Guest Blog: My Pathway to Medicine

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The current trend on social media in the world of medicine is #mypathtomedicine. This is an age old question all medics, and potential medics, are asked. It is an opening question at medical school interviews, and, as I am finding out, at postgraduate interviews, at funding interviews, at speciality job interviews…. Why medicine? What drew you to surgery? Have you always wanted to be a doctor? When did you know?

I did not have an eye-opening, career-defining moment. I was born and grew up around Lake Victoria, in Sub-Saharan Africa, and I had the childhood that children read of in story books; that in which I spent afternoons under the hot sunshine feeding giraffes, and evenings on the lake shore hearing tales from people in all walks of life and from a spectrum of cultural backgrounds. Yet, all around me I was exposed to great disparities - unaffordable health care for those whom were desperately sick, shunning of people with disabilities, ethnic cleansing in the town where I grew up…. It carved in me a great sense of injustice, and the need to try and change what I think is one of the greatest downfalls of mankind. Perhaps, over time it instilled in me the subconscious desire for a profession in which we act both in a role of leadership and in servanthood. And so, my life decisions were starting to be influenced by this underlying notion. A brief example- when I was a teenager and moved to England my parents padded me up with warm winter clothes. That summer, I returned to Kenya and gave all of my warm, soft, cushioned clothes to my parents’ gardener. It was only when I experienced the next bitterly cold winter my mother asked me why - “Well, Jack’s children must be cold too”. Jack’s children live on the Equator; but, this was an instrumental step in the tumultuous direction I felt I was drawing towards.

Once I was naïve enough to realise I wanted to help tackle a global crisis, I needed to negotiate how I would do this. I had always toyed with the idea of being a medic from a very young age, but had never taken ownership until a stroke of serendipity. I was nine years old when my parents sent me to boarding school, because of the limited educational opportunities where I grew up. In the depths of the Rift Valley, I met a teacher from England whom nonchalantly one Sunday afternoon told me I was going to be a doctor. I thought he was mad. A doctor? Don’t hospitals smell like vinegar?! Aren’t doctors all men?

How can a girl be a surgeon? At the tender age of nine I had already unhooked the fully loaded question! In the world where I grew up, women didn’t often work, and the few that did were definitely not leading ward rounds or spending their nights in emergency theatre. However, I have been fortunate enough to have strong, open-minded, cross-cultural parents. Recently, as a fully qualified doctor, I was invited to an Oxford graduation for a female Asian-Caucasian friend whom I met in Kenya. It was during my reflection there that I realised my father was the first gate-opener for me. He would tell me I could do anything my brother did, that I could be a doctor if I wanted to be, and that being a girl had nothing to do with either the problem or the solution. My parents worked as hard as they could to give us the best opportunities possible, and so when I was 16 I attended an all-girls’ boarding school. It was here that I fundamentally learnt it was okay to be a girl. And even more so, that the future game-changers in our world will be women, and men, whom are intelligent and whom are ambitious. And that, at said school, when I was taught to pour wine and slice cheese it is not because “women belong in the kitchen”, but because some of the most influential professional and personal relationships are best formed over a hand-poured glass of red!

In tandem with the social and cultural environments, the critical step for applying to medical school was securing academic rankings. During my much longed for holidays at home, I would spend Saturday evenings preparing for medical school entry exams with a one-legged tutor whom insisted we sat on the veranda so he could simultaneously smoke. My Sunday afternoons were caught in a cacophony of ill-conceived chemistry experiments and a stroll around my parents garden with my trusted dog, gaining first-hand experience in plant biology. My mother would plan our holidays to visit my grandparents in Toronto around my exams, and she would stay awake in the darkest nights, supporting me when I was convinced I wasn’t smart enough to get into medical school. Even today, I have to remind myself that we are not given a spirit of fear or timidity, because Imposter Syndrome still lingers in the shadows as a doctor.

The week I got accepted into medical school is still a blur. The shear relief and the overwhelming sense of happiness was juxtaposed with my grandmother’s funeral (from old age), and with the blood chilling murder of my godfather’s wife. Yet, through it all my friends and family had supported me and stood fast beside me. Getting into medical school was the first step, getting through medical school was the next step, and it is only when we take a moment to rest that we appreciate all of these steps are journeys in their own right.

