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dxmedstudent · 6 years

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Hey I'm final year biomedic and I've applied to med school in the UK but i'm a bit worried considering the state the NHS is in at the moment... Is the job still enjoyable/manageable despite the serious lack of funding?

Hey! Fellow biomed! That’s an interesting question. There are always articles floating around about how terrible it is in the NHS, and also articles about how bad it was in the ‘good old days’. Now, I wasn’t around 10 years ago, or even 5 years ago (as a doctor, I mean. I most certainly did exist!), so I can’t say whether the articles about the bad/good old days are true. But the articles about now? Most of it is correct. The NHS is understaffed (most rotas have empty slots; most rotas I’ve worked in certainly have). Previous hospital closures, an ageing population and increased pressures mean people are waiting longer in A&E, meaning when people like me are oncall there are more sick people waiting to be seen than there were before. Hospitals are always short of beds. Cuts to social care mean we are struggling to send vulnerable old patients or those with disabilities home, which causes them misery and the hospital further bed shortages and delays. Understaffing, whether due to rota gaps or sickness, means we all have to work harder to make up the difference, which contributes to menal illness and burnout. It’s tough on us, but we learn to cope as best as we can. I’m wondering how we’ll cope this winter, but then again, I wonder every winter, then I just do the best I can. Many of us feel that training is inadequate; it can feel like you’re left to your own devices to seek opportunities, train yourself and do your exams. That’s probably why we get so mad when the public talk about forcing docs to stay in the NHS for X years to ‘pay back their training’; most of our training is us teaching ourselves, and learning through our colleagues. I can say that most people I know in medicine have experienced mental illness, usually anxiety or depression. I know a shedload of people with IBS. Everyone has impostor syndrome. Most people I know have considered leaving medicine, at least once. Plenty of people end up taking time out of training to work out what they want to do. Some people go part time. Some people go into non-clinical specialities; in my experience it’s often because of exhausting experiences with people. I have to admit that not everyone is very nice; sometimes patients or their relatives are hostile. Sometimes colleagues wear us down. Sometimes the work environment itself does. So many people feel worn down, and I’m not going to downplay the seriousness of the abuse many people experience. That said, I still enjoy medicine, much to the surprise of my family, who I rant to frequently. In my few years as a doctor, I’ve had grown men cry when I ‘fixed’ their agonising trigeminal neuralgia. I’ve set patients with anxiety or depression on a road to discovery; you can’t imagine how amazing it is to see somoene smile after several consultations seeing them cry. I’ve helped marriages, where one partner’s vaginal symptoms were preventing much desired intimacy. I’ve had the ‘bad news’ talk with relatives, only for the patient to recover, and to share their family’s happiness. I’ve also shared their sadness when patients passed away. It’s still incredibly rewarding when you diagnose someone and give them something which makes them better. It’s an amazing feeling when you reassure a new mum that her baby is going to be OK. When your patient with recurrent miscarriages makes it to term. When you deliver a baby for the first time. When someone who came in looking like absolute death gets to go home well again. When you first spot something serious. When you realise your gut instinct was right. When you allow someone to live a comfortable life. When you make sure that someone has a good death; free from pain, surrounded by loved ones. Even if you can’t make someone better, you can always do your best to make them feel better. That’s my rule.I’ve treated what feels like a million infections, reassured a million patients, and had a million chats with family members. Sometimes things can feel samey, and I admit that sometimes it just feels like an exhausting never-ending stream of pressure. But there’s still so many rewarding experiences, that rarely does a shift go by without me feeling like I’m doing something worthwhile. Last weekend, I had a patient who was bleeding severely, probably from their inperable bowel cancer. They were palliative; we were so limited in what we could do. But we staunched the bleeding, and gave them valuable time with their loved ones. Even days after I went back to my regular ward, I’d bump into their family in the corridor, and they’d update me and thank me. Yes, the system is under a huge amount of pressure, and we’re often exhausted and at the ends of our tethers. It’s, frankly, an exhausting career; there are much easier ways to make money and have nicer hours, and have more time to live a nice normal life. And I absolutely do not think less of anyone who leaves medicine to have a happier life. Or anyone who says ‘well, that’s not for me. Because yes, it’s a difficult life. I know people who tell me they wish they’d never gone into medicine, and I can’t deny their truth. It really does push some of us into burnout, and some of us need to leave for our sanity. I’m not joking when I say medicine’s for people with hero complexes; I think there’s a little of that in all of us. We want to help people, to make things better. We’re driven, clever, hardworking, stubborn and kind. And it takes a huge toll on us sometimes. But it’s part of us, and many of us find it fulfilling, despite the problems. And I don’t think you’ll ever know if you never try. I can’t promise I’ll stay in medicine forever (and I don’t believe in trying to predict the future, but making the best decision for ourselves whenever the time comes), but at least I’ll know that I did my best. And I’ll know where my story led. I’ve experienced so much through medicine that I never would have seen, learned so much about people and human nature, and been fortunate enough to help people in so many ways. And for that I’ll always be thankful. Good luck with your finals and with your application. :) I can’t tell you whether medicine will be right for you, or even what medicine will look at in 6 years time when you’ll graduate from medicine. Only you know how much you want to see for yourself, and whether you feel you’ll enjoy it. By that point I might even be almost a consultant… or a GP; it’s a long time when it comes to the healthcare service and what conditions might be like. So it’s hard to predict just what you and I may have to deal with in the future. But I’ll be trying my best to deal with things one day at a time. Which is all we can do, I guess. So that’s my advice; take things one step at a time and see what happens.

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