Career tips for international medical graduates. With Ibifunke Pegba-Otemolu

Ibifunke: [00:00:00] Good morning, everyone. You’re welcome to the Thriving in the NHS monthly huddle. My name is Ibifunke Pegba-Otemolu, and I’m the host of the driving in the NHS Huddle. I’ve got with me this morning Mr Mat Daniel. He’s a surgeon, an ENT pediatric surgeon.

He’s also a career coach and has spent lots of time in education and supports for NHS staff. So today, we’re looking forward to gaining a lot of wisdom from him on how to plan our careers. Thank you, Mr Mat Daniel. Thank

Mat: you very much for inviting me. I’m looking forward to it.

Ibifunke: So can I ask, Mr Mat Daniel, while people are filling the form, at what point did you know you wanted to be a surgeon?

Mat: Um, oh, that’s a great question. Um, it’s probably for me, I think it’s been more of a journey rather than a point. Um, and if I think at at medical school, I probably realized [00:01:00] that that I was interested in the kind of things that have relatively quick fixes, you know, sort of the kind of stuff stuff where a patient comes in, you do something about it, um, and then they walk out, um, and and they’re better. And that kind of always appealed to me, um, in the medical side much more than that sort of kind of longer term, um, chronic disease management.

So that kind of was was my starting point. So so I probably gravitated towards things that were the kind of the short term, um, type short term relationships rather than the long term relationships for the most part. That sounds like these people

Ibifunke: that pick Sergei.

Mat: Okay. maybe.

Um, and then I did, um, my, um, my sort of first f 1 equivalent or sort of house officer job as it was in those days. Um, and I picked I picked a job that that rotated. It was 3 months in the professorial surgery unit and 3 months in ENT. And I kind of thought the the there was lower GI, and I thought it was working for the professor of [00:02:00] surgery, and I thought, wow. This was gonna be amazing.

Um, and I thought, well, ENT is just like it just comes with the job. And I absolutely hated the general surgery job, um, and I currently rotated through ENT, which was, you know, a sort of a bolt on. And I thought, wow. This is good. And actually, for me, it was because because quite early on in ENT, I was doing stuff.

I was treating and discharging patients. Um, and and, you know, largely for me, it was it kind of it felt like somewhere where I belong. It kinda felt like there were people like me. They shared my values. You know, sort of we laughed at the same thing.

We like the same patients. Um, and again, I think that’s quite common, isn’t it? You know, we gravitate to other people that are like us. Um, so, um, so so I did that, and then then I did general then I did a core surgical training equivalent, and I made sure that I had ENT in that. And in in in my days, that was a 3 year, um, rotation.

Um, and then I then I came back to ENT then as an SHO, and I kinda thought, you know, [00:03:00] yes. I’m really enjoying that, and and then I decided to stay in ENT. Um, so so that kind of how I ended up in ENT. And then how I ended up in the pediatric ENT was, of course, I did ENT in general, um, but I quite enjoyed that the pediatric surgery as part of my surgical training, and and I enjoyed that. And I enjoyed pediatrics before, so I kind of, um, always gravitated to to children.

So I think that’s kind of how I ended up doing children. Um, and so to weirdly, I kind of said that I enjoy that very transactional short term relationships, but kind of what I found that they they can when I became a consultant that that that I then missed that really deep connection that that those people that are in the kind of long term relationship medicine have, which, you know, in surgery, largely, I probably haven’t got that. I mean, I do have some patients that I have that relationship with, but majority of what the worry that I do is kind of, you know, in and out. So I found I actually quite missed those long term deep relationships and connections. And and that’s probably 1 of the reasons why I’ve ended [00:04:00] up going into kind of coaching leadership education because that is where I have those longer term deep relationships.

Ibifunke: That is good. Uh, it’s good that we’ve come to that. So can you talk to us a bit more about that role, what that role looks like for you? Suppose there’s someone here who is thinking about it. What what are the things that you found in that role that you really enjoy, and what was your journey into that

Mat: role?

You mean my kind of coaching leadership? Yes. Yeah. Yeah. Um, so, um, I think, you know, for for me, it kind of started off my my I guess I’m interested in making a difference to others.

Yeah. And and, you know, and and I think most people that do health care will have a version of that of, you know, of helping people or whatever. You know? Kinda that’s probably most of us will have that that within us. Um, and 1 of the things that, um, um, that that I found with my with my clinical career, you know, being focused purely on clinical career is is, you know, kind of that’s fine and, you know, you you gradually get [00:05:00] more and more senior.

And then you kind of you reach a point where you realize that actually, if you’re really gonna want to make a difference, you need to be making a difference to the whole system. And, you know, as frontline doctors, we’re making a difference to the person that sits in front of us, or at least, you know, I as an ENT surgeon do. Maybe if somebody I mean, derive from thinking maybe public health or occupational health or, you know, maybe a and e. There there might be there might be things that the doctor does that is much more based around system. But if I think, you know, my practice as an ENT surgeon, if I kind of think, you know, taking tonsils out, that makes a difference to the 1 person in front of me.

And 1 of the things that I realized was that that that actually in order for me to make a really big difference, I need to think beyond the 1 patient in front of me. Um, and I enjoy treating the 1 patient in front of me or, you know, or helping the 1 trainee in front of me. But if I really want to make a difference that is bigger, then then that means having to work at the level of the whole system or having to work at level of [00:06:00] population, whatever that might be. And I think that’s kinda why I then sort of thought, you know, oh, okay. What what can I do that that is working beyond just the 1 patient in front of me?

And how I got into coaching, I had coaching myself when I when I was making some career decisions, and I found it really beneficial, um, and kind of it’s always stuck with me. And I’ve always done lots of, um, education, um, and coaching kind of just seemed the natural addition to my skill set, um, in, in order to, to try and help not just the 1 person, but also work at kind of system level, um, uh, to, to make a difference to more than the 1 person in front of me. And I think that that’s the kind of, I think a lot of doctors struggle with that because, you know, naturally we treat the 1 patient in front of us, which is great and very rewarding, and we get that instant reward and recognition. But I think a lot of people get frustrated because, you know, we talk about are the system. You [00:07:00] know, all of us that are here today, we are the system.

So when we talk about the system, what we’re talking about is ourselves and and and each other. Um, and maybe, you know, 1 of the things that I perhaps realized is is that that that that, you know and don’t get me wrong. I’m perfectly capable of moaning just as well as everybody else. Yes. And I do a large amount of that.

Actually, sort of 1 of the things I realized was that really, you know, the the system is us. And if things are to change, it it’s up to us to change it. You know, we can’t sort of wish for for the different government or different tax payers or whatever. You you know, the system is us is us. If we’re gonna change it, it it’s up to us to change it.

And, you know, some of you on here will write articles and influence social media. You know, some of you will go into politics. Some of you will be chief execs. Some of you will be medical directors. You know, sort of some of you will be organizing, you know, podcasts and webinars.

