Richard Phillips is an Academic FY1 Doctor in Birmingham interested in helping to bridge the gap between pre-clinical and clinical medicine.
This one goes out to anyone starting a new chapter of their lives during the 2020 lockdown measures.
I am an FY1 doctor who started work in June 2020, during the first peak of the COVID-19 pandemic. Anyone who knows me personally will know that I do not view medicine as a day job but a core part of my identity (we don’t have time to analyse the issues with that statement here I’m afraid!) and so commencing work was something that I was always especially looking forward to. But when it felt like the whole world was revering hospital staff, it felt to me like this year could not have been a more special time to start my career in medicine.
**A fleeting snap of a fresh-faced (behind the mask!) new doctor**
So, let’s jump forward 4 months. The second peak (as predicted by many) is upon us. However, I do not have the feelings I had before. The optimism has been replaced with fatigue; the excitement with apprehension. These feelings stem, primarily, not from the effects of my job but from the impact of lockdown on my personal wellbeing. For our foundation years my partner and I made the decision to move to a new city together. As such we have not yet established the social network that we previously took for granted. With an almost weekly increase on restrictions in our home city the opportunities to forge meaningful friendships with colleagues, neighbours and members of our community has been extremely difficult. Being unable to invite people into my home or share a drink at a pub has significantly affected how I can make new friends.
Which leads me nicely on to the following revelation – work has become an escape. No, I do not mean I have become a workaholic doctor, staying late to chase bloods or ensure that the patient lists are all formatted in size 8 Calibri font. Nor am I stating that my home life is a living hell – I am happily cohabiting with my partner and we engage in your classic lockdown activities (as shown in images below). I reference more the fact that between the hours of 8-5 I forget, despite being surrounded by it, that we are living under the shadow of a virus. I think that my workplace wellbeing greatly outranks my social wellbeing and this can be attributed to one simple explanation: real and varied human interaction. Sadly, and unavoidably, my parents have been relegated to 2D abstract concepts. My friends too. My beautiful nephew, Lucas, who is already a year old, has grown before my eyes almost exclusively in pictures and short video clips. Yet when I am at work I am exposed to the quirks and idiosyncrasies of human nature that cannot be conveyed through pixels. These displays of humanity are amplified significantly when applied to a hospital setting, where the whole range of human emotions are played out on a daily basis – from shock to anger to fear to elation to stress to hunger to exhaustion. This pandemic has taught me many lessons but one of gratitude cannot be understated. I am grateful for my SHO who cracks a joke about cricket every day. I am grateful to the ward clerk who introduced the team to Smooth radio (and boy is it smooth!). I am grateful to the ward nurses who are truly the MVPs of our ward. I am just grateful to be surrounded by people.
** Home wellbeing exercises: would recommend making sushi; would not recommend starting a 3000-piece jigsaw on your living room floor**
So how does any of this relate to medical education? Firstly, could it be that our relationship with work during these lockdown measures is changing. Perhaps (for a time) our jobs will be viewed as “I get to go to work” as opposed to “I have to go to work”. The comradery I feel for my fellow junior doctors that I share a ward with has never felt higher, despite the mild terror that faces us in these coming weeks. For FY1s, such as myself, we have experienced both sides of the coin. In March we were students, now we are doctors. Although difficult times lie ahead, I know that I would rather be at work. I think as medical professionals we should remember this when we fail to comprehend why someone working from home would ignore a lockdown measure.
** A team that Richard is proud to be part of **
Secondly, and more importantly is the workplace wellbeing that has come from reinstating medical student placements. This cohort of aspiring doctors are equally isolated when not in the hospital and for them the opportunity to leave lockdown to attend placement will no doubt be a wonderful source of escapism. Thus now, more than ever, we should be promoting an inclusive environment where students are not shunned away or made to feel unwelcome but are offered the same access to human interaction that is reserved for all other key workers. This week I have had the misfortune to work on a ward that has been infiltrated by COVID-19. This ward was intended to be kept “cold” but has become “hot”. With this development come consequences for our doctors of tomorrow. Many students are barred from entering these wards, seen to be an inconvenience or a waste of PPE. For them, their minimal chance at patient-centred learning is being removed once again. We cannot say how this is going to impact their progress to becoming clinicians, but we can hazard a pretty good guess on what it is going to do to their wellbeing.
To finish, hopefully reading this will not evoke just negativity but provoke our cohort of junior doctors to be grateful for what we have, to harness any opportunities to include medical students at this time, and to above all look after ourselves.
Stay safe and stay happy.
Dr Richard Phillips