Life After Medical School – The Journey of a Doctor with a Disability

In this episode, we explore life as a doctor, living with a disability. We are speaking to Dr Genevieve Shimwell, Dr Imran Sahgal and medical student Georgia Savvides, from the University of Manchester.

 

This 3-part podcast series explores the personal journeys of a final year medical student and a GP (general practitioner), who both live with a physical disability. The podcasts allow guests to discuss the challenges and experiences they have encountered.

 

We hope the discussion resonates with some people and for others, gives an insight into living with a disability.

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Welcome to the One Med Learn podcast.

Hello and welcome back to another podcast from Manchester Medical School and this is

part three discussing the journey of a doctor with a disability. I'm here again with our

two special guests, Georgia and Imran. I am Dr Genevieve Schimwell. I am a GP and clinical

lecturer at the university and we're now talking about how the disability might impact

post university and drawing life as a doctor. Georgia, with qualification and graduation

on the skyline for you, what are some of your fears about starting work as a doctor? Would

you share these with us?

I think the workload is something that I'm a bit worried about. As an F1 I will be running

around the hospital trying to get my jobs done and I worry about over-exerting myself

and making sure people know that I need to take breaks because I think it's very easy

to want to get everything done and go for it. So that's one of the things I'm worried

about. Another thing is a bit further down the line so if I do end up pursuing a career

path in surgery, will I get adaptations and when I have to have another replacement surgery,

how will I handle the time off associated with that as well? So I think those are the

main things on my mind. So I'd quite like to hear from you Imran. You can give any insight.

So I have a bit of insight on the first part. So I was fortunate enough to do my junior

doctor years at, I'm going to name drop, entry hospital. So it's the first time I've ever

been to this hospital so I've never been there as a student and actually the two people

who were the leads for the foundation year doctors coming through were amazing and they

originally had meetings with them. They basically asked do I need anything? Is there any adaptations

that I need? Is there any support that I need? Those kind of things and they had those chat

with me early on and just made me feel so welcome and that was good. I agree. So I am

obviously not the quickest and obviously if an emergency call goes out, obviously you

have to get there in the time frame. I forgot about that. In my first year, that was one

of the things I was worried about. I mentioned that it's in my letter on occupational health

because I had a look at it and I remember saying to him, oh my gosh, if I have to run,

what am I going to do? And he just went, there's a whole team.

Yes, and that's the key thing. There is a team. The reality is someone would get there

and I think, so yes, there was no way I was going to use same bolt from one side of the

atrium hospital to the other. It's not happening. It's more like slug pace for me. So yeah, it

wasn't going to happen, but I got there. I did try my best to be as quick as possible.

But yeah, they were very supportive of it. They understood and I was fortunate enough

not to need it. I kind of decided my own adaptations on the job. So for example, we're doing a ward

round. I would get a silver trolley and just use them as my crutches. So you just see me

just basically pushing myself off and just floating across the ward on a silver trolley.

Using it as a guess now you could use the moving hive computer things.

I don't think trolleys with loads of paper notes exist nowadays.

That shows how much of a dinosaur I am. So yeah, so there wasn't really any other. So for example,

doing cannulas and doing procedures, I'd always do them sitting down. We're fortunate enough that

beds obviously go up and down so I can move it to the height that I need it, those kind of things

really. So I think for me, it was a lot of learning on the job what I couldn't and could not do.

And yeah, the atrium hospital was really supportive from that point of view. I'm kind of in the same

boat with you in that I will probably at some point need surgery again and I've been fortunate

enough not to need it in my medical career. But I am worried of that day of what will happen.

And it does play in my mind a little bit because I am single income. So that's kind of things with

two kids. So they're kind of little worries. I would imagine my GP, my GP are very supportive

so for example, the bed was a I've recently had this job. So I got this post in August.

