ST6 in Geriatric and General Internal Medicine
Dr Matthew Roycroft
I’m an ST6 in Geriatric and General Internal Medicine in Yorkshire working less-than-full-time, which has allowed me to develop something approaching a ‘portfolio career’ by giving me that most precious commodity: time. This time allows me to do various things but most notably co-chairing the Royal College of Physicians (London) (RCP) Trainees’ Committee, developing and leading education programmes, and providing a small amount of time to do some medical education research.
Some of these roles have leadership elements to them but all are equally important to me: they add variety and interest to what I do but also provide different insights into how different parts of the NHS work. This is hugely useful for many leadership challenges as understanding something from another point of view is far easier (I think) if you’re actually involved in something different yourself. It’s far too easy, and not particularly helpful when looking for solutions, to only see the NHS from a clinician’s perspective.
My role at the RCP is primarily in working with my excellent co-chair, Dr Michael FitzPatrick, to coordinate the activity of the 30 or so members of the Trainees’ Committee and ensure a trainee perspective is provided on decisions being made by the College. My role is also to ensure we’re part of national discussions around medical education, training and working. We’re lucky in that those on our committee are, without exception, incredibly motivated to improve things, but unlucky in that they’re already incredibly busy (as they are all junior doctors) and so don’t have huge amounts of time to put towards this unpaid role. Finding ways to utilise the former whilst mitigating the effects of the latter is a challenge we’ve addressed by creating a structure providing good amounts of autonomy to members, but probably most importantly we try to recognise the great work being done – far too often in healthcare this is forgotten about. On a human level it’s incredibly important, but it’s also a great motivator to keep doing something!
One of the things I’m most pleased about introducing to the committee is providing time (and expert speakers) for education for all of us about how local and national systems work and how they can be influenced. We’ve dedicated an hour or so for this every time we meet (which is only a few times a year). Whether this creates short-term benefits is debatable; I think it does because it’s both interesting and gives back a little to the trainees who have given up a lot of their time to work with us and may help them engage better. But longer term I believe it will create benefits for both the RCP itself but also organisations (of which there are many) that work in similar ways. The NHS isn’t short of energy and enthusiasm from its staff but it is, again in my opinion, short of staff that have the knowledge and skills to be able to transfer that energy to the betterment of an entire organisation or team.
National and regional positions, however, move things very slowly: we may have some influence but it’s very hard to pinpoint or define what difference we’ve really made. Consequently, some of the most satisfying work I’ve done has been at a far more local level and doesn’t make it into any of my formal job roles. A lot of this is in being a senior trainee with years of experience and the ability to understand more about how things work; I can direct people appropriately to help them solve something they’re trying to do. I really believe that all NHS staff, and I include non-clinical staff in this, want the NHS to work well, but often find there’s a disconnect between clinical and non-clinical staff. The NHS suffers from the consequences of regular and significant changes to the way it works. What may have been sensible at one point in time becomes thoroughly unhelpful a few years later, due to an unintended consequence of some change (often externally created), but a lot can be done to address these areas that have lost their initial reason for existing.
To any trainee reading this, there’s really one message I’d like to pass on: get involved! The system isn’t perfect (far from it) and doesn’t always make sense, but if it’s ever going to improve the solution will always be found within. That means you, your friends and colleagues!