Medical Women Talking Podcast

Medical Women Talking is a new series of interviews with a range of inspiring women doctors from different specialties and backgrounds who've had successful careers in medicine. Hosted by Professor Dame Jane Dacre.

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.

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.

Play episode one

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.

Play episode two

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.

Play episode three

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

Play episode four

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.

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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.

Play episode six

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’.

Play episode seven

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.

Play episode eight

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.

Play episode nine

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.

Play episode 10

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 her 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, as was 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 want to do both.

Jane Dacre 02:01
So you had quite an interesting childhood. Didn't you tell me about that?

Parveen Kumar 02:06
So rather strange childhood. So I was born in Lahore, which then was in India's that longer. And then during the partition, the member of the British came across in my bathroom 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, of course, a huge amount of problems. And the people had to cross the border, millions lost their homes, they were killing people. And if you were in a train, or you want to cross the board, by train, the train comes up tunnel, they would blow it up. And I remember standing in at the bottom of garden, watching hoardes go past saying Pakistan's in.., long.. Pakistan. So we were three of us, my three brothers, two brothers, and myself and my mother, we were actually in the hall 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 traveled in the convoy into Delhi. And it was still it was in 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 on having a refugee camp in your own country, and you're staying in refugee camp to there for quite some time until my mother managed to contact my father. Because remember, we didn't have phones and telephones if you could just phone up.

And my father being sent by Nero to China, for the United Nations, so you've been seconded to the United Nations. So eventually, my mother, sue me fairly then from Delhi to Calcutta by another two day long train trips, got onto a plane and let you all fun for us really enjoyed all that seeing all these strange things. These are the old players, the old American clippers where you actually had a room with the curtain so we will be quite enjoyed this. I think we went to Bangkok, Hong Kong and then went to Shanghai, where we met up with a father and he then had to find somewhere for us to stay so we stayed in a hotel with the Americans in Shanghai, on the boat burned and then we went to now king as was called in those days. has a lovely house and and my brother was old enough to go to the American School. So you would have been a math I say 8000, a couple of years younger. So then instead of Ayers, who looked after you, we had armors. That is, and they sort of looked after us, although we didn't speak Chinese. And then so first for me, the second one coming from my poor mother and my father was that we will nationalist China with, obviously, imaginations of Americans. And then Mao huge progress was coming down in China. And we have to leave very, very quickly. So my father goes onto a plane and sent us back to India. And I think he must have gotten one of the last place leaving Shanghai and came to India. And then now my father was working, you know, so we were back now, because we lost everything in both places, to start again, from the reasonable family having actually nothing. But now this where can we all which was sent to boarding schools, 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, by the English really. And then the terrible 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, believes in education, and education, not just for the sons, but the daughters as well. So she was sent off, obviously, you want to connect College, which was a 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 those days. So we were talking about the assertiveness, I suppose 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 we she decided, well, you know, 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 Of course, 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, we'll 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 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 didn't want to suddenly remember this but I remember reading this book on Damien the leper, I have a nose 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 giving and looking after people and I think my mother always also 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 have a good okay, we're gonna get disappointments. But I've got that go. Let me get on and do it my way.

Jane Dacre 09:15
See when two bots medical studio so I'm to be

Parveen Kumar 09:20
applied. And my my older brother was he got into parallel to do aeronautical engineering. I apply that got into carriage but couldn't afford it and got into bots, I applied to all the medical schools in London, and baths in wonderful and then my younger brother were dogs. So I think my elder brother probably would have done medicine that he had to do something that could support the family or he felt he ought to be there 

Jane Dacre 09:51
So they can't have been that many girls in medical school when you were there.

Parveen Kumar 09:56
The first year they were about a two this 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 stay back a year the University suddenly said that unless passed with more women that would take away the ground. So the following year, I think they're about 25 women.

Jane Dacre 10:22
So how many how many? There wouldn't be

Parveen Kumar 10:25
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 was enough girls. So I kept him away this 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 University level but I stayed with the medical school because I was a started it so I had pursued cyber defense for but that 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 think I was wouldn't be a physician. I think surgery didn't really treat me in any way. And the reason I think I chose gastroenterology was this amazing chap called Tony Dawson, Ashley Dawson, Sandra Nicholson, who came unbeaten 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 all sorts of great physician. So I want to get psychology.