And, you know, everybody does different things, but it is up to us to change the system because the system is us. Yeah. Thank

Ibifunke: you for [00:08:00] that. That’s actually a good point to start and and break. So we’ve got, um, results in from the pool.

We’ve got 24 people in. About 20 of them or 19 have failed have responded. So majority of people are junior doctors. We’ve got, um, a few middle grades, so 26 percent middle grade. We’ve got, um, SAS representation 5 percent and 5 percent post CCT, GP, or consultants.

Majority of people have been in the UK for less than 3 years. Um, 18 percent have been here for 3 to 5 years, and another 12 percent have been here for more than 5 years. What is a what is a career? Like, when you think about your career, especially if you’re a junior doctor, what are the things that you would say someone should think about when you [00:09:00] think my career? What thoughts should they have?

Mat: So for for me, a a career is a an ever changing lifelong endeavor, um, and career career isn’t just paid work. You know? Career career is everything that 1 does in in the world of work, and some of that will be paid and some of that will be will be unpaid. So and I guess there’s kind of 3 things for me. So so the first thing is that that it is it is a lifelong endeavor.

And often often people think of, you know, what’s my next step or what do I need to achieve? Um, and I think that’s problematic. The challenge for us as doctors appraised on our ability to tick boxes. So we are professional box tickers. We are brilliant at ticking boxes because [00:10:00] that is what we need to do in order to progress our careers.

But the problem with that is that that creates a mindset where all of the time we’re thinking, what’s my next box to tick? What’s my next box? I’ve ticked this box. I’ve ticked that box. Okay?

So and, you know, for me, it’s less about, you know, what do I need to get to because because, you know, it’s a lifelong journey. And if I kind of give my example is, you know, maybe for me when when I became a consultant, I kind of work towards that, and I thought this is what I need to do. And then I became a consultant, and I thought, now what? Yeah. You know, I’ve got another 25 years of work ahead of me.

I’m a consultant or, you know, I’m a GP. You know, where do I go next? And I think that’s quite common that, you know, people climb the ladder and they get to the top of the ladder, whatever top looks like for them. Um, and then they sort of say, where where do you go next? Be because they haven’t really considered a career as a lifelong endeavor.

So for me, you know, yes, the next step is important. I’m not suggesting that it’s not. You know, it is important to focus on the next step. But actually, you know, it’s important for me to think [00:11:00] about the long the long term and the long journey. Um, and the key thing really to recognize in there would would be would be some key things that you want to have in your life.

And, you know, these might be kind of values, things that are important to you. Um, and if you reckon, sort of say, you know, these are 5, 6, 7 things that I want in my life, um, of of, you know, always and in the long term, then that’s something that that is really important because that then helps you determine where’s my career going. So you don’t need sort of a a fixed point. You don’t need necessarily a goal to aim. Having some goals along the way, that’s helpful.

I’m not saying it’s not. But you don’t focus just on the next job or just on the goal. I think what for me is much more important is recognizing that this is a lifelong endeavor, and it’s thinking, okay. What’s my life about? What do I want?

What do I want people to say about me when I retire? What legacy do I want to leave behind? So that kind of big picture thing. And then sort of once you recognize this is the broad direction, then [00:12:00] you can sort of say, well, this is the thing. These are the small things.

These are the small goals that I need to do. So that kind of long term thinking would be an important thing for me. Um, the other thing is that it’s ever changing. Um, and 1 of the challenge of making career decisions, particularly in the long term, is that that that people are making career decisions, um, based on the information that is available today. And even if even if somebody and and it’s impossible to have all the information available.

Yeah? So, you know, if any of you there sort of our foundation doctors thinking, oh, you know, I wanna be a pediatric airway surgeon too. The reality is that that as a foundation doctor, you you you cannot possibly have and assimilate all of the information about what’s it like to be a consultant because there’s so much information out there. And until you are in that role, you can’t possibly know what it’s like. So all the time we’re making decisions with with limited information.

Problem number 1. And problem number 2, in 10 years time, when you do become a [00:13:00] pediatric airway consultant, you it’ll all be changed. The system will be different, you know. Who knows if NHS will exist? So things are always changing.

So so for me and, you know, that’s just how life is, isn’t it? And and for me, it’s kind of about accepting that things are always changing. But the key, I think, when it comes to career management is is is positioning yourself so that you are in a position of strength. Um, and particularly that for me would be around around having a track record of achievements, um, and and upskilling yourself. Yeah?

And, you know, upskilling that might be, you know, doing projects or it might be shadowing, doing committees, you know, sit sitting, putting your hand up to committees, doing projects, writing papers, or that might be sort of going and doing postgraduate certificates, courses, degrees. You know? Sort of it can be anything by gaining experience, gaining education. Because if that means when the world changes, you know, if you have a track record of achievement over here, it’s easy to then transfer that over here when the world changes. If you have a set of qualifications, it’s [00:14:00] easy to look for generalizability of things.

Yeah? So build a track record of achievement, upscale yourself, develop yourself, um, because the world will change. And, you know, if you have a track record of achievement and if you’re highly skilled and highly thought of, when the world changes, you’re gonna be well positioned, um, to take advantage of whatever the change might happen. Um, and the third thing that I talked about in that, you know, what a career is is the idea that not everything that we do, um, is going to be paid for. And I think the the the the the challenge is that sort of when people think that everything I do, I need to be renumerate renumerated for.

Um, and I think, you know, that that’s kinda becomes problematic because the reality is that a lot of the time, many of us do stuff for free, hours and hours and hours of free stuff. And and sometimes, you know, that leads to something that becomes financially beneficial, and sometimes it doesn’t. And, you know, and and that’s okay. But for me, you know, doing doing the stuff for free, number 1, that’s investing in myself. [00:15:00] Yeah.

Because, you know, if I do stuff for free, that’s investing in myself, but that’s also me investing in others. And if we are here because we want to make a difference to other people, if we are doing stuff for free while we’re investing in ourselves, um, and we’re making a difference to other people. Yeah. Um, and I’m not suggesting that people do all the work for free because, you know, of course, we all have to we all have to eat and we all have to have our mortgages. So so, you know, I I I do think that that that by and large, people need to be paid, um, for what they deliver.

Um, but equally, I would say don’t don’t be afraid to do stuff for free because, um, because it’s quite common that you end up doing stuff where you’re not getting paid for. But in the long term, you know, that that leads to, um, advantages. And, again, you know, sort of maybe if I think of some specific examples, um, for me, I did, um, a lot of undergraduate medical education as a relatively junior consultant and as a senior trainee, and I shadowed the the the professor, um, who who was in charge. And I didn’t get paid for [00:16:00] any of that, but, you know, I did OSCEs. I wrote MCQs.

I wrote educational materials. I enjoyed doing it. Yeah. And that meant I was building myself up. I was upskilling myself.

I was building a track record. I was helping students, and I was helping the professor. And for a number of years, that led to no financial benefit. But then when the professor retired, I was the obvious person to take that role on because I’d already been doing it. I already knew what was involved.

