Dr Barbara Lachana Onen, acute/general internal medicine consultant, talks about her journey from war-torn Uganda to a medical career in the UK.
I was born in Uganda during a time of civil unrest. The day I was born, a bomb hit the maternity unit and the large glass window shattered onto all the newborn babies. Thankfully, no baby was significantly harmed or killed that night. My parents left the country for Kenya, then later Botswana.
My father, Dr Churchill Lukwiya Onen, was the first university educated medical doctor in our family. I am so proud to mention that he was also the first Black African to give the prestigious Lilly lecture at the Royal College of Physicians (RCP). Thus, my parents always strongly believed in education. It is only through their hard work and determination that I was able to attend medical school at the University of Leeds, with the added privilege of a partial scholarship.
I finished my medical school training and moved to Oxford for internship at the John Radcliffe Hospital, pursuing core medical training after foundation year training. I found membership of the RCP (MRCP) a very difficult life period, and I struggled with my exams. My maternal great-grandmother, in the village in Uganda, had heard how much I was struggling. In my culture, it is the ultimate honour when an old woman cuts her precious grey hair and hands it to you with the intention of bestowing good luck and wisdom. My great-grandmother may not have been formally educated but she had the foresight and wisdom to invest her fortunes in my education. This was an incredible blessing for me and the day that I passed my exam, you can only but imagine the ululation and celebration in my village, back home in Mucwini.
Overcoming the hurdle of and going through the process of preparation for MRCP renewed an incredible self-belief that I could overcome very many things. This was put to the test during my acute and general internal medicine specialty training years when I wanted to tailor my training to align more with my values, by not subscribing to the traditional predefined pathways.
After my specialty training (ST) year 3, I obtained a place at the London School of Hygiene and Tropical Medicine to do a Master’s in Tropical Medicine and International Health, looking at the feasibility of ambulatory care in low- and middle-income countries. This was initially met with resistance that it was not the norm for trainees to take an out of programme (OOP) year after ST3.
A couple of years later, following ST6, I obtained a place on the coveted RCP Chief Registrar (CR) Programme at the John Radcliffe Hospital in Oxford. Again, this was met with resistance as it was a second OOP year, in a place outside my deanery, in my final year of specialty training and with ambition of bringing my certificate of completion of training (CCT) date forward by three months to CCT at the end of the CR year. This was not the traditional training route.
With ongoing persistence, I am humbled to say that I was given the opportunity to pursue my master’s project after my ST3 year and this won the Oxford Sir Richard Peto prize. I had the opportunity to be a part of the incredible RCP Chief Registrar Programme during my final training year, working on quality improvement and leadership to improve patient care at one of the biggest ambulatory care units in the country, in Oxford. I presented at national and international conferences, won a plethora of prizes, worked with incredible people and learnt an inordinate amount regarding leadership and quality improvement.
This put me in good stead to achieve CCT at the end of my CR/ST7 year, obtain a substantive consultant post, and have the opportunity to take part in the incredible and supportive RCP Emerging Women Leaders Programme, which I’ll start in October. This is a programme designed specifically to address the underrepresentation of female consultants in leadership roles within the RCP and the wider medical profession.
All these experiences served to instil endurance, perseverance and resilience. A famous African proverb cites that ‘it takes a village to raise a child’. I think it also takes a village to raise good doctors. It is our family (sometimes in my case, sprinkled with great grandmother’s hair), friends, mentors, good working relationships and windows of opportunity through our networks (be that through the RCP or the wider medical community) that help propel us to success. It takes a bit of courage to do some of the hard things we encounter; and sometimes to be able to deal gracefully with disappointment. Disappointment is an inevitable occurrence within the sphere of medicine but should not hinder us from continuing to pursue our dreams and aspirations for continued improvement of patient care and wellbeing.