Its been an odd year for trainees in the UK; a year of wake up calls, angst, frustration and challenges. Perhaps we can look back in ten years and say that we did the right thing, for the right reasons and in the end it was worth it, perhaps we will look back and say that we tried, and in the end were left with something imperfect, but reasonable and perhaps it will all just be forgotten.
If you’re a junior doctor, June means ARCP; ‘Annual Review of Competencies and Progression. It’s a bit like the week before New Year for medics, when you stand on the edge of your life and try to account for your existence…decide if you’re doing enough to be what you want to be.
Except somebody else is deciding it.
For ARCP, there are boxes on an ePortfolio and the aim of the game is simply to tick all of them. I once sat in front of an ARCP panel who told me without a hint of irony “this is not about how good a doctor you are or not, I have no way of telling that, obviously”. The aim of the game is to tick the box.
I didn’t always hate ARCP. I think it used to fit me.
When you think about it, this isn’t a surprise. When you’re a child, making friends is easy because you don’t really think to much about the other person. it’s not important what they might be able to offer you in the long term or if they want to bring out the best in you. You just want to play hide and seek and then go home and have your dinner; there isn’t a long term plan and you’re just that person that’s playing hide and seek. ARCP used to fit me because I didn’t know who I was.
This year I can firmly say I have never been in worse shape for ARCP. I have never ticked fewer boxes. It’s not that I don’t care. In fact the past month has mostly been a desperate attempt to pull myself back up the ladder. I have trolled shamelessly for work place based assessments. I have scrabbled about for an audit to do.
Lately it just seems our values are too different to be real friends.
ARCP values reflection, it comes as a template. You write in the boxes.
Anyone who knows me knows that I reflect, probably too much. But I don’t reflect in boxes. I have a small number of consultants whose doors I might knock on and they are consultants who I know will listen and tell me the truth. More importantly, they are consultants who know me. I have medical friends who I can thrash things out with. I have Twitter. I think, I talk, I write, I share and if there is an error involved I present it to my colleagues. I have shared four reflections as columns in the BMA news and online this year. Another by Medical Education. I reflect, but not in boxes.
ARCP also values leadership. It values an insight into management.
As I said, it’s been a difficult year for trainees, but it’s also been a year of opportunities. I have been passionate about something. I have engaged members of the public, I have engaged management, I have engaged politicians. I have written I hope, balanced and thoughtful opinion pieces for national news, for the BMA, open democracy and even (to my surprise) a socialist magazine. I was featured across two pages of the BMA news. I had a blog chosen as lead for the Huffington Post and 6 months after I first let loose on my own blog, I had tipped 70,000 views. I have spoken on both national TV and radio.
I have endured being named by a consultant in an ITV news article as symbol of a “generation of doctors (who)… work less hard for more money” and I remained respectful in my reply.
Next month I will be on the interview panel for the safe working guardian at my trust, not because I am completely sold on the new contract, but because I recognise that if we don’t have a voice in that room, it is hard to blame them for not listening.
When we all gasped in horror at the Government’s plan to remove nursing bursaries. I did my best to raise awareness of their petition. I wrote something that was shared more than ten thousand times.
When earlier this year, the wrath of Twitter was unleashed on our physician associate colleagues I wrote honestly about my experiences with them and respectfully about my fears.
I do my best to stand up and be counted. I believe it is important to be in the arena.
You should know though that on my ePortfolio the box for “leadership and management” in my end of year report just reads “Nil”.
“Leadership and management skills development” – Nil
You will understand now why I have no love for ARCP. Five years ago, I’d have told myself I didn’t fit in but I think it’s probably the other way around. It’s doesn’t fit me and you know what? I don’t regret it…after all, how else could I live with myself?