So a permanent GP, well two days a week there. And the bed that I used was just didn't move. So

stationary and I'm like obviously if I'm doing examinations, I need the bed to be lower because

I'm sitting down. So they've got a new bed in so stuff like that which yeah, which is nice. It's

a nice touch that they're trying to accommodate these kind of things really. But yes, I do fear that

just like yourself and how that's going to be, how much time I'm going to need off,

those kind of things are a fear for me as well. But I would like to think they would be supportive.

And is there anyone you think you can kind of get advice on that and speak to about that

to help plan? Yeah, well from a GP point of view, yeah, I mean you could. I mean,

you always have sick leave and stuff like that. So I think I'm lucky that I have been a doctor since

2010, I think. So we've been in the NHS since then. So I guess from a sick pay point of view,

it goes up each year. So I think by year five of working for the NHS, your sick pay is better than

say in the first few years. So I guess that the first few years will technically be a little bit

of a worry. Hospital-wise, occupational health is key. And I was going to mention it and having

those discussions with them, I would say. But like I said, I've been fortunate enough not

to need to have those conversations yet. But maybe kind of forward planning, having a little

look through the contracts and what's included, what you're entitled to or seeking advice from

the BMA potentially might be helpful to give you kind of an idea of how to plan for this going

forward for you. Yeah, and I think one of the other things I wanted to ask you is, do you ever

have days where you need to take a day off related to disability? Because I worry about that. Because

if there's a day that I wake up and you know, I am in a lot of pain, what do I do? It is a worry.

And I think my worry was that it would be flagged up. And I think that was my concern. So I just

went in and dealt with it. And it shouldn't be like that. But that was just my mentality that I'm

worried that this is going to come back and bite me. And therefore, you know, or people will view

me as less of a person as a doctor. So I'm here with a disability. I've just, you know, if you

listen to part one and part two, I've mentioned about how I've just wanted to fit in and not have

the disability or not people see me with a disability. I wanted to be basically like everyone else.

So those people without a disability. So and if I'm showing that vulnerability and or a sign of

weakness is how I viewed it. And therefore, I just plowed on. Can I ask that, have you ever been

given the impression that would validate that fit? No, I haven't. I've never had that. That's just my

own sort of mental battle that I have. That people will, if I played the disabled card, sorry, I

air-quoted there on a podcast, which doesn't make any sense. So if I play the disability card, then

you know, it might annoy colleagues and things like that. So and therefore I'm damaging. That's

how I see it. And that probably isn't the case. I think the reality is they probably will be really

supportive. They would probably really appreciative that I'm able to open up and say, this is what I

can do or can't do. You know, I am struggling here. They'll kind of be invulnerable. Whereas I haven't

been like that. Interestingly, man, on part two, your take home message was encouraging listeners

who may have a disability to speak out and discuss your personal situation and how it might affect

you. And I suppose that's something that could be taken forward now in working life as well as

through medical school and training, isn't it? Definitely. And you taking that own message on

board personally. I probably should, should I listen to my own advice? So I think this is this

really important kind of messages you're sharing with us today. And I think really empowering for

our listeners to hear from your experiences. Inman, do you want to share some of your experiences

about working as a doctor, please? Yeah, so it's always been an issue. I think from working in

hospitals, I was a lot fitter. So I was able to mobilize a lot better around hospitals.

And I guess my main issue has come. So I'm a GP and part of training I've had was to do GP

placements. And the first GP placement I had was in year one of so GPS T one. So this would have

been back in 2013, 2012, 2013. And part of our training, we had to basically video our consultations.

And we would watch them back with our supervisor, who would then critique them. One of the things

that happened on this video was that a patient openly asked me about my disability. So not

prompted, not me saying, Hey guys, I've got a disability. They've decided to initiate this

conversation. And this was recorded on this video. So the GP supervisor was amazing. I just want to

get that out there that they they picked up on this. And they debrief me on this. And basically

said, How did you feel in that situation? And they could see that this was going to be a challenge

that I had throughout my career. And they advised me that it's important to think of a response.

