my career is the use of mentors. I have had amazing mentors, and I still have a mentor till today. And I think it's really powerful to get somebody that would, you know, guide you and support you throughout your career. And those mentors could be male They could be female, there could be anybody that could be in surgery or they could be out of surgery. So really finding a mentor and believing in the power of mentorship, I think is really, really key. I think one of the other things that I would give her the tip is really around upskilling yourself. So I think as a surgeon, when the opportunity came, and I think a lot of trainees do this, they take masters then in different courses, or they take whatever courses that come, I think if there's an opportunity, and there's something that you want to go for upskill yourself, go and read about it, because I think when you read about it, upskill yourself and do the courses, you're more confident, and you could sell yourself, you can stand strong, because you know, it's you know, the skill inside out. So really take the opportunity for any courses or anything that comes your way to upskill yourself, because that definitely will increase your confidence as you go forward. And I think my final tip is really don't be afraid to fail. You know, I think sometimes we're so afraid to all I've come this far I don't want to or, you know, something comes in and we're just afraid, just don't be afraid to fail. You know, give it a chance, give it given that given, you know, try an opportunity and see what happens. Because most of the time, and you actually get that success. So it's been open minded. And if you fail, that's okay, stand back up and get going because there'll be another opportunity that you'll be ready to take, you know,
Jane Dacre 21:41
So pick yourself up, dust yourself down, and on you go what a fantastic philosophy. What great advice Gozie. Thank you very much for talking to me today.
Gozie Offiah 21:53
You're very welcome.
Jane Dacre 21:56
Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 4: Dr Fiona Cornish
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant. Listen, and be inspired. Fiona Cornish is a GP, she also has four children. She has been the president of the medical Women's Federation, and is passionate about inspiring the next generation of women doctors. Fiona, tell me about your career. How When did you first decide you wanted to be a doctor?
Fiona Cornish 01:00
I think it was when I was about 14 or 15. I really liked sciences. But I didn't want to work in a lab. I wanted to work with people. So I looked around and thought that medicine would be a really good career for me to combine the science and the people. And I my parents weren't doctors. So I had the closest was a great uncle. But I investigated it and thought that it would be a really good career to go for.
Jane Dacre 01:34
And how did you go about getting there?
Fiona Cornish 01:37
Well, I applied to Cambridge, because I wanted to go to a university to rather than a straight to a medical school so that I'd have more variety of people. And I thought it sounded a very good course. Of course, at that stage one's not very experienced or clued up. So go and have a look around. And I was I talked to people who were doctors, I didn't have much work experience, really, I did go and visit a surgeon and had a look at an operation. And I talked to a few people, but I didn't have nearly as much opportunity of work experience as people do nowadays. So it was a bit of a punt, really. So off I went to Cambridge. And of course for the first three that years there. You don't see any patients. It's all science. It's a very traditional course. But I really enjoyed it. And at Cambridge, you're allowed to do a different subject in your third year. So actually did history of art they were you were allowed to do any subject. So that was really interesting and gave me a a different outlook on on Cambridge and different subjects meeting different people. And I found that really valuable.
Fiona Cornish 03:00
quite an academic person. Are you quite an academic person behind the scenes? It sounds like a glittering academic career so far.
Fiona Cornish 03:09
Oh, well, I was a bit nerdy, yes. Double maths, chemistry and biology.
Fiona Cornish 03:14
Well, it's interesting. A lot of the women I talked to do admit to me that that girly swats behind the scenes, absolutely.
Fiona Cornish 03:24
My school wanted me to do maths, but I said I wanted to do medicine. I'm very glad I did. I'm sure I would have plateaued Cambridge, Maths is stratospheric I would have reached a plateau not being able to go further.
Fiona Cornish 03:37
That interesting mix between people and and sciences is something that something that comes through, and then also not so much being academic, but being prepared to work hard seems to seems to come through.
Jane Dacre 03:53
Yes, I think that is somebody said, you know, you're very lucky to be blessed with the ability for toil. And, you know, I think you need to be able to work hard as a doctor and it is good if you've, if that is something that you're willing to do. And, and of course, you know, I did the music and the sport and everything else as well. So I'm used to my life being very busy. I was at that stage. So it just continued really.
Fiona Cornish 04:23
Okay, so then you qualified at did you do your clinical at Cambridge?
Jane Dacre 04:29
No, I actually went to St. Thomas's. Most people in those days did go to London, and it was a very small new medical school in Cambridge. It's now the other way around. Everyone stays at Addenbrooke's and nobody goes to London, but in my day, you people, most people went to London, some went to Oxford, and I ended up at St. Thomas's, which was, well it was interesting because the Oxford and Cambridge people were slightly regarded as intruders arriving after the preclinical course. But we all we all mixed in, it was just it was slightly more difficult to, to integrate than I had been expecting. But then I had a great time there. And that was good see a different side of life. And also nice to be in London where, you know, a lot of my university friends had had moved to London, and we're all doing different things. So I shared a house with my brother, who was training to be a barrister, and another friend who was in the city. So it was a good mix.
Fiona Cornish 05:35
And so when did you decide on your specialty and why?
Fiona Cornish 05:39
Well, I was quite keen on pediatrics at one stage. And then I realized that general practice would really suit me because I loved the variety. And I thought, well, I'm going to see everyone all ages, male or female, some very ill some not so ill. And because I'm keen on, on people, I thought, well, I'll be able to build up a relationship with my patients over years. And that I think, is incredibly valuable. And something which a doctor, it's a privilege really to be able to do that. So I applied to a GP training scheme. And Cambridge was a place I knew. So I applied there. And in those days, general practice was incredibly popular. There were four places on the the vocational training scheme each year and there were 100 applicants. So it was a fairly scary interview panel of about 10 or 12 consultants. Anyway, I was lucky enough to get a place there and went to Cambridge and I had a very good rotation with obstetrics and gynecology, pediatrics, geriatrics, general medicine, and then a year in general practice. So I felt that was very good. The GP training scheme has changed quite a bit since then. Not everyone does pediatrics obstetrics. But in those days, we did.
Fiona Cornish 07:10
And then you stayed in Cambridge,
Fiona Cornish 07:13
then I stayed in Cambridge, I was looking for I was doing a GP locum I'd just got married and then discovered rather quickly after getting married that I was pregnant. So there I was doing a GP locum My husband was a fairly precarious academic who was done a material PhD. So I was doing a locum in the practice because one of the partners had gone off sick. And they then needed to, he decided to leave. So they needed to replace him. And so I was in the in the practice anyway. And they did a rather low key interview, and I said, But I'm pregnant. And they said, In those days, very un-pc, so they asked me a while I told them I was pregnant. And then they said, are you planning to have any more children? Which you wouldn't be able to ask now I'm sure. So I said, Probably. Anyway, they were very enlightened. There was one female GP and three much older men. And they said, Yes, you can be a halftime partner. And so I was very lucky. And then went on to have four pregnancies or, you know, and took four months maternity leave each time,
Fiona Cornish 08:28
So not much maternity leave.
08:31
Well, only three months was paid. And we weren't really in a position to take an awful lot longer than that, because my husband's career hadn't really got going. So I took one month of holiday stroke, unpaid leave, and the three months of paid and then went back to work. So
Fiona Cornish 08:51
I was talking to I think the short periods of maternity leave was was what we all did in those days was yes, we had to. But I was talking to another mother of the women that were talking to who said that when she was asked, during her job interview whether she was going to have children said, Oh, no, no, no, no. And then of course, she got pregnant as soon as she as soon as she got the job. So it's, it's quite a, it was quite a difficult time then so fantastic, that that they that they didn't bat an eyelid and that you carried on?
Fiona Cornish 09:27
Well, yes, I think it was very much helped the work had been an all male partnership. And then one of those they had one woman Pauline Brimblecome who was my immediate senior and she had blazed the trail. She had two children. She was the one who had, you know, got them to think about it and to have a woman and so I was actually I did well coming after someone who'd been the trailblazer. So I think it's it's very good if there's someone who's already paved the way A you can, you can benefit a lot from that if there's another woman who's been before you and done something, it makes it much easier. So it wasn't the first time they'd ever seen a pregnant doctor in the practice.
Fiona Cornish 10:14
So did you, you said you you worked part time. And so that's also quite unusual to is it to be able to work part time in those days?
Fiona Cornish 10:24
Yes, I think it showed because general practice was quite, could be quite flexible, because it works as a small business. So I didn't job share, I think it's easier actually not to Job share. I was a free standing halftime partner who did two and a half days a week, I did my on call, every once a week, that was part of the deal. And in those days, we were on call, you took the bleep you were on call for the night. I remember saying do you mind if I just finish breastfeeding, and then I'll come and visit you. We did whole weekends. So you'd have the bleep for the whole weekend you'd set off for a walk with your children not very far. And then the bleep would go, no mobile phones had to turn around and go back to the house, and then ring the answering service and be told where to go what to do. So although I was half time I, I took on the responsibilities of being on call and being buying into the partnership and doing some of the practice management. So it was it worked fine. And I think that's easier than job sharing where you're very dependent on somebody else. And you've got to fit in with their timetable as well. So when people ask me, I always say that it's better to be a free standing person rather than a job share, if possible.
Fiona Cornish 11:51
It gives you more flexibility. So have you always worked part time, then?
Jane Dacre 11:55
No then as my children got older, I increased up to four days a week. So most of once they were, say eight and above, I had them quite close together had four children under five. So was quite a military operation. And then after that, I went up to four days a week. So we had a child minder for the first child and then went to a nanny once we had two
Fiona Cornish 12:28
so lots of people are intrigued about how we managed with childcare in those days. So what did you childminder first?
12:35
Yes. And then a live out nanny who just came on the days that I was working. And luckily for me, I mean, my practice spot a mile and a half away. And the school the children were at is between our house and the surgery, so I could take them to school on my way. And then the nanny would be there to look after the little ones or whoever wasn't at school and then collect them. And then I tried to have quite early afternoon surgeries so that I could be home by five. And in those days, there didn't seem to be quite so much paperwork and admin and the stuff that makes the GP day very long nowadays. So it does require a bit of efficiency, though. So I was always trying to get everything done as I went along.
Fiona Cornish 13:25
I strive to be efficient and organized. It's not it's not my forte, but I really work hard at it. I think we all do.
Fiona Cornish 13:34
We all do. We've got and then what really used to bug me was these men hanging around at the end of the day, just chatting and having a nice time and you thinking, why aren't you getting home? And then I realized that actually, if you delayed it a bit you miss bath time.
Jane Dacre 13:50
Did you have any time for yourself?
Fiona Cornish 13:52
No, I don't think I had any free time for about 10 years.
Fiona Cornish 13:56
So what about keeping body and soul together? How do you how do you what do you do to relax and maintain your wellbeing?
Jane Dacre 14:03
Well, when the children were little, and I suppose there wasn't any such thing as me time, but we did. We did go out in the evening. So we often had a babysitter. I still sang in a choir, and we'd be quite happy to go to evening events. We didn't have any sort of qualms about leaving our children with a babysitter. And I'm afraid we always paid a babysitter rather than doing a babysitting circle where you had to go and babysit for somebody else another night. So and the other thing that was massively helpful my parents were enormously helpful and used to have all four Children's Day for example for the whole of half term. So that I because it's difficult with holidays to work out. Exactly. You know how to occupy everyone over the holidays with only six weeks holiday.
Fiona Cornish 14:56
Because the other thing that I think is different now is coming across is being different now is that I think we could afford our own homes. And although we spent most of our money on it, we could afford childcare. And I think that's something that appears to be much more much more different now because of the relative... do I call it a relative reduction or the lack of increase in income.
Fiona Cornish 15:26
Yes, exactly. So, you know, we had our own house, good size house, when when we started, so we've never had to move. And I have been very lucky in living very near to my work. So I haven't had a lot of time traveling. And one piece of advice I was given years ago was to get a cleaner. You know, you're a busy doctor, you've done all this training, you've got children, you do not want to come home and spend your time cleaning. Now that sounds indulgent. But I think it's it's very good advice that I give to other people.
Fiona Cornish 15:58
I think it's essential. It's essential, but I struggle to see how it's affordable, so for people coming through. So you talked about being in a choir. other things are you able to were you able to do other stuff, because you talked about being involved in sports? And what have you when you were at university? Did that go by the wayside?
Jane Dacre 16:21
It did rather I mean, it's quite energetic running about with children. But I enjoyed tennis, which I couldn't really do very much until the children were a bit bigger. And then I played with them, but took them to tennis lessons. So and that's nice. So now they can all play tennis. And that is a fun thing to do. Running is quite good, because you can do it in a limited time. So I've always enjoyed running, I did cross country running at Cambridge, and I've done half marathons and a London Marathon. But that was quite difficult for us. I used to do every other day my husband would be, you know, on waking up, alert while I went off for a run, run the run the farm and then came back again. So and of course in Cambridge you can bicycle everywhere. So that's a good way of getting exercise. And once the children were old enough, they all bicycle to school.
Jane Dacre 17:05
So that's lovely, isn't it?
Jane Dacre 17:17
Which is a very nice way to go to school. Yeah.
Fiona Cornish 17:21
So you got involved in the medical Women's Federation told me about that?
Fiona Cornish 17:25
Oh, yes. well, I was very early on I was instructed by Pauline Brimblecome to go to medical Women's Federation meeting. It was the reason she got into it was that at the Addenbrooke's Hospital, there was six male obstetrician consultants, and they were appointing a new one. And they appointed another man. And this really got Pauline going. And so she was very good at promoting women. So I was a diligent junior partner. I went along to a medical Women's Federation and was very impressed with these dynamic older women who had struggled far more than I had to to achieve their career goals. And so I have always been involved with it ever since then. And it was absolutely awe inspiring, really, to meet these older women. And my husband used to think that it was a bunch of, you know, cardigans, and cocoa and not a very glamorous organization. But actually, then more younger people used to go and I could really see the point of it. And so I used to go to local meetings, and then national meetings. And then I got the tap on the shoulder to be an officer and I started as the treasurer, and then was the Vice President and then and then the President and I find them really rewarding thing to do, and was very interesting.
Fiona Cornish 18:59
What sort of things did you do for them? What did what were your greatest achievements in the MWF?
Jane Dacre 19:07
Well, there were several sides to it. One was campaigning for better arrangements for women. So a simple thing was that in the rcgp exams, if you were less than full time, you still had to do the full number of assignments for your exams and things and we pushed for that to be pro rata. And that sort of simple thing just made people's lives better. So that sort of thing was good. We promoted women in leadership roles. We participated in things like women in the city, which I think you were involved with
Jane Dacre 19:43
I was a happy recipient
Fiona Cornish 19:44
a winner
Jane Dacre 19:45
Yes. So just generally promoting women in leadership positions. And the meetings of the MWF are always lovely because they had complete mixture of specialities, and a mixture of seniority. So if you went to one of their meetings, you would meet women doctors from all sorts of different areas and all different levels. And then it was a really good environment, for example, for junior doctors to do an abstract presentation or to participate in a conference, a very supportive environment and they could cut their teeth on, you know, being doing some public speaking in a in a very nice environment where people are going to be encouraging. It was a good way of networking. And people used to, you know, really make good contact and for career, learning about how to develop their careers and and how to be more flexible working was another thing we had a lot of campaigning for. And we were represented on the GPC I was the medical Women's Federation rep on the GPC for a bit. They had somebody on all the BMA committees, which was, which was very good.
Fiona Cornish 21:05
I think it's it's really helpful for people who are stuck in the NHS, which can feel a bit overwhelming to have an outside professional support group. And yes, the Royal Colleges and the medical Women's Federation and other organizations fulfill that sort of well being role. And they they do as well as some just being political or doing whatever else
Jane Dacre 21:30
And we tried to set up a mentoring scheme. Well, we called it buddying, because in those mentoring, some people seem to have very specific definition and criteria of mentoring. So we called it a buddying scheme. And the idea was that a more experienced doctor could be put in contact with a more junior one. And not necessarily, you know, the very senior with a very junior, because what we found was that people gain a lot from talking to someone who's just one or two years ahead of them, so that they're in touch with what they're doing. And have got, you know, instead of being out of date, or Well, in my day, we did this and, but actually really practical advice. And this is how you need to organize your rota in here, you know, if you're getting married next year, I suggest you do this, that or the other to make sure your router is organized. So really quite practical things.
Fiona Cornish 22:24
Fantastic. So we're coming to the end of our time now. So I was just wondering whether you had any pieces of advice to give those people who might be listening who are on their way on their way up on their way through?
Fiona Cornish 22:36
Yes, well, I think get a cleaner is one, don't delay having your children. Don't worry about being under qualified for a post plenty of men will apply for things when they haven't ticked all the boxes. So you know, enjoy your career. Work hard, play hard, a full life makes you a better doctor. Take the opportunities so yes, rather than No. Make the most of your friends and colleagues. Learn to speak up build confidence early on. Find inspiring role models, male and female qualities to admire be the three A's I was told able amiable and available
Fiona Cornish 23:21
Any not to do, any learning from bad times mistakes, anything to avoid?
Fiona Cornish 23:30
qualities to avoid, don't be grumpy or brusque with patients or not a team player because, you know, we all have seen people behaving like that. And it's, it's not a good thing. So don't be one of those. Support your friends and colleagues. Connect with all staff including nurses and allied health professionals and think about the work culture that you're in. That's those I had to do a 10 top tips once I think
Fiona Cornish 24:02
it's fantastic advice. Fantastic advice for those coming through. So Fiona, thank you so much for for talking to me that's been really, really illuminating to hear from you. So thank you. I'm sure people will love to listen to it.
Fiona Cornish 24:17
Thank you very much. It's been a pleasure.
Jane Dacre 24:21
Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 5: Dr Sarah Clarke
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant. Listen, and be inspired. Today I'm talking to Dr. Sarah Clarke. Sarah is not only a female interventional cardiologist, which makes her rather rare. She's also the fourth female president of the Royal College of Physicians. She's had a fantastic career, and she's going to share it with you today. Can we start off by you just telling me a little bit about your career so far? So, for example, when did you decide to become a doctor?
