Halfway through my intercalated year: reflections

I've officially passed the halfway point of my intercalated year so I thought I'd reflect on what I've learnt so far and what the future 5 months will hold until my thesis is due...

I have a new found appreciation (and frustration) for clinical research

Writing good-quality research papers realistically takes at least a year (assuming no delays). But that's the catch: there is always a delay. I've had to wait 6 months in order to get access to the data I need for my thesis (from NHS Digital)... Then if you add the extra delays associated with ethics approval, grant outcomes, and so forth... a decent project takes at least 1.5-2 years to complete from conception to publication (luckily, I didn't have to deal with a lot of these applications for my Master's). You then have to pay thousands to get published in a high-impact journal and make lots of new applications if you need more money or want to do further projects exploring different research questions with the same data. The waiting around is beyond frustrating.

On the other hand, analysing data and communicating your results to others is a great skill. Oftentimes, you unearth interesting and exciting results and there is always a talk, conference, or research group keen to hear what your work was about. It's nice to get to know people truly passionate about their field and their niche research interests. You'll expand your networks to include some of the most intelligent minds in the country /experts in their field.

I think the best thing about research is if your work makes a tangible impact. For example, if you've come up with a new guideline, threshold measurement, or screening tool OR you've discovered something nobody else has (although, it'll need to be replicated many times before you're taken seriously). Despite this, I've had experiences that have really felt impactful. For example, I'm currently working with my Year 2 supervisor to produce follow-up work on my publication on ethnic-specific Vitamin B12 reference ranges. This year, I've had the pleasure of working on a paper analysing the accuracy of a screen for eating disorders in young people and if published, will be first author and HOPEFULLY see tangible impact if it's used in clinical practice.

I do not think I will pursue Psychiatry as a specialty

Although my passion for mental health remains, I doubt I will pursue Psychiatry as a specialty. I think the research is cutting-edge and relevant, however, most of it, unfortunately, hasn't propelled clinical practice forward. The reality is that a lot of mental health conditions develop due to circumstances out of a doctor's control. Within my role as a psychiatrist, I can't help someone out of poverty, arrange for them to get better housing, give them better wages, take away their past trauma or abuse... And I know that would make me feel incredibly useless and guilty.

This is not to say that Psychiatry is useless or isn't rewarding when you CAN do something. However, not just in the UK but worldwide, mental health services are underfunded, overstretched, and limited in the support they can provide. I don't know if I can be the best doctor I can be in such an environment.

Lastly, I also want to work exclusively with children and feel as though I can better use my skills in a field like Paediatrics. I'm grateful to have been able to talk with child & adolescent psychiatrists this year and use their wisdom to make a decision that's right for me.

I do not want a career in academia

This year showed me that I do not, in fact, want to pursue academic medicine. I applied for a postgraduate degree partly to figure this out - I knew I would either love it and really find my niche (probably even go on to do a PhD at some point) or decide it wasn't for me. I have definitely realised the latter. But I hope to continue research alongside my clinical practice.

Academia is very admin-heavy and requires a lot of time, energy, and coordination to complete endless writing... If I had to choose between being in the hospital providing hands-on care to patients or in an office plugging away at research papers all year, I'd choose the hospital. My extroverted personality thrives on teamwork and chatting to patients. Academia just doesn't give me the same thrill and can feel quite lonely due to the remote way of working.

However, I do enjoy writing and love working on things I'm interested in. It's a bonus if that ends up as a research project and eventual publication, which propels me forward in my career. Nevertheless, Professor Jess is definitely not where I see myself going.

I would like to relocate

I realised that the UK can be quite limiting when it comes to medicine and research. This, as well as other reasons I have shared before (Blog post on considerations when wanting to relocate), have pushed me to consider relocating to practice elsewhere. The U.S. ranks the best in the world when it comes to research and has many perks for doctors, from teaching to job opportunities to pay. With the bottleneck of training opportunities, poor pay, and lack of high-quality teaching currently plaguing the NHS, the U.S. is looking more attractive every day. However, I'm remaining very open-minded on where I want to go and probably won't make a concrete decision until F1. I just know I need to try.

Intercalating is 100% worth it and has helped with my career prospects

Although a part of my opinion is because I didn't pay out-of-pocket for my Master's degree*, I do believe intercalating has given me breathing space; allowed me to see medicine from a new lens; and I have actually had time away to miss it.

*My Master's is not a taught course, it's purely research. However, I have been incredibly supported by my supervisor and boosted my CV by:

• working on incredible projects with UK-wide implications;

• understanding how research is conducted and leading my own project;

• becoming a fully accredited researcher for the Office of National Statistics;

• learning how to code in R;

• strengthening my statistical analysis skills;

• interviewing participants for qualitative studies;

• getting published;

• and lots of other soft skills e.g., networking and experiences that Cambridge has given me

I simply would not have been able to do this alongside medical school due to time constraints. It's prepared me to go back happier and more fulfilled (no more FOMO) because I got to explore my interest and my career prospects. Since I want to do Paediatrics (possibly Paediatric Surgery), and want to relocate, having strong research experience can help me stand out as it's attractive for research facilities / teaching hospitals. It also means I now have the credentials to do data analysis jobs such as interning at research institutions over the summer to earn some money.

These are my reflections so far but I plan to check in again at the end of the year - who knows, things may change...