The Second Year Slump: understanding the ups and downs of doing a PhD

I loved my PhD, it was one of the most amazing things I’ve ever had the privilege of doing in my career. It was also the start of my physical decline, the point at which I developed alopecia and started to have auto immune attacks. It was (next to FRCPath) the psychologically most challenging thing I’ve ever done. I don’t regret it for one second, but there are aspects of what it is like to do a PhD that I think I would have been better prepared for if someone had talked to me about them before I started. Now I supervise PhD students myself and I try to have some of the conversations with them that I wish that someone had had with me. 

Completing any PhD is a roller coaster and crossing the finish line is a huge mile stone. There is a lot of road from the start to completion however. So today I wanted to talk about one topic in particular that if I had known about when I started would have meant, when it happened to me, I didn’t feel so alone, out if my depth and like a failure compared to my peers. I’m talking about the second year slump.

Now this post is going to focus on PhDs but a lot of the thinking about why this is challenging and hard can be applied to any form of long term project that is high stakes and mostly undertaken in isolation. There are probably points we can all take away for different aspects of our working lives

So what is the second year slump?

The second year slump is the time during the middle of your PhD when you feel like you’ve lost your way. It’s the time where most students have a massive crisis of confidence both linked to their own skills and whether they can ever complete, but also linked to the project itself and whether it will have value. It is a pretty dark and lonely time where everything feels really hard and very isolating.

A question of timing?

Why does it happen when it happens? The second year is that point in a project when you have been doing it for long enough to understand the scale of the project and are so firmly embedded in it that you see both all of the challenges and all of the faults. You are also still quite far away from seeing the finish line or having outputs that make you feel you are really achieving.

Now obviously the second year slump doesn’t always occur in the second year, when it happens depends somewhat on the time scale of your PhD, it may be later if you’re working part time. The thing is it has happened to every PhD student I’ve spoken to at some point and certainly to every PhD student I’ve ever supervised.

One of the difficult things about entering the middle stage of your PhD is that you are getting to the point where you will be actively comparing yourself against others. Am I doing OK? Am I working hard enough? Am I productive enough? The problem is that every single project is different, your learning needs as a student will also be different as everyone starts in a different place. Therefore comparing how you are doing against others is often a fools errand. To compound this you are often benchmarking against peers that are either super enthusiastic as they have just started, or against other peers who are getting outputs (papers/posters) and meeting their success criteria because they are further down the line. Very rarely do you have someone in exactly the same boat to truly compare against, and yet we are rarely told to not compare against others.

The road ahead is all starting to become very real

The other thing about the middle of any long term project is that you are too far away from the end to truly be able to conceptualise what that looks like, and far enough from the beginning that the true challenges of the task are becoming very real. Rather than being filled with lots of enthusiasm and just an idea that it is going to be challenging, you know know quite how challenging the path ahead will be.

At this stage it can often feel like no progress is being made. The increments are so small that you can’t fully judge the distance you have travelled and you are so fully focussed on what is in front of you that you forget quite how far you’ve come. One of the tricks that I’ve been thinking of doing with my new starters is to get them to write notes to themselves for 6, 12 and 18 months as with a reminder of where they are and what they hope to have achieved by that point. I hope that by doing this it will give them something concrete to reflect back on to truly understand their level of progress. Pairing students during the second year slump with new starters can also actually help at this point. As well as developing them as educators it can also stand to show them how much knowledge they have acquired since they were the new starter themselves.

‘Oh, everyone wants to know about me’

It is a truth universally acknowledge that you should never ask a PhD student how it is going. The main issue with this is, if you are anything like I was at this point, I had very little life outside of work and my PhD so I just didn’t have a lot of small talk that wasn’t about my project. The problem is (and I acknowledge the irony here) everyone has an opinion or some advice. People who haven’t done a PhD have nothing to really compare it against in terms of giving you the support you need. We also all know of those other PhD students who use discussion as a way of making themselves feel better by talking about how great they are doing, whereas in truth we know that they were actually doing no better than anyone else. This is often compounded by your supervisor who will have a 1001 different priorities and will be trying to strike a balance between pushing enough and (if you are lucky) caring enough about your health and wellbeing to not push too much.

During the second year slump it can be tricky to find anything positive to say. You can’t babble on about everyone you’ve just met or how great it is to start, you often have nothing concrete that people will understand (like papers and posters) to share, and in all honesty this phase of an experimental PhD is often just filled with a lot of failure which can be difficult to discuss for fear of judgement. These things can all make just simply answering the question ‘how is the PhD going?’ challenging.

Stepping into your future

Finally, and I know it doesn’t feel like it, this is the point at which you really are developing and learning most. You’re at the point where you are starting to take risks and explore what it’s like to do novel work, you are truly beginning to work as a scientist and that can be scary and require adjustment.

At the start of your PhD you will mostly be doing the ‘safe’ work. Learning techniques and building on work done by others, but not initially taking those next big leaps of thought that are required for you to develop your own work. During your second year you are usually going to be making your own intellectual leaps and so the consequence of that is that there is a lot of failure and trouble shooting as you try and work things out. As you really grow into undertaking work as an independent researcher, you make that shift into following up on your own thoughts and really take responsibility for planning your work. That responsibility and the fact that your success is intrinsically linked to how well you develop into this new role can be truly terrifying, but it’s rarely articulated. Most people think the adjustment happens in the first year, but in my experience it is definitely during the second year when this shift starts to occur.

So if you are feeling low and lonely in the middle of any project, know that it is not you, it’s probably a function of the type of work you are doing. Remember that this is hard and that’s OK as you are truly beginning to reach your potential and anything worth doing is not easy, so be kind to yourself. If you are a supervisor or other form of mentor, talk about this with your students that are coming on board, think of ways to make it easier. Last of all and for the love of all you hold dear, don’t as a second year PhD student if they’ve started on their thesis yet, unless you’re prepared to give them a LOT of tea, cake and sympathy.

All opinions on this blog are my own

You Can’t Please Everyone: Why I try to remember the rule of thirds

I don’t think that anyone enjoys being disliked, but some people are much better at dealing with it when it inevitably happens than others. That’s because trying to please everyone people is frankly exhausting and ultimately futile as people are so varied as to make it impossible. I don’t know about you but after 2 years of COVID-19 I’m too tired to do it anymore. I think having reached acceptance that I can’t and won’t be everyone’s cup of tea has come with a feeling of freedom, so I thought I’d share some thoughts of how I got here.

How do you know if you are a people pleaser?

For many years I didn’t realise that everyone wasn’t like me. It meant I also didn’t understand why some people were able to behave like they did (not always badly but with independence) without suffering the crippling shame spirals that happened to me. So how do you know if you are a people pleaser? Some great examples are below.

https://www.scienceofpeople.com/people-pleaser/

You may not be a dyed in the wool people pleaser all the time. It’s true primate behaviour to become more extreme in this behaviour during times of stress, meeting new groups or in high stakes situations. Which is why I suspect that for me it’s been made worse by COVID-19. Being aware of your tendencies so you can undertake a review of whether or not they are helping you is key. For instance I have a tendency to over compensate initially when I’m annoyed at someone whilst I process that irritation. This can lead to me having less good outcomes in the long than if I’d taken a more neutral stance, as I am guilty therefore of sending mixed signals.

Playing well with others

This pleasing people can be especially challenging when it comes to working on group projects or when running events. I’ve been running events and working in groups/teams for most of my life and for all of my NHS career. Most of you won’t know this but for many years, even in my spare time, I ran role playing conventions or live role-playing events for dozens or even hundreds of people. The main thing that I have learnt in my time doing these is that it is actually impossible to please everyone. The things that were one person’s highlight will inevitably end up on the list of another’s persons disappointments – especially when events reach a certain size. Everyone is different and therefore it is almost impossible to tick the boxes of everyone attending.

When I was putting myself through the ringer and getting upset about the not universal love for a freeform I’d spent a year and over 150,000 words writing a good friend turned round, hugged me and whispered in my ear ‘remember the rule of thirds’.

Now I had never heard about this but on follow up questioning it turns out as follows:

  • A third of the people will love it
  • A third of the people will be ambivalent or think its OK
  • A third of the people will hate it

You will hear most from the lovers and the haters but what you actually need to know is how many of the ‘good enough’ people there were. If you manage to get over over a third you are probably doing something right (unless the extras all come from the lovers category). Those are the people you won’t be able to judge the numbers of unless you specifically go out there and seek their feedback – otherwise you respond to the most vocal and may react incorrectly.

The thing is as I go through my career I think the last part is really becoming a key part of my thinking. Am I or do I respond to the things that are shouted loudest or do I take the time to actually evaluate the situation that is beyond the noise to make an action plan which may work for the quiet majority?

It isn’t just about groups

I’ve started off talking about groups but obviously people pleasing can have challenging aspects in 1:1 settings. In fact overcoming people pleasing tendencies in these 1:1 settings can be key to maximising your own effectiveness both at work and at home. I’d like to state for the record that this is very different from me advocating for selfishness. We should absolutely all be team players, but it is important to also ensure that you have the capacity and reserves left to be the best version of yourself so that you deliver as fully as possible.

Below are some of the things I’ve been thinking about/learning in order to handle some of these 1:1 settings better.

Set your success criteria without bias

When I have someone in front of me asking for something I find it incredibly challenging in the moment to say no. Especially when each individual request doesn’t feel unreasonable or large. This year though I’ve been trying to move towards not seeing these 1:1 moments in isolation, but rather to measure them against a holistic whole of what is happening in my life. One important step towards being able to judge whether taking something on is people pleasing or appropriate, is to set boundaries and measure your responses against these.

These decisions can be very challenging in the moment and so one of the things I’ve started to do is to set my own success criteria, before I start projects, but also for my year. These are not another rod for my own back but are a way of checking in with myself about whether something is going in the right direction and whether the decisions I’ve been making are actually serving me and the goal.

It’s important to do this before being in the moment. When I’m in the moment emotions and other pulls can make it difficult for me to evaluate. By having a list that is done before I get into the situation it enables me to have made an unbiased set of judgements that are more reliable for me to use as benchmarks.

One example of this happened recently. This year I had promised myself and my family that after the last 2 years of work coming first I would start to regain a balance where actually my family would be my priority for a while. In May we had some news that meant that this was even more important. In that moment I was able to go back to my list and goals and re-evaluate commitments against my stated aim for this year. Although it was sad I then stepped away from a number of things I was agreeing to that were interfering with my top goal for the year, spending time with my family.

I’m aware other people may think I’m barmy to have to do things this way, but I really easily slip into a default of yes, and in many ways that’s great and where I aspire to be. Not at the costs of my main goals however.

Communicate and manage expectations

If you are going to do this though, communication is key. One of the reasons that I can get more drawn into things than I originally intended is because either myself or the other side haven’t accurately communicated their expectations.

One of the things I dropped in the above example was being a school governor. I only started the role in September 2021 and I had been told that it involved 3 2 hour meetings a year. This I had decided I could manage even in a pandemic and that giving back to my community was sufficiently important to me that I could make it work. Then the mission creep occurred. Suddenly it was 3 meetings a year plus a governor monitoring day per term, then that plus, as Health and Safety governor, I needed to do an inspection visit per term, and finally I became governor with responsibility for science teaching review. Suddenly my 3 evening meetings a year were replaced by at least 2 day visits a term plus the other meetings. Something that was simply incompatible with my goal for this year. In previous years I would have just made it work, I’d signed up after all. This year I reviewed against my goals and found that it just didn’t fit with me achieving the things I’d prioritised for my life so I quit.

The lesson for me from this is that we have to be very clear in communicating our expectations and what the situation will actually look like. That works for both sides. I should have been clearer about the commitment I could actually make and they should have been clearer about what they needed. So many things in my career have been subject to mission creep and I’m trying to be much more aware when I take on new things what they should look like and how much variability from that I’m prepared to accept.