And the reality is that if a stranger had come in, they wouldn’t know what the role involves. They haven’t done it. Whereas I’d already been doing it for, I’m gonna say, I don’t know, probably 7 years before I before I actually got the paid job. Yeah. So I do get paid for that job now, you know, sort of which is great.

But but I got that job be because I invested and I did it for free. So, you know, it did lead to financial benefits. So don’t be afraid to do stuff that doesn’t have any obvious financial benefit, um, as as long as it’s something that aligns with with your broad career direction. Yeah. So for me, I did it for free because I knew that I was [00:17:00] interested in medical education.

Yeah. You know, if somebody had sort of asked me, you know, I don’t know. You know? Would you would you would you, um, try to think what I might not be interested. You know?

Would would would you do clinical governance for free for 7 years? And I kinda sorta said, well, that’s not where my career is going. So so, no, I wouldn’t do that because, you know, because my career direction was developing others. So medical education, that sits well. But if somebody says, do you wanna do a stack of clinical governance for free for 7 years?

And I’m kinda thinking, well, it it doesn’t really align with my career. So so that’s kind of how we think of the stuff that you do for free or not. Does it align with your broad career direction? If it does align with your career directions, then, yes, do it. If it doesn’t align with your career direction, then unless you needed to build your CV, probably not.

Okay.

Ibifunke: So I think 1 of the key things you’ve talked about without actually saying, um, those words is having some clarity about the direction you want to go in, so what your interests are, and [00:18:00] making sure that what you’re filling your basket with, so your up and your positioning of yourself is aligned with those things that you’re interested in and you see yourself doing in the long run. That’s really good. That’s really good. Um, I’ve I’ve been taking notes.

Yeah. That’s really good. Thank you. So another question I would like to ask is you talked about the point where you needed coaching yourself. Yeah.

How did you recognize that a coach coming into your decision making was something that was important, and how did you access that?

Mat: So, again, it was a, you you know, it wasn’t a single point. It was it was a journey. And I think for for me, um, I think, actually, sort of several things fed into it. So the first thing is that that, you know, I I was a relatively new consultant.

And up to that stage, I was very much focused on I need to become a consultant, and I became a consultant. And then I kinda thought, you know, what what what [00:19:00] what else? Where do I go next? Yeah. Um, so that was kinda 1 aspect.

So I had I had major health problems, um, and that kind of also made me think sort of okay. And it probably made me realize that I’m not gonna be alive forever. Um, and I kinda thought, you know, okay. So I need to think, you know, I I I can’t carry on, um, as as I am. So I thought I need I need to think about I’m not gonna be here forever.

Um, and, um, I think also a kind of a general a general sort of maybe kinda probably a bit burnout and frustration sort of at at at work in the in the sense that, you know, I was doing I was doing good things at helping the 1 person in front of me, but I was frustrated with, you know, the system that I talked about in the beginning. And that was before I realized how much influence I have because, you know, because I kind of felt that there was the system was doing all of these things to me, um, and and I was frustrated. So, um, and I kind of thought, well, you know, where [00:20:00] where’s my career going? You know, what what what am I doing next? And then, you know, I I I googled, um, and I identified, um, a coach that that specialized in coaching doctors.

For me, you know, it it it it wasn’t it wasn’t about I I was I was interested when my career was going. Yeah? So it wasn’t it wasn’t so much about, um, I didn’t see coaching for my mental health and well-being, you know, although I sort of have had therapy for my mental health separately from coaching. But, you know, the coaching particularly was, um, to to really to look where my career decision’s going. And I knew where’s what is my career in medicine look like?

Um, and, um, and and I think I sort of sought a coach out for that. Um, and then, you know, and I found it really beneficial. So that we worked out, um, a whole uh, we we did exercises and that kind of gave me clarity. And much of the benefits of coaching happens outside of the 1 hour, the 1 and a half hour that that you end up with [00:21:00] the coach. But for me, it kinda probably ended up being a process of of of over a year or so where where I gradually sort of got clearer as to where what my direction would be.

And, you know, and for me, 1 of the things that I identified for me, my direction was gonna be around developing people. Yeah. And that kind of that developing people, that’s a golden thread that that that has run through my career the rest of the time. Yeah. So that’s not that’s not a job title.

Yeah. You know, it’s not it’s not a degree to do. It’s not a promotion to aim for. So, you know, for for me, it’s it’s kind of it’s it’s guiding light for my career if you like. Yeah.

So that’s why I talked about, you know, it’s not job title or a particular promotion, but it’s a guiding light. Yeah. And then I knew, okay. This this is the guiding light, you know, in my case, developing people. Um, and then it was around sort of saying, okay.

What are the opportunities? What roles exist? What jobs exist? You know? How can I how can I upscale myself, um, in those fields?

Um, and [00:22:00] and then I did that. Um, if I kind of think from you know, that’s my personal experience. If I think of my experience of working with with, um, other people, um, there’s there’s a variety of different things that kind of comes into, um, what what that guiding principle. And, you know, and and it may be something like, in my case, that it might be developing people. Um, for a for a lot of of other people, um, you know, at at at the and it depends on where in your career you are.

Yeah? So for a lot of other people, you know, a guiding principle might be, you know, sort of balance. You know, I want balance in my life. If I’ve got a family, I’ve got children, you know, I I’ve or whatever, elderly parents, whatever it might be, caring responsibility, I want that to balance with my my career. And, you know, and that becomes a guiding principle.

Yeah. And, of course, you know, that that kind of is gonna look different to what to what mine might look like. Yeah. Because, you know, for me, if I’m doing this on a Saturday, you know, that’s okay because my guiding principle is developing others and this is developing others. Yeah.

You know, if [00:23:00] your if your guiding life is, you know, balanced, then then you need sort of really good boundaries around your career, which is that, you know, on Saturdays, you spend with your family or, you know, you have every Wednesday off to spend with your family. Um, so, you know, it it it might be that. And and, you know, for everybody is different. Every individual is different. Um, but I think, you know, for me, it was that that where’s my life going, where’s my career going, um, that kind of big picture stuff.

It also changes. Yeah. Because over over lifetime, um, because because, you know, maybe, you know, I’m I’m I’m 50 and I had coaching when I was, you know, 40 or or or in my early forties. And, you know, and I talk about where’s my life going, where’s my legacy. And, you know, people in your audience that are 22, 23 are gonna think you’re like, I don’t know where my life’s going.

I just need my next job. Yeah? So so it changes. Yeah? So if I if I kind of think with with people that that I work with that are early on in their careers, you know, often it’s around which specialty.

Yeah? [00:24:00] Um, and but the key for me in the specialty is that that what you’re gonna be doing as a doctor, that’s a tiny proportion of of your career. Yeah? Because, you know, are you gonna be taking out tonsils, or you’re gonna be prescribing drugs? You know?

Are you gonna be doing, um, Ogds? Are you gonna be sort of taking mental health histories? That that that’s what you actually do as a doctor with a patient. That that’s tiny tiny. Yeah.

