Exclusive give away- 5 copies of Dr Yumiko Kadota‘s Emotional Female

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On taking a break from training and re-entering the workforce

In the wake of the op-ed published in the ABC, I thought I should share some thoughts about my year off in the hope of encouraging more people to take time out. When we are trainees caught up in the loop of exams, job applications and education, with the associated stress, competition and politics, it seems like a race to the end. There is an implicit worry amongst trainees that taking time to do anything else will show a lack of dedication and will be looked down upon at job interviews, when trying to re-enter the workforce. This is re-enforced by the wisdom that any gaps in time on your CV need to be accounted for, ideally with something related to your profession, if not, with something understandable for (conservative, privileged) interviewers.

Some of these worries rang true. I did find it harder to get fellow jobs. I was asked what I had been doing in 2020 and why I needed to do a second fellowship, which having “failed” 2019, was a hairy question to answer. I suspect, however, that my difficulties were more related to a number of external factors, such as COVID19 rendering fewer fellow jobs available for 2021, and the blatant nepotism, which means that often one is being interviewed for a job that has already been promised to someone else. This combined with my poor performance at several tele-interviews, which I shan’t delve into further, other than to say that I am not a natural, effusive charmer and Zoom is not my natural medium.

Despite this, taking time out from training in 2020 was an excellent decision. I was initially extremely worried about finances – turns out I cope poorly with uncertainty. This plus my worries about my future in medicine meant that I went into the year off, not like a teen excited about gap year adventures, but like a control freak facing a (personal) violent revolution. I shouldn’t have worried about any of these things. COVID19 meant that any plans for international travel were shelved. I received a small scholarship for research and locum work turned out to be so abundant and lucrative, that I actually earned more in 2020 than when I worked under the hospital JMO award.

Also, while it was technically harder to find a job after taking a year off from schmoozing, I have found that being my authentic self (awkward and all) allowed me to find “my people.” I know this sounds trite and hippy, but I really found people through social media, advocacy and work. People that want to employ me because I do my job well and am a normal human being with interests and hobbies, even though I can be socially obtuse in environments where narcissistic personalities are rewarded. I have found friends popping up everywhere to support me: friends who will contact friends to help me find jobs, friends who will put in a kind word formally (in references) or informally, friends happy to provide emotional support or places to live. Former bosses even took time out from their hectic schedules to ring and encourage me to continue my training.

This has been one of the major positive lessons I have taken from my negative experiences over the past decade. I have had so many experiences where seniors have provided unconstructive feedback, where they seemed to want to reshape me into the model doctor (confident, commanding, charming and usually male). Other times, they seemed most intent on discouraging me from continuing in my current career path at all. Yet, by being my authentic self, I have found a place for me anyway. It mightn’t be in the most prestigious centre and I mightn’t walk into an inner city staff specialist job when I finish, but I will be ok.

That isn’t to say I haven’t made mistakes and that I am not working on myself at all. I am always striving to become a better person and I think that will be a lifetime project. In 2020, I used a flexible schedule to invest in myself more intensively. I spent more time in yoga and learning to meditate. I found a company that does singing and voice lessons via Zoom so that I could rid myself of the feedback, “you have a somniferous monotone”, forever, while having fun. I spent more time with my very funny, but endlessly dissatisfied with me (Chinese) Aunty. I took up snorkelling and learned more about the ocean and found that nature is the greatest balm for the modern world’s relentlessness.

I also learned that I am a lazy-workaholic. That means, I like sleeping and being lazy but I am also very bad at relaxing. When I found that my research thesis did not require persistent 9-5 dedication, I signed up for 3 days a week in community palliative care. Thus, taking a year off from training meant I could experience other areas of medicine. This was invaluable for me. I am now much more confident with heavy duty palliative care medications and I gained experience palliating patients with incurable neurological disorders. In addition, visiting people’s homes over a wide area, in the multicultural and socioeconomic stew called Sydney, was both fun and eye opening. I share some observations from this experience here.

Coming into 2021, I have gained greater self acceptance and self soothing skills. I have regained hope for my future and am again coming up with innumerable, mutually impossible dreams for my personal life and career. Despite my early misgivings, I 100% recommend taking time out from training. With most of us now coming into medicine as graduate students, there will be legitimate reasons why many of us will wish to take time off during our training. The norm where training is your life for 10+ years at the expense of literally everything else, should not be the norm and it is ok to prioritise your self care. If, like me, you return to training later, by living authentically and wholeheartedly I bet you will find “your people” too. You will end up somewhere, with something, even if it isn’t exactly where you imagined yourself day 1 of medical school. My only sadness is that my colleagues, who are no longer here, didn’t stick around to see this too. That they didn’t live on to find their place in medicine (or out of it) and that they didn’t live to realise that the pressures and judgements of mainstream medicine are not immutable and all powerful.

You are never alone

Surrounded by my colleagues at ANZAN, I immediately felt overwhelmed. Look at all of these doctors, young and old, chatting cheerfully, laughing and acting like Neurology is the passion of their life. Tired, burnt out and struggling to imagine myself as a neurologist, or as anything really, and following an election that left me gutted, I couldn’t bring myself up to chatting with influential Professors with my “good behaviour” on.

We all put on a facade at work, which we think others want to see. A facade of energy, enthusiasm and competence. For some this comes naturally, for others sometimes or always, this is an immense struggle. Paradoxically, this facade makes it harder for doctors, who struggle, to seek help. Conversations around mental illness and burn out occurred despite the underlying culture of fear that admitting to these struggles would be used against you. We put up with bullying and at times, inhumane conditions for a career. How hard it must be for those of us who work this hard for so long, then turn around and walk away?

Talking to friends away from the bright lights of sponsorship stalls showed me that many of us struggle silently. Many of my friends admit burn out. Others had periods in their career where they considered quitting and becoming something else altogether! An anthropologist! A model! An artist! The statistics show that this is common. The growth of sites like Creative Careers in Medicine, show that there are many of us who leave the well trodden path. We are discouraged from taking gap years, yet more and more of us take them and I haven’t yet heard someone come back regretting it. (Of course, many of us have responsibilities and cannot do this).

If you feel alone, please reach out.

Find a friend away from the bright lights and sycophancy. Sometimes official supervisors are less than helpful. If so, find someone you relate to. If the rise of unwieldy facebook groups has taught me anything, it is that there are such a wide variety of doctors and people out there.

In the words of Florence Welch, in trying times, we must “hold onto each other”.