Conference Season is Upon Us: My top tips for conference presentations

girlymicro Academic Life, Education, Healthcare Science, Research/Academia, Science Communication

I’m off to ASM in Houston in a few weeks and conference season is well and truly upon is. I’ve been fortunate enough to get asked to speak at a number of events over the years, but I still clearly remember how terrified I was when as a trainee I spoke to my first big room. Last year, I gave my first key note lectures. I’d been asked to do a couple in 2020, and then the pandemic hit, so all of those events were cancelled. I felt as nervous as that trainee again. I prevaricated, I self flagellated and then finally managed to force myself to sit down in front of a blank screen and just get started. If you are in any of those stages, this post is for you, I hope it helps.

No one can tell you the best way – only what is the best way for them

First things first. When as a trainee I was preparing my first talk I got A LOT of advice. My first problem was trying to use all of it, even when it was conflicting. I was advised to rehearse over and over until I had it memorised, I was advised to have a script and notes. I was advised to do none of those things as it would be too staged. So, my first tip is this. Seek advice, gain knowledge from those more experienced, but then use what helps you and discard the rest. Your personal process will be different to everyone else’s, and it’s worth acknowledging this early and accepting that you will find a way that works best for you and refine it with experience.

For instance, I hate rehearsals, and I never have a script. It makes me stressed and forces me to feel like I have to deliver the same way every time. I know my content, I know my story and the audience and I are a team who deliver the final product together. I bounce off them and try to read the room, and fingers crossed, it seems to work OK.

The one time I don’t work this way is for extremely time restricted presentations, such as 5 minute fellowship interviews. For those I practice so much I can recite the words in my sleep. These are different because:

  • you HAVE to get all your content in, your career kind of depends on it
  • the time lines are short and hard, they will just cut you off and so you need to know you will finish in the window given
  • there will be no audience bounce, there will be no reading the room, they are going to remain neutral to what you are presenting, and so focussing on them can make the scenario even more stressful.

What I hope you take away from this is that there are no hard and fast rules, there will always be exceptions, but if you can, do what works for you and don’t try to be anyone else.

Ask for learning objectives and check what other talks/speakers are in your session

There is little worse than sitting, waiting to go on for your talk, and hearing the person before you give the talk that you have basically written to give next. I have learnt the hard way to make an effort to ask what an organiser would like me to cover, and to always check what the agenda is before I turn up for the day to see the lay of the land from other speakers titles. A little repetition is not a bad thing, ground hog day is unlikely to land well. This one is more of an issue for invited speaker sessions, although even if you are presenting novel research data it’s worth seeing who else is in your session, as you may be able to reallocate slide time if the 3 people in front of you are talking about the same virus. They are likely to have covered a lot of the generics and you can then invest time elsewhere.

I don’t always get very far, but these days I also ask for learning objectives when I’m invited to speak – what would you like me to cover? any particular highlights that you are interested in? what is the audience size and mix likely to be? All of these things can dictate not just your content but how you think about delivery, such as how much interaction you can include.

Think about your audience

This one seems like a no brainer, but I often think that it’s forgotten. It is really easy as the person delivering to get caught up with your nerves and write a presentation that you feel comfortable with, without thinking about those that will be listening. Now, I’m not suggesting that you deliberately produce content that makes you uncomfortable, but sometimes it is easy to teach in a way that suits us rather than the learners. It can be really worrying to include interactive content, what if no one responds, but if you are on at the end of the day after 7 hours of didactic teaching, your learners may be ready for something that re-engages them.

The thing that scientists and clinicians also often do when they are nervous is to resort to technicality and jargon. It can act as a shield. If you are presenting to a mixed cohort, of either different levels of knowledge or professional backgrounds, this defence mechanism can end up making your content inaccessible to a number of people within the room. It’s OK to have a couple of slides that stretch people, it’s usually not OK to have a whole talk like that, unless you know your audience really well.

Think about the tone of the presentation

I struggled a lot when I was asked to do the talk below. I struggled thinking that maybe I should turn up as ‘Dr Cloutman-Green’ with formality and pretend gravitas. You would not believe how long I went around in my head about it. I then decided that they had asked me to speak about my blog, and my blog is anything but formal and hierarchical, and so I turned up as me, with all the sarcasm and self mocking that entails. In the setting, at the end of the last day of the conference, when everyone was tired, including a little humour felt like the right way to go.

I would however have made different choices if I was turning up to present my PhD thesis in a viva, or if I was presenting to the board, I would have still been me, but a slightly less overt version. Some settings require a formal tone, some lend themselves to informality and some you can decide the path you wish to walk. The key thing is to make an active decision based on the invite, topic and audience to ensure that you match what your tone is with what you wish to achieve.

Find out if you need to allow room for questions

One of the things that often catches people out at research meetings is there is not always a standard of whether there will be time for questions or not, you can sometimes guess by slot length but not necessarily with any certainty. It is always worth explicitly asking if you need to allow time for questions so you can plan your talk length accordingly. I’ve Chaired conference sessions where this wasn’t handled well and it meant that it was really challenging to keep everyone to time and some speakers had much better opportunities for audience interaction than others. If you aren’t told definitely ask, not least so you can prepare for what your answers might be.

Think about what you want for your slides

This again might be a really obvious one, but if you are teaching on an MSc you are likely to want a lot more information on your slides, as they are likely to be annotated and used for later learning. Your conference talk may be recorded, the slides may get circulated, but the reality is that they are much less likely to be used as a later teaching resource. Therefore you will want to pitch your slide content based on your participants/learners, which is another good reason to find out a bit about them.

It is also worth thinking about how important it is for the people in the room to be able to read and understand what you have included on a slide. I’ve lost track of the number of times I’ve seen speakers apologise for tables and overwhelming numbers of charts that are not visible to anyone sitting beyond the front row. Unless it’s high level conceptual stuff there is little point including slides that are not going to be accessible to your audience. It is also worth (and I am not good at this) ensuring that colours and fonts etc do not present unnecessary challenges to engagement.

Plan in your breaks/interactive moments

Even if you are the best speaker in the world, and I am definitely not, there are always slots in any agenda or meeting which will make it more challenging. The post lunch slot, where everyone is digesting and sleepy, and the end of day slot where everyone wants to make sure they catch their trains are just a couple of examples. If you are allocated one of these slots, or are given a 3 hour lesson slot, planning how to keep learners engaged is key. More than 20 minutes staring at your powerpoint is going to be enough for anyone. So can you include things like videos or other types of content to break it up? Can you include live quizzes that embed some of the discussion topics? Can you get people to talk to neighbours or even do some group work? It is sometimes easy to stand up and go through 60 slides, when the experience of everyone in the room might have been better with 6 and a modified activity based approach. Again, it depends on the setting and audience, but if you can be brave and consider stepping beyond the lectern during your session.

Make sure you have backups

No matter how prepared you believe you are for giving a session there are some days when it will not be enough, for this one you need to make sure you are the master of your own destiny. There have been numerous events where I have turned up to speak believing that my slides will be already loaded as I had sent them to the organiser well ahead of time, and had the tech guy look at me in bewilderment as they had nothing. I always carry my talks on a USB stick, having emailed them so I can also get access to an email version in case my USB files is corrupted, and I will have them stored on cloud storage as a back up in case I need to download directly onto a system. The fear of having to just get up and talk without slides haunts me too much to leave anything to chance.

Know how you might wing it if needed

The reason I know very clearly what it feels like to have a slide deck that doesn’t work is because it happened to me at a conference in 2021. I rocked up having sent my slides ahead of time, having been told that the organiser had checked them when they were loaded onto the laptop. I started my talk and then realised that every single slide that had a table or anything other than a textbox was entirely blank. I then proceeded to give my 30 minute with a variety of blank slides. When you’re up there there is nothing that you can do but wing it. I pivoted to a session where instead of trying to focus on my slides I talked about clinical experiences linked to the visible titles. I survived, it was even well reviewed, but I never want to do it again. That said, those 30 seconds staring at the first blank slides and working out what to do taught me a valuable lesson, and now I do my ‘what if’ worst case scenario planning ahead of staring at the audience whilst on my sofa with tea, so that I know what I will do if something goes wrong. I also now try to make sure I personally check my slides prior to any session.

Have a watch or phone that you take up with you

You would be amazed at the number of teaching and conference rooms that don’t have a clock on the wall or visible from the stage. I’ve been caught out by this a few times, and when you full screen your slides you can’t always seen the clock. That means you are subject to the session Chair giving you a 5 minute wrap up when you are only half way through your slides, as time feels different when you’re staring into 1000 faces and hoping not to screw up. I always take my phone (on silent) these days and set a stopwatch so that I can gauge where I am in relation to time without having to rely on someone else. I find the slide rush just waaaaay too stressful otherwise.

Be prepared to handle the question that is a actually a comment

This may be a shock to you, but I’m a woman. This means at any given presentation with questions I have a ~30% chance of a male colleague standing up and giving me the question that isn’t a question, but a comment on how they would have a) done my work better b) point out some key point I have missed c) tell me about their work and their experience. This may not be my most attractive feature but I have made a life choice to shut all of these options down hard. I am open to questions and shared learning, I am not open to someone taking question time from someone else in order to rail road a session into something different. If someone starts with “this isn’t really a question but more of a comment” I will generally reply before they get any further with “that’s really great and I’d love to hear it over coffee but I think we need to address the questions in the room first” and then actively call on someone else. You may wish to have a different technique, you may wish to pivot the comment back into something relevant to your talk so you effectively answer it as if it was the question you wanted to hear. You may have a completely different approach (I’d love to hear them all). If there is plenty of time I also sometimes let it slide, but it is a particular bug bear of mine.

Bring yourself into the room

I’ve touched on this one a little throughout, but I think you will have a much better experience, as will your audience if you can bring yourself into the room. That can be anything from including your favourite colour as part of your slide colour scheme to sharing parts of yourself, in terms of stories or experiences, as part of your session. The more you are prepared to share of yourself, the more your audience will connect with you and the better the chance of your content landing. If you are giving your research presentation, maybe take 10 seconds to share why you chose you that given topic, especially if you have a passion for it – like mine for Klebsiella and Adeno. Don’t be afraid to include humour and light and shade within what you are presenting. Audiences often want to know why they should care about what you are talking to them about, so feel free to convince them, and not just by sharing raw data.

Put your nerves into context

It is almost always nerve racking speaking in front of people, even after you’ve done it for years. One of the things I always say to both myself and my students is “what is the worst that can happen”. I’ve seen some truly terrible talks in my time, but I don’t remember who gave any of them, I remember the topic and why it was bad. Even if I did give a bad session and someone remembered it was me, would they remember in 3 years? If they did, the worst outcome is that they may not invite me back to speak, there will be plenty of other people who will, plenty of people who weren’t in that room that day or who won’t remember. Everyone, and I mean everyone, has bad days at the office. Everyone has sessions that don’t go well or land in the way they hoped. The important thing is to learn from them. Sometimes there isn’t even that, I have given the same activity sessions dozens of times, and every now and again it just won’t work. The participants may be in a bad mood, or there’s tech failure. It happens. Bring your best to every moment and that is all you can do, the rest doesn’t matter, the rest isn’t permanent. So good luck and be bold and I can’t wait to hear you speak!

All opinions in this blog are my own

Learning to Take Your Place: The path to owning the space you find yourself in

girlymicro Academic Life, General, Healthcare Science, Leadership, Microbiology (Clinical)

I remember my first attendance at the CSO Healthcare Science awards incredibly clearly. It was probably around 2015, and I had been nominated for the Rising Star award (I didn’t win, the amazing Lisa Ayres rightfully rocked it). It was my first dinner event, and I didn’t really know anyone. Everyone was in their finest evening wear, they’d all done their make up, they all knew each other. I remember sitting there on my own and feeling how much I just didn’t fit into this world. When the Lead Healthcare Scientist award was given out (we didn’t even have one at that point) I remember the banter on stage about where the winner had brought their dress from. I wouldn’t even know where my dress was from, at best M and S, not something that would be discussion worthy for over 100 people. I was so aware on that night that this was a world where I didn’t fit in, or have the tools to navigate.

Despite being Girlymicro, I’m not actually particularly good at the getting dressed up thing. I’m not one of those girls who has ‘wardrobe choices’ and saints help me if I have to paint my nails. It’s just outside of my wheel house. I’ve also posted before about how bad I am at networking and how I’ve had to develop coping strategies to be able to feel comfortable in rooms at conferences. I have friends and colleagues who are naturally gifted in this regard, but I am not one of them. I am not ashamed of who I am, or where I come from, I’m a proud brummy girl who has worked hard, but that doesn’t change the fact that in 2015 I stared at out at a room full of people from my profession, supposedly from my world, and just felt as other as it was possible to be.

Roll on eight years, and through some twist of fate I don’t think I will ever truly understand, I find myself standing outside of Westminster Abbey, waiting to go in to witness the Coronation of King Charles III. I have gone through a lot of emotions in the journey to this spot, but when standing here I didn’t feel like the girl who didn’t fit in. I arrived through those doors comfortable in my own skin, proud to be representing my profession and not scared to represent all that I am in the process. So how did I get from there to here? How I did I change and grow to feel like I could (most days) own the space I find myself in?

Honour the reason you’re here

The first thing for me was the realisation of how many people, woman in particular, have fought and sacrificed so that I could have the opportunity to even feel like an imposter in a space. I’ve posted about my mum and her journey to support science before, but there are so many woman who have faced so many challenges just so I would have the opportunity, or the door opened. Over time I’ve realised how important it is to seize those opportunities in order to honour those that came before. To move the dialogue on and to ensure that I leave things more open and equal requires me to do my bit, to make my sacrifices for those who will come after, to go through that open door and wedge it open so that others can follow behind and then take even bigger strides than I will. The cost of my feeling uncomfortable and experiencing self doubt is nothing compared to what those who went before experienced. If I think of myself as part of a wider picture, of just another brick on the yellow brick road, then it becomes less about me and more about the journey, and what I do to support others. That doesn’t require me to know anything about hats, false lashes or designers, that only requires me to be passionate about why I’m doing what I am doing. Suddenly everything else feels slightly less intimidating, after all, I know my why.

Be decisive: decide who you want to be in that space

So, you are not like everyone else, congratulations! I think that may just be a very good thing. When you enter a new world, a new network, a new experience, you have an opportunity to be deliberate in deciding who you want to be. You aren’t carrying the baggage of being know as ‘the new girl’ even though you’ve been there 20 years now. You aren’t that girl who spilled adenovirus tissue culture. You are shiny and new. You therefore have the opportunity to tell your tale, to share your why and really focus on the impact you want to have. Most of the time you have been invited into that space, so try to reflect on why that is and what you want to achieve. If, like me, you want to move the dialogue forward than it is OK not to be like the other people in the room, you have probably been invited into that space for just that reason. Don’t lose sight of who you are because of the newness, see it as opportunity to be the essence of what you want to bring into that space. If you can focus on why you have chosen to be there, rather than being overwhelmed by the choices of others, then I find it very grounding. For me, that reason can be anything from, I came to have 1 conversations with X that I couldn’t have other wise, to I came because I want to raise awareness of Y. Sometimes, for me, that can just be me actively introducing myself as a Healthcare Scientist and opening the door for people to ask me what one of those is, so I can discuss how awesome this work force are.

Acknowledge your fears

One of the things that has helped me most is to not just ignore my fears and pretend they don’t exist, but to spend time in reflecting on why they exist and what triggers lead to them overwhelm me. For me, it’s often about letting people down, or standing out in the wrong way – thus diluting my message and meaning I lose my voice. For the Coronation, because I knew not feeling like I was fitting in appearance wise would be a trigger for me and therefore not achieving the representation I wanted to achieve, I took steps before I went. I researched what to wear, I learnt to understand the dress code. This meant on the day I didn’t worry about that part at all, I could just focus on representing IPC and the Healthcare Scientist profession, this isn’t hard, because I have the best job in the world and love my profession. Suddenly I’m freed up to focus on joy and not fear. In 2015, I hadn’t done this work and it’s not something that happened over night. I had to take the time to learn more about me so I could then manage my responses. The work is worth it though. Obviously, this doesn’t always mean you won’t be taken from left field, but most of the time if you’ve put in the work you can free yourself up to be present and enjoy the moment.

Understand that the world is not you centric

The other things is, and I don’t want to ruin anyone’s egos here, you’re just not that important. The BBC did not care what I was wearing at the Coronation, in 2015 I was probably hardly noticed at that event, let alone anyone bothering to think enough about me to judge my outfit or elevator pitch. Frankly, we are mostly just not that important to other people. Therefore a lot of the fears we have about being judged are really not that relevant, we’re just not that seen. Also, even if the worst happens, and you spill that red wine all over the carpet at the House of Commons drinks reception (yep, I did that) the likelihood is that no one will remember. In my case the only person who remembers is Professor Mark Fielder, mostly because I almost spilled it on him too, and we just laugh about it now. I have been to some truly awful conference presentations, but I remember the topics, I don’t remember the speaker. Even if the worst happens, when you get over the mortification, you will be the one that remembers it, it is unlikely that anyone else will. So be braver, the worst is probably not that bad, spend less time worrying over it and embrace the good that could happen instead.

Have the bravery to keep being you

Finally, and this may be because I’m just growing old disreputably, but be brave enough to be you. You find yourself in this moment, and no matter the reason you arrived at it you are the master of your own destiny. Be brave enough to bring all of you into that moment and be who you want to be. It’s not always easy in the moment but I promise you, you will regret the moments when you wuss out and toe the party line or try to be someone else so much more then any moment when you were truly yourself, no matter what the reception. For me, I guess its always about having honesty with myself, and building relationships with others based on the trust that I will be seen. Relationships and moments built without that honest and courageous authenticity will never be really real, you’ll always question them and yourself within them. By being who you are then, good or bad, what you create with others is the truth and has real meaning. I feel it is only by being bravely who we are that we can have the impact that we want for our lives and for changing the world for those who will come after. So lets raise a glass, to being authentically and completely us, and celebrate all that we are, both the good and the work in progress!

All opinions in this blog are my own

An Unexpected Invitation: Representing the Healthcare Science & IPC workforce at the Coronation of King Charles III

girlymicro General, Healthcare Science, Leadership, Microbiology (Clinical), Science Communication

Please note, this is a rather self indulgent post written to help me remember in future years what was a truly spectacular day and set of events.  Please forgive me and feel free to skip.

Let me start off by saying what an incredibly normal person I am.  I have a job I am passionate about, friends and family I love, but apart from quite how fortunate I count myself to be, I am incredibly normal.  I don’t have ‘connections’, I didn’t go to private school, and neither I nor my family are part of any clubs or other exclusive societies.  So imagine my outright shock when in March this email dropped into my inbox on a Friday afternoon:

This is a joke………right?