You can’t fix everything

One of the situations that I know is a real challenge for me and my people pleasing tendancies is when I’m presented with a situation where I feel like I should help or ‘fix’. At times like this I become a real helicopter friend/manager and I try to ride in on my white horse and make things better (mixing my metaphors all over the shop and I don’t care – see that’s what I call growth). It comes from a good place, I don’t like seeing people upset or struggling. The problem with this is that a) I often then take on unexpected extra work as part of the response and b) I actually take the learning away from the person I’m trying to help. There is a big difference between assistance/support that enables learning and development and ‘fixing’ which then takes the learning experience away, although fixes the situation in the short term. I struggle to know when in the midst of these situations when to step away or hold my ground to allow space for development to occur and how much help is too much.

This brings me onto something I’ve mentioned previously. It is sometimes just not possible to please everyone. Sometimes you have to have the courage to be disliked and honestly this is definitely harder 1:1. This can happen for a number of reasons: sometimes it’s because it’s a collective decision and not everyone in the group is going to be on board, sometimes you have to make a decision that is in the best interest long term but may not garner immediate approval or understanding, and sometimes (especially in IPC) you make difficult decisions on the basis of safety. I have found this the most challenging aspect of leadership, but I have come to one conclusion and that is I need to acknowledge the noise but not be deafened by it. I have to put it into context to be able to deal with it. If I believe that have done all I can, communicated/collaborated as well as I possibly can, then I have done the best I can in the moment and I have to put my people pleasing aside.

Remember context is key

You can only control you, your responses and what you have decided to put out there. You can’t control how it is received and you definitely can’t control the responses of others. Often these responses are not even about you or what you have put into the world. They will be intrinsically caught up in the perceptions of others, their prior experiences and their current emotional state. Fundamentally it is not all about you and you have little to no control over the people you are trying to please. The more we recognise this, the more we can put our energy into focussing on success criteria and moving forward in the wider landscape.

I’ve found the below image really useful in addition to checking against my success criteria. If my only motivation in saying yes is to please, then actually my answer is really no and the sooner I deal with that the better it will be for all involved.

People pleasing isn’t a zero sum game, by prioritising something over something else there is always a resource cost. If you like me have spent energy for years trying to please in situations where you have little or no control of the outcome my plea is to stop. Think. Why I am doing this? Is it actually helpful? Does it align with my values? Does it move things forward? If the answer is no, then the answer is no. You are allowed to decline, you are allowed to choose where to focus your energies, you are allowed to have your own goals. So say it with me now ‘No’ ‘Thank you for thinking of me, but I can’t right now’ ‘It isn’t the right time for me right now, but please do contact me again in the future in case I can help then’. Your world will be a better place for embracing the power of N O, you will succeed more, do more and in my case I will get to spend time with the people I love who are, after all my reason for being.

Celebrating National Pathology Week: What is a Trust Lead Healthcare Scientist?

To round off the posts about different opportunities for Healthcare Scientists outside of the laboratory/clinic this week for National Pathology Week I wanted to end by discussing opportunities for Healthcare Scientists as leaders.  Now leadership is obviously possible at all levels and there are lots of different options, but as I accepted my Trust Lead Healthcare Scientist position 5 years ago this week I thought I would focus on that.

What is a ‘Lead’ Healthcare Scientist?

To continue the theme of this week, from my experience no two Trust Lead Healthcare Scientist jobs are the same.  I share my post with the wonderful Dr Stuart Adams, and even our experience of the post is different because we lead on different things.

The main theme that I have been able to discern across Trusts is that the role of the Trust Lead Healthcare Scientist is to provide professional leadership for the Healthcare Science (HCS) workforce across specialism boundaries and to provide representation for the workforce either at, or to exec level, in order to ensure the integration of healthcare science provision across patient pathways.

In the role we have at GOSH there are three main areas of responsibility we share for the Healthcare Science workforce:

  • Research
  • Workforce development
  • Education

We report to the medical director and have a committee called the Healthcare Science Education Working Group which we work collaboratively with in order to try to get representation from across healthcare science involved and engaged in decision making.  We also work really closely with the GOSH Learning Academy or GLA, which is probably why in all honesty I feel like we are making more headway currently with workforce and education.

The long term aspiration has always been to make these roles analogous to a Chief Nurse or Medical Director position but for now, just having a seat at the table is key.

How it started

These roles have come into different Trusts at different points and there are still a number of Trusts who do not have HCS representation at or to board level.  My first awareness of this role even being a possibility was due our education lead in 2015, who I’d been working with on other things as part of my PGCert. She emailed me to see if I would be interested in working with others to set up a HCS group in order to have a cross Trust forum.  This idea was a revelation to me.  I’d worked at GOSH for more than 10 years and had met HCS from outside pathology on leadership courses and as part of trying to organise Reach Out for Healthcare Science, but we had never had a forum where we could regularly meet as a group, get to know each better and establish links, as well as identify shared barriers and opportunities.  It was as part of this work that the Healthcare Science Education Working Group (HSEWG) was established.

Prior to the establishing of this group I also had no idea about the strategic set up of HCS outside of GOSH. Alex Milsom and Ruth Thomsen came to present to this new group about both Trust Lead HCS and the work being done of the CSO office and NHS England, suddenly my world increase in size. The HSEWG started to work towards creating a Trust Lead HCS post. As we had no funding we were hoping that we could at least get a named post that had recognition by the board and a defined remit. At this point however I had no intention of applying for such a post myself, there were so many others who were more qualified, better experienced and better placed.

Not long afterwards a letter went out from Chief Scientific Officer Sue Hill to all Trust CEO’s and in 2016s Lead HCS jobs started to be advertised (see above).  Many of the posts, like ours being prepared, were unfunded.  At the same time as these were being developed we got a new energised and inspiring Head of Education (Lynn Shields) who in her interview from the outset was determined to represent all professional groups.  She found £15000 a year in development funds for HCS and from that created a 1 day a week band 8B Trust Lead HCS post. Thus the GOSH Lead HCS post finally became a reality in 2017.  By this time I was about to start my NIHR Clinical Lectureship and had become so engaged and excited by the possibilities of what the HCS workforce could achieve that when it was advertised I ignored my fears and went for it.  The complication was that I was also about to go on sabbatical for 2 months to Boston Children’s Hospital and so it was proposed that the post was split into 2 0.1 WTE roles.  This was the best thing that could have happened, my co-lead and I have very different skills sets and I love not having to do what can be a challenging role in isolation.

Where we’re headed

The one thing I’ve learnt in this post is that nothing can be achieved well in isolation. The job is in itself all about collaboration and involves working both with GOSH and across the system to drive change and improvement. It took me a some time to really grasp the difference between an operational (doing role) and a strategic role. Lead HCS in my experience is definitely strategic, it’s about working out the vision for where you want to get to and a rough road map, but really working with others to actually achieve it. I think we (the HSEWG) have a good idea of where we as a team would like to get to, but in a world where we have clinical and other commitments delivery can be a little more challenging.

The vision that we have can’t exist in isolation however. There is amazing HCS leadership at regional level. I’m fortunate enough to have continued to work with Ruth Thomsen as our regional lead for London. She has taught me so much, listened to my woes and is a constant source of inspiration.  I can’t advise enough finding out who your local leads are and building relationships with them. The ones I know are all both top notch scientists and top notch people. Even if you are not in a leadership position yet they can help orientate you to the world of HCS outside your Trust and if you’re lucky mentor you to help you achieve your potential.

Not only are there regional HCS networks but there are also national ones. Obviously most of us are aware of things linked to our specialisms but it’s definitely worth linking into the national work being done by the Chief Scientific Officer and her team, they even have a twitter account to make it easy.  There are regular webinars and an annual conference that can be a great way to find out what is happening national at a strategic level and how it’s likely to impact you and your Trust.  Current important themes like the implementation of ICS boards as well as HEE joining NHS England will filter down and impact us all.  By being aware of this we can make sure we are part of the conversation rather than an after thought.

NB. Talking about orientation outside of your Trust now is also the time to find out a little more about Integrated Care Systems (ICS) as these come into play from the 1st July and will really impact on how we deliver services, what our training funding and support potentially looks like and where some of decision making occurs.

Why is it important to have these roles?

That brings me onto not only why I enjoy the role but also why I think it’s key that HCS at other Trusts see if they can bring in equivalent posts.  This isn’t because I believe that I am in any way amazing, in fact there is lots that I wish I could do better and so much more I wish that I could achieve.  That said, even if I struggle to get us where I want to during my time in post, I have managed to get a seat at the table.  A lot of the time I get to be in the room when items are discussed and I can say ‘have you thought about how this will impact the Healthcare Scientists?’.  This is especially true with new patient pathways or with new builds.  Have they thought about the fact that opening X number of new beds will lead to X number of new samples, and so they can’t just increase the establishment on the ward but also need to increase numbers in diagnostics.  There are also times when I can provide a solution that no one else in the room may have conceptualised, linking to triage or changes in flow, because I can suggest a rapid test or a modification.  As Shirley Chisholm said ‘If they don’t give you a seat at the table bring a folding chair’.  Once you get into the room, a chair will follow.

It’s also about visible leadership, this week we’ve talk a lot about different roles but if we are not out there and visible, both to our own profession and others, we limit both our own trajectories and our wider impact.  Leadership roles are really common in nursing and medical disciplines and increasingly common for Allied Healthcare Professionals (AHP), but we will never have the same input unless we are seen and active in breaking down silos and fostering collaboration.  I hope that by being seen and by being open about the benefits and challenges of these roles that others will feel inspired to see this as a route they would want to follow.

I have one more possibly contentious point that I’m going to mention here because it’s something that I really believe in, although others are free to disagree.  I think using the collective name of Healthcare Scientists is key for us to have a voice in a lot of these conversations.  I am a proud Clinical Scientist, I’m proud of the work I did to get my state registration and to get on the HSS register as a Consultant Clinical Scientist.  However I switch the title I use based on the audience I’m speaking with and who I’m representing in that conversation.  Using the term Healthcare Scientist helps as many senior people within the Trust don’t know the difference between a Biomedical vs Clinical Scientist. This is of course something that we can address over time but is often not necessary for the messaging we are trying to do.  Registration titles are, currently, still also quite pathology linked, whilst using Healthcare Scientist can span so many other disciplines across the Trust.  Registration titles also mean that we exclude our unregistered workforce from being included in these conversations or under the umbrella of the discussion. Using specific registration titles can therefore introduce unnecessary barriers to communicating key messages in the moment.

Numbers and representation matter.  At GOSH HCS represent over 13% of the workforce and we have the numbers to get listened to if we discuss HCS using those numbers as a whole.  If I start splitting us into smaller groups I lose impact, when someone says ‘how many people will be disadvantaged by that?’ me replying ‘4 ophthalmic visual scientists’ isn’t the same as ‘over 700 Healthcare Scientists’.  At a national level it’s even more challenging as we are only about 5% of the workforce and are advocating and challenging for the same pots of funding or prioritisation as much larger groups.  Yes we have have impact across pathways, but numbers do count.  It is much easier for me to say we need to have a Healthcare Scientist on this group than to say we need to have a bioinformatician and a BMS and a Clinical Scientist, and a physiological scientist etc……..suddenly we are asking for 5 seats when we are more likely to succeed when we act together and ask for one and then show what we do with it.  So I’m a Consultant Clinical Scientist working in Infection Prevention and Control but I am also a Trust Lead Healthcare Scientist representing all of the Healthcare Scientists within my Trust.

The potential of our work force to create and support change is immense, but to do that we need to be in the room and part of the conversation. Leadership matters, representation matters, being seen matters, so lets advocate for ourselves, get into the room and change the world!