So that was back in 2012, 2013. To this day, I have had this so many times in my career.

And to this day, I do not have a good enough response. And what I mean by that is because

every time it happens, I'm always taken back by it. And I think to myself,

this is a medical issue, this that should stay between my close loved ones, and myself and the

doctors that are around me. So why is it that I am kind of it's made the assumption that because

I have a disability, and I'm a doctor, that I should openly be sharing my confidential information.

And I appreciate that a lot of the times it's not because people are being offensive or anything

like that. And they are genuinely curious. However, it's not something that I should be,

I should need to share or have this conversation about. It's up to me if I want to share this.

And especially in a place of work where I'm not there as a patient, I am there as a doctor.

And the surprising thing is so I post this idea to do this podcast back in, I think,

about the September time. And like I said, I've got a new GP job, which has started in August.

And I've moved from Liverpool to Warrenton. And this has been so evident since moving to this area

where I found, so for example, I had a conversation with one of the receptionists who asked me,

"Oh, so Imran, what's your disability?" And I was kind of taking it back and I just blurted it out.

And it was something which I kind of regret sort of saying it because it's not something I like to share.

And I'll come to that in a second why. But she basically mentioned, "Oh yeah, because all the

patients are asking." And my point was, well, she was saying, "What shall I tell the patients?"

And I was like, "It's none of their business. I shouldn't have to share what my disability is

because you want to break my confidentiality. It makes no sense whatsoever." And I guess obviously,

I appreciate, you know, this is different to your experience, Georgia, because you're trying to,

you know, get out there or steal sarcoma. And it's really powerful that you send that message.

And, you know, there's a lot of people with disabilities who are championing their disability

and raising awareness. But at the same time, there'd probably be a lot of people in a similar

position to me that I have a very obvious physical disability. However, why am I being made to talk

about it all the time? I don't want to talk about it all the time. It's a mental battle that I struggle

with all the time, myself. And even the other, you know, people will make comments, patients are

making comments, which they think are ingest, but hit me hard. And it's there, then I'm always on the

back foot. I always don't know how to respond. I've planned it so many times, but yeah, it still

doesn't come out. And I still don't know how. And the problem you have is, you say, "I don't want to

talk about it." You then spend the next minute or two, you know, for them apologising because

they think they've offended you. When the reality is, "I don't have time to talk about this. I have

10 minute appointments. I'm not here for me. I'm here for you to deal with your problems as a doctor.

I'm not here for you to quiz me as a random person you've met." And even that random person, we

shouldn't be having to discuss it. And I guess obviously I've grown up from a pair

of parents basically saying, "Your personal problems are yourselves." And obviously in a Muslim

community, everyone is quite nosy where we've lived. And they talk a lot. And my parents

didn't want that. They were private people in their culture and they wanted to keep things

private. And I guess that's how I've stayed. And I'm fine with that. And I appreciate, obviously,

students have done it as well. We're students have asked what's happened. And I think the

problem we have now is because among crutches, a lot of people think, "Oh, you've had an accident."

So does that confusion? And then when I'm saying, "No, this is me from birth," they feel they need

to pry a bit more. And I don't want them to pry a bit more. That's the end of the conversation for

me. It's not a discussion I want to have. Would you say it doesn't define you? You are a doctor.

You are a successful doctor. You're able to do your job. And you don't want it to define you.

So yeah. And I guess that's the thing that unfortunately for me, it stands out. So I

know how well I've done. And I might sound a bit bigheaded here. And I appreciate that.

I have achieved so much. And I know I gain a lot of respect because I have a disability.

I'm a doctor and I'm helping people. And I get that. And I've heard consultants

talking to patients where just when I was at Aintree doing A&E, one of the consultants basically had

basic mention to a patient. We've got a doctor there who's got a disability. He's doing so well.