Sarah Clarke 01:13
Thanks, Jane. So when I was at school, I was actually more of a physical scientist rather than a biological science. I did maths, further maths, physics, chemistry, and didn't really know what I wanted to do thought I don't teach or do actually or accounting. I didn't really know much about what they were, what they were, what they involved. But, so when I when I applied to university, when I got when I actually got my A levels, I decided to take a year out and have a think. And I noticed an advert in the Surrey Comet for a research assistant at the Royal Marsden in Sutton in Surrey. And I thought, well, that sounds interesting. I'll go and do that. And at the same time, I was sitting the entrance exams to Cambridge. So I went along to the Royal Marsden and met Professor Trevor Holmes, whose twin was also there working in pediatric oncology. And Trevor was a an oncologist best physician. And I had an absolutely fabulous year, they were just, they were really got me involved. I went on the ward rounds, I went into clinics, and basically I was measuring tumour sizes for their for some of the trials and documenting or so they're responsible for my first publication in it before the age of 20. And while I was there, they were very encouraging about a career in medicine. And I began to realize the opportunities that were there. So when I applied, I applied for medicine. And I applied to go to Gerton and sat the exam and I got in seventh term. So I've having finished at the Marsden. I went up to Gerton. And so that's where my medical career started. And I did my three years there, and then I went on decided to stay on in Cambridge, I enjoyed living in Cambridge, having sort of lived in London for years, and went to Addenbrooke's to complete my clinical component of the of the degree.
Jane Dacre 02:59
So what sort of background you come from Sarah, where do you have doctors in your family?
Sarah Clarke 03:05
No, no doctors at all, all engineers. Yeah, engineering, really
Jane Dacre 03:11
Gosh, so it's quite a change. So then you qualify as a doctor, I assume. And you're a cardiologist. There aren't that many female cardiologists so why cardiology?
Sarah Clarke 03:28
You're right. There aren't enough women cardiologists, absolutely. I did my my rotation at Addenbrooke's. And the different jobs I did was renal medicine, oncology. cardiology was one of them and dermatology. I liked cardiology, because it was technical. And I must, because I come from a sort of physical science background, I liked the technical technical aspect of it. I was very practical and I'm very practical. So like the hands on, it seemed very relevant to across medicine. And it had the sort of acute element as well as the chronic element to it. So I enjoyed doing I enjoyed my time doing my cardiology Junior role, and then decided to apply for the registrar rotation, which actually happened to be in Cambridge, and took me to Papworth where I was I started getting into the cath lab and, you know, realize that the interventional side of it was for me, because the the speed at which technology changes the hands on the acuteness that having to respond quickly, is an ever evolving specialty and, and I liked that pace, and having to make quick decisions.
Jane Dacre 04:40
But presumably, you were in quite a minority during that career progression. Did that bother you at all?
Sarah Clarke 04:48
No, didn't bother me at all. And I was well aware that I was, you know, there weren't many women in cardiology at that time. Didn't concern me. I wouldn't say it was an easy road. You know, I had to do with some decisions, which I felt weren't fair, but I decided to hold my own and, and get through
Jane Dacre 05:10
what sort of what sort of thing wasn't there?
Sarah Clarke 05:14
So I think when, when there were suggestions about where you will rotate in the suggestion that I might want to sort of do general cardiology, and perhaps not the interventional side, because I might want to have a career break at some stage. So, whereas for me, I was totally committed to doing intervention, and I had to, you know, work hard to get further when I went to I had a fellowship abroad in the states in Boston, for a year. And so in going there, it was, it was great, because it actually enabled me to flourish more, but it but it was in order to in order to get through that, yes, there were barriers that maybe I should do something more general, the general medicine, you know, rather than go down a specialty that was competitive, long hours out of hours, as well. And the suggestion that, you know, that was probably going to be more difficult career pathway for me.
Jane Dacre 06:09
So I have to say, you don't look like someone who chooses the easy path, because not only have you had a career in cardiology, but you've also got into medical leadership. So what what were your motivations for going for leadership positions?
Sarah Clarke 06:29
So when I having become a consultant at Papworth, we were in the old hospital. And at that time, it was beginning because this concept of working in regions and working collaboratively across hospitals, and was all beginning to evolve. So I got involved in developing the heart attack service, because it's very relevant to what I was doing anyway. And it was something I could take on and became clinical director at an early stage, partly because there had been a long gap between the previous consultant being appointed and me coming in. So I became a clinical director quite quickly, for cardiology, and got involved in with regional work and developing the the heart attack service, not only it was across the region, and that was really rewarding work working with like-minded people, leaders forward thinking, wanting to deliver optimal services across organizations, getting people on board to do it. Because here, we are now talking about 24/7 on call getting out of bed going in at all hours. It was a very different concept of what had happened before. But technology is advanced as well, because when I first started, we weren't using stents. So stenting has, you know, completely revolutionized what we can do, or what we could do, we still can do so. So I got very involved in projects at an early age, and which I really enjoyed. And so it was, it was partly the heart attack service. But then, what kept popping up was redesign and movement of Papworth hospital into Cambridge. And so I became involved in the design and delivery with the new hospital, which took over what took place over several years, because a lot debate whether we should move or not, it kept going backwards and forwards, but ultimately got to the stage where we could spend some time, we spent time with various different, engineers and and developers to look at different designs of the new Hospital in Cambridge at the campus. And it was just fascinating to learn about how a hospital works and how it can work optimally. So we decided that the the hospital had to be designed around the patient pathway. So no, inpatients meets and outpatient, even if they're going into any scanning room or anywhere in the hospital. So they can we've managed to separate outpatients inpatients completely single rooms, all, you know, in the same same design, so that if you if there is a cardiac arrest, you can go into any room and it's gonna look exactly the same, you know, where everything is same with yet same with catalogs. So this is real, it was really interesting to actually think very carefully about the patient pathway and what patients needed, what they wanted, what was going to give them a good experience, whether they're an outpatient or an inpatient. So that was that was really enjoyable, and it's quite every time I drive over the railway bridge to go in to go into work every day. Or every day, the moment that whenever I drive in, it's always a pleasure to see this wonderful building that I feel I was I had a part of, and that was very rewarding,
Jane Dacre 09:27
Fantastic achievement. So presumably you also broadened out to be working with different members of the team because that can't have only been been doctors.
Sarah Clarke 09:40
Sure, no it was I mean, it was obviously doctors, it was the nurses, the radiographers work, but working across organizations as well, because that was being a tertiary center was, you know, was was being fed by hospitals around us. So we needed to make sure that everyone was on board and we could develop pathways To make sure that patients were coming in appropriately, so it was a yes, it was working within the team at the hospital, but also a much wider team and getting people on board this this new facility, this is what we can do. And it's not just standalone, it's actually for the region. And of course, it's also a national center as well.
Jane Dacre 10:17
So was it that that because you then moved on to national leadership roles, starting in cardiology, how did you, how did you take that step?
Sarah Clarke 10:28
So when I was a registrar, I went to I went to one of the conferences, and they invited me to do some reporting. So I had a dictaphone and went round and interviewed people like Roger Boyle and, and, and we put it up on the website very, very early on. And so became set up as a roving reporter scheme for the for the conferences. And then after that, I was then sort of brought into the fold at the British Cardiovascular society and sat on the program committee Education Committee, and became then got elected to be Vice President for Education at the at the British Cardiovascular Sociaty, which then then I was responsible for developing the education education portfolio. But also the National Conference, which my predecessor Ian Simpson had started to transform, but we completely changed it into something that was very much more designed around tracks. So trainee track revalidation track, education, track, intervention track, etc. You know, we really redesigned it so that people could see very clearly when they were coming into a conference, what experience they wanted to have, they want to go for special specialty training, or they want to have more general training, and developed an education zone where we had simulators, and, and hot topics where people do very, very quick updates on things. So did a lot of change there, which was, which was really rewarding to see. And it's significantly significant, increase the number of people that came to the conference. And because it became more relevant. So I really enjoyed doing that. And after that, I was it was just I stood for President. So I stood for president and was successful, and became the first female president at the bush Congress starting, I'd have to say sadly, there hasn't been another woman yet. But I keep encouraging all the my female interventional and general general cardiology colleagues, wherever to, to think about it, because it was a very rewarding time. And at the time, I, you know, I really enjoyed working with a lot of my colleagues, as president there, you know, to try and to develop, we embrace cardiology, as it's evolved over the last few years.
Jane Dacre 12:43
And so how did you then move over to the broader Church of the Royal College of Physicians?
Sarah Clarke 12:53
I suppose, when I when I stopped being President, when that when that term finished, I'd become engaged more in the improvement programs, national improvement programs, such as getting it right first time. So I was involved in the gearshift getting breakfast time for cardiology, and work with Professor Simon ray from Manchester in in going around and doing all the visits and looking at how we could improve cardiology services. This was just before lockdown. And then at the top, the core vice president role came up at the college. And it seemed to me, you know, I was I've spent all my time in cardiology, but thought, actually, there's more I can do that there's more like to do across medicine. And you know, that the same principles of how you go about doing things and assessing and deciding what you're going to do and delivering would be the same so. So I thought I would apply for that role. It's elected role. And it was great because I was successful, which gave me the opportunity to think slightly more outside the box of just not just cardiology anymore. But all everything that I've learned. All the principles are different experiences that I'd had were completely irrelevant across the different specialties. So it enabled me to bring together a wider group of people to look at this the problem more generically. And and so that's that's how I became involved in the college. And then president, and then President. Yes.
Jane Dacre 14:22
It isn't always a bed of roses, though, is it as I know, to to my own, I bear the scars myself. So I do want to mention some highs and some lows. So far, you've been doing the job for about a year now.
Sarah Clarke 14:39
Yes, highs are very much the people that I'm working with within the college, but also, it's a huge privilege. And I felt this very much when I went out visited trusts and met other people in trusts and looked at how they were working and trying to sort of work with them to improve things and I think For me, the highs of the visits, the trust visits are due to the college as well. So this time, it's not speciality based. It's more based on meeting the trainees, meeting the consultants, and then meeting the senior management team to understand across the spectrum, what are the issues? What can I help with? What can I advise, what can we recommend, and certainly recommend to senior management teams, and highlight things that perhaps they weren't, aren't aware of, and need to be aware of, or messages that don't seem to be getting through sometimes. So for me going out there being on the road and visiting the different trusts is always something I've enjoyed as doing. And this the same is the same at the college. So meeting different people and meeting for me now meeting people in different specialties and trying to work outside my comfort zone. So I do one day a week interventional cardiology now go back and do my do my day, my day job, I suppose, what has been my day job for many years. But the rest of the time, it's actually trying to make sure that is working outside the box and across the different specialties and medical specialties in general medicine, acute and emergency care. And the another highlight for me is is working with the other presidents as a team, particularly when we're facing the challenges that we've got in the NHS. So the Academy is a collection of all the different presidents in the different specialties. And we're a good bunch, I think we work really well together. We've got similar thoughts about how we should do things we've got, we know we were very good at bouncing off each other, also very good at supporting each other because you mentioned the lows. Of course there are lows. And and I think one of the biggest challenges nowadays is how is social media, it can be cruel, it can be lonely, and it's trying not to take it personally in any way. And you know, having the support of people around you not only in the college, but from other presidents who, like you say you know what it's like, and you don't know what it's like until you do the job. So the fact that they, they know what it's like, and they support you and the minute something happens, there's a phone call, there's a you know, WhatsApp is really is really good because it actually makes you feel, you know, you're not alone. And it yes, you're absolutely right. It can be quite lonely at times. And it UK can feel like a personal attack, that you absolutely have to not take it as that. I'm very lucky, I've got support. I mean, at home, I've got really good support. So it's very easy for me to go home and rant for a bit and then get it off my chest and then move on. So yeah, it's not easy. However, the positives far outweigh the negatives.
Jane Dacre 17:50
I mean, I agree social media can be absolutely vicious and often comes along being vicious at a time when you least expect it to. And can I, you mentioned a little bit about having supported at home because often a very high achieving woman in a relationship comes across difficulties in in your home life. How does that all work for you?
Sarah Clarke 18:23
So I don't have children about I don't have children my own. But I'm married. And I've got husband to spit older than me. But he did general practice for many years in Cambridge. So we met in Cambridge, not at university, but after we qualified. And he was a general practitioner in Cambridge for many years, but also with somebody who got involved in improvement and developed out of our services and things. So we're sort of not quite like minded and so he understands things that I do and can support in that way and things that I do and the frustrations etc. But now he doesn't he works for NHS digital, which he actually really enjoys. So it's, it's, he's got a little bit more time than I have. So he's able to he's now supports me, which is fantastic. He's interested in what I do interested in meeting the people that I work with, and very good at being a sounding board for ideas that I have what I want to do and and also, when things aren't going well helping me understand perhaps what I could do differently or was Am I right? Am I gonna think that different perspectives, you know, is very good at doing that. So we're quite were actually I'm very lucky, very lucky. Jane. Got a good good partner. Good team were good team.
Jane Dacre 19:36
It sounds it's it sounds great to have that support. So and also the people who listen to this podcast will be considering whether or not they go on to leadership positions. Is there any advice that you would give to people coming people coming through things to look out for things to be aware of
19:58
I think if you're, if you're somebody who likes not just to do the job, but to think about different ways of doing things, or leading your team and developing your team and going forward, it is important to do a leadership course of some sort, just so that you get to understand the principles and how to work with people and how to drive things for drive change. And one of the courses I went on was a Women Transforming leadership program in Oxford. It was just women, but it was women across lots of different careers, you know, finance lawyers, medics, were a real mixed bag, and it was residential. So we were locked up together for a whole week. And we had various challenges to persuade us to get through. And I think that that week that I spent in Oxford, I learned so much about not just how to do things and how to work, but also you learn about yourself, and what sort of person you are and how you can and should try and adapt to different situations. So I think it's really important to get some basic grounding, and do a course where you can spend some time with other people in a safe space, and talk about, you know, the challenges and perhaps things that you find more difficult things you find easier. And how you get through things, you learn so much. And I think once you've started develop their skills, as you start doing different things, you begin to learn how to deal with something, not everything always goes right, as you know. So you learn from everything that you do, but you've got a way of coping with it, and and developing yourself as you go along. So it is a sort of a developmental process. I think, as a leader, you know, the different things that I've done, I can see how each of the different roles I've had, I've been able to build build upon personally, as a person, but also it's enabled me to take on some more, you know, tougher challenges, like being president at the RCP. So my advice would be to get some get some, some grounding in principles and, and also build a network of people build that network of people around you. So I'm still in touch with my group from Oxford from all those years ago. And you know, we, if anyone has a problem, this of WhatsApp goes and we will try and dip in and help each other. And until you must build a network around you of people that you trust that you can go to, and if the several people that I've got a lot of people that I had a particular problem, I would know who my go to person was who could help me with that. And that's, it's really important to have a network of people around you.
Jane Dacre 22:40
Very wise, we're really grateful to you for your time. So, Sarah, thank you very much. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 6: Professor Meghana Pandit
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant, listen, and be inspired. Today I'm talking to Megana Pandit, Megana started her career as an obstetrician and gynecologist, but got into NHS management. She is now the Chief Executive of Oxford University Hospitals. This is an extraordinary achievement. She's the first Indian woman, Chief Executive of an NHS Trust.
Meghana Pandit 01:05
Let me start by saying that I never imagined in my entire life and career that I would be a CEO, let alone the CEO at Oxford University Hospitals. And there's a reason for that. So I started my medical training, I was born and brought up in India, in Bombay, which is now Mumbai. And I went to medical school in Mumbai, I was a national scholar in 1984. And I was in one of the top medical schools in Bombay, linked to the King Edward Memorial Hospital. It was a great, great five, five years, you know, lots of learning and lots of fun. And then I met someone and I fell in love with them. And that person lived in Oxford. So I moved to Oxford, I got married, I moved to Oxford in 1991. And the day I arrived here, it was minus 11. And I was coming from 35 degrees Celsius. And it was a culture shock. But of course I was I had traveled widely before with my parents. And it was just the feeling that this is not a holiday, I'm here and my life has changed. That that was the feeling that suddenly sort of caught me unawares. But I've had right from that day, absolutely fantastic support from my husband and my family. And that is pretty much what has enabled me to do what what I have done and what I do today. And that's from every aspect from the way I was raised, the values that I have, and I bring with me every day. And and when things don't go so well the support that I need. So, of course, when I said I trained in Mumbai, and to come here, I had to set the plan. And that that was you know, that was a culture shock. My parents in-law were both GPs. And it was in those days, I sat in in with my mother in law in surgery GP surgery, and sort of just got to understand how we interact with people, how we, you know, take a history and examine people very different to what happens in different parts of the world actually, in the way it's conducted. And I started the PLAB and my first job was at St. Mary's Hospital in Paddington. But before I get to that, I'll tell you the connection with Oxford. So I was living in Oxford. And my husband is also a doctor, and he was doing his D. Phil at the time. But he wrote to the professor of medicine in Oxford, and said that his wife, new wife, was sitting the PLAB and could I could I shadow him on on his firm. And he graciously accepted me on his firm. And that was Professor John Ledingham, who is absolutely fantastic. And I will never forget the ward rounds that he did on busy medical wards, and his team, and I shadowed him. And I used to walk down the academic corridor where my office currently is as the chief executive. And, you know, it was it was just a sort of feeling where I've got my entire career to do I still have to sit the PLAB and pass it. And I'm sitting in the Cairnes library in the John Radcliffe hospital. And you know what, what's going to happen? I just have to focus on one thing at a time. Anyway, I passed the exam and I said to John, I said, I want to be an obstetrician gynecologist, and he looked at me and he said, Why would you want Why would you do that? Why would you even want to do that?
Jane Dacre 04:46
I was going to ask you
Meghana Pandit 04:50
I said no, no, I that's what I wanted to do. And I wanted to do that. I wanted to be a gynecologist and obstetrician because I always felt there was a fantastic mix of medicine and surgery. And there was always an emotional component. And there was that quality of life component which which I wanted to improve for women. And one of my aunts was a gynecologist, actually, she she I was born in her clinic. But anyway, so I, he said, Well, if that's what you want, that's fine. But look, the world is your oyster. And he wrote to me and I still have that letter. He said, The world is your oyster. You can do whatever you want. And you know, there you go. So my first job was at St. Mary's Hospital in Paddington. And those early influences working with Dame Lesley Regan, Guy Beeston, John Smith and Frank Loeffler, they were the forming days. I mean, they gave me such a solid framework and base that, you know, it was a springboard for the rest of my life, really, not just career. And the first day on the first morning, when I went on to the ward, and Dame Leslie Reagan came, she was the consultant and I just the first thought I had in my head, you know, was, I want to be like that one day. And it was extraordinary. And, yeah, I don't think I don't think I'll ever get to be like, but it lays a stone. I'm
Jane Dacre 06:15
I'm interviewing Leslie Regan as well. Okay. We'll have you both.
