Kevin Dueck is a Family Medicine Resident (R1) at McMaster University who graduated from medical school at Western University in 2016
To be content
Justin Lam graduated from University of Toronto Medical School in 2017 and is now a first year resident in Paediatrics at UofT and SickKids
Denis Daneman is Chair Emeritus, UofT Dept of Paediatrics, and Paediatrician-in-Chief Emeritus, SickKids
I sat in front of my laptop, staring at an email draft to a potential mentor. I knew it was pointless trying to perfect it, but I felt I needed to read it just one more time. He was, after all, a legend in my medical world, a well-respected clinician and expert in the field, with a prolific academic career and an illustrious research career. Also, I had only interacted with him a handful of times before. I was reaching out to him because of what I perceived to be his ability to balance his career with a family. How had he done it? I hit send. His reply came not 10 minutes later. Our first meeting was set.
Before I knew it, we were meeting for the third time. It was during this meeting that I was given an article written by a psychiatrist about how he had chosen not only his specialty, but also between a “quiet life” and a “calling” , a process that I myself was going through at the time and had begun to explore with the help of this mentor. ...continue reading
Magbule Doko is a family physician in Windsor, Ontario, and an adjunct professor at The University of Western Ontario
School. Career. Children. Partner. Parents. Siblings. Being a Doctor. Getting Older. Turning 30. Teaching the next generation of doctors. Next step in my career. In-laws. Body. Health. Meditation. Having another baby. Trying to make the world a better place. Trying to understand who I am. Vacation time. Couple time. Debt. Income. Work. People living. People dying. Crying. New life. ...continue reading
I entered medical school in much the same way I later entered parenthood: without any real clue. In Quebec, we had the option to apply to medical school at the age of 18, straight from CEGEP. In the blur that would follow from age 19 (the start of medical school) to age 29 (graduation from a child psychiatry fellowship), I moved across the country, got married and had my first child. There is nothing remotely spectacular in these events, except for the lack of time I had to notice them. Now that my children (mostly) sleep through the night, I’ve developed the time and capacity to remember and reflect on the first of my 10 years of motherhood. ...continue reading
Professor Dame Carol Black is Principal of Newnham College Cambridge, Expert Adviser on Health and Work to the Department of Health, England, Chair of the Nuffield Trust, and Chair of the Governance Board of the Centre for Workforce Intelligence. She was a keynote speaker at the recent International Conference on Physician Health
Whatever the nature of their work, whatever skills they bring to bear, however strong their calling and dedication, employees come under the influences of their workplace and of those who employ them. It is as true for doctors as it is for the drivers of tube trains, the builders of Olympic stadia or civil servants in Whitehall. The evidence, gathered painstakingly over many years, in such different arenas of work, is consistent and strong. It leaves no doubt about the characteristics that we look for in identifying good work and a good workplace.
The effects of workplace influences are felt and measured to varying degrees in ways that are clear. First is the personal health and wellbeing of employees – their physical health and their mental health, the former often measurable declared, the latter often masked and hidden.
Second is the performance of the group, the team, and ultimately the institution for which they work. In health care such performance is measured in terms of the quality of patient experience, the safety of care and health outcome.
These measures correlate with features common to organisations which have achieved success in promoting staff physical and mental health and well-being. ...continue reading
Recognising achievement is important. A Fellowship ceremony at a Royal College marks the beginning of a career in a chosen specialty but it also bookends a difficult period of intense study, commitment, and sacrifice. It was a privilege to witness this milestone as a new wave of young doctors shared their pride and pleasure with friends and families. They are the future of medicine.
The academic procession of almost exclusively older men, predominantly grey haired and in elaborate academic robes, added gravitas to the occasion. But, I also wondered to myself what they might think of the changes in a profession undergoing a radical transformation.
Young doctors think differently. They expect a professional life with a work life balance. Work is not the only thing - an approach endorsed by working time directives and official guidance on duty and responsibility. Young doctors do not buy into the historical model of a male dominated competitive and career focused process of education and training. Expecting people to fit into an old style training programme is no longer realistic. The long and arduous rotas of previous generations are no longer acceptable and this means fewer hours.
Many senior doctors feel there is now insufficient exposure to patients- and they may have a point. If we simply reduce the hours without revising the educational model, this is unavoidable. It is simply impossible to squeeze traditional teaching into the time available so there will, inevitably, be less patient exposure, less experiential learning and, almost inevitably, inadequately trained doctors. We need to think differently. Education must adapt. We can no longer think of training towards an endpoint, but looking at training itself as a long term process.
The gender balance in medicine has also changed. Pregnancy is a reality. Yet, I am not sure that our medical leadership has fully accepted the principles of equality that must allow young women to integrate career and family, not to mention fathers. There is no equality without paternity leave. It is not sufficient to support the rhetoric of healthy pregnancy, shared family responsibilities and professional equality if we do not see it put into practice. Rather than see pregnancy as an inconvenience in medical training or an awkward gap where service needs are compromised, we need to accept it as the norm. It is unfair and unrealistic to expect half the profession to sublimate nature and delay pregnancy simply to fit with an archaic training model. We need to change the way we think and we need to change what we do
To create a caring empathetic and nurturing profession, we need to care, nurture and appreciate the needs and expectations of our colleagues. We need to be creative, and redesign, not just careers and curricula, but our mind set.
Uncomfortable as it may be, it is important that the profession has a radical rethink. True leadership means fostering change. It’s not just the attitudes of young doctors. Medicine has also changed; it is more technical, more ‘high intensity’, constantly monitored and increasingly less tolerant of uncertainty. On-call is difficult, work is tough, doctors’ quarters are long gone as are the comforts of the doctors’ mess. It’s the day job, except that it is at night.
Let’s recognise that doctors’ life aspirations have changed, the gender balance has changed, and the job has changed. We, the older members of the profession, need to change too.