OK OK you need to forgive me for getting my Dickens on with the title of this blog. It just felt right as this situation isn’t something our trainees and students should need to manage in the current day, but especially in the current financial climate what should or should not happen has little impact on what . Great scientists don’t just come from wealthy backgrounds, and the current approach means that we are less likely to find the great minds of the future if just getting through to qualification has so many financial strings attached.

My family are my everything, but I don’t ‘come from money’ and there have definitely been points in my life where both I and my mum have struggled to keep afloat, pay bills and afford heating. We have, on the other hand, always been lucky enough to be able to eat and have a roof over our heads. We’ve also always felt blessed, my husband is my everything, and my mum and I are super close, and so we’ve always had each other to lean on when times got tough. When one of us had something, we all had it, and I’ve lost track of the number of times we’ve covered each others bills or shopping.

It is a bit challenging however when you enter the world of clinical training and most of your seniors either have parents who are giving them £10,000 for house renovations or have been senior for so long that they have forgotten what it’s like to not have savings and have never experienced not having enough money in the bank to be able to pay their rent that month. This is the reality of a lot of students and trainees at the moment however, and I just wanted to take this moment to talk through, not only my experiences, but also how we can be mindful of making our learning environment as inclusive as possible.

Let me start by saying that I don’t resent people having more money or coming from a more affluent background. I have always led a (experience) rich and wonderful life. What I do want to say, as someone who now doesn’t worry about paying my mortgage, is that unless I am deliberately cognisant of the fact that others aren’t in the same position it is easy to make assumptions and unconsciously overlook barriers to others who are not in the same position and impact on their ability to participate and make the most of the learning opportunities we belive we are offering them.

I thought I would kick off with some of my experiences during training to show what I’m talking about.

When they forgot to pay me

It took me 13 years to get a permanent position in the Trust I trained and worked it. This meant that there were a number of Octobers when I rocked up to work and my access had been disabled, my logins removed, and despite continuing to work as I got used to resolving these, no pay check at the end of the month. There were at least 3 occasions when I got paid nothing, not a single penny, as someone had forgotten to let someone know I still existed or some piece of paper hadn’t gone through. The feeling of being forgotten by the system is bad enough, but I don’t know about you, but I don’t have reserves enough to manage to pay my (then) rent if I don’t get paid. On one spectacularly humiliating occasion, I sat in my consultants office and cried as HR couldn’t fix it in the normal 3 days. He wrote me a personal check for £1500 and told me to pay it back when I could. I will forever be grateful, but we also shouldn’t be putting anyone in that position. We have a duty of care to those training with us, and the system shares that responsibility. It needs to work. I had a kind consultant who saved the day, but what if I hadn’t?

When I was sent away to a training course

In the second year of my training, I went to Leeds for a mycology course. It was a necessary part of my training and it was my first time travelling for work. I planned the trip, sorted the POs, and checked the Trust paperwork to work out subsistence payments, as they were part of the policy. The trip was slightly less minute as the course had been full (it only ran every 2 years), and I was taking the place of someone who dropped out. Because of this, I hadn’t had time to adjust my finances. It was planned at short notice.

Just before I left, I popped in to see the lab manager to update her and double-check everything, as that’s the kind of girl I am. When I hit the subsistence part of the conversation, she stopped me. She told me that I wasn’t entitled, despite travelling for work purposes. She told me that as a Clinical Scientist, I wasn’t entitled to it, as that was only for medics and Biomedical Scientists. My training pot covered the course costs but nothing else, and I would have to find what was probably £500, for the train and everything else, not only to initially pay out which had been what I believed, but full stop. I didn’t have that money, but as the course was booked and they changed the information at the last minute, I had already brought the train tickets and booked the hotel. I was locked in. That was a difficult week. Luckily, I had some family in Leeds who came and took me out for dinner one night, and the course included lunch, and the hotel had breakfast, so I knew I would eat every day. The costs I had to figure out later and I had just enough to put on my credit card, as I knew I had to pay, I was just expecting to claim back rather than cover it long term.

