International Women's Day stories 2016
International Women’s Day is held this year on 8 March. With the unfortunate consequences of the recent contract imposition on doctors in England still fresh in mind, the Faculty thought this would be a good opportunity to share some good news stories from a handful of the growing number of female intensivists working in the NHS.
A hearteningly common theme throughout these life stories is the supportive and collaborative nature of working in ICM. It’s a central feature of the specialty that has attracted thousands of trainee doctors through the doors of the ICU.
We hope to hear from more of our Fellows, Members and trainees as our newly commissioned careers work gets going this year.
At the ICS State of the Art meeting last year I chaired a plenary session on Social Media in critical care. I did warn the panel of six young, enthusiastic men I might throw in a googly but not what it might be.
“Why no women on the panel?”
You will have seen a similar question posed multiple times on the Twittersphere of late with regards to the SCCM Sepsis 3 panel. This is not intended as criticism of the ICSSOA or Sepsis 3 panelists, who are great people working very hard to produce fantastic FOAMed and research respectively for the whole specialty, but the question remains.
The Faculty’s Recruitment Sub-Committee, recently combined with the QA Working Party to form the Quality, Recruitment and Careers Sub-Committee (QRC) of our Training & Assessment Committee. The brand new careers element was an important addition to the work of this group. The QRC, headed by Jonathan Goodall, will need to ask itself some searching questions as it takes the careers strategy forward, a key aspect of which will be women in ICM. Less than 50% of recruits to ICM are women, though we are delighted to see the proportion is increasing. Is ICM less attractive to female applicants? Once in the specialty, does the academic world not appear to be open to women intensivists? What can be done to make the specialty attractive to all applicants?
For International Women’s Day we have gathered a range of excellent female role models to tell us about their journeys in ICM, I hope they might inspire a few more women into ICM. We would love to hear your stories too, ICM is a great job for everyone and I hope the trend in recruitment of women to training continues.
So Mother's Day followed by International Women's Day. I am a woman and a mother and work full time as a consultant in Anaesthesia and Intensive Care Medicine. I spend a lot of time in London for the RCoA and FICM and I am an associate postgraduate dean in Yorkshire and the Humber. And, yes, my children know who I am. I have a very good work life balance and manage to run, sing and ring church bells in my spare time! But I do like to shop, buy shoes and sit down at the end of the day with a glass of fizz. How do I do it? Well Intensive Care Medicine is fantastic for providing some structure to the working day whilst being incredibly unpredictable in between. I know well in advance what days I will be working, the start time is constant and, when not on call, I can usually leave on time too. Combine this with the opportunity to be in the Emergency Department managing multiple trauma or dealing with equally as sick patients on the unit, being called to cardiac arrests on the ward or seeing patients in a follow up clinic, I think I have the perfect job. Don't get me wrong it can be stressful at times, telling a loved one that their relative is going to die is never easy (for you or for them), but I have never regretted my career choice and would not change a thing.
Despite there being more women than ever in medicine there are fewer in ICM in comparison. I would encourage all you women out there to seriously consider a career in ICM if you want to work in an acute specialty which brings clinical variety, fantastic team working opportunities and a good work life balance. You'll never know unless you try it so go on ... girl power!
I trained in North West and Mersey and had been surrounded by strong female role models who were excellent doctors, professionally highly successful and had full lives outside of work. They inspired me to never question ICM as a female friendly career. They had achieved it, so why shouldn’t I? When I moved to South Yorkshire in 2001 there were no female ICM consultants practicing in the region, but that is no longer the case and every hospital in the region has women working in the specialty, inspiring and supporting future generations of intensivists.
My colleagues in the region supported me to become Regional Advisor and from there I just stuck my head above the parapet and became increasingly involved with FICM work. I represent my Fellow RAs as Lead RA and have a significant role in leading ICM national recruitment, helping to select and create the right environment for the next generation of ICM doctors.
Stories like these help make it clear that ICM is a great and fulfilling career and it doesn’t have to be to the detriment of everything else that matters to you.