On the 31st January 2020, I was fortunate to be awarded the British Empire Medal for services to healthcare and I wrote a little about how I didn’t believe it in a blog post.  That was a fascinating process in itself, especially as I couldn’t tell anyone. When this email dropped into my inbox however, frankly it felt like someone was playing a bit of a joke.  I opened and returned the form, almost on auto pilot because it felt like the kind of thing you should do, but as soon as I hit send I phoned my mum and Mr Girlymicro and had a bit of a breakdown after I calmly got the words out.  Just saying the words ‘I think I’ve just been invited to the Coronation’ put me into a complete spin.  You see, I’m the girl that snuggles down with a cup of tea and Agatha Christie when I manage to get time off, or to be completely honest, some truly awful reality TV (hated by my husband 🙂 like Love is Blind.  I am not the girl that gets invited to fancy dinners or big events, let alone something to be seen on the international stage.  Writing the Girlymicro blog is often the most down time I get on a weekend.  So after sending my reply I sat back and just assumed that they would at some point realise their mistake and life would carry on.

Costume drama

As time went on and more emails went back and forth it gradually hit me that I may, in actual fact, need to attend the Coronation.  I went through a period of properly freaking out about how I wouldn’t fit in, and how I’d have nothing sensible to say, my family pointed out it was too late for that, I’d accepted the invitation.  I was locked in.

Then I proceeded to have, what a dear friend, referred to as a ‘Costume Drama’. Now, I get up in the morning and dress in the clothes in front of me.  I am guaranteed to have covered myself in food/tea/detritus within an hour of dressing.  I don’t wear makeup, and when I do I am lucky to not poke my own eye out with my eye liner.  As the reality dawned on me, it also occured to me that I was going to need to have something to wear.  Bear in mind that when I went to the Garden Party at Buckingham Palace I had a tail spin because I had never brought a hat and I just didn’t know what to expect. It took me 6 months to find something to wear and I had a little less than 6 weeks to get this sorted.  This also felt like a complete level above what I had needed to achieve for afternoon tea.

I have previously posted about how I feel about clothing expectations.  In this case, I began to increasingly feel like clothing would have a role as armour, as a way to step into a space where you felt like you needed to put your best foot forward.  I needed to find something to wear that would help me feel like I deserved to be there and could occupy the space I had been given.  At the same time, I wanted to balance the costume with who I am, I wanted to feel both like I belonged and still feel like me.  So, being a scientist, I hit research mode and pulled together as many sources as I could to find the ‘uniform’ that was likely to be worn at such an event, and then to find ways to modify it so I could ‘fit in’ and still be me.  I know some of you will be reading this and feel disappointed that I was not prepared to stand out. To make a statement.  Sometimes, I feel that the freedom to make a statement comes from a position of privilege.  Not always, sometimes it’s merely bravery and not worrying about the consequences.  In this case, I didn’t feel I wanted to make a statement, I don’t feel like I come from a place where I have enough privilege to go against the tide. You may think it shows a lack of bravery, but the last thing I wanted was to stick out in anything but a ‘that’s a nice dress’ way.  I was nervous enough, and a lot of those nerves stemmed from knowing that I was representing not just myself but all of you, my family, my profession, and my friends.  What I wanted most was to make everyone proud, and so standing out needed to be done in the best possible way by rocking a look that acknowledged the event and still felt like me.

Feeling the weight of representation

You see, as time went on, I became more and more aware that the invitation I’d received wasn’t really about me, it was about us.  I didn’t get a BEM for my work in isolation, it was for the work we had done as a community, I was just lucky enough to be the one who got a medal pinned to her chest.  As the event drew nearer, I was so aware that I was representing both Healthcare Scientists and Infection Prevention and Control on an enormous stage.  I am so proud to be part of both of those groups.  I am prouder than I can state about my profession, a profession that is so often hidden and doesn’t get mentioned at the big events.  I knew that the one thing I would be able to do on the day was talk about it and shine a spot light, if even just to a few people, on the amazing work my colleagues do and the sacrifices that they all made during the pandemic.  I was aware that even though it was my name on the invite, in point of fact, in many ways, it wasn’t about me at all.  I needed to use this unique opportunity to shine that spotlight on the people who deserve to be seen.

Coming, ready or not

Knowing it wasn’t really about me didn’t stop me from feeling nervous, however. I often get in my own head about big moments or events, especially things like this that feel too big and outside of the normal, for someone as normal as me.  At times like this, I like to remember a quote of one of my favourite TV series:

“Bottom line is even if you see ’em coming, you’re not ready for the big moments. No one asks for their life to change, not really. But it does. So what, are we helpless? Puppets? No. The big moments are gonna come, can’t help that. It’s what you do afterwards that counts. That’s when you find out who you are. You’ll see what I mean.”

Whistler – Angel Season One

My family, friends and colleagues did a great job of helping me get out of my own way.  I really struggled at first with people asking me why I’d been invited.  I didn’t know, I didn’t have an answer, but with the help of those around me I practiced an answer I could use on the day, ‘I got invited because of the great work that IPC and Healthcare Scientists did during the pandemic, coming together to really make a difference for children and young people, in terms of not only testing but also in keeping them safe in healthcare.  I’m representing a great group of people who all go above and beyond every day, and I’m really honoured to be invited.’ I was as prepared as I was going to be.

A fairy tale day

So, the day arrived.  I continued to be nervous, but I had all the lists and instructions to make me feel prepared.  In the end, everyone I have to say was simply wonderful.  I had been prepared for the formality, but I don’t think I had been prepared for the nice bits, the bits where we laughed and the bits where the event was in some ways just like every other event, just bigger and shinier, and with some of my hero’s present.

The day started at 5:15 am.  I knew that there wouldn’t be many bathroom opportunities and so I could only have one (yes, that’s right, one!) cup of tea.  Because I also knew that doing my hair and make up would stress me out and I wanted to enjoy the day, and because London has people who will do this for a very reasonable price at 6am, a wonderful lady arrived to make me feel pretty.  I was made up, hat on and in a taxi by 7:45.  All the time, with the news running in the background saying people were arriving and making me feel like I was already late.

I had that strange anxiety, like getting to an airport, where you just want to get through security and take your seat.  I have to say that from the minute I showed my invite and started walking from Victoria Gardens down towards the Abbey, everyone was just so lovely and the nerves started to fade.  Security was easy, and the atmosphere just felt really special.  I felt like I do when running a half marathon, when everyone on the side of the road cheers you on, with less running and more hat.  This part was made even nicer by running into another IPC legend Clare Johnstone as I was nearing the Abbey.  This was great because not only did I have someone to experience it with, but we could also take a photo of each other to record the occasion. 

Clare and I weren’t sitting in the same area, so I made my way to find my seat, just behind the North Quire.  I was in some way saddened to realise that I wouldn’t have a good view of the procession, although to be honest, I’d not been expecting one.  What I hadn’t expected was that everyone from Rishi Sunak to Ant and Dec would have to walk right by me both before and during the ceremony, as the Quire was mostly blocked with performers.  This meant I got to do some grade A up close people watching in the 2 hours plus you had to be seated prior to the arrival of King Charles III, including Lionel Richie being a complete gentleman as he went by, asking how I was doing and saying he like my dress.  The other thing that was interesting to note was that everyone had to scrum for seats.  Now, as a pleb I’d expected this to be the case for me, but no, it was also the case for those much more famous than I.  Those entering through the West Door had reserved seats, but everyone else was very much equitable in terms of finding your own within the section you had been allocated to.  I found this somewhat pleasing.

We all knew the toilets were going to be locked down at 10am, and having been sitting since 8am it seemed sensible to try to get a visit out of the way as there would be no further opportunity until after 13:30.  I state this here because, although the event was spectacular, the fact that toilets are always an issue somewhat amused me.  There were 3 female toilets for the entire of the Abbey, for everyone from Hollywood celebrity to little old me, it made no difference.  My colleagues have often heard me swear I will never use a portaloo, as I hate them from an IPC perspective.  The available toilets were a step up, but they were still just temporary toilets.  Of the 3 cubicles available, 1 did not have a working lock on the door, and 1 was blocked, only leaving 1 toilet in reality for everyone to use.  Also, the cubicles were small.  Normally, this would be less of an issue, but as I’m not someone who has often tried to negotiate such things with a rather large hat, it was challenging.  Toilets are an issue, even if you are a King.

When the ceremony started I was fortunate enough to have found a seat next door to the seating reserved for the Heralds.  This was very cool as I got to see them process, but also got to sit and get an up close view of all their regalia and to see a lot more of their roles.  The advantage to being off to one side and therefore not quite on camera was that although the event was still very formal, I got to enjoy some informal moments that made us all laugh.  Some parts of the order of service did not quite go as planned, such as the Prince and Princess of Wales entering iut of order. Because we were in quite close quarters together there was a real sense of comradery, which I hadn’t expected, as we all got up at incorrect points or couldn’t work out when to sit down when things were not quite as stated.

There was also some slight drama, when during the first hymn, the older lady next to me tried to drink some water, choked and then vomited water all down her, me and quite a chunk of the floor.  Trying to silently signal and collect tissues, check she was OK and clean her up was significantly easier given where we were seated, but again our whole section silently pulled together to try and help.  This is the disadvantage of telling people that bathroom access is limited, as over 5 hours is a long time for some people to not feel like they can drink.

There was never really a dull moment during the service, and it felt like the congregation were constantly involved in small ways during the service.  The moment when the enormity really struck me however, of where I was and what was happening, was during the singing of the national anthem, it made me choke up a little, it just felt truly historic, it really felt like I was living through a never to be repeated moment, and I felt so lucky to be there to witness it.

And then it was over, and yet somehow the time after the Coronation itself felt like the nicest bit.  You could almost feel the collective sigh of relief, and the atmosphere suddenly became much more informal, with people taking selfies with each other, talking and introducing themselves and mingling much more freely.  At this point I could really talk to people about the amazing work my colleagues do and what an honour it was to be there.  It also meant I could get a couple of pics of the Abbey in a way you weren’t permitted before the ceremony.

Then, as I was leaving the Abbey something happened that really made my day.  I got to leave the Abbey and walk with Dame Judy Dench and Sir Kenneth Branagh.  I mean, I didn’t have the courage to say anything, especially as they were just talking to each other in a really normal way, but I got to wander down the road with 2 complete legends, and then say hi to Stephen Fry.  The only way I could have been  more excited was if I’d gotten to meet Michelle Obama, but it appears she didn’t get an invite.

It was a truly magical day that exceeded all my expectations, I got to talk to people about the work we do, I got to feel part of history, and I got to visit a world, however briefly, which I never believed would welcome someone like me, and yet it did with open arms.  I felt like I was welcome, I felt like I was seen and unexpectedly I felt like I deserved to be there.

My 7 seconds of fame on the BBC, plus the legend that is Dame Judy Dench again!!

Carrying your family with you

My friends and family mean so much to me, and they properly stepped up to the occasion, from sending gin minis for after the service that I could use to celebrate, to sending me pieces of jewellery that I could wear on the day and therefore carry them with me to help me deal with the nerves, and to help me feel like I belonged.  They helped me move from feeling worried about the need to represent people and a profession who mean so much to me, to feeling the joy of doing the same.  They helped me stay in the moment and understand that rather than fearing letting people down, I should celebrate making them feel seen.

Seeing their excitement, feeling their support for me stepping onto this enormous stage and celebrating me embracing all of who I am and where I’ve come from made all the difference, and no amount of drizzle could dampen the day.

I was collected by my husband Jon after the ceremony, and not only did he bring me an umbrella, but he also brought me comfortable shoes to switch into. I’ve rarely loved him more. Sharing the build-up and the day with people I love, as well as seeing the responses on social media, really did make it a day I will never forget. Thank you for sharing it with me.

All opinions in this blog are my own

Just One More Block: Sometimes, the Only Way is Through

girlymicro Academic Life, General, Healthcare Science, Leadership

Many years ago, before Mr Girlymicro walked me down the aisle, we went on a trip. This was rather a special trip and involved him, mummy Girlymicro and me taking the trans siberian express from Moscow to Beijing. As a way to meet my mother, it could be said to be a rather extreme introduction! At one point, in Ekaterinburg, we had gone shopping and brought a LOT of food to last us the next train leg. It was hot, and to be honest, I wither in anything above 23 degrees. Our collective Russian was pretty poor, and so there was no choice but to walk from the supermarket back to the hotel. It quickly became apparent that we were unprepared for carrying so much stuff in the rather excessive heat. Mr Girlymicro was in charge of directions. Every block he  would turn to us and say ‘nearly there, just one more block’. Every time we believed him until after 17 blocks we made it back. Thus, the phrase ‘just one more block’ was born in our household as a way to tackle a challenge that feels truly insurmountable.

The last few weeks have been pretty hard, and this phrase has been used quite a lot. I’ve not been feeling great post COVID, and when I don’t feel great physically, I also struggle mentally. I tend to spiral about interactions and struggle to find the perspective to determine if anything I’ve done is any good. At the same point, I am aware that this is a transient state, and I’m cognisant that I am in it. It’s just, weirdly, sometimes knowing that doesn’t make it feel that much better. The thing is though, life doesn’t stop when you’re not at your best, when you’re not having your best day. Life continues, and sometimes you just have to put on your big girl pants and deliver anyway.  Sometimes, the only way is through. So, here are some of my thoughts on just making it through the day when the world gets tough.

Take one step (or block), one action at a time

Sometimes, when I’m finding things very challenging, I have to focus on super short term goals. Sometimes that can be getting through the week, sometimes that can be getting through the day and frankly sometimes that can mean I take the world 10 minutes at a time and focus my world down to a pin point. This may seem a little crazy, but it’s the way I trick my mind and stop being either physically or mentally overwhelmed by the big picture. I may not know how I’m going to survive running a week long course when ill, but I can picture myself surviving the next 10 minutes. All I have to then do is rinse and repeat.

If it’s workload that is overwhelming me, I do the same thing, just with tasks. Instead of focussing on all the things I have to achieve and feeling panicked, I make a commitment to myself that I will complete a single thing. That single thing can then flex depending on my capacity, it could be as simple as making a single call or sending a single email, it could be as complex as reading through a PhD thesis. It’s not the complexity that matters, it’s the commitment to a single act. Doing enough of these then means that without worrying about the whole, I’m still making headway. Now, obviously, in an ideal world you would do this in order of priority, but frankly some days that just doesn’t work for me. Sometimes, I’m just in too deep. Something is better than nothing.

Progress is not always visible, find/make what markers you can

The more senior I become, the less able I seem to be to be able to see progress. So much of what I do now can feel really amorphous. Sometimes, I really miss the days when I would spend a Friday Sanger sequencing, with the radio on. I would start the day with nothing and end it with results that I would phone out to support patient care. The achievements were visible. They felt tangible. The world I live in now is more strategic and tasks run for months, if not years often. It’s harder, therefore, to KNOW you’ve achieved or made a difference. This is the nature of the work, but I’ve learnt that I need some form of progress markers, just to maintain momentum. I therefore try to make sure that I make some milestones, even if the project as a whole doesn’t require them for reporting.

This sounds easier than it is sometimes, and to be honest, I’m still a work in progress on how to do it well. Mostly it’s challenging as this takes time and space to reflect in order to determine what these milestones should be, and this is not something I always grant myself until necessity hits. If you make the time investment in the planning phase it does make it easier in the long term to see the wood for the trees. These milestones may need to be a little inventive as not all long term tasks lend themselves to this process easily. Mine can be anything getting X to produce document Y (or even seeing a draft), to managing to pin A down for a meeting that’s been cancelled for the last 3 years. Whatever it is, it’s about acknowledging that just managing to get that small piece of the puzzle in place is progress.

Acknowledge that you don’t have to spend every day changing the world

I’m super guilty of this one, I have delusions of superhero status, but I am not wonder woman, and neither are you. Some days, everything comes together, and we make massive leaps forward. What we often don’t acknowledge in these moments of great success is the the number of days it took to get us there where it felt like zero progress was occurring. Any big change is not a single moment. It’s many much smaller, less visible moments that suddenly come together in a way that is apparent. In the words of Hamilton, ‘I’m not standing still, I’m lying in wait’. It can be hard to recognise and value those ‘waiting’ moments however.

Not just that, though. We can’t function at 100% all the time, we’ll at least I can’t.  If you try, it means that you end up with huge peaks and troughs as you drain your battery. I’m rubbish at doing this in practice, but I acknowledge that what is needed is consistency in order to create impact. Small steps often get you further than single huge leaps. If we set all of our energy on trying to leap tall buildings rather than putting one foot in front of the other, we may actually be making life both harder for ourselves and be less effective. We have to know when to look at the sky and when to look at our feet.

Don’t treat yourself in a way you wouldn’t treat a friend

My inner critic is not kind. Right now, for instance, I’m having a real ‘you don’t really achieve or do anything’ inner dialogue. The thing is, I would never treat someone else the way I treat myself. I would remind someone else of all the progress they’ve made, I would remind them of their benchmarks, I would give them a reality check on their expectations of both themselves and the environment they are in. I would remind them that mistakes and failure are human and, in fact, a crucial part of learning and having a growth mindset. I would do all these things for others, but I struggle to do them for myself. I guess writing this blog is often my way of having kinder conversations with myself.

The way we speak to ourselves matters. Our self-talk, our inner monologue really does impact on how we see the world and how we respond to challenges. I’m trying to be cognisant of this and (between blog writing) actively pep talk myself when trying to manage challenges, or sometimes just get through the day. I’m also super lucky to be able to reach out to Mr Girlymicro for a ‘just one more block’ conversation when I can’t get there myself.

Know who you can show your real face to

Sometimes, as I mentioned above, our inner critic is just too strong, or the external forces are too overwhelming. In this case, you may not be able to get there on your own. You may have to reach out and have that moment of vulnerability with someone else to get through. I love a good sounding board, I think they add so much value, and I’m fortunate to have a number of people who I can show the true unpolished version of myself to who will take the appropriate cues of what I need in the moment. I also have you guys who give your time to read my rambling thought processes and always support my thinking and discussion around it.

Reaching out can be a double-edged sword however, you need to know who you can go through this process with. If you are at point where you are already slightly crushed by your inner dialogue, the last thing you need is someone who will escalate that voice. At the same point, you need to have someone who you trust to call you out if that’s what’s needed. There are times when you just tea and sympathy, there are times when you want coaching, there are times when you want advice, there are times when you need someone to call bullshit on your excuses and push you over the hump you’ve created. You need to know that you are with someone who can pivot to what is actually needed in the conversation, and who knows you well enough to be able to read what you need. Either that or you need to be able to reflect enough and go to the right person for the right things. There’s nothing worse than really needing a sympathetic ear and ending up with a lecture on how to do it better that echoes all the criticism you’ve already been giving yourself. Support is invaluable, but choose your route wisely.

Bribery works, for me anyway

I’ve already talked about breaking the world down into manageable chunks of time, or tasks, in order to be able to move forward by inches if needed. If you are strong of mind and have will power this approach on it’s own may be enough, I however still feel like I have the mind of somewhat upset toddler, and so sometimes will power enough doesn’t cut it for me. Sometimes I need to bribe myself. This shouldn’t work as I know as an adult that I can just decide to get these things anyway, and yet for me it still does. I bribe myself with anything from a biscuit and a cup of tea if I manage the next 1000 words to if I make myself run a half marathon I can buy myself that dress I’ve been lusting after. Sometimes completion of the task in itself is enough reward, especially if getting it off my list leads to a decrease in stress level, but honestly right now I just move from one immovable deadline to the next and something more is needed.

