‘Personal’ or ‘Professional’ development?

When I started writing the curriculum for our Whole Hearted Medicine wellbeing retreats for doctors I knew that I wanted the doctors who came on our retreats to receive recognition that the hard work they would be doing while they were with us was important. I knew for myself that the compassionate self reflection that I had engaged in post burn out was actually some of the most difficult work I had done in my life- despite having a medical degree and specialty fellowship in General Practice. I also knew that without doing this work, both my degree and my fellowship were useless to me. I couldn’t work as a doctor unless I was a happy and healthy human.

My determination to make sure that the doctors who engaged in the work of compassionate self reflection as a path to deepen their self awareness meant that I needed to align this difficult work with the important framework of Continuing Professional Development (CPD). In 2020 there weren’t a lot of CPD providers who were doing this but with the growing spectre of COVID-19 in all of our lives ‘doctor wellbeing’ was beginning to gain some traction as a concept worth discussing. Despite the fact that we have now had CPD accreditation for this work with various specialty colleges for nearly 3 years I still find myself regularly having the conversation with colleagues and workplaces to defend the role of education around wellbeing as being a crucial part of medical education.

As doctors, we are expected to maintain our CPD to ensure that our skills and knowledge stay current in the ever shifting landscape of Medicine. I have the utmost respect for this system and the expectation that as highly trained professionals we continue to learn and grow through out our professional lifetimes. My only personal point of contention was how narrow I perceived the definition of CPD to be. You see I, like most doctors have always engaged in many more hours of CPD than has ever been demanded of me by regulatory bodies. My skills and knowledge span areas of interest as diverse as Emergency Medicine and acute care including Advanced Cardiac Life Support training; mental health including advanced training in Focussed Psychological Strategies; Breastfeeding Medicine including an International Board Certification in Lactation Consultancy; Women’s Health including Advanced Obstetric Life Support and Implanon insertion training to procedural training in skin cancer excision and toenail wedge resection. As a generalist, the breadth of my medical skills and knowledge is immense. Yet, in all of that investment into my learning, there was never a CPD accredited opportunity to be supported in how to sit with the discomfort of our work as doctors, with the immense lows of supporting patients as they experience illness and suffering. No recognised training that helped me to balance the care of others with the holistic & sustainable care of myself. No acknowledgement that the investment in my skills and knowledge was all well and good- but as the vessel that housed all of those skills and that knowledge, I too deserved some investment of my precious time and energy. Instead, as many ‘good’ doctors do, I committed my continuing professional development to the acquisition of skills and knowledge purely for the sole purpose of sharing them with my patients.

Now this noble path of altruism is not to be attacked. Medicine attracts many who are devoted to the service of others- myself included. The issue here is that as a pre selected group of high achieving (perhaps a bit perfectionistic) people who are devoted to the service of others, who often have not encountered hurdles in our lives that we couldn’t overcome by sheer grit and willpower, working in a field that means we carry a heavy load of emotional and psychological weight for our patients- I think you can see where I’m going here? The issue is that this path of altruism in the absence of self awareness simply becomes self sacrifice and that is a recipe for burn out.

Of course, many will argue that the work I have just mentioned is not in fact ‘professional development’ but rather ‘personal development’. The issue I see with this is two fold:

1. The investment in training that goes into each and every registered doctor is immense. In a vocation as demanding and confronting as medicine, the so called ‘soft skills’ that make up emotional IQ (as defined by Danial Goleman) including self-awareness, self-regulation, motivation, empathy and social skills- are actually crucially important to our ability to use and share our medical knowledge and training with our patients and profession. These ‘soft skills’ are as much learnable and practicable skills as any procedural skill and contrary to what might sometimes be argued- anything but innate. If we fail to then also invest in the framework of support and training that up skills doctors in these ‘soft skills’ then we are effectively locking away a significant portion of this training investment in professionals who are ill equipped and unsupported to navigate the demands of this challenging industry.
2. More importantly than a purely practical argument however, as people who dedicate our lives to the service of others we deserve support and care that helps us to continue to serve from a place of abundance. Where our needs are met first and foremost, allowing us to serve others without the depletion and burn out that currently plagues healthcare. This is an ethical issue that brings to the forefront the question- how do we as a society care for the health and wellbeing of those who care for us? Happy, healthy, well supported humans make happy, healthy, well supported doctors.

Without investment in the vessel, the contents are useless.

So here in lies my ‘why’.

As a doctor myself I have walked the gauntlet of training.

I have devoted myself so steadfastly to my profession that I know I am ‘good doctor’.

But I have also pushed myself so far in the laser pointed focus of my goal to serve others, that I neglected to serve myself too.

I have watched my desire to ever practice medicine again disappear and my sense of self teeter dangerously close to the point of complete collapse.

I came very close to ‘wasting’ (for want of a better term) all the many years of training and study invested in me and I know deep in my soul that particularly in the helping and healing professions, trying to separate ‘professional’ from ‘personal’ development is impossible. In fact, what we need to do for healthcare professionals is to teach them how to integrate both the healthcare professional AND the person… not try to further delineate them.

So today I focus my energy on doing just that.

My drive and personal mission in life is to ensure that the importance of supportive and compassionate training in emotional IQ in medical education is understood to be AS important as anatomy, physiology and pathology. To support doctors to find that inner sense of self awareness and to use that to inform their work. To marry the art and science of medicine in such a way that results in connection and joy for both those receiving the healing… but also for those doing the healing. And if in order to do that I need to continually realign our curriculum with the changing goal posts of CPD accreditation or workplace acceptance, I will do that.

I will do that because I know how important support for compassionate self inquiry and reflection is for the longevity of my many colleagues in medicine.

I know how important this work is to the enjoyment of my amazing colleagues.

I know how important this work is for the health and wellbeing of my beautiful colleagues.

And I know how important this work is to me.