Meghana Pandit 06:22
Yeah, you can tell her that. But anyway, so that was a really good time. And then I did lots of lots of SHO jobs as one does. Lots of hard work, commuting from Oxford to London and then commuting. And then I spent two years in Oxford as a SHO. I had some trouble I have to say in passing my part one, I just wasn't interested in doing exams. I just moved countries. I was you know, I was changing. My life had changed. And I was just wanting to relax, really. But I kept sitting the part one MRCOG, eventually passed it. And the next really good phase in my career was when I went to America, I went to Ann Arbor, Michigan, my husband and I both went there for a year to work. I was visiting lecturer there with Professor John de Lancey. He's the professor of urogynecology, who actually discovered well described the first person to describe the continence mechanism and women and the pelvic floor anatomy. And I worked with him. And you know, he is an amazing person. I mean, obviously, I'm still in touch with him. Firstly, the resources available for research in America, were eye wateringly different to what we had, or still have. And, and the learning in terms of just anatomy and clinical work, different operative techniques and research methodology from him was was really fantastic. And the thing he said to me when I got there was, what do you want to achieve? You know, you have a small baby, the weather here is dreadful, you will want to travel. So what do you want to achieve in your year with me? And I said, Well, if I get at least one peer reviewed publication, and then and an opportunity to speak at a large conference, I'd be happy. And he said, That's fine, we'll get that done. And you know, all that learning about research and learning about privatization, learning about how you speak when you're speaking to an audience of 2000, you know, all of that. And I got three papers out of it. I got and also got, I spoke at large conferences, and I want to prizes I want actually the young gynecologist of the Year award. And I was, I received that in the con at the conference, our COG annual conference in Cape Town in 19, I believe it was, must have been 2000, or 1999. And that was a very proud moment. But when I came back to, and this is where it all sort of started going a little wrong for me. And I don't know what I'd ever done to make it go wrong. Because I came back, I had a small baby, and I was doing 16 hour shifts. And that was really difficult. That was the start of the different hours of working. And believe me, I was commuting from Oxford to another hospital and doing 5pm to 9am shift seven nights in a row. Now those are undoable.
Jane Dacre 09:15
How far were you commuting?
Meghana Pandit 09:18
An hour. An hour's commute
Jane Dacre 09:20
An hour added to your day,
Meghana Pandit 09:23
both ways out, but
Jane Dacre 09:24
and a small baby.
Meghana Pandit 09:25
Yeah. So that's why I chose to go flexible at that point. And I wasn't treated very well when I said can I train flexibly? And anyway, I said, you know, I carried on I said that's what I have to do for my family and to continue my career. And I when I got to CCT I had I mean, you know, I had people say to me things like your face does not fit. I had people saying to me, we are not going to give you a job here because you will take away our private practice, you know, all sorts of things. And I just thought, Well, why would I want to work in this unit? If that's what they say to me? That's, that's not I'm not going to let go of what I've learned from John de Lancey what I've learned since then three years, so four years of solid urogynecology learning, why would I give that up? That's not the right thing to do. And why would I want to work with people who told me my face doesn't fit? So I,
Jane Dacre 10:25
this was back in the UK, was it? Yes, yes. Yes. Exactly. NHS? Yes. Yes. In London or outside London.
Meghana Pandit 10:35
In the hospital, where I'm the CEO now.
Jane Dacre 10:37
Okay. Gosh. Don't get mad get even Meghana.
Meghana Pandit 10:45
So, so. So anyway, so I took a job in ADDH. I went to because they actually phoned me and said, We want to advertise a urogynae job? Are you interested? And I said, Yes. And there was an hour long commute, again, from Oxford. So I went there. And I was a consultant there for nine years, actually. And the first, I mean, it was hard work. I mean, it's bad enough to be a new consultant. But this was really difficult. And the unit was going through a bad time. They were, you know, we got to sort of two years, three years into job in my role as consultant and found that there were poor outcomes, you know, the trainees were giving bad GMC survey results, lots of complaints, disharmony amongst consultants and unhappy staff generally. And I thought, This can't be this can't be right. Why is this happening? And I said, I went to the medical director, and I said, I'd like to be the Clinical Director, please. And they said, you know, it was very wise advice. And they said, look, you've been a consultant for what, three years? I think you need to sort of maybe go and get some training somewhere about how to be a clinical director, and then we can think about it. So I did just that I went to the Kings Fund. And I was I did a not long but a two week course on how to be a clinical director. And about six months later, I came back to the medical director. And I said, Well, I've done the course you recommended, so I would still like to be a Clinical Director, please. And he said, Okay, well, look, the current person's term is going to come up, and we're going to re advertise, but they're likely to apply again. And I said, that's fine. I'm used to competition. And I said to all my colleagues, I'm going to put my hat in the ring to be a clinical director, and one of the senior colleagues and man colleague said to me, Oh, if I were you, I wouldn't apply because the top corridors told me that I'm going to be given the job. So you will only be embarrassing yourself by turning up to the interview and not getting it. And I said, Well, that's fine.
Jane Dacre 12:59
Was it a competitor?
Meghana Pandit 13:01
Yes Yes. a competitor. So I said, No, that's fine. I will, I will be interviewed. And I can I'll see, you there. And of course, he didn't turn up to the interview. He just wanted perhaps me to withdraw so that there would be no obvious person and then he might have been asked, I don't know. But anyway,
Jane Dacre 13:20
so did you want to do it? Why did you want to do it?
Meghana Pandit 13:24
So I'm coming to the so yeah, so I'm coming to that. So I wanted to do it, because I had a strong desire to get things right. I did not want to just complain about the outcomes and the and things not being positive, I didn't want to sit in the background saying, oh, somebody else is not doing it right. Or somebody else is not providing me help with digital, somebody else is not providing me help with admin support. I wanted to say, okay, somebody needs to fix it. And I'm willing to give it a try to fix it. And I have gone and got the training about how to be a clinical director and I am putting my hand up to say, I will try and fix it. Here are my ideas, here are my ideas, to remove waste from processes to make things efficient to create frameworks of behavior, create frameworks for trainees and create a program for trainees and all this sort of thing. And I did get that job as clinical director and I was very fortunate to work with the newly appointed head of midwifery and a newly appointed General Manager, and they're still my friends to this day. And we, over the next three years literally working with the team that we had the people in the department, we turned it around, and you know, I was no longer standing in front of the television camera apologizing to a family. You know, we were celebrating good outcomes. So that was really nice thing and I thought I'd really liked it and I had a very busy clinical practice at that time. And and then the organization when appointing divisional directors. So I again, I then was asked if I would like to be a divisional director and I became a divisional director for women and children's division. And it sort of gave me a buzz, I felt that I was being effective on a larger scale, that I was able to influence outcomes for a larger number of people than the person right in front of me. You know, of course, I loved my clinical practice, you know, and I loved my patients. I loved being in theaters operating. But this was just a different challenge. And I found it very stimulating, to try and make an impact and a positive change for be in people's lives. And I thought, Okay, I'm doing all these things. But I wonder if there's a theory that describes all these changes and behaviors I'm trying to make, because I didn't always get it right, then, you know, sometimes I was, I was, I wanted to just go ahead and set in a pace setting way other times I, I sort of maybe didn't speak to the right people at the right time. And I thought, let me explore if there's a theory, and that's where the MBA comes in. So I looked around to for an MBA, and I found the Oxford Brookes Global MBA program, which was, which was, which could be done as one as I worked. And I took that up in 2011. In the summer of 2011. I started doing it. And suddenly, one day, I saw that there was a job being advertised at University Hospitals, Coventry, and Warwickshire as the chief medical officer. And I thought, well, that would be a nice thing to do. I really like what I'm doing. And then the MBA is fascinating. I'm learning a lot. And I remember people saying, Well, why would you want to do that you've got a great job, you're a divisional director, you're doing so well, and your patients love you and your colleagues in the hospital are great, and the hospital is going great guns, they're going to join up with new Buckingham university soon. So why do you want to move? And I said, well, because I think I like the thought of being a chief medical officer in a bigger hospital, to have a bigger impact. And I went there. And I was interviewed, and I got the job. And I thought I literally to this day, I feel like I hit the lottery on that day, when the CEO of that hospital, Andy Hardy phoned me to say, I'd like to offer you the job of the CMO. I could not believe it. And that that really changed my life. Because when I went in, I didn't know very much. But I had very supportive colleagues. I had two deputy or I had two deputies were appointed before I started the job and Director of Quality. And Paul, Andy and Mike were so supportive and superb in the way they shepherded me through the first 18 months. And you know, I felt, you know, when one moves hospitals at that level, you feel like you're an outsider. You come into a new family, and everybody's looking at you going, Oh, what are you going to do or say and you don't really know what's going on. In that hospital. You don't know who gets on with whom or who is married to whom and many people are in the hospital working together. You don't have that history. But I think that helped me and and the support that I help certainly did. And I was there for almost seven years of the CMO and I cried when I left because it was like a family.
Jane Dacre 18:38
Did you carry on your clinical work at that stage?
Meghana Pandit 18:40
I did. I did. So when I went there in 2012 I stopped doing obstetrics, but I carried on doing one day of gynecology. It was a it was a big job, University Hospitals. Coventry had about 400 consultants then a staff of about 1000. And based on two sites, one in Coventry and one in rugby and linked to Warwick medical school. So it was a big, big place. But you know, I thought okay, I could do one day of gynecology, but over so I carried on doing that. I think in 2018 probably I changed to just one hour to half a day rather than one whole day. I stopped operating, I think in about 2015 but I carried on doing outpatient procedures and clinic. And I had great colleagues there and I learned a lot while I was CMO. One of the things I did was I started a master's program in at Warwick University in healthcare management, which has which is now oversubscribed. It's a great master's program. I still teach on it. I also managed to be there exactly at the right time. When there was a partnership with Virginia Mason in Institute, Virginia Mason Institute is a small hospital in Seattle, who are regarded as one of the safest hospitals in North America, following their adoption of lean methodology, which they learned from Toyota Motor industry. And they've been doing that for 15 years. And Jeremy Hunt, who was then Secretary of State for Health, had been there and really was impressed with what they did and said, Well, I will fund he funded five hospitals. And we partnered with Virginia Mason Institute so that the NHS could understand and learn that I learned about lean methodology and waste reduction. And, you know, there were people cynical about it, but actually, that has been a fantastic program. And that's what gave me my passion for quality improvement. And I firmly believe that quality improvement is about respect for all respect for the people who do the work and enabling them to make change. And my role as as you know, the chief executive is to facilitate the change that they want to happen and unblock any obstacles that they have in their way. What I also did when I was in Coventry was lead change programs. So here I was, you know, doing my MBA and actually using what I'm learning on the MBA to translate that and implement that into the work I was doing in the hospital. So I wrote a lead on the writing of the clinical strategy. I lead change programs and one of the change programs I led along with Mark Radford, who was the Chief Nurse at the time with me in Coventry was getting emergency care, right. And we saw the A&E performance improve from about eight, low 80s to 96%, within six weeks because of this change program that we led. And it stayed like that for about seven, eight months.
Jane Dacre 21:50
The four-hour wait
Meghana Pandit 21:51
yeah, yeah, the wait, yeah. And the whole, the whole country was watching. And I remember going talking about the change program everywhere. And it was such a buzz in the organization, because everybody's work got easier and better. And patients were, you know, served a lot better than waiting on in the corridor. I also lead finance improvement programs. And I also lead operational productivity, particularly in theaters. So I was doing a lot and I became a Deputy CEO at the time as well. But I think success as a CMO as the Chief Medical Officer really came from being from compassionate Leadership. So really, from listening, understanding, and empathizing with people from creating supporting supportive environments for staff for really implementing very well, quality improvement in the organization, learning to fail. And failure is not bad. If you fail, you move forward fast, I think that's really important to understand. But also maintaining a relentless focus on patient safety and staff welfare, and always putting patients at the center of everything we did. And I still do. So that really thing I think is worth success game as a CMO. And then Oxford came calling so in January 2019, I became chief medical officer at Oxford. And I remember being told that my main task when I was appointed was to improve the safety culture in the organization. And I thought, Okay, so I've come back after 16 years, when I was told my face doesn't fit. And I have to now change improve the safety culture. Isn't that interesting? But that was fine.
Jane Dacre 23:37
I remember visits. But yes. Visits to Oxford. Before you came. I remember having the discussion with you. It was a very unhappy place. So it's really interesting. Anyway, carry on.
Meghana Pandit 23:53
So I, you know, I didn't say Well, here I come having won the, you know, HSG Patient Safety Award for Coventry. Here I've come and I'm going to change everything. I that clearly was not the way I think I was wiser now, and slightly different from when I had been a clinical director. And I said, Okay, look, here are the things we could think about doing, you know, and we introduced safety messages. So every Tuesday, a safety message has gone out since February 2019. In this organization, from the Chief Medical Officer and Chief Nurse every single Tuesday without fail, and these are just learning points. There are bullet points that are expressed as learning from incidents or from mortalities. I started a pilot of a patient safety Response Team, where senior doctors, nurses and governance practitioners review the harm incidents that have happened in the previous 24 hours, with a view to making sure that the area is safe today that there is no ongoing risk and the duty of candour has been delivered. And also doing a quick review of why this happened. And can it be can it can be, is there any learning from it, so it doesn't happen again. We started that as a pilot and people said, oh, but how are we going to do this, there are four sides, you know, it may never work, you know, da, di, da. And now, I don't have to go to it. It carries on every single day, as a patient safety review team, people have written emails to say thank you very much for this, we cannot believe how supported we feel as staff. And, you know, as a result of all of these things, including safety huddles, there is no blame culture now. Whereas there was previously, so the reporting rates are high, the learning is high. And for instance, the number of never events dropped sharply. There was something like 11, when when I came and then there were two and you know, gradual drop from 11 to six and two and, and now we're stabilized, you know, at around three, or four or five. But that is,
Jane Dacre 25:54
You've moved up now to being more active. But you did this as an interim to start to
Meghana Pandit 26:03
I yeah, I'm coming to that. So within a year of within a year of being, starting all those safety, changes COVID came in March 2020. And it was really about continuing those things and not saying, Oh, my God, there's chaos. There's COVID, we need to stop this and re and just focus on something else. I said, No, we got to keep going with the safety because this is more important now than ever. And I think that's what sort of made sure that this organization realized that the focus was on safety. And then, after three and a half years as a CMO, I, I yeah, I became, I thought, you know, my predecessor, my CEO, retired, and there was an opportunity for somebody to be a CEO. And I said, I put my hand up. Because I've done 10 years as a CMO, I think I've learned lots, I think I have, I have things I can offer. And I'd like to do it. So I was initially appointed as a fixed term CEO for six for one year. Well, within six months, the board, the draft board, decided to start a process of appointment of a substantive CEO. And I was interviewed competitively, again, and I was appointed in March as a substantive CEO, here at Oxford. And it's a privilege to be in this role. It's a fantastic role. There's lots to give, and lots to get done. And I presented a vision to the organization and the board, which is based fundamentally around our people, patient care, productivity and partnerships. And you know, that there has to be change. And that change has to come into it comes in several forms. One, I would definitely say that there should be kindness to each other, and, and to bullying and discrimination. There should be introduction of management and leadership in the medical curriculum, which I'm working with Oxford University now, which is the best medical school in the world. And I really feel that people should be open to change and be engaged with change, and regard every challenge as an opportunity to shine. Because, you know, that's what challenges are. And Humility is a lot better than arrogance. And working as a team is really important. And I think some people realize it too late. But teamwork actually does work. And ultimately, I think fundamentally, it's all about compassion, collaboration and clear communication. So that better never stops.
Jane Dacre 28:46
Fantastic. That's such a wonderful story. I noticed your your alliteration, your partnership patient care, yes. You and then compassion courtesy. I used to do that in the RCP. So I could remember. But it is it did you describe it all really well. So can I just say we're coming towards the end now, but I just want to ask you some sort of specific questions in terms of general reflections, which is highs and lows Is there anything you would like to highlight as the maybe the best bit and the worst bit in that in that career journey?
Meghana Pandit 29:27
So the highs, highs, definitely our my, you know, my time in Coventry, and in America, and also being the CEO. Those are our highs, absolute highs. The lows are I've alluded to them the lows are about being bullied, bullied as a junior doctor, and and just, it was very hard. It was very hard at times when I was bullied
Jane Dacre 30:00
And towards that it sounds as if some of that was around the time that you were a bit more vulnerable. You had a young child to How many children do you have? And has the impact? Has there been an impact of you being so successful in your professional career? On your family life? Some people say that it causes difficulties.
Meghana Pandit 30:20
So I don't think I Well, it may be that I mean, I don't know if I'd had more children, would I be in the same place? I am. Now? I don't know. It's very difficult to answer, because I don't think it was. I have one child. I have a 25 year old son, who is absolutely fantastic. But you see, my issue was slightly different, which was that my husband was in a very busy specialty as well, which is anesthetics. So he was doing anesthetics while I was doing obstetrics and gynecology. And those are the two busiest specialties. Yeah. And and also, unfortunately, my parents in law passed away early. So what that meant was that we were entirely reliant on nannies and au pairs. And that I think that that that it wasn't my career, it was it was that that meant that we only had one child.
Jane Dacre 31:15
Yeah, and childcare is an absolute nightmare to do. I think it's even worse now.
Meghana Pandit 31:23
I mean, there were times when I remember a time when I was operating, and actually, my husband was anesthetizing that list. And suddenly, my bleep went off. And it was that my son had fallen in the nursery. It was a hospital nursery, but he'd fallen and and he needed attention. So, you know, we both looked at each other and thought, who's going to go who's going to leave? So I had to then say to the consultant, can you please take over I got to go because my son needs attention. You know, it's those sorts of things. It's very difficult.
Jane Dacre 31:58
It is it is very difficult. So So when these those things have happened, just that last that last thing now what what's helped you what's helped you to get through you've mentioned some some mentors, but just generally what what do you think helps.
Meghana Pandit 32:11
So my husband has been an absolute rock. He, he has helped every single time. And then just doing things like you know, going on holidays, I like I like to cook. So I cook a variety of of cuisines, which which, which I absolutely love doing, and I can switch off, I can play the music and cook and that takes me to another world. And then the other thing I do more recently over the last 10 years is fishing. I think that is the most therapeutic thing in the world. And I like to fish, my husband likes to ski My son loves skiing. So we go to North America, and I go fishing and they go skiing. And it's it's amazingly fishing. Fly fishing. Fantastic. I shall do a lot of it when I'm retired.
Jane Dacre 33:12
Excellent. So So Meghana, it's been a pleasure to talk to you today. So just to remind everybody that Meghana is the first female CEO in Oxford, and the first female person of color who's the chief executive of a large acute trust. So, Meghana, thank you so much for talking to me today.