Because, you know, the really, really big stuff is is what kind of team are you part of? What are you working hours? What’s the organization you like? What kind of organizations you’re gonna work with? What hours are you gonna work?

How much out of hours commitment’s gonna be? You know? Are you gonna get called in at weekends? Do you work hero by yourself? Do you work as part of a team?

You know? What kind of a team? Are you part of a doctors? Are you part of multidisciplinary teams? And, you know, for me, actually, those those kind of questions are probably really, really, really important.

And, you know, and and and and I I I don’t think that people always think of those [00:25:00] things yet because people always sort of think, you know, do I wanna be taking out tonsils? Do I wanna be prescribing statins? You know, do I wanna be talking to the to depressed people, you know, for for example. And, you know, people sort of say, well, I don’t know which of these 3 do I want to do yet. But but, like, that’s that’s taking out tonsils, that’s a tiny, tiny bit of of what I do.

You know, a career is so much more than what you actually do in that patient interaction. Yeah. So for people that are early and on in their careers, um, I I would sort of kind of say if you if you’re trying to make a decision about, you know, which specialty you go to or, you know, which hospital you go to, you know, or or do you progress? You know, do you go for this job? Do you go for the other job?

Um, it it’s it’s for me, it would be always thinking about, you know, what what’s the big picture? What’s the job like? Not not what am I gonna be doing with the patient, but what’s the whole job like? You know, I think that for me would be important. And remember also that things change over time.

Yeah. Because, you know, if you’d asked if you’d invited me on this sort of 20 years ago, and I [00:26:00] would just all I would have talked about would be it’s really important to do research. You know? I’m so proud that I’m doing this research, and, you know, I’m hoping to do that. I’m applying for grants, etcetera.

Now I’ve talked about none of that so far because people’s life changes. And that’s also okay because, you know, we all change. And 1 of the things that that I often hear is people want people want lots of things. Yeah. So, you know, people want they want their weekends off, and they want the family, and they want to be a senior leader, and they wanna do postgraduate exams, and they wanna do research papers, and they want to be head of clinical governance.

And I kinda sort of thinking, well, you’ve only got so much to heart in here. And, you know, peep people get people get stuck because there’s so many things that they want to do, but there’s only a limited amount of time. Yeah. And, you know, what needs to happen then is a reality check and some prioritization. Okay.

Which things do you want to do? And 1 of the concepts that I really like, and I got sort of that from 1 of the guests on my podcast, was the idea that you can do all of these things, just not at the same time. Yeah? So, you know, for these 3 months, you’ve got an exam [00:27:00] coming up. You know, forget your family.

You’re gonna focus on exam. After you’ve done exam, you know that you’re not gonna have to work very much on that. So for the next 3 months, prioritize your family, your health, your well-being, and forget about revision because you’re not gonna have to do anything for 3 months. Yeah. Or, you know, this job is gonna be really busy.

You know, I’m gonna be new in a role for the first 3 months. I’m gonna really have to work very hard. So just accept that for the next 3 months, your career takes priority and, you know, your exercise might take a bit of a backseat. But then recognize it’s actually in 3 months’ time, you’re gonna dial down with your career prioritization and you’re gonna dial up your exercise or, you know, your well-being or whatever it might be. So that all the time, we’re kind of adjusting.

So all of us want everything and all of these things, but you can’t have them at the same time. So you can do them sequentially, or you can kind of dial them up and down month by month, week by week. Yeah. And that’s kind of that’s that’s 1 way that you can try and squeeze everything into your life. I hope you’re enjoying the show.

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Ibifunke: So 1 of the things that I’ve found and 1 of the reasons, um, I do this is because I realized that the journey for international medical graduates is different. Yeah. And what’s very interesting about that journey is that it doesn’t matter where the international medical graduates is from, which is where I think that there might be opportunities to change the system because we get treated in a way that makes life creates unique challenges for us. So thinking about the careers, 1 of the things in the system is so we we can’t have we [00:29:00] we can’t just do jobs we like or stay at jobs we like or things like that. You your your jobs are tied into your visas such that you may lose a job you like just because somebody is not willing to extend your visa, or you may not be able to switch roles because you can’t get a visa in the role you want and things like that.

So lots of our career decisions are bound by these thoughts. People rush into GP training, I think, sometimes because it’s it I got advice that way, so I assume that’s the way people think about things. It’s just go do GP training. You’ll get a visa. You have visa security for 3 years.

You don’t have to worry about all these, um, job things. And I I worry sometimes that we lose sight of the bigger picture of the career and what your guiding light should be. [00:30:00] Last month, we talked about identity and purpose and why it’s important. So just bringing that all together to think about the unique challenges of the IMGs, what would you recommend in terms of thinking about the career, the long term, just thinking about everything you said, but now looking at it through the lens of an international medical graduate that has all these constraints on their decision making. Um,

Mat: So, um, I suppose, you know, it’s not something that that I necessarily know very much about.

Yeah. So so feel free. If you hear me making assumptions, feel feel free to correct me. Yeah. Sort of.

So that that would be the first thing to say. Um, the you know, for for for me, it’s it’s interesting to hear that, um, because, I mean, it sounds quite quite abusive, rather abusive relationship between the NHS and international doctors. Okay. You know, I say that, you know, as a white person who’s a British graduate. So that’s number 1.

And number 2, you [00:31:00] know, for me in my department, we’re desperately short of doctors. Yeah. You know, desperately short is always a struggle to find people. Um, and and I think everybody else is always struggling. So so it’s interesting that, you know, on 1 hand, we’ve created a system where everybody’s desperate for doctors.

And on the other hand, we’ve created a system where we don’t support people well, and we don’t welcome people, and we don’t reward people. Yeah? Um, so so some something’s wrong. And and actually, you know, 1 of the things that that I would say, you know, to international, um, graduates and probably to all other doctors is is to recognize what you’re worth. Yeah.

Because, you know, because because if I think of of the doctors that are in my department, you know, whether international or not, it’s it’s our department wouldn’t function without them. Yeah. So, you know, if they left, we wouldn’t be able to function them. And and often, the the the the the the those doctors that are in training roles are often quite [00:32:00] well protected. You know?

Sort of they they have well protected they’re they’re often not on sort of standard. They’ll be on locally employed contracts, and and I don’t think anybody knows what those contracts are. Or I think, you know, they’re all different and people as my understanding is that, you know, people can put whatever they want into those contracts because it’s not it’s not a nationally agreed contract, yeah, as far as I’m aware. Yeah. Um, so but but it’s recognizing that, actually, you know, you you really are contributing a lot to the department.

Your departments are lucky to have you, and the departments probably wouldn’t be able to function, um, without you. Um, and, you know, there’s a balance to be had. Yeah? Because, you know, because you there there does need to be a little bit of humility about where my role in the department is, but you can have humility and also recognizing your worth. Yeah.

To me, the 2 it’s quite possible for the 2 things to coexist. [00:33:00] Yeah. To sort of say, you know, I contribute to this department. I’m a valuable member to this department. This department will struggle without me.

