There’s nothing like the deep sense of desperation you have when you arrive at work for a busy day, only to find two colleagues have phoned in sick and this afternoon’s clinic has been inadvertently overbooked. It’s bad enough when this happens occasionally. When it happens most days it can feel almost unbearable.
The harsh reality of trying to balance providing safe services for our patients and their families with constantly feeling under immense pressure is now the challenge that paediatricians of every grade, and in all parts of the country, face.
Paediatric trainees who leave to work in other specialties, or even outside medicine, will often say, “I look around at the consultants I work with. They are all brilliant doctors, but they look exhausted and burnt out. Why would I want to continue in a specialty where that is my future?”. SAS doctors often tell us they have no desire to be a consultant: “Why would I want to do get involved in the politics and paperwork at the expense of clinical practice which I love?”
Talking to consultant colleagues who are feeling anxious about how they can possibly sustain a fulfilling career until their mid to late 60s, the comment is often “I just cannot imagine how I can carry on like this. It feels like all my love for my work and my patients is being squeezed out of me. When I check my consultant WhatsApp group in the morning and realise we have, yet again, multiple rota gaps at work today, I literally feel sick.”
So there is no pretending. We work in incredibly challenging times.
And yet - it is our firm belief that this is a career well worth doing. Paediatrics, like no other specialty, offers a rewarding career for all comers - academics, generalists, specialists, part time workers, city dwellers, remote and rural paediatricians - there is a truly meaningful contribution to make to child health in this country, and beyond, through our work.
We want to start a conversation about how to improve the lived experience of paediatricians...
So, where do we go from here? We need to start by acknowledging that all the feelings we’ve described are real and now widespread. The reasons for the challenges are difficult to solve. However, we can no longer pretend that all is well, and the complexity and magnitude of the task cannot be an excuse for not tackling it.
As a College we want to start a conversation about how we can collectively work to improve the lived experience of paediatricians. This ranges from direct support through College-run schemes to lobbying decision makers at a national level. We have already seen successes including getting paediatrics on the shortage occupation list to ease approval for non-EU paediatricians’ visas, but there is much more we can all do.
There are some really positive initiatives developed and supported by the College that you may not have seen yet, including:
- The Trainee Charter - identifies standards for good training in paediatrics
- Stepping Up programme - helps support paediatricians as they transition to their consultant career
- Career support service - provides personal guidance through a network of careers advisors
- Mentoring support - for all paediatricians
- Clinical leadership courses - for senior paediatricians to develop professionally
- Supporting national schemes including supporting the pilot for any paediatric trainee wanting to train less than full time
- Developing a robust training programme in line with the Shape of Training review
To pull all this work together and to give this important work senior leadership, we are planning to appoint a Clinical Lead for retention and wellbeing whose role will be to pull together all the current good practice nationally and share it as well as to identify areas that need work. As paediatricians we will be best placed to understand what we need to do.
Thank you so much for all that you do on a daily basis in spite of the challenges. Let’s start that conversation to improve things from here.