The Food Medic - S4 E10: Life As A Junior Doctor - Instagram Vs Reality

Episode Date: July 24, 2020

On the season finale, Hazel is Joined by Dr Amile Inusa. Amile is a Junior Doctor and co-host of the podcast, Life After The Letters. They chat about life as junior doctor - and to what to expect for all the new doctors starting in August - taking less conventional routes in training, juggling side projects alongside medicine, supporting your mental health working in healthcare, and racism in the NHS.DID YOU LOVE THIS SEASON? PLEASE LET US KNOW BY LEAVING A REVIEW AND 5 STAR RATING - SEE YOU AGAIN NEXT TIME! Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Dr. Hazel Wallace. I'm a medical doctor, a registered associate nutritionist, an author and founder of The Food Medic. So this is our final episode of season four. I hope you guys enjoyed it as much as I did. I know it was slightly different than before in terms of the recording and also the content but I think for me this may have been my favorite season so far and I think we're going out on a big hit with this final guest. So today I have Amelie joining me and she is a junior doctor and co-host of the podcast Life After the Letters. She studied medicine at the University of Manchester and also completed a master's degree there in healthcare ethics and law. Having taken two years out of training to do

local work and explore other interests, Amelie will be resuming training in paediatrics from September. Her interests lie strongly in health inequalities, culture change and communications. Myself and Emily met a couple of years ago through a blogging job and we instantly connected and stayed in touch. And I featured on her podcast also. So on this episode, we chat about life as a junior doctor, what to expect for all our new doctors starting in August, taking less conventional routes in training, juggling side projects along medicine, supporting your mental health and your colleagues and also racism in the NHS. I absolutely loved this episode it just felt like I was catching up with an old friend but we also cover some

really important topics so I hope you enjoyed it as much as I did recording it. So I guess just to start off it would be really lovely for you to kind of in your own words explain briefly who you are, what you do. Yeah so I graduated from Manchester Med School in 2016 which feels feels so long ago, but actually it was only four years ago. So since I graduated, I came to work in North London. No, I worked in Basildon first and then I worked in North London. And then for the past two years, I've just been locuming essentially. And also like trying my hand at lots and lots of different things. So yeah, it's been a fun two

years like not being in training and I'm going back into training I'm so sad about it but I'll be starting doing paediatrics from September so I'm also looking forward to some of that structure back yeah I know absolutely um it's interesting how our paths are like pretty similar because I also graduated 2016 and kind of like have floated in and out of full-time training and plan to go into full-time training next year but like one of the reasons I really wanted to get you on here is first of all it's like long overdue and second of all like there's so many people now starting their first jobs as doctors this August and as we've been through that, we're still junior

doctors. I think it'd be really nice to kind of like talk about expectation versus reality, coming out of med school and going into the first year as a doctor. How did you find it? And what did you think it was going to be like? Well, do you know what I think is mad? I think it's so mad that loads of the people who are going to be starting in August have already worked during Covid periods so I think that's absolutely just mad that they've been working for so long didn't get to go on their electives and going straight into a job which actually you know when we started it would be so scary like that Black Wednesday before that Black Wednesday came about you'd be like oh my gosh we're going to start our work on our new jobs. And I'm sure they've gone through similar feelings already.

But I just remember starting and being so excited. And maybe that was because I absolutely loved medical school. So like starting as a F1 junior doctor, I was kind of excited to meet new people, start a new job, a proper job. I had like ups and downs, mainly ups. But yeah, I really enjoyed my time doing training. Yeah, that's a really important point that there will be loads of medical students who have already done some work. I have to say like, the medical students that were working with us probably didn't get as much hands on experience as they would have liked. Obviously, we're trying to like protect them as much as possible. So they were helping us like a lot of the administrative staff and calling up to like check patients after we discharged them and things

like that but I think they were really nervous when they were first recruited or redeployed and then it's it's interesting how within like two weeks they've kind of like slotted into the team and they know where they're going oh that's good yeah and did you feel like you could support them whilst they were there yeah like I mean they were like can you teach me everything you can while we're here and I was like I can try but like obviously the situation was so different and I was like we are all learning what COVID is and how to manage these patients so we're literally like the consultants are on the same level as you at this point but they were also like can you teach me how to do a discharge letter and I think that's the the kind of things that you don't learn at med school is the stuff that you have to do on a day-to-day basis that isn't very exciting but it's really important and it will make your day