So maybe the next question is whether I would ever return back to Africa, the pearl of the world? Not “Today”. For “Today” I am still learning, and negotiating, and discovering there is need all over the world. But, there is always “Tomorrow” …

 

karishma shah

Karishma Shah

Academic Foundation Doctor in Orthopaedics

Oxford University Hospitals

Oxford University Clinical Academic Graduate School

@KariShah_

Guest Blog: Mental Health Awareness Week 2018

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The Medical Women’s Federation kicked off Mental Health Awareness week in the afterglow of a magnificent May meeting in Cardiff. As an active MWF member for over 25 years, I can vouch for it as a purposeful and integrated network of women doctors that remains progressively relevant in todays' medical working climate. As medical women we have tremendous power to change lives - not just ours, but our family’s, our society’s and that of our patients’. The function of MWF as a supportive network is in keeping with the Personal Wellbeing Networks, which is highlighted in this month’s British Journal of Psychiatry as increasing our social capital and improving even severe mental illness.

While mental health illnesses can affect both sexes, it is well known that some are more common in women, such as mood disorders and eating disorders being clear examples. Depression will rate as one of the major burdens of healthcare in the 2020's and yet the provision of mental health services remains a postcode lottery. Whilst applauding 'mental health awareness', this initiative needs to be matched with an equivalent sustainable provision of service, as mental health resources remain consistently underfunded. Child and Adolescent services are one of the most neglected. Self-harm in girls is increasing, as are eating disorders. Netflix was condemned this week for airing a series glamourising teenage suicide in the exam season when this phenomenon peaks.

Research undertaken by the Mental Health Foundation has found that 74% of adults have felt so stressed at some point over the last year that they felt overwhelmed and unable to cope. The percentage was even higher among women and those aged between 18 to 24 years old. 47,000 people were detained under the Mental Health Act last year, a massive increase over the past 5 years. This is due to shortcomings, particularly lack of beds and consistently underfunded care in the community and social care. This contributes to the enormous burden that is placed on families in wider society, and as dementia increases with longevity, women will be most affected, as we live, on average 5 years longer than men. Women are the primary care givers looking after children for up to 17 years and then spending up to another 17 years looking after parents.

Women in a quarter of the UK are still missing out on vital maternal mental health services. The Maternal Mental Health Alliance has produced a series of maps which show current specialist perinatal mental health provision for women across the UK. Mother and baby facilities are disparate throughout the UK, mainly concentrated in the South, even though the need to expand geographically has been highlighted to the Department of Health. The Duchess of Cambridge visited the Perinatal Mental Health service at the South London and Maudsley Trust and highlighted that women's health services must be prioritised.

The MWF harbours a wealth of expertise, as Dr Henrietta Bowden-Jones, our newly inaugurated President, is an internationally renowned expert within the field. Dr Bowden-Jones appeared on BBC Breakfast this week to speak on the new announcement that gambling machines fixed bets will be reduced to £2 instead of £100. Dr Roz Ramsey, former MWF Honorary Secretary, has just coedited a book – ‘The Female Mind: a user's guide’ - which examines how gender affects mental health.

As medical women we have tremendous power to change lives - not just ours, but our family’s, our society’s and that of our patients’. There are integral factors that women face in the modern medical life, including pregnancy, work-life balance, pressures on the NHS, along with increasingly working in isolation. The recent edition of Medical Woman - 'The Flexible Issue' - is a marvellous read that explores a variety of these important areas, such as coping with Obsessive Compulsive Disorder and articles on labour, stress, and work-life balance. Members of MWF receive our bi-annual publications of Medical Woman, and I highly recommend this issue to all.

Our inclusivity, mutual encouragement and mentoring of younger members, whilst promoting career progression and getting our message across, ensures MWF safeguards against and acts as the perfect antidote to stress.

If you are not yet a member of the largest body of women doctors in the UK, click here to join us today!

 

Dr Amanda Owen is the MWIA National Co-Ordinator and a Retired Psychiatrist.

