I wanted to feature this piece with a little bias, it has to be said. It is written by Dr Hannah Gardner, who happens to be my good lady wife! There is no conflict really, I thought this story should be put out there as Hannah’s situation was a little unusual. This is someone who left medicine (not unheard of), but was drawn back into it again! And into critical care……..
A little re-intro!
As I looked at the person staring back at me in the mirror, I took a deep breath and tried to calm the butterflies in my stomach. I had scrubs on, a stethoscope around my neck, short, unpainted nails and looked like every other doctor in the changing rooms. The only difference was, this was my first shift back on intensive care and indeed as a doctor, in three and a half years. How on earth did I end up back here?!
Since the age of 6, I had dreamed of being a doctor – I can’t tell you why, no one in my family was a doctor, but I set my mind to it and there was no persuading me otherwise. I did everything I was meant to; work experience at the local hospice, shadowing in a GP surgery, lots of extra-curricular achievements and straight A’s in my A-levels. I made it to medical school.
University Life and the early years
My 5 years at University were absolutely fantastic – I made friends for life and really enjoyed the academic side of it, (even if I did miss a few lectures due to a hangover!) The time at Sheffield Medical School flew by and before I knew it, I was walking into Northampton General Hospital as an FY1…..I’d done it! I was a real-life doctor!
My foundation years involved a very steep learning curve, but I enjoyed the job and was getting positive feedback from my posts. I loved the clinical side of dealing with patients, but found the paperwork and rotas a little tedious, but who doesn’t when you work in the NHS?! I hadn’t decided which area to specialise in and so when an opportunity came up to do a clinical fellowship or ‘F3’, on Intensive Care, I jumped at it!
I always thought that ITU was an amazing place, where one could solidify knowledge of complex physiology on-the-go and improve your practical skill-set. I thought this would give me the chance to figure out my bigger plan, certainly throwing myself in at the proverbial deep end.
The fellowship year was hard – the job was great, but things in my personal life were becoming tricky and I was starting to feel the strain. I was finding the burden of an imposed rota, (difficult to swap in and out of), really hard. I was constantly missing family events such as weddings and birthdays, as well as jaunts with close non-medical and medical friends. I felt like I was always at work and if I wasn’t physically at work, I was either worrying about it or doing some ridiculous paperwork to prove I could do my job. I felt like it had completely and utterly taken over my life and the resentment started to grow. When the bleep would go off, I would pray it was a false alarm as I just didn’t want to deal with patients anymore. I found I was starting to avoid practical procedures, offering them up to others because I just wasn’t interested. I went from being enthusiastic, interested and ambitious, to completely apathetic. My bubble was about to burst!
The Fellowship was drawing to a close and I had survived it! Towards the end, I had to decide which training programme to apply for and the obvious choice seemed like anaesthetics, given my time on intensive care. About 2 months into my anaesthetics training, and in the midst of fertility difficulties, I left. I don’t know if I would call it ‘burn out’, but I had had enough. I couldn’t cope with what was happening in my personal life and the stresses of my job. I felt like even if I had wanted to carry on, I wasn’t clever enough to do so. I suffered from ‘imposter syndrome’ and just felt like I couldn’t do any of it….the job, the exams, the endless amounts of paperwork. I was done. So that was it….after 5 years at university and 3.5 years on the job, I just walked away from everything!
I decided I would do a few locum shifts to bring some money in whilst I figured out what to do, but I knew I had to leave medicine entirely. When I arrived at a hospital for my first locum shift, I essentially had a panic attack and physically couldn’t get out of the car. I drove home and got straight back into bed. Medicine had literally beaten me down and I couldn’t do it anymore!
I was stuck up the creek with no paddle! I had no ‘plan b’, as I had always focussed everything into becoming a doctor. This is the thing about us, as medics, as doctors…we very often have to channel everything into achieving what we want, so we end up with tunnel vision. I felt so lost after I left.
