I have what has been described as a ‘portfolio career’ - I’m not really sure what that means but I’d describe it as incredibly fortunate, privileged and ‘accidentally interesting’ perhaps.
I knew from the 4th year at medical school during our underwhelming 2-week public health module that I wanted to travel and work overseas in developing countries. At that time I had no idea how, where or when but the seed had been planted.
After completing my VTS and locuming for a year or so I headed off to Tobago for a few months as a volunteer with an environmental NGO called Coral Cay Conservation. I was the medical officer for a group of divers surveying the coral reefs around the island. This involved very little medicine but a lot of interesting project development roles and most importantly masses of diving (twice a day often) and a lot of rum consumption and beach parties. By this point I officially had the travel-bug.
From this island idyll I headed off to Uganda for a more serious role; volunteering for 2 years with a charity called Hospice Africa Uganda where I was the palliative care “consultant” for a rural hospice covering a vast geographical area including parts of the DRC, Tanzania & Rwanda as well as IDPs and swathes of remote south-western Uganda. I could go on forever about this job but now is not the time, if you are interested in hearing more about the work we did & my experiences there please don’t hesitate to contact me. I think this was the most formative and life-changing role I have ever done.
On the back of that I returned to the UK to do a masters in ‘public health in developing countries’ at the London School of Hygiene and Tropical Medicine. It was a tough year & we worked our butts off but I was amongst a fascinating and inspirational bunch (I think over 25 different countries were represented by the group) and the standard and content of the teaching and lectures was outstanding. I am still in-touch with many of these people and use their knowledge and contacts on a regular basis to help me out with all sorts of things.
Having the MPH has given me an entirely different perspective on medicine and I have used this in a number of different ways; in Cameroon I worked alongside Hospice Africa France developing and delivering the first African multi-disciplinary francophone palliative care course and then travelling around Cameroon following-up on some of the course students and helping them to advocate (in French!) for the development of a palliative care service in their setting, writing proposals and plans and lobbying the great and powerful. I also joined a THET palliative care mentoring project lead by Edinburgh University which took me to Zambia, I nearly visited Burkina Faso last year but was thwarted at the last minute by a coup and I have continued to visit Uganda to assist with the francophone course which is held there annually now.
I became a partner recently at a busy, deprived and very ethnically diverse practise in Pitsmoor, which may suggest that my wayward travelling days are over. Not so. I am fortunate enough to work with people who support my voluntary work and appreciate how important it is to me; in 2016 I am hoping to go to Bangladesh for 3 weeks with GP Update International and UNHCR to provide primary care teaching to medical staff in the refugee camps, as well as another trip to Uganda.
Volunteering is worthwhile and provides great opportunities and experiences but it is not kind to the bank balance, having a stable job here in the UK means that I can afford to continue with some of this work as well as developing my skills and fulfilling my ongoing educational needs as a UK GP. And in my spare time I try to stay in touch with as many of the people I have worked with, taught, mentored or visited in order to give continued support and encouragement. I provide medico-legal reports for a charity that do advocacy-work for asylum seekers. I’m a GP trainer. I am a respite foster carer. I’m a very fortunate GP.
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If I were to say that I had always known that I wanted to study medicine, and in particular haematology, then I would not be telling the truth. I had absolutely no idea what I wanted to study after school and had it not been for a brilliant female biology teacher, I don’t think my career would have gone down the path it has. The school I attended was a state school and I always remember being told to be “realistic” by a careers advisor when I said I wanted to study science at university. I wish he could see me now. Against advice I submitted an application to study Applied Biology at Newcastle University and to my shock I was successful. I received a first class degree with honours in 2008.
During my undergraduate degree I loved the research side of science and once I completed the degree I noticed an advertisement for a PhD studentship in Newcastle University funded by Leukaemia and Lymphoma Research (LLR). One thing I have not mentioned is that growing up I knew a few people who had leukaemia, some of whom did not survive. Leukaemia has therefore always been in my thoughts and I felt an overwhelming need to apply for the position. I am thankful every day that I was successful, and my female supervisor was to become one of the key role models in my future.
I started my 4-year PhD studentship in 2008 and continued to work as a post-doc for the LLR until 2013. My PhD research was concerned with investigating potential mechanisms by which therapy related leukaemia’s arise in order to reduce and/or prevent patients from developing leukaemia as a side effect of treatment for a primary disease. I was often asked what did I do in a ‘typical’ day and I always responded in the same way - “typical days do not exist in research”. Working in research consists of long days but never (in my opinion) tedious as there is always so much to do. Firstly, devising which experiments to do in which order in conjunction with my supervisors and fellow scientists is crucial. The length of time these experiments take can be anywhere between days and months. As well as devising and conducting experiments, the methods and results must be written up in the following formats; lab books so you or anyone can repeat your experiment in the future, PhD thesis so your work can be assessed by experts in the field, manuscripts for publication so the work that you and your fellow scientists have done can be published and shared with experts in the field around the world.
