A career in medicine can be all-consuming, and many doctors find themselves losing touch with the values and identities that bring joy and meaning to their lives. In this post I asked Nav, a GP/Post CCT doctor, about his experiences of taking a career break to re-connect with himself. He describes how he needed time out to re-evaluate what “normal” was for him, having been hooked into the relentless pressures of his profession. For Nav, exploration and creativity played a vital role.
How did your decision to take a career break come about?
My first proper career break was in August 2017 when I was at the end of my GPST2 year. Essentially, I was exhausted. Leading up to this I had been working in my first GP job, which required a 1 hour commute each way, plus busy days regularly hitting the 11–12-hour mark: the usual GP stuff of going through blood results, post, finishing late, and duty doctor stuff. Often, I wouldn’t even have lunch and survived on something like an energy drink. Being a GP can also be an extremely isolating job and I was the only trainee in the practice. Looking back I’m surprised I hadn’t burnt out by this point- I was barely sleeping, often getting an average 3 hours a night or less.
I then spent late 2016/early 2017 working in Paediatric A&E. The workload was intense, but I could manage that. The main exhausting element was the fixed rota, which anyone who works in an A&E knows can be horrible at times. It left very little time for anything outside of the job- no concept of a social life, no time to do anything. I also went from one viral illness to another, which left me feeling drained. I then really began to ask, “Why do I put myself through this?”
I recognised I was potentially headed for burnout and the deanery were very helpful. They approved my request to take six months off at the end of the year.
How did you decide what to do with this time?
I had previously taken an F3 year out (between F2 and going into specialty training) in which I did a short film-making course, and then worked as a locum SHO in AMU in a nearby hospital. I also went on a small trip to Bergen in Norway with money I had saved. I felt like a completely different person during that point. So I knew I needed something similar.
I reflected on why I felt like I did at that time. I asked myself what made me happy and what I was interested in. It all boiled down to recognising I liked having autonomy and the freedom to be curious. So I decided to spend more of my savings on doing small solo trips to places I wanted to visit, and just explore my interests. I went to Warsaw, Ghent, Bruges and Montreal, absorbing myself in museums, record stores, book stores, taking photographs, and doing things that interested me. I wanted opportunities to be alone and explore my identity beyond just being a doctor.
Daytime in Bruges
How did the break help?
To me the break helped because it allowed me a space to breathe and reflect- with no pressure. It allowed me to feel what my normal should be. As I was alone, I could seriously think about this.
Late night in Ghent
For example, by the end of the break I began drawing again (something which continues to this day) as well as crafting my own reading curriculum to get back into reading. This would not have happened without the break.
Do you think taking time out has had an impact on your career prospects?
It is something I worry about sometimes. During training, a gap didn’t make a difference, as it was fairly short. Once fully qualified (I’ve got my CCT) I think it can get tricky explaining gaps- but I’m upfront and honest about the reasons for taking a break. I discuss these things openly at my appraisals. At the end of the day I need to do what’s best for me. It’s my experiences of travel and taking time out for myself that have given me the confidence to accept I have nothing to feel guilty for if I do take a break or want to change direction.
What message/advice would you want to give to other medics who might be feeling burned out right now?
If you recognise you’re in burnout or beginning to reach that state- take a step back and take a break. Seek help or support if necessary. Talk to colleagues, friends or family. Prioritise your health and wellbeing always, over anything else. Recognise the issues affecting you and listen to yourself.
In Medicine you deal with the extremes of life. As a doctor you’re exposed to things that most people really don’t get access to. It’s hard not to get emotionally affected, but as a doctor you’re automatically expected to just deal with it. But things can still get to us as we’re all human at the end of the day.
I became a doctor in my early twenties like many people in England. Since then, this is all I have ever known. So this hyper-reality of situations involving life and death, worries about making mistakes, stressful on-calls, time pressures, department politics, seeing people at their worst or in emotional distress/crisis (including being on the receiving end of aggression, violence, threats and sadly occasional racism) has been my normal for the past decade. I’m sure many NHS workers reading this can easily relate.
So when you start to falter or question why you may be feeling like this, it’s easy to blame yourself when in reality if you take a step back from the job and analyse it objectively- it’s really no surprise you can end up feeling burnt out.
What changes would you like to see within medicine/the NHS to improve staff wellbeing?
I would echo the common issues many people state. Poorly staffed rotas, poor funding and issues such as recruitment needing to be addressed as a priority. These would be the core areas to target which I know would dramatically alter the day-to-day pressures of working life.
Other things are appreciating the idea that you can be a doctor and have other interests- that this concept of medicine having to be your whole identity is very antiquated. I also feel encouraging flexibility and ability to take breaks or move around specialities or different career paths with more ease would actually be very beneficial. I feel a lot of younger doctors and the next generation of medical students are naturally doing this, which is encouraging to see.
It’s also good to see programmes such as the NHS Practitioner Health Service becoming more established, so I do feel in some aspects there is some positive change.
What role does creativity have in supporting your mental health?
As a child, I was heavily into art and drawing. I was equally obsessed with music, reading and cinema from a young age. These have been lifelong interests long before medicine came into my life. I never actively talked about any of this stuff when growing up as no one around me was into it. I just loved what I loved.
I was even considering studying English Literature at University- I never had any shame in admitting I loved reading books, poems and plays (and still do). However, the fascination with Medicine eventually won out.
Things are now coming full circle as I recognise that these interests are simply part of who I am and that I can’t do without them. They are equal to the love or interest I have for medicine.
Sketchbook exercise
I think creativity has been something that has kept my mental health generally stable. It’s also got me through some isolated and very stressful times during training, as well as now during this Covid 19 period. It provides an alternative focus and drive that can absorb me regardless of what else is going on. I still get bad days and good days like most people, but overall creativity helps enormously to redirect focus.
For those who want to cultivate their own creativity what would you suggest as a first step?
I think my advice would be just to start doing something for yourself. It could be anything- it doesn’t have to be creative, but something that might interest or appeal to you. Ask yourself what you enjoyed in the past, or what you would do if money was not a factor? Then when you find something, make it an essential part of your routine- something that is a daily or regular habit. It should feel like play rather than work.
My approach is to set projects and try to realise them- just for my own curiosity. I approach them with the same intensity as medicine. I’ve recently got into apps like Bear and Notion- where I’m trying to create a notebook of all my interests/ideas. I’m always thinking of applying different skills to personal projects. I do share some things on social media such as drawings/sketches, but only if I think it can inspire or help others.
My “notebook” using the Notion app. Each abbreviated category link contains content or notes relating to different areas of interest
But most of all, I do these things to nurture my sense of curiosity and to keep learning. For me they are a way of understanding things differently. The important thing is whatever you do- choose to do it for yourself.
As we start to see signs that we may be at the beginning of the end of this pandemic, what possibilities might be open to you for recovery and restoration? What identities and joys do you want to re-connect with?
