I’m currently doing a PhD looking at how taking antibiotics affects your future risk of antibiotic-resistant infections. Usually I work as a hospital doctor at the John Radcliffe hospital, looking after people who have come in as an emergency with things like pneumonia, chest pain, and possible meningitis.
One thing I became interested during my time in front-line medicine was how much we use, and probably over-use, antibiotics. When an older person comes in, often they are unwell and confused, and you can’t really tell whether they have an infection or not, or where it might come from. Just like younger people, it might just be a nasty virus, or simply a reaction to medication, but we as Doctors we tend to think the best thing to do is ‘play it safe’ and give antibiotics, in case it’s a bacterial infection. (Often the tests we do are inconclusive, or take days to come back).
However it’s becoming clear that using antibiotics in this way may be doing more harm than good. People who have taken antibiotics are more likely to get a the ‘hospital superbug’ C. Difficiile’, and antibiotics are less likely to work for them if they get another infection. My research aims to measure the ‘unintended consequences’ of using antibiotics, to help us decide when it’s best to give antibiotics, or to hold off and wait to see what happens.
During my research time I’ve also learnt a bit about how to analyse bacterial genomes – to use most of the programmes requires you to learn to use command lines and a little bit of coding, which has been really hard for me. If you have the chance to learn coding at school – do it! It’s so much easier to learn when you’re young!! I’ve also taken over management of our research group’s website, and had some fun collaborating with an artist, Anna Dumitriu, which has been a fascinating experience.
Some links to work I’ve been involved in:
How I got to where I am now: (for students considering careers in medicine/science)
When I was at school, I wasn’t sure whether I wanted to be a doctor or a scientist, and debated applying for biology, physiology or medicine. (A previous dream of being a F1 car designer was dropped when I found A level physics really tough…never really understood the Raleigh equation…).
In the end, the most useful advice was that if I did medicine, I could always go into science later, but a scientist would have to go back and do a medical degree to be a doctor.
I loved the biology and the science of the human body, and the idea that the knowledge would be useful day-to-day. However, I wasn’t sure about my ability to deal with patients and the emotional side – I’d always been a bit shy and quiet. One thing I did was volunteer for a residential placement run by my school, where we were placed with young people with disabilities. We messed around London for a week together, assisted with getting around and things, and took some confidence from the fact that I didn’t totally mess up… But I think it is really hard to know age 16 whether you’ll have the ability to be a doctor in 8 years time- we change so much. I was lucky enough to get a place at the University of Oxford, which I chose because their degree offers 3 years of preclinical science then 3 years of clinical teaching. I know many of my colleagues who enjoyed getting straight to the hospital and clinical stuff. However for me, I appreciated those 3 years before the wards, when I could be a student, I could get a really solid science basis for the future, and to be honest, I had some time to grow up a bit.
Medical school was hard work, definitely. You see other students with more free time, able to do far less work, and still walk away with a good degree. Also if you get to medschool, you’re probably used to being near the top of your class and not struggling too much. Suddenly you find yourself very average and having to really work to keep up! I was lucky – I had some really inspirational teachers who got me through it, and I did enough to pass.
One thing that often comes up when people ask me about medicine is whether you have to stop doing other things you like- like sport, drama or music.
I rowed during my time at Oxford, and this took up a lot of time and definitely affected my academic work. However the experience in hindsight has been incredibly valuable. I’d almost say 50% of everything I learnt at Uni which has helped me be a Doctor, was through rowing! Time management, getting up at silly hours, being able to go from asleep to out the door in 5 minutes, working together, understanding and dealing with difficult personalities, how to get people with different priorities to pull together, how to listen, how to motivate… and also how to mess up, ‘fess up, and learn to mess up better next time. So I’m a big supporter of people who want to keep outside interests going. I think being a student is a time when you can get life experience in managing and being responsible for things, and also have the chance to make mistakes, so that when you progress to ‘real life’, you’ve already learnt a lot.
I was a junior doctor in Oxford, Reading and London. It is really, really hard, no beating about the bush. I think I was fairly lucky in that I was quite young, had no family commitments or health issues, and just got on with it. I was also very lucky that I actually really enjoyed the job. Despite my concerns, I found I enjoyed working with patients, and actually found patient communication one of my strengths. Like most people I was worried about how I’d respond to emergencies, or really sick patients, or distressing situations. But you get the training, and the experience, and you get better. The first time someone collapsed with a seizure in front of me I totally bricked it and froze, but luckily the very sensible nurses knew what to do, and gently guided me through the required actions (I’d previously only seen in teaching) whilst senior help arrived. That’s the thing -you’re doing difficult stuff, but there’s always support, and someone around who knows what they’re doing. Three years later I was the senior help.
These days, training as a junior doctor is becoming tougher. Not in terms of hours- these have been cut- but in terms of motivation, expectations and manageable workload. It’s good that juniors are no longer expected to work 100 hour weeks, but the work doesn’t go away- it means that you’re often paid for an 8-5 job, but your work takes you until 8pm, and when you’re on-call it’s crazy busy. Certainly after leaving university, many of my friends were quickly earning double or triple what I was, and working far, far less… There’s no trying to hide it – the demands of the job, and the environment of an overstretched, underfunded NHS is really hard on Doctors. You also have to keep doing exams! To progress after medical school, you’re expected to do further exams to progress to Registrar and Consultant level jobs.
One thing that remains true- there are so many different parts of medicine you can choose. In addition to the usual things you’d think of – being a GP, and A&E Doctor, or a Neurosurgeon, there are more desk-based specialties like Public Health or Pathology. You can do a job that requires good technical skills and procedures, from big operations in Cardiothoracic and Trauma/Orthopaedics, to smaller ones in Dermatology and Radiology (ultrasound scanning and image-guided biopsies). And you can always go into research at a later stage, as I and many of my colleagues at the Nuffield Department of Medicine here in Oxford have done. Many of my colleagues say that they are glad they did medical training first, as it gave them a really important question to ask, and they understood how important it was to patients.
So on balance, I’d say there are benefits and drawbacks to studying medicine if you’re interested in biological sciences. On one hand, you get to do a job that is often fascinating and useful, have a greater range of well-paid job options, and you can go into research at a later stage with more insight into doing science that might make a difference. You can also easily do clinical research with patients. On the other hand, you have to do a very competitive and demanding undergraduate course, and then work a very hard job with a challenging work/life balance for a number of years.
Ultimately, I’m very glad I did medicine, because I really enjoy the day job, and look forward to getting back to clinical work once my PhD is over! Hopefully I can combine my two interests in the future.