All opinions on this blog are my own

Celebrating National Pathology Week: What is a clinical microbiologist?

This one’s a re-share of a post from last year but I thought it was still a good one to continue this weeks exploration of roles.

To celebrate this week being National Pathology Week , I thought I should take some time to post about what a clinical microbiologist is. I do this because, when I was at university, I really didn’t know that this career path existed. So here is a shout out to all those students who are trying to decide their next steps. You too will find your way.

When I googled microbiologist this is the first item that comes up

Microbiologists study microorganisms (microbes) in order to understand how they affect our lives and how we can exploit them

Prospects.ac.uk

This seems like a pretty good cover-all description. It goes on to discuss that there are microbiologists in many different areas:

  • medicine.
  • healthcare (I’m not sure how they differentiate this from medicine or visa versa).
  • research.
  • agriculture and food safety.
  • environment and climate change.

I must admit that when I was at university most of the options I encountered were linked to the food and drink industry or pure research. I think that their list missed things like Pharmaceuticals (although they may count that as medicine) and other forms of production, i.e. cosmetics.

At university I only did one module of microbiology (I was reading Zoology) and that module was about environmental bacteria and plating out bacteria onto agar plates to see what grew.

How did I go from Zoology to Microbiology?

I really wanted to work in an area of science where I could work to make a difference. I wanted to work somewhere that I could see that difference being made. Working in research felt too abstract to me. When I discovered, through a friend, that I could become a scientist in healthcare I knew it was what I wanted to be.

The National Careers service says you need to have two to three A-levels to become a microbiologist, plus a post-graduate degree. That is mostly true. However, in a world of apprenticeships and T-Levels, that is no longer the only route.

When I became a Healthcare Scientist I became a Clinical Microbiology trainee. So, what was the difference between that and what I’d done at University? The main difference with clinical microbiology is that I focus on organisms that cause infection: parasites, viruses, fungi and bacteria.

I also discovered that there was so much more to microbiology than agar plates. Although – don’t get me wrong – agar plates are still a mainstay of life within the bacteriology laboratory.

One of the techniques I learnt to love was polymerase chain reaction (PCR), which enables us to look for the DNA or RNA of a microorganism instead of growing it. Viruses and parasites don’t grow on agar plates and bacteria and fungi may not grow well if exposed to antibiotics or if present in low levels. PCR allows us to diagnose patients with infections that would not be diagnosed otherwise, or to speed up the process so patients get put on the right treatment faster.

Variable number tandem repeat typing of Klebsiella pneumoniae

PCR also enables us to do things that are harder to do using traditional bacterial techniques such as culture. The picture is of patterns that are like bacterial fingerprints so that they can be clustered into similar groups. This enables me, as a clinical microbiologist, to tell whether bacteria within the same species are the same or not. This is important when deciding whether a bacteria has spread from one patient to another. It helps in acting like a hospital detective, which is a lot of my work in Infection Prevention and Control.

As a trainee I spent four years rotating within laboratory settings. I spent one year in a molecular laboratory, diagnosing patients using PCR. I then spent six months rotating between benches (each sample type has its own laboratory bench) in bacteriology: wounds, respiratory samples, faecal samples, blood cultures, urines, fluids (cerebral spinal fluid etc.) and the primary bench where samples were put onto agar plates. Six months in virology, a year in research and time in food and water, parasitology and mycology (fungal) labs.

The diagnostic process is pretty similar in principle between the specialisms:

  • collect specimen from possible site of infection.
  • select the most appropriate test to detect any organisms (agar plate for bacteria, PCR primers for viruses, etc.)
  • evaluate whether the result (positive or negative) is accurate and whether there are other tests that should be done, i.e. further characterisation of positives such as antimicrobial sensitivity.
  • decide on treatment or management of the infectious cause, i.e. antimicrobials or non-antibiotic management such as surgery.
  • advise on infection control if actions are needed to investigate where the infection came from or to protect others from risk.

During my first four years I spent most of my time in the laboratory doing the first three bullet points.

Time goes on. I’ve been in the NHS for 17 years. Most of my time is spent at my desk in the on-call bathroom. Since 2010, most of my time has been spent either in Infection Prevention and Control undertaking the final bullet point or increasing my skills by gaining Fellowship of the Royal College of Pathologists to do bullet point four.

I still support the lab and, occasionally, get my lab coat on – but not as much as I’d like. It is, therefore, possible to be a clinical microbiologist and be anywhere on the spectrum. You can go as far as you’d like and do the type of work that makes you happy. It’s why being a clinical microbiologist is a great career!

Modernising Scientific Careers Framework

All opinions on this blog are my own

Guest Blog from Anthony De Souza: From lab to educator, finding a new direction

Continuing the Girlymicro theme of raising awareness of roles outside the laboratory to Celebrate National Pathology Week 2022 today we have the inspiring Anthony De Souza sharing his journey from bench scientist to Practice Educator. I’ve already written about why I think it’s so important that Healthcare Scientists think of themselves as educators (see blog here) but Ant puts this into practice and talks about how he became a Practice Educator and why these roles are so important.

I was a geeky kid and was pretty obsessed with astronomy, pathology and nature. I was an avid reader and loved to immerse myself in my mother’s nursing books! I mean, I used to peruse the BNF for fun and at a church book sale I wanted a medical textbook.

In my teens I pondered whether to become a marine biologist, a science teacher, a dietician or scientist. After looking through four heaving A4 binders of job descriptions I settled on Biomedical Scientist, more specifically in Microbiology.

It was a career that allowed me to immerse myself in the medical world without being too close to the patient, something which I thought I may struggle with. My first taste of Microbiology in school was a lesson on bacterial culture which was my early foray into microbiology. From this point microbiology sparked an interest that I knew would always be there. After completing my IBMS accredited degree I was very lucky to get a trainee band 5 position in my local micro lab!

As time went on, I developed within Microbiology over a ten-year period. I realised that some of the most enjoyable parts of my role were when I taught or trained others, especially if they shared the same excitement I did. Whichever job I was in I always ended up being known as a teacher but being a teacher full time was not really for me, but I knew I wanted to get more involved.

I got to the point where I was feeling frustrated as an experienced band 6 and had gotten to the point where I felt like I had peaked within my current role and needed something to change. It was at this point that I seriously considered leaving the NHS and using my transferable skills in a different place. That’s when I was encouraged to apply for a job as a part time practice educator in our hospital. Up until this point, I had only ever heard of this role in a nursing context.

‘Most things feel impossible till it’s done’ – Nelson Mandela

During the application for this part time role, I had full on imposter syndrome and was talking myself out of applying. One of the biggest self-imposed barriers was feeling like I was leaving behind certainty and proven experience for a role in which I would need to build and grow within. I had gotten to the point where work felt comfortable, my knowledge and skills were developed for my role, and I felt confident in that. The thought of moving to an area outside of my core experience base was pretty terrifying but I knew I had to do it! I decided to apply and was successful in the interview!

Some of the key purposes of the role are outlined below:

  • Work to support learning and education and support specific workstreams, in my case this was Healthcare Science.
  • Create and maintain positive learning environments
  • Facilitating induction, education and continuing professional development
  • Encourage practice development, support service improvement
  • Promote high standards of care and act as a role model for others
  • Work multi-professionally, as needed

After being used to working in a small team within the lab my new role involved an even bigger and more diverse team. This exposed me to a greater appreciation for the work of other health professionals and the hospital as a whole.

At first, I found the job challenging; learning new names, getting to know the team, my place within it, learning new acronyms during meetings and adjusting to the different styles of communication. Some of my work involved supporting healthcare science learners, acting as a point of contact to raise issues, signposting relevant training & education and supporting outreach and engagement activities. As my role grew and developed, I was able to work more multi-professionally, increasing the visibility of our hidden workforce and even teaching nurses about healthcare science.

As a practice educator a PG Cert in Practice Education is essential to learn about educational theories and how this relates to designing learning for the learner. Whilst I may have been acting on natural instinct before gaining this qualification, the education and evidence-based practice approach to back up teaching has been important in the role.

This role could suit a range of people but what I think that this would suit someone who wants to make a difference, is passionate about education and training, has the ability to communicate well, work effectively with others and enjoys working both alone and with different teams. The job often involves taking yourself out of your comfort zone and identifying opportunities to share and develop learning.

Whilst I have now left the lab and am working full time as a practice educator, I still do look back fondly on my lab days and Microbiology. I love checking in on the lab and looking at exciting agar plates and learning about exciting cases, and who knows maybe one day I’ll go back for now though I am fully committed to this new direction. Just because I’ve left the lab, doesn’t mean its left me….

Follow Ant on Twitter @ADSMicro to find out more

All opinions on this blog are my own

Celebrating National Pathology Week: What is a clinical academic?

We are working through an exciting time within NHS careers, especially as Healthcare Scientists. Training pathways are becoming more formalised and alongside this diversity of opportunities are increasing, allowing Healthcare Scientists to have not only more options for their individual careers but also to increase the impact of this workforce across areas including academia, education, leadership, as well as clinical specialisms. Following on from this weeks Guest Blog by Dr Claire Walker discussing the transition from lab to lectern and life working as a Healthcare Scientist within the academic setting I thought I would write something on what it is like to be a Clinical Academic (CA), working with a foot in both camps.

So what is a clinical academic? I suspect that all of you who read this blog regularly will be able to picture my face when I googled and the top entry is the one below from the NHS Healthcare Careers webpage:

what is a clinical academic? – healthcare careers search response

I believe it’s pretty self evident that I am not a medical doctor and that although this description may once have been true it is far from telling the full story.

So what is a Clinical Academic?

Being a CA is not in fact based on profession, or even % time splits. It’s based on the role that is occupied. One of the big distinguishing features is that a CA holds roles both within a University and within a Healthcare organisation, usually one honorary position and another substantive. Throughout the lifetime of a CA career the substantive post may switch between being within healthcare or a University, its the maintenance of both that is probably the most CA universal theme.

The amount of lecturing vs research varies by individual. Most of the CAs I work with tend to be highly engaged with research, especially if they are mainly based in healthcare, as this provides them with funding to buy out their time. In roles where clinics are routine however this provides a buy out route in the other direction. Despite being more research than teaching focussed I still teach on a number of master and undergraduate courses, as well as speaking at conferences etc.

Some typical academic tasks include:

  • Grant applications
  • Publication writing
  • Public engagement
  • Research supervision
  • Data collection (in whatever field that might be)
  • Teaching
  • Peer review (grants, papers etc)
  • Conference presentations
  • Other writing: book chapters etc
  • Guidance and strategic inputting

What are the routes into clinical academia?

On the Healthcare Scientist career chart below there is a box for CA pathways, but to me it still feels a bit ‘to be developed’. This isn’t unique to Healthcare Science but provides particular issues for my colleagues in specialist laboratories, especially within the UKHSA as they don’t have such a clear progression route laid out for them. It currently doesn’t really capture the whole situation as many of us in the Consultant Clinical Scientist box will also hold CA responsibilities and so the pathways aren’t as split as they appear.

There are a variety of roles into CA careers, both formal and informal. There is a fairly specific skill set you need to develop:

  • PhD (usually a research PhD rather than a tought/professional doctorate)
  • Some form of teaching qualification (as determined by your university). Not required for existing post but usually required for new
  • Funding track record – as you need to demonstrate to your employer you can assure an income stream
  • Publication track record – needed both for funding and dissemination
  • These days an interest in public engagement/involvement doesn’t hurt

The most established formal route into a CA career is via the National Institute of Health Research (NIHR) and the Integrated Clinical Academic (ICA) programme.

This is a programme that provides skill development and funding support all the way through from taster sessions to funding support for you to run your own research group. I wrote an article about this route in 2016 for the ACB and not much has changed in terms of the benefits.