go a lot faster and also means that you're not leaving late if you grasp it early like writing discharge letters learning how to like writing the notes effectively efficiently like shorthand that kind of stuff being nice to people and knowing who to chat to like those kind of things what kind of tips did you pick up in your first year like that you would love to pass on to someone? Well, when I like look back, because also I've done loads of jobs, even during like my low coming time. So I think like something that's really, really important is just to ask questions and try and ask questions early. Because what you'll find is that you've got like so much to do, particularly when you're in like your F1, your F2 years.

But particularly F1, you've got so many things to do and you're doing them all for the first time so it's going to take you longer anyway but what you almost forget sometimes is that you do have seniors who are there to help you and you also do have like other F1 colleagues who have probably done the same thing maybe like last week or two weeks ago and they know how to explain it to you in a really easy way so I think just asking questions is something that you're going to have to like kind of like get over it and just do because there's almost like no space for ego when you're starting out in your first job because essentially all you really want to do is get your jobs done well and also get them done with like the support of the team because if you kind of like take on that responsibility on your own you're no longer protected so I think it's also important just to ask questions also as a

courtesy for yourself no absolutely I think because you have this new responsibility and you've got your own patients you kind of want to be really step up and things like that but you are it like literally you've just started the job and there's no silly questions and you have to think about you know the gravity of the situation. So always ask for help when you need it. And, and not just your doctor colleagues, but the other members who are on the ward. There's so many really, really useful teams. Oh, absolutely. And they've been there for years, most of them, like nurses are there for years, pharmacists are there for years, it's just doctors who tend to like skip teams so they might not even know the environment as well as all the other allied professionals yeah absolutely I've noticed

as well that with a lot of the work that you've been doing lately you're doing night shifts a lot which I really struggle with I'm like oh my god if you're doing that voluntarily like because I had to go back to nights for COVID and I was like struggling oh my gosh what is this life do you do you prefer nights or the funny thing is I don't prefer nights but what I do prefer is like having money so like if I if I'm doing nights I also know that I'm getting paid more and I know that I can do four nights instead of like five days so like just for me to like find some time for myself um I've been doing a lot more nights yeah that's so true like I actually you know I didn't really mind nights this time

and I found I was on kind of like the bulk of my nights during our first heat wave and so like I would come home sleep for like maybe three hours and then go into my garden and just kind of like nap and tan and I was like this is a good life you know honestly the weather in this period has just been amazing compared to like any other like time of year that I felt we've been so lucky with the weather it's so so true but um with night shifts do you have any tips for kind of surviving night shifts for any of the doctors starting in August? Well I feel like I've got my routine down really well but I think what everyone always struggles with is always that first

night so I'm not even talking about people with who have children because I don't know how they cope with like anything just generally but like people like whenever you're starting out your like first run of nights I think the first day is really hard to adjust to. And you probably have done your normal day the day before, whether that's at work or at home. And then what I do now is either I stay up really, really late the night before. And then I try and wake up relatively early the next morning, just so I can like be tired enough to try and nap before work. But like what is rubbish is if I'm like if I just can't get to sleep before work so there might be times when I literally just stay up the entire 24-hour period which isn't like recommended but it's just something that I find myself either sleeping

before or just like staying up but it's funny how much adrenaline and like food and chat keeps you up and going it's so true I'm the same with and chat keeps you up and going. It's so true. I'm the same with you. And I think everyone's the same. The first night, like it's so hit or miss whether you're going to nap in the day. It's like, I just have to get through this night. And then the next day. Especially if it's hot or like there's a mega sun outside.