Jane Dacre 11:52
Amazing. And you've had a long career in in gastroenterology.

Parveen Kumar 11:57
Yeah, no, that was the, that was the other problem because I was going to go for 20 years.

Jane Dacre 12:03
So how was that? What's it been?

Parveen Kumar 12:06
Through the similar sort of thing? I mean, so all the jokes around you, you know, you call flossing, 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 was not mentioned 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, I'm part of OSHA, she's a chat and carried on to an interesting job. And I think, because of the they didn't 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 off the football and the rugby, turn up to watch them all. And now we have great fun. And you know, they treated me as if

Jane 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 immense specialty, but you're also married and had children. So how did how did you handle all of that

Parveen Kumar 13:27
work just as soon as you so um, it but you know, it was a compromise. I mean, you had to compromises on Sunday. 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 pay an empty those identities on the bhgs. My supervisor said, you don't need that if you're a woman. And that goes like a red rag to a bull. Rarely Am 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, nannies and then au pairs. But if you know when a child was ill, you just felt awful leaving a child. But yet you had to go go to see the patients. And it was compromised. Maybe Maybe I got it wrong. Maybe I was concentrating more on the medicine and looking after patients than the family that we had. We had a great time in holidays. We saw each other obviously saw each other much more. Well,

Jane Dacre 14:39
you're still a close family now. So

Parveen Kumar 14:41
very close

Jane Dacre 14:43
that, can you

Parveen Kumar 14:44
Well, I think they probably does whenever you young resented that a bit and particularly over the book, because that was holidays weekends. Every night and As you know, we've, you know, we've gone on holiday and say go ski. And I would be sat in front of a window with with a piece of paper and wave goodbye to them as David took the girls off skiing. And it was it was awful that you could be that the new officer,

Jane Dacre 15:21
this the book has been a fantastic success, hasn't it? It's had they come on Clark. How did that 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 whole sort of hammered Smithsonian type of way. We we did research for fee of six months, then you were on the walls and you did endoscopy, then you did outpatients. So you sort of over five years would do everything you get claims Eskelsen, for 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 for a writer chapter, I'm guessing probably for a vertical to Sunday started. And in those days, all the letters were put out because they were tight with carbon copies. And I would just go in on a table by the Secretary, I would just go to look at minus sign it. The boys of C went and read everybody else's as well. So my supervisor might have stormed into my room and said, What's this? And I said, sometimes we tried a chapter and are you going to do it? I said, Yes. Is, as you've obviously read my letter, thanking them and say, I'm delighted. And you can't do that. And I said, I don't see why. So you know, nothing about gastropods? Yeah, some of them in Kasparov it. 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, you Landis. And of course, I was another little red flag. Certainly when, when he realized he was determined to do it, he said he'd help. And that's cool. My talk started.

Jane Dacre 17:14
So just as a chapter in gastroenterology, now, chapters in everything is then

Parveen Kumar 17:18
rising the whole thing. And, you know, we asked, we told to keep it locals, we asked all the people that thought, and they were so nice. I mean, we rewrote the chapters 1618 times. And there's one person I remember who said, point, would you be putting my name on it? And I said, of course, you know, you wrote it, you only recognize the word end, and it was mine. Because we, and they were so good to let us do it. And I remember, you know, people who taught me Jim Mathis, 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? Well, due, in

Parveen Kumar 18:02
a way Sangala sort of taught 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 pros 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 want two bullet points. So all these bullet points of whatever we said, we actually look back at original data. It's a huge amount of work. And often people will say, you know, like headaches would say all headaches have potential, but they're not. You know, certainly, if you've given the LinkedIn, so really, that you might get a headache. So I mean, it's also stupid things. But the sort of mantra of medicine, we have 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 years. So

Parveen Kumar 19:11
that was going on in the background, including bringing up kids

Jane Dacre 19:15
and being doing a lot of medical education students.