The NIHR schemes are great, they match your current salary and give both great training and consumables support. This does mean these schemes are highly competitive (20 – 40% success rate, depending on level) however these days you need a level of research track record (publications and funding) to even enter at Doctoral level – demonstrating a pre-existing commitment to a CA career.

What about the informal routes? As I said the skill sets required are pretty standard and so can be developed piecemeal rather than through a structured programme. It is possible to get funding to do both a PhD and a teaching qualification by going through other routes (I have a post linked to PhD funding coming). The other components, funding and publishing, you will get by applying for funding for the qualification based aspects and during your PhD, it just may take longer. That said the NIHR route is time consuming and far from guaranteed, so both routes require you to know why you want to become a CA and an understanding of the fact that getting there is not a 9 – 5 commitment.

Why do Clinical Academic careers matter?

So having said that it can be a challenging route to go down why should you put in the effort?

There are numerous reasons why CAs are essential in healthcare. Let’s start with individual patient benefits. Research, especially translational research, is key to providing the best possible patient care. If we want to provide cutting edge care then we need to be engaged in the research that is developing that care – from clinical trials to diagnostic development. Getting results that diagnose patients faster has great individual benefits for patients, as they get on the right treatment more rapidly. Being engaged with clinical trials means that patients may be offered treatment or management that would just not be open to them otherwise.

On a Trust scale research enables funding to support infrastructure or translation of new diagnostics/services that might just not be possible with normal budget constraints. I was recently the co-applicant on a grant which brought in over £500,000.00 of infrastructure funding, for both staff and equipment. This means that the initial financial burden of translating over something new is not placed on the NHS and the data to then support business cases for introduction can be collected with minimal financial impact. On a national scale this kind of funding also supports multi site projects which would be difficult to manage in any other way in order to support large scale changes within the healthcare system, meaning that the potential impact can be huge and provide wide scale change.

There are also so many benefits for you as an individual. My career and life changed the day I got my NIHR Doctoral Fellowship. It opened both my eyes and doors to paths that I could never have imagined. I wouldn’t be a Lead Healthcare Scientist now if it wasn’t for the NIHR. I’m not sure I would be a Consultant. I have travelled the world, given lectures to thousands of people, developed future CAs and been able to develop as a scientist and a leader thanks to the funding that was provided. Along the way I hope that I’ve also made a difference for patients both through being involved in national guidance and local change.

What does a day in the life of a clinical academic look like?

As with so many aspects of Healthcare Science no two CAs seems to be the same. The National School of Healthcare Science have a number of different profiles on their webpage which describe some of the different options.

For me my weeks are really varied, obviously for the last 2 years my clinical work has been a priority and so the academic side of my role has been less prominent. I’ve already talked about teaching but for instance this is what I will be doing this month:

  • Organising a specialist conference on Environmental Infection Prevention and Control
  • Reviewing papers for numerous journals
  • Reviewing a grant
  • Reviewing abstract submissions for a conference
  • Meeting with my PhD students
  • Editing a paper for submission
  • Meeting to review SOPs for a country wide clinical trial
  • Meeting to review data for an ongoing COVID-19 study
  • Meeting with the molecular team to talk about how we move our Gram negative typing forward
  • Carrying out an MSc viva
  • Attending 2 exam boards as an external examiner

As my clinical work is currently still pretty hard core a lot of this I’ll pick up for the moment in my own time. Also, none of it takes me as long as when I first started out and so it looks more overwhelming than it actually is – I hope you can see the variety however.

Photo credit – Rabit Hole Photography

There is no getting around the fact that being a CA is not a 9 – 5 post however, managing grant and other deadlines on top of clinical work often requires some significant juggling skills, and in my case a very supportive husband. It’s not something I would advise that people strive for if they don’t love research, if they don’t have so many ideas that they just need to do something with them, it is not a tick box career. You also have to grow to be comfortable with failure, only ~20% of grants are successful, paper reviewer comments can be harsh and your confidence will take repeated knocks. Every time this happens though I get better at what I do, I find the learning and try to make sure I do it better next time #lifeislearning.

Despite it’s challenges being a CA brings me untold joy, it provides me with an outlet for creative thought and means that even though I spend most of my days in an office not a lab, I still feel like a scientist. I get to collaborate with the most amazing people who are at the forefront of their fields to make improvements for patients that would either not be possible or would take years any other way. For me it’s been something that has more than repaid my investment in time, energy and creativity. It’s taken me to places I would never have imagined, introduced me to people that my life is better for having met and provided me with experiences that I didn’t think would ever happen to someone as normal as me. So if you love learning new things, making life better for patients and are happy to spend your weekends in front of a laptop then a Clinical Academic career may be the career for you!

All opinions on this blog are my own

Guest Blog Dr Claire Walker: The Clinical Academic Path – From the Lab to the Lectern 

To help us celebrate National Pathology Week the ever inspiring Dr Claire Walker has written a blog post to follow on from the talk she gave at HCSEd22 (videos to follow on YouTube). Healthcare Scientists work across the NHS and increasingly within academia, and so it’s important that we acknowledge the wide variety of roles that are open to us.

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.

The Clinical Academic Path – From the Lab to the Lectern 

What can we learn from clinical academic scientists during a conference about co-production? Turns out, given a platform to shout loudly enough, rather a lot. 

Minding the Gap 

What steps did I take to move from the clinical laboratory to an academic position? Well, I did what any clinical scientist worth their salt who’s been through the transition from CPA to UKAS would do, I performed a gap analysis. Yes, I really am that person. I looked at job adverts for senior clinical scientists and senior lecturers looking for key similarities and points of difference. To my delight I found that we had far more in common than that which divides us. Yes, there are a few key extras like the commitment to completing a teaching qualification and learning exciting new quality systems but where better to learn a new skill than a university filled with professional educators? The similarities in the roles didn’t genuinely surprise me but it did confirm what I had hoped to be true. If we are to educate and, hopefully, inspire the next generation of healthcare scientist then universities are looking to recruit leaders who’ve been there, done that, and lived to tell the tale.  

Clinical Academic Purgatory 

In a recent lecture on roles in the NHS, a student asked me where I currently sit. I pointed to the training pathway for healthcare scientists at point 4 – the Clinical Academic Career. ‘Ah I see’ they replied, “you’re in Clinical Academic Purgatory whilst you have your kids, you’ll go back to your real job eventually”. Well that stung a bit! But it’s a valid point, I think that the move to a teaching role in a university is often seen as a bit of a soft option. Nicer hours that running your own lab with a better work life balance, just don’t mention the marking! It’s not completely wrong either, the chance to spend my evenings and weekends with my partner and children even when drowning in marking is a huge perk.  

However, I view this move as more that a pause on my way to a consultant gig. I think that this collaboration offers us an incredibly important opportunity, the chance to share our stories. When I reflect on my many years in both universities and hospitals, the moments I remember are not learning the details of the complement cascade or T cell receptor VDJ recombination (though of course both are very useful) but the stories told by my mentors, colleagues and leaders that made me want to become the scientist I am today. To my mind, we have a responsibility to those who are following on from us. Through collaboration with our academic institutions, we can help perform this essential service to our profession.  

As a clinical scientist turned lecturer, I’ve spent a good deal of my career bouncing between the laboratory and the lectern but I have often found that never the twain shall meet. I think it’s time we change that.  

TLDR: What do we want? Co-Production! When do we want it? At the start of the next academic year. It is nearly summer after all. 

All opinions on this blog are my own

Scientists as Educators: Why I believe all scientists should invest time in understanding pedagogical principles

Let me start todays post by sharing what on earth pedagogy is as my husband kindly pointed out its not a term that comes in up in most every day conversation. Well according to the Merriam-Webster dictionary it means:

So why am I talking about this on a sunny Sunday afternoon. Well I’m chilling on the sofa and recovering from one of the highlights of my year, the Healthcare Science Education Conference (this year #HCSEd22). Needless to say I therefore have pedagogy on the brain as it’s an event that although pretty intense also re-energises and inspires me. There is absolutely nothing like seeing a room full of scientists coming together for change, and in my world when you combine this with mindset shifts linked to education it doesn’t get much better. We had many really amazing speakers and workshop leads that put both the science and art into education, plus the wonderful Ant De Souza chairing. When I have time to mess with the recordings they’ll be up on the Healthcare Science Education YouTube channel if you couldn’t attend the day.

Below are some of the great photos taken by Rabbit Hole Photography

This was the 5th Healthcare Science education conference and it’s been running for 6 years since 2017 (we missed a delivery year because of COVID-19). Over the years we’ve had some pretty diverse themes including:

  • Co-production in Education (2022)
  • Innovation in Education (2021)
  • What is the Role of Collaboration in Education? (2019)
  • The Role of Leadership in Education (2018)
  • Healthcare Science Education: Where are we now and where are we going? (2017)

I think it’s probably pretty obvious therefore that I’m interested in education, especially how Healthcare Scientists educate both themselves and others. It wasn’t always this way though. To be honest when I finished my training and got HCPC registration I had only really experienced education delivered in one way, from the front of a lecture theatre/teaching laboratory. I imagine you’re all thinking but what about CPD? Continuous professional development is important and I obviously have undertaken it, as we all have, but it’s task focussed learning. What I’m talking about is the wider mind set switch and set of skill development that enables us to think about the educational experience as a whole:

  • what kind of learning are we trying to achieve – what are our learning objectives?
  • what kind of educational experience is best to deliver those learning objectives?
  • how much time do we have with our learners – is it a one off session or a repeat?
  • where is the education setting going to take place – are we going to be in a lecture theatre or a more flexible space?
  • where are my learners in the topic? is this an introduction session or are we aiming to achieve changes in practice? deep vs surface learning?
  • how do I assess learning linked to the learning objectives and delivery method?
  • how am I going to get feedback? how am I going to evaluate if I’ve achieved my aims?
  • is there a role for the learners in co-producing the session? learning outcomes/assessment/delivery?

How did I get here?

Between achieving state registration and taking the next formal steps along this pathway I was fortunate enough to undertake a one year leadership course at GOSH called the ‘Gateway to Leadership Programme’. This was a commissioned course with monthly sessions delivered by external providers with additional coaching. The sessions were delivered in a wide variety of ways and whilst I sat in the room learning about leadership I also started to ask myself if this teaching was being delivered in an MDT format with different structures could other teaching be different too? For those outside of Healthcare Science this may seem like a really naïve position, other disciplines in healthcare, such as medicine, have been using problem based learning and other structures for years. I know this now, I’ve done the reading on it and now experienced it, but in 2009 it was just not my experience of any form of formal education.

In response to the learning experiences I had on that course, and the fact that it was my first cross disciplinary learning (outside of my Clinical Microbiology masters) I used the opportunity to quiz others in the room, to speak to my coaches about the differences between 1:1 learning and group learning strategies………………..long and short I was probably a pain the ass. I started to sign up to other courses that were being delivered by the Trust and I found that the hospital had an entire education team, an entire team dedicated to education and learning. This team didn’t deliver the mandatory education, they didn’t just deliver education on specific topics, they used something called pedagogy to put together education and learning opportunities in conjunction with subject matter experts, as education was a field of expertise in itself. It was nothing short of a revelation.

What were the next steps?

The people that I knew in training positions in pathology didn’t have a formal education qualification, most had an interest in training but it was focussed, for the most part, on specific delivery mechanisms such as portfolio completion. Although obviously valuable, this again limited the scope of the education I would be being taught to deliver if I went on similar courses and the rest of the departmental offerings were things like train the trainer courses. I was more interested in really getting to grips with some of the theory as well as the practical aspects. At the time I had a wonderful IPC lead as my boss called Deirdre and she suggested that what I really needed was to do a post graduate certificate in education. She suggested this because it meant that I would be able to support the team and the Trust in running courses in conjunction with universities, as it was a requirement on most of the modules for module leads to hold formal qualifications. At the time I was also pulling together my NIHR Doctoral Fellowship and looking to take the next steps as a Clinical Academic. UCL requires lecturers to have a minimum number of credits linked to a formal education qualification and so it seemed fortuitous to cost into my grant the course so I could undertake a PGCert as part of my PhD.