I think it’s quite possible to hold that view whilst at the same time having some humility about the fact that, you know, maybe maybe you’re not the only person in the department or maybe they could replace you or somebody else could do that. So so for me, 1 of the things that I would encourage would be, you know, there there I say it for for for the international graduates to think a bit more highly of themselves. Yeah. Sort of, you know, to to have to have a slightly greater sense of quite how much they contribute, um, and quite how big a difference they make. And that mindset to recognize that I’m a valuable team member, then what I would hope that that creates into a much more equal discussion between, you know, sort of people that are in the department making the decision, um, and people that are contributing.

Okay? And, of course, that relies on you being a good doctor and being a good team player and making a difference in contributing. Yeah? And if I can’t kind of [00:34:00] thinking of maybe as a consultant, um, the the I mean, we we haven’t had sort of anybody that I would have said was was was a problem, but all of our doctors, they make a difference. They put their hand up.

You know? They they they put themselves forward. They’re doing audits. They’re doing research projects. You know, they’re they’re all brilliant, sort of the international graduates that that that I work with.

Um, but if I kind of sort of say, if I imagine that sort of somebody who’s not a team player, somebody who has complaints, somebody who doesn’t put their hands up, somebody who never covers an on call shift when somebody’s dropped out, then that becomes a bit more problematic. Yeah? So if you’re a good doctor, then it’s much easier for you to think highly of yourself. So kind of that I I guess, you know, that that would be, um, a starting point. Um, the the sort of the the the the other thing that I’d say would be also then to think about long term, And the the I mean, I don’t know sort of how how visas, um, work, but, you [00:35:00] know, my sort of this might not be a great role.

You know, it might not be what I want to be doing in the long term, but but it’s a stepping stone. And and for me, that’s not a bad thing. Um, and certainly, if I think when I did my training, so I graduated 99, and and now our career paths were much, much longer than the career paths nowadays. You know? And nobody knew what they wanted to do.

Everybody traveled. They went to Australia and did A and E, and then, you know, people did the 3 year core surgery rotation, core medicine rotation. Um, and then eventually, people found themselves, and then you became a senior SHO for 18 months or 2 years, and then you became a registrar, I don’t know, maybe 6 years after you graduated, something like that. Yeah. So so the career pathways were much longer, and and we were better doctors for it.

Yeah. Um, because we did we did have a much broader, um, experience. Yeah. Of course, that doesn’t [00:36:00] suit the government agenda because the government wants consultants and GPs as quickly as possible. Yeah.

And some doctors want to be consultants as GPs as quickly as possible. But the model that I went through where where we spend much longer as trainees doctors, we were better doctors than somebody who spends less as a trainee doctor. You know, that that won’t be a shock. Yeah. And I guess sort of maybe 1 of the things for international graduates is that that you have an opportunity to be a better doctor than somebody who is on that career treadmill who’s who’s perhaps sort of a a UK graduate.

Because, you know, the UK graduates, they’re gonna come on a career treadmill, and they’re gonna go from 1 step to the next. So so maybe 1 of the things that you have is you have an opportunity to be a better doctor because you will accumulate a much greater degree of experience. Um, but there there might sort of be a a little bit of, um, acceptance in the beginning of your career that actually, you know, sort of the these jobs are not great, um, but it is thinking about, you know, what’s in it for the long term. Um, I’m also sort of a big [00:37:00] fan of of thinking strategically. So, you you know, if I think for me, you know, I would I would have enjoyed general practice.

I would have enjoyed psychiatry. I would have enjoyed pedes. I would have enjoyed gastro. You know, I would have enjoyed lots of different things. You know?

I’ve ended up doing ENT, which I love, but, you know, I would have liked to do lots of other things. So I don’t believe there’s just 1 career for most of us. Yeah. Now there might be some of you there sort of thinking I’ve all I’ve only ever wanted to do knee surgery, and and my life revolves around knee surgery. And if I’m not a knee surgeon, the world will end.

So I’m sure there are people out there that are like that. But I think majority of us, it’s like, well, we want to make a difference and and, you know, and it’s okay. I can make a difference doing gastro. I can make a difference taking out tonsils. I can do psychiatry general practice.

It’s all the same thing. It’s all making a difference to people, isn’t it? So so I I think I quite like the idea of thinking strategically about, you know, okay. You know, where where are the opportunities? Yeah.

Um, all all careers in medicine are good. You know? They they they they’re just different. Yeah. And if you have a very [00:38:00] clear interest in a specialty, well, that’s fine.

Then you need to pursue that. But if you’re early on in your career and you say, well, I wanna be a doctor, but I’m not I don’t I don’t know sort of which particular thing I want to do, then then, you know, do whatever is easy. Yeah. You know, why not why why would you know if if it’s easy to get into specialty a and really difficult to get into specialty b and you’re not fast, like, why would you do specialty b? Just do what’s easy.

Yeah. Um, but it does need to be a a little bit of thinking about what’s easy in the short term versus what’s easy in the long term. Yeah. Because you might find that stuff that’s easy in the short term might be difficult in the long term and vice versa. So so that kind of is is is something to think about.

And, um, I think, you know, you mentioned general practice. I I think I think GPs work really, really hard at the moment, Um, probably much harder than than certainly much harder than I work in my hospital role. Um, so so I think I think, you know, that that that’s kind of a challenge. Um, but equally, you know, if you’d asked me 10 years [00:39:00] ago, 10 years ago, I would have said, GP is a great career. You know, you run your own practice.

You run a business. You can spend money in whatever you want. And I would have said, in hospital, I have no power. I can’t spend money. I have no budget.

You know, everything I want to do has to go through a thousand committees and takes 10 years. But if you’re a GP principal, you can do whatever you want. You wanna employ this stuff, you can do that. You wanna put in a pharmacy, you can do that. So I would have said, GP, it’s a great career because you run your own business.

So 10 years ago, I would have said something completely different. So, you know, in 10 years time, general practice might again be a really great career. Um, whereas I think at the moment, GPs work really, very hard.

Ibifunke: Thank you. So many questions have come from that.

I’m struggling to prioritize which which ones to ask first. But I think I’ll I’ll digress slightly and then come back to some questions that came up from that. If 1 of the things, again, the decision making about training or going non training routes and being say, for [00:40:00] example, just doing the Cesar pathway, which the name has changed this year. I’m not yet familiar with the new name. But the non, excuse me, the non training routes and things like that.

Do you have any thoughts about how to make that decision and how to make the most of that decision if you choose to go that way? Because, for example, in surgery, there’s been, um, a clear understanding that the that SaaS roots hasn’t been protected and people haven’t been trained and given the same support as people who were in training or who are consultants. So do you have any thoughts? Have you had any experience with this?

Mat: So the the Caesar route is really hard.