Meghana Pandit 33:30
Thank you.
Jane Dacre 33:32
Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 7: Professor Scarlett McNally
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant, listen, and be inspired. Scarlett McNally is an orthopedic surgeon. That's very unusual for a woman. She's also an orthopedic surgeon with four children. Listen to her story here. At the moment, she's the president of the Medical Women's Federation. So she has a passion for supporting other women in medicine. Scarlett, could you start off by telling us a potted history of your career so far? And then we'll take it from there?
Scarlett McNally 01:11
Yes, and it's lovely to be on your podcast. Thank you. So I'm a consultant, orthopedic surgeon now and have been for 22 years. So I but I decided about 14 I wanted to go into medicine. And I went to talk to my uncle, the only medic I knew I cycled over to his house and said, I wanted it was good to do medicine. And he was a psychiatrist. He said ah, well, don't get pregnant until you're a registrar. And at the time, I knew what it involves getting pregnant, but I didn't know what a registrar was. But actually, that was quite an interesting bit of advice. And it's much easier to be pregnant when you're in a job when you've got a job to come back to. And it's very sad that 40 years later, we're still thinking along those lines, because medicine ought to be so much better. Anyway, I did. I went to medical school and knew I wanted to do surgery, I did not have a plan B. So every time someone tried to put me off, it didn't occur to me that they were thinking they were being kind, benevolent, unconscious bias, they call that because I didn't have a plan B I knew I wouldn't be a very good GP, I tell someone to stop smoking and do some exercise. And then if they didn't do it, and I had to see them a month or two later, I probably have another go at them. Because I knew at the time that health isn't about more than just fixing things. So for me, I just wanted to fix things and and it's lovely. It's just the best job in the world. I love it. And I went through all the SHO jobs worked on rotations at the time. So I just found one near a good karate club. And every six months, February and August, I put all my stuff in my Mini Metro, and my coffeemaker and my DVD and stuff, and went to a different place every six months. And some of them demonstrating, eventually got my registrar rotation. And I did a year in Australia as a Fellow which was great because I thought all surgery was going to go putting telescopes in people. So I'd have to learn how to do that. So I did a year of of that. And now don't do that at all. But it was lots more of other things you pick up sort of things I and yeah, I've done all sorts of stuff. I've been on committees and things I was on the Council of the Royal College of Surgeons of England for 10 years, which was great fun, it really did feel I was the ninth woman elected. It did feel like we were making a difference. And they let me write lots of leaflets like avoiding unconscious bias a guide for surgeons and an undergraduate curriculum so that people so that students can see the minimum standard. And I along the way, I did a part time, MA in education and a part-time MBA, but health service management, and I was director of education for my trust for three years. But looking back, I'd have done things differently if I'd be doing them now. And I'm now present to the medical Women's Federation, which is great, really interesting. And it's ideas, all sorts of different people who are not driven and wanting to fix things and being a bit short of time and pressured. It's really interesting. And I'm also Deputy Director for the Center for perioperative care, which is amazing actually it's part time half a day and wait for my time but it's about getting people fitter before surgery getting teams to talk together so that you don't have the same people - type of cancellations on the day that you could have predicted earlier. And getting getting teams talking together, getting safety steps done much better as all that stuff. It's lovely. It's lovely. I, in fact, I do I go around the country conferences, talking about all sorts of stuff. So that's me, but I'm on a half-time clinical now. And that is great.
Jane Dacre 05:23
So you've talked about doing the day job and obviously becoming competent at the day job. And the other thing that you mentioned is something that one of the other people I've been talking to calls side hustles. And that's quite an interesting way that women seem to thrive and survive in in their careers by having something to do that isn't just bread and butter NHS?
Scarlett McNally 05:51
Well, is it I'm just I've been challenging myself a lot over the last year or for I don't know that that I think it's that that's what the kind of women that have had to force themselves through the whatever glass ceilings off the glass cliffs or whatever, are the kinds of people that just don't stop, even when to be honest, they probably ought to, and then take on these extra roles. And I knew I'm driven by not wanting to see stuff done badly, because I want to fix it. And actually, sometimes that's the wrong approach. So I think we do pick up all these extra things, and suddenly think suddenly, you've got too much on because stuff does take time. And so I survived, because I can survive on not very much sleep, which is quite bad, because that causes dementia, and increased risk of suicide, actually, sleep deprivation, which is one reason we need to sort out rotors for people. But I was doing a lot of this stuff in the evenings, weekends spare time. Because I think it's the kind of people that are they've had to prove themselves to get to that position, then carry on doing that stuff, because that's what you think you have to do. And I think colleagues like that, too.
Jane Dacre 07:11
We're all very driven. I think the people that I've been talking to are all very driven. It's a pejorative term, but I think we're all girly swats that we do, we do work really hard. And all of the people that I have spoken, you've done very, very well in medicine, tend to work extremely hard. And, you know, sometimes that has its disbenefits as well as its benefits.
Scarlett McNally 07:43
And actually, the other problem is we are still proving ourselves. And so we send out something, we double check it, we've got the correct link in the email, you know, all that stuff. And it's interesting watching some of the men on the council Royal College of Surgeons, England, just assuming that the Secretary would do all that kind of stuff, and that sort of thing. Just a different way of doing business and a different expectation from the staff around them about what they'll do this. Particularly the nursing staff, I'm afraid to say different people are treated differently and have different expectations that someone will rush in and sort everything out for them.
Jane Dacre 08:32
But but you must have had an incredibly busy existence, though, in your 20 years as a consultant, orthopedic surgeon because you I mean, you've got you've got your career, you've got what I'm now calling the your side hustles. And you've also got children, haven't you?
Scarlett McNally 08:49
So yes, I have four children. They're now 20, 22 24, 26. And, and they're amazing people amazing. So interesting, about the job. The thing that I think was completely changed surgery was the national confidential, coroner patient outcome and death because before that time before 1999 When the CPOD report came out, we'd have to operate on whatever was there to be operated on. So that was all my time as a registrar, if I was on call and an operation to be done, I do them and we do. You know, and it made you quite a difficult person because you had to argue with people to get your case down you had to get open for access to theatre within six hours. But to other people listening you can train someone to do the technical operating and the skills and all that stuff. You can train people to do the team brief and the dealing with the team well and you can be an amazing amazing at your day job and it gets easier and easier because things put into patterns. But it was the fact that it changed. It's now life or limb threatening only at night was fantastic not just for patients, especially the it was worse for patients if you operate on them at night. But it transformed, being able to get some sleep and seeing your kids and being predictable, and then there'd be trauma less the next day. So someone had phoned you up in the middle of the night go, Oh, we got this person with a compound tibial fracture or bone, you'd look at the x ray on the thing, or they describe it to you. And you say, Oh, great, make sure the analgesia whatever. See you in the morning. Oh, thanks. You know, it wasn't a Get up, drive the hospital do the operation drive back. It just changed. Just before I became a consultant. So that was transformative. I'm just saying that because people don't realize this people my age are working being deans or medical schools or whatever they look amazingly, as they're doing not realize surgery, you work as a team. Huge amount is is day case surgery now, but 85% surgery done in a day case. So it isn't, you can just work really hard Mondays and Tuesdays have the rest of the week off, you can do that. But you're you work with a team. It's not you alone trying to do something heroic, which to be honest, it really did have to be in the 1990s. And I was a horrible person then. So in terms of the children, my husband's an was a nurse, and he dropped his hours to bring up the children. And that was that was the deal. And he'd often go away at weekends and things, you know, vintage car things and cycling and you know, sailing, and also he was a very busy kind of person. And so I'd get the kit, you know, you've done a shift, I get the kids. And I did you know it was some family holidays when I should have come back from work earlier. But I was trying to sort out some emails and stuff. So you know, he'd packed the car and all that. And I thought that was the deal. And looking back that was difficult. But yeah, and the kids are amazing. And that my key top tip is live near the hospital. Because then you're not I mean, admittedly lots of people are doing shifts. We didn't have to commute and travel. I cycled work, so I'm never queuing for the carpark. And that also means I arrive serene, because the endorphins have hit me at 15 minutes when I get to wrok all that stuff.
Jane Dacre 12:15
And kids in local schools.
Scarlett McNally 12:17
Yes, we did local primary schools. And then I was struggling a bit with four kids, you know, a 6,4,2 zero. So I then put the giving the local the oldest one into the prep school because I thought I can't do all this reading afterwards. And all the extra stuff you're supposed to do. I couldn't guarantee that. And my husband's, dyslexic, you know, he did kind of my kids are actually and we did the toe by toe reading. And I did as much as I could we say but yeah. So but at the time, that was the right choice for me.
Jane Dacre 13:00
Did you have other childcare?
Scarlett McNally 13:05
Oh, for a while whenever little my mother would come and stay for a weekend sometimes. One of my sister in law's came for a few weekends to send Jamie off for a weekend away. We had but we paid loads of money on babysitters. And we had nurseries for the little ones. In fact, even Australia, we had nurseries. They went to the two that we got to Australia with her nursery. But yeah, we pay for nurseries and we had but we got that through salary sacrifice schemes. When they were little we had a child minder initially, because I hadn't booked the nursery in time because I didn't actually believe I was having a baby. I don't you know, I just knew something's gonna go wrong. So it's a bit of a miss. Mix Match. But yeah, we always had nurseries and school and, you know, stuff. But yeah, and then Saturdays, you know, you'd have often a couple of different birthday parties in different parts of town and, you know, gymnastics and dance and rugby and all that stuff. It was very family focused. But the other thing is live in town, you know, all my colleagues with their fancy, lovely beautiful country houses, you then have one parent committed to driving, whereas we right by Eastbourne station, and we've got there were teenagers across the road who could be on standby if one of us was on call and Jamie's away. And they come in, they come and do. I just phone them up. Come on down. I've been called in up there in three minutes. So it's those those things you need is the geography. And the money makes a huge difference.
Jane Dacre 14:45
And it's interesting, just listening to what you say reflecting on the randomness of childcare crises. So you need to have people who are well and around who can come and and help out, but you got through it.
Scarlett McNally 15:00
Yeah, yeah
Jane Dacre 15:03
The other thing that, so you talk slightly wistfully about family and about getting through it, because it is quite a struggle, isn't it?
Scarlett McNally 15:11
It is. and I would have done things differently. I thought at the time that if I went part time, I would be looked down upon. I think it was also quite handy having kids two years apart, because I had a four month sabbatical every two years of maternity leave, so I could just be a mummy I was, I was dreadful at it, actually. Because people would be trying to go to mother and baby coffee mornings, I was like, there's no point in meeting people. I'm gonna go back to work. But it was great to have to be able to settle my son into school because I was on maternity leave with my youngest daughter, and he was four. So we had a lovely summer and settled him in for because you could only do you did three hours a day for the first week and then bit more for the second week, it was it would have been quite difficult to manage otherwise, although my husband would have taken time off work to do that. So yeah, that was a lovely time.
Jane Dacre 16:08
And then also, though, you've struggled with your health, haven't you? You've had some health problems that you've been quite open about. So how's that impacted on to your life in your career?
Scarlett McNally 16:25
So December 2018, and I got taken ill very suddenly. And I basically had heart failure. And just over a few months, I thought I was anemic and swollen legs and shorter breath walking upstairs or cycling up a hill. And I got diagnosed very quickly. And it turned out to be myeloma, which is cancer of plasma cells, and those produce abnormal antibodies which circulate around your heart and mine landed on my heart and caused heart failure. So it's Amyloidosis and the hearts rigid and it couldn't pump. So I was getting dizzy if I stood up and all that. So anyway, the treatment starts with chemotherapy and so busy when I was marched out, I was collapsed at work, I knew I'd put myself in to see the cardiologist to have an echo at some point that morning and that GP in arranged anyway kind of collapsed off the get up, echocardiogram table and I was MRIs, all sorts of anyway, and loads of chemo and I knew that a stem cell transplant was the only was the best what attempt at you aren't allowed to say cure but of going into remission, but I was told I wasn't fit enough. So I have all sorts of different chemo at point. One didn't work and, you know, anyway, so I had a stem cell transplant September 2020. And I'd I'd had to prove that I was fit enough I got an electric bike and cycled every day. And I was eating my fruit and vegetables and steaks and everything to try and get myself as fit as i could be. And I made them do cardiopulmonary exercise testing, so I was eligible. And then I had the harvest just before the pandemic struck February 2020 of my own stem cells, and then I went in for two and a half weeks in and a stem cell transplant which is absolutely draining literally just liquid green poo and my hair falling out and all that stuff. But I was so the problem is during the pandemic I was shielding I was so angry. And so I just took on loads of stuff, I was writing staff I was going on online meetings, all this stuff. And actually after the pandemic it was a bit tough going back to in person meetings, it takes a bit more time you got to plan your travel you got all that stuff. And and also at one point I should have been chairing a committee and somebody who thought he was being kind that benevolent bias said oh no, we thought you might need more treatment so we haven't put you on that committee with that kind of it made me quite angry with how other people are dealt with. And it was quite straightforward for me going back to work part time My manager was great. East Sussex healthcare NHS Trust you come and work here it's fine. It's not me. But my manager was great. And why is it so difficult for people going back to after maternity leave and you know, we need to make the system better and being a surgeon in training is a really difficult time we need to make that better and a bit more funding so people have CPD time extra when they're trying to look after their kids that weekend. You know, so all of that. It was difficult and I thought it was settling down but I took on these extra two roles because I thought I wouldn't be able to operate again at one point but now I am where you're back last time and it's great and amazing and I still have top up immunotherapy every four weeks which it does feel you know It feels like a period actually, you know, you predict when you're gonna have a bad time off the steroids or whatever. And so I adjust my my timetable is adjusted. So I didn't didn't work the end two weeks on those weeks. So yeah, but so it's still I'm still alive. And I'm but I'm trying to rush everything in because it didn't occur to me that I wouldn't, I wouldn't die, I was trying to get everything out. And I've got this job writing editorials in the BMJ every two weeks or opinion pieces, I just write stuff. So you can it's on open access, BMJ Scotland and you'll find it and I write about road traffic and prevention and not being perfect. And accepting people if you've gone to work, there's a minimum standard should be a baseline. And you just look after your team. And if someone's having a bad day, they just come back from sick leave, they haven't done that operation for just give them a bit of positivity. And I have the whole team ready to help and I tell my team when the breaks are gonna be you know, are this anons case is going to be so nice and boring, or go off and have coffee, then leave me with some, you know, 15 blades for a night and I'll be cool. But don't leave me when it's the difficult case with with a kit because I don't know quite what I'm doing yet. So and they will laugh and I'm going to really it's just it's such it just works in this isn't a surgical thing.
Jane Dacre 21:14
Do think it that that very difficult experience. It sounds as if you feel as if it's made you more whole.
Scarlett McNally 21:21
Yeah. And it's made me appreciate people. And I think the problem with surgery is you're so busy getting the next job and proving yourself with all these papers and you're the best, you've got the right answer in the journal club. And you're all pompous, whatever, and you've got there on time. And it means that if people can't do that, that some people in that room think they're lesser. And they're not. It's only temporary. It's like being pregnant is only temporary, and people should be given a little bit of extra support during that time. And, you know, having small kids is only temporary or my mother's got dementia, I have to manage all her stuff, but, you know, I suddenly have to zone out and do something and then, but I need the rest of the team to make sure that I've come back on track, you know, but it has made me more human.
Jane Dacre 22:05
So in the last, in the last few days, there's been all sorts of negativity in the press about sexual harassment in surgery. Is that something that's affected you?
Scarlett McNally 22:18
Yes, I mean, sexism is a daily occurrence, people treating you differently because you're a woman. And that is a problem. And I didn't, I thought that would be fixed by now, but it's not. And people having lesser opportunities because of their gender, or because they've had less time I'm actually more supportive of people who I think have had a worse time in the past. I've never in the past been into positive discrimination. But now I'm a bit more helpful to people like this little bit of a quiet medical student we had recently and I was trying to encourage him because the tall handsome one we had the previous week was just [unclear] and stuff, it made me realize what people have come through.
Jane Dacre 23:03
But so that's sexism is one thing. Yes, sexual. Sexual harrassment, sexual misconduct, I think
Scarlett McNally 23:12
So I was registrar in the nine a SHO registrar in the 1990s it was completely normal for people to have say rude jokes, flirt excessively but at the time there was a quite a lot of blurring you were living in a hospital accommodation these were the people who went to the pub with you we're on call quite a lot. And this so some there was too much blurring of that really by today's standards. And some people would have to be told you know, what was not acceptable and there was more alcohol around in social settings right around work and I think that's quite can be was what quite a big problem. But I got married in 1995 So I have a big badge and I got my fellowships you know after fellowship now it's membership and so I got a badge that said Mrs Scarlet McNally orthopedic registrar and then orthopedic consult so people don't mess because they know and I think it's this bro thing. Why would you you wouldn't mess with someone that's Jay's and he's six foot four and he works in A&E. You know, it just so for me, personally. It all stopped. Absolutely. When I came back from honeymoon it stopped. And, and also as a consultant, you don't see other people but I've witnessed it. And the last time I tried to do something about it. Somebody obviously I've been in the same hospital for 22 years and this isn't somebody works in that hospital. The person gave me a very hard time. And I've written the person who's done the bad behavior. And I've actually helped my trust with five different bullying allegations as an investigator of other people. And the problem is the reporting system is so tough, because people have to bring the evidence, and they think they try and deny stuff. I mean, it's not not about sexual misconduct, but about other things, you know. So people, you know, treating people badly giving them a task and taking it away, or say it wasn't good enough or, or something, or giving them a hard time for something hadn't told them they ought to be doing and all these people manage people really badly. So a we need better management, a leadership, training, and B, we need to give people a bit more time. And C, we need to put in the prevention stuff so that some things are not okay. And there will be allyship and stuff to try and stop people saying what they shouldn't say, and the Vanderbilt cup of coffee that if you do the first aid bit in the room, if somebody said something wrong, you go oh, we're not allowed to say that are we? And everything stops, you've got the first aid, but then later, someone very senior goes, come on what's going on? Are you okay? Because often it's the person going through a divorce, or their parents who've got dementia or they've got money troubles or anything that lash out, because they're so fixed, they're so burned out, maybe, and they're stuck in the moment. And it's those people, sometimes they have no insight into how they come over to other people. And sure, there should be disciplinary process, people who've been done bad stuff. But we also need to support those, those people or our patients to and our colleagues to in some of them didn't realize that impact. So that's why I wrote the avoiding unconscious bias document for the College of Surgeons, and we got some elearning about it. And I'm really pleased that this has taken on board is something we can there's going to be code of conduct. But I think we need to lift it to value everybody for what they're doing. When they're there for the minutes during work, they need to be valued. And I knew we've we've you don't want the podcast to run on too long, but it was something else I wanted to talk about because it's predominantly women audience.