And obviously trying to relate that to patients. So I know I'm earning a lot of respect. However,

I don't want to be in-run with a disability. I want to be in-run because I'm hilarious or whatever

it is. But unfortunately, I am in-run with a disability. And that's how I'm known, unfortunately.

So yeah, it's difficult because obviously colleagues are prying as well. And I think that's

just because they feel you're a doctor. You'll be open to these kind of things. But it's not

something that I want to talk about because yes, it's something that I don't feel comfortable with.

But yes, I'm still having to do it. And the reality is until I finish as a doctor or

probably anywhere or working at the university, I'll probably still have these conversations.

I think it's so important you're being able to put this message across because as you said before,

people questioning, prying, it's mostly from not a place of malintention. It's wanting to cause

upset. It's curiosity. But it's about you having your boundaries and you being respected to keep

those boundaries and to keep your information to yourself. Yeah. And it is a little bit that

expectation because they think, right, he's a doctor. So he'll want to educate and therefore he'll

be happy to share those things. But I'm not there for that. That's interesting. I've never had to,

like before speaking to you, I've never had to think of that before because I think I've always

felt obliged to explain why I need a seat or why I need to sit down. I feel like the need to

explain to them, you know, and I guess that's the flip side of having something that's a bit more

hidden. I feel like I have to validate. I was like, this is why I'm being rude and not letting the

consultant sit down in the ward round. You know, so and I've never actually considered just saying,

I, you know, I have a disability, would you mind if I sit down? Yeah.

Because that should be the end of the conversation. Interesting perspective. Because I think,

yeah, I always end up saying, oh, I've got this replacement. They're like, oh, my gosh,

you're so young. How did that happen? And then I've got to be like, oh, well, when I was 15 years

old, go back to that sentence again. So it's like, you know, there's there's two sides of it,

right? So I feel very fortunate that I guess on the get go, if you see me walking down the street,

people can make a perception of me without knowing I've got a disability. But then I have to explain

it so that they know what to expect as well. But that's the point, isn't it? You shouldn't have to.

You shouldn't have to. Because that's your information that should be between you, you love

ones, and, you know, your doctors. Yeah. I've never had to think about that before. So thank you.

It's really food for thought. Yeah. So yeah, I think I guess that's the main thing from a

work point of view is is that kind of sort of thinking about that side of things. And then

obviously, like I said, the colleagues side, it's a case of, you know, they wanting you to share more.

And I remember, and the problem I have is there's other bits that I'm having to deal with as well.

And so if I'm telling them about my disability, then a lot of people in the medical field might

know more, and they want to pry more. And they're questions that I'm not comfortable in sharing.

So it's going down a slippery road, really. And I guess it's what's comfortable for everyone.

So yes, some people want to like we mentioned, some people need want to talk about it. And they

feel like, you know, this is a good message to educate someone. But I'm not in a need to educate

people about my condition, because my condition is for me. And there's lots of other people who

are educating about my condition. Yeah. Thank you guys for sharing your experiences. I think there's

a lot of powerful messages being put across there. Are there any take home kind of points

that you want to share with the audience before we wrap up for today? I guess obviously, it's

one no in your limitations. So there's positive and negatives to it. So I think yes, it's saying

that yes, I have a disability. I don't need to share more than that. But at times, it's

making sure you're aware that there are people that are wanting to support you. Medicine is a

great career to be in. And as a disability, I'm very fortunate to be in a career. And I really

enjoy it as a GP. And I have I also work for the University of Manchester. And, you know, I have

career wise, I have a great life. So it's being kind of vulnerable enough to say, I have a disability,

I may need this support. And not kind of thinking, actually, I can do this by myself. And you don't

need to do it by yourself. It's not making you any less of a person. It's more to help you

achieve being the best doctor you can be. Wow. Thank you, Rymann. Thank you guys so much for

coming today and for sharing your experiences. And that concludes part three. Thank you for having us.

Thank you so much. Bye. Bye.

Bye.

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