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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.

Thursday 19 December 2019

Hi, I'm a 31-year-old doctor... and a PhD student

At a PhD induction I was chatting to a fellow new PhD student. She asked me about my background and I explained that I was actually a doctor and was taking time out to do a PhD.

'What, you're already a doctor? Why do a PhD? You already get to call yourself 'doctor'!'

I had a little giggle and then realised that to many people, I am an 'old' new PhD student, and the fact that I have a whole other professional identity (that, yes, technically comes with title of doctor) is a bit bonkers.  I mean, why put yourself through a PhD?!  Four months in to a PhD I only have 3 years to complete (most science types this side of the pond take at least 4) and it already feels daunting to get something finished in that time.  Clinicians often say it must be nice to have a break from clinical work - but all I'd say is that it's very much 'out of the frying pan, into the fire'!

It's surprising how controversial it is to be a doctor who is back to being a student. I already have a job and a career, and an all-encompassing one at that.  Looking after cancer patients with all the crazy shifts, difficult decisions, and emotional ups and downs is surely enough!  But to the wider world, the controversy is greater still.  Yup, I am more expensive than a straight-from-undergrad PhD student, and clinician scientists are inevitably more expensive than pure scientists.  Are we really worth it, with our divided loyalties and dual demands on our attention?

I'd counter that with some of the following arguments.  I'm one of the few people in my building who have worked at the oncological coal face and know how it feels to sit down with another human being and tell them there are no options left.  I know what it means for someone to have anti-cancer treatment and what people endure to get better, or get more time.  On a more practical level, being a doctor means being organised, comfortable with stress and at ease with long hours (and recognise when it's time to stop).  Hopefully it means being able to plan and manage your time, and function independently.  I'm used to swizzling clinical jobs every few months and starting again, again, with new skills/routines/colleagues, which is useful when you have endless new protocols with which to engage in the lab. Obviously these are skills all PhD students hope to hone during our studies but it's a good place to start.  And importantly, at the other end, we are able to be the connection between scientific innovation and those who might benefit from it: patients.  So we may seem costly, but I'd say it's potentially a pretty good package deal. 

The real reason, for me, is passion for change.  Having a difficult conversation with a patient about limited, or indeed no, treatment options, or treatment not working, is part of the role of an oncologist.  But obviously it sucks.  I think I'm quite good at breaking bad news.  However, it's a seriously weird thing to feel like you're good at, and obviously a gut-wrenching one. It feels deeply unsatisfying to accept the status quo, especially when even in my short clinical lifetime there has been such innovation and progress. I'm keen to be a driver of that change. 

So yes it's a bit weird doing a PhD as an 'older person' (ha! As if 31 is old) with a mortgage, a wedding ring and a second career on the go, but it's also lovely to have the perspective of where a PhD sits in the rest of your life.  I'm under no illusions that this will be stressful, but nothing is as stressful as clinical stress, with real human lives at stake.  I also think back to the anxious twenty-something who felt she had to be everywhere (work and social) all the time, whereas now I have let that guilt slide a little and just trust in myself - I work hard, which is just as well, because science is hard, but it's not everything.  I'm writing this now also to hold onto these important truths when all my experiments start to fail and I enter the Dark Zone of a PhD...!

One thing I will say - I envy the energy and vivacity of my fellow PhD students.  I'm sure that the seven years since I graduated from medical school and the many night shifts, long shifts and weekends of work that have happened since then have somewhat worn me down.  That's certainly something I will latch onto, if they'll let me :)


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