My journey may not have been typical and it certainly was not easy! I graduated from the Faculty of Medicine, Cairo University. I married my college mate shortly after I finished my house officer year. With a mind set on acute illness, I enrolled in a research degree on critical care nephrology. Once achieved, I was blessed by having a gorgeous son. We as a small family, decided to pursue further training in the United Kingdom. Through quite a lot of hard work, I succeeded in securing joint registrar training in ICM and Renal Medicine in the Yorkshire deanery. I consider myself a fighter and embarking on this training path has certainly tested my fighting skills. There were many sleepless nights and may be a few tears, but I succeeded in achieving excellent training in both specialties, chiselled an enviable CV and made a lot of friends along the way.
Throughout this journey, my son has always been noted to be a child who is enjoying a lot of affection at home and has kept us very amused with his school achievements and computing adventures. Now I am almost at the end of my training and a proud mother to a very argumentative 11-year old boy. So yes, it may have been hard and not very typical, but it was certainly worth it and is highly recommended for the fighter woman in you.
As I sit here on maternity leave with my 7 month old baby napping upstairs, my 4 year old at school, due to start back at work in a few weeks, what an interesting time to be asked to write something on life as a Less Than Full Time (LTFT) trainee in ICM. I have been LTFT since just after passing the FRCA and then starting a family at the end of my ST3 year. I had already been successful in getting an ICM number on the old joint scheme, and thought I had finished my exams. I was told at the time that ICM was not an easy option, particularly if I wanted family, but you can’t help what you are interested in. I am now ST5, with 6 years of training to go! But what’s the rush? I initially found it hard when trainees I had previously supervised were now my seniors, and even applying for consultant jobs, but it’s worth it to see my two boys grow up. I currently feel anxious about going back to work, but also excited to be back doing what I enjoy and to be learning again. Like all mums I worry; how will I cope at work, will the kids be ok at school/nursery, and how on earth am I going to find time to revise for the FFICM exam?
Balancing motherhood and work is one big juggling act that requires good planning, and time management. My husband is also a medic so coordinating rotas and weekends is another challenge. It is all worth it though. This is the second time I will have gone back after maternity leave, and although nervous last time, it was fine. Not only was it fine, I enjoyed having a mix of work and home life back again. I managed to create time for e-portfolios and CV boosting activities, and somehow passed the dreaded ARCPs. There is plenty of support from supervisors and colleagues, as there are ever increasing numbers of LTFT trainees with families in Anaesthetics, and now in ICM. Over the last few years I believe there has been a change in culture for the better.
I guess I’m not your typical ICM consultant; single mum, 2 kids, went to an inner city comprehensive school in Bradford. As a teenager my ambition was to present ‘Newsnight’, but I think I was always going to be a doctor in reality. A five year course in Medicine was an easier choice when university fees were paid for by the government and I qualified for a grant. As a surgical house officer I’d taken an interest in patients coming back to the ward from ICU in the days before HDU. So, a career in Anaesthetics it was (via Cardiothoracics) to gain a bit of ICU experience, then Medicine in Shetland to have the opportunity to deal with whatever came through the door and finally a kibbutz to realise I had no farming skills whatsoever.
After travelling it was perhaps easier to settle down to exam work but I wasn’t sure about Anaesthetics. Intensive Care was the clinical work I enjoyed, staying on after my SHO rotation to do a year as a fellow.
In retrospect, I was burnt out after that, starting my SpR training and dealing with an illness I didn’t really understand was tough. I soldiered on and shouldn’t have waited until people were standing up for me on the bus before going off sick. I‘d lost all my hair. The Regional Advisor at the time was extremely supportive and I did work part time for a year before quitting training.
I went to college to do a photography course but couldn’t quite bring myself to leave critical care. I was offered a critical care practitioner’s job part time. I could earn some money as well as hand print photos. In my head I never really left ICU. I have really fond memories of my 4 years at North Manchester General and I’m sure I’d be writing an entirely different story if it wasn’t for the support of the team there. I settled down, had a baby, enjoyed taking photos and loved working in critical care. I could have carried on as a trust grade forever but knew I was every bit as good as the trainees on the rota with me. It worked well in my 30s but I could see I would want to be a consultant in my 40s. The flexible careers scheme was my route back into Anaesthetics training. I’m pretty organised but studying for the Final FRCA with a baby was like a military operation. I was more focused than before and enjoyed my time away from work and study.
