After deciding to relocate from London to Aberdeen to take up a post as an FY1, Dr Simon Lammy reveals the challenges and motivations behind the move
Sunrise from Ward 14 at Aberdeen Royal Infirmary. Photograph: Dr Simon Lammy
Scotland is a long way from London. The majority of my friends struggle to imagine what would motivate me to move from the South to pursue a job in Scotland but they are truly lost for words at my delight about embarking upon my early years as a doctor in the city of Aberdeen. I made the move because there is a perception that Scotland offers more robust training; so this was why I undertook a 1000-mile trip one bright day in July towards the Granite City from the kaleidoscopic world that is London.
"The experiences of those first couple of weeks, from orthopaedics to cardiology, gave me the confidence to confront certain situations and respond appropriately"
In the moments after finding out that you’ve passed your finals, the memories of many months of determination and personal sacrifice all come together. However, that moment quickly disappears a nd is replaced by a feeling of dread that grows stronger as the start date for a new job approaches.
Quite understandably, the fear that grips almost every single graduate was for me compounded by the realisation that I perhaps underestimated the enormity of transplanting my life from London to Aberdeen.
Starting out as a junior doctor was a similar experience to hitting concrete. Due to the nature of the work patterns, I had the misfortune of starting on two weeks’ leave thus losing out on being baptised early. I got around this by taking on lots of locum work during those two weeks to help me get to know my new hospital.
The experiences of those first couple of weeks, from orthopaedics to cardiology, gave me the confidence to confront certain situations and respond appropriately.
However, the independence and increased responsibility I enjoyed on nightshifts, contrasted enormously with day shifts; an exercise that requires team work and delegation of tasks to make a ‘big ship’ more efficient. Thus days as opposed to nights tested me more thoroughly.
Constant readjustment has been the dominant experience for me and it has tested my capacity to respond adequately and appropriately. I am on gastroenterology at the moment and the expectation on me to use initiative concerning diagnostic and therapeutic procedures has been surprising. However, the confidence my seniors have shown in me to just crack on and do a paracentesis is very comforting.
If clinical exposure is one of the founding reasons for me coming to Scotland then educational progression is certainly the other. The Edinburgh Surgical Sciences Qualification, the innovative MSc that the College conducts with the University of Edinburgh, maintains the academic momentum for graduates to pass finals which is so often lost through the steep clinical learning curve at the beginning of foundation training. Conducted through an online portal, students embark upon a postgraduate certificate for the first year. This transforms to a diploma in year-two and masters in year-three where each year builds upon the basic scientific principles and surgical fundamentals that underpin surgical progression and thought.
The curriculum during year-one broadly encompasses the knowledge required to pass MRCS Part A. Subject matter is taught as systems (e.g. cardiovascular) and communicated in dedicated blocks (i.e. two weeks) through online tutorials based on a clinical case (e.g. chest pain). This requires a good grasp of the anatomy, physiology and pathology underpinning that case in order to pass the formative multiple choice questions in each of those three disciplines at the end of each block. Students also have access to an array of online textbooks to help them work through the knowledge for each case. However, the major advantage of the structure is the expectation of students to engage in discussion forums for each case.
Just as my job has been an exercise in constant readjustment, the discussion forums have been an exercise in adjusting to another way of acquiring information and learning from others. These experiences are being documented as a photographic blog because, as you can imagine, combining a masters programme with my job demands a lot of time and energy, so reflective learning is important. However, for me, foundation training is a long process; hopefully towards the end of this first year my academic and clinical experiences should be thoroughly broadened to help me become a better clinician and one day a surgeon.
Dr Simon Lammy, Foundation Year 1, Gastroenterology, Aberdeen Royal Infirmary