Was it what I had hoped?

So in 2013 I started a 2 year PGCert in teaching and learning in higher and professional education at the Institute of Education (now part of UCL). I think the nicest way to put it is that it was a shock to the system.

It was like nothing I had ever done, the essays were first person present tense for one thing, it felt like I was back in primary school writing for my teacher. The first 6 months were hard, I was clinging to the educational culture I had always sat in as a scientist and the idea of moving away from being the ‘expert’ in the room to someone who facilitated learning was something that definitely did not happen over night. When it did however it caused me to completely shift my thinking about how we deliver on education and training in healthcare science and the need to move away from thinking of ourselves as people who deliver task based learning to the fact that we are all educators. Therefore learning about how we do it, why we do it certain ways and how those choices impact on the success of the learning is a key thing for all of us as a workforce moving forward.

Coincidentally an article I wrote on this for the Academy of Healthcare Science Leadership Journal came out this week, here is the link to the whole edition it’s got some really interesting stuff (not written by me 🙂 ) https://www.ahcs.ac.uk/wp-content/uploads/2022/06/HCS-Leadership-Journal-Spring-Edition-2022.pdf

Despite the fact that the transitioning into thinking like an educator took me some time I think it was one of the most valuable things that has ever happened to me. So much so that I have since worked with others to get 5 other Healthcare Scientists funding to go through the same process. I also utilised the course to attain Fellowship of the Higher Education Academy which has enabled me to have the credibility to be able to put some of what I’d learnt into practice on a larger scale when I applied to be part of the T-Level Healthcare Science Development panel as an employer representative. It also meant that in 2021 I was fortunate enough to spend time working with a wonderful Lead Practice Educator in IPC called Kate to input into the first paediatric IPC course.

Why does it matter?

It is sometimes easy to forget that as a Healthcare Science workforce we exist as part of a wider system. By taking steps to upskill and acknowledge ourselves as educators we achieve 2 main things:

  • we can do a better job of training not just our own work force, but of supporting the system by sharing our specialist and valuable knowledge
  • we can build links and break down silos by working across disciplines and healthcare professions by working as educators across those boundaries in order to maximise our impact, with all the side benefits that has to us as scientists

The students and others coming through education now will have had a very different experience of education to that I experienced when training, therefore their training needs and expectations are going to be very different to those I had when I joined the NHS. The new curriculums being delivered by the National School of Healthcare Science and Apprenticeship/T-Level groups are bench marked against teaching and education delivered in other specialisms/professions and so standing still is not going to be an option. The more we understand, the better choices we can make, in terms of influencing those choices for our workforce and how we like to work with others. So lets not just join the education revolution but take what steps we can to lead it, for the benefit of ourselves, our workforce and the NHS as a whole. Hopefully I will see you all at #HCSEd23.

All opinions on this blog are my own

Responding With Grace: The art of learning to take a complement

Last month I was fortunate enough to be asked to present at the 40th anniversary celebrations for the Healthcare Infection Society, I gave a talk that was pretty OK and seemed to land with those in the room. In it I spoke about the impact that the society had made on my career with the funding they had awarded, I also spoke about the impact and learning that had happened on those occasions they hadn’t awarded me funding – my CV of failure. For the rest of the day lovely people came up and spoke to me about how much they’d enjoyed the presentation, especially the section on failure. I spent most of the day a little thrown by it, not just because I didn’t feel worthy of the response but because it dawned on me that I just don’t know how to take a compliment. Those conversations felt like a social contract I had entered into without fully understanding the requirements and I just didn’t know what to say or how to appropriately respond.

This has led me to reflect on why I was so out of my depth. Was it the setting? When I give academic presentations at conferences I am usually prepped for questions and critique as a result of what I am saying – therefore compliments are usually less on my mind. People are often very kind about this blog and other things I post on twitter and other forms of social media, but when responding to those comments a nice gif is easily available and so the terms of the social contract are more easily fulfilled. So setting certainly plays a part, but even so the fact that I have reached the ripe age of 42 and I am so unskilled in this means I need to step up my game.

Why is it hard to just say thank you

Arrogance is not a good look and vanity is a deadly sin (I’m not religious but it’s all kind of embedded in society and subconscious lessons learnt) therefore it can be really hard to judge what is required as part of the social contract when someone gives you a compliment. The obvious choices are to say thank you – but that shuts down further conversation if not done correctly, or to dismiss it as not something you are not worthy of – which is hard to do without coming off as rude. It feels like a paradox that compliments are something I want to regularly give out but I am not sure that societal rules enable me to navigate appropriately when I receive them.

You’d think that these concepts of arrogance and vanity in terms of acknowledging success were old hat and not something present in todays workplaces, but I’ll never forget being told not to put the first award I won out on my desk as ‘my success makes other people feel uncomfortable’. When responding to unexpected compliments it can almost feel like a trap, be gracious but not too responsive, accept the compliment but don’t take it to heart. I am in no way saying that any of the wonderful people who spoke to me after my session were anything other than lovely and genuine, but more reflecting on the way that society and societal rules can make it difficult to be fully present in the moment.

The horror of the compliment circle

The worst example of compliment horror I’ve ever experienced was as part of a leadership programme. We met every 3 months for 2 days, at some point during the 2 days we were all made to sit in a circle and offer a compliment to someone else in the circle, I found it tortuous. The giving out of the compliments was easy enough but the receiving them I found deeply uncomfortable. The forced nature of the setting meant there was nothing spontaneous in either the giving or the receiving. I was filled with so much horror that these moments were coming that I would do homework of prepping my list for all 29 others before I went. It was like being picked for team sports if you were selected last because no one could easily think of a compliment for you. It wasn’t really acceptable either to use a compliment that someone had already used for someone else and so you were forced to be either highly superficial or super inventive. For an exercise that was supposed to bring us together and support us getting to know one another it succeeded, but not for the reasons the instructors anticipated, it brought us together in our hatred of the activity. I’m sure this type of activity lands differently in different societal or cultural environments, but for that group of 30 women it was universally an unpleasant and challenging experience.

NB – In all honesty the compliment circle was not the most horrendous part of this course, at some point I will share the horrors of being forced to communicate my leadership challenges through the medium of interpretative dance or the dream journaling where I basically recounted plotlines from TV or the movies just so I had something to say.

Once it’s out there it’s no longer yours to control

I was speaking to the ever wise and wonderful Nicola Baldwin the other day and mentioned the fact that I was thinking about this and she said ‘what you need to understand is that once you have put it out into the world the response to (whatever it is) is no longer yours to control, you’ve given it a life of it’s own’. Nicola as a playwright obviously has a lot of experience with this and it was really interesting to hear her thoughts. Once you have written the paper, given the talk or shared the blog your duty really might lie in bearing witness to the response rather than controlling it. Fundamentally, at the point you have put it out there it is no longer about you, it is about the response of others.

The other thing that this conversation sparked in me was some thinking about how I would react if the reaction was not positive. Would I find a negative reaction difficult to deal with? Would I think about it differently? Interestingly I think that in fact negative reactions might be easier to manage as I psychologically already move to the place where it is acknowledged that it is about how the person received it not how I intended it to be received. Although I don’t enjoy criticism I suspect that I have much greater resilience in dealing with failure than I have in dealing with responses to success. Making the mental shift to knowing that neither of these situations are really about you makes it easier to have strategies to deal with both.

So how should I respond?

So having done some thinking I’ve come up what I know are some really obvious phrases that most of you already use – I acknowledge that this is not going to be news to many people but just thinking about it has helped me.

Options are to say thank you and leave it at that:

  • “Thank you! You made my day!”
  • “Thank you! It means a lot to me.”
  • “Much obliged!”
  • “That’s very kind of you.”

You can also use it (after the thank you) as an opportunity to follow up and offer more info/develop the relationship further:

  • Use it as an opportunity to acknowledge others contributions
  • Ask questions to gain insight so you can improve things further
  • Get to understand the person better – understand what resonated with them and why

Knowing that for good or ill it’s about being in the moment and having some of the pressure removed to ‘do it right’ by knowing that bearing witness to the reaction of others might be all that is required of me is a tremendous relief. As someone who, you may have noticed, has a tendency to over think, strategies are important to me. So next time someone comes up to me and says something nice, instead of responding in fear and wanting to run to the bathroom and hide, I intend to say ‘thank you that’s made my day’ and follow up with a question that builds the relationship. In the end after all it is not really about me.

All opinions on this blog are my own

Daring to Be Imperfect: Celebrating the joys of imperfection

The last few weeks have been pretty stressful, for a whole bunch of reasons. The last few years even more so. The pandemic has made me highly aware that one of my responses to stress is to jump into the rabbit of hole that is perfectionism. This is dangerous territory for me as the deeper I dive the more I feel like I don’t match up, that I’m just not doing a good enough job and that I’m letting my colleagues and patients down by not being ‘more’. I have to consciously remind myself that being good enough is not about being perfect……..its about being open to improvement and learning. I have to actively remind myself that nobodies perfect. Trite I know but its true.

The truth less told

My husband and I often sing the following lyrics to each other:
“Raggy Dolls, Raggy Dolls
Dolls like you and me
Raggy Dolls, Raggy Dolls
Made imperfectly
So if you’re not at ease with your nobbly knees
and your fingers are all thumbs
Stand on your two left feet,
and join our Raggy Doll chums
Cause Raggy Dolls, Raggy Dolls
Are happy just to be
Raggy Dolls, Raggy Dolls
Dolls like you and me!”

Video for those of you who weren’t kids in the 80s/90s

Singing this is something we do when we get carried away into a shame spiral. When our actions have demonstrated imperfection and we feel bad as a result, when we have jumped into the perfection rabbit hole and forgotten that just being normal is OK. It acts as a reality check in the standards we are setting for ourselves and for others, a tongue in cheek way of grounding each other when the stresses of life get too much.

The fact that we even need to do this has recently left me wondering……….if nobodies perfect, and we all acknowledge this to be true, why do we spend so much time trying to be? Do we think that rule doesn’t apply to us? Are we somehow better than everyone else that we could reach perfection? If the answer to that question is no (and I suspect it is) why do we constantly beat ourselves up for not reaching a target that we have pre defined as unattainable? What is it about perfection that seems to be so alluring that we will all put ourselves through so much emotional anguish to strive for?

My journey to imperfection

In some ways I completely get the striving for perfection, we’ve been told it’s a good thing all our lives. When as a child I got 96% in a history exam I still clearly remember my father asking ‘what happened to the other 4%’. Failure is uncomfortable and (because we are trained to see it this way) often humiliating. Worse than that if we fail in medicine the consequences are not just for ourselves but have significant impacts on others. It’s a reflection that we aren’t enough, haven’t tried hard enough, aren’t smart enough. The truth is however that the world isn’t split into black and white, good and bad, perfect and imperfect. There is a spectrum, a pathway and instead of obsessing about moving from one ‘category’ to the next the process should be about moving forward on the pathway. We are neither failures or successes, we are all in fact just works in progress.