Jane Dacre 23:14
So go ahead. I was just going to I was going to say we've heard some fantastic things about your life and your career, I was just going to ask you if there was anything that you felt that you needed to say to the next generation of people who might be listening to this podcast, and we'll perhaps use that as a way of, of winding up.
Scarlett McNally 27:23
Thank you. So earlier, this year, my husband left, and I found it shocking. And I didn't realize he always had the stuff he wanted to do the bloke staff loads of, you know, cycling trips, vintage vehicles, but I thought he came back to me afterwards, we had all these four kids with all their different, you know, whatever they're doing at the time, and I thought we were a great family, you know, we were a great team. And we had the pandemic together, which proved to be part of the problem that we couldn't go out just him and me as a as a couple. And we had different ideas about what the kids should be doing other priorities and things. But I didn't realize how profound it was. And I think it's also a bit of burnout from working in the hospital, he was a nurse. And he lived say because I was shielding. He was an he went in to the spare room. And bunched his shifts up over two weeks. And then we'd have a week where he actually didn't have COVID so that we can have family time. But I didn't realize that he he just got tired. And he just didn't have the buzz anymore. And he was really proud of me, you know, he's been talking about various, you know, it's like creepily interested in different people involved in in what I'm doing. But he just was really tired bringing up the kids he found difficult, you know, always having to justify himself, not being able to cope with paperwork from school stuff, which I did. And you know, I did more than my fair share more than most of my fellow surgeons, wives, husbands. Sorry, I did more than most consultants only by a lot. But it was tough. And I didn't realize how tough it was on him. And I think he just lost the spark he just saw particularly after I'd been ill and came back and was trying to just work in order to take care of this stuff and working toward I was always just a bit stressed. And the steroids do make me a bit weird. Every it was twice a week. And so I just I'm quite regretful of how I've handled things. There was a moment where I could have thought you know what, I'm going to take ill health retire or go part time or, or something or drop some of these commitments because there so long as you do that succession planning and lift up people, there'll be people to fill the roles behind and sometimes so my top tips are, make time for your bloke or your significant other. Have a night where a babysitter just arrives and you go out even if you haven't booked them just you know, use any don't. You don't have to do things brilliantly, you know, and use other people's help and get the in-laws to come and cover for bits or, except that the cooking won't be done to your standard or people don't have to, I don't know. And spend time with the kids, the teenagers need a lot of time just to ignore you and to begin list places, but you need that, that's when it gets difficult up to the age of 10 they love you and adore you and you can, you know, send them to Auntie's or look after them for we, we did quite a lot of that as well. You know, bring in the extended family. So they've got other people to talk to when they're teenagers. And they, they just, you know, it's lovely, if they've got a nice Granny, they can talk to you or they're gonna have a special weekend up inYork with Auntie Joan, you know, and split them up, if you've got too many have an inset day, when they've got an inset day, take one off for a special day, you know, you know, ice creams, or, you know, I took mine to Disneyland on the plane to Paris. And when I had a completely different half term once, I just went to Egypt just with her. And, but the inset days are made just book them off book them all off on annual leave the beginning of the year, book them off. Special time.
Jane Dacre 31:07
So listening to you. It sounds to me as if you've done a pretty fantastic job at a huge number of things all at the same time. This isn't meant to be a counselling session, but I would say Scarlett, we shouldn't be so hard on ourselves. We do our best. We do our best.
Scarlett McNally 31:28
You're right and we can't be perfect. We need to know what good enough looks like accept it in ourselves and other people, get enough sleep. And, you know, it just live different things come at different times. You don't have to do stuff perfectly. Really, really. And but also, also there's life in different phases. You don't have to cram everything in and things are very different now.
Jane Dacre 31:52
One of them one of the people who teaches on my leadership courses, you can have it all, but not all at the same time. Absolutely. So, Scarlett, we've reached the end of our time. So thank you so much for talking to me. It's been fantastic to hear you and good luck. I think it's all it's all looks as if it's coming back together. I hope everything works out for you.
Scarlett McNally 32:05
Thank you and again, just for anyone. Sometimes you're so rock bottom. You can't see that it'll be okay. But it will be sorry, to get emotionally open. But it will be and there are different phases in life. There are different people that help pull you through just from a distance. But yeah, there's, there's always going to be something else. There's always going to be a different phase. But thank you so much.
Jane Dacre 32:48
Well, thank you for talking to me. And thank you for your honesty. I'm sure that people will find your podcasts really inspirational. So thanks,Scarlett. Thank you. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 8: Professor Dame Averil Mansfield
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant. Listen, and be inspired. Professor Averil Mansfield needs no introduction. She has recently written an autobiography about her career. She was the first ever female professor of surgery in this country. She's a remarkable woman with a remarkable story. Perhaps a really interesting thing about her is that her dad was a welder. And what I'd like to start with is just to ask you to give me a potted history of your career so far
Averil Mansfield 01:12
Starting with my early years,
Jane Dacre 01:14
yes, what made you want to do medicine in the first place, when
Averil Mansfield 01:18
I was a girl in Blackpool from a working class family, living in a council house, where there were really no books. So a lot of my early influences came from the local library. And I can't speak too highly of those influences. From the local library, where the librarian was prepared to recognize the sorts of things I enjoyed reading and direct me to new things. And they included medicine, and in particular surgery. And I became at the age of eight, fascinated by the stories of surgical exploits, people doing things for the first time, without any knowledge that these things could work, even that people could survive having their chest opened or whatever it happened to be. So I determined at that point, that that was what I wanted to be was not just to be a doctor, but to be a surgeon Gosh. So that's where it all started.
Jane Dacre 02:15
So did you then set out to achieve that
Averil Mansfield 02:19
from then on, I was single minded about it. That's what I wanted to be. My parents were very cautious. Not surprisingly, working class parents, my father was a welder. And the idea that a child of his could become a doctor was a step too far. And particularly my mother thought it was way above my station, really to even suggest that. In fact, on one occasion, I won a prize at school. And he got into the local paper Averil wants to nurse now, you know, no problems with nursing. That's a wonderful career, but I wanted to be a doctor and I was really cross about it.
Jane Dacre 02:53
So what was any of that to do with you being a girl?
Averil Mansfield 02:57
It might have been, but that was not made evident to me. My father's mother never really paid any kind of notice of the fact that I happen to be female. You know, it was, I could do whatever I wanted to do, really, except not to aim too high.
Jane Dacre 03:12
Right. And did you have siblings?
Averil Mansfield 03:14
No, I was one alone. Okay, Nearly killed my mother when I was born. So never again. Never again. Yes, yes, indeed. So I've no no medical relatives of any kind, no experience, really of medicine, never. My first visit to a hospital that was to go and visit my my best friend at schools, parents who were in hospital and it was completely new for me, I almost fainted. And I thought this will be the end of my career if I faint
Jane Dacre 03:45
So then, I mean, getting into medical school is quite challenging, particularly from that kind of background. How did that go?
Averil Mansfield 03:52
Well, it was I only applied to to medical schools, I've often looked back and thought that was a bit limited. But I was living in Blackpool. I applied to Liverpool and Manchester because I thought if he went any further you fell off. I mean, it was really the edge of my horizon as they were a long way away, in my view. And both of them offered me a place which was quite surprising. So I had a choice. And I had been to both of them just for the interview hadn't been for any other reason didn't have open days then. And I took a fancy to Liverpool and it was such a good choice. Lovely place. A a lovely place. And B has not only a good medical school, but also lots of music, which was my other big interest lovely laughter the combination was wonderful. And it's very much a university and the city combined it which is such a lovely thing. It's It's tremendously important, I think to be part of the city if you're in the university.
Jane Dacre 04:52
No I can I can imagine I can imagine that I have great fondness for Liverpool. It's where we put our CP North
Averil Mansfield 05:00
Yes indeed to be there and aspire
Jane Dacre 05:03
The medical community is very nice. Yes, yes. So you get to Liverpool? How did you get on?
Averil Mansfield 05:10
With great difficulty, and to my astonishment, because, you know, I've never been away from home before I didn't have brothers, I'd never seen a naked body. And there I am confronted the first thing that I go into second year because I've got the qualifications to skip the first year. So it's anatomy day one, and this vast hall full of dead bodies that are in formalin in revealing all which I had never seen before. And lo and behold, of course, they give me the nether regions for my first bit of dissection. I mean, can you imagine that? Today? Probably did it on purpose. I'm sure they did. Sure they did. And I really struggled. And of course, the one thing above everything else I've been looking forward to was human anatomy, I was a good dissecter of the frog at school. And, you know, the idea that I've got the dissected human body was was exciting, but it really overwhelmed me. And I just backed off and didn't do terribly well at all. In fact, I failed the first important exam. Because I was just overwhelmed by it. And I took refuge in music, there's no doubt about that. I was good at the music. I was better at the music than I was at the anatomy, surprisingly. And so I did that. But of course I when I'd failed the exam, I realized this could be the end of my career. And I knuckled down and passed it of course, never failed anything after that. But it was a big shock.
Jane Dacre 06:38
Gosh, Yes, I am something that comes to everybody at some stage, doesn't it? And so how did you get on after that you presumably got it the next time.
Averil Mansfield 06:47
I got it the next time. And then of course, it was straight into clinical medicine, which was what I wanted, and I loved it, I just, I just adored the rest of my course. And then became a when I graduated, I then became a House Officer in Liverpool. And that probably was one of the happiest years of my life. It's kind of crazy looking back, because we worked all the hours, God sent, we really did, I can remember saying to my boss, is there any time off in this job, which was a bit of a risky thing to say to your boss. And he said that I suppose you could go into Liverpool on a Wednesday evening, provided you're back in time to do the village round. I remember those words. And that basically was it for the next year, you were almost a prisoner in the hospital. But the great thing is you were with a group of like minded people you lived in, you had that support structure, the firm structure that we now seem to have lost. And it was tremendously supportive. And I absolutely loved it, I was learning on the job, I had an Australian registrar with whom I confided about my ambition to become a surgeon. So he then took me step by step through increasing severity of surgery to the to the point when I was doing appendescectomies, as a house officer, imagine that today, how wonderful that was, I did about 20 as a house. And then was prepared to say to me, you can do it, you'll be fine. You can you can go for this career, it will be okay, which is so valuable. I can't tell you how valuable that was. To have somebody who would actually assess you. Not just your skills, but your resilience. I guess that was a big part of it. You know, the fact that you might have been up all night, and yet you were still capable of going in assisting with an aorta or something. It that was what he was looking at and was just as skilled
Jane Dacre 08:53
So quite inspirational. Yeah. Is he still around?
Averil Mansfield 08:56
No, he's not. He's dead. And the his boss, there were three of them. There was the professor and then there were two other consultants but the junior of those three, who I thought had been there for me, but of course was not terribly old. And he was just learning vascular surgery was it all brand new? And so he was my inspiration really the consultant Edgar Parry, who was a Welshman, and just a wonderful person to work with, whose was a good example of how to behave as a surgeon and never saw him lose his temper or get angry. The worst I ever heard him say in theater was damn and that with a Welsh accent, but a Welsh accent into the word Damn. I mean, that was absolutely the worst I've ever heard. And I always had that belief that he would get out of any difficulties that we got that he got into in a complex bit of surgery. I had that confidence. And he also had this wonderful attitude, that his job All, this was much more evident than later when I became a registrar but that his job was to make me better than him. Not to just bring me up to that standard, but to actually encourage me to go one step further.
Jane Dacre 10:13
So did you stay in the same hospital for your registrar jobs
Averil Mansfield 10:18
It's interesting because I did a year. I've six months to have surgeon than six months house physician, then I did obstetrics and gynecology because many people said that would be a better career for a woman. Okay, you know how it was? Yes. And so I did it and did not like it and have no desire to become an obstetrician and gynecologist, none at all. And so then went back to being the senior house officer in surgery in a different hospital, then later went off to the States for two years. Then I came back and became a registrar in the hospital after being a house officer with the same boss.
Jane Dacre 10:57
Okay, and stayed there? .
Averil Mansfield 10:59
As you did in those in we moved a lot of course, yes. And then having done my two years as a registrar, and got my fellowship, I then became a senior registrar. And then it was the most comfortable time in a way because I was lecturer at that stage, I've taken a university appointment. Largely because I wanted to become a vascular specialist. I wanted to be a general surgeon with a special interest in vascular surgery because it was new, it was an up and coming thing, and I loved it. So I took this academic post, and really thoroughly enjoyed that. And it allowed me to develop those new skills that I needed to do.
Jane Dacre 11:45
And did you do teaching along the way?
Averil Mansfield 11:48
Teaching yes, I've had to run the the exams I started research when I was a register. That's kind of interesting because my mother almost died when I was little of a pulmonary embolus after the surgery that she required as a result of my birth, and that it was in the family folklore, how dangerous this pulmonary embolus was. And so my first venture into his act was on on deep vein, thrombosis and pulmonary embolism. Yeah, my Hunterian professorship at the Royal College of Surgeons was on management of the source of pulmonary embolism. So that was my big and I set up a laboratory as a registrar funded by me. I mean, there wasn't any obvious source of funding then, just to get started. And I was looking at fibrinolysis in surgical patients. That's that's how I began research really. And I continued research all the way through my life as one did. So that was the start of it all.
Jane Dacre 12:51
incredible, an incredible story. So so we're up at senior registrar level, what about giving did you become a you continued on the academic track?
Averil Mansfield 13:01
No, I did not. I did not want to be be a professor, I absolutely did not want to be a professor. The only reason I wanted the academic job was to a allow me to continue with the research and be to allow me to be flexible in what I was concentrating on in my surgical training. That wasn't a trading post in vascular surgery. But there were two surgeons in Liverpool who were doing vascular surgery. So this was a way of my manipulating my life. So I could go and learn from those surgeons
Jane Dacre 13:31
By having a post that it was didn't really exist or didn't exist before by making your own post
Averil Mansfield 13:40
Yes, yes. Basically making your own your own training.
Jane Dacre 13:42
Yeah, you can. We used to be able to do that. We could do it. We can't, we can't do it anymore. Which is a good thing, and maybe not such a good thing. So what happened next?
Averil Mansfield 13:53
Well, the next thing that happened, of course, he's suddenly in one year 1972. It just so happens, everything seemed to happen at once I got a Hunterian professorship, I got the Moynihan fellowship of the of the Association of surgeons, which took me off to the States for 10 weeks. Everything happened at once. And then I applied for a consultant job and amazingly got it. It was a second application, the first one I did not get. And I was shattered by that, but was perfectly content not to be coming to London, which is where the first application was for. And my second application was for the teaching hospital in Liverpool, and I got that job and I was so excited to get that it's wonderful, wonderful. So I was appointed NHS consultant to two of the three teaching hospitals. So my time is split between the two. Both of them of course thought they owned me full time, as happens when you split your job. And I was doing general surgery, but introducing to both of those hospitals. vascular surgery for the first time, things like aneurysms and bypass isn't carotids. And, and it was new. And that meant engaging with the nursing staff with the theater staff, and particularly, of course with the anaesthetists who needed to get used to this new branch of surgery, which they are all enjoyed as, as did I, but it developed from then on.
Averil Mansfield 13:54
And so were you there for a while then as a consultant,
Averil Mansfield 14:13
I was a consultant for 10 years, and then met Jack and he was in London. And I was in Liverpool, we both had good consultant surgical jobs. Neither of us wished to move. But in the end, I moved to London. And, and it was a fantastic move for me. Of course, I didn't want to quit Liverpool. But at the same time, I can see looking back on it that it was it was an extremely good move from my point of view because moving to St. Mary's where Felix Eastcot had done the first carotid endarterectomy in the world was a good place to start my future career as a pure vascular surgeon because once I moved to London, I stopped doing general surgery on the advice of Hugh Dudley, who said to me, you need to concentrate on vascular surgery. I was reluctant, but it was the right. It was the right thing
Jane Dacre 16:29
At that time, you wouldn't have had very many female role models, you wouldn't have had very many female colleagues, you know, how did you get on the How did you? How did you manage?
Averil Mansfield 16:30
Well, there were a couple of women and I'm going to mention both of them. One was Phyllis George, who was at the Royal Free and one was Margaret Gilcheck who is also in the Mary's circuit of of hospitals. And both of them were very happy to give me a bit of advice, you know, usually in the ladies cloakroom. prior to giving a talk, perhaps, we just helped me to get through that next step in my career, so, and Phyllis, George, was the person who suggested I applied for the counsel of the college and said, but don't say anything. Don't tell anybody. I suggested it, just do it, you know. So I did and amazingly got onto the Council of the College of Surgeons. So that was all very good indeed. And became vice president eventually Vice President. Yes.
Jane Dacre 17:34
Were you the first?
Averil Mansfield 17:34
No Physllis George had been the first I was the second
Jane Dacre 17:38
But breaking barriers all the way along? Yes. Being Yes, the first female professor,
Averil Mansfield 17:46
Well, then it came on the way. I mean, that came later, becoming asked to take on. I mean, I was on the selection committee, for the chair of surgery at St. Mary's, that's how it arose. And it was at the time when St. Mary's was going to be the first into Imperial College, Imperial College is going to become medical as well as science and technology, then we were going to be the first to move in. And it was clearly going to be a time when somebody who'd got a little bit more experience at committees and negotiations and such like, needed to be in the various chairs. And the first chair that came up for grabs was the chair of surgery. And the two shortlisted candidates were young and inexperienced, perfectly okay, but you hadn't got any of that background of committees and negotiations. And they, neither of them was deemed appointable. And I went back to my office at the end of a rather long and gloomy afternoon when we haven't made an appointment. And two hours later, the Dean rang up and said, we'd like to you to take on the job. And I just laughed at him, don't be ridiculous, I don't want to be a professor of surgery. I mean, in retrospect, I can now see that it was important for a woman to become a professor of surgery, I had no idea that I would be the first Not a clue. But of course, when I think about it, it should have been obvious. So then, gently, I did take that on and and ran the department. I mean, the reason I was not keen was it involves so much more than just being a surgeon and looking after patients and students. I mean, there's so much more to it, as you well know, particularly the running of the finances, which I I found very difficult.