Yeah, I know. Or you have like, you know, young children outside and things like that. And also I do agree like having some people don't eat at all during a night shift and then I think other people like just don't stop eating and I think I'm somewhere in between like I need like I need food to keep me going yeah uh even on a day shift I need food keeping me going but I need to keep me awake like you need to like chew on something absolutely but I also feel like you know the people who don't eat on nights I feel like they're the ones who just

aren't that prepared if that makes sense so I feel like they're the probably the same people who probably like buy their lunch at work and stuff so that's so true not to shame them but yeah like they're unprepared they're less efficient than we are but um so we met like five years ago when we were both doing bloggery kind of stuff or influencing and we both still have our fingers in many pies um so you co-host a podcast you have your instagram account or I guess you've got two Instagram accounts because you run a book club as well oh yes yes yes I do yeah and now you're obviously going back into training and paediatrics so how do you manage to jug it all in addition to medicine and do you think it's important to have these non-medical interests well you know when you even like go back to like when we even like first even started applying to

medical school when we're all in our first year of med school we're all like very well-rounded we've all probably like been into basing society or like done like a run club or like one of the school athletes medics come in so well-rounded but then there's something at the end which almost you kind of just like get pushed to the end where you're just thinking about medicine and just studying and passing your exams and I think that's like very like natural if you like allow it to happen and I think like for you and me maybe we were like doing like a lot of fitness stuff at university so that also allowed us to like have a slightly different outlet but I think what's really really important is for people just to have something

that they can hold on to and the reason I say that also is because I think sometimes when you just do like your studies and you just focus on medicine only I think it can almost like just become your identity and then when as soon as like one thing like goes wrong in the workplace it typically just in my own like experience of anecdotes from my friends it typically tends to be the people who have put their entire identities into the work who get really like have a crisis of identity when something goes wrong and things are bound to go wrong like all the time and like mistakes you're going to make but I think what's important is like as long as you're willing to do the work and as long as you like have good intentions that's like probably like the most important thing in medicine so I think it's really important just to

remember who you are outside of your job as well but that's just something I would also say to everyone. Yeah and I think in the first few years of being a doctor actually throughout your career you're constantly like thinking about how to improve your portfolio and like when's the next exam or the next application and that can be really draining and then you're constantly like oh I need to stay late and do this audit or you need to be doing all these other things and I think it's changing but I don't think medicine recognizes that there's other ways that people can show kind of dedication to kind of quality improvement and personal improvement that's not just kind of doing tick box exercises no absolutely and I think you're right and that is changing like there is some programs so I'm also part of

the clinical entrepreneur program so like my aim when I finished my f2 year was to take two years out just to like one make some money but also to to start a media company. So I think there are programs like the clinical entrepreneur program that allows medics who are a bit more like interested in like business or like innovative ideas to continue in medicine whilst also like nurturing those parts of them. Yeah. And I definitely feel like maybe it's just because of, you know, there's going to be some kind of bias in terms of the people who follow my camp. But a lot of the medical students or even like doctors, even doctors who are like GPs now, are interested in kind of finding ways

that they can kind of expand their other interests and work alongside medicine. And, you know, the BMA, heaven is, they're, you know, going to be supporting like flexible training moving forward and things like that, which is already good. But I don't know, I still feel, and I don't know if you agree, that there's like a stigma attached to being a doctor with a slightly convoluted route in medicine.

Or if you've taken time out to loco I'm like they're like oh another year out kind of thing and you're like no like that's so shady like you know whenever I start in a new A&E everyone's like okay cool so what's what are you up to what are you doing what stage are you I'm like so I'm an F4 they're like oh F4 never heard of that is that a new thing are you gonna be an F10 I'm like oh my gosh I heard this joke yesterday so true it's like literally that is like the exact quote to what someone said to me this week another doctor and I was like I mean what do you want me to call it exactly and it's like at that moment you're like oh my gosh I start proving myself should I start listing off all the things I've done with my time I'm like I'm not just being lazy in my spare time and that's like obviously allowed and important to like have rest but I

think there definitely is a stigma and I'm sure you've seen that yeah I know absolutely I think also like a lot of the doctors I've worked with in the last like couple of weeks like they didn't know me initially and they were kind of like weren't really sure and then we kind of opened up that conversation a bit more as we got as we got into it they were like oh like I didn't realize like you know you've done so much and blah blah blah and I guess like it's very easy to just like judge people but if I turned around and said like hey I had a baby or I had to care for someone no one would be judging me like they wouldn't be like oh like but if you've got like a side hustle it's kind of like oh well you know are you really committed to medicine yeah absolutely and especially for you as someone