There is also something to be said for celebrating some of the milestones, for celebrating progress rather than waiting for the pay off or success. This means that you are more aware of those milestones happening and value them, instead of using an end point to determine how you feel about a task or yourself. Sometimes you might not succeed at the end goal, but you will have learnt a lot along the way, by celebrating the milestones you can therefore remember progress made rather than focussing on the failure.

Some days, it’s merely the act of showing up that counts

If all of the tips and tricks don’t work, if all the chocolate on the globe still wouldn’t cut it, sometimes you have to remember that you are still showing up. You are still working on being present. You may not make the progress that day you wished to make, that deadline may have flown past with you barely able to engage with it, but there is always tomorrow and the hope that it will be better than today. It may not be the perfection that you wanted, but that doesn’t mean that what you’ve produced doesn’t have value. Finally, and I mean this with every ounce of my being, your value as a human being is not tied to what you produce. You have value irrespective of your successes and failures. You have value in just being you, and there is no deadline on that.

All opinions in this blog are my own

Guest Blog by Dr Claire Walker: Bots, ChatGPT and AI – Is this the end to assessments in Higher Education as we know it?

girlymicro Academic Life, Education, Guest blog, Healthcare Science, Research/Academia, Science Communication

Whilst SARS CoV2 continues to kick my ass and make doing much other than getting out of bed a challenge, the wonderful Dr Claire Walker has stepped up yet again in order to ensure that whilst Professor Cloutman-Green may be dozing, Girlymicro still delivers! Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on the transition from lab to academia.

Bots, ChatGPT and AI – Is this the end to assessments in Higher Education as we know it?

The impact of ChatGPT on assessment is a hot topic in high education at the moment, you can scarcely open a newspaper without seeing scaremongering headlines shouting this is the end to course works as we know it.

I’m not sure I really agree with this, I’ve had a play with ChatGPT and remain fairly confident that I can spot a bot at forty paces. Students have always had access to a use a ghost-writer for take-home exams and essays, and from this perspective, ChatGPT is hardly a new problem. I’m also convinced that my  students are honest, and genuinely believe that they want to prove their knowledge and understanding through coursework’s and examination. Afterall, they will need these skills when they venture out into the world of work so there is no benefit to committing academic fraud. Even if you aren’t caught on day one, it’s going to catch up with you eventually.

That said, there is a question being whispered around higher education institutions at the moment regarding the coursework questions and exam papers – ‘have you run it through ChatGPT? What did you think? Could you tell it was a bot answer?’. So before I throw the baby out with the bathwater and panic, I thought I’d take time to note down some of the flaws that I see in ChatGPT. Currently, ChatGPT only has access to information up to 2021 and cannot access papers behind paywalls so if you design your questions to reflect on current knowledge and practice, the bot will return an error. I often create a new virus, disease or genetic defect for a paper, the bots also error when presented with these and cannot hypothesise the way a student can.  Bots cannot make personal reflections which are essential in synthesis of clinical information, it’s very obviously if a reflection is generated by AI.. Also we know our students, we know their writing styles and have a very good idea of what level of knowledge they have – it’s our job (!). We do teach the content of the modules after all. Finally, we already have AI detecting tech built into our anti-plagiarism systems. This is a cat and mouse game, and the bots won’t stay ahead for very long. 

Even so, this is just one lecturer’s opinion so I thought I’d go right to the source – and ask ChatCPT itself. And you can read for yourself. I’m not convinced we’ll be getting it to write any more blog posts any time soon….

Input Question: Write a 500 word blog post on the impact of ChatGPT and AI on student take home exams in biomedical science education

ChatGPT Blog Post:

The rise of artificial intelligence has been transforming various sectors of society, including education. One area that has seen significant changes is in student take-home exams in biomedical science education. With the advent of ChatGPT and other AI tools, students have a new level of accessibility and support in their studies. In this blog post, we will discuss the impact of ChatGPT and AI on student take-home exams in biomedical science education.

Firstly, ChatGPT and other AI tools have revolutionized the way students can access information. Instead of spending hours poring over textbooks, students can simply ask ChatGPT to find the relevant information they need. This saves a lot of time and effort, freeing up students to focus on understanding and applying the information. Furthermore, the ability to quickly access information means that students can study more efficiently, making better use of their time and ultimately improving their academic performance.

Secondly, ChatGPT and other AI tools have enhanced the quality of student work. These tools can provide students with instant feedback on their work, allowing them to identify areas for improvement and make corrections before submitting their assignments. This means that students can produce higher-quality work and learn from their mistakes more quickly. Additionally, AI tools can help students catch errors that they might have missed on their own, leading to more accurate and thorough work.

Thirdly, ChatGPT and other AI tools have increased the accessibility of biomedical science education. For students who may have difficulty accessing traditional classroom-based education, these tools offer a new avenue for learning. With ChatGPT, students can learn at their own pace and on their own schedule, making education more accessible to those who may have other responsibilities such as work or family commitments. This also means that students who live in remote or underprivileged areas can access high-quality education that might otherwise be out of reach.

However, while there are many benefits to using ChatGPT and other AI tools in student take-home exams, there are also some potential drawbacks to consider. For example, there is a risk that students may become overly reliant on these tools, leading to a reduction in critical thinking skills. Additionally, the use of AI tools may make it easier for students to plagiarize, as they can simply copy and paste information without fully understanding it.

To mitigate these risks, it is important to ensure that students are taught how to use these tools responsibly. This includes educating them on the importance of critical thinking and encouraging them to use AI tools as a supplement to their learning, rather than a replacement for it. It also means teaching students how to properly cite and reference sources, and providing them with opportunities to practice these skills.

In conclusion, ChatGPT and other AI tools have had a significant impact on student take-home exams in biomedical science education. These tools have improved the accessibility and quality of education, while also helping students learn more efficiently. However, it is important to approach these tools with caution and ensure that students are using them responsibly. By doing so, we can continue to harness the power of AI to enhance biomedical science education for students around the world.

Certainly ChatGPT has a high opinion of itself but there are some good points made here. This could be a useful study tool to help students learn and revise topics. With this in mind, you can’t uninvent a technology. Now is the time to elevate the different assessment methods that we use. So with that I’m off to mark an in-person practical exam, set a group work project and spend a week listening to students present a critical evaluation of papers written after 2021. I don’t think ChatCPT has me out of a job just yet…

TLDR – It’s not like the Bot started the blog post with ‘I am become death the destroyer of the higher education assessment system’, just yet.

All opinions in this blog are my own

The Paths that Made Us: Learning to be grateful for the moments that made us who we are

girlymicro Academic Life, General, Healthcare Science, Leadership

April is always a time of heightened emotion for me, and as time progresses, it is also increasingly a time for reflection. April was the month where the life I had planned for myself vanished over a period of 48 hours and when I lost one of the only constants I’d ever had, my sister, as well as my unborn niece. I’ve written about what happened before, and this post isn’t really about that. This post is about what came after and how I have come in recent years to appreciate the person that those experiences made me. I’m not saying I’m not sometimes sad for the person I may have been if those 48 hours hadn’t happened, I’m saying that I am grateful for where this alternative path has led me. The result is miles away from anything I could have pictured, but I have still found myself in a place of joy and love. So this post is to acknowledge that sometimes we have to accept the paths that made us.

As a result of this thinking I thought I would share some of the places my path has led that I didn’t expect, and share some of the lessons I’ve learnt that I am grateful for, in case it helps you also see things through a slightly different lens.

Be scared, but do it anyway

I often talk about how blessed I am. The truth is that I am always a little scared. There’s a part of my brain that always fears when the good happens, what the cost will be. I do have a blessed life, but I have also experienced some pretty significant trauma. I am very aware at all points in my life how quickly everything could just go away. I am also still painfully aware of the memory of how that made me feel. At first, this made me scared of the good things because I just then waited for the bad to follow. I still have spirals when this is the case, but for the most part, it means I try to value every single moment. Every compliment, every moment of joy, every step on the path. It also means that I know I have survived. I have survived days that I thought would be unsurvivable, so on my worst days I still know I will survive what’s to come.

This learning to live with fear has had some other benefits. It’s so easy to let fear limit us in other aspects of our life, fear of failure, fear of humiliation, and fear of being seen. All of these things can stop us from grabbing opportunities when they come our way. The thing is, my biggest fear is that linked to my own mortality and those of the people I love, and I am still forced to face that every day. It makes the other fears I hold feel a little smaller. They have a little less control. They have a little less impact. I say yes to things I wouldn’t have dreamed of if I had been on a different path, and saying yes has opened doors I could not have imagined existed. So bring on the fear, I’ve walked through it and survived, and so will you.

A child free life still has value and meaning

I’ve posted before and included a plea before about the fact that childless individuals still have lives with meaning, and asking that we are not the people who are always defaulted to working late or moving our leave, as we still have commitments to family and people that love us.

In recent years (and I still stand by the original plea) I have come to appreciate the flexibility that my child free status has given me and how that has enabled me to seize opportunities I would not have been able to otherwise. I don’t know if I had children that I would have been able to gain my PhD in the way I did, as it involved a fair few nights when I worked to midnight. I don’t know that I would have been able to balance achieving FRCPath if I had children, as I was studying at 5am before work and again when I got home. I’ve been able to build a research career because I can travel overseas to conferences and at weekends, and I am regularly the person who leaves work at 7 pm. All of these things would have been harder if not impossible if I needed to be home for pick up or take my child to football on the weekend.

I don’t know that my eyes would have been so firmly fixed on the horizon and thinking what’s next if I was focussed a raising another human being (and if I didn’t have a husband with the patience of a saint). All of these freedoms have led to me being able to attain things I’d never dreamed of, I became a Consultant, a Professor, I got a New Year’s Honour and an invite to the Coronation. I don’t for one minute think I would have felt that I’d missed out on anything by having children, as I really don’t think I would have realised many of these things are possible. I do, however, feel truly blessed by the wealth of the life that I live and the time I get to spend with my wonderful husband partaking in some once in a lifetime events. My life is rich. Perhaps rich is a different way to the way I’d planned, but rich non the less.

Sometimes you need to hear no enough to realise that yes, you can

For a chunk of my life I was told certain things might not happen for me. When I was unwell in my teens I’ve talked about how I was told university might not be for me. As a trainee I was often told that it would be unlikely that someone like me would achieve FRCPath working in a paediatric setting and I would therefore not make consultant, and I was told for years that someone like me wouldn’t make professor.

The thing is, from my position now, I am grateful for every single one of those no’s. Those no’s made me really focus on what was important to me and brought clarity to my thinking. Those no’s taught me about the barriers and attitudes that weren’t openly discussed and the occasional prejudice than hearing a yeses ever could. Those no’s made me smarter by teaching me how to work around barriers and to be a more strategic thinker, which has benefits elsewhere. Those no’s were sometimes what I needed to light a fire under me and make me decide to prove others wrong in order to really achieve change, not just for myself but for those following me.

The other thing that those no’s taught me is to differentiate when a no is really a ‘not yet’. This has been a crucial life skill for me, sometimes my enthusiasm drives me forward at pace, and there are some times in life when actually slowing down means that you will get more benefit from the process/experience. Sometimes, a ‘not yet’ means that you will be better able to do the task when you reach your destination. Being able to know when no means no is sometimes the most useful skill in any interaction.

Instability can sometimes help you thrive

I was at GOSH for over 13 years before my temporary contract became a permanent job, and even then it only occured because of a HR error when I transitioned from my PhD contract back onto a GOSH one. That instability caused me huge levels of stress the uncertainty of whether I would have a job from one year to the next, or where I would end up if something I loved so much just disappeared. It meant that I seized every opportunity that came to me, as I didn’t know which networks would be important for my future or if I would ever have an opportunity presented to me again. I took exams early or in a very planned way in order to ensure that future pathways and options were not closed off to me, as I could never know when I might need them.

Now, don’t get me wrong, all of this meant that I overcommitted and worked waaaaay harder than I might otherwise have. It meant that, at one point, I didn’t have a weekend off for three years. It has also meant that I have the career that I have now. Sitting on my laurels and becoming comfortable was never an option. Saying no to others was never really an option, as you never knew if you would need their support in the future. This has meant that the breadth of experiences I’ve been able to access has been wonderful. It also means that I know find myself as a Consultant, having maintained an interest in research and in education, both of which mean so much to me. I have gone above and beyond to ensure I could maintain all three.

I sometimes think that if I had had a permanent band 7 or even band 6 post, then that is where I might have stayed, instead I have a job that challenges me every day to be better and I continue to have access to a diverse portfolio of things that inspire me and bring me joy. And finally, a job that is permanent and in a field that I love. So that instability may have been worth it and the driver I needed to get to my dream job.

Some days the only way is through

I’m writing this whilst feeling pretty dire, I’m still post COVID and struggling with the day to day. I am however still working and still functioning. I have posted before about some of the health challenges I live with on a day to day basis, none of them are massively severe but they do impact how easy I sometimes find life. It’s sometimes easy when it takes me this long to recover from something to feel down about it. Instead I’d like to say that there is an upside. I spend a lot of time focussing on the end goal and pushing through when I feel tired or unwell, it’s a regular life event for me. This means that I have developed the skill of being able to become incredibly focussed in order to get something done. If I say I will deliver, I will deliver, come hell or high water, short of incapacitation I will deliver on my word. Without it, I wouldn’t have managed to sit my GCSE’s, I wouldn’t have been able to manage at university, and I certainly wouldn’t have completed my Clinical Scientist training.

Now, sometimes I admit that I take this too far, and sometimes it means that I don’t take the rest I need or tap out when I should. It does mean, however, that if push comes to shove, I am able to just push through and make things happen. This is something that has been invaluable in delivering in a world where I have a tendency to over commit, and it’s led to me being able to deliver on things like this blog, which means so much to me. So, although it may not always be the healthiest trait, it is a trait that I see the value in and am grateful to have developed.

There are so many times in life when all we can see is the gloom and the dark clouds on the horizon. It is often difficult to find the distance emptionally or the time to really put some of our challenges into context and to see all that they bring to us as individuals, the good and the bad. We may sometimes be broken, but that does not make us less beautiful. In fact, sometimes, the fires that forge us enable us to emerge as truer versions of ourselves than we may otherwise have been.

So if you are still surrounded by the flames hang in there, there will be a time when you too can look at your past and see it as the source of your strength rather than the thing that was trying to break your spirit.

All opinions in this blog are my own

Guest Blog by Dr Claire Walker: Is there a place for Simulated Placement in Biomedical Science Education?

girlymicro Guest blog, Healthcare Science, Research/Academia

Well, it finally happened, on the third anniversary of lockdown I got faint lines on my SARS CoV2 lateral flow test and my first infection. I’m currently sofa bound and feel like I’ve been hit by a truck and the ever wonderful Dr Walker has stepped in and written me a post so you were not left hanging for a second week without your Girlymicro fix.

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on the transition from lab to academia.

Op-Ed. Is there a place for Simulated Placement in Biomedical Science Education?

Hi all, it’s me again, banging the drum for getting students to come and complete an IBMS accredited degree, to get their portfolios and to become members of the NHS pathology workforce. I left my position in clinical pathology and research to come and teach on an accredited degree course to get bums on seats in the NHS – but specifically the best, most talented bums on the best seats in the house. I wanted to inspire the most able, talented students to come and work in the greatest profession around. And to top that off, in the most interesting of all the disciplines, you know, Immunology (Sorry @Girlymicro but it’s clearly superior). All opinions in this blog are very much my own. 

As some of you will know students studying an iBMS accredited degree typically engage in a 39 week generally unpaid placement in a clinical laboratory to collate a portfolio of evidence sufficient to gain Health and Care Professional (HCPC) Registration on completion of their degree. This lets them apply to jobs as a registered Biomedical Scientist when their degree is complete. Sadly, this placement is completed only by a minority of students for a variety of different reasons. There are significant challenges in the implementation and supporting of clinical placements. One only has to consider the high clinical workloads in pathology, especially post-COVID, the increasing complexity of equipment and techniques, as well as the high demand for placements from students which many labs simply lack time and capacity to support. Particularly as there is no guarantee that a student will return to the training lab to work full time at the end of the degree. Put simply, it’s a lot of effort for no guarantee of reward for the lab’s investment. It doesn’t feel like a very sustainable system, and we need innovative solutions.

And the team at Staffordshire University have got them in spades. I was extremely fortunate to attend an ideation event at the Staffordshire Uni on ‘The Role of Simulated and Alternative Placement in Evidencing Standards of Proficiency for Biomedical Scientists’ hosted by Ian Davies and Aimee Pinnington. I was absolutely bowled over by the work they are putting into developing an authentic clinical experience in their biomedical science degree programmes. It’s not hurt by their great links with local hospitals, the fact they both have extensive experience in the NHS as HCPC reg scientists, and their obvious enthusiasm for the subject matter.

Clinical simulation is an exciting component of healthcare education which to date has largely been overlooked in the training of our biomedical scientist workforce. Simulation is a well-established method that allows learners to practice in a controlled environment with no risk of harm to patients. In many healthcare professions, simulation-based activities are used as discrete learning opportunities throughout the curricula as part of academic modules but perhaps there is a need to do more to integrate this learning to create a more authentic learning experience. There is much enthusiasm amongst those of us walking the clinical/academic line as HCPC registered Senior Lecturers to do more to support our students to get their registration. The ideation event at Staffordshire University gave us the opportunity to discuss different options to embed skills and behaviours within the University experience. Overall, I felt that this was not with the aim of replacing a traditional laboratory placement, but rather to find tools to support routes to registration and really consolidating the value of the student placement experience. I feel we need to work out exactly what students get from their time, and if any of this can be done in the University environment to reduce pressure on the pathology laboratories.

Meme from Biomedical Sciences day – what does a biomedical scientist do? Created by the haematology team at Hull and East Yorkshire Hospitals

I came to this meeting not really knowing what to expect, and feeling that nothing could really replace the unique and essential experience of working for a full year in the clinical lab. And I walked away from this meeting excited and brimming with ideas to put into practice on my own immunology course. I’ve no interest in getting rid of placements entirely but I do think the University needs to do more to get students ready for practice, and that as a profession we need to shake off some cobwebs and look at what we can do to enhance recruitment. After all, I left a much beloved research career to get the most talented bums on the most important seats in pathology.

TL:DR What do we want? Simulated and alternative placements to be introduced to accredited degrees. When do we want it? When they have been properly devised to replicated an authentic placement experience ideally by HCPC registered healthcare scientists collaborating with University staff (who may or may not be the same people!).

All opinions in this blog are my own

Learning to Live in the Grey: Moving back to a risk assessment based approach for IPC

girlymicro Microbiology (Clinical)

This is the post I was supposed to get out last week but didn’t quite make it as my mind latched onto dealing with what was directly in front of me, rather than being in a more conceptual space. That said, after having just run a course, where the main theme was supporting participants to be able to use frameworks to make risk assessments, it still feels like an important conversation to have. Now, these are just my observations and thoughts. They are not meant to be criticisms of any person or indeed the system itself. I hope it will just continue the conversation about what serves us and our patients best, and we all know there is not a one size fits all approach.