#LifeofaMedWoman

Guest Blog: Mentorship, Seeds and Paying It Forward

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Although I'm someone who is still relatively early on in their medical career, I can already vouch for the importance of mentorship and words of encouragement at the right time.

I've just started in my dream speciality of radiology and I certainly didn't get here on my own. The week of application I had a wobble about my abilities, what it would mean for my personal life and questioned if I even had a chance in hell of getting in. A wise colleague who was also applying for radiology encouraged me to just go for it. I took the jump, got out of my own way, and thankfully landed on my feet.

My story could have ended very differently. Fear, listening to some of the discouraging “oh that's really competitive” talk around me and a lack of confidence would have seen me stop chasing the thing I really wanted; and then where would I have been?

In my first week of radiology training we had a session introducing us to the interventional radiology and a fancy bit of kit we would have the opportunity to play with. We also got to meet Dr Nelofer Gafoor, one of the interventional radiologists.

After our introduction Dr Gafoor spoke about entering interventional radiology and then came this off the cuff statement: “Oh and by the way, don't let anyone tell you that you can't do something. You can get married and have children and work and be an interventional radiologist if you want to. Look at me.”

And look we did. These words struck a chord. I remember discussing it with one of my colleagues. She had never met a female interventional radiologist before, let alone one who wore heels and lipstick, smiled at us and was so encouraging.

I'm not saying we should all be interventional radiologists, but I am a firm believer in doing whatever you want to do regardless of your gender. As a strong convert of the Sheryl Sandberg effect, I'm talking about sitting at the table. For those of you who are unfamiliar; Sandberg, chief operating officer at Facebook, talks in her book Lean In about women not sitting at the table and essentially taking themselves out of the competition too soon due to lack of self-belief, amongst other reasons.

I know this very well because I've done it to myself at times when I experienced a crisis of confidence and I saw it yesterday in someone else. Walking a 10 minute journey with a bright intelligent final year female medical student I was floored when she said she didn't think she would be good enough to enter a speciality such as radiology. At the very start of her medical career I could see no reason as to why this could be true. When I dug a little deeper it was a confidence issue. I tried my best to encourage her, gave her my e-mail address so I could answer more of her questions in the future and wished her the best.

She may take heed of my words and maybe she won't but the point is, you never know the potential impact your words could really have. When I approached Dr Gafoor to get permission for this post, she barely remembered what she had said but I remember them as if they were yesterday. And so do my female colleagues. Sometimes a few words of encouragement are enough to plant the seed of possibility in someone’s mind. They won't all grow, but I'm going to keep planting them because I'm only here since someone took the time to throw the seed of possibility along with some sun my way. I will always be grateful for that and try to pay it forward.

Dr Salma Aslamsalma aslam

Dr Salma Aslam is an ST1 Radiology Registrar who since graduating from Bristol University has continued her love of writing and has written for the BMA and the Guardian.

#LifeofaMedWoman

Guest Blog: Edinburgh’s New MWF Student Committee

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It has taken 100 years for the Medical Women’s Federation to return home to Edinburgh, the city where Jex-Blake and the Edinburgh Seven first bravely battled for women to have the right to attend university and study medicine. Fortunately, the trend caught on - over 600 women are currently on the MBChB programme at Edinburgh Medical School and this year saw the founding of our first student-led MWF committee.

Eager and enthusiastic, the committee spans all six year groups and has brought together likeminded women who are keen to represent the views and ideals of Edinburgh’s medics and promote equality and inclusivity on campus.

We already have a full timetable of events planned for the coming year and are excited to partner with and work alongside other prominent student groups such as Edinburgh University Feminist Society, Edinburgh University Obstetrics and Gynaecology Society and another innovative new team, Edinburgh University Medical Ethics and Humanities Society. Through these interdisciplinary collaborations, we hope to raise the profile of the MWF and reach out to the greatest number of students possible, whilst hosting a larger number of events on campus than each group would be able to individually.

edinburgh student committee

Our first event of the year was an overriding success – a lecture on the benefits and challenges of vaccination and screening for cervical cancer, delivered by Edinburgh-based research fellow, Dr Ramya Bhatia and hosted by MWF, EUOGS and MedAid. Her narrative about her time spent in Malawi was thought-provoking and emotive and demonstrated to her captive audience the demanding and rewarding career female medics can experience abroad. Coming up later this year, we hope to present equally engaging topics for discussion such as FGM, image positivity and work-life balance in clinical practice.