who has like a public profile I think people also have like preconceptions about who you are because all they get to see is like an image and a book here and a podcast there and it to some people those activities look frivolous even though I understand like the amount of work you've put in or people like you've put into to all of that. But hopefully I see things changing. And I think I definitely see things changing with the generation that comes after us. Yeah, I agree. I think it will be like a slow shift. But like from, you know, even in the last four years, it's definitely moved in the right direction but speaking of doing you know all of these things and we're both obviously very busy burnout is something that like I've become more aware of and like obviously have been aware of but from a personal kind of point of view I

think I've definitely experienced it especially I've just finished my three, four months on COVID and taken some time out. And I just, after a week, I was like, there's nothing left in the tank. You know, I'm completely burnt the candle at both ends. I was working full time and then trying to keep the food medical in. And I don't really feel like there's a huge amount of support. It's something that we definitely talk about more as doctors. And if you open the BMJ like they you know talk about it more but in terms of physical support there's not much there I wonder

like how do you support your own mental health as a doctor and do you think do you have any ideas on how we could support our colleagues? I think like things have I've become more like cognizant of how to like self-care and what I mean by self-care is not just like, like the candles and like the reading books and the time alone, but it's also just having boundaries at work. So I like, I say this all the time, but I think setting boundaries for yourself is really, really important. Because like when you start your F1 or your F2 years, you essentially are pushed into this environment where you've got loads and loads of jobs to get done there's a possibility that you might not get everything done in the one day but your natural human instinct is just to try and get everything done because you've been like brought through medical school where you're like always overachieve and you also want people to look at you as a competent doctor particularly when you're first starting out you're like early 20s typically and you're starting out on awards you almost assume that people are thinking oh who's this like baby doctor who's just starting and I think so often you're just like trying to prove yourself and you're trying to get so much

done but I think it's important just to be cognizant of the fact that actually it's important to get so and so tasks done and like you can leave the rest till tomorrow and also like making sure that you take your time out to go and have a break like now when I was in my f1 there'll be loads of times I just wouldn't go and have like lunch just because I thought oh I'm gonna keep working working working I'll take my break at like three o'clock but then by the time three o'clock rolls over I'm like oh yeah I finish in two hours I'll go home and then I like raid the fridge when I go home now I will be the first person to like leave the war

be like hey guys I'm just going for a coffee break even if no one else wants to come with me but I think it's just important to like give yourself 15 minutes to decompress and then like come back to work yeah no absolutely I think and I feel like when I in my f1 year like I remember I would like eat my lunch on the tube at 7 p.m and I was like this is ludicrous like this is such a sad life and I was like oh my god I don't think I'm gonna survive my life as a doctor and then I realized like I literally do not have to do you know like a discharge letter can wait until tomorrow that like this patient is not going home for four more days and you're like oh my god but I feel I feel you on that because I love getting my discharge letters done early and I almost feel like accomplished not even for other people but for myself

but I think it's important to recognize like when your behaviors are starting to damage the way that you like show up at work or the way that you feel yeah and I think creating boundaries is really important and when you're outside of the hospital trying to switch off from the hospital and if that's spending time with people who are like non-medics just so the chat is different because anytime I'm with a doctor I will just talk about medicine even if I try not to it's just natural isn't it like it's just and especially this COVID time I don't know if you're speaking to your other like doctor friends during this time but like all we were talking about was I mean all anyone was talking about was was covid yeah yeah that was what I was gonna say

speaking of which I was gonna ask um kind of your reflections of COVID and like how you found it as a doctor. So I always remember my like first ever COVID case. So it was like, I think it was a Wednesday before. This is like a Wednesday before lockdown. And there were like whispers of a lockdown being imminent and like whispers of, oh, you know what they're doing in Spain and Italy. They might like lock us down. But no, England's not going to to do that that's all we were talking about the time and everyone was like fairly blasé just like as Brits usually are we were all just very blasé about everything and then one of the nurses like came up to me and she was like oh Amelie we have a suspected

corona you know how everyone just says it like it's corona so you have we have a suspected corona in the ambulance and should we get them to come out and this is when we were in the pediatric department and there was like just no we hadn't really dealt with patients with coronavirus and also with a child a well child is a child that's like happy and smiling and eating and drinking and playing and and laughs and giggles so I was like what's the child like blah blah and all I heard was like how happy and like bubbly they were. So I was like, leave them in the ambulance. I'm going to come into the ambulance because if they come into hospital, we'd have to like have disinfected the entire children's A&E.