For me, this one is about 2 things, parity of access and clarity of information. To be honest, I’m still fuming that my professional discipline was used to stop me from having access to the same resources as the colleagues I worked with every day. The other thing is that we need to be really clear with everyone ahead of time about how access to opportunities and finances are going to work so that they are empowered to a) choose whether they want to engage and b) how that engagement might work best for them.

When they reduced my hours to 3 days a week

This is probably, and I’m using my sarcastic voice here, my favourite example of the system making changes without considering the individual.

I finally had a full-time permanent NHS job. I thought the days of forgetting to pay me were behind. Then, out of the blue, I get my pay slip, and it is rather less than I was expecting, and that’s being polite. I’m really confused, and so I reach out to payroll. Those days, they were in-house, and I knew them pretty well as I’d sat and cried in their office whilst they sorted emergency payments for enough years. They investigate and tell me that I now work three days a week……….I look at them in confusion and point out that I don’t, and that, if I did indeed, work three days a week it would be nice of someone to have told me.

It turns out that a general manager, who had left 6 months previously, had asked before they left for a delayed change to be made to my hours on the HR system, reducing me to 3 days a week. They hadn’t told my bosses, they hadn’t told me. As they had left, it wasn’t possible to find out why it had happened, but it had. This was the most stressful one as I reached out to my union to see whether someone could, in fact, just change my working hours that way. It was also stressful because, unlike the annual contract mix-up, they couldn’t issue an emergency payment because it looked like a deliberate change and had to be investigated first. I have no idea what the underlying rationale for this one was, but my take home is that if you are going to make changes that impact someone’s life, you should probably tell them.

So, having experienced a variety of incidents myself, I’ve been trying to think of how can we do better. Where can we be more aware? Where can we make different choices?

Too often we expect students to pay and reclaim

This one is tricky as supervisors and mentors we are not always there to pay instead or we may not always be able to cover it ourselves, depending on circumstances. When I was training I was expected to find, frequently thousands of pounds, to pay out for training courses etc that would eventually be reimbursed. Sometimes, this took over 12 months once the expenses were submitted. If I can, I always try and get courses for my students paid by invoice, despite the work involved, so they don’t have to bear the upfront costs. If there are other expenses I will either try and pay and then reclaim myself, if I can, or make sure they have all the forms, know all the rules and get included in the emails so any delays to repayment are minimised.

Your access to training should not be limited by the amount you can outlay up front, when there is funding available, and so we should do everything we can to make sure we don’t impose barriers to learning for our students and trainees.

Choosing between committing to post and surviving

The fact of the matter is that many of our students are struggling right now. Many have had to take on additional jobs or hours to make things work financially. This can prove challenging in terms of supervision, as it understandably means that they are becoming more stressed. More stressed, not just because of the money worries, but because they now have no downtime to recuperate and process the challenges of their studies.

I know one of my colleagues has done a pretty great job of trying to find extra funded, flexible bits of project work, that has enabled her students to pick up extra income without the regular commitment required to take on weekend shop/pub/restaurant work.

In some circumstances, additional work is what is needed for someone to make it through the week and pay their bills. In this case, it’s about having supportive and clear conversations where expectations are managed and signposting is undertaken.

Conferences – outfits and food

Conferences can be stressful experiences at the best of times, especially if you are presenting or nervous about networking. This can be exacerbated by worrying about what you’re going to wear or how you are going to afford to eat, especially if its taking place in a more expensive city or country.

One of the things I think we can do is to assure students that they don’t have to go and invest in a suit to present their poster or talk. They don’t have to turn up in a formal expensive outfit. They should present in something that makes them feel comfortable and like their best selves. Frankly, I don’t care if that means they present in a giant hippo costume. Students shouldn’t feel like they have to spend money in order to share their work, and I’m prepared to be a complete mummy bear academic of anyone, making them feel less because of it.

The other thing we try and do is make sure that breakfast is included in any hotel bookings, and depending on circumstances, dinner, so that those costs are already taken care of. We also try to eat dinner together so that as a supervisor team, we pick up those expenses so our students don’t have to outlay. Then, it’s only lunch that needs to be covered by the individual.