K. It is not an easy route. So the going into training is much, much easier. So that that will be the first thing. Um, and, you know, I know so in in our department, you know, we we we’ve had 1, um, doctor that’s gone through the Caesar route successfully and achieved [00:41:00] it, Um, and we’ve got another 2 doctors that that work in our department that are going for it at the moment.

It is much, much harder. If you’re a trainee, you step on a conveyor belt, everything’s laid on for you. You know exactly what you need to do. You get checked every year. You know, if you’re not meeting your things, you get specific training and specific support.

And at the end of, you know, 6 years, 4 years, 5 years, whatever it is, you step off the conveyor belt and you have CCT. You know, it is much, much easier. Yeah. You know, sort of the Caesar route from what I’ve seen is is, you know, the first thing is how you structure your training, and I’m gonna come back onto that in a minute. But the actual paperwork of of proving that you’ve done the equivalent of everything, it is just it is a mountain, um, of paperwork and and, you know, really, really detailed close scrutiny.

If you’re training, you just turn up, they tell you this is what you need to achieve and you achieve it and you get signed off. And then next year, this is what you need to achieve. You achieve it, you get signed off. It’s it’s all structured, then it all just happens. Whereas the Caesar route, it is all down to [00:42:00] you.

You know, it’s up to you to make it happen. It’s up to you, um, to to to provide that structure. So if you have a choice, I would go for training be because going down the Caesar route is is much, much harder. Yeah. I mean, 1 of the the things some people struggle with, um, the idea of training versus Caesar if they want to work less than full time.

Yeah. Because people say, oh, you know, I can I can I can be a trust grade doctor and work 50 percent of the time? Um, and, actually, it’s quite possible to do that as a trainee. So the argument of of being less than full time, um, in in a non training route, that doesn’t stack up because there are lots of trainees that that are working, um, part time. So if you wanna work part time, you know, go still go for a training route.

Um, so so that that that will be 1 thing. And then, um, um, the other, um, the other sort of argument that people talk about, the advantage of going down the trust grade route is that you don’t you don’t have to rotate through different hospitals. Okay? [00:43:00] But that’s a problem. Sort of in it’s a problem because whether trainees like it or not, rotating through different hospitals, that is what makes you a good doctor.

Yeah. So, and, and I know that it’s disruptive to the family. I recognize all of that, but that is what makes you a good doctor. That is what makes you a consultant. The fact that you go and do different stuff, that’s what makes you a good consultant.

So, you know, I did I did my undergraduate in Birmingham. I made a deliberate decision to move, and I moved from Birmingham to Leeds, and then I made a different made a specific decision to move to from Leeds to East Midlands, and I did my fellowship in Sydney. So for me, these were specific decisions to say I am leaving the region where I’m in because I want different experiences, and it is that that makes you a good doctor. Yeah. So staying in the same hospital, that might be comfy, but that is not how you’re gonna be a good doctor.

Yeah. So, you know, harsh reality check, I’m afraid. When it comes to Caesar application route, you have to have worked in different hospitals because, you know, as a trainee, you have to have worked in different [00:44:00] hospitals, and you have to replicate the same for Caesar. So if you if you’ve just worked for 6 years, you know, sort of as an ENT doctor or whatever in my hospital, you that will not be sufficient for Caesar application because you have to have worked, um, in different departments. Yeah?

So, again, you know, the argument that you can work in the same hospital and then do CSER, it doesn’t stack up. Number 1, you’re not gonna be a good doctor if you spend all your time in the same hospital. You’re not gonna be a good consultant if you spend all your time in the same hospital, not in my view, um, number 1. And then number 2, you have to work in different hospitals in order to achieve CSER. So if you’ve just been in the same hospital, you won’t you won’t be meeting your CSER requirements.

Yeah. Because there’s a requirement that you work in different hospitals. When it comes to training, then I think that I mean, it it it it’s it’s interesting sort of to hear you say about how people are, um, supported. Because if I think for for us, our our locally employed sort of TrustGrid SAS group, [00:45:00] they are treated the same as our trainees. Okay?

So, you know, we we have, in our department, we have locally employed doctors that are on the registrar tier, and we have a series of registrar job plans. And they slot into a registrar job plan, and they have the same job plan as a registrar has. They have the same supervision as a registrar has, and and they have the same, um, the same hours as a registrar has. You probably ought to ask them as well, though, because, you know, may maybe it’s maybe it’s not quite as that. So, um, I guess, you know, where the challenge is, they probably the you know, if you think if we’ve got, like, 9 firms, for example, the the people in training roles, they will get first pick of the firms.

Okay? So, you know, that that may be where the difference is. You know, if you’re a local employed doctor in our department, you won’t get first pick of the firms because the first pick will go to people that are in the training roles. And, um, so I think that kind of where the difference is, but you’re probably better off asking 1 of the people in my department whether that [00:46:00] really is as ROSI, um, as as I say, um, that that it is or not. If I think of this, another hospital that that I work with, so they don’t have training registrars, and that’s a very different model because everybody that is on that sort of SAS locally employed, um, tier, they are there purely in a service provision role.

Okay? So and and, you know, we have training registrars. If you’re a local employed doctor, you just slot into a training registrar role, and you get treated as a trainee registrar. Okay? Um, and the advantage of that is you rotate through the different firms, um, and you you you have the same job plan as a registrar.

So, you know, 4 clinics, 4 theater sessions, um, and 2 sessions of CPD. But the the disadvantages, you probably don’t get paid as much as an SAS doctor because I think if you’re an SAS doctor, you get paid more. And certainly out of hours, you would get paid more, and you don’t get stability because all the time you’re rotating from 1 thing to another. So maybe if you’re if you’re early on in your career, then [00:47:00] maybe coming to a department like mine when you get a registered equivalent job, that’s probably quite useful. But if you’re a 50 year old, sort of trust grade doctor, and sort of says, I just want to turn up and do the job, then you probably don’t wanna rotate every 6 months to work with a different consultant.

You know, you wanna say, okay. You might say, fine. I’m an SAS doctor. My expertise is gonna be thyroid surgery. And then you want to develop that as an expertise.

Yeah? So, you know, so so that then you are a specialist in your own right rather than somebody who’s working in in a train in a training capacity. So the people that come to us, they might be early on in their career. They’re training for the purposes of developing themselves into the Caesar route. But maybe, you know, if you’re an established specialist, then you don’t wanna be rotating through into a training post to sort of every 6 months.

You know, if you’re a specialist, you want to establish yourself as a specialist doctor and, you know, and develop your own practice rather than rotating. So, um, but I guess sort of maybe where the challenge is if you’re if you’re new sort of to the UK and you do want to learn, you know, [00:48:00] if you’re in your twenties or thirties, you want to learn, you want to develop, you want to train, then then you probably want to go into a department that will train you rather than a department that’s gonna give you, you know, a very much a service level job, and you’re just gonna be doing on calls and and and and service clinics because that probably isn’t training. Yeah. Um, but I I don’t know, so Divina, maybe you or other people on the call might know what other hospitals offer. I mean, I know what we offer in the 2 hospitals that I work in, and and, you know, maybe maybe that’s not on offer everywhere.