So I strolled out and then went into the ambulance with my full, full PPE. And that was the first time I'd like put on like the whole full PPE. And then what I really struggled with was the fact that I was wearing like a mask you know there's so much that I rely on as a doctor in terms of people knowing that I'm a kind person and that I'm like laughing and I'm smiling and that I'm connecting with them but all they can literally would have been able to see is my eyes and I wouldn't even be able to like lay my hand on the mum who was like hysterically crying because her husband had been in a high-risk area just like the two

days before and he'd been unwell and then when she started noticing that her young child had a temperature that's when she became really worried but as soon as I saw the child I was able to like reassure mum obviously do all the necessary observations and stuff and then we sent them back in the ambulance home and they took them home so I think from then a couple of days later they decided to like lock everything down and that's when I noticed everything like changing in hospital the types of patients we were seeing were different so I work in A&E normally so even we were seeing a lot more patients with like mental health conditions and like I just saw a lot of people who had attempted suicide and also were like taking overdoses I just happened to see a lot

more in the first like two or so weeks after COVID was announced and it just shows you how many vulnerable people that we have in our society so all it takes is like the anticipation of the world like shutting down for people to realize oh my gosh I'm no longer going to have a job I'm no longer going to be able to like couch surf between my friends houses the bar restaurant industry which people are paid like cash in hand they won't have any like funds or any recourse so everyone was like devastated I remember and that that was also the two weeks when the government hadn't announced they were could furlough people and like furloughing wasn't even in our like everyday language so yeah it's interesting how much it like knocked on into A&E yeah I didn't really think about that like um I didn't see those cases because the ward that I

was on used to be the normal gastro ward and so within the overall weekend we had transformed it into like COVID confirmed on one side and COVID suspected on the other side. And, you know, that was all we were seeing. And it was just like... I was going mad to have only seen unwell people. Yeah, I mean, some of them were like relatively well. So we were like a low dependency ward. So we weren't doing like ventilation or anything. We weren't even doing CPAP.

It was just oxygen therapy and then everything else. And if people required escalation, they'd go to HDU or ITU. So there was a lot of palliation going on, which I found tough. I mean, I think palliative care is amazing and so amazing. And during this time, the support that they gave gave us like they were coming on the wards all the time so I don't think I would have got through it if they weren't there all the time but just kind of doing it every day like because I just come from a nutrition job where like it was very rare to if at all to palliate someone and so we were doing it then like three or four times a day uh like me alone and that was just my patients and so I think that's what I found really weird but because we were so busy I didn't

really think about it like I just kind of got on with it and I mean I think how people picture it to be in the hospitals they think it's going to be a war zone and and luckily well I can speak on behalf of my hospital it wasn't like that it was actually really well organized yeah and we had we had everything we needed sometimes things were a bit tight and short but there was no time where I felt like I was really unsafe or my patients were unsafe and that's what I'm really grateful for but what was amazing was to just see how quickly the whole hospital transformed into this infection control thing it's absolutely mad isn't it I think what's really like amazing about that is that um it just shows how much we're there to like care for the

people who are like in front of us and like when there doesn't seem to be enough like leeway in the system we will figure out a way to make it happen so I thought that was so cool to see in all these hospitals and that's when leadership really showed yeah yeah it'll be interesting to see where we'll be at like coming out of this you know I think there'll be a long time before we come back to like normality and I don't know about you but we're still like we do our like MDTs remotely and everything still but like it's interesting how you can do that like it's like you know like do we really all need to be exactly in the same room or wasting our time to like get to those places when we could just do it online like absolutely can I ask you a question did you find that people were more like compassionate as a result in terms of like doctors and just the way

teams are working yeah definitely I mean the consultants were really present on the ward they made sure that they did twice daily ward rounds which is unheard of and I think they were also like really worried or very aware that these patients who look pretty well from the end of the bed could go off yeah especially like our younger patients who can tolerate like levels of oxygen that we would normally be really worried about and then you're like oh they may have normal oxygen saturations but then their respiratory rate's gone up but they're really comfortable they're speaking in full sentences and then an hour later you're like calling it to you and you're getting outreach and so I think we

