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Old friends, new skills | time to fill in your census forms

In this month's blog, Dr Hilary Williams, RCP vice president for Wales reflects on another successful Cardiff Update in medicine, why we should celebrate diversity of career pathways and why everyone deserves some time out to learn new skills.

Sunshine in Cardiff

It did feel as though, ever so briefly, the sun shone above us in Cardiff earlier this month, as over 200 physicians met for our sold-out 2023 Update to celebrate what’s brilliant about medicine and why, for many of us, medicine is more than a career. The feedback has been great:

‘The speakers all loved their topics, the passion came across. Great programme … a good day with great lectures and able speakers.’

I continue to be amazed by the knowledge and commitment of our doctors. It was fantastic to see people taking the time to update their knowledge and build their skills, and I always come away from the Update reminded of why I love being a doctor. Even as a cancer specialist, I learned something from every session, and came away thinking about what clinical care should look like now and in the future. After all, a broad range of generalist skills, built up during years of training and kept updated through CPD, is surely the backbone of medical care. Taking the time to talk to our patients and their families, and to listen carefully to them, gets us a very long way – and perhaps even makes us think in a more targeted way about tests and onward referrals.

All of which means I return, once again, to the importance of giving the NHS workforce enough time to care. Experienced clinicians make better decisions. Studying in Sheffield, I still remember how Professor Weetman could always catch us out with something we had missed, firmly but kindly reminding us to always take a social history to start the discharge plan. The Update hosted a very timely presentation from Dr Alexander Royston, the Turner-Warwick lecturer from southwest England, who reminded us how critical the post-take ward round is for teaching and learning.

Diversity is what makes us great

The night before our Update, we were joined by the RCP president Dr Sarah Clarke, RCP registrar Professor Cathryn Edwards and RCP SAS lead Dr Jamie Read for a celebration of our specialty and specialist (SAS) colleagues. We welcomed delegates from Hywel Dda, Velindre, Cardiff and Vale and Aneurin Bevan health boards, and we hope to visit Betsi for a repeat event next year.

Hosted at the Marriott, our evening event was a wonderful opportunity to recognise our SAS colleagues and their achievements: our speakers – Dr Georgina Forbes, chair of the Faculty of Sexual and Reproductive Health in Wales and Dr Frauke Pelz, SAS tutor for Cardiff and Vale University Health Board – talked passionately about leadership, fulfillment and finding happiness in following a non-traditional career path in medicine.

Supporting our SAS doctors has been a focus for the RCP in Wales for some years now. Not everyone wants to follow the training pathway. For a variety of reasons, a growing number of our colleagues are choosing to take a different route. Some are international medical graduates (IMGs), others take the decision to improve their work–life balance, because of caring responsibilities, or because they want to have more control over where they live, how they work or what they learn.

There should be no one-size-fits-all approach in medicine. We need to celebrate diversity of career pathway, skillset, and background, especially among IMGs, who are an increasingly important part of the medical workforce, driving the growth in licensed doctors joining the UK medical profession. Medicine has always been good at putting people in boxes by telling us that there is only one way to the top – but everyone’s journey is different and should be taken at their own pace. I was particularly humbled by the very honest and open discussion led by Dr Frauke Pelz, who told us about the shock of arriving in the UK as an East German refugee in the 1980s. She left her family behind, not knowing if she would ever see them again. The loneliness of arriving in a new country with a very different culture can be very isolating and we must all get better at reaching out to new colleagues and asking them about their stories.

There is a role for all of us in medicine – not everybody wants to take the same route and we need to find the space to help all individuals grow and develop their special interests. The RCP is hoping to work with other royal colleges and HEIW in the new year to expand our SAS network with other events and maybe even a buddy system for new arrivals – watch this space.

Time to care, time to train

Finally, for all my consultant and SAS colleagues out there, I want to mention an important email that landed in your inbox last week: an invitation to complete our 2023 census of UK consultant and SAS physicians. Please take the time to fill this in. It provides us with invaluable information that we can use to influence government and the NHS on your behalf. Our 2022 results were published at the Update earlier this month in our new workforce briefing, More than a career, which highlighted some alarming numbers: in Wales, only 33% of consultant physicians feel in control of their workload, while 74% feel that rota gaps are having a negative impact on patient care.

In our media messages, we warned that 47% of consultant physicians in Wales are expected to reach their intended retirement age within the next decade, which is likely to remove more than 400 doctors from the NHS Wales medical workforce by 2032. Without enough doctors in training staying in Wales to replace them, staffing shortages will continue to worsen, leading to even tougher working conditions and a growing recruitment and retention crisis.

Massive thanks to Dr Andrew Lansdown, RCP regional adviser for south Wales central, and Dr Olwen Williams, my predecessor as RCP vice president for Wales, who joined me in speaking to the BBC, ITV, S4C, the BMJ and the Western Mail about why doctors love what we do and why we want to deliver good care to the people of Wales – ultimately, let’s face it, the solution is more people, more time and more resource in the system.

Well, the rain has started lashing the windows of my office again as I write this, so it’s time to sign off. As ever, thank you for everything that you do. The toll on individual doctors and our patients can feel insurmountable at times, and the RCP team in Wales will continue to advocate loudly for you. After all, we need time to care and time to train.

Dr Hilary Williams
RCP vice president for Wales
Consultant medical oncologist