Since becoming a Consultant my ‘perfection’ moments have become more frequent, partly because the shoes I’ve stepped into were considerable: I’m benchmarking against someone who was not only superb but also had 30+ years of experience. I joked with a friend the other week that what I have become best at since taking up the post is being comfortable with failure. She got really angry at this, saying that not achieving inbox zero etc wasn’t my failure but a failure of the system. I don’t feel her rage as I don’t see failure as being such an abhorrent word and so I’m happy to use it. Maybe however, what I should have said, is that I’m becoming more comfortable with imperfection, both mine and that of the system I work in. This doesn’t mean that we accept the status quo and not try to improve, but that we also shouldn’t spiral into self hatred just because of the fact that we don’t always achieve the standard we set in our minds. Perfectionism can be paralysing and mean that if perfect is the only standard we measure ourselves against we fail to grow and achieve. Instead lets aim high but know that the standard I’m actually aiming for is that in 15 years I can benchmark against my consultant who just retired, not on day 1 on the job.

There is power in being me

In many ways I’ve come to accept that it is my imperfections that lead to my strengths, they are the things that make me uniquely me. It’s my imperfections that led me to start writing this blog as an honest way of organising my thoughts and trying to be a better scientist, leader and human being. In all honesty, if I was perfect they would probably be little to write about or discuss.

One example of this is that I’m not someone who remembers and is able to quote facts, I remember events linked to stories. This means that unlike my consultant I replaced I will never be a walking encyclopaedia of microbiology and infectious disease. It does mean however that I have been able to work with Nicola Baldwin and others to set up the Nosocomial Project where we use stories in order to engage in conversations about healthcare science and infection control, in a way my consultant never would have. The impacts of these two skills are not the same but they both have impact and maybe shouldn’t be measured against each other or have value judgements attached.

One of the other things I’m learning is that I am not alone in feeling the pressures of perfection and by sharing my imperfections it not only helps me but helps others. I work every day surrounded by some of the smartest, most accomplished people on the planet, quite literally world leading experts in what they do. Sometimes it can be easy therefore to believe the hype and to judge yourself against their appearance of perfection and competence. The pressure to live up to appearances is enormous. I am not by any stretch of the imagination in their category but I feel that by being honest about who I really am gives other license to take off the mask of perfection that they wear.

Why striving for perfection could actually be a bad thing

Perfection could be described as the death of learning as once it is achieved then there is no room for progression. Instead of striving for perfection we need to be striving for learning. To take it a step at a time and do each one better than the one before, allowing us to benchmark against where we were, not where we are striving toward. I sometimes think that perfectionism also stops us from being fully self aware, from being able to fully explore where our strengths and weaknesses are to support us in making the best choices for our futures. If we place a value judgement and associated stigma on not being perfect then we may not be able to live with the self judgement required to truly evaluate our skill sets, as instead of being able to enter a growth mindset self reflection drives us into a shame spiral.

Are the dangers of perfectionism the same when we expect perfection in others? When we put leaders, friends, or partners up on a pedestal of perfection are we in fact setting them up to fail? If we place people on pedestals and they don’t achieve are we just doing it in a way that allows us to accept our own failures better? If we accept that imperfection in ourselves is a key way to enable us to truly improve should we be offering this same perspective to other key relationships in our lives? That doesn’t mean we can’t have high expectations of those we have relationships with, but those expectations should be constructive rather than destructive. Otherwise expecting perfection in others may mean we cannot demonstrate the empathy required to build relationships and therefore limit the stability and longevity of those connections.

Acknowledging imperfection is not a way to get out of doing the work we all need to do to be better, but instead a way of freeing us up to actually be fully participant in doing it. If I have freed myself of the delusion that I have to be prefect I’m less scared to take a true look at myself and work out where to begin. It’s about wasting less time in agonising over why we aren’t better and on self recrimination to spend that time on making progress and learning how to improve. So join me in the Raggy Doll army, embrace your imperfections for the learning they offer and for everything they do to make up the wonderful person who is uniquely you.

All opinions on this blog are my own

Wearing My Quitter Badge With Pride: Why FOMO can damage your health

I have written lots of posts on this blog about being brave and saying yes to opportunities. For once I’m going to write about something that for me requires even more courage, and that is saying no. It’s not that I don’t stand by those previous posts, saying yes is incredibly important. The thing is we all need to know why we are saying yes (or no) and to make sure that we are choosing our responses for the right reasons. Neither response should be driven by fear. There are times that for our own health and wellbeing we need to know when to choose our responses in a way that isn’t about career progression or opportunities, and we need to acknowledge that that saying no is also OK.

I’m a FOMO (fear of missing out) addict.  I always want to be engaged, I want to both support and be seen to do so.  I’ve worked so hard to get into the room that I live in some level of fear about not being in it. I worry that if I leave the room I fought to get in, not only will I be forgotten, but I will be barred from re-entry.

Over the last year a number of things have happened which have forced me to put this fear into context. FOMO is a fear of missing out on the possible, but by not being present for my life I’ve been missing out on the reality of my life that is happening every day. Recent events have prompted me to send emails resigning from a couple of things. I thought it would feel awful (it might still at some point in the future) but it didn’t, it felt great. Not because I am not heart broken to step away from those roles but because of the removal of the weight of those responsibilities that I had not realised I was carrying with me.

I feel like not only am I happy that I took the plunge but in fact I want to Marie Kondo my diary i.e. look at each item/commitment and say ‘does this bring me joy?’. If the answer is no then I need to follow up with asking myself honestly ‘why am I doing it?’. Obviously there are many things in our day to day working lives that just need to happen, but I think you would also be amazed at how many of those things that we feel obligated to do are actually just a routine or something that we are doing because we tell ourselves we should. It is these things we need to interrogate ourselves over and ask what it is that they are giving us: joy, experience, contacts? Are they still giving those things to us or are we attached to the memory/habit. Are we just scared to face up to what it would mean to move on?

Reasons to regularly review

What this current experience has shown me is that I don’t review my working life. The last couple of weeks have taught me that I should. I’ve spent some time thinking about it and the thought that has struck me (and you probably all knew this already – I’m often behind) is that you have to let go of the things that no longer serve you to make room for things that will let you continue to grow. I’ve not been letting go of things. Partly because I’ve finally reached the goal I was desperate to achieve in my working life and to be frank I’m so happy about that I’m still scared someone will take it away from me. I’m so used to having to tick so many boxes, often driven by the check list of others, that I’ve stopped reflecting on what was on the list for me.

If you, like me, have fallen into the habit of just taking on more, of just carrying on without reviewing your why, this is my plea for you to take a moment to see whether this is something you need to change. We should take a moment to put a review date in our diaries – I’m aiming for once every 6 months – to go through my lists of committees and responsibilities to see whether they are still a good fit for me and for those I’m working with. After all, it’s not just about my needs but also about making sure that I still offer what was required.

Carve out time to maximise impact

For me its not just a review of task, it’s also a review of mindset that is required. It’s very easy to become a human ‘doing’ and not a human ‘being’. Due to the pandemic I feel I’ve got into the habit of being in responsive mode. Constantly responding to changing information, changing guidance and the hundreds of daily emails. Don’t get me wrong, this is where I think many of us needed to be for the last couple of years, but we need to break ourselves of this habit. It’s nigh on impossible to be strategic in responsive mode. It is also not good for our own well being – at least it’s not for mine. I know get stressed and twitchy if I don’t access emails on the weekend. I worry about being judged for not immediately responding to every demand. The problem is that after the last 2 years I am broken and I can’t maintain it. Not just that but whilst I’ve been taking the time to reflect I’m pretty sure that it’s not where I do my best work. Responsive mode is fine when in crisis. Crisis is time consuming however and leads to focus on specific issues. To work on how to improve services and identify where we can do better requires us to take the time to step back, calmly reflect and then make plans. Switching from responsive to strategic mode is therefore important not just for me as an individual but is also key to doing a better job for patients.

Interrogate your reasons for saying yes

Not only am I a FOMO addict but I’m also a people pleaser. I feel the need to get feedback from others in order to feel like I succeed (I have another post coming on this). This can be an effective driver but when it takes over it can become a really destructive trait. You do not need to say yes to everything in order to ‘show up’. You don’t need to work 12 hour days ever day in order to be successful, in order to be enough. In fact by working those hours and becoming so focussed on the minutiae you may actually be performing less well than if you did your 9 – 5 and had adequate time off to reflect and recuperate.

These are my reasons for over committing but your may be very different. All of the different drivers we have are both good and bad, it all depends on how they are balanced. In times of stress it can become difficult to find that balance – and we have all been mighty stressed over the last 2 years. Now is a good time to look at ourselves and our decisions to make deliberate and mindful choices moving forward. Our judgement of worth needs to be internal not external if we’re to get out of this loop.

Know your worth

Self worth is a tricky thing. As I said above I’m a people pleaser, my self worth is often therefore derived from pleasing others. It is also linked to success, and like many in my field I define that success linked to outputs – presentations, guidelines, grant funding, papers published. Like many others I have lived, breathed, and focussed on pandemic management for the last 2 years. Therefore my sense of self has become distorted and my self worth has become even more focussed on work.

The thing is there is way more to me than my job. I have passions and interests both linked to work (like writing and The Nosocomial Project) and with my family. It is my family that have paid the price for the shift in how I behave and determine my value, and it is my family that now need to be my focus in order re-establish the balance I need to move forward. As teams, as managers and supervisors we need to support each other in shifting mindsets post this unusual period, and remind them that it’s OK to leave on time, to have weekends and eat lunch. It is OK to be the fullest version of yourself.

Give yourself permission to say no

So moving forward I am going to give myself permission to not just review options and step away from projects, but also to say no to new ones. If I lose traction, if I lose opportunities because I say no on occasion and if I’m not ‘always on’ then that is a price that I have determined I’m willing to pay. Those people who know me and have supported me will not disappear overnight just because I take more time to focus my energies on being the best person I can be.

Opening doors for others

I’m also not going to feel guilty about stepping back. This feeling of guilt has been difficult to manage but it’s not well founded. By stepping back from positions I’ve done for a while I’m opening up progression windows for others to make connections and gain experience in exactly the same that I did. By learning to say ‘no but have you thought about’ I am making opportunities for others and hopefully lifting others up by putting their names forward. Realising this has been crucial to me not feeling guilty about saying no. My saying no means that others can say yes and that is nothing to feel guilty about.

Situations change and the thing that was right for you 2 years ago may not be right thing for you now and that’s ok. Fear and guilt shouldn’t prevent us from letting go of things in order to grow and learn. So as much as I’m an advocate of yes I am also learning to become more comfortable with no. Find your joy, say yes to putting yourself first and know that by doing so you will become even better tomorrow than you are today!

All opinions on this blog are my own

If Not You Then Who? Why seizing the opportunities that come your way is so important

We’ve all had the emails arrive with requests. We are looking for a new member of X committee, a training rep for X group or would you like to give a lecture to Y. For many year when these dropped into my inbox I ignored them. They were being sent to everyone and so ‘they’ weren’t actually looking for someone like me. I wasn’t experienced enough knowledgeable enough, connected enough to ever find success in replying to something like this. Then one year I took a chance and replied. I volunteered to become the HSST lead for the Microbiology Professionals Committee of the Association of Biochemistry and Laboratory Medicine (a LOT of letters I know). They couldn’t reply fast enough with how happy they were I’d replied.

Don’t get me wrong, the ACB weren’t particularly excited that I’d replied……..more they were excited that anyone had. What I’ve learnt since from sending out these emails myself, is that hardly anyone does. The world is full of people who doubt that they would succeed and so don’t put themselves out there and give it a shot. So today I want to talk about all the reasons why, when that email arrives, you should click reply, open the next door in your career and step through it boldly.

You never know where these things will lead

When I sent that email I had no idea where it would lead. Now I know it was the first in a series of steps that took me from where I started to being considered a leader within my profession. At each step I never could have predicted what the one a couple of steps down further down the road would involve. What I do know is that each one I took, I took with purpose. Sometimes I wanted to give back, sometimes I wanted to increase my skills and sometimes I wanted to gain experience. The choices are your own but also not taking those steps and being purposeful is also a choice.