were all just like hands on deck and that was really nice and even the kind of senior registrars were just very aware that it was kind of like the juniors who were running the shift but also a bit terrified as well so I think yeah people were definitely more compassionate to one another as well and like you try to come in early for your shift so you can let the night team go off early and I mean you do that anyway but I was a bit more aware of it I feel you I totally agree with that as well did you find that yeah 100% I think in this time it's also been like the hospitals have looked after us and I think we're just not used to like hospitals like providing food for us or kind of making sure that we have like rest areas or making sure that we're taking sufficient breaks if we're doing like 12 hour shifts

so I think what's been amazing is like how much like the humanity of medicine has been allowed to like come back into the system and I just really hope that that's something we take forward even just the fact that we would obviously I think we were just so aware of the fact that we couldn't speak to family members as well face to face so even just like the care and the willingness to pick up the phone contact a family member twice three times a day if needs be I think just doing that is like a really cool thing that I hope we're able to take take into our future practice not just waiting for people to like come into hospital but just trying to figure out ways of like maintaining confidentiality but also allowing people to like

do their normal lives and not have to come to hospital between the hours of nine to five to come and speak to the doctor yeah no I completely agree yeah there's definitely time and space for that and it's not like just because we've got other kind of clinical roles we should be leaving that up to someone else to be doing it's god there's been so much happening in the NHS and I think like you said it will be interesting and I hope that people take it forward um the other kind of major thing that's happened over the last couple of weeks I guess following the murder of George Floyd and Blackout Tuesday and the protests that followed, there's been a greater awareness of systemic racism, not just in our society, but also in our hospitals. And I know that you've spoken about this, kind of the racism that exists in the NHS and you've shared your experiences. And I mean, if you're comfortable to, I'd love to open up that conversation and maybe you can explain some of the posts that you've been sharing and what you found out.

Yeah, absolutely. I think what's interesting is I have been having, I've been having these conversations for years. So when I was in med school, I did the widening participation role for the BMA. I also sat in the Equality Inclusion Committee in my second or third was in med school I did the widening participation role for the BMA and also sat in the equality inclusion committee in like my second or third year of med school and so I think I've always just been aware of these conversations and also I think just me and my like black friends and my brown friends we've all had like very similar experiences like growing up going to school like I even had to change schools to make sure I got like the correct predicted grades even though I pretty much got straight A's and A stars so I had to change sixth form to make sure I could get into university I've had friends who were like put in bottom sets and had to like

work their way up even though they showed like an exemplary record after they like moved schools so it's just like little things like that where it shouldn't ordinarily happen but these experiences happen more and more often with people of color and particularly black people so I think I've just been all well it's not even I think I've always been aware of this and I've always had these conversations I think what's different now and what definitely changed um I think was about six weeks ago was the ability to have these conversations with people who aren't black number one but also just white people as well generally yeah so six weeks ago I was like oh I really want to share something about the NHS because I'm all I'm seeing like on my feed and obviously a lot of my friends are doctors

are people being like oh this Amy Cooper situation's so bad this George Floyd situation's so bad and I'm like but where was everyone back in like 2014 when Black Lives Matter first came about and then I was like hold on what I think is important for us as people who are like sit within industries is to share how our industry also can be complicit in something so for a while I was thinking how to put it out how to put it out and I was like you know what I'm good at Instagram let me just let me create a cute carousel post I'll even make it pink just a little bit comfortable and I'm gonna post it and I'm just gonna like drop it and I'm telling

you Hazel I've never been so nervous to like share something because what you don't want to be seen as is like the angry black woman doctor oh my gosh she's always pulling the race card I'm like I'm not I'm not these are just like facts that too like important to share no I mean you did not come across like that anyway but yeah like but that's that's the real fear that people have do you know what I mean it's almost like it's also the same I'm sure with women who are like groups of men and then you don't want to be like oh you're just doing this because it's like you're being chauvinistic or you're not giving the same opportunities as I'm a woman then you look like that hysterical