Pre-pandemic it felt, to me, that there were guidelines frameworks out there, particularly linked to things like Carbapenemase Producing Enterobacteriales (CPE’s), but in the main part Infection Prevention and Control (IPC) teams used a lot of personal judgement and experience to determine routes to management, with input from Health Protection Units as needed. The pandemic led to a big switch, where a command and control approach was undertaken. This made complete sense, as resources were restricted and shared across the system. Therefore, frameworks supported us all practising in similar ways and with expectation setting. They also supported large scale evidence collection to improve interventions. We were also in a scenario where some of the diversity of what we were dealing with was removed, in terms of IPC, the focus was mainly on one key organism. Now we are moving back into ‘business as usual’ both in terms of patient flow, and in terms of organisms, that one size fits all approach feels like it may do us a disservice, as the challenges are now so much more diverse. We therefore need to think about how me move back to a much more risk based approach, where instead of having a single organism focus, we also take the setting and the patient into consideration.

Risk assessment and risk based decision making

Those of you who have read some of my other blogs, about the fact that I genuinely believe that IPC is 90% risk assessment will not be surprised that I believe that we need to empower people to undertake these risk assessments better. For 3 years we have given everyone very specific instructions for their actions on every part of the pathway, when to test, what test to use, what PPE to wear, all possible because we were focussed on one thing, much like the standard risk matrix below: risk = SARS CoV2, and all risk mitigations are rated against this in a 2:2 matrix.

We are moving back to a world where, instead of using a matrix where everything is measured for it’s efficacy against against a single pathogen, we need to consider multiple pathogens, their characteristics, and how these play out differently in different patient populations and in different settings. Therefore a standard risk matrix approach does not serve the outcome of increased patient safety we all want to achieve.

Sadly, it also gets even more complicated. We have been living in a healthcare system for the last 3 years where everything, action wise, felt like it was determined by testing and test results. That means that we have been functioning using a test based action algorithm for a very long time. Now, I’m a scientist, and therefore love a good diagnostic test. However, in healthcare there are so many things that can impact on test outcomes: timing of the sample, factors such as antibiotics, quality of the sample, test requesting accuracy, specimen type etc etc etc. We are not just optimising all of our testing pathways for improved sensitivity in relation to a single organism, we are trying to use the best choice we can in order to maximise information output for a wide range, there will therefore be things that bias the accuracy of those results. So we are back in a healthcare world where we need to stop being so focussed on the test and the test result, and start seeing the patient in front of us again, irrespective of what the negative test may say. We need to move back from a test based approach to a symptom based approach. If my patient has respiratory symptoms, they should be in droplet/airborne precautions, irrespective of what the test results say. If my patient has diarrhoea, then we need to put them in contact precautions irrespective of a negative gastro panel, unless you have clinically evaluated other reasons for the symptoms. This clinical evaluation step is key, and you can’t put all of the information linked to that in a flowchart, therefore we need to switch from command and control responses, to supporting the experts at the bedside to use their clinical knowledge to evaluate patients, and support them in better risk based decision making to support IPC. We have to acknowledge that the assessment process is complex, but also feel that we have supported staff enough to be able to make those complex judgements.

https://hbr.org/2022/08/solving-tough-problems-requires-a-mindset-shift?

Acknowledging the uncertainty in the system

The problem with a risk assessment based strategy, managed primarily at the bed side, is two fold. Firstly, you have to be prepared to support with the education to enable it to succeed and to know when to escalate and question. This can be time consuming and it is a task that needs to be continuously supported, as staff, patient mix and environments change. Secondly, we have to have honest conversations with staff to help them to understand and become more comfortable with some of the principles of uncertainty. This is because algorithm based approaches often offer, sometimes unreal, certainty. If I do A and then B in compliance with a flow chart everything will be alright. By increasing complexity in decision making, you also introduce uncertainty, and that needs to be acknowledge and addressed as part of our approaches. Otherwise staff will never feel empowered to take the steps required.

Types of uncertainty

The first thing to say, is that not all uncertainty is the same, and therefore you need to approach different types using different tools. Epistemic uncertainty, is the one in healthcare we can probably do the most about. It’s the kind of uncertainty which we can, sometimes, address by asking better questions. Questions like, I notice you seem to be using a lot of tissues, do you have have a cold or feel like you have a bad chest? Questions like, have you been in contact with anyone who has had an infection or been unwell recently? Or have you been travelling a lot recently? If we can support our staff to feel more confident in collecting the information they need, and then knowing what to do with it, they will feel more confident in making decisions without escalating all of those decisions up to someone else for sign off.

Other forms of uncertainty, such as aleatoric uncertainty are harder to address. This isn’t uncertainty that you can address by gaining more or better information, it’s the kind of random chance events that you have to manage by becoming more comfortable with the fact that healthcare is multifactorial, and you may never be 100% about any action or solution. An example I always use in my head for this is a 4 bedded bay where someone has just vomited due to norovirus. We know on the balance of evidence all 3 other patients are likely to acquire norovirus, as it will stay in the air for ~2 hours and up to a million copies of the virus will circulate prior to deposition. What we don’t know is, did 1 of those 3 patients have norovirus last month after a wedding, and therefore currently has sufficient immunity against the circulating strain? Is 1 of the others one of the small number of people who have receptor variance which means they are less likely to acquire infection? You can’t get that information by looking at them, you are unlikely to be able to get that information by testing or asking questions. Therefore you have to manage the uncertainty and deal with the decision making you can undertake, with the information available to you. That decision making also becomes much more complex when consensus making is difficult, and so supporting staff to know how and when to escalate when this occurs is really important.

So how do we deal with uncertainty better?

For me, the first step is to acknowledge that it is there, rather than trying to persuade ourselves that bedside risk assessment is a) easy and b) doesn’t come with any discomfort for the staff we are asking to undertake it. It takes time and space to be able to this well, both for the required educational component and for the staff to be able to have the cognitive space to ask and process the questions, as well as undertake any follow up. It also takes us to really recognise that we are a single team working across that healthcare pathway, this isn’t about IPC putting their responsibilities onto someone else, it’s about improving patient outcomes by having the people evaluating patients as close as possible to the ones making informed decision about those patients. It does not stop the requirement for complex decision making to be escalated or remove the need to be able to ask for support. It also requires feedback and monitoring so that staff do not feel like they are being left alone to carry a risk or fearing consequences for inappropriate decision making. It is about empowerment in patient care, not resource saving.

I personally believe that we need to move away from central dictates for IPC decision making, patients are unique, and combining that with different environments and organisms means that numerous factors need to be taken into consideration if we are to provide the best possible care. That cannot be done well centrally, where we never see the patient and are not aware of the minute by minute changes in their wellbeing. Supporting those at the bedside to make better decisions and empowering them to be the people who respond to those changes is key to moving away from the single organism focus of the pandemic. IPC teams are key, they should be the ones educating, empowering and being the escalation points, but there are simply not enough of them to have one at every bedside and so we need to look at spreading the knowledge and IPC love!

his-dipc-day-2022Download

All opinions in this blog are my own

You Spin Me Right Round Baby, Right Round: Getting through the day when it’s all a bit too much

girlymicro General

I had great plans about what I was going to post today, but to be honest, it hasn’t quite worked out. It hasn’t worked out because I can’t focus on the post I had drafted because I am currently feeling so overwhelmed by the day job. I’ve been prepping and then running a course for three weeks, and the emails have mounted up to a point where I can’t see a way forward. I have lectures coming up that aren’t written. I feel run down and grotty because I pushed myself too hard physically, and to top it all off, yesterday was filled with frustrating politics. So, instead of posting about Infection Control, today’s post will be about reminding myself of some of the tools I use to re-centre myself when I feel like I’m spinning out of control.

Know tomorrow is another day

I am sadly not one of those people who always look like a graceful swan, working frantically under the water but appearing calm and graceful to all observers. I am the person who wears her heart on her sleeve and quite frankly gets stuff done but looks like a cartoon Tasmanian Devil in the process. I ride the emotional roller coaster and just try not to scream too loudly. Sometimes, I just need to take a step back from the chaos and try to realise a) what’s real, b) what is just because of tiredness, c) what really matters. Some things that feel so challenging in the moment feel so different once they are resolved, like the sun coming out. Therefore, getting worked up about them hardly seems worth it. When things feel like they currently do, I try to remind myself that everything will feel different tomorrow, or when I start to feel more like myself. This means that I also need to try to remind myself not to react so much in the moment. I find that taking a brief moment to focus on a point in the future that feels removed from where I’m at can really help me reset my thinking, be that planning for a future holiday, focussing on sorting a future talk etc, focussing on the future whilst also not losing time I don’t have to fix the present.

Just like any roller coaster, this too will end

When everything is coming at you, it can feel like the end of a game of Tetris, when everything is coming at you so fast you don’t have a moment to even recognise what pieces you are juggling, let alone how to fit them in. The thing is, even this is a state of mind, if I was in a different place I would be excited by the challenge rather than feeling a rising state of panic. The key thing, for me, is that I recognise when I am entering a mental space where I am losing perspective. I have two approaches to this:

Step one (a) is to make a total list that will enable me to get a better idea of where I’m at with things. Step one (b) happens when I’m too far into my stressing, in this case making a complete list actually freaks me out even more, and so I make a next day list. I list enough that I feel like I have identified the urgent things, but make sure not to be so extensive that I worry about how I’m going to get the entire list done.

The second approach is that I go through my diary and try to gain some time I can block out as ‘task time’, so I actually have some time to make the things on my list happen. I may not have solved the issues but at least I know what it will take to make me feel like I’m back in control enough to get off the roller coaster.

Focus on one thing, directly in front of you

If it all else fails, and I can’t even cope with ‘The List’ I pick one thing. The biggest, most urgent, most panic inducing thing and just give that 100% of my focus. I split it down into pieces that are easier to mentally digest and just start at the very beginning. I’ve said there are times when looking to the future helps me, there are also times when I just need to look at my feet and take one step at a time. I also find that, to stop the prevaricator in me, I need to put the ‘Do not disturb’ sign on my door to buy me not just the physical time, but the undisrupted mental time to get into the task and enable me to find a rhythm. Sometimes, I need to pick at a couple of easy things to lead into the big thing, but often, for me, it’s better to just pull off that band aid and get to it.

Even if it’s as bad as you think, how bad is that really?

All of this is about process managing my way out of where I’m at, but there is also recognising what are the real consequences of where I am. I’ve previously written a blog post about the reality of deadlines, but there is also the aspect that we feel these things so keenly because we are the centre of our worlds, therefore when we feel things aren’t correct we assume that everyone else clearly sees the same. The reality is that most of the people we interact with aren’t all that focussed on us. If there are deadlines that are real, then we manage them, but just like others aren’t fully aware of our individual workloads, they are also not as aware of our weaknesses and failures as we perceive them to be. This can be especially true if you’re a perfectionist, and you feel that if something is delivered and it is not as you envisioned that it is a massive reflection of your failure. As far as I’m aware, I have yet to meet a mind reader and so the only person who is benchmarking against the vision in your mind is you, therefore cut yourself a break. When it comes to outputs on days like today I tell myself ‘done is better than good’ and that my benchmark for done is usually pretty damn high. Therefore, just get it done!

Plan your way out

When I have given myself a good talking to, and dealt with the immediate panic in front of me, it’s time to work out how I’m going to tackle the rest. I’ve already talked about blocking out some task time and moving towards making a list, but for me, this part is also about being able to visualise my progress. What are my quick wins, so I feel like I’m getting somewhere. What if any bits can I seek help with, we are not one women armies after all. Are there any bits in hindsight I can drop, or are no longer needed, to buy me some extra time? Any deadlines I can move? Once I’ve got myself to a space where I feel brave enough to look at the entire list and see the big picture, I can be proactive about moving forward. Or the BIG question……..do I just feel this way because I’m feeling run down and ill, in which case I need to stop worrying about it and get some rest.

Sometimes, you just have to get a little distance

If the answer to the question ‘do I just feel this way because I’m feeling run down and ill?’ is ‘yes’ then the answer is to down tools and get some space. I started this post on Friday but just couldn’t manage it and so took Friday night and Saturday off. I’m finishing it on Sunday so as not to put extra pressure on myself to finish it on my Monday morning tube journey in. I have a tendency to work harder when I feel out of control, and that is fine, to a point. The issue with pushing harder when the tank is already empty is, as my husband regularly says to me, ‘ease down you’re only grinding metal’ (it’s an Aliens quote). You have to know when you are in a space where it’s productive to work, versus when you are in a space where it’s more productive to rest. If you step away you will come back refreshed, with a new perspective, and sometimes the challenges are either just not as great any more, or you can see solutions you wouldn’t have seen otherwise. I have a great team around me, who really help flag to me when I’m just doubling down when I should step away, them and my husband are absolute lifesavers in terms of reminding me that I’m more productive long term if I rest. Be aware however, that resting is different to ostriching, so being honest with yourself is key.

Anyway I’m still pretty tired but I’m better for the rest. Hopefully you all won’t judge me too harshly for my honesty and that by sharing how I feel we can all support each other a little bit better when the deadlines are looming and the sky feels like it might come crashing down. Here are the tips I’ve been channelling this weekend to help get me through:

  • Take a deep breath
  • Work out whether you actually have an issue or whether what you really need is rest
  • Decide whether to look to the future (to gain perspective) or to identify a single task to work on (to support focus)
  • Use the resources you have available to you, you are not in this on your own

If all else fails, phone a friend, we are after all here to help.

All opinions in this blog are my own

Should I Stay or Should I Go Now? Why decision-making linked to projects and roles requires us to flex as we grow

girlymicro General, Leadership

Let me start by saying that I am not for one second thinking about moving on from my job, I love it, even on the hard days. It’s not just jobs that we need to think about however, the same review process is true of positions (like committees) and also things like projects. Sometimes, when you are in all of these things, it can be hard to have the distance to reflect on whether carrying on is the right choice, not only for us but also for others. As I get older and slightly more established as a Consultant, I’ve been doing some thinking about which things to maintain and which it’s time to move on from to enable the development of others. I thought therefore that now is as good a time as any to talk about what that review process looks like.

Know what you are trying to achieve

I’m a default to yes kind of girl, unless I have a clear reason to decline I will always agree to give advice, help your project, join your committee, become a Governor etc. There are so many reasons why this is actually great. It opens doors to opportunities, experiences, and networks I just wouldn’t have otherwise. The problem with it is that in the moment you might not truly consider the purpose of the request, and whether it aligns with your values and aspirations.

Now, I’m not saying that everything has to have a why. What I am saying is that if you don’t take the time to think about the purpose and what added value you bring to the role, it can be difficult to judge further down the line whether those things have changed and whether you want to continue.

There are times when this is easier than others. If you are in a position where you are no longer being heard and you question what you are bringing to the table because it is not being considered, you have the choice to step away or rectify the situation, as others may be feeling the same.

Things like mission creep can be harder to manage. When you gradually find yourself taking on more and more, beyond the original terms of your commitment. The key word here is creep. It happens gradually, and you may take some time to realise it. If you don’t have regular points where you review your commitments, you may not even know that it’s happening. This is often a mark that you are valued, but it can also be a marker that others aren’t respecting your time and boundaries. If you don’t have clarity about what it is you wanted to achieve by saying yes, it can be hard to determine whether this enhanced role is still fulfilling your objectives, or whether you need to cut back or walk away.

Even if you are also a default to yes person, doing it with clarity of purpose enables you to review along the way. Also, know that if you say yes to everything, you will by default say no to other things, even if not actively. If you don’t know what your aspirations and objectives are, you can end up signing up to many things that actually draw your focus from the place you wanted to end up.

Know when something still serves you

If there is one thing in life that is inescapable, it is that we live in flux, everything changes, some things for the good, and some less so. Work based commitments are no different. Sometimes, scenarios change, or your end point changes and the current project/post/role no longer provides what you require. For instance, the terms of reference on a committee may change and no longer reflect the purpose for which you joined it, or you have started a research project but the findings suggest you should focus on a new area of research that does not really appeal. There is little to no point in getting upset about this. It happens, and sometimes you have to acknowledge that you can’t change the situation to serve you. At the point that you recognise this, you may need to make some decisions about your future or the future of a project, no matter what the prior investment may have been.

Awareness of both yourself and your situation is key when changes are happening or projects are evolving, so you can actively engage in decision-making linked to those changes, rather than getting swept up as a passenger in events. This has happened to me at numerous points in my career, and it is especially likely at transition points. The shift from trainee to qualified, qualified to senior, senior to consultant, but also at points where you are deciding what that individual career route looks like. Within projects, you can become so focussed on the original goal that some of the surrounding details pass you by. If you are not actively engaging with the hard conversations with yourself, you may find you end up in a career/project cul de sac that leaves you unhappy or requires you to make a horizontal move to get you back on the right track.

Once you are in the cul de sac it can be may be possible to change where you are at, but not always – a training post for example cannot always become a registered post as there are so many external factors involved. It is much better to avoid the cul de sac if you can, by being open and honest with yourself early on, but also working to be aware of those external factors to better understand where they are leading you and if you can influence them. Sadly, if you find yourself in one, there’s nothing to be done but to plan your exit strategy.

It is possible that if this happens and you haven’t seen it coming, the first response is to feel trapped and to experience all the emotions that come with that. Sometimes, those emotions can make it tempting to double down and try to force change rather than to step back and take a rationale look at both the external situation and why you feel the way you do. Both of these are required, however, for you to find your way out. Flogging a dead horse is not going to get it to win the race. Your only choice at that point is to find a new horse. Sometimes, work based choices can be the same, and it requires you to have the reflective insight to understand when to step away.

Know when you are still serving the purpose

I’m in my 40s and fortunate enough to be fairly well established in my career. I’m super happy with where I’m at, but in recent years I’ve had to sit myself down and have a serious talk with myself about whether I am still the right person to undertake some of the things that give me quite a lot of joy. I’m talking about some of the school outreach I do and even some of the committees I’ve been on for years. Just because I still enjoy something doesn’t mean that I am the best person to do it. In fact, if the project is good and matters to you, it is even more important to be aware of whether you are serving it or if it is now only serving you.

Some forms of outreach are a perfect example of this. I really enjoy going into schools and speaking to students. There are still occasions where I think I am the best person to do this, when showing can raise awareness of roles etc, but there are plenty of occasions when I would not be the right person any more. I am probably not the best person to go in and talk about university choices or to talk about A-levels. I’ve been out of the system for waaaaaaay too long. I am also, probably, not the best person to do a standard career visit. For one, I am now probably too old for the students to connect who I am with their life choices, for another I am showing a career after 20 years in the job and what they most want is someone whose recently graduated and moved into the role. Someone who resonates with them and shows where they could be in 5 years rather than 20. This was a really hard discussion to have with myself, but this kind of activity isn’t about me, it’s about the individuals whom I’m there to serve, therefore being open about the fact that what I bring to the table has changed is important. Knowing this and taking the opportunity to pay it forward to someone who can do it better can improve the experience of all those involved.

The other part of this self dialogue is about whether I am being selfish. I’ve reached a point in my career where I am privileged to be offered all kinds of opportunities rather than having to go looking for them. This is, let me be honest, amazing, and a real confidence boost. It does however mean that I have to have some conversations with myself questioning whether it is always appropriate for me to take them, or keep them, or whether the time has come to pay it forward and hand over some of those opportunities to others. One example of this is that I have now stepped down from a number of committees that I used to sit on. I really enjoyed sitting on them, personally I got a lot out of it. At the same point however, I would never have had the opportunity to gain the skills and build the networks I have, if someone hadn’t stepped aside in order for me to be able to join. These conversations generally involve me asking myself: Am I still learning? Am I still being challenged? If the answer is no, I’m just enjoying it, then I’m probably blocking a learning experience that could be beneficial to others and I should consider stepping aside for them to benefit.

