Medicine work experience: The best insight from a Paediatric consultant

I have spoken previously about the importance of reflection. So, In this post on medicine work experience, I want to help you out with this! After each paragraph of excellent insight, I will pose a question to you to become incredible at reflection!

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Please Could you tell me what your Job title is and what a typical day in your life would look like?

Firstly, I am a Consultant in Paediatric Emergency Medicine. I am also a Consultant in Paediatric Allergy and the Head of patient safety for the children’s hospital.

In short, no two days are the same really. However, a typical day in A&E would be going into work to hand over, looking around in the department to see where the resources need to be positioned and where I  need to be. After that, I’ll check which different MDT members are on that day and helping all run smoothly. On the other hand, sometimes I’ll be doing Outpatient Allergy testing in the clinic, seeing lots of different patients. My Head of safety role involves lots of meetings to discuss what has been going right and what hasn’t been going well recently in regards to the safety of the patients.

Medicine work experience reflective point: What can you learn about the nature of a Paediatric role here? Is it diverse and varied? Does it involve community medicine too?

What is the biggest thing medical students/junior don’t know when they start placements?

Hmm, I’d say that you can’t know everything and don’t pretend you do. In other words, be humble, understand what you are competent with and what you are not and be prepared to seek help. Those would be the words of advice I would give. For instance, people used to come out of medical school and feel an obligation to be someone they weren’t ready to be. That is nonsense. Nothing changes in the two days between Graduating University and becoming a Foundation Doctor really. It’s about understanding you still have much to learn.

Medicine work experience reflective point. Firstly, what can you learn about humility here? Secondly, Has this taught you to know your own limits? Lastly, where have you used this skill?

In your opinion, a brilliant doctor would be like what animal and why?

Honestly, I don’t think there is one answer I can give.  Like humans, all animals have different characteristics. And all animals are suited to different jobs. Ah! I’m being told to choose one, oh crumbs I’m struggling with this!

A shark, because I think sharks are clever and can sense something from a mile away, they follow it and don’t stop until they get what they want. My job is like being a detective and not stopping until I have the right answer.

Medicine work experience reflective point: Firstly, where have you shown the skills underpinning this answer? Secondly, can you explain a situation in medicine you would need this skill?

Why medicine?

Medicine work experience reflective point: what can you understand from this? How does your WHY compare to this (similarities and differences)?

Could you describe the journey one would have to take from the first year of med school to your role now?

The first thing you have to do is get through medical school. What do I mean by that, really it’s learning to be comfortable seeing patients and doctor basics? After that,  you would have to do Foundation years; that’s two  2 years of foundation Doctor jobs. If you want to be a paediatrician you ask for a job in that speciality. Then, you’d apply for a Paediatrics training programme which is  8 years long, or shorter if you are very good. During the 8 years, there are professional exams you have to take and various hoops to jump through.

” Firstly, be comfortable seeing patients”

You may need to take time out to do research if you want to be an academic doctor, or do teaching as a consultant. In those years many people’s lives change as they get married, move house, have children and so the process can be longer. You might take a year to go travelling during that time, I went to Australia to see how medicine was performed there. All being well, after your training in the specialty you’ll become a consultant, apply for a job and hopefully get it!

Medicine work experience reflective point: You may be asked “where you see yourself in ten years” at the interview. Use this to construct an answer specific to you!

What is the biggest misconception you think the general public has about Paediatrics and more generally being a doctor?

In Paediatrics, I think a huge misconception is that we can cure everything. Most of my world in an emergency is about managing normal childhood illness. What do I mean by that, well if a child comes in with a fever with a variety of symptoms, this could lead to many diagnoses. Most of the time we don’t need to treat for the most serious possible diagnosis.  The Public often expects us to fix everything, but a lot of the work is checking the child is well, and healthy and then sending them home.

More generally, I think people don’t understand the amazing variety of roles you can fill as a doctor. From a Radiologist in a dark room  who is looking at X-rays, to a Pathologist who works in a lab and a Psychiatrist who spends a lot of time talking to patients . There is such a variety of types of Doctors. Some love  the fast paced environment, like Emergency Medicine and some don’t. There is something for everyone .

Medicine work experience reflective point: What has this taught you about preventative medicine? How can you apply this to the NHS values?

How would you describe the good and bad aspects of the dynamic between doctors and nurses/health care assistants etc?