Jane Dacre 19:42
I don't like I don't like running money things but you've got to do it and you've got to very carefully
Averil Mansfield 19:48
you do otherwise you're out of
Jane Dacre 19:50
Not my comfort zone either. So you've talked about or you've reflected on a really positive career path as if you've glided through, and it's all been absolutely fantastic. And I, and I hear people saying, well, it's alright for you. But there must have been some bumps in the road.
Averil Mansfield 20:12
remarkably few in all honesty, I suppose I had some difficulties when I first met the professor of surgery in Liverpool when I was at the senior lecturer at the lecture stage, because he clearly hadn't ever worked with a woman before. And and found it quite difficult, I think, certainly very different. But we became good friends. And he became a great supporter of mine in the long run, and taught me so much about how to conduct research and how to get it published, and how to get noticed in the world of surgery. So that was out of that you find one little episode when I moved to London, which would interest everybody, I think, is the fact that they had a dreadful thing called the trial by Sherry, the night before the interviews, and you had to wander around with a full glass of sherry in your hand and talk to about 30 different consultants who might be interested in who got the appointment the next day. And as I've said to my children, nobody can fill a full glass. So you have to have the glass full, you don't drink it, you just hold it. And I then went home from that, and I got a phone call. About an hour later, when I was at home saying you should withdraw, you're not going to get the job, it would look very bad on your CV, if you apply for this job. And you don't get it. After all, you're a senior consultant already. But you're not going to get it, you should withdraw. And I said, Thank you so much for the advice. I'll sleep on it. Of course, I have no intention of withdrawing None whatsoever. And I got the job, but it was it was it that was the most shocking thing of all this, somebody would feel that they could actually interfere in the process, which is clearly what they were doing. They were trying to stop me from being there.
Jane Dacre 22:06
Yeah. It's interesting isn't it, you think that sometimes people might think these things, but then when they feel empowered to act? Yeah, it makes it very shocking. So if I could digress for a little bit, were talking to each other now the day after the report on on sexual harassment, and sexual misconduct? Yes, in surgery? Did you come across any of that topically?
Averil Mansfield 22:29
Happuly not. Happily not at all? Never, ever. And I don't understand why some people are subjected to it at all. I mean, it is totally wrong and should never happen. I simply can't understand it. And I felt for some time that we need to address the question of behavior in surgeons. That's the only group I can speak about. I'm sure it happens in other groups in society to before it does. Certainly surgeons have always had a different attitude, a sort of somebody people regarded as a sort of godlike approach to their work. Which is is not required, it is a perfectly ordinary good job of work. What you need is a good skill, a good approach to your patients, patients at the heart of all you do, and it does not need anything that is difficult, or demanding, or upsetting for the people you work with. And it really does need to be ruled out of our lives. It's it's horrendous, but it's still there. And I sat on that discrimination working party at the college with Helena Kennedy Yes. And she was wonderful. She was a fantastic chair of that event. And then they went there thinking that this was a thing of the past that behavior of this kind is gone. And and I had to listen to people giving evidence during those three months of that working party. That really astonished me because I thought it should be an was a thing of the past. It's clearly not until the this report that's come out is saying that there is still a problem. And it simply has somehow to be tackled and got rid of it. It has no place in society, let alone it surgery. Absolutely not.
Jane Dacre 24:25
I think where we we will tolerate less bad behavior these days as would in tha past
Averil Mansfield 24:32
Maybe that's what it is that is a change of approach that you know, we kind of accept, as happened in other spheres of life, the film sector and so forth, that there was something some things had to happen in order to make progress. That certainly is not the case and it's certainly not the case in surgery. Nothing like that needs to be involved in any way.
Jane Dacre 24:55
No. Can I can I change tack a little bit and ask a little bit about About you, because you've obviously had an incredibly fulfilling and busy life. So where does family fit in? And most of the women that are aspiring to have careers like yours, struggle of it to to find their place when it comes to having a partner having children having family life. How have you have you managed all of that?
Averil Mansfield 25:25
Well I had no children of my own. And when I married Jack, he had three. So I acquired three stepchildren, one of them was 11. The other two were teenagers. It was challenging, I can imagine. But lovely, at the same time, but I decided that for my first two years, moving south, I wouldn't work full time. So I took a six session to start off with, so I had some spare time, a to adjust to the move, and the most importantly, of all, to get to know the children because I, I realized that it, it was something that needed to be established right at the very beginning, or it would never happen. I needed to get that relationship with them. And that takes time, and a lot of energy. And those children are like my children, I love them dearly. And I now have six grandchildren who you know, I'm granny, and that's it really. So that has been wonderful. But I also made me realize what a huge commitment children are, and what a huge responsibility they are. And I really worry about the cost of child care now for the for the younger generation coming through, and the availability out which is not easily available for the young to find childcare. Fortunately, my when I acquired my three, they were beyond the need for having child care. They were old enough to cope. But if you've got babies, it must be extremely difficult if you want to go back to work and find proper care to look after them. So it was really educational to me to discover that but also a very happy ending to my career.
Jane Dacre 27:08
And so do you do grandparent duties these days?
Averil Mansfield 27:11
I do. I mean, I'm one of these people who loves them when they get to the point that you can have a conversation with them. I like them better. So teenagers are fine. I'm very happy with them. Yes, I do. I spend a lot of time with them,.
Jane Dacre 27:24
Well, I think we will get roped in because childcare is so difficult. Yes. And difficult to manage. Yeah. Okay, well, we're coming to the to the end of our time. So can I just ask you to think back over your career and think what advice you might give to aspiring women who want to go through medicine, and either be surgeons or become leaders or whatever? What would you say, to inspire them and help him along the way?
Averil Mansfield 27:55
I think one of the things that matters most to me is that you are not just a surgeon, you are a human being as well, and you have a family, and you have interests which you maintain. So for me, crucial to the enjoyment of my life has been the maintenance of those two other things, the family, and music, and music dominates my retirement in a big way. It really does. It's very important to me, but I maintained it to a degree all the way through, it's very easy to drop your interest when you're flat out being a surgeon. But you'll be grateful if you are a trainee surgeon eventually, that you've maintained it and you have those skills that are still with you when you reach the retirement age. And I think the other word that I've used many times with with juniors junior doctors in their training grades is focus because it's one thing I never really had I never was very good at focusing but really successful people are able to focus and focus in on a topic or a subject almost to the exclusion of everything else and get to to progress that topic to the endpoint to the to the successful point at the end of it in your researches or your studies or whatever it happens to be
Jane Dacre 29:16
or perhaps in playing the cello because I know from realize that you are an aspiring and probably very good cellist
Averil Mansfield 29:25
I'm not a very good cellist. I'm much better pianist
Jane Dacre 29:28
Well, Avril, thank you very much for talking to me today. It's been lovely. Thank you. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 9: Professor Jeanette Dixon
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant, listen, and be inspired. Jeanette Dixon is the chair of the Academy of Medical Royal Colleges. She's a clinical radiologist by background and has had an incredible career in medical leadership. I just wanted to start off by you giving me a bit of a summary of your career just edited highlights and how did you end up where you are.
Jeanette Dixon 01:05
Okay, so the accent usually gives the game away that I was born north of the border. Glaswegian. Like many Glaswegians went to university in Glasgow and did some post jobs there I am that all that I did the host jobs and and then it was it was a time when often jobs were six months long and I wanted to get my MRCP I knew I wanted to be an oncologist but I needed an MRCP so wants to get a rotation because I didn't want to be able to study without without changing job every six months I managed to feel the part one MRCP first time so I wanted some job security. So I applied for any job. That was a one in five or quieter. Again, it was a very long time ago and ended up having had a few interviews I ended up in Eastbourne so I ended up on the train to Eastbourne not actually knowing really sport and was until I looked at the map in London Victoria. And the the interviewed me gave me a job I went down there. I spent a while back there got my membership first time around the set. The second part first time around, I knew I wanted to do oncology wasn't entirely sure where I wanted to do oncology a job came up in Glasgow didn't think I would be shortlisted for the job but I put in an invite anyway just to an application anyway just to get some interview practice and went up for some interview practice and was offered a job. So that was about 15 months, going 500 miles one way and then 500 Miles another at that time. Although I got the registrar job and was looking forward to being a senior registrar I was [unclear]. So there was no it was a run through training. And again, this was before there was an awful lot of money put into cancer in the early noughties. I wanted to be competitive because there was no guarantee of a job anywhere and there was certainly no guarantee of a job where I thought I wanted to work in Glasgow. So I looked around for some research and managed to get an MD at the Patterson Institute Manchester I did that and then managed to get an inter deanery transferred down to finish off my training in London Northwest and Mount Vernon Cancer Center, which is where I am now I moved I kept moving, kept moving and then suddenly decided that this was where it was going to be. Got the consultant job here. So been a consultant since 2002. And have always done something else. In addition, I think it's a really important to balance your your work with something that you find gives you an opportunity to meet other people to go out and talk to network with other doctors and other healthcare professionals. So initially did a lot of work in the educational space, worked my way up from clinical tutor, educational supervisor, clinical supervisor through training program director, and was the first head of school for Clinical Oncology for London and KSS Daenerys. And then went into medical management and was the CTO of that department. And then after a while doing that I felt I needed something different. So I the college, my college the Royal College of radiologists, which is where clinical oncologist sit advertised an officer post in professional standards, professional practice. And I did that and applied for that and was elected unopposed, which means nobody else wanted to do it at the time, and I did that job and then went on to be the vice president for oncology and then the President for other radiologists. And then the academy Chair came up and my colleagues were nice enough to elect me as the academy chair. So the theme of clinically I'm a clinical oncologist, I treat patients with cancer with all treatment modalities, radiotherapy, all the drug modalities, but not surgery. And I predominantly treat lung cancer. So I've done that, always, always as alongside every other role I've done. But the theme of the other parts of my career is much more about better patient care, but better patient care by better standards for doctors, better support for doctors. Making a you if you make doctors lives easier, better if you make them happier, you improve patient safety, you improve patient care. So it's patient out improving patient outcomes, but by helping my colleagues.
Jane Dacre 05:49
Fantastic. So what an amazing career pathway. Can I just get you to cast your mind? Right back? Why did you become a doctor in the first place?
Jeanette Dixon 06:01
That's a that's a sort of interesting one. So again, I'm not the first person in my family to go to university, but I was kind of the first but the first one and the part that spoke to each other that went to university. And there wasn't a lot of careers advice a lot around at that point in time. So when it looked like I had good enough grades, good enough academic achievement to go to university, there wasn't a lot of ability to go in, this is what you should do. So and this is what university is for universities about education. So I kind of took the sort of naive view that when you went into university, you got a job at the end of it. And I thought medicine looked like an interesting job, my my peer support healthcare professionals, but it looked like an interesting job. And I thought it's a job that will or will never go out of fashion, or they'll always be employment, there'll be a reasonable wage, so I'll be able to support myself throughout my life. And my parents work in healthcare, so it's probably okay, so that's why I became a doctor. So it's slightly interesting route into medicine. I think.
Jane Dacre 07:07
It's also interesting that you talk about doing it because it was a secure job a good job. People now don't necessarily think it's as good a job as you as you might have thought, and I assume that you're a bit caught in the thick of it now. In your position in the academy?
Jeanette Dixon 07:30
Yeah, I think I think it's a really tricky one, I would still recommend the job because I think the job is wonderful. I think the patients, and that interaction with people and help and much is it's a bit right, or it sounds a bit trite to say helping people at some of the worst point in their lives, not necessarily getting them better, completely based on curing them but actually helping them be the best they can be. At the moment, I think that is a lot of our colleagues who don't see that. And I think that's a real shame. I think as as senior colleagues and senior leaders, I think some of that blame must sit with us, but I think a lot of it sits with the way the way that medicine has developed and the the general the feeling that the NHS is not being funded appropriately, that doctors haven't been remunerated appropriately. That the the way trainees are trained is not helpful for trainees. Some of that I can absolutely agree with some of it, I think, well, some of the stuff that was brought in to help trainees that trainees complained about 20 years ago, ie, you having a good structured training, being able to see all parts of the curriculum, having access to all different types of hospital specialties, not being dependent on one person or one firm for a reference, I think, I think the unintended consequences of that, and the huge expansion of thoughts, as we have seen is that we have taken away the camaraderie and the support and that genuine view for some of our colleagues that they are actually making a difference.
Jane Dacre 09:15
Yeah, I mean, it certainly is interesting to hear a lot of a lot of younger people. are feeling burnt out and you're quite right in our day, somehow you had medical families to rely on and they don't those bonds don't seem to be quite as strong as they were. So uh, yeah, I agree with you, that you went into a you kept saying you always wanted to be an oncologist. Why did you always want to be an oncologist? I mean, it's dealing with some pretty tricky stuff.
Jeanette Dixon 09:44
I think. I think the thing is, it's, as you know, medicine is a hugely broad church, you've taken huge numbers of people who are all different personalities. So it's great that we all liked different things. When I went on the wards. First as a clinical medical students, it was Glasgow, it was a deprived area, you always got taken to see patients with sight. So you do have your the bedside classical bedside teaching model, take a history from the patient, examine the patient, and it was the 90s, it was the 80s. So you would have somebody with cardiovascular disease, or you'd have somebody with a pleural effusion. Generally, that was those were the signs on the medical wards at that point in time. So you'd have somebody with atrial fibrillation or somebody somebody with bad hypertension or somebody with congestive cardiac failure, where you'd have somebody with SVC, or a pleural effusion. And at the end of it, the teaching junior doctor, as they were usually a SHO or your registrar would say, so, so and so yeah, you've got the diagnosis, he has congestive cardiac failure, this is what we're going to do. Or they've got intra fibrillation, and this is what we're going to do. And this is why we're going to do it. When it came to the cancer patients was like, well, we'll send them off to the Cancer Center. And we have no idea what happens there. And it was a recurring theme that nobody really knew what happened in the Cancer Center. And I thought, I'd quite like to know that myself. And so I went and did an elective in the Cancer Center. And I found that was true. Nobody really knew what happens, whether you were doing medicine, or whether you were doing surgery, it's like a black box. And I'm one of those folk that you can't tell me something and then leave it and give me a hint and not show me the rest. So I kind of went and did an elective in the cancer center, and actually just liked the patients and liked liked the openness and honesty at that point in time. You know and it's still true. Often when you speak to patients, and you say you've got cancer they go, like when am I going to die? How long have got to live, what's going to happen whereas if you say that a patient with COPD or diabetes or congestive cardiac failure, who has the same prognosis, they don't ask the same questions. And so certainly, we back in the day, when I started training, there was an honesty, which I really liked, I really like that direct, honest communication with patients. And I liked the cards on the table. And I also liked then, when I got into clinical oncology, I really liked the radiotherapy and like the technical aspects of radiotherapy, the anatomy that you have to do to be able to plan radiotherapy and really enjoyed the cutting edge, your the, the literature changes so frequently, that you're actually doing things change within a year or two. So you, you have to be constantly learning. So again, it kept me It kept me interested. It kept me enthused, it kept me amused and, and stimulated in a way that other specialties when I looked at them, or when I was your when I was rotating through them, just didn't just didn't do it for me.
Jane Dacre 13:00
So I mean, clearly it was a good specialty for you, and you've done incredibly well. In your career. Have you found bumps in the road? Is there are there is there anything that you think might be helpful to share that would help younger people coming through?
Jeanette Dixon 13:18
I think I think that's a really tricky one, isn't it? When you look back? What we all when we all look back, we tend to remember mostly the good stuff don't like because we're human beings and we like the good stuff. So have there been bumps in the road? Yes, their have. So you know, I mentioned earlier, I failed the first part of my membership, I struggled a wee while I think I had two or three interviews before I got my first SHO job. And I had to had to apply to for two or three research posts before I managed to secure one for an MD I think I think there was also much of my training I lived through a belief, there wouldn't necessarily be many consultant jobs there. That changed very quickly. So I think part of those those bumps are, you know, they're not the same when you look back on them because tech, you're there are there are a lot of you there was always a lot of jobs out there. And I was always going to get a job it was just a question of whether I was going to get a job or if I was willing to compromise on the fact that I wanted a one in five or quieter because I wanted to study so I think I think it's it's the bumps in the road have been what the ordinary bumps in the road you would expect. I don't think I've had a huge amount of major problems.
Jane Dacre 14:42
So that's that's, that's pretty good. What about life outside medicine? It sounds you come across as someone with a lot of dedication to the to the cause. Do you have time for other stuff?
Jeanette Dixon 14:56
Oh, yeah, yeah, I've got a I think the trick is also to make time for other stuff. I think you need to you you talk about being dedicated. That's lovely to hear. But that is that work life balance, what is my work life balance? Where do I enjoy it. So I, even with all the other roles I've done, I do prioritize going out with friends, I do prioritize visiting relatives and whatnot. So, you know, I very much enjoy baking, I enjoy cooking, I enjoy the cinema, I enjoy the theater, I enjoy opera, I enjoy music, I enjoy socializing with friends. So there's all of that kind of thing. I do exercise regularly, which I don't enjoy very much, but it's very good for me. So I do do it. And but you know, what? I think one of the points that at one point, I realized that every time that there was a chance to get a new job and move, it was either the new job or the boyfriend of the time. And I kind of chose to move most times. So I don't have a partner and I don't have kids. Is that because of dedication? Is that? Because it just the way the world does? Who knows?
Jane Dacre 16:10
Maybe there are some who might feel as it makes it a bit easier?
Jeanette Dixon 16:16
Well, you don't have to please anybody but yourself, which may be the reason.
Jane Dacre 16:21
So you can say you can Yeah, be as independent as you want to be. Perhaps, I don't know. So in your current job, you've been thrust into the limelight at a very difficult time. And you're you're having to deal with the people that are running the country. So what does that feel like?
Jeanette Dixon 16:42
Well, you know, that's one thing, where the swan looks very beautiful and elegant and relaxed above the water. But underneath the waterline, it's a slightly different story. It kind of feels like that a lot. And I think it's one of the interesting things is meeting people, one of the things certainly with all of college existence and getting involved with colleges, you meet people who are not doctors and who don't work in health care, and who sometimes have a lot of power over health care, and sometimes understand it really well, but sometimes have very curious blind spots. So I like people and getting to know people and getting to understand people and we are what makes them tick. And this is provided opportunity for that. It's also brought out skills that I do have. So the the things that medicine, we teach your communication skills, holding risk, negotiation, complex systems, all of those skills come into play. I think when you're when you're discuss it when you're meeting, politicians, government, Department of Health, all of those things, but at the end of the day, it's making that connection, I think with people and understanding that most of life is negotiation. And you know, they have they have an agenda, you have an agenda. Can you, can you align those agendas? Can you can you bring things together better? Because when you align an agenda, you almost inevitably get a proper, the best outcome?