I also have to be honest with myself that as I progress I gain new commitments, if I don’t let some of the previous commitments go I am actually not serving anyone well. I have to ask myself: Do I have the time/resources/interest in order to continue? Time is my most limited resource, and if I can’t give something the time it requires it is better that I let someone else take over who can.

So here are my two questions I regularly ask myself in order to help support decision making:

What is my motivation for being involved/continuing (guilt or obligation is not a reason to stay)?

Would passing on this opportunity to others benefit them and the objective, or would walking away cause actual harm?

If you can honestly ask these questions of yourself and reflect on the results it can really help guide your thinking of whether you should stay or go for any project or role/position.

All opinions in this blog are my own

Developing the Courage to Stand Tall: Time to ignore the fear and realise it’s OK to stand out

girlymicro General, Leadership

January so far, although always hard as it’s so dark, has held some really good news, and February has knocked it out of the park in terms of nice events, with celebrating both a Professorship and Freedom of the City of London. One of the interesting things that has struck me about both of these though, is how reticent I’ve been feeling about shouting about them, especially in the lead up. Almost as if I fear that once I talk about them, they could be taken away.  This is slightly ridiculous as they aren’t the kind of things that will disappear. They are however the kinds of things that feel really important to me and I don’t want to risk them being tarnished or diminished by others. We all know the people out there who will be: ‘well, you only got X because of Y’ or ‘that kind of thing isn’t really that important these days, is it?’ or even ‘I would have gone for that too, but we both know it’s just playing into the system, and I’m not about that’. The kinds of things that get said to your face, let alone the kinds of things that get said behind your back.

Now, I’m a grown-up (most of the time), and I tend to let these things wash over me, but it can certainly take the shine off things. Worst than that, sometimes I allow it to take the shine off things merely because I predict it will happen rather than waiting for the reality. Sometimes, I am my own worst enemy.

After all of these years, I’ve just accepted the reality of this, but I didn’t realise until very recently that in Australia and New Zealand they have a term for it = To Cut Down Tall Poppies. I think I’m probably late to the table, but in case anyone else is in the same boat (to mix metaphors), the term refers to:

People who criticise others who stand out from the crowd

Or

The idea is that we, as human beings, do not like outliers. We do not like different or people who stick their head above the parapet and dare to be seen. This really hit a cord with me. There have been numerous times over the last few years where, as I’ve been fortunate enough to succeed, the reaction has not been particularly positive. Even from some colleagues that I trusted to support me, especially as I started to forge my own path, which was different to the one they perhaps expected.

The end result has been that sometimes, instead of embracing the joy of the moment, I’ve spent too much time worrying about others’ reactions. Sometimes, I haven’t even mentioned to colleagues and others the end results of things I’ve worked long and hard for, as I’ve been too concerned about making situations harder for myself. I’m super fortunate now to have a great team that always exhibit genuine joy or amusement for some of these moments, but it’s taken me time to get here, and habits can be difficult to unlearn.

So how do we move from a space where we feel like we need to limit ourselves, limit our futures, in order to feel safe in the space we occupy. How do we move from the person who cowers to the person who has the courage to stand tall and occupy the space they rightfully possess. The below are a few lessons I’ve learnt, sometimes the hard way, and some things I’m trying to embody in order to be a bit braver every day, especially when it comes to owning my success and supporting that of others.

Know when and how to apply your boundaries

I once was awarded a grant for over £600,000.00. When I mentioned it to my colleagues at the time I was made to stand up in a meeting and apologise for not including any medical colleagues on my application, to explain why I had not reached out to add them to my grant. I patiently explained it was a Healthcare Science fellowship, that I was on supporting another Healthcare Scientist. I was thrown by the reaction. I apologised before I had time to think whether I should. My immediate reaction was to say sorry for overstepping my bounds, for being outside of my box.

In reality, the opposite was true. It was them who were breaching my boundaries. I was just so taken aback by it that I was unprepared. I’m still a natural apologiser. My default is still to say sorry and run from the situation. I don’t like conflict. What I try to remember now, though, is this. Every time I am in that situation and I take the easy route out, I make it harder for the person that follows. I reinforce the thinking that asking me ‘why’ and forcing me into a scenario where I needed to say ‘sorry’ was the right response, instead of simply saying ‘congratulations’. I also make it OK for them to do it to me again in the future.

Sure enough, I don’t discuss my grant funding very often in-house anymore. I don’t tell people when I succeed. I’ve even gone so far as not to host most of my research in my department. It’s been shown too many times to me how it could be weaponised against me on a whim when I stepped out of my box too much or when I didn’t play the game. As something that is super important to me, I removed the risk by removing the opportunity for it to be limited. I’m aware that hasn’t helped break down those very silo’s I’ve avoided, though.  All I’ve done is leave the same traps for others. So now my job is to be braver and to try and change things rather than hide from them. Now, I need to not only know my boundaries but stand by them to support others.

Know how we impact others by our choices

The problem with being too set in these boundaries however, is that you may not allow room for growth and change. We can get so caught up in protecting ourselves that we go too far the other way and isolate ourselves, closing off both ourselves and the setting. This is the difficult balancing act. The thing is, nothing stays the same. People change, both in how they interact and whether they are still decision makers. Personnel in general change, so we also need to be aware that boundaries may need to shift and flex rather than staying the same. In the example used about boundaries above, many of those people don’t work with me anymore, and so imposing the same rules now as then, may no longer serve the same purpose. We do ourselves and others no favours in being immovable in our responses. Instead we need to try to remain agile enough that we are aware of potential challenges without losing opportunities.

One of the biggest lessons I’ve learnt is that to remain open requires you to be brave enough to be vulnerable and to potentially face disappointment. If we don’t and just assume others won’t have your back, you have thereby remove their opportunity to support you and therefore you won’t ever have their support. In addition, let’s be honest here, some of the fear of telling others is definitely linked to imposter syndrome and the fear of being ‘found out’. In the end I think it comes down to being aware enough to set boundaries when they need to be set, but also spending enough time reflecting and trying to live your values. That despite the risks, you decide to be seen anyway, because that is what will help and support others. It is what will ultimately lead to change for all.

Own your own path

During the first workshop for the Nosocomial Project, a mentor who I admired greatly said to me, ‘Don’t you understand that you are taking an enormous risk? What if it goes wrong?’ The thing is, by avoiding risk and listening to people who, often kindly, warn us about the possibility of failure, we ensure that the best we will ever be is average. We will never truly reach our potential if we fear what it is to be seen or to fail. You won’t always succeed. It won’t always work out. You will however always learn and it will bring you one step closer to succeeding next time.

In moments like the one above, you have to be able to look inside yourself and have the strength and the determination to carry on seeing the vision or the end point. I’m not saying you won’t have self doubt, I’m not saying to not have fear. I have all of those things in spades. What I’m saying is that you need to make the conscious decision not to let them stop you. Have fear, but do it anyway. Don’t let others make you listen to those inner voices more than they deserve to be heard.

Often, we say to ourselves in these moments, ‘Who am I to…….’. The way I respond in these moments to myself (and don’t laugh – or do because it sounds ridiculous) is by saying ‘I am Dream Fucking Cloutman-Green and I am because I can’. It’s my mantra and combined with my ‘Get Psyched’ mix it has got me through a LOT of days and moments of self doubt. Find the thing that works for you, and don’t let others pressure you to be less, and sure as hell don’t pressure yourself to be average.

Let’s change the conversation

The change starts with us, every interaction we have, every moment when we choose jealously or fear of failure over joy for someone else. I am not a saint, I sometimes have that moment when someone declares great news where my brain flashes the ‘what about me’ message to my eyes.  The things is that response isn’t based upon reality because a) there are more than enough opportunities for everyone to succeed, therefore someone else’s success doesn’t come at a cost to you and b) even if it did cost you just because we are trained into thinking everything is a competition does not make it so. Therefore, I hope that despite what my initial reaction in my head might be, I would know that it was built on false thinking and that joy was always the correct response. This isn’t Highlander. There can be more than one (lovely 80s reference for those of you who are old like me – to the rest of you, YouTube it).

We change the conversation by being aware of the way we have been trained to think and behave towards each other. Not by denying that that taught behaviour exists, but by acknowledging it and actively dealing with it each time it rears its ugly head. Every time we respond initially in the moment, in our minds, with less than joy we need to course correct. Ensure that words out of our mouths and our body language demonstrate that joy, but also take some time afterwards to understand why it triggered us in the way it did. Being open with ourselves opens the door to reflection and learning in order to improve who we are. Nothing changes by accident, each and every one of us needs to put in the work.

So my final thoughts are:

  • Let’s actively welcome in the good rather than looking for the bad
  • Let’s choose to celebrate with the four people that see us and raise us up rather than focus on the one person who can’t
  • Let’s acknowledge our journey, our progress and not get distracted by the stumbles along the way
  • Let’s fertilise the soil rather than beheading the outliers so we all grow healthier and better to achieve our potential

All opinions in this blog are my own

Pinching Myself Again: Switching out Dr for Professor

girlymicro Academic Life, Microbiology (Research), Research/Academia

While I was away on holiday, I got some pretty amazing news, and now that the contract is in and signed, I finally feel like I can share it. I made Professor! You may think that as I’ve known for a couple of weeks this is coming, this blog post would have already been written, but I didn’t really believe it would come through until I got the official letter so I’m afraid I’m playing catch up.

As you may have picked up, I am still blown away by the fact that this has happened and because I genuinely never thought that someone like me would get here, I thought I would share a little about what it means, why it means so much and how it happened. I do this to inspire others to follow, not to crow, although in the spirit of full disclosure, I am super happy that it’s happened.  Also, a warning, I can only talk from my experience, and that is linked to a somewhat unconventional path. Please read the below in that light.

What is an Honorary Professor anyway?

Now, before I go any further, it is an Honorary Professorship as I’m still employed by my Trust rather than UCL, and because of that, it is also not a Chair. It is a title given to someone, who is not employed by a university, but who contributes to the work of that university, in my case via grant funding, paper writing, lecturing and student supervision, but unlike a Chair I am not involved in management. It is also worth noting that, like the academic professional pathway itself, it changes between universities and my only experience is with UCL.

In the UK, this (Honorary Professor) is the highest title to be awarded to individuals whom the university wish to appoint, honor, and to work with. These individuals are not university staff nor employees. An external person is usually recommended by an internal university academic staff, and recommended for approval by the head of department, for which the documents are then forwarded to faculty dean, vice president and president (or deputy vice chancellor) for approval.

https://en.wikipedia.org/wiki/Honorary_title_(academic)

As the title is Honorary, I’m allowed to use the title, but no, I do not get an office, a pay rise, or anything other than a webpage 🙂 My father may have asked me a few times. The success is more about reaching an academic benchmark and achieving recognition for both your work and it’s impact. It also is the final significant step on my journey as a Clinical Academic. I was always told that I should try to ensure that I move up both professional ladders in order to demonstrate success in this area, and so for me, this is as big an achievement as when I became a Consultant in my clinical work.

Why the surprise?

Let me start out by talking about why this felt unattainable and why, therefore, it is such a surprise. I’ve been developing a Clinical Academic career since 2008, so the best part of 15 years. In that time hardly anyone has suggested that making Professor could be something I should aim for. Worse than that, it is in fact an aspiration that I have been told more times than I can count is out of reach for ‘someone like me’. Now, the ‘someone like me’ description changes between the advisors, but a sample have been: you’re a scientist in a medics world, you’re too emotional, you’re too open/honest, you don’t play enough politics, you’re too young, you’re a woman, you will never publish in good enough journals as you work in Infection Prevention and Control.

To put this in context, my medical colleagues automatically make Associate Professor the moment they become consultants, irrespective of their publication or funding track records. They are therefore lined up for the next step and the pathway is fairly established. That said, very few of them go on to take it, partly because that next step is more like climbing a mountain. Put that together with the fact that only 3% of people who graduate with a PhD get to be a professor, and you can see why many people may not decide to pursue it, and why this moment feels momentous to me. Being able to show the world that this is actually what a professor CAN look like is really important to me. To be able to show you can not fit into the stereotype and still get there.

It’s not just about time served

Meeting the criteria to become a professor is not about length of time in post or time served post PhD, there’s quite a lot more to it. You have to be able to demonstrate a diverse portfolio that ticks a number of boxes. One example below is for progression linked to research, but as you can see, you also have to demonstrate not only suitability in the research domain but also in at least 2 other domains.

Progression through the above grades might be expected to be attained by demonstrating an ability to meet:

the threshold research criteria at the next level; and

several of the core and/or specialist research criteria at the next level; and

at least the threshold education criteria or some of the criteria in either of the two other domains (enterprise and external engagement; institutional citizenship) at the next level.

https://www.ucl.ac.uk/human-resources/policies/2021/oct/academic-career-framework
Research thresholds

Along the way, you will meet a LOT of people who will have an opinion on how you should develop the CV to enable you to eventually apply. One of the things I learnt early was to not listen to those who just said I shouldn’t do try. That’s different from not taking advice. It’s different from heeding the advice of people who say not yet, because there is more to do that will increase your chances of success. These people are often the ones who are wishing you well on the pathway and have some knowledge of the process requirements. The ones who can’t share your vision are the ones to thank for their input and move along. The ones who contribute to your process are incredibly valuable, even if sometimes the truth is hard to hear.

Education thresholds

I’m only an Honourary Professor, but even so, I have to meet the same thresholds as my full-time colleagues, as there is only a single standard. As I said above, the Honourary bit really links into your employer rather than the standard you have to attain.

What kind of things do you need to do?

It was International Women and Girls in Science Day this weekend, and I wanted to take a moment therefore to recognise why it can be much for challenging for women and people of colour to attain a Professorship, why it can be difficult for women to find the support they need. I mentioned that some of the stats say that only 3% of PhDs become professors, but the numbers are significantly worse if you are female, and worse still if you are a female person of colour. I’m no expert in this area, but I think it’s worth talking about and raising awareness. There are articles from those better informed than I to talk about it:

Are Female Professors Held To A Different Standard Than Their Male Counterparts?

Ratings-and-bias-against-women-over-time

Talented-women-of-colour-are-blocked-why-are-there-so-few-black-female-professors

Why so Few, Still? Challenges to Attracting, Advancing, and Keeping Women Faculty of Color in Academia

One of the first lessons I learnt was that you are going to struggle to get to the finish line if you try to do it alone. I’ve said it before, and I genuinely believe it, science is a team sport. It will be that team who enables you to demonstrate the breadth, as well as the depth needed. I have a wonderful academic colleague who supported my application, and my research group have always pushed and supported me to aim for the sky. That said, it strikes me that when I say science is a team sport, and that a team is what is required to get you to the finish line, sometimes women are not invited into the same rooms that support others. I’m so aware of the pub nights, meeting clubs, etc, that I’ve been briefly involved in, where names are thrown around prior to meetings, where relationships are built and plans are made. The hours I work generally preclude me from the ‘just popping to the pub’ crowd and the ‘medical discussion groups’ I’ve been to were just too linked into the Old Boys Network tradition for me to feel comfortable. I’m lucky though, at least occasionally I get asked, and therefore I could make an active choice about my path. That isn’t true for everyone. I chose to make my own path, I chose to play with a team that works for me. The word choice is key, and it speaks to my privilege that I get to use it.

The other factor is that women often have ended up being the ones that do the majority of some of the ‘non core’ activities, such as chairing diversity committees or undertaking public engagement. These activities are often things I love and the breadth they provide have always been important to me. The problem is that you have to have enough ‘core’ to secure promotion. You have to be getting grants, publishing papers, and supervising PhD students. Without these, you won’t be able to move forward, no matter how wonderful or talented you are. There are only 2 ways to handle this, keep doing more (and therefore having no time to be ‘in the club’) or be really clear with your boundaries to maintain time for core activities, and this can be easier said than done. To change the stats we have to support each other enough to be able to help with this. Someone’s worth for progression shouldn’t depend on their ability to say no!

It’s a marathon and not a sprint

There are so many boxes to tick and things to be achieved that making Professor is definitely a task of years, on average 15 years post completion of a PhD. I can’t say it enough times, however, that it is not merely about years and time. There are so many things to learn about yourself and your work before it becomes a possibility. What kind of supervisor are you? What is the work that inspires you? Even before you start on the knowledge accumulation.

As I said above, there is also a lot of growing to be done, and I’m nowhere near finished yet. Being able to set boundaries, being able to say no, knowing when to say yes, all of the leadership challenges you can imagine, on top of trying to be creative and deliver new thinking in order to move your research area forward. Just making the networks and finding your collaborators in order to make this happen will take years, and it takes time to build trust and relationships. So buckle in for the ride, and know there is no shortcut for gaining experience.

You will fail and fall many times, but like most challenges in life, it’s about having the passion and persistence to just keep turning up. To turn up after the failures and the difficult conversations. To turn up and take the learning and the growth. To always see the opportunities and develop the knowledge of how to circumvent the barriers. Keeping true to who you are and your values in the face of that failure and the criticism that sometimes comes with it. All of these things, if you don’t let them change you and make you bitter/cynical, will make the successes oh so sweet. Then it’s your job to pay it forward.

Take the time to know you

Like every long-term career journey, becoming a professor requires you to take some time to also know yourself. I’ve said that I got a lot of advice and one of the things I took away from it was that, because it’s a process of years, no 2 people will go about it the same way. From the criteria listed, you can see that you can put a lot of the puzzle pieces together in different ways. Therefore, it’s important to develop in a way that works for you as an individual. What aspects of the role bring you joy? What helps you thrive instead of feeling burnt out? It’s OK to focus on these things and maintain them within your portfolio of practice.

I also think knowing what you are not good or are weak at is also key. None of us are good at everything. None of us enjoy everything. You will have to pick up some core tasks that may not intuitively suit you, but knowing when they are core and when they are not will help you make better judgements. Also, being aware of your weaknesses will enable you to approach those areas more strategically in order to allow you to overcome.

It’s not just what it means to me

I actually don’t have words to express how grateful I am for the responses I’ve had since I shared the news. Part of me always worries about the fact that I might get ‘well why you’, I think it’s the imposter syndrome. Everyone has been so supportive, more than that, a lot of comments have talked about it showing to others that it can be done. This, to me, is SO important. There are so many wonderful Healthcare Scientists out there, so many wonderful Clinical Academics, but so few of them are Professors. It may sound trite, but you can’t be what you can’t see. If you don’t know this is an option, it’s hard to aspire to it as a path. So thank you for your support. Thank you for being my cheer leaders and for sharing what is such a joyful moment for me. In return, I share with you the email my father sent out to my old school teachers and his friends, in order to demonstrate that I know both what this means and how fortunate (or badass) I am. I’m off to break open a bottle of bubbly!

Congratulations to Elaine Cloutman-Green

Thank you to anyone and everyone who has contributed to Elaine’s development by offering advice, education, knowledge, guidance, comfort, discipline!!!!!!!, culture, sophistication!!!!, fellowship and friendship.

Especially her soulmate, mentor and amazing husband Jon.

