Last year there were nearly 150,000 doctors employed by the National Health Service. Since 2004 this figure has been increasing annually by 2.5%. Doctors, whether they are gynaecologists, cardiologists, or GPs to name a few, are an extremely important part of our society.
So what is it like being a doctor? What are the hardest decisions doctors have faced in the field? Andrew Baldwin, Nina Hjelde, and Charlotte Goumalatsou share their experience and insight, answering questions from junior doctors around the world, on making Difficult decisions, time constraints, juggling learning the latest medical knowledge and workload, as well as what being a doctor really means to them.
What is the hardest decision you’ve ever made as a doctor? – Chin Wei Wong (Coventry, UK)
Nina Hjelde: The toughest moments for me have been when I’ve made the conscious decision to stay late and help a colleague or Patient at the cost of missing a key moment in my personal life… Medical school trains you, to a certain degree, to deal with death and breaking bad news. It never warned me how much of your own family you sometimes have to sacrifice.
Charlotte Goumalatsou: As a junior registrar I was on call and there was a woman with abdominal pain who was 28 weeks pregnant. Her membranes had ruptured three weeks beforehand and there were signs of impending chorioamnionitis. I examined her and there had been a cord prolapse at 2cm dilated, which leads to fetal demise very quickly if delivery is not imminent. There was a flicker of fetal heartbeat activity on the scan, but fetal position, lack of amniotic fluid, and my inexperience as a scanner made the scan difficult. So I made the decision to take the woman to theatre for an emergency caesarean section and called in the consultant from home. Unfortunately, the baby was born with no signs of life and didn’t respond to resuscitation. I often look back at that delivery and wonder if I did the right thing. But I know that I couldn’t have not acted, and not given that baby a chance.
Andrew Baldwin: We make difficult decisions every day when it comes to looking after patients; however for me, choosing which specialty to train in was probably most difficult. I found everything interesting. But I have no regrets about becoming a GP; the wide variety of knowledge required, running a business, and building long-term relationships with patients are very fulfilling.
How do you deal with the time constraints that are put on doctors when treating patients? Do you ever get frustrated by it? Do you have any particular tips to making sure a patient feels valued and acknowledged? – Victoria McKinnon (Ontario, Canada)
Andrew Baldwin: As a GP in the United Kingdom, I get frustrated every day by time constraints. I generally see 40 patients a day. But you can use short periods of time over weeks and months to build relationships and get to know your patients. My tip would be to find something out about your patient. While visiting an elderly man recently, he told me how in World War Two he crashed his Wellington bomber aircraft into the Mediterranean and spent two days afloat on a life-raft before being rescued. Inspiring!
Nina Hjelde: Smile and give a little personal story about yourself. Even something as mundane as the fact that the new rain jacket your mum bought you was put to good use in the storm this morning. It makes you more human and patients really appreciate that.
Charlotte Goumalatsou: I think this gets easier with experience in some ways – you will arrive at decisions quicker and your communication style will become more efficient. And to make patients feel valued, sometimes you have to let them sit down and shout or rant without interruption. This usually lasts a maximum of two minutes and then it’s possible to take a history and get on with the consultation.
What is your advice for keeping up-to-date with the latest medical knowledge, while being so occupied with work in hospital, sometimes only being able to sleep for five hours? – Elaine Kar Man (Pahang, Malaysia)
Nina Hjelde: Don’t be too hard on yourself if you don’t manage to read every journal! I recommend that you become familiar with the local guidelines since those will be regularly revised based on the best evidence.
Charlotte Goumalatsou: I never find time to go to the library now or sit for ages studying, and there’s no magic answer. Just squeeze in ten minutes when you can, before bed and over a cup of tea when on call.
Andrew Baldwin: Life is difficult for junior doctors! Having recently qualified, you will be up-to-date with much of the latest medical practice. My advice would be to focus on the specialty you are rotating through – learn from your seniors or read around a specific case you have seen.
What does being a doctor mean to you?
Charlotte Goumalatsou: I always knew I wanted to do medicine, like you just know that you are left or right-handed. I love the problem-solving aspect, working in a team in theatre and on labour ward, the emergency situations, having women as patients, and getting to operate. Delivering a baby never gets old and since having a baby myself I find it more emotional than before.
Andrew Baldwin: Actually, I hope that my identity is not caught up in being a doctor, despite the title and all-consuming nature of the work. Why medicine? It’s difficult to articulate but there is something so special about the human body in health and disease, the people who come attached to that body and the people we get to work with.
Nina Hjelde: I love the fact that you have such a privileged and unique opportunity to play a role in someone’s time of need. You also get to work alongside some of the most incredible people.
Featured image credit: Stethoscope by Parentingupstream. CC0 public domain via Pixabay.
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