During my time in research I also attended and presented work at conferences, which are a hub of information and are always vital in discussing new and evolving research and treatments in the field of haematology. To date I have published two papers with my research group and we are still working on publishing other data from my PhD thesis. One of these papers was a collaboration with Professor Janet Rowley’s group in Chicago, another amazing role model of mine who sadly passed away in 2013. Although the majority of my time in research was spent in the laboratory conducting experiments, I also spent time on the Haematology wards at the Northern Centre for Cancer Care, Freeman Hospital in Newcastle. The first thing that shocked me was the vast age range of patients on the ward and I was fortunate enough to be asked to follow a patients treatment and progress during my time on the ward and beyond. I was also struck by the necessity of working as a team between the academic and clinical professions of haematology, for example the type of leukaemia a patient has is determined by scientists in the lab and the results are passed to the medical teams to devise treatment protocols for each patient.
Throughout my PhD I was struck by how much I loved conducting research and also communicating with patients. I therefore decided to apply to study medicine with the aim of working as a clinical researcher, hopefully for the LLR! I was accepted to study medicine by the University of Sheffield in 2013. The hardest decision to make when accepting my offer to study medicine was leaving the LLR after 5 years….but hopefully it will be temporary! I am now in my third year of medicine and therefore completed the “academic” phase of the course and I am now moving into the “clinical” phase, which is mainly rotating around departments in different hospitals. I thought that as a mature student I would be the only older student on the course. I think there are roughly 30 mature/post-grad students in my year so that has helped me to not feel so old! Studying medicine is hard work, there is no getting away from that. You definitely have to have an interest in the subject as there is A LOT of reading. If I am honest, by the end of second year I was starting to forget why I was doing medicine as I just felt like I lived in a lecture theatre. But now I am in third year it all makes sense and I am putting into practice everything we have been taught. I love being in the hospitals, learning more about creating differential diagnosis and treatment plans as well as actually getting to know some of the patients. Some days are tough but most days are great and I can’t think of any other career I would rather be doing! However, there is never a greater satisfaction or a more humbling experience than attending and participating in events to raise funds for the LLR and meeting the patients who have been affected or are currently affected by a haematological malignancy. Their strength and determination is infectious and continuously helps me to focus on the reasons I want to do the job that I do!
On a personal level I have also started going to local state schools and talking to young students about my research and studying medicine in order to encourage young people to consider career paths that I certainly did not consider at my school. The most common response is that they had never considered science as a career path until either me or me and a team of fellow scientists had gone in to talk to them about research and medicine. I am also a student mentor for the SOAMS programme at Sheffield which is a great way to answer any concerns that students thinking about studying medicine have prior to applying. In summary, the advice I give to students is don’t panic if you haven’t got your life mapped out after school. Also if there is a career you want to do then don’t give up on it if a few hurdles are put in the way. It will just make it more worth it when you do get there. Having role models is vital and I have been lucky to have the most amazing role model from birth, my mother. Keep in mind why you are doing what you are doing and always have the self-belief that you will succeed, no matter how long it takes!
My journey here isn’t what you might call typical. I am 10 years older than most of the other students in my year. “That‘s practically a whole generation!” as one of my non-medic friends so kindly put it.
I didn’t choose to do chemistry A-Level when I selected my choices aged 16. I don’t think I had ever really considered a career in medicine at that time. It was only on my gap year, teaching English to under-privileged primary school children in Thailand that I began to think that was what I wanted to do.
My parents dutifully researched Medicine courses back in England but found that without chemistry A-Level there was really no way in. So I opted to go ahead with my plan to study Applied Communications at Newcastle University. I couldn’t possibly delay university by another two years to gain the all-important chemistry A-Level – I’d be ancient by the time I started if I did that! Little did I know…
I went on to have the best three years of my life in Newcastle and gained a first class degree for my efforts. I spent a year working in marketing in Australia following my degree and got a place on the BT Global Services graduate scheme on my return.
I was working in Internal Communications in London – I had a good job with great prospects. But I couldn’t shake the feeling that there was more to life. What was I doing that was actually helping people? Was I really making a difference?
It was a throw-away comment from a friend of a friend that made me realise that re-training was an option. As stupid as it sounds retraining was a possibility!
I was accepted at Sheffield to the six-year pre-med course. This gives people without a science background the opportunity to study medicine by teaching all the chemistry, biology and physics you need in a pre-medical year at the start. For me this was ideal – it gave me a whole year to remember how to learn, revise and sit exams again.