A new life…a new day
I owe the next stage of my career to my brother, Ben. He had worked for my Father’s business, a Health and Safety Consultancy, after he left University. He had then gone on to expand it following my Father’s retirement and was now running a very successful organisation called The Navitas Group. He offered me a role within the online training area of the business.
Stepping into that role was like entering a whole new world! I worked 9-5, Monday to Friday and I had every weekend free to do as I pleased! I was busy at work, but no decision I made resulted in someone dying. The people I worked with were a relatively constant entity…they weren’t going to disappear off to another city after 6 months. It felt like bliss! The work-life balance was without doubt, a million times better than what I had been doing within hospital medicine and I knew I had made the right decision.
Whenever I told anyone I had left medicine, they would pause for a while in disbelief, then tended to always say, ‘you can always go back!’. I would say, without hesitation, ‘but I won’t!’
The only problem with working for my brother, was that I felt like any success was on the back of him. I was convinced that people would think, ‘she’s only got that job because she’s his sister.’ Whilst that was true initially, I worked bloody hard to prove to everyone that I was worthy of the job and that I was doing it well.
Well out of medicine…
Over the next 3.5 years, a lot happened. I was promoted three times, until I was the Operations Manager running that pillar of the company. I became involved in board meetings and the financial nuances of the company. I managed a team of about 15 people and became a pivotal part in hiring others and disciplining poorly performing members of the team. This was worlds away from the skills I had been taught as a doctor! Then…a medical opportunity came my way from within the business. I leapt at this opportunity….strange that!! I was partnered up with one of the UK’s leading training providers for non-surgical aesthetic procedures, writing a post graduate level qualification for them.
So, my career appeared to be going from strength to strength. Then, after a long battle riddled with upset and difficulty, I was finally blessed falling pregnant with my little boy. My husband and I had been trying for our little one for over two years and had to go for many hospital consultations, scans and procedures. I remember thinking whilst going through it all, there is no way I could have gone through all of this whilst being a doctor!
Wondering thoughts…deja vu and a new life
But as I grew in size, my mind started to wander back to the hospital and what my peers were doing. Whilst I enjoyed the people I worked with, I began to think more and more, ‘what did I actually achieve today?’ I started to miss the buzz of the hospital and the teamwork within it. I missed treating patients and them thanking them for making them feel better. There was no doubt that I was in a very fortunate position, earning good money, for far less hours, but it somehow felt like it wasn’t enough. I figured I was probably just having a wobble because I was about to become a mum for the first time and put it to the back of my mind. After all, I had wanted this baby for over 2 years, surely when he arrived, that would be enough for me?!
Finley was born in January 2019 and I went back to work for 3 days a week, the following October. It was daunting to be going back, but I was looking forward to having some ‘me time’, even though I missed him dreadfully. But, as soon as I started, that same niggle came back. I wanted to be a doctor again!
Dare to tell…?
I had no idea where to start. Who would I talk to about this? Where could I get advice? How would I even get my license back? I wasn’t ready to be a full blown hospital doctor yet, so I decided, given my partnership with the aesthetics company, that I would train in this. That way, I could still do my normal job, but do this in the evenings and weekends; a link back in if you like. I got my license back quite quickly from the GMC and got myself trained up. All the GMC needed was proof from a previous employer confirming who I was, and I was allowed to prescribe again! I enjoyed doing injectables and indeed, I still practice as an aesthetic practitioner, however, it still wasn’t enough. As cliche as it sounds, I wanted to help people and really make a difference…..that hadn’t happened working in the corporate sector and still wasn’t now!
Support…where can help be found?!
I started to explore various avenues and researched job options. I felt I didn’t stand a chance of getting a job – I had been absent from medicine for over 3 years and also only wanted to go back part time. Who would want me? I did find there were many good resources online…below are a few:
Health Education England
On a whim, I emailed my old boss from ITU and asked if there would be a chance of me doing any locum shifts, to get my foot back in the door. The rest, as they say, is history! I was offered a position as a clinical fellow at 50% LTFT……I didn’t hesitate in saying yes! The conversation that followed with my brother was understandably very emotional. But he understood and supported my decision. He continues to go from strength to strength and I’m super proud of all he is achieving.