Jane Dacre 18:17
And I suppose I know a little bit from experience, but aligning the agenda of all of the numerous different Medical Royal Colleges. And also the government is quite a tall ask, isn't it?
Jeanette Dixon 18:31
Do you want to get a job that wasn't a challenge Jane, I think, I think I think there's not as different as it appears on the outside. I think more you're I've never met a doctor yet, who doesn't want to come to work to do a good job and who doesn't want to make the patient's life better in some way. And that's even not, that's not just doctors who patient-face. But those doctors who don't patient-face. You want to do the same thing. Everybody wants the patient to be better, because at least you we all know, one day we too will be patients. I think what what government often want is to make sure that they aren't getting the best for the patient for the money they're spending. And so it's that discussion around what does good look like? What can good look like? What should be there? What shouldn't be there that and that open conversation, I think is the is where you, you find that you're not as far apart as you think, sometimes
Jane Dacre 19:33
sometimes. Very, very diplomatic answer. So throughout your career, I assume that you've been inspired, motivated by by people by events. Can you give us a little bit of an insight into what's inspired you to to work in the way that you have done and to do the jobs that you have?
Jeanette Dixon 20:00
Again, I this is an interesting one because I if I go back and say so why did I enjoy that job it was often I found somebody there who spoke a language or spoke about patients in the same way that I perceive patients or spoke about the service and the NHS and the service delivery in the same way I did. And I think, you know, the probably the, the major first person I think, was a role model was probably the CD when I, when I was a registrar. So he he in Glasgow, he has a lot of common sense, he was very pragmatic. At that time, there was a large number of folks in that in Glasgow, there was 20 odd consultants, that sandwich, it was a very big department. That's, that's a relatively small department. But they had come from different areas, and they'd been trained in different ways. And he could see, well, that person was trained in that way because of the resource available in that area. So he opened my eyes to not just the patients in front of you, but the service or the other patients. And I think most of the time when I've been when I when I've really been struck by things, it's people taking my view from one patient in front of me to the bigger picture, the bigger service, the best bang for the most patients, all of that thing. So he was the he started that off. And I think, coming through all of them, all of the educational stuff. Again, Wendy Reid, who was the my initial sort of line manager when I was head of school in London, she was somebody who was very passionate about education, very passionate about education being important and being seen on an if you're the psychiatrists talk about parity of esteem. So everybody knows what research is everybody, you know venerates academics, but who venerates those who train the next generation of doctors who actually makes them professional. And I think Wendy was very passionate about that. And some of that rubbed off on me as well. I think coming through the the college system, I've met an awful lot of folks from other specialties at a very high level. Some have been men, some have been women. But I think, you know, there's been an awful lot of people who want who feel passionately about their specialties and who feel passionately about the service that patients receive and improving the service centers that patients receive. So those people I have admired and respected and listened to and often taken advice from.
Jane Dacre 22:49
So what Wendy has also been one of my interviewees in these podcasts, you'll, you'll be pleased, pleased to know so. And somewhere I've chosen some of the rights some of the right people. So one of the things that one of the reasons why I've been running courses for women in leadership is because women often are relatively overlooked. And various things like the gender pay gap suggest that's that the case that the case, do you think that you can identify any times when you were treated differently? Because you were female? Or have you never noticed?
Jeanette Dixon 23:30
I think you're I think if you're saying recently, I think working in the NHS recently, I think that's not so much the case. But I think if you go back to when I started, so I trained in the 80s graduated in 91. in Glasgow, so I, I once thought about this for a while and realized I hadn't actually worked for a female consultants until my first SHO job. So until 12 years after graduation, and I've never actually been trained by a female consultant. That didn't mean there wasn't female consultants in Glasgow at the time, it's just that I had never been under their rotation. So So however, my medical year was 50% women, which was the same as medical school intake at that point in time, I was the same was we were the first year who had 50% Female intake. So that was an interesting one. So I kind of came I wasn't a proper Trailblazer. Trailblazer there were women that just weren't many of them. And they were few and far between. And Did I did I notice there was a feeling that in order to be appointed, you certainly had to outperform the men, you could you if there was if you have performed the same as a bloke interview, he'd get the job and unspoken rule. Nobody ever said it but it was certainly an implication. I did at some point hear that, you know, somebody, somebody had said to a male colleague, you know, people assessing the MRCP, look at them, that maybe 50% Women setting the MRCP, part one, in three years time, they'll all have children and be want to be GPs, and you will have a chance to get a job to the male to my male colleague who I think was pretty, pretty fearless to say that to me, because I've never been, I've never been slow about having an opinion. And so I, that has been more of a kind of, unspoken thing. I think when it comes to the gender pay gap, you see it in local awards, you see it in appraisals, you see it, in how women write or how women start to write research papers, and then get trained. You know, one of my favorite analogies is if you if you read a local award application from a man, he kind of puts his knickers on over these trousers and saved the world every day. If you read one from a woman, it's very much the team decided we went by consensus, we we supported each other, we helped each other. And you can always tell the difference, because these are anonymized things, but you can't you can get a very high feeling for for the gender of the person writing it. Now. Is that nature? Is it nurture? I don't know. I know women in medicine, often work part time, they often have other they often take the burden of the majority of caring responsibilities. Not always, but the they often do. So I think their bandwidth to participate and their bandwidth to blow their own trumpet is less. And in many ways, if they see things improving that they've contributed to the, the the need the feel that that is recognition in its in itself. I don't buy into that. But this is what you feel from some women. So when you see the gender pay gap, it was mainly around from my understanding mainly around other rules, when people negotiate thing, negotiate work for, for example, being a CD. Now I didn't it never occurred to me to negotiate to be the CD, it was what was offered the pay was what was offered I'd take it, or I wouldn't take it. And I think that's that's a tricky one. It's how you get people to value that. I think I think I've always worked in a very highly feminized specialty. So we have had many women that are something like are our current trainee intake was 73% Women our current female across the patch of clinical oncology. 66% of us are women. I think when I when I went, I went part time, for the first time when I became President. I'm about the only woman I know who doesn't work full time, who worked full time at that point who doesn't work less than full time. So I think I think it's, it's interesting, I chose a specialty that I enjoyed and I liked. But there were always women there.
Jane Dacre 28:17
It's interesting, isn't it that the culture within a specialty sometimes seems to shine through doesn't it? And I assume that you recognized a a gentle but you know, one shouldn't stereotype one shouldn't stereotype? So okay, so we're getting towards the end now and thinking of women that might be coming through? What would you say to women who are aspiring to be like you to be to be women leaders? What what should they do? What advice would you give them?
Jeanette Dixon 28:53
I think if you're aspiring to do it, then take every opportunity to do it. Don't necessarily wait for opportunities to appear, try and find opportunities proactively. Don't be don't be surprised if things don't work out. And everything's not perfect, because it is hard. I think leading is hard. And doing any sort of leadership role is hard. managing people and managing doctors, if you ever get into that role is hard. And I think practice those skills, you have skills and that you know even if you think you don't practice those skills, because they get better and the more you practice, and I think it's also a bit about the won't think is that a bit. The imposter syndrome is a phrase I never came across until very recently. But to me, it's not about that it's about, you can do it, you just need to think about it. You, you need to challenge yourself to go up to the next level. I think to find, find good friends, find people who will give you good advice, and honest advice and constructive criticism and listen to them. But have a support network that you can go to who can support you when things are not great? And things are all when there's always some times when things are not great. But also have people who will be honest with you, I think is the important thing.
Jane Dacre 30:41
That's excellent, thank you so much. And thank you. Thank you so much for your time, I bet let you get back to running medicine.
Jeanette Dixon 30:53
It's busy job Jane Thank you.
Jane Dacre 30:55
Thank you. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 10: Professor Dame Jane Dacre
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant. Listen, and be inspired.
Suzy Lishman 00:41
My name is Suzy Lishman. I'm a pathologist and a medical examiner. And when Jane first interviewed me for this series, I asked her who'd be interviewing her as the series felt incomplete without having her story. And the answer, as it turns out, is me. So I'm delighted to have the opportunity to chat to Professor Dame Jane Dacre rheumatologist, medical educator, past president of the Royal College of Physicians, and now multitalented multitasker with a wide range of interesting roles. Jane, thank you for agreeing to be on the other side of the interview today. Would you start with a summary of your career journey, please?
Jane Dacre 01:21
Yes, well, thank you. Thank you for agreeing to interview me. I was hoping to avoid this. But there you go. Yeah, well, I decided I was going to be a doctor at the age of 12. I have no real reason why my father was a doctor. So maybe I was just not very imaginative. And I decided I was going to work for that. And I suspect on reflection, I was good at science at school. And I also liked people and and the sort of science I was good at was biology. So so that was what put me in the position of looking in looking in that direction. So I went to a small girls public school, which was not very aspirational. So I had to work very hard to get the right grades to get into medical school. So I started to be very conscientious, because I had that in mind. And so yeah, I went to medical school, the first couple of years, I found quite difficult because I hadn't been to a school that really did science. And then once I got into the clinical years at UCL medical school, actually, I started to really enjoy it and start to flourish. Slightly unusually, I suppose I got married during my last year of medical school. And one of the strange things about that now is that my father being an anesthetist had a name that was recognized at the time amongst surgeons. And when I was at medical school, people used to say, Oh, your Peter's daughter, and I really hated it. And so I changed my name when I got married to Dacre. And as people may know, I did that for anonymity. And as it turns out, the Dacre family, because of my Dailymail brother in law were much more notorious than my original name would have been a nobody would have known my original name anyway. So that was, perhaps an early mistake.
Suzy Lishman 03:35
So when after you're qualified, I know obviously, you trained in in rheumatology and medical education has become a really important part of your life. What led you down those paths?
Jane Dacre 03:47
Well, I I actually, I'm sorry to say this. Suzy, I did some SHO work as a pathologist in microbiology, and I really missed the patients. I just really missed talking to the old lady, the elderly ladies and the patients and wanted to get back into the clinical coalface. So I did the MRCP. I was working as an SHO in Bristol at the time. And I came back to London and got a job at the Homerton hospital. In fact, it was the old Hackney Hospital in those days as a medical registrar. And I absolutely loved it. And during that time, I started to teach a lot of medical students. And there was a funny thing about it at the time, because I think I was quite a lot less formal having come from UCL than the traditional teaching that they'd had at Barts and so I was mentioned in dispatches for being somebody who was an approachable teacher. And so In a way that sparked my interest in medical education, so I started doing extra training sessions. Whilst I was going along with my own training program as a medical registrar, and then as a rheumatology, registrar, and then I had my first child and then everything fell apart. I was really unwell. I had a disastrous first labour that resulted in a high forceps and having some bladder damage. And also my eldest daughter was, was born with a broken collarbone because it was so difficult to get her out. And I had great difficulty in in passing urine after that and had to be catheterized I had to have a suprapubic catheter, which went on for weeks. And in trying to get rid of the catheter, I was given an overdose of distigmine by an obstetrician. And I had a full blown cholinergic crisis on the landing at home. And I everybody at the time thought that maybe I would not survive it. And so I was admitted to hospital and had to have intravenous atropine for about three or four days to stop this. And when I got back home, I was not not very well for for a while and had a young baby. So I had a lot of problems. And strangely, what it did was just spurred me on to get back to get back to work, because I just needed to get my my life back together again. So I actually also during that time, I lost my job because I was in a research job with no maternity cover, no maternity leave, and the money ran out. And they said, Well, we haven't got any money for maternity leave. So that's it, sorry. And so I had to fight my way back, which I did as a sort of half paid Registrar for about a year, and I had a young baby and the whole thing was really difficult. But at that time a senior registrar's job came up. And I had, I think a nine month old baby, I'd been really ill. And I was I was not sure whether whether I could go back to work full time. And I ended up sharing a job doing the first job share physician new job share with Tim Spector, Tim of the ZOE app. And I did that because Tim was getting really interested in research. And I was struggling to get back to work and I wanted to work full time, but didn't want to have to do all of the on calls. So we shared the job and had a slightly bizarre, but pretty good training. And then I got was doing half a senior registrar job and at the same time, I got a research fellowship eventually. And so I did those two together. And that was it. That was at Barts. And so I still kind of kept up my interest in medical education. And they were wanting to explore clinical skills and a clinical skill center at Barts. And so I was was sort of invited to apply to help to develop the clinical skill center of Barts because it was quite unusual in those days to to be as focused on education as I was. So I became the first senior lecturer in clinical skills in the country. I then worked four days a week rather than five so that I could spend Friday's going going to Sainsbury's and doing the shopping and keeping my act together. Until Tim told me it was time I became a full time skiver rather than a part time martyr. And at that stage, I went back up to full time and I've been full time ever since and had two more children so I although I kind of did have a bit of PTSD after my first pregnancy, I managed to deal with it.
Suzy Lishman 09:54
That's an amazing story. And I think I've known you 15 years and I'm not sure I knew all of that. You I was going to ask you about challenges along the way. But I think you've had enough that already mentioned.
Jane Dacre 10:05
Well, I don't I don't I, I sort of you can either dwell on these things and let them define you or you can roll your sleeves up. And I think that what that taught me was that I was in the roll your sleeves up school. And so I didn't want to dwell on it. I just wanted to get get back to doing what I thought was what I wanted to be doing.
Suzy Lishman 10:29
Can you tell me a bit more about the full time skiver rather than part time? Martyr bit? What What do you mean by that?
Jane Dacre 10:34
Well, Tim was very, he's a very entrepreneurial able guy. And he could see that I was working part time, officially, but putting in full time hours, and doing it so that I didn't feel guilty about going to the shops. And he said to me, if he wanted to go and play golf, on a weekday, he would just do it and not tell anybody. And he felt I was martyring myself and probably shouldn't be, but just should be a bit more confident about being flexible with with how I live my life. Because at that time, my husband, Nigel was an aspiring television journalist. And he was the editor of various news programs, including news at 10. And I used to have regular childcare crises. Because every time there was a war in a small country, or somebody got shot, or there was a TV, then we'd have this fight over who would look after the children and how we'd get to work. So I, I really needed some kind of flexibility, which, which I had to be quite strong about in order to get it.
Suzy Lishman 11:51
Yeah, I think that's a really valuable point. And I think something that we will have to get our heads around at some stage. But I really like Tim's way of putting it given that you were doing all of these things, and you're a full time consultant, and you were doing medical education. And you had three children and a husband with a challenging career. At what stage on why did you start to take on external roles.
Jane Dacre 12:13
Um, it wasn't, it wasn't immediate, but it was actually due to a guy called Mike Besser, who'd seen the time was doing a lot of education. And I'd created done quite a few firsts in education because I was just interested in doing it. So things like the first finals OSCE I ran at Bart's hospital, and the first clinical skills center. And so at the time, they needed someone to be the medical secretary for the part one board of the MRCP. And so just after I'd had my third child and was coming back to work from maternity leave, Mike Besser approached me and asked me if I would take on that role. And that was it at at the MRCP in London, and for some completely crazy reason, I thought I would give it a go. And so I became responsible for setting the papers. For the part one MRCP the the senior physician at the time, was incredibly fastidious and had enormous attention to detail and made my life absolute hell, but I did the role and so I started to get into working for the, for the Federation of the Medical Royal Colleges. And I suppose to cut a long story short, they were also at the stage when they were wanting to revamp the MRCP exam. So I got involved in redesigning the MRCP and actually creating the single best answer questions and also paces together with my colleague, Peter Coppelman we we help to design paces and we designed communication skills stations are which still exists now. Because there was no postgraduate exam that that involved what we thought was adequate training in and examination in communication skills. So we had great fun doing that. And so that was implemented I think it was June 2001. And is still going which is, which is good. So I went up through the ranks in the in the RCP exam, and ended up being the Medical Director of the of the whole exam, which fitted in well with my job at UCL because during that time, I started to do research in two exams, and the creation of exams and who did well and who did badly and differential attainment and a lot of that kind of stuff. So, off the back of that I applied for academic promotion and became a professor of medical education. But I was still a rheumatologist and general physician in the day job.
Suzy Lishman 15:17
Fascinating. Thank you. You've clearly got a lot of plates spinning. Do you ever drop any? And how do you deal with it? If you do?
Jane Dacre 15:27
Of course, I drop them all the time. I think one of the things about spinning a lot of plates is that it makes you almost expect occasional failures, and expect things to go wrong. And a mantra that that I've learned to love is that the best is the enemy of the good. And although we start off, as women in medicine, being trying to be perfectionist, and and doing everything really, really well, I have come to learn that 90% or 80%, has got to be good enough. And but yeah, childcare disasters are the absolute worst. If a child is ill, or if something happens to one of the children, and it completely pulls the rug from from under you in, in in terms of what you're doing, and it's quite difficult sometimes to keep the show on the road.
Suzy Lishman 16:35
You talked a lot about the roles that you took on seemed to sort of lead on from one to another, or people approached you and suggested them, is there anything that you regret not applying for? Or that you did apply for and didn't get that you wish that you had?
Jane Dacre 16:52
well, I that another philosophy that I have is that I try not to have regrets. So I, I must sort of pick yourself up, dust yourself down and get on with it person. And, you know, of course, there are opportunities missed but in that, in the end it it turns out, all right. So yes, of course, there are various jobs and things that I haven't got over the years as, as with everybody, and you feel quite bruised about it for a while and you feel unworthy, and you feel stupid, and you wish you'd never never even thought that you might have done it. And and then I move on. So I try not to try not to dwell on the disasters, I suppose the worst time was was some when I was struggling to get back into medicine after having Claire, my first child, because I just thought that you know, that the whole that I got everything the wrong way around, and that it wasn't going to work out. And I was going to be a bad mother and a bad doctor and all of that.
Suzy Lishman 17:59
Do you feel you came up against any particular barriers as a woman? I mean, you've said you job shared with Tim Spector, which was quite an unusual thing to do at the time. And you managed to juggle all of this while having three children and with the childcare challenges that you had, did you feel supported by colleagues? Or was it a real challenge?
Jane Dacre 18:19
my whole family side of my life was ignored by colleagues apart from that one comment by Tim so I had to pretend that everything was all fine and dandy and and not bring not mention my children in in the first few years, I have to say that's changed. I've become much more open about it really, because a lot of other people have children too. And we need to be able to talk about it to, to share, share the problems. So I did feel or I had felt in my university career that I reached a glass ceiling. And that was why I stood to be president of the Royal College of Physicians, because I felt that as a woman, I just was not even thought about for academic promotion within my within my home organization. And so I went to the when I stood for the college and was was elected and and that sort of made it all better. But at the time, yes, I did feel that I was divided, invented. So I liked I quite liked to innovate. And I'd come up with things that I thought were innovations, they'd be taken away and given to some bloke.