I trained part time while my children were young and moved regions for my then partner’s job. I found it much tougher coming back after a long maternity leave in a new region but the North East soon became home. It seems strange that I was unsure about applying for advanced ICM training when it was the whole point in returning. My uncertainty was short-lived: it was the best year of training. In the space of three months I gained my CCT, split up from my partner, moved house, started a locum consultant job and was appointed to my current post. I think resilience is just in my genes.
The perception that ICM can’t fit around family life is entirely wrong. In training and as a new consultant I relied on bulletproof childcare. Our nannies were amazing and the kids loved them. Now I work around my kids’ schedule, but it’s my colleagues that really make my job possible. A slight adjustment to their job plans means I can fit work around my kids. I accept I can’t do everything. I have only ever been on one school trip and helped out at one school fair. I am often doing the washing at midnight between emails and I have a really easy recipe when it’s the school cake stall. I have never said yes to the request for packed lunches, the kids will always be eating school dinners. At home we all share a love of dancing, and I even get to do a weekly ballet class too. A career in ICM can be family friendly and your colleagues are essential to making it work.
I trained in ICM in the 1990s so the system was quite different to current training programmes. Having graduated from Manchester in 1989 I spent a year in my house jobs and then did a year as a medical SHO. In 1991 I started my Anaesthetics training. I trained before the formal ICM training programme was introduced and during my Anaesthetics training had several attachments in an ICU in the NW region. I married another medic (ophthalmologist) in 1994 and had our first son whilst a trainee in 1997. I was appointed as a consultant in ICM and Anaesthetics in 1999 and was pregnant with our second son at my consultant interview (I admitted this to colleagues in the pub after the interview!). Our third son and our daughter followed in 2001 and 2004. Throughout my career I have chosen to work full time and I have had a wide variety of child care arrangements from family through nanny, child-minder and nursery with different times in the children’s lives requiring different solutions.
I chose to pursue a career in ICM because I enjoyed the resuscitation and practical procedure of Acute Medicine and Anaesthetics but I also like talking to patients and their relatives and looking after patients over a more prolonged period. I also find care of the dying an extremely worthwhile and important part of the role. My interest in these aspects has been shown by me starting and running a follow up clinic, involvement in end of life work and longstanding involvement in patient and relative experience work.
My major non clinical interest has always been post graduate education. I have been involved in training and education throughout my career and have been fortunate to hold many interesting roles including Faculty Tutor, FPD and DME. My eldest son left home to go to university in October and I am extremely fortunate that he is happy, healthy and doing a course he loves so I guess we must have got something right along the way. The prospect of a ‘slightly less full nest’ alarmed me and I was appointed to an Associate Dean role 5 days after he left. I started this new role in January, stopping Anaesthetics to do this, but I still have a clinical commitment of 7PAs ICU sessions each week. I still enjoy ICU and believe I will remain an intensivist until I retire. It always has and always will present many challenges but for me they are outweighed by the job satisfaction and the great teams that I have been lucky enough to work with.
When the cavalry came to help with the sickest of the sick when I was a houseman struggling on the wards, they wore scrubs. They seemed to love their jobs and were encouraging when asked about an ICM career. I entered Anaesthetic training in 2005, at the time the most established path to ICM. I opted to go less than full-time (LTFT) after my first child was born in 2009. Somewhere in the tumult of the exams, sleep deprivation and the birth of number two in 2012 I had given up ICM as an option. I had also started to notice that unlike Anaesthetics, ICM had far fewer women in their ranks. There is undoubtedly an albeit subtle influence on your thinking when you cannot see people you can relate to doing the job you aspire to.
It’s a wonderful gift to know what you really want to do with your working life. Being LTFT had made me appreciate how much I value the challenge of critical care and what that brings to the rest of my life. Faced with the sad prospect of my higher ICM module being my last job in ICU, I applied for dual training in 2014. I’m currently the only local trainee navigating my way through LTFT dual ICM/Anaesthetics.
