Dr Patricia Hamilton

Former RCPCH President

Start year of presidency: 2006

End year of presidency: 2009

My CV demonstrates the unplanned and unguided nature of a career in medicine in the 1970s. Like many of my contemporaries, opportunities presented themselves and one took a deep breath and went through doors that opened. There was not much time to decide, as each six month post meant applying for the next one almost immediately.  Usually each move was influenced by someone who inspired me; not by formal advice but by example.

I trained in paediatrics in Bristol, Birmingham, London (UCH and GOS) and Plymouth, and in all of these places I found true role-models among the consultants. I made a detour into Obstetrics in Nottingham, which set me up well for a Neonatal Fellowship in Vancouver. I learned there how to look after premature twins in a small plane taking off over a snowy runway (pilot’s comment: “we’ve only got one go at this”) and that a helicopter is not an easy place for evaluating clinical signs.

I had not really thought about my longer-term future, and it was not until I was at Great Ormond Street that I had to think about where I might go as a consultant. A job at St George’s, Tooting became vacant, and I was appointed consultant and senior lecturer in neonatology in 1987.

There I enjoyed teaching and the training and career guidance of junior doctors, who I found to be much more thoughtful about future life. They were more settled, not just in where they wanted to live, but also with partners and families to consider. This was very different from our peripatetic “training” and long hours of work with frequent night and weekend on-call rotas.

St George’s, like many hospitals at that time, was facing considerable management pressures and I added management roles to my clinical duties. One of my early tasks was to introduce annual appraisal to the consultant workforce - you may imagine how well that went down with the older generation! I became a Medical Director of the Hospital with particular remit of Children and Women’s services.

One day Keith Dodd, then Honorary Secretary of the RCPCH, rang me up and asked me if I would be interested in working for the College - and so began my association with the RCPCH.  I became a member of various committees, then chair of a few, and then took some officer roles. I became Honorary Secretary and then Vice President for Training and Assessment and I was President from 2006 to 2009. It was an honour to be elected and I was proud to be paving the way for women in paediatrics by being the first woman President of the RCPCH.

My philosophy for the College was that we were best placed to improve healthcare for children and young people through providing the best recruitment, training and performance. I wanted strong partnerships with our fellow professionals and robust interactions with the Department of Health and other organisations. I planned to extend the concept of family-friendly care to the families of our young trainees and indeed our consultants. Hard work was already guaranteed, but I wanted the profession to be recognised as one that cared about its own young trainees and their families. Then, I reasoned, we could attract the brightest and best newly qualified doctors to join us in paediatrics and we could also retain them.

I consider the main achievement during my Presidency was the acquisition and design of our new College building. The decisions to move from Hallam Street, not to buy the adjacent GMC premises and to pay a considerable sum of money for the new College, were made after much discussion and agonising. It cost me many sleepless nights, but I believe the new building encapsulates and furthers our aims, and strengthens the influence of the College.

As President I represented the RCPCH in many fora, including the European Academy of Paediatrics of which I was President from 2009 until 2011.

Following my term as RCPCH President I was appointed to the Department of Health as Director of Medical Education (England). We set up Medical Education for England (MEE), which addressed the issues of recruitment and training for all disciplines of medicine. The challenges of the European working-time directive had to be tackled to ensure that proper working hours did not compromise the quality of training or the service. In addition we started to rationalise recruitment and selection to regulate the numbers of applicants applying for the appropriate number of posts across all specialties.

So now in retirement I have tried to both look back to summarise a paediatric career as I saw it and try to remember how it was to be looking forward.