Awards and other dinners

I’ve already written a little bit about this one. Once you’ve been to a few awards dinners, you by default have stuff to wear and an idea of what to expect. I think we forget that these may not be the exciting experience they are sold as if you don’t have something to wear and so the reward can feel more like a burden. I hope that organisers now take into account that having things like ‘black tie’ dress codes can actually exclude people who are worthy to be there. I personally hate the tag line ‘dress to impress’. If we want to be inclusive we should think about which we are unintentionally excluding or making uncomfortable with our decision-making. This is one of those areas where I think we all need to give it some more thought about how we do it well.

Social pub outings – the dreaded Christmas dinner

When I go for coffee or lunch with my students and trainees I will always pay. Nit because I’m rich or have loads of disposable income, but because I have more of it than they do. I never want someone to turn down a coffee invite because they don’t have the disposable income to pay for it, and therefore miss out on the discussion we would have otherwise had. They should also know that this is the rule, so that they don’t have to face any uncertainty anxiety, over whether this time I will cover the cost or not. There is a consistency that they can rely on.

For things like Christmas dinners, we will usually cover the food and the first drink and soft drinks. That means that anyone who wants to get a drink to toast with, and after that they can make an individual choice. I know other groups who pay for wine during dinner but not afterwards. I think every group is different and that is OK.

The main thing is that everyone needs to know what the parameters are, and no one should be excluded from attending, if its a group activity, by financial parameters. This is one of the reasons (and there are others, like equity of access) why I dislike the evening pub visit approach to academia, where decisions and ideas are discussed within a setting that not everyone can have access to. It increases the less visible gaps that are already present.

Membership fees as barriers to progression

In my field there are a LOT of professional fees, I pay out over £1000 every year in fees alone. I’ve been doing this since before I had a consultant post, as it takes time to find one in Healthcare Science. I pay the same fee level, despite earning 2/3 of the salary of my medical colleagues in similar roles, for the same right to use my abbreviations. This is OK now, I accept that as what is required for my practice and I can make it work. For trainees trying to attain those qualifications, the fees may present an insurmountable barrier. As you have to tick these boxes in order to progress, not being able to pay for them may also artificially delay talented staff from achieving their potential. On a national scale, the formal training schemes mean that less individuals are impacted, but those who are on less traditional routes still need support and ways forward. One of the thing we’ve tried to do as Healthcare Science leadership team is to offer routes where some of these fees could be reimbursed. Admittedly, you only get them for the first attempt, but at least it’s better than nothing.

Child care or caring costs

We talk a lot of about what to increase access and support learners, but I’m not sure we always fully scope out what that means. What support do we offer to those with caring responsibilities to allow them to engage with the same activities as their peers. I’m not just talking child care here, I’m talking about those students that love with grandparents or have family with other caring requirements. One of the great things about SfAM, when I was a Trustee, was that they launched a child care grant. ASM now have child care facilities at all of their meetings. This is a great step forward but we have further to go. A £300 child care grant will not pay for an overnight carer to look after your disabled husband. If you have visual impairment and need someone to attend with you, it will not cover the cost of them doing so. I don’t have solutions for this one, apart from mentioning it on committees and other things I’m involved with, but it is worth considering if we could do more.

Awareness of how much thinking space this takes up

I just wanted to finish by saying that as supervisors, mentors and managers we should have an understanding of just how much thinking space dealing with financial worries can take up. We may not always be able to fix the problem, but it is key that we are both empathetic to it’s existence and have done the work on our side to be able to sign post to support and other services that are available and may have some solutions. Finances are incredibly personal and it takes trust for individuals to discuss them, and so we should consider any sharing of concerns as a real demonstration of that trust, and do our best to show it was well placed.

One of the ways we can stave this off is by setting up our groups and interactions so that they do not introduce barriers, either intentionally or unintentionally. We won’t always get it right, but hopefully we will learn from our mistakes and do a better job next time. Our trainees and learners are the future, and that future should be bright and not dependent on them being able to financially be able to access opportunities in order to allow them to succeed.

All opinions in this blog are my own