Plus a small contribution of determination, intelligence, gin!!, character, industry, more gin!!, worldliness, industry, even more gin!!, nouse and a chunk of good, old fashioned, inherited Yorkshire grit from herself.

Who would think that a coalminer and car worker’s grand daughter,
born in Good Hope Hospital of common stock,
Villa Holt End season ticket holding fan,
whose education was via Northfield Manor Junior, Hillcrest and Shenley Court Secondary Schools,
then Liverpool University Biology (BSc 2.1), Physics(MRes) departments, UCL (Msc Queen Mary’s Med Sch) and PhD
Who could forget reading her thesis “The role of the environment in the transmission of Healthcare Associated Infection”?
Fellowship of the Royal Society of Pathologist could achieve such high academic status.

Deputy director of Prevention and Infection Control at Great Ormond Street Hospital,
Pathology consultant
British Empire Medal in the New Year’s Honours List for work on Covid
Freman of the Worshipful Company of Plumbers (I would not let her turn on a tap!!!!)

Now UCL, University College London have for her research work on the prevention of the spread of water bourne diseases and academic teaching programmes about Virology and reducing the spread of disease have in their infinite wisdom have honoured and rewarded her making her:

PROFESSOR ELAINE CLOUTMAN-GREEN

Very well done
Eeh ba gum, sh dun reyt gud tha’ nose!, anno we’er chuffed to bits,
Her sister Claire would have been even prouder of Elaine than her Dad of her success

Dr Alan Green January 2023

All opinions in this blog are my own

Guest Blog by Lilian Chiwera: Surgical site infection prevention day initiatives – making change now to help tomorrow

girlymicro Guest blog, Microbiology (Clinical)

I wanted to quickly write and introduce you to the passionate and energetic Lilian Chiwera. Lilian is leading on a new project that aims to raise awareness of and better embed surgical site surveillance in healthcare. Her enthusiasm is infectious and she has swept many of us up in her wake, so grab a cup of tea and read why this piece of work is so important and why we should all want to step up and see how we could get involved.

Lilian Chiwera is a independent Surgical Site Infection (SSI) surveillance & prevention expert with experience setting up and coordinating a very successful SSI surveillance service at Guys & St Thomas’ NHS Foundation Trust (GSTT) from 2009 – 2022. Currently working in Digital Transformation, Lilian is exploring how best infection prevention and SSI prevention can be aligned with current digital transformation agendas. Blogs via: https://www.lilycompassion.com/

“I think I can officially declare that I’m now married to surgical site infection (SSI) prevention! There is no day or hour which passes by when I don’t think about what we can do to prevent avoidable SSIs and promote patient safety in our organisations. Yes, my passion for this important patient safety initiative is overflowing. I am honoured and humbled to have so many people supporting our latest push for SSI Prevention Day (SSIPD) initiatives.”

I must thank Elaine for asking me to write this blog. I have always looked up to Elaine, she is fun, very knowledgeable and always inspiring us through her fabulous blogs. When Elaine asked me to write this blog, I thought… where do I even begin. Elaine coached me on how to write blogs and I have never looked back. Check my previous blogs here and a fabulous selfie I took at the 2022 Infection Prevention Society Conference in Bournemouth, UK.

Given the number of people now supporting these initiatives I thought it was prudent for me to open this up to our SSI Prevention Day Group. I was not disappointed! Everyone came all signed up to do everything possible to support our call to action. It was no surprise therefore when Karen Ousey was so quick out of the blocks to write the piece below, thank you Karen!

Why surgical site prevention?

“Surgical site infections (SSIs) are among the most common and costly health care-associated infections, leading to adverse patient outcomes and death. The continued global discussions identifying the importance of reducing and preventing anti-microbial resistance and embedding antimicrobial stewardship strategies into practice highlights the significance of raising awareness for prevention of SSI for clinical staff and patients alike. Despite there being published SSI guidelines, there is still a lot of work needed to ensure improved compliance with implementation of evidence-based SSI prevention measures. Recently there have been some awareness campaigns that are attempting to raise awareness of wound infection. These include the International Stop Wound Infection Day (ISWID) held virtually on the 3rd Thursday of October annually which embraces Europe, Oceania and the Americas. The campaign features a range of free to access resources relevant to different countries and short videos from global wound care key opinion leaders and recordings demonstrating skills such as taking a wound swab. This campaign led by the International Wound Infection Institute states: Wound infection is a significant problem in both acute surgical wounds, leading SSIs, and non-healing, chronic wounds. Antimicrobial resistance is also a growing public health challenge worldwide which was identified as one of the top 10 threats to global health by the World Health Organisation in 2019. The ISWID campaign has been running for 2 years (2021 and 2022) and has seen lots of interactions from clinical staff across the world through social media posts and people being able to download free resources relating to prevention of wound infection.” Karen Ousey

It’s clear from Karen’s piece above that there is already lots of work going on around tackling wound infections. My desire has always been to ensure that we promote this important patient safety initiative together! In other words, an annual SSIPD can only be effective if all key stakeholders are involved and actively participate. Key stakeholders include all healthcare professionals and consumers of healthcare – covering a broad spectrum of specialisms i.e., Infection Prevention and Control (IPC) and SSI Surveillance and Prevention (SSISP) societies and collaboratives as well as patient safety advocates, journalists, musicians, quality improvement, human factors experts, psychologists, and many others. I therefore hope to see more stakeholders, in addition to those already signed up (see figure 1) collaborating with us on this important patient safety initiative.

Figure 1: Confirmed and proposed supporters

So, what are we really proposing?

Raise the profile of SSIs via:

  1. An annual SSI Prevention Day (SSIPD)/week
  2. Annual regulatory style SSIP inspection tool that will allow us to monitor surgical safety practices throughout the year via our dedicated SSI champions. These SSI champions will disseminate key findings/learning from inspections and action plans for the following year during the annual SSI Prevention SSIPD
  3. An SSI champion model that will give us an opportunity to standardise existing SSI surveillance and prevention processes in the UK and all countries around the globe through our dedicated local hospital, regional, country, and continent SSI champions.
  4. Proposed SSI champions will span a variety of healthcare professionals and consumers of healthcare. Our ambition is to embrace arts (journalism, music, etc.), science, other IPC branches, human factors experts, implementation science specialists, psychologists, Patient and Public Involvement (PPI) groups and many others to help us raise the profile of this important patient safety initiative.

Figure 2: proposed SSIP champion model and areas of initial focus

Proposed benefits include but are not limited to the following:

  1. provision of SSI/infection prevention expertise from ward to board by compassionate local champions, experienced SSI prevention champions, patient safety and infection prevention and control experts.
  2. Opportunity for collaboration and learning from each other.
  3. Opportunity for Chief Nursing Officers (CNO) and Chief Medical officers (CMO), Politicians and Journalists to champion an important patient safety initiative in the UK and globally.

From humble beginnings

What started as just another tweet in April 2022 has turned out to be perhaps one of the best SSIP campaign I have ever coordinated on social media (SoMe). By October 2022 I was presenting our SSI prevention day initiatives proposals at the largest Infection Prevention conference in the UK. Interestingly, the main reason I submitted an IPS conference abstract was because I just could not imagine myself missing seeing my friend Lisa Butcher being inaugurated as new IPS President. Therefore, I ended up taking the opportunity (aka killing two birds with one stone as some say!) to share our SSIPD aspirations with many conference attendees. Our IPS poster which was produced with input from many of our SSIPD group members was very well received. I left the conference believing that this campaign could become as popular or even surpass successes of the WHO annual Hand Hygiene campaign. Check out the timeline of activities via our Twitter handle here and hashtag #SSIPreventionDay.

Engaging our senior leadership

I presented our proposals to the Head of IPC at NHS England, after being given the go ahead by the Chief Nursing Officer. Engaging senior healthcare leaders and politicians is a critical component of our proposals. This draws from my experiences at Guy’s & St Thomas’ NHS Foundation Trust where with Dame Eileen Sills support, we established a very successful SSI surveillance and prevention service.

Proposed next steps

We held our first ever virtual brainstorm meeting which was kindly chaired by the wonderful, very experienced Infection Prevention Champion and Clinical Director at Gama Healthcare, Karen Wares on the 4th of January 2023. Everyone came ready to brainstorm! Check some of our highlights via our Twitter handle here. We’re planning our next meeting in February 2023, where we hope to consolidate and firm the future direction of our work. We now have a WhatsApp group where we’re ‘bouncing ideas off each other’, have a Facebook and LinkedIn page which you can join and be part of our exciting patient safety initiatives.

Conclusion

We’re proposing a novel patient safety initiative which we hope will bring enormous surgical patient benefits.  We believe our proposed SSIPD initiatives are feasible, given the level of traction gained over a short period. Thank you to our supporters and advocates who got us to where we’re today… buzzing with excitement! They call me the SSI Queen and I think I have lived up to my title on this occasion, with amazing support of course.

Surgical Site Infection Prevention Day Initiatives Group at the Inaugural Meeting on the 4th January 2023

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All opinion in this blog are my own

I Keep Running Up That Hill: Why is it that the email mountain never gets any smaller?

girlymicro General

I’m just back from a week on leave and I have returned to the inevitable email mountain. Last time I took 2 weeks leave, I came back to over 7500 emails and it has taken me to about now, 3 months later, to even vaguely catch up with myself – if you’re one of the 87 who have not yet been dealt with, I apologise.

At the height of the pandemic I was getting more than 600 emails a day. One thing struck me then, and has stayed with me, it’s impossible to deal with them all. Trying was just a state of denial that was not in fact helping the situation. I needed to face up to the reality and know that if the email avalanche was never going to stop, I needed to dig in and find another way. Here are a few things I’ve come up with that enable me to keep running up the email mountain when the peak always remains out of sight.

Expectation management

Like many of the challenges in our day to day working lives, this one can be helped by a little expectation management. This applies to you as much as to everyone else. You are not Superwoman. You will not manage to get through all of the things that are thrown at you every day. The best you are likely to manage is to develop systems that enable you to identify key and urgent tasks. The rest you will need to have other strategies to help you pick at the edges of over time. I think a lot of us fall into the trap of thinking we can do it all, as we remember the days when we got a handful of emails a day and believe that we can handle our current work in the same way. We can’t. This is not our failure. This is merely the reality we now live in. Life has changed, and we need to change with it. So, put your guilt aside and take a step into managing what’s in front of you.

If you email me, and it lands in one of those brief and glorious moments when I am not in a meeting or multi-tasking, you are likely to get an immediate response. Sadly, most emails do not arrive in this sweet spot. They therefore arrive and fall into, what I refer to as, the email black hole. Once you are in the black hole, time has little meaning, it could be 2 minutes until release, it could be 2 months, occasionally it could be 2 years. Being upfront with people about this possible outcome is important as it then enables others, especially your students or direct reports, to have ways of managing you based on urgency or need. I try, therefore, to sign post to others the best ways to deal with both me and the email black hole ahead of time.

Know the rules of the game

I’ve accepted the realities of how I work, and in order to avoid stressing myself and/or disappointing others, it’s necessary to share that knowledge in order to help everyone involved know what to expect. I know that I’m pretty well trained to respond to anything that comes in with big bold red text. I am programmed to be slightly panicked into opening it and for it to therefore stand out against the rest of the list. I am also aware of how poor I am generally at responding to things, and so if I receive multiple emails from the same person, about the same thing, guilt will also cause it to climb higher up my list of priorities. Now, please don’t use this to play the system, but I therefore tell students and people who need to be in the know, that if they need a definite response they need to email me 3 times, in red, with a deadline date in the title. This then triggers all of my mental anxieties and is ‘likely’ to lead to a response.

Outside of psychological strategies you can also consider setting your own rules for your level of engagement, in order to help you prioritise when you have a lot coming in. For me, I’m trying to be more conscious of the whole cc issue. If you email me, if I am the receiver, rather than the cc, I assume you need me to be an active participant. If you cc me in, I will assume it’s a nice to know, an FYI. I will never, therefore, consider an email where I am only cc’d in as urgent. I will get to it when I get to it, which could be in 12 months time. I will also only scan it for context and likely then just file it. I try to make others aware of this and also to be consistent about it myself when I send out emails, although I know it’s a challenge. I am also aware there are some people who set auto file on any emails they are just cc’d in and so it is important to be aware of the rules of others when considering communication. I think I would never read anything I was cc’d on if I set up a filing system that just filed them and I’m not that brave, but this is my middle road.

The last thing I’m trying to be clearer on to others, in terms of rules of response, is that if you email me for a decision/opinion, a none response does not indicate agreement. There are certain people, or groups, that have a tendency to email for an opinion and assume that a none response means I am in agreement. A none response, however, merely means I haven’t seen or had time to respond to your email. Only a response is actually a response. The assumption that a none response is an agreement is probably understandable to some extent, but in this particular case it could lead to incorrect decision making, and so I am trying to define what an interaction with these groups looks like and be better about communicating it and not assuming everyone understands the rules.

Manage your high-risk moments

For me, there are a few high-risk moments when dealing with email mountain. The first is people who send emails and assume that I will be able to see and respond immediately. This is one of those things where I try to be clear about the fact that if something needs an immediate acknowledgement you need to pick up the phone and call me, or better yet call the team phone and they can either action it immediately for you or escalate to me in multiple ways, even if I’m in a meeting. Sending an email in no way ensures I will see it, let alone that I will be able to respond in the moment. If it is urgent, then it needs to be treated as such.

The second is kind of linked. It’s the assumption that I monitor my inbox 24 hours a day, 7 days a week, and that my inbox and I are somehow linked, like in the matrix, so I will always be in responsive mode. I’ve lost tract of the number of times this has caused issues, especially when I have an out of office on, as people assume I will still be checking my inbox. For the sake of my own health and wellbeing, I no longer do this, I do not access anything to do with work whilst I am on leave. My teams know I am always available to them on WhatsApp for a quick check-in or escalation, but I am not generally available. They are also great at only getting in contact unless they have need. I am now very clear with my out of office messages and explicitly state that I will not be accessing email or contactable via work phone. I am also clear that I may never get to anything you send during my annual leave period, volumes being what they are. They are then directed to various key contacts, or they can re-send their query when I return. That way, no one can claim they were unaware and I can remove some of the stress of the unknown.

Establish ways to see the woods for the trees

One of the things I particularly struggle with is the panic that sets in when I don’t think I even know whether there are high priority or key things to action in my inbox, just because there is so much in there and most of it is unread. This, for me, can lead to a kind of decision paralysis, and then I just feel completely overwhelmed. BTW, this is definitely where I am now, sitting here writing this blog. I’ve tried a couple of approaches to remove at least some of the detritus that mean I feel out of control and unaware of what’s key.

Firstly, I try to clear my diary, both before and after leave, for a day in order to feel like I’m going away calmer knowing I haven’t left anything urgent, and to help identify important items when I return. This is not always working, this Monday for instance I ended up being on service and a bunch of meetings had dropped in whilst I was away, hence the panic as I still have over 1000 unread, but at least I am making active decisions to try and improve my management.

The second thing I’ve set up are a whole load of rules for auto filing things that I need to have but don’t need to review. This means that emails get moved into folders, and whenever I have time I can open and review them later. These rules need constant review and updating to make sure they are still capturing some of the email senders that fall into this category, but it means there is one less thing to think about and several hundred fewer emails per week in my inbox. The last thing I have set up is a filing system where I can manually move things for different types of action, to try to remove some of my being overwhelmed. I have folders that say: action, read, waiting for response. Emails that go into the action folder are ones that will take more than 5 minutes to do and aren’t urgent, so that I can work my way through them when I have made diary time. Warning – I am sometimes aware that my action folder is where my emails go to die, so if you’re going to have one, might I suggest, you actively manage it rather than risk it just being another form of denial about how much there is to do.

If all else fails say NO

One of my biggest challenges with managing emails, which I alluded to above, is the NHS tendency to have back to back meetings. I can’t read, action and move things forward when I’m in back to back meetings for 8 hours a day. Not just that, but when you already have an email backlog already this just makes it worst, as you end the day with all the emails you started with PLUS all the emails that you haven’t managed to respond to that day. Sometimes, it just feels like quick sand. I’ve started trying to book out time in my diary to support keeping on top of things, trying to keep some meeting free time, but it really is a constant struggle. You may have other issues that compound your struggle, you may not be able to address them all, but at least by reflecting and being aware of them you can be conscious of what is making your workflow harder.

There is always a final option, one to be used in rare and extreme circumstances when it all become too much. You can declare email bankruptcy. You can, if you’ve managed to action the urgent, put out a message that says that you will not be acting on any emails sent before a certain date and that if they are important please re-send or get in touch. Then you file everything away in a folder that’s clearly labelled, so you still have it, but are honest with yourself about the fact that you are not actively working on it’s contents. That way if something comes through and the information in that folder is required you can search for it, but you have effectively cleared your desk to focus on present/future. It’s the nuclear option but it is sometimes psychologically useful to know that it is there.

So there you have it, some of the ways I’m trying to manage the never ending inbox. Email is not going away and working practices mean that we are likely to receive more and more of it not less. Finding ways to manage what’s in front of you without losing your health and well being is key. There are only so many hours in the day and, I speak from experience, just trying to work every weekend to compensate does not make it better, nor is it sustainable. We therefore need to change both our attitudes to email and how we define rules for ourselves and others around it. For a tool that is about supporting communication, communication is key to managing it. When it gets too much, managing the email mountain , like all forms of challenge, is about taking it one day at a time and being kind to ourselves as the only route forward.

All opinions in this blog are my own

The Sound of Deadlines Rushing Past: Surviving in a world where deadlines are constant and there’s never enough time

girlymicro Academic Life, General, Leadership

I was fairly unwell before Christmas and was off sick and then struggling for a while. This was particularly traumatic as there were all the inevitable end of year deadlines that just wouldn’t stop coming, and frankly, I was in no position to be able to meet them. The thing is, it is now January, and I didn’t meet those deadlines, many of them I still haven’t delivered on. The other thing to note is that I am both a) still alive, and b) still employed. As someone who has a fairly visceral fear of the deadline, this is pretty shocking to me. So I wanted to kick off the year with what this experience has taught me and what I’m taking from this moving forward. Many of these things the rest of the universe probably already know, but sometimes I take a while to catch up.

Know when a deadline is a deadline and when it is more of a suggestion

The first thing to say is that I have never really taken the time to explore whether the dates or other information given to me are even true deadlines. Give me a date and a time and I will agonise and feel guilt if I fail to deliver.  I work on the assumption that if you give me a cut-off then it really is a task that has one. Reflecting on my Christmas experience however, I have learnt there are probably three scenarios where I will be given deadlines:

  • True deadlines – papers for committee meetings, grant deadlines etc. This is where a number of subsequent actions are riding on yours and if you don’t deliver, the domino effect is both real and important in the wider scheme of things
  • Gate keeping deadlines – manuscript review deadlines for other authors, 1st draft deadlines for policies, etc. This is where the task needs to happen, and in a timely fashion. The exact date itself, however, is arbitrary and so as long as communication is good and the time period doesn’t substantially extend the process itself is unharmed
  • Courtesy deadlines – submitting a conference presentation 3 days ahead (normally), arranging planning meetings etc. These often get given dates to ensure that they happen, but in reality as long as they get done before they evolve into a true deadline i.e. before presenting at the conference, then the timescale is actually flexible

It is really important to understand what kind of deadline you’re dealing with, otherwise you will treat everything as a true deadline (exhibit no. 1 = me) and that means you may deliver on a courtesy deadline over a true deadline, with the associated consequences. Without understanding what type of deadline you have you can also not really be truly aware of all of the possible options you can take when you are truly over whelmed and unable to deliver on everything.