It’s such a variable question based on where you work, being in Emergency Paediatrics, we have a flat management style,meaning there is not much in the way of hierarchy. When I’m in charge, I make the final calls, of course, but I work hand in glove with the Senior Nurse and Nursing team. There is lots of mutual respect, listening and understanding. We all have different strengths. In a Resuscitation team, every member (up to 20 different members) has a different role, every member is as valuable in that crucial moment as each other. 

In adult medicine there can sometimes be more of a hierarchy and sometimes there may be standoffs but I can barely remember that, as I have been in Paediatrics for so long.

Medicine work experience reflective point: What can you learn about the multi-disciplinary team? How have you developed teamwork?

What is the most valuable lesson you have learned in your time as a doctor?

The most valuable lesson I’ve learned is self-awareness. You have to work in a team. Don’t try and always be working by yourself. Identify someone who has a different approach to you and that you trust to have in your back pocket. If I’m getting stuck with a patient and am not getting to the bottom of the issue,  you want to talk to someone who doesn’t think the same as you. So, the best bit of advice is finding someone who thinks differently to you and does it differently. Diversity of thought and approach and personality, this is my biggest learning point. When I started, we all naturally identified who we respected. A lot of these people often reflect you and your personality and style. Move away from that, find those who think well, but differently and use them to help.

Medicine work experience reflective point: How have you developed self awareness? When have you worked in a team to overcome a difficult problem?

How is what you do different from nurses/ healthcare assistants etc?

Broadly speaking medicine is about diagnostics, it is about caring for them by proactively finding out what is wrong. As a consultant, it is more about directing care than delivering care. Whereas Nurses work in delivering the care that Doctors prescribe. Doctors constantly manage risk, you need to know how to assess the risk and reward of situations. For example, whether to give a painful injection for example or leave then to heal on their own. 

Medicine work experience reflective point: Where have you shown strengths in research, leadership and decision making? How does this relate to this scenario? Where will you use this skill in future?

 What is the thing you enjoy most about your job and what is most challenging?

Undeniably, the best thing in Medicine is working in A&E on a not too busy day and getting to spend time with each kid, working with different professionals. On any one of the days I have to be ingenious in the way I examine them, sometimes you have to look at them on the parent’s laps, or I’ll have to examine them whilst playing with them. You teach your juniors, you learn, you support the Nurses. You get to do a combination of using your brain on complex cerebral procedures and more practical things like putting on a plaster cast. The variety of what you see and who you work with is the most enjoyable thing.

“The variety is the most enjoyable thing.”

The way I feel is that because I manage risk and work in a high-risk environment it is inevitable that I will get it wrong. You are taught to work like this and process this in Medical school but when you actually get it wrong, you feel very vulnerable. Worst comes to worst you can be run out of your job and be criminally prosecuted. I have refrained from making a diagnosis before, that resulted in a child dying and the effects were huge. Mental health can be affected. In medicine, the support for Doctors is getting better but you can sometimes feel that although you’re in an amazing team, you still feel alone when things go wrong.

Medicine work experience reflective point: How can you show you understand the benefits and serious risks in Medicine? Reflect on a situation that has prepared you for this.

What was it like to be a Paediatric doctor during COVID 19?

During COVID, what has been worrying is that people have been too scared to come to the hospital. As a result, children have been getting far sicker than that they would normally be. The parents, children, the family don’t want to contribute to the problem they imagine that we are facing. The message we have put out is if you’re worried,  then come in.

“It’s coming back to bite us.”

There has also been a  change in the way we have had to work, a lot of the routine work in my allergy stuff has been put on hold, some of this will come back to bite us as realise that children will be getting sicker than when we last saw them. The benefits are that the new way of working remotely through telephone and video consults in allergy has been amazing, and really effective.

There has been an attitude in recent years that everyone seems to feel that they have a God-given right to free healthcare. In reality, you only have to go to other parts of the world to see that healthcare is inequitable. There has been new respect for the NHS and we are lucky to have had this kind of support. Yet sometimes we do feel that we are seen [by the public] as the opposition and the enemy.

Medicine work experience reflective point: How can you reflect on COVID-19 and the impact its had on medicine? What have you learnt during COVID that will benefit you as a doctor?

Conclusion

In conclusion, I hope this has inspired you in your application to medciine and thatyou are now super equipped to reflect on this experience! Make sure you join my email list to be updated hen I next post( I promise, I don’t have time to spam you lol).
Feel free to leave a comment on what you have taken from this, or if you want to add/ask anything. I would love to hear from you!

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