We want our society to be a forum for celebration as well as discussion and we aim to recognise the achievements and progress of women in medicine through an evening of poster presentations on notable female medics throughout history near the end of the academic year. We wish to use this as an opportunity to reflect on the contributions they, and also, we, have made to the medical community at Edinburgh and further afield. To accompany this event, each week a committee member will share through Facebook and our new Instagram account, a short profile entitled ‘Woman of the Week’, about someone who has inspired them during their medical career. We hope this will help introduce more role models to our followers whilst familiarising students with our committee and maintaining an active presence on social media.

As on-going projects, we responded to the wish for current medical students to have more contact with current medical professionals for inspiration, advice and encouragement. As such, we are in the process of formalising MWF’s student-doctor buddying scheme, whereby on request students are paired with female physicians who have graciously volunteered to support these promising future doctors. In February, we plan to bring together students and doctors from a range of specialities in a Speed Dating event, to provide an insight into a plethora of careers where women can thrive and hopefully encourage current students to pursue a speciality they had not previously considered.

We hope MWF at Edinburgh will be for everyone, by pioneering progression and forward-thinking. As we gain publicity and following, we hope to go forward to create a legacy for women at Edinburgh Medical School and to challenge every assumption and stereotype we encounter along the way.

Rebecca Murphy Lonergan

Rebecca Murphy Lonergan is a medical student at the Edinburgh University Medical School and a founding member of the MWF student committee.

If you would like to find out how you can get involved with the Medical Women’s Federation, please email us at: This email address is being protected from spambots. You need JavaScript enabled to view it..

Guest Blog: Hamlin Fistula Hospital in Addis Ababa, Ethiopia

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MWIA´s president elect, Dr. Clarissa Fabre visited the Hamlin Fistula Hospital in Addis Ababa.

I recently visited the Hamlin Fistula Hospital in Addis Ababa. It was an inspiring experience. Founded in 1974 by Drs Catherine and Reginald Hamlin, it now has 5 satellite sites in Ethiopia as well as the main hospital in Addis Ababa. Young girls in rural Ethiopia often marry in their teens, are poorly nourished, have poorly supervised pregnancies, develop obstructed labour, form fistulae between vagina and bladder or between vagina and rectum. They leak urine or faeces, they smell, are consequently rejected by their husbands, and become social outcasts. They walk miles to get to medical care. At the Fistula Hospital, they are strengthened and nourished, their fistulas are repaired, and they are rehabilitated. Some of them become nursing assistants when they are well again, and help with the care of future patients.

It is astonishing that around 4000 patients with fistulae are still treated each year (the phenomenon is virtually unknown in high income countries). The problem is poor access to medical care in labour, and especially access to caesarian sections if indicated (in rural communities 90% of births are outside a healthcare facility). The Hamlin Fistula Hospital now trains 20 midwives each year on a four year degree course. The midwives come from these poor rural communities and will return there once their course is completed.

How could MWF become involved with the Fistula Hospital? All treatment for these girls is free of charge. They arrive at the hospital as social outcasts after days of walking. Once their treatment is complete, each girl is discharged with a clean new dress and a bus ticket home. What a transformation! Charities in the U.K (www.hamlinfistulauk.org), Australia, Canada and the US are very successful in raising funds. Our members, who are trained uro-gynaecologists might consider a placement as volunteers.fitsula hospital clarissa

The Hamlin Fistula Hospital is a wonderful oasis of medical care. It is set among trees and flowers, the staff are dedicated to holistic care. Dr Catherine Hamlin is now 93 years old (her husband died over 20 years ago) and she lives on site. She is known as 'the mother of all mothers' and has created a unique centre of excellent medical care, combined with a loving and caring environment. I would highly recommend that MWF supports the whole concept in any way that we can.

 

Dr Clarissa Fabre

Past president MWF
MWIA president-elect
MWIA representative to WHO

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