Did you know you can just ask for an extension?

I’m just throwing this out there because it’s something I’ve only recently discovered. Did you know you can ask for an extension? This seems like a really bizarre statement I know, but I knew this was a theoretical possibility when a student but I had no idea it translated to real life. I really didn’t.  When I talk about understanding what your options might be if you can’t manage all of your deadlines, this is what I’m talking about. I didn’t even know this was an option that I could action.

During the pandemic I was forced to write to people on a number of occasions as I kept getting pulled into various last minute urgent events, and thus had no choice. The first few times I emailed to say I wouldn’t make X deadline but I can get it to you at Y, I came close to panic. Every single time I got an email back saying ‘thanks for letting us know, we’re looking forward to getting it on Y’. Not a single angry response. Not a single ‘we’ll find someone better/more available’. Nope. Every time, a chilled out ‘that’s fine’. Now this is just me being me, but why didn’t I know this? Why didn’t someone tell me years ago? All those nights working till midnight as I promised something that day!

The other thing that my husband has been telling me for years and I didn’t believe. Friday deadlines aren’t real (unless it’s an automatic form that could close or a grant deadline where they really mean it). Again, this is something I just didn’t believe, but I now realise. No one is going to go into their inbox to check at 8am on a Saturday morning. The number of midnight’s when I could have been sat on the sofa doing it on Saturday afternoon instead. Friday deadlines, I now realise, are purely there so the info is in someone’s inbox at 9am on Monday morning. Unless the situation is one of the exceptions, no one is impacted. This has even led to a few occasions recently where, because I’m trying not to work on weekends, I’ve just done something at 8am on Monday morning and sent before 9. Shocker, no one has cared.

Prioritise, and sometimes that includes your wellbeing

The other aspect of this is being aware of when sometimes the deadlines are for other people not for you. Courtesy deadlines are often there to make other peoples lives or processes run more smoothly, and I would always support being a good colleague. That said if meeting a courtesy deadline means that you will incur a substantial personal cost, then this is a time to put your communication skills to the test and think about re-framing the deadline.

Once you know which deadlines are really deadlines and which are deadlines can be negotiated, you are then in a position to be able to prioritise. Now, this isn’t just about juggling all those deadline balls, it’s also about when you have to prioritise yourself. It’s important to take ownership, it’s important to be accountable, but not at the expense of your health and mental well being. This can often be challenging, as working out where we are on the list of prioritise is frequently hard to determine when you are in it. This is why checking in with others, and finding helpful critical friends who can give context and perspective may help. I’m reading this out whilst my husband looks at me and roll his eyes – apparently you must also listen to the advice not just seek it.

Failing to meet deadlines is not the end of the world

I don’t really think of myself as being senior, it’s just not really important to me or part of my identity as long as I have a voice. That means it has only been a recent thing that I’ve reflected on my experience over the years with the mentors, Consultants, professors etc in my life. None of them every managed to turn the things I needed around to any deadline I ever set. I sat there and reminded them, sent diary invites to discuss and frequently in the end wrote things for them or submitted anyway. This wasn’t because they didn’t care, it’s just they had so much on their plate and they couldn’t manage it all. Now I don’t want to be that person but we don’t get everything we want in this life, there are only so many hours in a day. Sometimes, therefore, I feel like I am this girl. Why did I think I was special enough to be able to achieve what all those ahead of me could not. Context is key and denial is not always helpful. I can only aim to do better but beating myself up if I fail is not helpful. As my wise DIPC says to me ‘did anyone die?’ If the answer is no, if what actually happened was I disappointed myself, then I have to have perspective and we have to be kinder to ourselves.

There were a few times over the past three years when I had to unexpectedly put my work laptop and phone in a cupboard and step away completely to deal with other life stuff. I missed deadlines, I missed emails, but nothing that I missed still haunts me. Things just didn’t get done. People weren’t angry, people were super understanding, and my teams were wonderful and helped so much. The world continued to turn. Sometimes, it’s easy to forget, as humans are so ego centric, that the world does not stop if we are not in it, the void gets filled. I failed, I survived and so will you.

Tips that I’ve learnt to manage a world filled with deadline pot holes

  • Share the load – be clear that you will need email or calendar reminders – if it is important others will help you get there
  • Aim for clear communication to support prioritisation – if they only email you about it once it probably isn’t that key. Be clear about the fact that you will need prompts or chasers
  • Clear diary time and include it as a specific hold to do the task, rather than just having it on a to do list
  • Ask about deadlines up front before you take on something and be prepared to negotiate your involvement.  Do you still want to be involved? Can you meet their deadlines? Can you adjust their deadlines so they work for you too?
  • Know when deadlines are part of your agenda or part of someone else’s 

All opinions in this blog are my own

Welcome to 2023: Here’s a toast to being open to the unexpected in the 12 months ahead

girlymicro General

I don’t know about you, but I feel like the 20s have shown their fair share of surprises in the last three years, and let’s be honest, most of them haven’t been pleasant. I think, therefore, the need to get back to normal, to find our centre again, can be overwhelming. I also think many of us feel the need to somehow ‘get back on track with our lives’. I completely feel this too. However, I also feel like the rules of the game have changed a little and that perhaps we need to change too. The unexpected is scary and frequently unsettling, especially if you are someone like me who has always had a five and ten year plan. Even I have been thinking, however, that it is in that unease and unknown that some of the real opportunities for us all lie. So, below is my plea for why, in 2023, we should try a few off piste manoeuvres and be prepared to follow where they lead.

The girl with a plan

I always have a plan, I think it’s the gamer in me, or maybe it’s the reason why I found gaming attractive, but I need to know what I’m heading towards and why I’m going that way. I tend not to be able to play around the edges of things, and so if I’m going to do something, then I am going to put a heap of energy/time into it. I need, therefore, to understand the payoff and if it aligns with my values before I get too involved.

Now, don’t get me wrong, I think this has some positive aspects. For example, it enabled me to submit my PhD a year early so I could have a clear year to study for FRCPath. The problem with this approach is that you can be so focussed on the end game that you don’t get to fully experience the journey or spend time just being present enough to really grasp the opportunities that come your way, that are not necessarily badged as such. I think the big things still stand out, the emails to contribute that are explicit, but by not taking the time to have the chats or low key communications you may miss out on things that might have developed into the truly wonderful. Having a plan (I believe) is a necessary way to attain clarity and purpose, but if it becomes too defined it can become a limitation rather than a support.

The joy of serendipity

This blog is one great example for me of something that just wasn’t part of the plan. It was an idea linked to something that I am passionate about and believe in, science communication and engagement, but the plan was about working towards a consultant post and this didn’t really tie in with that. In fact one of the things that I frequently got told was blocking my progress to a consultant post was that I spent too much time on ‘stuff’, that my interest in education and communication was a distraction and that I needed to be more focussed, not less. It is therefore a difficult line to walk, as in moments of stress or lack of self belief, it can be tempting to double down on the plan.

For this reason I think it’s so important to hear the thoughts of people outside of your work bubble and occasionally throw some feelers out to see whether it’s worth following through. One Christmas I just sat and talked to friends and this blog is the result. The very act of just having relaxed conversations with people who are less aware of or focussed on your plan can lead to space for creative thought. It can free your mind to hear new ideas that you just wouldn’t have considered on your own. They can stop you staring at your feet and lift your eyes back up to the horizon.

Sometimes it’s important to start something without knowing where it will lead to, without knowing how it will contribute. Taking risks sometimes on things that just speak to your values, or just stand out as important, can sometimes lead to places you’d never have imagined. This blog, although I’d not predicted or had specific plans linked to it, has grown to a place where it directly supports where I want to be. It’s not just the blog however, other things like my NIHR doctoral fellowship were the same. I started it believing it would be another step on the journey, whereas it gave me access and took me places I hadn’t even been able to envision from where I started. Even those things that you start thinking out are linked to a grand plan require being open to fresh possibilities along the way.

The limitation of blinkers

Change and opportunities come in all kinds of different forms. I’ve been thinking that the pandemic caused my plans to be on pause, as it was impossible to plan, there was no structure, every day was just some new form of change and chaos. I found this incredibly challenging but I wonder if it also opened up a new pathway, it made space for change. It presented a way for me to still feel like I was moving forward by allowing me to have a creative outlet, rather than an academic or professional one. I was searching for a way to centre myself and to support others, whilst at the same time also needing to have something that enabled me to process everything that was happening, and find some dedicated time for myself. It forced me to remove my blinkers and to use my expanded vision to find a new way forward.

Everything that has an upside has its downsides. I wonder therefore if it hadn’t been for the pandemic raising the blog up the priority list would I ever have made a second post? Would I have made it happen after becoming a consultant, and would it, therefore, have been a very different animal? Did the pandemic therefore create the level of disruption in my world that was required for me to be able to step away from the plan for a while and see the wide world of opportunities, rather than just the path I had laid ahead for myself?

Letting go of the map

This is one the key lessons that I’m trying to cling onto now that we are moving forward in the pandemic, it would be all too easy to revert to previous habits and put my blinkers back on. I had a coach who encouraged me to live in the now, to embrace living in the chaos and the unknown. That was in 2013 and I think that’s its only now, 10 years later, that I can really begin to understand what she meant. Sometimes I’m a slow learner. The thing is that the intention is not always as easy as the implementation. It requires bravery to move to living in chaos, not because that is the way the whole world is living but because you choose to. To still be comfortable living with some of that uncertainty, not because you have to, but because you see the possibilities that lie within that discomfort. I will never be the kind of person who can live moment to moment and just go with the flow, but I believe I can move to being the kind of person who is open to opportunities that don’t come fully formulated, or that let me develop in ways that are not just tied to professional me. I also think it’s important to be open to the mistakes and learning that might come from this unexpected pathway.

Being tied to the past you

One of my biggest challenges in all of this is the need to make sure not just that I don’t just revert to old habits, but also that I don’t let the other things linked with the job shut down routes to engaging with the unexpected. It’s far too easy to easy to get sucked into the inbox or the paper that hasn’t been written on a weekend, rather than using that time to develop and expand other aspects of myself. Sometimes the weight of the to do list means that looking at my feet feels like the only way forward. This is why taking time to actively reflect and be aware of my tendencies to manage both my workload and stress this way is key. I’ve not worked this one out yet but I’ve thought about working on things like putting in diary reminders, or trying to ring fence my weekends so as not to be tempted to fall into old habits. I think the fact that I am actively continuing to write every week will also help to ensure that I have dedicated time to ensure space for creative thought.

I’m hoping that you, like me, will try and find the courage we need to enter 2023 bravely, open to wonder and not let our conservative instincts overtake and limit us.

All opinions in this blog are my own

Farewell 2022: Looking back and reflecting on how we can be our own most unreliable witness

girlymicro General

As the days grow shorter and the weather worsens reflections can turn more pensive and gloomy. At this time of year, especially this year, I’m struggling to find a sense of achievement. It feels like I’ve got nowhere fast and I can feel the self doubt crowding into the edges of my psyche. Here’s the thing though, I am my own worst critic. I remember the failures and not the successes. I remember the list of to do’s that didn’t get done. With that in mind I thought I would write a post that would remind me of the boxes ticked and movements made. I hope that if you are in the same boat you might consider doing the same, fingers crossed it might help you too.

Things that have gone well

In order to get me into a positive growth mindset, prior to tackling the things yet to do, let’s start with the good stuff. Please forgive the self indulgence whilst I build up to the learning. There have been a lot of professional successes and my students and team continue to make me prouder than I can say, but as this is about emotion for me, I’m going to talk about the personal stuff.

After being slightly lacking a visual identity for 6 years Girlymicro finally got an image to sum her up from the gifted David Sondered (his website is here). This female scientist breaking barriers and sitting out of time pleases me more than I can say. She feels like a homage to all those female scientists who went before, many of which are sadly forgotten. Also, for those who may not know, I love a steam punk or a victoriana game setting, and she definitely reflects this aspect of who I am.

I posted this year about how much this blog and you have come to mean to me. As it happens my friends have been on at me to start a podcast for almost as long as the blog has existed, and 2022 was the year it finally happened. It’s still finding its feet and is not posting as frequently as I’d like because life is busy, but it’s there. What’s feels so wonderful about this is that it’s a co project with Mr Girlymicro, so, like many things in my life, it’s a family affair. It means I still get to do the science I love without it taking time away from my loved ones. I also feel it represents a number of things that are important to me. 1) Science is a team sport and so even talking about it as a partnership feels like it represents this. 2) Science can’t live in isolation in an ivory tower, it has meaning when shared and this sharing shouldn’t just be by scientists to scientists. Mr Girlymicro keeps me honest and asks me the questions that he wants the answers to, not just what I think needs sharing.

One of the other things that really inspired me to be better this year was being asked to give my first talks and Plenary lectures linked to Girlymicro. I’m used to standing in front of people and talking science and data, there’s something different about standing in front of people and talking linked to something that is so personal, something that normally just goes out into the world on a Friday night. It took me longer than I had thought possible to write those sessions, I didn’t want the people who had put so much faith in me, or put their valuable time and energy into reading and responding to the blog down. It felt so very different to giving an academic talk but it was beyond fulfilling. It was another one of those moments that really caused me to sit down and reflect on the way I do things and the way I think. Without this blog, and you reading it, this moment would never have happened. So, thank you.

This leads me onto something that has become pretty key to my well being, as in a time of stress and exhaustion during the pandemic it has, along with the blog, continued to be a space where I’ve felt like I could still have impact and creatively explore. The Nosocomial project. I think it would be fair to say that it has developed and grown more than Nicola could have dreamt when we had tea together back in 2017. This project has continued to grow this year and the inspirational Nicola Baldwin took some of my words and turned them into a piece called ‘All Opinions In This Blog Are My Own’ which was performed by myself and some wonderful fellow Healthcare Scientists at the Bloomsbury Festival. It felt so different both speaking and hearing my words in front of an audience. It gave everything a new life and I hearing it from the lips of other people really did cause me to reflect on it in a new way. It was also so different seeing the audience, many of whom hadn’t read the blog, engage with the words for the first time. It was like, to me, what happens when you sit down and verbalise an idea that’s lived in your brain for a long time to someone else for the first time. The mere act of saying the words aloud changes them, and that was both a terrifying and amazing moment to live through. It was like building up to look in a mirror without knowing whether you’d be strong enough to stare at your reflection, and then finding you could. Thank you to Nicola for making it happen and to Sam, Claire, Ant and Ozge for standing up with me and taking a risk.

We all know how much I love a bit of tea and cake…I don’t think I’ve hidden this from you. One of the other moments that gave me real joy, as it meant I got to combine who I am as a person with who I am as a scientist, was that I got to talk about science and whole genome sequencing through the metaphor of cake. One of the core tenants of this blog is making science and scientists less ‘other’ and this was one of those moments when I really got to enjoy standing up to talk about things that I think are brilliant. Not only that, but due to the Nosocomial Project I got to do it to different audiences, scientific, clinical and public and it was lovely to see the response from those different groups.

Talking about the Nosocomial Project, it was not the only thing that started up again and enabled me to get out in person to start engaging again. Other pieces of work that have been going for some time, like the Healthcare Science Education conference #HCSEd and the Environment Network meetings got back to normal in terms of delivery. Both of these projects had been running for at least 3 years pre pandemic and although I found the break hard it was also important to me for a couple of reasons. It made me realise how much I value being engaged in them and how much value I think they bring to the communities that they support. This has enabled me to come back to them re-energised. The gap has also given me some time to ponder what the next steps might be be, which has enabled me to also come back to them with purpose – so watch this space.

One of the things I’ve also tried to prioritise this year is my post pandemic recovery. The pandemic isn’t over and it’s still taken up a lot of my bandwidth in 2022, and been a source of continuing resource drain. That said, I’ve started to remember who I was outside of Dr Cloutman-Green and began to find my smile and laugh. I tried to find some time to prioritise people like my husband and mum who have given up so much in recent years just to keep me on my feet and in the fight. I won’t ever be able to repay them, but this year has been a start. I’m not there yet, the batteries are still pretty empty but I am at least beginning to remember who I am, and finding time for some things that bring me joy.

Part of that finding time for me is that I have taken some steps linked to a blog post I wrote January 2022. In that post I wrote about a not so secret ambition I had of writing a book and some steps that I was going to achieve this year. Now, I had let fear stand in my way and periodically I’m still in this space, where I fear humiliation and failure, but I have written the submission chapters and in 2023 I’m going to take a leap and submit them. I was hoping to have done this prior to the end of the year but to be honest life has got in the way and I want to do it when I’m ready. This is obviously a delicate balance between making sure it’s right and making sure I’m not delaying through fear. It’s one of the reasons I’m including it here. Part of the fear is that people will find out and judge me if it doesn’t succeed. So now you all know I’m doing it, and if I don’t succeed I will share the learning and hope that someone else will learn from it and not make the same mistakes. Keeping it secret isn’t serving me and so now it’s out in the wild – and if you have any tips about where to submit it do let me know. It’s basically, at it’s heart, this blog in book form. If you don’t try you will always fail.

Talking about writing and stepping out of your comfort zone. The first ever text book chapter I’ve ever written comes out in the textbook below in April. This was a disastrous idea and to be honest I hated just about every moment of writing it, but mostly because I had agreed to write it before a global pandemic and then had to deliver it during the 1st year of a global pandemic. This meant that the writing was not quite the Murder She Wrote joy I’d anticipated, but more delivering exhausting word count on no sleep on the few moments of down time I could get. That said, the editors were kinder than you’d believe and did A LOT of heavy lifting on my behalf with edits, and part of me thinks that if I can get one done in that setting surely any others will be easier? Plus I learnt a lot and hopefully people will find the end result useful.

Finally, the unexpectedly wonderful continued to happen and I got to share it with Mr Girlymicro. I was fortunate enough to be able to do some amazing things in 2022, like attending the Queens Garden Party. These things are amazing in themselves, but when you can share them with people you love they are even better. It takes a village to keep this scientist in one piece and without all those who pick me up when I fall, put me back together, feed me and tell me that ‘yes, you can’ I would not manage to achieve any of the things I’ve been fortunate enough to achieve. I’m hoping that 2023 will continue to be filled with the surprisingly wonderful and that I can continue to share those moments both with you, my cheer leaders, and with the people I love,

Things that I’ve learnt

So that was all the wonderful, now we need to get to the learning. This is probably the more important part of reflecting, even if it is sometimes the more challenging part, in the end it is probably the thing that we should be most grateful for.