Um, and and perhaps if other people don’t do, um, what we offer, then, you know, for for for any consultants listening, you know, you can sort of say, well, you know, where math works, that’s what they offer. I’m sure it’s not perfect. You know, if you ask our if you ask our local employed doctors, they’re gonna say, right. Is that what mister Daniel said? So, you know, you might get you might get an element of that if you ask them.

But, you know, for those people that are consultants or GPs, uh, sort of that are [00:49:00] on the call or or listen afterwards, you might sort of say, well, okay. You know, this is what they do. And, you know, we have really high quality candidates. You know, we don’t struggle to recruit, but probably because because we offer people a good job. Yeah.

Visa is still a problem. Yeah. But, you know, we offer people a good job, and we offer people training, and and that’s why we get high quality candidates. And, you know, and all of ours are really high quality candidates. And then maybe if somebody else is saying, oh, we’re struggling to recruit, well, you know, the consultants, the heads of service, they need to think how do we create jobs that are going to be attractive.

Yeah. And, you know, maybe what we’ve created is is a way of working that’s attractive. Yeah. The registrars like it as well because, you know, instead of doing 1 in 5 on call rotor, they do a 1 in 9 on call rotor. Because, you know, we maybe we’ve got 6 registrars, 5 registrars, and then 3 or 4 local employed doctors.

So so, you know, it’s great for the registrars as well. So registrars benefit from it as well. So everybody benefits

Ibifunke: from it. Yeah. I think that’s that’s really useful.

We have where I currently [00:50:00] work, we have something quite similar, but there’s always of because I I spent quite a few years working as a locally employed doctor before I got into training. So I’ve tasted both sides of it, and there’s always that sacrifice Yeah. Of if there’s anything if anything needs to be done, then it falls on the locally employed doctors, which is fair enough based on training contracts and agreements and things. But it’s that’s a discussion for a a different day. But thank you.

That’s that’s very good because I’ve I’ve spoken with quite a few people who’ve made the decision not to go into training. So there’s on 1 hand, there’s making the decision not to go into training. On the other hand, there’s been unsuccessful Yeah. At attempting to get into training. So I suppose the question would then be if you’re unsuccessful and you have this career plan, how do you how do you manage that?

How do [00:51:00] you make sure? Because I did do a talk at some point about if you’re making that decision or if you’re not getting into it, how do you make sure that from the start, you’re setting yourself up for success? But then you have far more experience. I’d like to hear from you what your thoughts are. If it’s if it’s not possible, either by choice or, um, um, unsuccessful attempts to get into training, what would be your principles for someone who’s then having to go through the Cesar route to make sure that they do it in the best way possible.

So 1 of the things you’ve said is rotating through hospitals. What what are sort of other things? Because these are challenges that are unique to international medical

Mat: graduates. Yeah. So I’d say, you know, the the the first thing, if I start with that not being successful at getting in, okay, so, um, you know, for for me, I think a lot of that’s fixable.

Yeah. So to, you [00:52:00] know, that that that requires it requires skill, and it requires investment, and it requires hard work. And, you know, and maybe, you know, I’m I’m more familiar with with with surgery than anything else. But, you know, if you think for surgery, you know, there’s a checklist. You know what you have to do.

Yeah? You have to do so many audits, you know, and you get so many points. You have to close a loop. You have to write a guideline, do service evaluation, write a paper, and, you know, you you know exactly what you have to do. Yeah?

And if I think for the the people the people that that I know that didn’t manage to get into training, you know, whether that’s as international graduates or not, it’s because they haven’t done the work. Yeah? So so and and I guess maybe the challenge for international graduates would be having the opportunities to do the work. Okay? Because, you know, so if somebody comes and they’re UK based doctors and very early on, you know, in your final year, your f 1, they know I’m I want to do surgery.

So that means I have to do audits. So right in f 1, they start looking at that. And in f 2, they sort of say they they start looking at that. Whereas, if you’re [00:53:00] an international graduate and comes and says, right, I want to apply for core surgery, um, then, you know, you’re probably gonna be 3 years behind because everybody else started to thinking about core surgery 3 years ago and started having a look at the checklist 3 years ago. Yeah.

So the first thing that I would say would be that, you know, if you are wanting to get into training, but you’ve not been successful, you’re probably gonna be 2 or 3 years behind everybody else. Yeah? And what you need to do is you need to sort of say, okay. I’m 2 or 3 years behind. It’s gonna take me 2 or 3 years in in order to get my portfolio up to scratch.

But you know exactly what you need to do because all the checklists are out there. Yeah. Um, so to where where to get the opportunities, I would say the opportunities are created by yourselves. Okay? And again, you know, if I kind of think the the people that I work with, you know, if you do have an international graduate who put who puts their hand up, who’s willing to do the weekend, who always covers the extra shit, if you come to me and sort of say, you know, I need to do a project and an audit, I’m quite likely to help you.

Yeah? Because I know that you [00:54:00] work hard. I’ve noticed that you work hard. Yeah. Of course, you can tell me how hard you work as well.

Yeah. So don’t be afraid to come and tell me sort of, you know, you know, tell me, oh, you know, I’m tired. Why are you tired? Oh, I covered the weekend. Okay.

So you put your hand there. Well done, you. And sort of say, you know, I’m tired today. Why are you tired? You know?

Well, I sort of had to cover a late shift because so and so was ill. So don’t be afraid to tell people how hard you work. Yeah? Uh, but if I know that you’re working hard, if you come to me for help, I’m I’m I’m probably likely sort of to say yes. Okay?

There’s a bit of a challenge between where you work because, you know, if you work in a big hospital, you’re probably gonna have more opportunities. If you work in a small hospital, you might sort of have fewer opportunities for those projects. Yeah? So that kind of might be a little bit of a challenge. Now sort of if you didn’t get in or you chose not to get in and then you are working, if you sort of say, okay.

You know, I didn’t get into training, but I do want to get CCT, um, and do Caesar, then I would say is start at the beginning. Yeah. Because, you know, if you think the trainees, right from the beginning, somebody’s watching them [00:55:00] like a hawk all the time. They have annual appraisals, and all the time, um, they they are working on their portfolio. And every year, somebody checks to see, are you on track?

What have you achieved? The problem with the Caesar route is that, you know, say, okay. You know, I didn’t get in or I chose not to, but I’m gonna Caesar. You kinda say, well, you know, I’m gonna start doing my portfolio in 5 years’ time. Yeah?

You need to start doing your portfolio today. Yeah? You know, that’s what the trainees do. So, you know, sign up to I to ISCP. You know, start collecting your WPA PBA.

Make sure that you have, you know, so ISCP, that’s for surgeons. Yeah. You know, whatever whatever portfolio you’re working to. So to set set up your portfolios I’ll give

Ibifunke: you. I will give you.

I will give you. I will give you. So it is. I will give you. Now you’re watching me.