What I hadn’t realised back then is that people frequently ask people they know to get things done, not necessarily because they are the best person but because they are the person they can identify. This means that visibility and being part of networks is key to getting some of the opportunities that would benefit you and your profession.

In my case, that application to be a HSST rep emboldened me to apply for a bursary to attend my first overseas conference in Denver (see pic). After attending my first SHEA conference I was encouraged to apply to their international ambassador scheme, and became the first UK Ambassador. That then led to them paying for me to attend a conference at Disney in Florida, which was not only amazing, but meant I made the connections to sort out a 2 month sabbatical at Boston Childrens Hospital. This helped my NIHR Clinical Lectureship application. That progression helped give me the confidence and experience to apply to become Trust Lead Healthcare Scientist and to become a Clinical Academic.

Gain experience you won’t get in the day job

There are many reasons why it can be difficult to get the kind of experience that volunteering for professional bodies/guideline groups/any external responsibility can provide:

  • Sometimes its hard to be seen in a different way if we’ve been in post for a while, and therefore it can be hard to get identified for opportunities internally
  • Internal committees may find it difficult to accommodate extra people under existing terms of reference
  • Concepts linked to hierarchy may matter more for exisiting structures versus new groups/committees
  • External groups are often specifically looking to engage new people, garner new views and so it can be easier to align personal desires to be exposed to new experiences with the needs of these groups
  • Experienced provided by external groups may just not be provided internally i.e. experience of being a charity trustee

The activities linked to these groups may provide a lower stakes way to get experience. This can include chairing your first meetings, making decisions linked to the success of small pots of grant funding, inputting into a strategic plan. When doing this as part of our day jobs this can feel high stakes and be daunting. If you can gain experience of similar processes in a lower stakes environment you can participate in the learning without some of the stress and anxiety which might otherwise be present.

Often the experience isn’t limited to the activity itself but the experience of working with new people from different backgrounds. This experience helps make us more rounded professionals as well as supporting us in expanding our networks.

Progression is a series of steps

As I described in ‘not knowing where things will lead’ it is often hard to see where taking a series of these smaller steps will take you to. Frequently engaging in these activities is not about ticking off part of a big life plan but about making small progressions that support the whole. If you are a trainee it can be a really nice way of ticking off competencies, if you are already registered it can bring some variety to your CPD for the year. Meeting new people and making new friends is a benefit in itself.

One of the wonderful things about seeing these encounters as small steps is that you don’t have to feel overwhelmed by the big picture, in fact you don’t have to know what that big picture will look like. I talk a lot about having goals in mind, and I stand by that, but there is also joy in taking small steps into the unknown where you just enjoy and value the step in itself. Where you focus on the learning and the experience of that encounter for what it’s offering you in the moment. Taking multiples of these small steps combine to lead to big changes but the little steps have value in themselves and should be appreciated as such.

Don’t be afraid to be seen

I think on some level we all fear being visible, of sticking our heads above the parapet. It feeds into imposter syndrome and our fear that we aren’t ‘enough’. Fear of failure, of not getting chosen, is embedded in most of us from standing in lines to be picked at school if nothing else. I know and understand these fears. Fear is OK, it’s natural, in some cases in the right amount it can even be helpful. The problem comes when it overwhelms, or when we pay it too much heed and therefore we let it stop us from becoming all that we can. I feel this is especially true if it stops us learning, either from the experience itself or from even engaging in the opportunity to start with.

I often sit in my fear for a bit when I’m trying to move forward. This may sound like a strange phrase or a strange thing to do, but sometimes I need to experience the fear to understand it. I don’t dismiss it as I’ve never been able to make that work, instead I allow myself to feel and to ask myself ‘if this fear is real what is the worst that will happen’. What are the worst case scenarios. Then I ask myself, ‘what does this worst case scenario actually mean for me?’. Is the worst case that someone doesn’t pick me? In which case I’ll be a bit bummed out for a few days but there will be more opportunities. Is the worst case that I will make myself look like a bit of an idiot? To be honest I’ve been there before and whether its for this specific reason or not I am likely to be there again. One thing I’ve learnt it that you and your behaviour/embarrassment has way more longevity in your mind than in others. To be frank you are simply not important enough to most other people for them to remember a stupid comment in 6 months time, and those that you are important enough to probably won’t care. Most of the time when I do this I realise that even in the worst case scenarios the event would have little meaning in my life a few months down the line. Therefore the potential cost is still worth it. I don’t talk myself out of fear, I embrace it and that way it doesn’t control me.

Help your community

Finally, and I think this is so important. Our communities survive because of the fact that we engage as part of them. Guidelines don’t get written if people don’t volunteer to write them, events don’t get organised, outreach doesn’t get undertaken and manuscripts don’t get published. It really is a case of trying to make the sum greater than the parts.

As well as learning experiences in themselves, these opportunities are vital for both our profession and our patients. So much of what we do isn’t ‘paid’ as such, so much of our impact is based on the community choosing to engage and work together towards making things different, and hopefully better than they are today. We reap the benefits from the work of this community whether we volunteer or not, but we benefit so much more if we are part of the process. As each one of us steps forward to support our communities the output benefits, as the contribution comes from a more varied group of people and stands a better chance of therefore representing the society/community it is linked to. So instead of seeing your application as a way to benefit you and feeling stressed or worried about how it is received, see it for what it is, something that will benefit those receiving it and something they will be grateful to open.

Since sending that first email asking to be considered I’ve travelled the world, met amazing people and opened up a world of opportunities I just couldn’t have imagined, just because I hit reply and YES. So give yourself the gift of believing in yourself the way that you believe in others, you deserve it!

All opinions on this blog are my own

Conference Season Is Upon Us: Top tips for anyone who struggles with networking

Firstly apologies, this post was supposed to go up before ECCMID as I was hoping it would help others attending. Work was just too full on and I didn’t have the headspace to get it written. As there are still a lot of events yet to come I’m hoping it will still prove useful however.

We all know how very important networking is, especially at conferences. So much of a career that makes a difference in science is based on who you know and who you collaborate with. The problem is making those connections and getting to know people, especially in the early part of your career, often requires taking the plunge and being the one to open a conversion with someone you’ve never met.

I have an amazing friend called Diane who is a wonder to behold in these setting. She happily goes up to talk to people who she’s never met and just starts talking to them with great enthusiasm. Shes fearless and draws the best out of those she engages with. If you are a Diane you probably need read no further. For me however, there is little worse than that moment when you enter a room at a meeting/event, get your cup of tea and survey the 100s of people before you. In this moment you know that really now is the time, you HAVE to find someone to talk to. How do you choose who? What on earth do you say that means you don’t come across as an idiot? The very thought of it gives me palpitations. So here are some things I’ve learnt that take some of the stress out of networking at conferences.

Find an in

There are some moments and set ups at conferences when it is easier to start a conversation than others. There is always the chance that the person next to you in an interesting session will strike up a conversation to help them process what they’ve heard but in general they will be doing the same as you, ducking into and out of sessions that trigger their fancy, meaning they will be you focused on what comes next not starting a chat.

I find however there are two key moments when people are available for the cold start up conversation.

The first is at food breaks/receptions. During these moments there will be people who are there solo and also looking to develop their networks. I find the best thing to do in these situations is to get there early. There are always a limited number of tables where people can put down drinks, if you can find one and hold a place then people will effectively come to you. If this fails and there are no tables, just being close to the source of the refreshments often does the same job. Food and drink are great removers of hierarchy and being somewhere visible means that those in a similar position to you will be able to see you and hopefully will head your way. Worst case you make some small talk to the group that comes to your table and you can politely extricate yourself if it all feels too weird by saying you’re popping to get another drink.

The other place where people will be desperate to speak to you is during poster sessions. So many people will be waiting at their posters for an hour in the desperate hope that someone will come and show an interest. This is often a great time to make connections/exchange contact details (see NB below) If you scope out the listing you will know you are speaking to people who are interested in the same kind of work as you. This can shortcut some of the small talk you might otherwise need to make. It also enables you to know whether you are making a connection with a peer or whether you are connecting with a potential mentor/future employer.

The other thing to think about prior to these conversations is what you can offer, what is your unique selling point?

  • Knowledge (technique, setting or organism)
  • Access (organism, patients, research equipment)
  • Support (mentorship, peer-peer)
  • Collaboration (shared goals, shared research, shared implementation)

NB one of my biggest tips for all of these situations is to make sure you have some business cards printed – even if you print them yourself – this means that you can have something easy to hand out or pin to posters if you want authors to get in touch

Find your tribe

Anyone who reads this blog regularly will know that I’m a bit of a twitterholic (@girlymicro if we haven’t met). One of the many reasons that I’ve stuck with twitter since I initially signed up is that it has transformed my networking experiences. Twitter has offered me a way to circumvent the cold start up conversation by allowing me to find my tribe.

These days every conference/meeting has a hashtag. By following this hashtag you can find people who are interested in the same things as you, people who are in the same sessions or who even have shared connections. In many ways its an improved version of doing the poster walk.  Not only does this give you a conversational in but also by tweeting yourself linked to the thread before you ever meet in person it allows you to have a low stakes initial introduction.

One of the things I also love about twitter is it enables me to find and arrange to meet up with people who I primarily know online in order to strengthen my networks by getting to know each other better. It also gives me the chance to arrange collaboration events, like podcast recordings, when we just happen to be in the same place for a limited time.  Both of these can obviously be done by email but can be much easier to arrange when at an event when you suddenly have half an hour free. Especially at big conferences you could wander the halls for 4 days and not meet anyone you know, this way you can make the most of every second.

Take a study buddy

I absorb my learning best when I have someone to talk through my thoughts with. I have a couple of trusted study buddies that I will by preference attend events with. These guys help me get the most out of any event by:

  • Encouraging me to be braver – ask those questions I might talk myself out of, talk to that person that I should really try to connect with
  • Providing me with a sounding board for ideas when I’m in the moment
  • Enabling us to divide and conquer – there are often multiple sessions I want to be in at the same time, this way we can split up and meet at whichever session is actually proving most appropriate
  • Knowing me well enough to give me space when I need down time to re-energise
  • Crucially for me they are also there so I can feel safe from a health perspective if I have issues. They’ve helped me manage severe reactions, broken limbs etc and I trust them to get me where I need to be and give healthcare workers the right info if I need care

Mel and Lena have been my colleagues for years and they can not only get me out of a shame spiral if I do something stupid but also, by having them available to have conversations all together with new collaborators, we can make much more rapid progress on projects from the very start.

One of the other great things about going with a great study buddy is that you can also achieve other goals whilst at the conference. You can start to get papers drafted, do that research return or catch up about PhD students. If you do have supervision responsibilities whilst you’re away, as you have trainees with you, you can also share the load in terms of ensuring you have downtime. A lot of my most creative breakthroughs have happened with these guys whilst we’ve been away, surrounded both by new science and the time to reflect on how we could encorporate new thinking into our work.

Do some pre-work

I can get really insecure when going to high stakes meetings, like some of the ones I’ve been to at the House of Commons. I never really feel like I fit in and I have been known to hide in the bathrooms there until 5 minutes prior to an event start so I don’t have to face the ‘meet a stranger’ chit chat. In recent years I’ve learnt the value of doing some pre-work ahead of these meetings. This has taken different forms:

  • Reaching out on social media to see if any of my connections are attending
  • Approaching a professional body, especially if I’m on their guestlist, to find out who else they are sending so I can pre-arrange meeting at the session
  • Researching the event to look at speakers and attendance list (if available) so I can pre plan who I might want to speak to and what I could start a conversation with

In these events part of the value is in expanding your network and so really thinking about why you are going and what you hope to achieve is really worth it. Then you can match your elevator pitch (who you are, what you do and what you can offer) to your goals to help you achieve them.