I then fortunately saw an advert on the Physician Mums Group PMGUK, which is a very supportive Facebook group that I am part of, for a Return to Work course being held the following month. I can’t link anyone to this as it is a closed, invite only group. The course in question ran over 4 days and was FREE! Held by Maudsley Simulation, which aims to support doctors returning to work, it seemed too good to be true! A ‘break’ could just be a period of maternity leave, or in some cases, circumstances as long as 11 years. I cannot rate this course highly enough. It was absolutely fantastic, and I came away with the confidence I needed to start my new job. The course covered basic procedures such as cannulas & catheters, ALS, scenarios with acutely unwell patients and communication skills. A lot of the course was also based around self-care, the psychological impact of returning to work and where to find additional support. It was fantastic to realise I was not the only one in this boat and what was also inspiring was listening to others’ situations. As we were put through our paces, I was so surprised and relieved as to how much I had retained and what comes naturally from the doctor that always lay awake within me!
The big return!!!
And then it was time to go back. I cannot explain the nerves I felt on that first shift, feeling completely overwhelmed by how much I had forgotten and how much I didn’t know. But those nerves were unnecessary. Just as I had remembered, critical care is one of the most supportive settings you can be in. Yes, the patients are the sickest in the hospital, but the team are fantastic, and you are never alone. Everyone has been very understanding of my situation and have done all they can to support me through this transition.
By going back at 50%, I have the perfect work-life balance and never feel ‘overwhelmed’ by medicine, as I did before. I am thoroughly enjoying being back on the unit, working in an MDT and putting my medical knowledge (limited though it is), to use. I have found that a lot of the practical procedures seem to have ‘muscle memory’, and I’m starting to feel confident in those again. My communication skills have only improved since having time in the corporate setting and I feel like I have a different perspective on things, since becoming a parent.
I think as a medical student; you are often made to believe that medicine is like a train on a track. It only moves in one direction and once you have picked your destination, you can’t change your mind. I am proof that this is not the case. I wonder if I had had more support at the time, and perhaps had an arranged out of practice break, or dropped my hours, I may not have had 3.5 years out of medicine. Having said all of that though, I have no regrets. I have learnt many new skills from working in the corporate world and I’m happy with where I am right now.
For anyone thinking of returning to medicine after a break, there is so much support out there for you. The links are all above, but I’m sure there are many more. Get in contact with your old bosses, your local trusts and the deaneries. I would say people in general are kind and want to help where they can – you just have to find the right path for you.
For anyone working with someone on their return – be kind. I cannot explain how daunting it is to come back. Who knows what that person has been through, to be in that situation – I certainly heard some very moving stories on the Return to Work course I attended. These people have been so brave to make the move back into the profession, but they will be anxious and nervous and will need your support. Check in on them regularly, support them with practical skills, offer some teaching on the main things you see on your shift. Or just offer them a cuppa if they look like a rabbit in headlights!
And what about me?! Well, I’m 6 weeks in and have no regrets so far. I don’t have a long-term plan and I like it that way. I work 2-3 days a week and can focus on being the best doctor I can be, whilst I’m there, and I enjoy the other days with my son. I spend 50% of my shifts feeling overwhelmed and 50% feeling proud of myself but hopefully over time, those percentages will read a little better. As my friends ascend the Reg ranks, or take a partnership in a GP practice, I remind myself, that other routes are allowed and it’s ok to do things my way, with a smile on my face and a passion for the profession.
The Happy Gallery!
Reviewed by: husband and CCN founder Dr Jonny Wilkinson
Post natal depression and how to cope…an article by Hannah when things were very difficult. This period is eluded to within her piece above…