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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 cancer 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 training to be a cancer specialist, and am currently doing a PhD in cancer stem cell biology. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Tuesday 6 March 2018

Registrar Reflections

Happy new year, bloggers!  Or rather, Happy Spring!  As ever, I've been a bad bean at keeping up with things.  Updates from my end:

- I'm a Medical Oncology Registrar - yikes! (i.e. the last bit of my specialist cancer doctor training)
- I'm heading back to the homeland - wowsers! (i.e. I got a Clinical Lectureship in Scotland to facilitate ongoing nerding out alongside clinical training with mountains in situ!)
- I said 'yes' to getting married - woohoo! (I'm not sure this one needs explaining...)

So it looks like 2018 is going to be a busy year.  But the first of those three things is the main thing keeping me entertained at the moment.  People say becoming a registrar is the scariest step up after qualifying from medical school in the first place.  Seems to me that makes it an important experience to reflect on, and four weeks in, here are my early thoughts on being a new registrar.

1) People are a lot nicer to you when you're a registrar than when you're an SHO.  Not that they were horrible to me before.  It's just a totally different vibe, both within and beyond your department.  Within my department, everyone has been supportive and helpful, offering help and general wisdom.  Beyond my department, people are willing to hear you out with a kinder word.  I guess it's just a general conveyance of being wanted.  Something I will definitely reflect on in my interactions with junior colleagues. 

Disproportionate excitement at having my own one of these.  

2) It actually feels like I'm being trained to be a specialist with specific skills and knowledge, rather than a bum on a seat that will learn things by osmosis.  It's really made me think about the point of middle-stage training - in my case, Core Medical Training.  I've been a doctor for nearly 6 years, but I'm pretty sure this is the first time I've started a clinical job and felt like I haven't been chucked in head first in hopes that I'll just work it out. It's also the first time I've had a desk!  And a locker!!!

3) It's quite scary that people take your word so seriously.  But that's part and parcel of getting more responsibility, right?

4) There are a lot more men than women the higher you climb up the ladder. 

5) Associated with being higher up the ladder - it does not stop you getting a lot of advice you didn't ask for.  I've been pondering if this is an issue suffered more by female professionals, because I don't recall my male colleagues ever grumbling about it.  Don't get me wrong - I am in serious need of help, wisdom, support and advice, particularly at this juncture of my professional life.  And to an extent I probably don't know what I need to know, and should listen to random nuggets of advice.  But I'm getting a little tired about being given advice about work, life, work/life balance, family life, social life etc etc... without being asked about my background in any of these areas. 
Seems apt at this point to give kudos to my last Educational Supervisor, who, three years ago, spent the first few minutes of our introductory session getting a summary of my life so far.  Meant that when he did give me advice, it felt like it meant something and was actually relevant (and it was indeed life advice I think I'll remember for a long time to come).  Again, something I will reflect on moving forward. 

6) Also I need to chill about the whole 'unwanted advice' thing.  It's always well meant.  I think.  And it's going to keep happening.  I think.  So might as well not raise my blood pressure over it. 

7) The main difference of moving from generalism to specialism is the loss of one's barometer.  I feel like in general medical situations I'm pretty ok at feeling it out - you know, 'bad' versus 'not bad', and knowing when to worry versus when to be reassured.  When you move to becoming a specialist, your barometer is not yet fully formed.  I'm sure it will, in time.  Right now I feel like I'm anxious pretty much all the time, and asking a thousand questions.  But I think it's probably better to be neurotic at this stage of things that over-relaxed. 

No #snowmaggedon will stop me getting to work...
8) I'm not terrible at this.  I did my first 7-day stint as the oncology registrar on call recently, which involved being the acute oncology ward registrar as well as taking referrals/giving advice all over the region and making admission/discharge decisions through the oncology triage unit.  It was full-on information overload, with my bleeps, mobile phone and emails all going off, often simultaneously, in addition to nurses and junior doctors coming to me with problems that needed solving.  Going home at night-time over the weekend knowing my phone could go off at anytime was a whole new experience.  I didn't do it all perfectly and there is a LOT of room for development - but I did it.  There were no tears, we even had a few laughs.  When one of the F1s said I'd been a good registrar, I wanted to hug her.  I left thinking 'I can do this'. 

There will be many nerve-wracking 'firsts' over the next few weeks, but I'm going to have to embrace the familiarity of these emotions.  I KNOW what it's like to be absolutely terrified - my first week of nights as an FY1 (= intern) I basically didn't sleep for terror, and cried after almost every shift.  I've got to take some confidence from the fact that I've come so far from those scary days.  Plus I think a lot of the nerves comes from being a perfectionist.  Not an awful quality, as long as you keep it in check...

Also high fives and hugs to Mr KP and friends who have provided important moral support.  Maybe that's the difference - it's much easier to go to work and do your thing when your house is in order (metaphorically as well as literally).  Yippee!