crazy woman but I suppose there's a like I say a double disadvantage of being like two minorities so I decided to put out the post and to share the I think it was about five facts that I shared and these are all from reports I've been reading over the years. I think one of them that you included was that there's a pay gap between white male doctors, white female doctors and then black female doctors and why this really stuck in my head is because about a year ago I maybe it was longer I shared a BMJ article on my Instagram about the difference in pay between white male doctors and white female doctors and then you were like yeah but what about black female doctors and I was like whoa I didn't even think about this and then you like sent me

what the statistics were and I was like how did I not like know this and how come this was not acknowledged in this article and and it was just like yeah so when you shared this again I was like yeah it is funny though because like you'd open the BMJ and you're like okay let's see where the biggest discrepancies are and I think obviously as a black woman I'm like oh I wonder how much like black women are getting paid compared to this random group of women that they talk about because I also can see like the higher up that you go in the NHS whether that's our royal colleges or whether that's within trust boards and executive boards you just don't see black people at all like I looked at all of the NHS executive boards in London and I could only see one black woman out of all the members and she was like in a mental health trust so you think oh there's like basically

no black people in like acute boards in London where like 45% of people are non-white in London so so sorry in the BMJ article they only talked about men and women so I was like okay let me have a quick look through their data where does the biggest gaps lie and interestingly to me and there were two big gaps so there was the biggest gap between white women and black women so that 19p difference and then after that the biggest gap was between like south asian men and south asian women so it's just really really interesting to see like which characteristics our society kind of uphold and that's like your proximity to whiteness that's your proximity to maleness and also your proximity to patriarchy.

So we all know that like South Asian men and white men have a bigger, like a closer proximity to like all of those things I just mentioned. So it's really interesting how that plays out in like your pay, the positions that you're able to get. And then obviously this kind of stuff with microaggressions has a knock on effect on how you show up at work and how much you're able to give at work and which opportunities that you're getting and obviously that leads to like um reduced progression yeah and I mean it's not just doctors though it's also patients and one of I think your second one I've just pulled up my

Instagram is a statistic that black women are five times more likely to die in childbirth than white women and I think you know there's a lot of people talking about this now uh Candice Brathwaite has kind of written her book around this um she had a really traumatic time in her childbirth and I guess just like thinking about this, you know, it's not just doctors that it's affected. It's also patients. And how can we do better? And is it just encouraging these conversations? Is it calling out these microaggressions in work? I think, again, going back to all of these doctors who are starting again in August, they should be moving forward with this momentum and encouraging the change and opening up these conversations yeah and I think it's also important for us to for us to like look inwardly because there are so many times where you can be like okay that racist patient who's shouting like

the n-word here shouting the f-word to like gay men here like you know that they're they're doing bad things but what you just don't see so much is okay how is it that i'm seeing that white patients are being attended to quicker why is it that the sickle cell patients are left in pain for longer or we're calling them morphine seeking and why is it that when like the brown women the hijab who's my senior talks i don't listen to her or I question her more than I question like my white male doctor they're showing me things that I think we just need to like look inwardly for and see how we too we can be complicit because it's those like small we call them microaggressions but we only call them micro not because they're small and

insignificant but because they like they occur on a one-to-one level so I think it's really really important that people also just try and figure out how they too are complicit and trying to understand that also allows you to call out more which is important I I'm like oh should we just like cancel everyone but I think there's just like no point like going into like cancel culture because they're all complicit in lots of different ways there are ways as me as a black person also might not um recognize like the excellence of my black doctors as much as I do of my white doctors or I might expect more from black and brown people than I do from like white people in terms of like in positions of authority so I think it's really really important for us to just sit down read these books and then once you start

reading these books and starting understanding how these things are like systemic and how they affect whole groups of people for centuries that's when it becomes a lot more clear um yeah because also I'm also worried about sharing my experiences because what I don't want someone to do is to look at my one or two experiences and say yo that's what every black doctor is going through or them feeling because I like present myself in like a relatively like close to white proximity kind of way that they feel like more comfortable they're like oh no but it's fine because Amelie's succeeding and she's confident and she's doing her all these cool things I want people to like recognize how insidious it is in our society. Yeah, no, absolutely. And also like,