2022 continued to the theme of the 20’s so far by being a year of making the unpopular calls. In some ways this year was harder because there wasn’t guidance to stand behind, it was about personal advocation and decision making. I wrote a blog post that really helped me work through some of my thinking and learning on this and it did really help me with some of my processing. I don’t enjoy conflict but standing up for what you think is right is an important part of leadership. Sometimes that means making the hard calls, not just saying the easy things, or what people want to hear. It’s recognising that if you give in to easy in the moment you can end up causing harm or suffering in the long term, and so standing resolute in the moment, no matter how challenging, is necessary. It is also difficult because you have to sometimes roll the dice, we are not always right, all you can do is make the right call in the moment and be open to change and sharing learning if it doesn’t turn out to be the right call long term. As someone who struggles with self doubt and perfectionism this can feed into my inner fears but that doesn’t mean it isn’t something that needs to happen. Whatever happens, the sun will come up tomorrow and as long as I’ve learnt more than I knew the day before there will always be hope.

One of the things I’ve learnt about making the calls is that being a consultant doesn’t fix everything. Being a consultant has however made a heap of difference to the frequency and extent of challenge and how that challenge is undertaken. I became a consultant during a pandemic, and in many ways although unbelievably hard, it also made it easier. I had one real focus. Now I need to work out what kind of consultant I want to be, whilst still being stressed and exhausted by the pandemic and having very little band width to manage it. The other thing is, that although most people have responded the change, there will always be a couple who see that change as more of something to challenge than to celebrate, after all change is hard. I keep putting so much pressure on myself to be good enough, but that pressure is only coming from me. Instead I have realised that this is my job for the next 20 years, there is plenty of time time for learning and for indeed making mistakes. I do not need to be the finished product right now, in fact I’m mostly thinking I’ll probably only begin to approach it by the time I am ready to retire. So bear with me whilst I hold on in there for a while yet. I talked a bit about this and both my hopes and fears in a blog post I wrote on the retirement of my old consultant and mentor I hope it might help others.

One of the things I’m still exploring and pondering on is that both hearing and memory are more selective than I realised, as George Orwell said “To see what is in front of one’s nose needs a constant struggle.” That means that it is not just me that is an unreliable witness, there are rooms full of us. We are entering (or have always been and I was naïve to it) a period where people’s hearing and interpretation is very much coloured by what they wish we had said, not what we had actually said. I know this has always been the case to a certain extent, but it feels a particular issue at the moment both in the clinical and scientific worlds. Selective use of evidence seems to be rife and I feel more and more that things I write or say are selectively used or deliberately mis-interpreted. Now, that misinterpretation does not always come with ill intent, and for me that’s where the learning lies. How do I communicate more clearly? How do I communicate clearly, especially during periods of anxiety or conflict? How do I in the same situations clarify understanding in a way that doesn’t feel like it’s confrontational or insinuating something negative? How do I remain open to feedback on this and other things when they feed into my fear of failure or when the attacks themselves feel personal? I’ve learnt that not everyone sees through the same lens, but I’m still working on how we make those different lenses align so that we can focus on the outcome, although I posted something that contained some of my early thoughts here,

Things that are still a work in progress

This year there have been a lot of shame spiralling and although frequently linked to tiredness or stress, frankly some of it has been deserved. It’s probably no secret that I’m not a very patient person, I tend to struggle with standing still. I often therefore end up having ideas and conversations in my head and then just crack on with them, regardless of territory or hierarchy. This means, that personality wise, no matter how much I aim to provide collaborative leadership I need to work harder and do more. The other thing is that, perhaps not uniquely, I have a tendency to seek input and collaboration from those who are likely to constructively challenge or collaborate with me. This means that I may not engage as widely or with those who may have conflicting views as much as I should. Listening to fear should not stop me listening and I need to try and put more energy into reaching out to those who are reticent adopters or have territory issues or different values. That said, the reason I tend not to do this isn’t because of a lack of will, it’s more due to the number of plates being spun. This means that most things function on minimal time and so spending more time and energy means that other things suffer. It is a constant balance between what I aspire to and what I can achieve, all I can say is that I’m working on it.

This year has given me so much joy but it has had it’s odd challenges. I don’t know whether it’s due to slightly increased visibility or because it just happens that I’ve seen things or they’ve got back to me, but for the first time I’ve become aware of some of the negative press that goes around linked to me. Comments like ‘She’s only out for herself’ and ‘It’s all about self publicity’, as well as some less pleasant stuff about me as a person. I think that’s just one of the things about engaging with a wider circle, not everyone is going to love you, your message or your values. As the other half of my Lead Healthcare Scientist post described me I’m apparently Marmite, you either love me and what I have to say or you don’t. I’d heard the phrase ‘haters going to hate’ before but I think I probably don’t find it quite that simple. I think where I’m landing is that I will take the learning that I can from it and then try to let it go. Some people don’t like the fact that I share so much of myself, or find the fact that I talk about successes boastful. To me these are almost two sides of the same coin. I talk about successes as I believe that it’s good to be open about opportunities and inspire others. I talk openly about what’s happening and my challenges and failures so people see that it’s not all roses and that failures are key to finding success, in the hope that this means they will carry on when they face road blocks and not repeat some of my mistakes. All I can aim to be is consistent and I’m working on dealing with the rest.

This last one kinds of leads on. I can’t be liked by everyone.  I need to stop letting that destroy me. Frankly it’s (for the most part) not personal. I’m just not that important in most other peoples lives. People can dislike what I represent, people can dislike my choices, people can dislike the discomfort I create in them. I honestly can’t do much about that. I am also learning that I can’t and shouldn’t try to fix it. Intellectually I am completely on board with this, it just sometimes that abdominal discomfort you get which shows that you mind may be OK with it but there a whole lot of the rest of you isn’t. Yep, it’s like that. I can’t fix it and so what I’m thinking is that I need to stop running from it and run right into and embrace it. It’s finding a way to balance this and not lose the learning discussed above. I’m going to try in 2023 putting away my umbrella and just dancing in the rain and finding the joy in every moment.

Things I’m looking forward to

So, having talked about some of the learning and challenge I’m setting myself for 2023 I wanted to talk briefly about what some of things I’m really looking forward to.

I am fortunate to have amazing IPC, academic and HCS teams. They put up with my kookiness and continuous need to take on impossible challenges. They challenge and support me and I’m so lucky to be looking at another year working with them.

I wrote a little bit about what this blog has come to mean to me and how it’s become fairly core to my day today. This last year the blog has opened doors I couldn’t have imagined and I’m really crossing my fingers and toes that 2023 it will continue to surprise me. I am hoping that the book linked to this blog gets submitted and that whatever happens I learn from the experience. I’m also hoping to develop the podcast a little more, and I’m looking forward to getting to meet more of you in person now we are getting out and about. Mostly, I’m hoping that you will continue to stop by and join me on a Friday for a chat about what the weeks have had to offer.

Personally, I’m hoping that 2023 will be a year of learning and continued improvement. I want to improve and find out who I am as a Consultant as well as feeling more confident across the aspects of the role that give me self doubt. I really want to do this and manage my interactions whilst still channelling the 3P’s (passion, purpose and principles) and staying true to myself and my values, no matter what challenges are presented. Sometimes it feels like you can only get ahead by stepping on others or stabbing them in the back, and I really want to try and show that losing yourself is not what is required to make progress.

Finally, I want to continue to find joyful surprise in what the world throws at me, to embrace what comes my way and always remind myself of quite how lucky I am that I get to do a job that I love, in a profession that I’m passionate about, surrounding by people I adore. I am quite the luckiest girl in the world and in 2023 I want to remember that no matter how significant the challenges placed in front of me.

When it all comes down to it, my plan is to channel a little Spirited in 2023 and everyday try a little harder and make the active choice to try and be better, and bring a little good into the world.

All opinions in this blog are my own

Merry Christmas, One and All

girlymicro General

Scrooge was better than his word. He did it all, and infinitely more; and to Tiny Tim, who did not die, he was a second father. He became as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world. Some people laughed to see the alteration in him, but he let them laugh, and little heeded them; for he was wise enough to know that nothing ever happened on this globe, for good, at which some people did not have their fill of laughter in the outset; and knowing that such as these would be blind anyway, he thought it quite as well that they should wrinkle up their eyes in grins, as have the malady in less attractive forms. His own heart laughed: and that was quite enough for him.

He had no further intercourse with Spirits, but lived upon the Total Abstinence Principle, ever afterwards; and it was always said of him, that he knew how to keep Christmas well, if any man alive possessed the knowledge. May that be truly said of us, and all of us! And so, as Tiny Tim observed, God bless Us, Every One!

(A Christmas Carol by Charles Dickens)

Merry Christmas everyone, wishing you all love and laughter and excessive amounts of good cheer

All opinions on this blog are my own

It’s Not All Bad in the World of Infection Prevention and Control: The most wonderful time of the year is approaching!

girlymicro General, Microbiology (Clinical), Science Communication

NB this article was originally written for the Association of Clinical Biochemistry and Laboratory Medicine and published December 2021

There’s no getting around the fact that it’s been a tough couple of years in the world of Microbiology, Virology and Infection Prevention and Control (IPC), but at this time of year its worth reviewing the bits of our jobs that are to be honest pretty awesome.  The bits that energise rather than drain us and remind us of why we love our work. 

Before I go any further, I should probably make a confession and declare that I am a bit of Christmas fanatic.  I’m the person who goes to Christmas shops when on holiday in June and thinks that as soon as November hits Christmas films and music are go!  So it’s probably of no surprise that my favourite IPC event occurs in December as part of the build up to Christmas.  Hopefully, you will also appreciate how great it is even if you don’t love Christmas as much as I do. 

I work in a paediatric hospital and every year the patients are lucky enough to be visited by not only Santa, but also his reindeer.  What does this have to do with IPC I hear you ask?  Well any animals brought onto site need to have an IPC risk assessment as they can be linked to zoonotic transmission of infection and thus pose a risk to patients.  My colleagues’ favourite time of the year is when she gets to do this for the rabbits and ducklings at Easter, but for me the reindeer assessment is very much my favourite.

Reindeer can be a source of ticks, which can harbour organisms that lead to Lyme disease and other tick borne infections, as well as being a source of more exotic bacterial infections (List of zoonotic diseases – GOV.UK (www.gov.uk)).  The reindeer that come to us are captive rather than wild, but even so they are still coming onto healthcare premises and need a review. The task therefore, although a joy, does have a serious aspect in terms of ensuring that the area is properly set up in order to permit the patients to visit, whilst ensuring that they are kept safe and not exposed to any risk.

We work with both the school and Santa to ensure that:

  • All animals are established in an environment that supports safe handling of the reindeer to avoid injury for them and anyone interacting with them.
  • Signage and other provision is made to ensure that there is no eating or drinking near to the animals or their enclosure, to reduce any infection transmission risk.
  • Hand hygiene facilities are available for hand hygiene after contact, especially as the patients will feed the reindeer.
  • Decontamination equipment is available to ensure the area can be adequately cleaned after Santa and his reindeer leave to visit other children.

Last year when we inspected we also had the added aspect of ensuring that Santa was SARS CoV2 free and was protected from any exposures whilst on-site.  This included having Santa complete a health screening questionnaire, including questions like whether he had any symptoms or SARS CoV2 household contacts, such as Mrs Claus, in order to assess his SARS CoV2 transmission risk.  He also needed to wear personal protective equipment i.e. fluid repellent surgical masks, to protect him and the children and young people.

This was a new aspect to the visit that made it more challenging and certainly inspired the patients to be differently engaged and ask questions such as: how does Santa manage to avoid the quarantine restrictions linked to visiting red countries?  and if Santa was vaccinated?  We responded that Santa was of course vaccinated as he had been part of the SARS CoV2 vaccine clinical trials and was therefore an early adopter of the vaccine.  We also talked about the fact that because he could manipulate time, he and the reindeer had plans about how they were still going to be able to safely visit all households and quarantine as necessary.  We also discussed that whilst he was with us we would provide him with personal protective equipment training, in the same way their clinical teams have, to ensure that he is kept safe and also protects the children he encounters along the way.  It turned into a really good way to talk to families about how we use a variety of measures in hospitals and healthcare to keep people safe, and to emphasise that although masks look scary they are actually a really good way of protecting everyone.

This experience brings me joy every year but last year in particular it reminded me that keeping people safe and raising awareness of what we do, does not have to exist in isolation from activities that are fun and engaging.  I love visiting the reindeer, however seeing patients be inspired to ask questions and explore IPC in a way they may not feel confident to do normally, also made me aware that it may be not only a joyous experience but a useful one.  It turned something fun for all involved into something that was also educational and supportive of good practice.  So this year as well as making sure I have enough carrots I will be ensuring that I’ve thought about how to make the most of this unique encounter to make a difference for everyone involved.

All opinions on this blog are my own

Guest Blog by Phillipa Burns: Part 2, the view from the finish line

girlymicro Guest blog, Healthcare Science, Microbiology (Clinical)

In the final of a series of blog parts linked to taking FRCPath parts 1 and 2, the wonderful Phillipa Burns has written a guest blog about her recent experience of sitting and passing part 2 in Medical Microbiology.

Phillipa Burns works as a Principal Clinical Scientist (HSST) at Hull University Teaching Hospitals NHS Trust. She has over
two decades of diagnostic microbiology experience, and is currently completing the Higher Scientific Specialist training Programme, with a planned Doctoral graduation in 2024 from the University of Manchester. As she recently passed the her FRCPath in Medical Microbiology in 2022 she is ideally placed to talk about what her experience has been, especially now the exam has gone back to face to face after several years online.

I read the guest blog by Ren Barclay-Elliot about her recent Part 1 experience; it was so generous and thoughtfully written that I thought the kindest gift I could give back would be a piece on preparing for Part 2.

I must say though that the kindest thing you can do for yourself after Part 1 is to take a break, revive and recharge, irrespective of the result, before reaching for the books again.

Trust me when I say that HSST is a marathon and not a sprint; build your reserves before stomping up the next hill.

The caveat to my gift of kindness is that I only have experience of the Medical Microbiology exam; but hopefully this will still be helpful to other life science pathways.

A little about me

I started HSST in 2018, after 16 years working as a Biomedical Scientist in Medical Microbiology.

I think my career can be best described as “mostly wore a white coat and often wore different hats!”; this is true of many scientists that pick up the hats of quality, safety, research and management.

Entering HSST as a direct entrant allowed me to leave all my previous roles and responsibilities behind and to focus on the completion of the programme; I know that the vast majority of HSSTers are master jugglers who are completing this course alongside another role.

Truly, you are all amazing.

First Steps

Part 1 was the first examination I had sat in 14 years and I was revision rusty; I got by with a little help from my friends and by reading guidance and making short notes.  I knew that this approach wasn’t going to cut it for Part 2.

Decide when you want to sit

Plan the best time for you and be honest with yourself about your readiness and your resilience

Look at what is ahead in the calendar; you will be giving up a lot of time and social events in the name of revision so if you have huge life events on the horizon factor these in.

Even if your sole reason for preferring the attempt to be in the Autumn is that you revise best in the outdoors, then make that choice and enjoy reading in the summer sun

Timing really makes a difference, especially if you have children to factor in. I have small children and I couldn’t sacrifice another Christmas to revision; find your redlines and stick with them.

Find some study buddies

Ideally a small group, 4 or 5,  that covers a range of knowledge and skills.  Studying with a both medical and scientific trainees worked best for me.

You need to like who you revise with and it needs to be a safe space; you will share your worries, knowledge gaps, the things everyone expects you to know but you just can’t keep in your head!

It has to be judgement free and welcoming.

Do not worry if it takes a few groups before you find your tribe; I knew that early morning revision groups were never going to work for me but a few fellow night owls were a great find.

Keep the information flowing with chat groups and emails; it is amazing how much information a determined group can gather.

Be prepared to do your fair share of the prep work; exam revision is stressful – especially towards the end and it really helps if everyone does their bit.

Notes

Part 2 checks your knowledge recall under pressure in the format of OSPEs, SAQs and LAQs.

The whole curriculum is covered; this feels daunting but if you break down the revision into key topics and cover one or two a week you easily get through it.

Most of the exam is skills learnt from doing the day job; they are just “stretched” to cover every series of unfortunate events that can happen with cases. It really helps to reflect on the calls you have had during the day and think “what would I have done if that was a child/drug resistant/linked to another case/pregnant woman etc.,” Let your imagination run wild and really challenge yourself until you reach a layer of confidence with your reasoning and decision making. If there are things missing in your day job, find courses and ask for placements.

Make notes that are aligned to the exam format; covering the clinical, infection control, treatment, public health and laboratory identification elements.

Revision

Team event or lone wolf; your approach has to work for you.

I learnt more with a team, and they added depth to my knowledge; the diversity in the both my study groups was phenomenal – I was always awed by the talent in the room and the experiences that my peers had

The exam covers guidance and it is easy to know what you do in your workplace and why; but you need to know if that is evidenced in national guidance, recent studies – be critical of your own practice and look at the quality of the evidence. Also prepare for situations on the edge of the guidance, the grey areas and when you need an expert consult.

Read around the subject; big studies that have changed practice – challenge yourself to understand the design and outcomes. Social media is invaluable for “Top 10 ID papers this year” and tweetorials.

Be able to write, the exam is 6 hours of handache! I spent the last month of my revision hand writing until I was quick enough to tackle a 3 hr paper. A lamy fountain pen proved to be my saviour.

The Exam

Get to the venue early, ideally the night before.

Plan your route and make sure you have all your ID and stationery in your bag.

Take snacks, the need for a sugar hit mid paper was very real

Take study leave before and slowly ease off the revision so that you are rested; this is really hard to do but it is easy to become sleep deprived and to underperform in the verbal stations due to fatigue

Wear smart casual, but comfortable, clothing – it is a long day

Take time after the exam to decompress and debrief, by this point you will know if your study group are sharers and talkers, respect the wishes of those that just want to forget until results day

The whole experience left me very tired, unsure if I hit the brief; this is completely normal.

Results Day

Have a plan, my consultants checked my result for me! I was horrendously nervous and sleep deprived.

Agree with your group if you are going to wait for people to check in; remember this is a tough exam and fail is just a “first attempt at learning”

Check in with the quiet people, give them time to talk about it and reflect.

Celebrate the milestone, pass or fail, reaching this peak in knowledge is a huge achievement.

HSST is so relentlessly busy it is easy to swap the FRCPath preparation for the other items on the to-do-list; I have taken my own advice and had a little pause to just look back at the progress I have made in the past four years.

I have timetabled in events with my much missed extended family & friends; these became the extras that I struggled to fit in whilst revising and I have put some other books, rather than podcasts, on my audible app.

Tomorrow, my fellowship with the Royal College of Pathologists will be ratified and I can officially use the designation, FRCPath; I have asked others – “When does it feel real?”,  this seems to be a common feeling when you have recently crossed the line. I cannot pretend to be unaffected by the enormity of the achievement, I will be smiling for months (maybe years) and I fully expect to sob with joy when I see my study buddies at the investiture ceremony in February.

My final words are “that if you can see it, you can be it”; be proud of the seven little letters (and the many others you have earned), show your career path and light the way for others to follow.

Plenty of people showed me that this is possible, and to them I am forever grateful.

Check out the other blog posts in this series:

Guest Blog by Karen Barclay-Elliott: Life, the universe and surviving FRCPath part 1 – December 2nd

Your Wish is My Demand: Here are some of my tips for sitting MRCPath in Micro/Viro – November 29th

The Trials and Tribulations of High Stakes Assessments: How I still remember everything about FRCPath – November 25th

All opinions on this blog are my own