Admittedly it is hard work organising non-standard training. The burden of non-clinical career maintenance tasks is high, changes every few years and can be frustrating. There is another exam now and a young family not to mention my husband’s medical career to balance. We have an impressively complicated online family diary! Most of my peers have long finished training. I now often work for consultants I remember as new-starters but that does tend to guarantee a collegial atmosphere at work! I’ve not rushed through training but clinically, I hope that shows. 11 years of specialty training and counting also means I’ve had a chance to get involved in longer term interests like the GAT (Group of Anaesthetists in Training) Committee and regional quality and safety projects. I personally feel more prepared for all aspects of consultancy than I think I would have if I’d taken a more straightforward route. More importantly, I’ve loved my varied rotation and have found great friends and role models along the way.
When people talk about work-life balance I think they forget about the quality of work as a factor. The hours may be shorter or less anti-social doing something else but they’d seem longer to me if I weren’t working in these incredible teams. I only hope contract changes don’t make this trade-off untenable for me. My career in ICM so far has offered me the chance to participate in the most varied, dynamic and stimulating area of medicine I can imagine whilst raising a young family. I’d love to see more women consider it.
I grew up in Somerset, attending the local Comprehensive School, before gaining a place at the University of Southampton to study medicine in 1994. It was whilst an undergraduate that I decided a career as a clinical academic might be the one for me. I undertook an Intercalated BSc, which meant spending nine months working on a research project in a laboratory run by a remarkable woman called Jane Warner, who had just returned from nearly a decade working at John Hopkins in the US. I found I loved being able to ask questions about the mechanisms of disease and work out how to answer them. I also met a variety of inspirational clinical academics, many of whom I am still in touch with today, that cemented my ambition to pursue that route.
After graduation and House Officer posts, I relocated to Cambridge to undertake medical SHO training. My second SHO post was on the John V Farman ICU, Addenbrooke’s Hospital, and it was here I discovered my passion for clinical ICM. I later undertook a further ICM SHO post at St Thomas’ Hospital, London, where there was a selection of very impressive female Consultants, who provided me with great role models for women in medicine. Subsequently, I completed Higher Specialist training in ICM (London) and Respiratory Medicine (Cambridge), undertook a PhD (University of Cambridge), and was appointed to the UK’s first NIHR Academic Lecturer post in ICM. It all sounds so straightforward when written out like this, however it was anything but.
In 2008 I married one of the world’s most supportive men. In 2010, whilst working away from home Monday to Friday competing my Advanced ICM year, I became pregnant. I finished my ICM training and took up my ACL post in Feb 2011, and six weeks into my new post, I was unexpectedly admitted to hospital with pregnancy complications, and spent several weeks as an inpatient before our son was born prematurely. I returned to work in late 2011, to try and pick up my academic career once more, having not done an experiment for over two years due to Advanced ICM training and maternity leave. Colleagues, both clinical and academic were amazingly supportive, but it was a very tough time. I had long wanted to spend some time working in the US to experience a different healthcare and scientific system, so my husband and I decided we would see if we could make that happen before Henry reached school age. By what I can only describe as a miracle, in 2013 I was awarded a Fulbright All-disciplines Scholar Award, and later a Wellcome Trust Clinical Scientist Fellowship, so off we went to San Francisco! In summers 2015 we returned from San Francisco, for me to take up the post of University Lecturer in ICM at the University of Cambridge, and in time for Henry to start Reception class.
Being asked to write something for International Women’s Day has made me reflect on my career, and realise that I am lucky enough to have my dream job. There are without doubt things I would change, but if I won the National Lottery jackpot tomorrow, there is a strong chance I’d get up the next day and carry on doing my job. It is a tremendous privilege to spend my days attending patients on the John V Farman ICU at Addenbrooke’s Hospital, running my research group, and teaching physiology to medical undergraduates. I am rarely bored, and get to focus my attention, and that of my team, on questions I think are important in Intensive Care Medicine, to try to make a difference for patients.
How I made remote committee working work for me
The last 7 years witnessed radical reform in the way ICM training is delivered. This could only have been achieved nationally through regular communication and networking. Whilst occasional face to face meetings are necessary, a vast amount of crucial work can be achieved remotely through teleconferencing and videoconferencing. As former Lead Regional Advisor for ICM training in Scotland, linking through these modalities to FICMTAC and FICMQRC meetings facilitated both my ability to unify training in Scotland with the rest of the UK and communicate efficiently with colleagues regionally. Remote committee working can bring about change!
Elizabeth Wilson, President Elect, Scottish Intensive Care Society