To be or not to be (a doctor)

'If you had your time again, would you still have become a doctor?'

    The latter was a question to me a few weeks ago, not long after my article regarding the current NHS political changes. It was an interesting question, and one I have asked myself over many years. Careful consideration always produces the same honest, emphatically positive response. It is true that I can think of other paths I would have liked to travel; other subjects I would have enjoyed reading at university; other areas of the country (or even the world) where I would have enjoyed living. Then again, which of us (regardless of the nature of our upbringing, social status, occupation or interests) hasn't had similar thoughts? Is that not simply a case of 'the other man's grass is always greener'? Ultimately, we have to settle for something which will provide the backbone to our lives. Thirty one years after I first walked into a London medical school, I have no hesitation in saying that I would still chose to become a doctor.

    Of course, 'becoming a doctor' is not quite the same thing as receiving a Bachelor's degree in medicine. There are many years following the five or six spent as a medical student before a doctor can feel that he or she has arrived at the long-sought destination, during which time a junior doctor jumps the various postgraduate hurdles of training posts and postgraduate examinations. Even then, there is the need for life-long dedication to continuing professional development.

    So you may ask why I would do it all again; why, when the training is arduously prolonged, the workload overwhelming, and the political interference with the NHS so frustrating? The answer is because a medical degree can be one of life's most valuable passports. I am sure other professionals would claim similar attributes for their own qualifications. Nonetheless, the intimate involvement in people's lives that the practise of medicine requires can be both spiritually rewarding and tremendously humbling; bringing with it a tremendous sense of worth and satisfaction that few other occupations can easily trump. There is also the chance of a decent standard of living; although not necessarily a fortune to be made. However, the qualification is far more valuable than that. With imagination and determination, a medical degree can open so many opportunities in life that it is difficult to say where the boundaries are. In my view, those opportunities are far more valuable experiences than the acquisition of wealth.

This column is not a place for me to blow my personal trumpet. It is suffice to say that, suitably armed in educational terms, I have ventured into numerous occupational realms that, as a child, I never dreamt I would access. I have also had the pleasure of travelling the world, participating in grand society events and meeting people from all walks of life. For me, a medical degree has been the passport to life's sweet shop, enabling me to fulfil Rudyard Kipling's maxim of filling 'the unforgiving minute' in a kaleidoscope of ways.

So, the answer to the original question is an emphatic 'yes'; I would still become a doctor and, placing medical politics aside, I would encourage others to do so. More importantly, to any young person considering reading medicine, I would exhort you not to consider your degree as the 'be all and end all' of your aspirations. There is a whole world out there; with effort, determination, and imagination it is all yours to sample.

First published in the Scunthorpe Telegraph, Wednesday 11^th May 2011

The Encouraged Optimist

Sign seen on the bar of a pub ('The Dog') in Whalley, Lancashire:

'I'm going to live forever.

So far, so good.'

Extra, Extra, Read all about it!

Blessed with such wonderful weather, the Easter weekend was a great opportunity to clock up some time exercising in the great British outdoors; which is precisely what I had the fortune to be doing in that land known as God's own country, the Yorkshire Dales. However, with a few days away from the turmoil of the surgery, it was also an excellent time to catch up on some serious reading of an ever-growing backlog of medical journals.

Keeping up to date with medical developments is a task that doctors endeavour to perform on a regular and life-long basis. It is almost an impossible task, and we can only try to do some justice to the postbags of journals and medical newspapers that fall through our letterboxes on a weekly basis. However, most of us will select and concentrate on a few favourites and then scan the remainder for particularly eye-catching articles which the others may not have covered. For me, the British Medical Journal and the Journal of the
Royal College of General Practitioners are the main players, topped up with a couple of medical news magazines called GP and Pulse.

This particular weekend was of considerable interest, and I was able to update my knowledge of how vitamins pills may be bad for you by increasing the desire for fast foods (reported in the journal Psychological Science). I also took notice of various public health articles on the smog alert affecting Britain; found that the Archives of Disease in Childhood contained research linking excessively crying babies with the later development of behavioural problems; learned that the journal Arteriosclerosis, Thrombosis and Vascular Biology was reporting on the link between the time children watch television and the development of heart disease and high blood pressure; discovered that the General Medical Council is considering holding misconduct hearings for GPs behind closed doors; and that peat moss was once used for dressings for battle wounds during the First World War. Further reading included an article on euthanasia, and how elderly people in Holland are now carrying cards to ensure that doctors do not over-enthusiastically end their lives. There were also papers with evidence that playing a musical instrument may help protect against Alzheimer's Disease (reported in the journal Neuropsychology); reports on how air pollution raises the risk of breast cancer (reported by the American Association for Cancer Research), and finally, that the Boston University Medical School had discovered that the 'older' types of contraceptive pill may be safer than newer versions.

All of the above made for fascinating reading. However, the truth is, none of the articles were actually from the journals I earlier reported reading on a regular basis. In fact, they were all to be found in the nation's daily newspapers. I cannot imagine for one moment that any GP actually receives half of the journals mentioned above, let alone gets to read them. So, despite our best of efforts, we cannot possibly keep on top of every single development in medical science; I am not even certain that retirement would allow sufficient time to do achieve such a herculean task.

One often hears the phrase 'if in doubt, consult your GP'. However, a gentle plea on behalf of all my GP colleagues: whilst we do our best to keep our knowledge fresh, the next time you come to the surgery to discuss an article in this week's news, please bear in mind that journalists will often trawl through esoteric science journals to find eye-catching headlines which the jobbing GP will never read at first hand. If we sit their nodding wisely and saying nothing, it is probably because we are totally bemused and wishing we had paid more attention to the weekend's newspapers.

First Published in the Scunthorpe Telegraph, Monday 2^nd May 2011