Parveen Kumar 19:19
Yeah, for 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 nothing. I Well, must be one of the few people that I took myself off for a weekend course on how to teach. Isn't an add much to what I was doing already. But it was worthwhile knowing that what you would do was correct. And I went to go to McMaster to look at PBL and how they taught them and bring up the They packed the better the data here. And then they started to remember you had clear clinical college representatives.

Jane Dacre 20:11
So yes, for the RCP

Parveen Kumar 20:14
RCP. So I was at the RCP, regional deputy vision advisor that and then I became 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 said 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 clearly said, here's a budget. And, you know, you can point out, I think the college gave me a second postcard a second. And I was doing things in teams. And she and I just said, Right, okay, let's actually do actually do this. And so I set it up for bass and the Hamilton and got somebody to 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 Hamilton split, we joined with the London and then the London director said that I take on London and baths. 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 rotors have 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 WhatsApp building. And it's sort of its own by trust or something. And I said, I can't have that. The I got them to refurbish, and we did it. And then if you remember, you and I were the first female

Jane Dacre 22:26
we were we were quite unusual.

Parveen Kumar 22:30
We'll never have the ladies have color schemes and therefore for firms that I think then if you remember what we did was because they all had to have to consultant wardrobes, and you know those do 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 by doing that you set up the amazingly the first clinical skills of oratory 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 wanted to be done, then retrospect rather Pinery really

Jane Dacre 23:25
no fight didn't feel like 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 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 a bit 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 fit. So 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 one functional spirit, which then of course, also, you know, fed down to the students, because your students that you were given were your students and you would make sure that say Sanoma of weeks or whatever they were given 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, so there was a lovely spirit, which I think I missed 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 her happy and life patient at the end of it, which is nothing.

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 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 firms system to fall back on and in xiety and depression, but in terms of single knows. I don't know you just every single in Australia and you're strong,

Jane Dacre 25:25
maybe you maybe you just always moved on. I

Parveen Kumar 25:27
think it was very lucky. Come on, I must have been lucky because the double weary of being a female and adforum. But it didn't affect me. I didn't think fully I don't think being Indian made any difference. But I did get a bit of a stigma of being a woman.

Jane Dacre 25:45
Interesting. So whatsoever over your career, what's inspired you, you've clearly been quite quite driven to achieve so much. What or who has inspired you to?

Parveen Kumar 25:58
When I? Well, I think certainly my mother must have inspired me. And always regret not having said thank you, because you never do to a mother do. But also, I think the support I had for my husband, which was amazing. And then I think in terms of medical things, a lot of people in the office My role models are now I think Tony Dawson was one my talk 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 you won't be listening to this. But but you know, to, to write the book. There was just process to just the minutes you met, you just sat down and wrote and then the minute you finished, you went and you know, a different different life. So I think they will no, no major down. I probably think one afterwards.

Jane Dacre 27:07
Okay. Well, I think that's all that's all good. That's all very positive. So. 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 has been your family. And the the balancing act that you must have learned to do. Is there anything that you want to say about that, for people who, who maybe are embarking on a similar journey?

Parveen Kumar 27:36
I think, I think possibly go 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 extraordinary successful. You You are Dame you're very well known in medicine and to those women who aspire and and maybe 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 it them a success? I think it's a success for the people around me. You know, I would say that the PAs and the secretaries and kept up with them all these years. And I'm so lucky, I think I've had over 3040 years. And we're team and they really should be given the day but not 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. Nice for the next advice is, 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 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 CBE

Speakers: 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 the

Jane 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 there

Jennifer 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 notice

Jennifer 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.

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 why

Carrie 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 applied

for 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, so

Jane Dacre 04:43
you said there was a quota. What was the quota of girls in your year? Do you

Carrie 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 through

Carrie 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. Know

Carrie 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 the

circumstances 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. So

Jane 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 do

Jane Dacre 24:08
did you come to the UK then

Henrietta 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. So

Geeta 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? So

Geeta 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 this

Jane 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 Ankita

Jane 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

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 knows

Helen 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, I

Cathryn 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 one

Cathryn 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. Catherine

Jane 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. And

Jane 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't

Cathryn 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 are

Jane 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 and

Jane 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. And

Cathryn 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, really

Cathryn 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.