I am now entering my fourth year as a student doctor. It hasn’t been easy – my mind isn’t as sponge-like as the younger students! However, what I lack in memory I make up for with enthusiasm. Every day I feel lucky to have been given this opportunity. I am making the most of every chance to learn and I know that this is my calling. I also feel being a little older gives me an advantage when it comes to relating to patients, consultants, nurses and well, everyone really.
Don’t get me wrong, it is hard not having a salary as all your friends outside medicine ascend through the ranks. And the pressure of juggling a family with work is looming almost as soon as I finish my foundation training. But, I absolutely love medicine and the challenges, variety and opportunities it presents and there isn’t anything I would rather be doing.
Are the Nine to five traditions causing workforce exclusion for women and people with caring responsibilities?
Director of The Inspiring Leaders Network and Equilibrium
At a time when Health and Social Care are facing their biggest challenges, financial constraints, more for less and enhanced integration and partnership working, it seems imperative to ensure that we are utilising our best talent to think differently, challenge cultural norms which lead to poor patient care and outcomes and to manage and enhance new and existing relationships to drive forward, innovate and lead through new ways of working and models of care and best practice.
There is a plethora of evidence to demonstrate that having a more gender balanced and diverse board benefits not only the organisation but has significant benefits to the economy. There is much more than an anecdotal need for us to review, develop, support and transform our workforce.
The importance of women on boards across sectors has been evidenced widely. According to McKinsey, companies across all sectors with the most women on their boards of directors significantly and consistently outperform those with no female representation – by 41% in terms of return on equity and by 56% in terms of operating results. Furthermore addressing the gender balance in senior posts is particularly important; the Women and Work Commission found that allowing women’s full potential in the work place could be worth £23 billion a year to the Exchequer.
In a study of the Fortune 500, Catalyst reveals that companies in the highest percentile of women on their boards outperformed those in the lowest percentile by 53% higher return on equity, 42% higher return on sales, and 66% higher return on invested capital.
More locally, Leeds University Business School reports that having at least one woman as director on the board appears to cut a company’s chances of going bust by about 20%. Having two or three female directors lowers the risk further and during 2011, companies in the STOXX 600 Index with more than 30% women managers outperformed those with less than 20% women managers by nearly 8%.
So, having this evidence, what is it that still prevents equality in senior posts across the Health and Care landscape?
We know that in comparison the NHS performs better in terms of gender balance than the private sector, and that’s something we should absolutely be proud of, and, it’s not enough, how long should we have to wait for equality?
Women currently make up approx. 47% of the workforce, although currently women’s unemployment is at a 24 year high. Women are as ambitious as men; and with 1 in 3 female graduates having a degree in health related study compared with 1 in 11 males, maybe consideration to working practices viewed as the norm should be reviewed.
The traditional management role of 9-5 doesn’t conform to most people’s lives these days, people have different responsibilities and it would seem sensible to have a more fluid approach.
Lack of flexible working is not only a barrier to gender balance, but to talent management and succession planning. With an aging population, and an increase in diseases such as Dementia, more people are requiring the flexibility to care for elderly family, in addition people living with a disability may require the flexibility to work reduced hours, or just simply work in different ways that support their needs and enhance their ability to do a good job.
There is a clear business case to review and innovate our working and recruitment practices, this article serves to stimulate thoughts and showcase several good areas of practice.
Research from CIPD and Westfield Health suggested only a third of employers (34%) have a formal, written policy or an informal, verbal policy in place to support working carers in their workplace, this is concerning, given that 3 in 5 people will end up being a care for someone at some point in their lives. Caring comes in all shapes and sizes, but the commonality remains, employees need to support them in the workplace before they lose the talent.
Employee support and access to flexible working can greatly increase staff morale, engagement, attraction and retention, it also reduces staff absenteeism, as people will not need to take time off work sick to care for family due to the lack of options presented to them. In addition, burning the candle, attempting to juggle, has an impact on health and wellbeing, reduction in productivity at work and also reduced motivation.
Looking more broadly, most companies do offer some degree of flexible working; most frequently these consist of part-time or job share, variable/compressed hours and career breaks. The Confederation of British Industry (CBI) found in 2011 that 96% of UK companies offered at least 1 form of flexible working and 70% offered three or more types. However, The CBI further found that companies are extremely reluctant to extend these flexible-working patterns further and to larger groups of employees, as they feared that it would have a negative impact upon productivity. The Future of Work survey 2012 concluded that many UK companies were fearful of extending the boundaries of flexible working due to concerns around competitiveness.
