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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Saturday, 20 September 2014


So the time is nearly upon me to pack up my stethoscope and the NHS and leave the UK for American shores.  After over a year of emails, phone calls, panic and excitement, I can't believe in two weeks time I will be calling the USA home for nine months.

This blog so far has charted the ups and downs of my final months at medical school and the whirlwind first two years as a qualified doctor.  I have decided, as many do at this stage in their training, to tag out of training.  I am trading my stethoscope for a lab coat.

I am not alone: A third of UK doctors take a 'gap year' between their foundation years and specialty training.  I have to say, from personal experience I'd say that statistic is even higher.  Why?  A number of reasons really.  The last time I made a radical decision about my life was when I was applying to medical school as a teenager.  OK, so I took a year out to live in London and do a science degree, and had to apply for my first doctor job, but these were very much with the tide of my peers.  Finishing foundation (the UK name for these first two years) is the first time you actually have to decide a) what sort of a doctor are you going to be and b) where am I going to live for the next 5-10 years?!  It's quite odd hitting that sort of milestone in your mid twenties having made few major decisions in the interim aside from 'how am I going to make sure I actually have food in the house throughout my 12-day work stretch'?  Plus job applications come just after you've finished your first year of work and I certainly felt it was too soon for the big commitment of geography in particular.  And for some people they are still unsure about which specialty to commit to; if paeds is your hunch, it's a minimum 8 years of training - yikes if you're not 100% sure!  I love my job, but I'm also exhausted.  Sure, being a doctor is tiring, but so are all jobs - I think when you are a junior doctor, there is the added emotional, inexperienced stress factor which is all the more draining.
A few from recent countryside runs.

Plus, frankly, why not?  There's a big old world out there and in an age where so many people seem obsessed with nationalism and national pride, I am quite content to have my own pride about being a citizen of Planet Earth.  Life is short and I am keen to explore...

Little English town...
So I am meandering Stateside to Yale University for the year, and was lucky enough to get a Fulbright scholarship to help fund a brain tumour research project.  Being a Fulbrighter has already been an incredible experience and I haven't even gone yet - my fellow scholarship people and I had an induction session a few months ago and I just couldn't believe what an awesome bunch of people they were.  I think we shared disbelief that we had somehow got through the application process and felt unbelievably lucky.  As a medic, it was also hugely exciting and refreshing to meet these inspiring people from such a range of disciplines, given that my world is so often just about medicine.  I am excited about all these new friends and colleagues I am yet to meet, and all that I will learn about in a new area of science.

I'm saying my goodbyes, packing up my things and preparing for one hell of an adventure.  Recent events have reminded me once more that you just never know what wonderful things are around the corner, and that's a hell of a blessing.  America, be nice to me!

I shall miss you!

Wednesday, 3 September 2014

'Is there a doctor in the house?'

We juddered to a halt - I, along with the other tourists and commuters, struggled to stay on our feet.  A siren gave its intermittent noises indicating that the emergency stop button had been pressed.  I did a little harumphing and sighing, as did most of us.

But then I heard the words that chill you to your very bones the second they give you your medical degree.  

'Someone's unwell, we need some help'.

I was on my way to sort something out for my American travels - a strict appointment that I had been told in no uncertain terms I couldn't miss.  I was in jeans and a jumper with a casual canvas bag, earphones plugged in listening to my generic music device.  I could not have looked less like a doctor if I tried.  I waited a few seconds to see if anyone else was making any moves, peering to see if anyone else appeared to know what was going on.  Realising that no-one was doing so, I pottered over (I should add - there was no screaming or hysteria suggesting anything truly awful had happened.  I wouldn't want you to think I saunter in this fashion to all medical emergencies).

Again, reassess.  Man on floor.  Definitely awake, talking.  Also, it definitely appeared there there were no nurses or doctors or medical types around. Here we go...

'Um... can I help... I'm a doctor...'

Cue mass relief - 'make room, there's a doctor here'.  Weirdly, it was like a tension in the group of passengers who had crowded to help the gentleman was suddenly released, as if I had some kind of magic wand.  A quick ABC told me there was little I needed to do immediately.  I asked a few questions to rule out some of the worse things running through my mind and felt reassured.  I did by pure chance have my stethoscope in my bag but we were literally perched in the middle of the public transport network with everyone staring, so I decided to leave that.  Confidentiality and privacy had gone out of the window as it was.  We just needed to get moving to the station.  

Once we had made it to a station, I waited with the gentleman until relevant people came to get him to hospital.  Of course by this point I didn't care that I might be late for my appointment, but for what it's worth, I was perfectly on time.

There were a few interesting reflections from this.  One is how Londoners totally get an unfairly harsh reputation - everyone around this gentleman was trying to help.  When I asked if anyone had any water for him, about five people reached into their bags and someone even found a cup from somewhere. A few other people waited with me and were hugely apologetic when they had to head off.  

Another is, I guess, a more personal one about how crazily calm I felt despite having an entire crowd of strangers staring at me, hanging on my professional opinion.  It was like the ultimate OSCE.  I obviously don't know what happened to this gentleman, but I felt really comfortable with what I was doing and thinking.  That was... unexpected.  Does this mean in my two years as a qualified doctor, I actually have some experience to offer, and confidence in myself?

It is very strange to think that when I head to the USA in a few weeks, 'doctor' is a role I will be hanging up, along with my stethoscope, for nine months.  It's moments like this episode that make me realise that being a doctor is as much who I am as what I am.  And that is a very strange thing to accept.