Dr. Ashley's Journey (Dublin University)

In this series of articles, medical students and doctors from across the UK share their journey into medicine. Emmaline is a junior doctor living and working in London; she graduated from University College Dublin School of Medicine and Medical Sciences

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I’ve had quite a non-traditional route into and through medicine compared to many of my peers working in the UK. I am a dual US-British citizen, and was born and raised in the United States to my English father and Chinese mother. I always knew that I wanted it to be something related to science, but also that my first love had always been the humanities and literature.

In the States, medicine only exists as a post-graduate degree, so I had the luxury of not needing to know exactly what I wanted to do when I entered university.

I started my university career at Carleton College in Northfield, MN with the intention of majoring in biology, and that quickly translated into being a pre-medical student.

Medicine had a place for both the scientific wonder that drew me to biology, and the human insight that drew me to literature. Every patient has his own story, molded by unique experiences, culture, and upbringing. Although straightforward facts, numbers, and test results play a vital and fascinating role in treatment, patients’ illnesses must also be examined in the context of their stories.

Medicine, therefore, was a perfect culmination everything I loved.  Carleton, as a liberal arts school, was the perfect place for me to explore and expand upon all my varied interests.

I spent a lot of time as a pre-medical student volunteering both at the local hospital and with a local organisation that worked with adults with development disabilities. I also became certified as an emergency medical technician (EMT) over one of my summer breaks, and volunteered for the American Red Cross. I was a board member of the Minority Student Pre-health Coalition. I also organised shadowing opportunities with physicians, sending my CV to Carleton alumni who were working as doctors and asking if they’d be willing to allow me to spend a day or two with them.

Medical school is a massive commitment of time, money, and yourself. I felt it was important that I knew exactly what I was getting myself into, and that I would have experiences to talk about at interviews.

After graduating from Carleton, I took a gap year while I was working on medical school applications and took the MCAT, the medical school admission exam in the States. During that gap year, I worked as a Certified Nurse Aide (CNA) – the equivalent of an HCA – in a health and rehabilitation facility. The patients there were a mixture of post-op rehabilitation, long-term care, and palliative care. I worked the night shift for an entire year, and my experiences working in the US healthcare system added to a sense of unease I’d been feeling for a while. Healthcare reform came up frequently at my medical school interviews, as this was the year when Obamacare was one of the biggest news stories.

At the end of the day I knew that I didn’t particularly like the US healthcare system – the most expensive in the world, where access and quality of care depended on ability to pay.

I’d lived in the UK when I was a girl, and I’d always thought about going back to live there again in adulthood. I had an offer of medicine in a school in New York, but when I received an offer from an Irish medical school I started seriously considering making a transition to Europe. The more I thought about my future and what kind of healthcare system I wanted to work in, the more the move seemed like the right fit for me.

I spent four wonderful years in Dublin. I graduated from University College Dublin, and applied to complete the Foundation Programme in the UK. I spent my first years of training in London. The transition from medical student to qualified doctor is a massive one.

If I could give myself some advice looking back at those first two years as a doctor, I think my biggest mistake was allowing myself to drop most of my hobbies and the things I loved.

My life became working, staying late every day, and going home and sleeping. I’d picked up yoga in medical school and found it such a healthy outlet for me, but then became “too busy and stressed” when I was working as a junior doctor to keep up consistent practice. Same with cooking, reading, writing, dancing – all too easy to neglect because I was exhausted.

Physician burnout is something that is discussed a lot these days, and it’s a very real problem. Doctors can be notoriously bad at self-care, and it took me a year out in academia and research to recharge again.

We all come to medicine as something we love and are passionate about. But you have to have a life outside of and separate to the job. And you have to somehow do this despite all the pressures, demands, and strains this job will constantly place on you to consume all of your time and attention.

I’ve never regretted my decision to make the transition to this side of the world. I love working for the NHS, and am immensely proud to be an NHS doctor.

Dr. Ashley

Junior Doctor & Graduate from Dublin Medical School