Suzy Lishman 19:36
So you've achieved so much, and you've been president of the Royal College of Physicians, and you've just done so and you continue to do so many things. What keeps you going Why do you keep doing this? You don't have to do it anymore?
Jane Dacre 19:51
No, well, that's true, but I see a world around me where things need fixing. And so I quite like to get involved in making making things feel as if they're working a bit better. And I've discovered that that moving the policy levers is a good way of trying to get things fixed. It's often slow, and it's incomplete. And it's not, it's not perfect. But working in policy, for example, I now have a passion about women with children, probably from my own experience. And so I feel passionate about trying to do things or get involved in things that will make that better for those coming through because it shouldn't be such a struggle.
Suzy Lishman 20:34
Obviously, you're doing a lot of work now to support young women, particularly develop leadership potential and skills. Do you feel leadership is for everyone? Or is it something very specific that only a certain number of people should be doing?
Jane Dacre 20:49
I think some kind of leadership is for everyone. So you know, even if you're just raising your children, you have to learn how to make that particular teamwork. So, so some kind of leadership is for everyone. But I think that sort of highest echelons of leadership, not everybody wants, wants to do. I went to a retirement do yesterday for a clinical colleague, and there are some people who are completely fulfilled and really enjoy their work just dealing with patients. And so it's, it's it's horses for courses, I suppose. Different people want to do different things. I have done less direct patient care in the last few years because I've been doing more leadership and other people who have preferred to use their leadership skills on on trying to deal with the patient in front of them.
Suzy Lishman 21:44
Do you have any particular role models or people who inspired you along the way?
Jane Dacre 21:50
My first role model, who's now a great friend who really inspired me was actually Parveen Kumar. Because the two of us shared a firm together at the Homerton Hospital was the purple firm. And we used to call ourselves the purple ladies. And we were the first all female clinical team at Barts, the two of us together, and we had a ball. And we're still good friends. Now.
Suzy Lishman 22:17
I can imagine, well, what a team
Jane Dacre 22:20
we channelled ourselves, we tried to be the pink ladies from Grease, the purple firm, so we called ourselves the purple ladies.
Suzy Lishman 22:28
Fantastic. And coming towards the end now. Do you have any particular advice or words of wisdom or lessons that you've learned that you'd like to share with women who are perhaps at an earlier stage of their career and looking to what they might do next?
Jane Dacre 22:45
I think, I think I would say that it'll all be alright. In the end, I think you see in the middle of people's careers, a lot of people really struggling with, with keeping, keeping body and soul together and having children and working and, and, and, and it doesn't go on forever. And I think you can have it all, but not all at the same time as perhaps what what you should say. And the other thing is to if you can, and I know that different people have different capacity. If you can pick yourself up, dust yourself down, and carry on. Things get better eventually. So so you can ride out. If you can ride out the rough times it becomes worth it in the end.
Suzy Lishman 23:34
That's brilliant Jane. Thank you so much for talking to me today. I could talk to you for hours. And hopefully we'll continue this over a glass of wine sometime. But I'm so pleased that your insights and experience are going to be shared with everybody along with all of the other podcasts. So thank you for taking the time to talk to me.
Jane Dacre 23:51
Thank you very much for interviewing me. Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one
- Episode 11: Professor Faye Gishen
Jane Dacre 00:06
Hello, my name is Jane Dacre Welcome to the second season of medical women talking. The podcasts are made up of conversations with some amazing women doctors who've had incredible careers. Being a woman and a doctor can be challenging. But these conversations are designed to be shared to help those women aspiring to fulfilling careers and to leadership roles. We hear a lot of negative stuff about medicine these days. But these inspiring stories show us that medicine can still be brilliant, listen, and be inspired. Faye Gishen is the director of UCL medical school. She started her career by her own admission as a trailing spouse, but came back into the fold as a clinical academic in medical education, and is now the Director of UCL medical school. I was just wondering if we could start off by you giving me a summary of your career so far. And then we'll add some whistles and bells as we go along. So over to you, Faye.
Faye Gishen 01:09
Thank you. And thank you very much for asking me to be part of this. It's always pretty special to be part of a lineage of high achieving women. And it's really delightful to be asked. So thank you, Jane. I suppose I had a fairly conventional sort of beginning into medicine, I come from a long line of distinguished doctors, general practice, radiology, pediatrics, and I suppose more so then maybe the now medicine is really pretty heritable. So I sort of watched the role models around me as I grew up, a father who was a doctor, a teacher who was a mother, and maybe the dye was cast, then I would be a doctor with interest in education. So I finished school, took took a year out, went to medical school in London, did a BSc which was relatively unusual in those days amongst my cohort did membership. You won't remember this because it was long time ago, but you are actually my MRCP Part Two examiner. I was I was heavily pregnant. I managed to get through. And I think that was really pivotal. Because I think if I'd been doing things with a one or more young children, perhaps life would have turned out differently. So yeah, I mean, as you are always incredibly fair, I don't think you gave me any particular advantage. But I guess in retrospect, I was being shepherded by somebody who's been a real champion of women. So So Thanks very much. So I passed membership. I then started radiology, maybe for the reasons that I've already stated. I was how do I put this absolutely useless. I wasn't I wasn't cut out for a career in imaging. I think it's a fabulous career. I think you know, people, people really enjoy it. But I was useless. And I was too busy speaking to the patients when they came down to be ultrasounded. So I went to the dean at the time and thought about exploring other medical specialties and ended up taking a job as a palliative medicine SHO in North London, then got a number then went through my training always part time, I wasn't full time until a couple of years ago. And as I progressed, I got more and more interested in medical education, sort of joined UCL medical school quite peripherally, around 2007, and then worked my way up through different roles in the medical school, undertook a doctorate in education in my late 40s, which was tricky, with a with an almost full time job and three children at home, managed to get pull that off somehow and then have ended up as director of UCL medical school for the last two and a bit years. So that's my career in a nutshell.
Jane Dacre 04:23
Thank you. Thank you an extraordinary journey. So can I ask you some more specific questions about it? So also, when did you decide to be a doctor you say you were heavily influenced by your family? But when did that? When did you realize that that was what you were going to do?
Faye Gishen 04:42
I think probably I was about eight. I have memories of being very young and sort of not knowing but feeling that I was going to end up in medicine. The only other thing that ever that I ever thought seriously about was going straight into education, I guess So I used to run sort of little, I don't know how mums and dads entrusted their kids to me, but I do sort of with my cousin little mini summer schools where we'd we'd entertain, you know, relative's, kids, and we'd have them all day. So I've always liked people. I've always liked children. I've always liked being around young people. But I think I knew I wanted to do medicine at a very young age, and I never really wavered. I was always quite quite fixed on it, possibly a bit like you.
Jane Dacre 05:28
I was 12. And I have no idea. I think it was probably a lack of imagination. My just made me think well, okay, I'm good at science and like people, so can I come back also, in terms of choice of career because you're now in palliative medicine, but you were previously in radiology, you say, you were rubbish at it, but somehow there wasn't quite the right fit. So so what, what was that all about?
Faye Gishen 05:59
Yeah, I mean, I think I probably didn't, didn't do quite enough due diligence. And I sort of had had radiology all around me as I as I grew up. And also when I was learning for membership, I was at DGH I was at Barnet, General Hospital, and the radiologists were fantastic there. And they just taught us so comprehensively for MRCP. And I thought, yeah, I think I'm going to really enjoy this. But when I got into it, I had a couple of small kids already. And I found the exams very challenging and my heart wasn't in it. And I realized quite soon into radiology that I was a physician. I think I've probably always known that. And it wasn't, it wasn't too traumatic. I mean, I think one of the issues with imaging is you don't get much exposure necessarily as an undergraduate, certainly not in my day. And then there were no sort of SHO at the time options to sort of dip your toe in it. So I think I went into it perhaps a little bit blind. I realized that I that I wanted to get back into medicine as a as a career and one of the medical specialties. And, you know, again, I was I was I suppose influenced and led by particular role models that many of us have met along our along our paths. And I worked for and with a really inspiring group of palliative medicine physicians, one of whom I ended up working with as a consultant and never left. He's recently retired, but he was definitely a very strong influence. And I loved the way. I know, it sounds a bit twee. But palliative medicine really is an incredibly holistic specialty. I mean, you can't do anything without the multidisciplinary team. The patients are incredibly altruistic, in terms of things like research. And there's a lot of general medicine, it's obviously not just cancer. And and there's so much pathology, and there's so much to get your teeth sunk into as a physician. And I've always found it quite I know, this might sound odd to people. It's a very uplifting specialty. You know, the patients, as I said, are really interesting. And it's just, it's just fascinating, and I still I'm still clinically active, and I still see patients every week. And I think it anchors me strongly as a medical educator and vice versa. I think being a clinician helps me as an educator, being an educator helps me as a clinician, and I hope translates to my clinical care, but I still hugely enjoy it.
Jane Dacre 08:47
So it gives you a lot to do though. So moving on a little bit to talk about having a family life having three children still being active clinically, and also being the head of the medical school. How does all of that how does all of that work for you? What's the trick?
Faye Gishen 09:07
Well, I hope this doesn't sound sycophantic, but I have had some good mentorship along the way. And for anyone listening to this, who obviously won't know, I had a certain Jane Dacre as a mentor at a time, which was really formative for me. So transitioning into a leadership role during COVID. I had really strong role models around me, I had Deborah Gill, who was the previous incumbent, and I think having strong female role models and recognizing that it's sort of possible to do it all I mean, I, I I'd love to say it's completely possible but I think there are penalties to be paid as a woman you know, we see it and things like the gender pay gap. We see it in in other ways manifesting clinically, and in work, but I think you just, you know, I've worked like many of us very hard. I've tried my best I find having a portfolio career incredibly enriching. So I very much like having different facets to my roles, whether it's leadership, education, clinical work. So in a way, I've had my cake and eaten it. But the penalty is that, you know, you work incredibly full on hours. And if I'm honest, I think I treaded water professionally, for a really long time. It wasn't until my oldest child was probably leaving home and at university that I sort of permitted, allowed myself to really spread my wings and go for go for things and go for opportunities up till then I'd literally just worked part time and seen patients. But I think you can have a very enriching portfolio career. But I think, sort of holding big, high pressure leadership roles is not for everyone, but it but it is for some of us. And it's, it's an incredible privilege to be able to lead a large medical school with all the challenges that that brings.
Jane Dacre 11:14
So do you think you've been held back at all during your career a lot of women don't think they have. And then when they think about it a little bit more, they realize that perhaps there were times when there were barriers to their career progression related to their gender, or their family or something else.
Faye Gishen 11:35
I don't feel I've been held back, I feel that that that sort of implies that there were systems and things holding me back, I probably held myself back, if we use that phrase, I wasn't in the right headspace to commit to anything bigger 10 years ago, or even five years ago, because, you know, as for many of us, family is the number one priority. So I don't think I was held back, maybe somebody could look at my career trajectory and say, you know, it went and fits and starts and taking through lots of maternity leave, has a has a has a penalty, but that's how I chose it. That's how I wanted it. You know, I think if you look on paper, I'm probably several years behind my husband professionally, but those were my choices. And I've been able to support him. And I've been able to support my kids. And I've finally ended up in my late 40s and early 50s. With with the sort of career that's really pretty bespoke, and suits me really well for now.
Jane Dacre 12:38
Excellent. So So thinking about highs and lows, you've been very positive and talked about a lot of the highs that you've had along the way. Is there anything that you would like to share that that maybe didn't go quite so? Well? That's the most of what we learnt most we learned most from?
Faye Gishen 12:58
Yeah, definitely. I mean, my foray into into radiology was not smooth. I was the first I'll keep the region's anonymized so that people can't be identified. But I was the first ever around 2000 Part time trainee in my region. And actually, I, I don't, people didn't know how to handle that they, they didn't really have a sort of clear blueprint for training for part time, as I was seen as a bit of a nuisance. I think. I didn't feel hugely supported by some of the women in the department if I'm truly honest about it. It's the only time in my whole career where I've sort of faltered. And I remember going to see the dean, which I described earlier, the postgraduate Dean just sort of saying, Maybe I maybe I'm not cut out for this, maybe I can't find a path that's that's conducive to the work life balance I'm seeking. And actually, she was very supportive and sort of went back to basics. But I think that was quite an unpleasant time. I wouldn't, I wouldn't say that I was bullied or that I floridly. You know, anyone crossed the line, but I think the atmosphere was not conducive and supportive to having a family there was an expectation. I think perhaps it still exists in some branches of medicine, not really palliative medicine. I don't think our trainees feel that. But it wasn't an easy climate to be a part time woman and the exams, the postgraduate exams, having already done a set were really tough. And I failed my FRCR part one. I failed the physics part, no surprises there. And, you know, it was it was a time where I was at a junction and I was quite aware of that. And actually, it's been hugely formative and important in my life. And it was definitely in retrospect the right move. It's led me into medical education and palliative medicine, but at the time It felt tough.
Jane Dacre 15:02
I can imagine I can imagine. Can I ask you about childcare? Three children, job? How does it all work. I have to say, I know that I tried everything along the way. How about you?
Faye Gishen 15:16
I mean that there are times where it's been really, really tough. I mean, I don't have to tell you and many people probably listening to this podcast will will understand and it will resonate with them. I mean, the summer holidays, were sort of nightmarish every year. You had clinics, you had ward rounds, and yet you were you were expected to somehow they I've got an amazing, my parents are amazing and really helped me. My husband's been pretty supportable, though he wasn't always able to take sort of days or weeks on end of childcare. We coxed and boxed, we cobbled it together, we made a plan. You know, every every set of holidays. We just like you I'm sure Jane, we just sort of somehow made it work. And I think my kids have come out. I mean, I asked my children recently what what they thought about my my job and my career and what it was like to have, you know, these two professional parents, and I think I mean, what were they going to say to me, but I think that they were pretty proud, accepting. And, you know, they they sort of recognized that it's been an important thing for both of their parents. And I think they also appreciated the fact that we were around a lot and we were available for them. But I don't know what the right way is. I don't think there is a right way. You just You just try and make it work. But I think that the team effort is key.
Jane Dacre 16:48
Yeah, it's interesting. I get the feeling. It's harder now. Because it's more expensive. And because there aren't, there aren't people who live in quite the same way as they were site. I think it is harder. But I have to say, I don't think it was ever easy.
Faye Gishen 17:06
there were lots of cricket camps and football camps and art camps and things like that. And you know, I think they I hope they're fine for it.
Jane Dacre 17:15
So I'm following on from the theme, but not so much about children about everybody else. Do you think being a successful woman has impacted your personal life?
Faye Gishen 17:30
I suppose it depends what your metrics for success are. I think as I described treading water for a long time, I was able to sort of establish, you know, I had a lot of I had a lot of time away from work, because I was working part time, although as we all know, part timers are not always on paper part time. But I've got great friendship groups that I've really worked hard to nurture. Over the years, I've been in a walking group on a Saturday for 15 years, I'm in a book club, which has been running about the same time, you know, the book clubs, got loads of hugely successful women in it's got, you know, an MP, it's got a couple of CEOs, it's got the CFO of a big NHS Trust. You know, I think, I think networks and support networks are really important. And I, I don't know how I'll look back once I've retired. But at the moment, I feel like I have decent balances. I've got great friends, great family. So a few interests outside work to be fair, not as many as I'd probably like. I mean, I don't read as much as I'd like to, for example, because I just get into bed quite knackered of an evening. But I think that goes for many of us. But yeah, I mean, one day, I'm I'm planning to travel more and explore more and walk more. But for now, I you know, I think it's working reasonably well.
Jane Dacre 18:59
Excellent. So there are a lot will be a lot of the people who listen to listen to this podcast, who will be wondering what advice you might give them for their futures. So what about women that are starting out? And you know, there are more and more women who now do recognize that they want to be leaders in their own field, and to have a fulfilling career and have a family. So what advice would you give to those coming through?
Faye Gishen 19:30
I would say pick your timing carefully. You can't necessarily do everything from the word go. So once you get established as a GP or a consultant, I mean, I was always told to spend the first few years seeing patients getting clinically focusing on your clinical work. I didn't quite wait those five years, but I think it was good advice. I think as I spoke about having colleagues that you trust, getting into a department at Ah, you know, I can't overstate how important it is to be in a department that feels collegiate trustworthy. You know, I think it's absolutely vital that you, I've mulled over a lot about whether you need to be friends with colleagues, and I've come to the conclusion, my conclusion. You don't necessarily have to be friends. It's lovely to be friendly. But I like this concept of neighborliness. So just being able to sort of very professionally and safely and in a trustworthy way, sort of rub along and trust your colleagues. I think that's key. I mentioned mentorship, and sponsorship, I think it's particularly at times of transition in your career, having strong mentorship, maybe female mentorship is really important. And I mean, we can't always pick what goes on in our home lives. And if we have partners, and not all, you know, when you get pregnant, I mean, my first pregnancy was totally inadvertent. But, you know, I think I think it's important to sort of, I use the word triage before to sit down and think and reflect reflection has been a very important part of my career. particularly things like establishing Schwartz Rounds in higher education institutions. So I would say, try and have a plan. Have good good colleagues, if you can think about what's important to you, and what makes you tick, try and find a good mentor if you can. And, you know, just try not to pressure yourself too much. Because things sort of have a habit of somehow slotting into place and working out. And if it's not the ideal job to job that you go into as a new consultant or GP, these things wax and wane. I mean, my job description now looks virtually nothing like it did when I became a consultant in 2008. So I just think these things are dynamic. And I describe myself as an as an opportunist. I look out for opportunities. I take them if they feel right, if they present at the right time in my life, and, you know, to have people around you who can help give you sage advice and support you is really critical.
Jane Dacre 22:16
So I think what you're saying is go with the flow.
Faye Gishen 22:21
Well, yeah, I think so. And you know, if you do, there was, you know, depends what you think about things like Myers Briggs, but I'm a I'm a judger. So I'm quite on the judging spectrum. So by personality, I like to plan things but you can't always plan things. And we've seen that particularly over the last few years. So go with the flow, but maybe have some sort of idea about what what might suit you.
Jane Dacre 22:45
Excellent. Faye, thank you very much. It was great talking to you.
Faye Gishen 22:49
Thank you so much, Jane.
Jane Dacre 22:52
Thank you for listening to this episode of medical women talking. It's been a privilege to spend time with all these medical women. I hope you've enjoyed listening to this season. Don't forget there are many other interviews in season one