I can imagine it's been exhausting as well. Like, like you said, you were nervous to put that post out, but then everyone's questioning. And I know that that particular post went like wildfire and like was shared everywhere. And then they're probably turning to you to be a spokesperson on the, on behalf of like the NHS and you're like whoa it's like no no no I'm just trying to be cute on Instagram damn Daniel that's what I'm trying to do it's so funny because there were so many people trolling and then I was like who are these weird people trolling so there'll be people who would like create these um like you know the burner accounts where you have like no picture no name no followers

but you're following like hundreds of people so there'd be or you're following no people whatsoever then I had about interactions with five people like this and then they all start giving me all these papers and like talking about things that happen in hospital and I'm like hold on are you guys all doctors and I was like I need to stop engaging with these people so I just like did the whole block and delete thing this is about boundaries again you just got to protect your energy and your space people who like have a point that they want to get across but they also don't want to engage and listen so I'm just like yo ain't nobody got time yeah no I am all for the block and delete and protect that energy yeah you said your piece now

and the funny thing is like I think people don't recognize like as a black person these things are shocking to us as well because we also like oh no but yeah we're nice to people and like other people are nice to us and it's's like, hold on, hold on. If the facts are so this way, it's really important to interrogate why they are this way. So I think it's really important for people just to, like, not feel like they have to come to a conclusion straight away, but just, like, take their time to, like, understand and to learn and hear from experiences. Yeah, I think so, too. Yeah. experiences yeah I think so too yeah um well before we wrap up the pod do you have any final words of wisdom to our doctors out there I think um so this is like maybe for the new people

starting I think it's just really important as you like embark on this career just to like look out for one another and also advocate for one another because I think what's really really difficult is that some people have got jobs that they don't like some people are starting on jobs that they're like a bit scared of so maybe you're starting on like medicine nights or maybe you're starting in surgery and you've heard like scary things about those teams but I think it's really you get so much comfort from like other people who are going through the same thing as you so I think it's really, you get so much comfort from like other people who are going through the same thing as you. So I think it's really important, even those people who don't like satisfy your insider status thing.

So there's this thing in the GMC Refer to Refer report, and they talk about groups of people who have insider status and how these people are less likely to be alienated. So those are people who are like non-white. These are people who might be um have like graduated from the UK medical schools they might like know how to like speak the same language you do or like dress in the same way so you will feel like a natural affinity to those people I think what's really important is all of us as doctors start to like honor like the beauty of like individualness and honor the like the beauty of like different cultures and the people that we work with whether we feel like we can be best friends with them or not and just make sure that everyone else is getting the same opportunities that you're inviting those people out for lunch and I think it's just really really important for us to like consider the ways in which we can allow

other people to feel seen and to feel part of that conversation I can't believe you didn't rehearse that because that was beautiful your brain's amazing in terms of like just how you can like I don't know I feel like I'm still stop and start yeah you got a lot of quotables there. No not at all not at all and by the way I loved your podcast with Angela Saini like the last two they're so amazing. She is an amazing woman like she is really and just oh god it's just full of so much information the research she's done like it's so crazy like yeah bow down but thank you very much I've actually really enjoyed doing this whole season um which has been it's been female dominated I was like I was going to say.

I was like, Hazel, can you be inclusive here, please, of these men? No, they've been included for too long. That's so funny. Well, that was such a, I mean, I feel like that went really quickly, but we covered a lot in the last 50 minutes. So thank you so much for sitting in your cupboard and speaking to me. Honestly me honestly thank you I can't wait to get out of this Harry Potter situation do you have some nice uh lockdown food that your sister's gonna make you oh my gosh god bless my sister okay can I actually do one last shout out so like what I want everyone to do is to go on like my Instagram feed and just

have a look at my highlight so I think that's a highlight with like a burger on it. And if you click on it, what you'll see is like the food, my younger sister's been cooking me. I am eating at a gourmet restaurant. I don't even know what to say, but yeah, lockdown's been all right for me. Not going to lie to you. Oh, amazing. And so what's your handle for people to grab you on?

Yes. So my handle is Amalia. That is my full name. So A-M-I-L-E-Y-A. But everyone calls me Amalia. Amazing. Cool. Well, thank you so much. No, thank you, Hazel. Okay, guys.

So that is the end of the final episode of season four. I hope you enjoyed listening back. And I hope you continue to listen to our older episodes and I'll see you very soon for season five.