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As we near the close of speciality applications, we’re interviewing key members in each speciality to help those who are still undecided! Today, we bring you the views of Professor Neena Modi, she balances her time as a Professor and Honorary Clinician of Neonatal Medicine with her duties as the Chair of the Royal College of Paediatrics and Child Health.
We spoke to her about what it takes for a career in Paediatrics, the challenges facing it at the minute, and how she expects the training to be in the coming years.
Thank you for taking the time to speak to me today, could you tell me a little bit about how you became the president RCPCH?
It wasn’t well thought through. It was one of these chances that life sometimes throws upon you. The process for the RCPCH for the selection of president is a membership ballot. The various Royal Colleges have different ways in which they elect their president, but the way in which the RCPCH elects their president involves candidates first being nominated and seconded, and agreeing to have their name put forward and then there is a ballot of the entire membership.
I didn’t go into medicine thinking I wanted to have a professional role within the RCPCH. In fact, I had never been involved in the RCPCH in any great capacity. You know I’d done bits and pieces of work for them, for example as RCPCH representative as neonatal adviser on the BNF for Children. I hadn’t had any former officer role at all until it was suggested that I might want to think about putting for the role of vice president for science and research.
That was not something that had occurred to me, but when it was put to me by a previous president, I thought well actually I do have things I’d like to achieve from a national perspective, so maybe I should go for it.
Having done that, I thought, well, actually I know how the RCPCH works and there are more things I would like to achieve as president, so I put my name forward for that.
That’s great. It’s nice that service improvement became a passion very much of yours after getting into the Royal College. Am I correct in saying, that you have been the president for a few years now?
This is my third year now.
What’s been your biggest achievement so far?
Well, I’m very, very pleased that we’ve been able to do various things to strengthen the clinical research base for paediatrics.
Okay and what would you say has been the most challenging moment in those years, as well for you in your career?
The political climate for the NHS has been the most challenging issue so far.
What about your career as a whole, what’s been sort of your biggest challenge?
I think the most challenging time was actually creating an academic career for myself, at a time when there was no pre-assigned or established career pathway for clinical academics.
And is that something that you would say particularly changed over the years?
Oh, it’s changed enormously! There is a clear academic career pathway now, but when I was training there was absolutely nothing and everyone of my generation would say exactly the same thing that as clinical academics, we had to carve our own path.
Would you say that’s the biggest difference in paediatric training compared to when you were training and how the training pathways are now?
Compared to when I was training and how it is now; well I’ve already spoken about academic training, there was no pathway but then there is a pathway now. Then the clinical training pathway, there was good and bad, and there is good and bad now.
The good and bad previously was that there were fewer trainees; there was a greater sense of camaraderie and there was much more opportunity for learning and gaining experience on the job. There was a huge sense of collegiality. The bad thing was that the hours were atrociously long, and there was very little in the way of formal training. That is what definitely was bad. But now in 2017, this is a lot of formal training, hours are regulated and those are very good things.
What have we lost? I think the camaraderie; a lot of young people have lost the ability to seek out direction for themselves and there is a feeling that you have to do things only in the prescribed way.
Yeah. Would you say that that’s thinking outside the box?
Well, many of my trainees who’ve come through with me as young researchers have worried that they didn’t get a job and feel really despondent. I say to them well actually, consider yourself lucky because now you can directly try to find the kind of job you want – so there is always an opportunity in what might seem to be a disadvantage.
Definitely one door closes, another opens.
How do you balance your time clinically with your responsibilities as president? Do you still have clinical practice whilst you’re serving as the president?
I didn’t relinquish my clinical responsibilities when I became president, but there are various clichés that say that if you want to do something, you find the time to do it.
Another thing that I noticed in The BMJ is that there has been a lot of calls for the increase in training numbers to meet the demand. How do you make the paediatrics attractive to trainees to fill the gaps?
Well, let me throw the question back at you, should we be making it attractive, isn’t it an attractive specialty already?
Arguably it will find the biggest people interested in it, they will go to pediatrics.
That’s a reasonable hypothesis, isn’t it? People will seek out the areas that are a best fit for them. For example if you don’t want to be a psychiatrist then you don’t choose psychiatry. If you do want to be a psychiatrist you do become a psychiatrist. We want to attract people who are really thrilled by all of what paediatrics has to offer, and it has so much.
And I would say once again to all trainees, the future is yours. You’re the ones who see what’s not working. It’s for you to put forward solutions, and for you to say, well, actually we can do this another way, we can do this better. Why do you think we got to a position where we weren’t all working 96 hour weeks? It was because of a lot of advocacy on a lot of peoples’ parts. So, I would really love to see trainees of today take leadership seriously in terms of saying this is how we want things to be in the future.
I can look back on my career and say, yes, my generation had these ridiculous hours, we were working one in one or one in two rotas, we weren’t getting formal training, but gosh were we getting a lot of experience. And not one of my contemporaries has dropped out of medicine.
Although there was a lot of bad, there was also a lot of good, so I would say to trainees today take the things that are good now, but look forward, and ask yourself, where would you like to see things go when you’re many years into your career?
It’s an interesting one definitely. What do you think is the most important apart from a lot of paediatrics and sort of – what do you think is the most important trait that a junior doctor should have when it comes to working in the field?
Well, I think they should be thick skinned, because life is tough and things don’t go according to plan. You know your patients don’t always get better. If you have an intensive care specialty, then your patients often die. You’ve got to be compassionate but tough, otherwise it’s not for you. Also, recognise that the way in which we practice medicine in this country, which is a great way, is that we work in teams.
The NHS is about teamwork. It’s about multi-professional teamwork. And this is why I wish we could bring back that wonderful sense of really, really, really strong team support – the camaraderie.
But arguably didn’t that stem from working long hours together…
Of course it did, but you know there are lots of little things that might help now, so for example I think that we shouldn’t all be fixated on the precise number of hours. Certainly no one wants to go back to the bad old days, but quite frankly whether you work 40 hours or 41 hours, is neither here nor there.
So we have to reach a better way forward than turning ourselves into workers who clock in and clock out by the hour. A simple thing such as having a staff mess, where you can talk shop with your colleagues, whether they’re nursing colleagues, allied health colleagues or doctors. I’m surprised that chief executives up and down the country haven’t brought back staff messes. Maybe they’re missing a trick.
I just wanted to ask you one last question if that’s okay, what would be your message FY2s who are currently applying and considering paediatrics or may they are 50:50, what will be your message to them?
My message to them is if you want to be a paediatrician, and I absolutely agree that paediatrics is one of the great professions in the world, don’t worry about all the knocks and blows that come your way, but do it for the love of the job. That doesn’t mean tolerate bad things and bad conditions, but try and make them better. And lateral thinking and reflecting on how you would like your profession to be in 10, 15, 20 years down the line, is a positive way to approach your career.
Definitely. I think it’s a powerful message to them. Thank you very much for your time!
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