The children and young people of today are all our futures

You know you are getting old when the person sitting in front of you being interviewed looks much too young to have gone through all the training and education required to be a medical consultant. Well at least I did last week. I was privileged to be part of an interview panel aimed at recruiting a new doctor to join our paediatric team. Despite having a brilliant interview, the successful candidate looked much too young to be a consultant. Of course, they weren’t, it was just me feeling my age.

Likewise, last week I also had a chance to meet, eat a meal, and enjoy some great conversations with a group of doctors who were just starting out on their careers. The event was a Junior Doctors Forum. Rather cleverly, the Director of Medical Education had offered a free lunch to all who attended and had invited me as Chair to meet with them and find out what their experience to date had been like for them. Apart from the delightful company this invitation gave rise to, the chickpea curry was simply sublime.

The group were made up of Foundation Year 1 and 2 doctors (FY1, FY2), Junior Clinical Fellows, and Physician Associates. The medical foundation programme is a two year generic programme that forms the bridge between medical school and doctors specialist training. At the FY1 stage, individuals can begin to consolidate the skills learnt whilst undertaking their medical degree. Year two, the FY2 continues this learning whilst at the same time affording more opportunities to take management decisions, strengthening their pathway to becoming independent clinicians. All are appropriately supervised and this was one aspect of their experience that the folk I talked to described as being the most important one for them. I heard tales of the ‘Purple Consultant’ who each day, worked in the Emergency Department and provided on the spot experiential learning for the junior doctors, as well as being there to support them in their diagnosis and treatment decision making. What a great idea!

The group were all incredibly young, enthusiastic, bright, focused, and whilst at times naive, they were all super confident.  The conversations were a real learning opportunity for me. I asked them about their experience of the pandemic. Most said that whilst the pandemic had initially felt like a major hiccup in their journey to become a doctor, they now felt it had actually been a ‘once in a lifetime’ learning opportunity. Most of them had been seconded to work in critical care areas. Initially this had caused much anxiety, but on reflection they felt it was probably the safest place to be, and they reported that none of their colleagues working in ICU actually contracted Covid. They all noted that what had been important in the early months of the pandemic was what they described as ‘fantastic teamwork’.

I thought this was an interesting observation. There was a clear and easy sense of a shared identity amongst the group. It was clear they were all part of a medical family. Yet the conversations were full of examples of how they worked with nurses and other health care professionals, none of which sounded remotely rhetorical or patronising. There was no ‘them and us’, just a straightforward notion of being part of a team. It was a refreshing attitude to witness. However, I was amused by the way in which the group referred to their seniors, it was always with the prefix of Dr. No one called me Professor, despite my title being writ large on my identity badge. I didn’t mind.

As we talked it was hard to find anything they were particularly concerned about. That was the underlying purpose of the lunch time conversations, and I struggled to draw out anything negative. All said they preferred working in what they described as a District General Hospital rather than some of the larger and supposedly more prestigious hospitals in the North West. They felt the learning opportunities were greater with us and there was more opportunity for independent working. The one complaint I did hear mentioned a couple of times was the difficulty in taking time off for annual leave. This was sometimes allocated and felt to be not long enough to really make a difference. I’m on the case. 

Several of the doctors reported that they were going to be doing a FY3 year next year. In effect they were taking a year out of their training to do something different, to recharge the batteries and simply enjoy life again, away from studies and the demands of the junior doctor role. One FY2, a young lady, described her plans to walk the El Camino de Santiago way. 

Now this is something I have always wanted to do, and I have to admit to feeling a little envious of her plans. It’s an almost mythical walk, just about 800km long, starting in France and finishing at the Cathedral in Santiago de Compostela in Spain. Most people doing the entire walk will take some 35 days to do it. It’s a walk that, up until Covid hit the world, attracted some 300,000 thousand people a year. To be fair they wouldn’t all do the entire walk. This year was meant to be a special ‘Holy year’, but like many other things, this has been postponed until next year.

Listening to the young doctor describing the walk to her friends around the table I did wonder if now I would ever do the walk. It’s a young person’s walk for sure. The longest continuous walk I have ever done was the Coast 2 Coast, which is only some 200km long. But I never say never, so who knows? What I do know is that the Birmingham, RAND and Cambridge Evaluation Centre (BRACE) last week published their findings from their early evaluation of the children and young people’s mental health trailblazer programme. You can find out a lot more information about this brilliant programme here. 

Why do I use the word brilliant? Well their interim report showed that the trailblazer approach used in some 1,000 schools across England, with its focus on prevention and early intervention was enthusiastically welcomed and valued. Whilst the new entry to the mental health work force, the education mental health practitioners (EMHPs), was viewed as being valuable, recruitment and retention of these staff was, at times, a challenge. However, the programme is already having a positive impact in safeguarding the mental health of our children and young people. They are our future, and the recent past has clearly had a negative impact on many children’s and young people’s mental health and wellbeing. Whilst it’s unlikely I will be sitting around a table in the future eating chickpea curry and hearing from some of these next generation of potential doctors, I’m confident that with the right support in place for our children and young people, someone like me will be. As I get older and let younger tigers gain a voice, that thought makes me feel good about the future of our health and care system.