The NHS offers similar flexible working practices, however it would appear that these options reduce significantly, the more senior the post and also there is huge variation in availability and practices, seemingly dependent upon local practices and culture. However how often do we actively recruit flexibly?
In 2009 the Family Friendly Working Hours Taskforce under the lead of Yvette Cooper was established by the Department for Work and Pensions. It highlighted a number of compelling business reasons for flexible working such as falling absenteeism, greater retention of staff, increased productivity, greater staff loyalty and importantly the ability to recruit from a wider and more diverse talent pool of workers. After looking at business examples and hearing from employers and employees the Taskforce concluded there was a very strong business case for flexible working. In addition there was also a strong social case, which integrates improvements in child poverty and the gender pay gap.
Despite the case being made within recent years for an increase in flexible working opportunities, employers are still not providing the opportunities for work-life balance that employees feel they require particularly in more senior roles. Public perception is still very much behind the times in this also with 72% of the population not believing it possible to work part time in the case of senior roles thus demonstrating that the stigma of working part time persists. In fact it is the case that 1 in 10 workers earning over £40000 FTE do work part time. The reasons for working part time hours are varied, from childcare responsibilities, leisure commitments to caring for elderly relatives. However, the negative associations persist and many part time workers fear their commitment to their role is questioned and worry it may impact their chances of promotion.
Research has highlighted that for true flexible working to occur senior management must be enabling factors in the cultural shift. Demonstrating to senior managers the real savings that can made and the increasing productivity, which is possible, is crucial if agile working is to be followed through. Where senior managers play an active role in encouraging flexible working the benefits are clear.
Flexible working relies on mutual trust and the breaking down of tradition working patterns of presenteeism. The Future of Work Institute highlight that even though companies are aware that change is needed they can remain hesitant (2012). This aversion to risk is certainly a barrier for some companies particularly the more traditional roles.
In the case of job share the benefits to employers are clear. Employers keep two valued employees who might otherwise feel they need to leave in order to pursue work-family issues. In turn the employer retains two sets of positivity and creativity and also skill mix.
Working as a job share means the employees must communicate extremely effectively in order to plan goals and share achievements. Covering for illness and holidays is simpler and with less disruption in term of customer service.
In a UK survey by My Family Care and Hydrogen (a recruitment company) of 1.587 employees and 310 employers found that 54% of the working population want to work remotely or from home but just a third were encouraged to do so. 81% of workers seek flexible working above other benefits such as enhanced pensions or healthcare schemes. A further 45% would choose flexible working over a 10% salary increase. The survey concluded that flexible working is in fact ‘the future’ especially given the increasing numbers of working mothers in the UK, the increasing pension age and the rise of the ‘sandwich generation’ with dual caring responsibilities of children and aging parents.
Returning to diversity of boards, it would seem that at a time of great change, we need to enable and liberate all of our talent, prevent workforce exclusion and adapt and challenge current practices so that we can really begin to fully utilise the cognitive diversity of everyone, not just those who can work a 9-5, Monday to Friday week.
Senior positions are tougher than ever, there is a shortage of CEOs, and senior level leaders are suffering burnout and high levels of stress. This coupled with the recent shift in retirement age provides yet another argument in favour of flexible working and recruitment. We should be looking to retain our senior leaders and their wealth of knowledge and experience, rather than seeing hem walk into consultancy firms with all of their experience, skills and knowledge.
In the New Year we will be launching Equilibrium, an organisation, which is ambitious in its mission to, supports both individuals and organisations, to think differently about how they employ people. Equilibrium has been established to support organisations to be more flexible employers, and to support talented individuals to gain a place in the senior teams of public sector workforces.
The aims are to build a better future for both employees and organisations across the Public Sector to enhance quality, efficiency and innovation and ultimately lead to better service user outcomes. Equilibrium will facilitate and empower positive practical solutions to the workforce exclusion and talent drain currently facing today’s workforce market. We don’t want to just talk about it; we want to make a change!
We know that offering flexible work opportunities at the point of hiring can increase the talent pool, there is a great deal of evidence to suggest that many women are working below their ability and potential due the lack of flexible options, and we know its not just women who want flexibility.
Flexible working option can enable organisations to get the skills & experience they need, whilst reducing costs, to increase performance and engagement with employees and to enhance innovation through cognitive diversity.
We work with organisations to help fit the jigsaw together – flexible hiring as well as working opportunities, not recruiting what we had, but rethinking and designing what would work
‘We need to stop hiring like for like and think about how we can hire differently and better’
Healthcare boasts many talented and inspirational women so people question why there are still discussions about equality. A board member being a mother is still noteworthy in a way that that fatherhood would not be. Perhaps that is ok because we are recognising the skills that she brings from her family life to her role but I would rather both men and women have an equal role and responsibility in their family.