ST3 Cardiology Registrar

Dr Holly Morgan

Current Roles:

• Chair of the Wales Deanery Trainee Think Tank
• Joint Project Lead of 'The Core'
• British Junior Cardiologists’ Association (BJCA) Wales representative
• Society of Physicians in Wales (SOPW) Executive Committee Training Representative.

I am currently working as a cardiology registrar in the Royal Glamorgan Hospital. During my two years of core medical training I became involved in a number of projects that have since evolved into my current roles.

In 2015, a colleague and I applied for a grant from the Wales Deanery to set up an online platform for core medical trainees. We were successful, and over the following 12 months we designed and built the resource which was then rolled out to all medical trainees in Wales.

Thecore.wales is a website designed to make the training experience easier and more enjoyable. It provides educational opportunities, key contact information, a clinic booking system spanning multiple hospitals, event and study day advertising and an inter-trainee communication platform.

As this resource grew my colleague and I worked closely with the deanery to make improvements and collect feedback from users of the site. We also went on to set up a committee of other trainees who were keen to help support the running and development of the site. I found myself in an 'accidental' position of leadership as opposed to a role I had applied for.

I developed my organisational skills hugely as we were receiving large volumes of emails and attending meetings on top of working full time! We have now begun to expand the website UK-wide - and through this are now also working with the Royal College of Physicians.

Between 2015 and 2017, through developing the website, we both worked closely with the deanery. This lead on to involvement in other aspects of Welsh training, including the Train Work Live campaign, and the BMJ Careers Fair. 

In 2017 I found out I had been nominated for a Wales Deanery 'BEST award. The nomination was in the category of 'Outstanding Contribution to the Training Programme' and centred on my work on both the website and with the deanery.

At the award ceremony I was shocked and humbled to win not only my category but also 'Overall BEST Trainee of the Year'. Following the awards I was invited by the Postgraduate Dean, Dr Peter Donnelly, to join the Wales Deanery Trainee Think Tank (WDTTT), and given the opportunity to take over as Chair.

The WDTTT are a group of trainees from a number of specialties with a range of experience, who work alongside the deanery to ensure that high quality training and trainee welfare remain a core focus. In the previous year, the WDTTT worked on evaluating and raising awareness of the Professional Support Unit. This year, our main project focuses on challenges faced by less than full time trainees, and what we can do to improve their experience.

As a relatively junior member of the group, I saw the Chair’s role as a big challenge. My main task has been to sustain enthusiasm and motivation from group members and draw on each individual's strengths to progress our current project.

I believe trainees should take a pro-active role in improving their training, so I think this position suits me well. But it is not without its challenges - particularly arranging meetings that 12 busy doctors can all attend!

Overall, I think my own experience of leadership is not one of seeking out positions but rather falling into them as my training has progressed.

But I think it is important to know that positions of leadership and management are everywhere - whether that is in running your own project with a few colleagues, getting involved with the BMA or becoming a rota coordinator, mess president or rep for your own specialty college. If you enjoy communicating with others and want to make a difference then seek these opportunities out, no matter how small.

Reflections

My greatest leadership challenge has been maintaining motivation over time. You often hit stumbling blocks with projects and there are definitely times when you feel it would be easier to give up.

I take inspiration from senior colleagues. In particular, Dr Tom Lawson, current interim deputy Dean for postgraduate medical education, HEIW, has been a very supportive and inspirational consultant to work with. Not only does he have a full-time clinical position but he also has multiple other roles and despite this always makes times to support others.

Wales is an extremely friendly and accessible deanery and I have always felt well supported, which I feel has served to accelerate my leadership development. Not only were we awarded a grant by the Deanery to start our project, but we have had huge ongoing support from many consultants across the country which has made the resource what it is today.

Engaging in leadership opportunities can often be a challenge. There are certainly busy times when you feel you are spread very thinly. I have a clinical job that I really enjoy, and I think this keeps me going. My key tip is not to undertake projects alone. If you involve friends or colleagues it is often much more enjoyable. If you have a particularly busy period at work, others can continue the project and vice versa. It also ensures you have people around you who will listen to you rant on a bad day!

Developing leadership skills as a trainee is important as all consultants are in a position of leadership. So, it follows that trainee engagement in leadership is beneficial and prepares them for their future roles. As a foundation doctor I remember feeling that consultants were distant, remote figures. But often they are very similar minded to you – motivated, enthusiastic people who also want to make changes to improve care for their patients. As a trainee you rotate around and can be the fresh eyes needed to identify problems and suggest change; seeing what works in one place and bringing it to another.

Start small

I know many trainees who have become involved in what they perceived as small projects, but which have gone on to change the way hundreds of patients are cared for. Something simple like adapting a Diabetic Ketoacidosis (DKA) management pathway or reviewing how different wards store their notes or supplies - if a small change improves practice it can have a huge and long lasting positive impact.  Trainees can make a much bigger difference than we often realise.

In the busy NHS environment, consultants and other senior staff are very focused on day-to-day clinical practice. This can often feel frustrating to trainees who try to engage in leadership opportunities outside of their clinical roles and may struggle to find time to leave the wards or be approved study leave. This a challenge facing all those wishing to promote and support trainee leadership development during training. Formal positions, less than full time training or even time out of training can be a great solution. Having the time to do other work without trading off with clinical and training programme responsibilities can really allow trainees to shine as leaders.

Our clinical jobs can be very stressful, and personally I feel involvement in aspects of healthcare outside of direct patient care can help maintain balance and perspective. It is also important to have hobbies you enjoy outside of medicine!

My main satisfaction at the moment comes from inspiring others to engage in new projects. Recently a few of my junior colleagues wanted to start a quality improvement project and, with some guidance, went on not only to undertake and complete this but also to present this work at a local conference. I found supporting them and watching them grow as leaders themselves hugely satisfying.

 As doctors we are all leaders already. We sometimes just don't realise it!