Mat: So so so sign sign up sign up for that, um, and, um, start working, um, on on your portfolio early on. So that that that will be my 1 tip. And then also, you know, think about what you need to do. Yeah. So if I think I [00:56:00] mean, I know ENT because that’s what I do.

So, you know, people people are gonna have to do head and neck cancer. And if you work in a small district general hospital, they don’t do head and neck cancer. So, you know, you’re not gonna be able to do Caesar unless you walk away from the small district general hospital and you go and do somebody that has cancer. And, you know, likewise, you know, cochlear implants, for example, you know, skull based surgery, pediatric airway, district general hospitals don’t do that. But you have to have ticked those boxes in order to do CSER.

Yeah. So if you just sort of stay, you might get a job in a small district general hospital. It might be very comfortable and very safe, but but you will not get sufficient experiences. And even if you’re ticking up boxes on the portfolio to say that you can do that, when it comes to your exit exam, you know, if you haven’t worked in a unit that does head and neck cancer surgery, you’re not gonna be able to answer the questions that relate to that. Or if you’ve not worked in a unit that has a PICU, you’re not gonna be able to talk about how you manage a child in PICU.

Yeah. You know, speaking from my world. [00:57:00] Yeah. So you need to think, okay. You know, what what what do I need to do?

You know, which jobs do I need to do? And, you know, what boxes do I need to take? But also what learning do I need to do. And my top tip really would be would be kind of to to start right at the beginning, um, because, you know, the challenge that I’ve seen with the people going for Cesar route is that that the mountain of paperwork is absolutely enormous. Um, and and, you know, really, if you’re gonna be an ENT, you’re gonna be a trainee for 6 years.

So I’d say if you’re gonna do Cesar, you need to collect your portfolio for 6 years, and you present it in 6 years’ time. You might be able to do it a bit quicker. Yeah? But but, you know, you’re not gonna do your portfolio in 6 months if a trainee has spent 6 years putting portfolio together. Yeah?

So, you know, it’s gonna take you years and the sooner you start, the the the the easier, um, it is. Um, and yeah.

Ibifunke: That’s really, really helpful. Thank you. Um, this now so having chosen a career, completed training, um, done your specialty, see you’re [00:58:00] at a point where because burnout is a thing now in the world that is recognized particularly in medicine.

And 1 of the things that I do even like to think about or talk about is doctors who’ve lost taken their own lives because of challenges that relate to work. If you find how do you recognize in yourself that I’m at a point where things are not right and I need to do something? And what is that something that you would recommend people do?

Mat: I think I think that’s very, um, I think that’s very individual. So I’ll tell you how I recognize.

Yeah. So how I recognize that things are not going right for me is I’m not exercising. I’m not taking the dog for a walk or the dogs for a walk. Uh, I’m eating rubbish and I put weight on. So they so they they would be how I recognize that sort of that that that my balance, um, is wrong.

Um, and I think [00:59:00] for for for everybody, it will be different. So, you know, they are the sort of signs that often would be that that, you know, if people if if there’s a loss of motivation, yeah, you know, sort of if you if you, you know, all all all of you will be incredibly motivated to have gotten where you are so far. Yeah. Because, you know, you you none of you would get where you are today with without some real determination and some real motivation. Yeah.

So I would say if you find yourself thinking, you know, why am I bothering? You know, what’s it for? That for me would be starting to burn out. Yeah. Because my guess is that that isn’t you.

Yeah. Because, you know, you didn’t get where you are today by thinking why am I bothering. Yeah. So if you find yourself thinking why am I bothering, what’s the point, that for me would be a sign, um, of of burnout. Um, snappiness in the workplace, that will be a sign of work out.

Um, not having time for patients. Yeah. So I I think, you know, certainly, you know, that kind of also has happened to me, you know, when kind of a patient comes in and and and I find myself getting [01:00:00] frustrated, that for me would be a sign that sort of that something is wrong because, you know, like, why am I getting frustrated with my patients and my colleagues? It’s like, we’re all just trying the best. So if I find myself getting frustrated at work, you know, again, that for me would be a sign, um, and and I think a lot for other people, um, also.

Um, and sort of and I think, um, anger as well, a kind of uncontrolled anger, um, that would be a sign. Um, I think it’s very it’s very individual, you know, because, you know, we all we all have we all have different things. So so recognizing it. I mean, there’s questionnaires that you can do sort of screening questionnaires. You know, there’s 1 called Warwick Warwick Warwick, um, Edinburgh mental well-being scale, and there’s a there’s a whole sort of stack of other burnout screening questionnaires.

You know, you could do that, um, if you wanted, um, a check. So I suppose the other thing is, you know, if your friends are kind of sort of, say, funko, we’re staging an intervention and we’re taking you for a weekend away, you know, and you think, okay. So that’s the side. But that travels 2 ways. Yeah.

So so [01:01:00] maybe and often we don’t recognize it in ourselves. Yeah. So, actually, you know, 1 of the things that maybe we can do for each other, we can check-in with each other. Yeah. And and, again, I can kind of say, you know, if I think, you know, 1 of my work colleagues has sort of said, you know, how are you doing?

And I kind of thought, actually, I’m not doing very well, like, sort of some patient related thing. And, you know, and that that was really useful because, you know, my colleague asked me how are you doing, and, actually, how are you genuinely asked me how are you doing? So I said, how are you doing, Matt? You know? Not not how are you doing?

Oh, let’s go over here. Because, like, we also say, how are you today? I’m fine. Goodbye. Yeah.

My colleague said, how are you doing, Matt? You know? And it was, uh, you know, like, questions like that. And and, you know, and I kind of told my colleague, and that was really useful. And my colleague then sort of knew that that, you know, that something that something was was troublesome for me and, you know, and and helped me.

So so maybe sometimes we don’t see it ourselves, um, and maybe maybe we owe it to each other, whether that’s as friends, family [01:02:00] members, or colleagues. You know, we we owe it to each other to sort of say, how how are you doing? How are you really doing? You know, or as I say, you know, in in in my case, when my friends sort of said to me several years ago that they’re staging an intervention, I kind of thought okay, I get I get the message. Because then often we don’t know ourselves, do we, when we burn when we burnt out?

When you’re in the middle of that burnt out, you you you don’t know it. So get used to get used to signs. You know, for me, I’m not taking the dogs out. I’m not exercising. I’m eating crap.

You know, that for me are signs that sort of something’s not quite right, but then also maybe make it a habit of checking in on each other because often peep people won’t necessarily know themselves. So my final thoughts would be would be know your worth. Yeah. You know, you you you are phenomenal to have you you are clearly all of you are phenomenally driven, phenomenally achievement focused, and phenomenally capable. And you all of you contribute an [01:03:00] enormous amount to the NHS.

Um, so I would say, you know, don’t let anybody put you down. Don’t let anybody make you feel, um, inadequate. Don’t stand up for any abuse and, you know, and rec reckon recognize that that actually, you know, you are doing a really, really important job. Yeah. So know know know your worth.

Yeah. Even if other people don’t, but you know your worth.