Difficult conversations are common to all paediatricians - but I wouldn't swap my career for anything else

Camilla, VP for Education and Professional Development at the College, knows from talking with members about your enthusiasm and professional fulfilment... but also the challenges you face. It's when we truly listen to how people feel about their work we can start to identify solutions, together.

Life is pretty busy for most of us and it’s easy to rush around and seldom stop to savour the moment. I am terrible at finding time to appreciate the good things in my life, but earlier this month I found myself on a bus heading back to my Trust after giving a talk to a group of medical students considering paediatrics as a career choice. I chose to call my talk “Widening Your Horizons” and used my 30 minutes to describe some of the many avenues that life can take you down as a paediatrician – education, working in low income settings, doing research and so on. My bus trip didn’t just give me the opportunity to think about how invigorating and inspiring it is to meet and talk to medical students, but also allowed me to reflect on what a privileged life I have as a paediatrician in the UK and how I honestly wouldn’t swap my career for anything else!

I am endlessly fascinated talking to colleagues at all stages of their careers. It reminds me that we have all specialised in paediatrics, but we also all walk very different paths over the fullness of our working lives. Some will work almost entirely clinically throughout. Others will branch off into research or management or education. Still others will have a potpourri of responsibilities and interests. The great thing is that all of these are valuable and we need people with diverse interests and strengths. Fundamentally, we also need paediatricians who are, in the main, fulfilled and enthusiastic about their work, over their entire careers.

Now – none of us gets out of bed rearing to go every day! We all have phases in life when it feels especially tough. Hopefully this is a transient phase, but sometimes it isn’t. I know from talking to RCPCH members that many people are finding life as a paediatrician as challenging as it has ever been.

Listening and truly understanding how people feel about work is key to moving forwards

We’ve been thinking long and hard about this and what we can do at the College to support paediatricians at all stages of their careers better. What can we do as a College that Trusts can’t do?  How can we help equip colleagues to work in a constantly changing and challenging work environment? What are the particular issues and problems that make working life especially stressful? We can’t solve all the NHS’s problems, but...

Part of what we can do is listen. Listening and truly understanding how people feel about work is key to moving forwards. Not only does this clarify what the stressors are and what is bothering people the most, it often starts identifying solutions and ideas for making improvement.

We are now putting together ideas for online resources to support Trusts who recruit doctors from overseas, specifically to help with induction.

A few months ago, I found myself talking to a College Tutor from an average sized DGH (district general hospital) who told me how impossibly difficult it can be to support junior doctors who come from abroad and who are new to the NHS. She’d heard about bespoke induction programmes for foreign doctors at one or two big teaching hospitals, but there was no way she was going to be able to replicate that at her Trust. Over a cup of coffee, she and I started brainstorming how the College might help with this. The College already facilitates the Medical Training Initiative (paediatrics) scheme (MTI(p)). This scheme provides both applicants and Trusts with lots of support and resources for paediatricians coming to work from outside the UK/European Economic area.

However, more support is clearly necessary and my ever patient and eternally supportive colleagues in the RCPCH Education & Professional Development team were equally inspired by this clear need. So we are now in the process of putting together ideas for a variety of online resources to support trusts who recruit doctors from overseas, specifically to help with induction.

Difficult conversations are now common to all paediatricians in a whole host of clinical scenarios...

I opened my inbox the other day and among the emails I found the kind of email that always warms my heart!  “Dear Camilla” it went. “You don’t know me but I have an idea I wanted to share with you”...  My interest was instantly tweaked! Here was a hard working paediatrician who was struck at how difficult conversations now are with parents who have a baby at the extreme of prematurity. She had a role with the British Association of Perinatal Medicine (BAPM) and so was linked in with many others facing the same challenge, but her email was to suggest the College consider developing resources to support paediatricians with very difficult parent discussions.

In my role as VP for Education and Professional Development, an email like this is like a nugget of gold! How can one not be excited at the thought of how we might tackle this challenge? Once again, the Education and Training division were unfazed as we realised that “difficult conversations” are now common to all paediatricians in a whole host of clinical scenarios – safeguarding, end of life, educational supervision, etc. So we have convened a diverse group of professionals and parents and together we are developing ideas of how to take this forwards.

So watch this space – but the hope is to create a course and resources specifically for paediatricians wanting to develop advanced communication skills. This will align very well with the recently published paper 'Achieving Consensus: advice for paediatricians and other health professionals on prevention, recognition and management of conflict in paediatric practice’. 

I remain optimistic and excited about a career in paediatrics

These are just two examples. There is clearly so much more we can do. We have to be realistic about what is achievable and focus our energy on maximum impact, but there is a real determination at the College to work on ideas that can help make the working lives of paediatricians easier and hopefully better.

So I remain optimistic and excited about a career in paediatrics. I hope I conveyed my enthusiasm to the medical students I spoke to this month!  Let’s keep talking and sharing ideas so we can make all of our lives, and our patients, better.