Become the person others come to speak to

One of the things that has become lovely in recent years is that I’ve realised if you are presenting/organising/chairing people come to speak to you. This removes a whole lot of the stress of networking. As I mentioned above, people will often come to you even when you are presenting posters. Its always worth submitting work therefore to events you are attending, not only to get feedback on get science, but also to support you in developing your networks.

Even if you are not in a position to submit work then you should think about offering to support the organisation of events. Meetings are frequently looking for individuals who are happy to support the event organisation, both ahead of time and to do things like man the desks during the event itself. This will mean that you get to know other people who are supporting event delivery with you and give you an opportunity to network with delegates and speakers in a supported way. These connections can be transformative in terms of giving you further opportunities down the line.

Know your self and your limits

Most people assume I’m an extrovert when they meet me and I definitely have a lot of those traits. The things is, I can only manage networking for a fixed period of time. I’m good for a couple of meetings but then I need to retreat back into my bathroom office and answer some emails, otherwise I just feel progressively drained. The older I get the more I need my own space. This is usually fine but presents a real problem at places like conferences where I may need to be in full on extrovert mode for 16 hours a day. I find it exhausting.

One of the things that I’ve discovered about networking is that I therefore have to schedule it in a way that works for me. I can’t agree to go to lots of dinners on top of full day events, either from a health or a social resource point of view. I therefore pick the moments that work best for me and don’t over commit. This does mean I sometimes worry about missing out and not making the most of every opportunity but it also means that I put myself and my wellbeing first. It means that I don’t leave a conference unable to engage with work when I get back as I’ve already used up all my resources. Therefore my top piece of advice is to understand that networking is key but find a way to do it that works for you. Pick your key moments and do them well, rather than trying to be all things to all people.

All opinions on this blog are my own

FRCPath Notes: Some notes on organism identification and antimicrobials in case useful for others

In 2015 I put a note on twitter offering to share my FRCPath notes if anyone was interested. No one replied and so I assumed that (understandably) that everyone was focussed on making their own. Just recently however someone responded to ask if I still could. Long and short I’m delighted to share, mostly because they took me forever to put together and so them having a life after FRCPath gives them even more value as far as I’m concerned. These notes were put together for my FRCPath lab folder but the individual components may be useful to anyone interested in organism identification.

Note of caution, these notes are from 2015 and they were made for my personal use. They therefore may need updating and sense checking if being used by other people. The images are taken from publicly available sources and so despite the note saying they belong to me they only do in the sense that they were combined by me into their current form.

I have included a couple of blank templates I used as structure for revision notes and short questions. These are in word. The rest of the documents are in PDF. I know that some people may prefer word versions so they can update and edit. If you’d like these in a different format please DM on twitter @girlymicro.

Again, I make no claims that these are amazing, only that they were useful to me

Antimicrobial therapy

A table listing types of antibiotic, target and interactions

A table of treatment options and durations for infections caused by atypical mycobacteria

A table of typical antimicrobial therapy durations by broad condition type

Table of typical antimicrobial therapies listed by micro-organism

Notes on antiparasitic therapy listed by parasite

Gram negative bacterial identification

Identification notes by organism

Plate appearance, identification and Gram stain info by organism

Plate appearance, identification and Gram stain info by organism

Plate appearance, identification and Gram stain info by organism

Gram positive bacterial identification

Identification notes by organism

Identification notes by organism

Plate appearance, identification and Gram stain info by organism

Plate appearance, identification and Gram stain info by organism

Fungal identification

Plate appearance, identification and Gram stain info by organism

Parasite identification

Vector, identification and common presentation info by organism

Viral identification

Vector, identification and common presentation info by organism

Note templates

Example of note templates and completed organism notes in case helpful in terms of headers for other

All opinions on this blog are my own

Girlymicro’s 100th Post: What I’ve learnt in my 1st year as a consultant

It has kind of snuck up on me, but this is the 100th blog post on Girlymicrobiologist.com. I’ve had such tremendous fun and learnt so much about myself writing them. Talking to people about them has also been an unanticipated joy. I don’t therefore think I’d realised how many posts had happened over the last 18 months or so. To mark the occasion I thought about writing some top tips and discussing the things I’d enjoyed most, but I cover a lot of that in my 1 year anniversary blog. Serendipitously this post coincides with me having been in a Consultant post for a year this week, so I thought instead I would share what it’s been like………….

Everything I thought and more

I’d worked with a fairly single minded focus to get here. At some points it really felt like it was never going to happen. The wonderful thing is that it has been everything I hoped for and more, something that isn’t always true for dreams and aspirations.

The interesting thing for me is that the core of my job isn’t really that different from my job before, I kept waiting for it to change but it hasn’t really. The biggest change I think is the weight of responsibility I feel for my team and that, for some of the big decisions, I end up advocating on my own. I am aware some days that I’m on a trapeze without a safety net. That said, as the Consultant Nurse for IPC/DIPC and I talk every day we always have each others back. I can’t imagine having spent the last year in a pandemic doing this solo, and so this relationship has been a god send.

I must however talk about the thing that has been strangest to me. I left work on a Friday and came back on a Monday as a Consultant. From one day to the next a lot of people changed the way they interacted with me. People who had known me in both roles. On the Friday they would challenge me routinely and call me Elaine. When I came back on the Monday, the same people called me Doctor and just agreed to things. When I sent emails that I anticipated would come back with nit picking or challenge from some medical colleagues they just responded with OK thanks. Don’t get me wrong there have been plenty of difficult conversations but far fewer than I had anticipated. Anyone who believes hierarchy doesn’t exist in the NHS should experience this transformation by just sticking Consultant into their job title. I still can’t quite get my head around it.

The other thing that I’d been really fearful of when I switched was using the Infection Control Doctor title and having people telling me I couldn’t as I wasn’t a traditional medical doctor. I agonised about having it in my signature and putting people’s backs up. You know what…..not a single person has mentioned it, let alone said anything bad. I can’t tell you how grateful I am for this. It was that title more than any of the others that held real meaning for me and I was so scared of being rejected in that post. The fact that people haven’t rejected it but in fact embraced it means so much. As someone coming from a different place via a different route it is hard to quantify how much that has meant to me and given me hope for how we embrace change/difference in the future.

The whole truth and nothing but the truth

Now I’d be lying if I said the joy and acceptance described above hasn’t come with a whole of heap of challenges. I’m going to talk about the challenges of becoming an IPC Consultant in the times of COVID-19 below, and some of the bits I’m going to cover here I don’t know whether they are the same or worse because I started in a pandemic. It is worth stating that most of these existed before the big P, but that like many things in a period of change they may have been exacerbated.

I talked about about how much the IPC Doctor role has meant to me, its been the goal for 16+ years afterall. I think because I assign so much mental value to it that I doubt myself and fear that everyone is going to realise the horrible mistake they made on a pretty much daily basis. The shoes I’ve had to fill are massive ones left by such an impressive and knowledgeable individual, you can’t help but worry you will disappoint. Taking over at this point is therefore challenging when there have been big decisions and big changes every week it feels. I’ve talked before about how failure is key to learning but every action right now feels like it is too important to fail. That fuels my inner perfectionist and means I have a tenancy to spiral. Deep breaths and ‘faking it until I become it’ have definitely been my survival tools for my first year in post. I’ll let you know when the ‘become it’ happens.

The acceptance has been great, I’ve been incredibly lucky but on some level I still know I’m never going to be part of the club. My micro consultant colleagues go for coffee and lunch together but I can’t join them. I’m the person setting the guidance that says you shouldn’t mix, even after work. They will always spend more time with each other in hand overs etc which means they have enhanced relationships with each other. This isn’t a bad thing. I have relationships that they don’t have and my job role is different. I guess it’s human nature to want to be accepted and part of the group however. The strength of my position is that it is different and in many ways my strength is that I’ve always followed my own path. There have been times over the last year that I’ve needed to remind myself of that. They have been nothing but supportive and inclusive when I’ve reached out and so it has been a lesson to me that if I need help I just need to ask for it.

This leads me onto the next thing. I’m a stand alone Consultant Clinical Scientist within my department. I have nursing and medical consultants that I work with but no one like me. This has meant that sometimes it requires specific focus for both myself and others to remember the scientist part of that title. Being a scientist is a huge part of who I am and my concept of self. It’s understandable that others may not always remember that. Doing the bits that mean I am still a scientist is hugely important to me, things like undertaking research and advocating for my professional group. Some of this is tied in to re-discovering my identify full stop having focussed for so long on reaching this point. I’ve crossed the finish line and so what does the next goal look like, how does that fit in with my scientific identity. How do I ‘fit’ whilst still maintaining that of which I am proud and makes me different. This one is definitely a work in progress and as I learn more I’ll share whatever conclusions I come to.

Here’s the one that will surprise none of you = the to do list never ends. I feel like I’m constantly running to stand still, working weekends just to keep sight of what’s going on. Some of this I think is linked to me wanting to do my best and being anxious about it, some of it is because I don’t want to let go of some things I used to be involved with, but to be honest I think a LOT of it is trying to do all the pre-pandemic work on top of a pandemic work load. The ever changing guidance and the constant messaging required to keep people safe. If life is like this three years from now I will definitely need to drop things that I would love to still be engaged with, for right now I’m mostly taking each week at a time and hoping at some point to see what a consultant post in non-pandemic times might look like.

IPC doctor in the time of COVID-19

Until that day arrives when SARS CoV2 doesn’t control my every moment I continue to spin that one enormous plate on top of everything else. One of the biggest things I’ve learnt over the last year is that leadership, in all its forms, could not be more important. There have been some pretty tough lessons about seniority that I’ve had to learn as well.

I’m used to being able to make decisions, decisions based on evidence. If the data is sufficient I’m not used to people challenging or not engaging with those decisions. I’m going to post about this more in a future blog I think, but one of the lessons I’ve had to learn is that my ability to influence has limits. That the risk assessment others are making is not necessarily the same as the one that I am, and the weighting of the different factors within it are not necessarily the same as mine. Sometimes my role is to advise but if that advice is not taken up because that risk assessment is different it is not a failure of me in the role that I hold. It is the reality of advising on a single part of a much greater puzzle. Try as I may therefore I have had to acknowledge that this isn’t a battle for an outcome, but a collaboration where the outcome may or may not be the one that I would have chosen. As long as I advocate to the best of my ability, live up to my values and embody the leadership I want to see, that is all I can do. If I see it as a battle we all lose, if I see it as co-production we all win. Changing my point of view on this has been key to my surviving at certain points, especially linked to Omicron.

Talking about leadership, I don’t think embodying that leadership has ever been more important. Everyone is tired and everyone has gone through a period of extraordinary stress. I’m still asking staff to behave in ways that add to that stress i.e. by not having lunch or even drinks with their teams together outside of work. This means that a key way that we normally support each other is no longer available. We haven’t been able to celebrate or commiserate with each other for over 2 years. I’m a really strong believer in not asking others to do what I’m not prepared to do myself. Over the last year that has included me leading the way with opting in openly and discussing the pros and cons of routine asymptomatic lateral flow testing. Being open with people about my reactions to the vaccines and booster but how I went ahead and had them for the protection of myself, my colleagues and my patients anyway. It has also included me missing out on that same support I have deprived others of by reducing their contact with colleagues. To me its about fairness and showing with actions rather than words that we are all in this together.

The importance of paying it forward

There are some people in my world who went all in to get me this post, people who I will never be able to thank enough. Mentors who have been with me every step of the way and who put their names and reputations out there vocally to support me, fought battles for me that I know no detail about. Those people have changed my life. So now it’s my turn. My turn to fight for others. My turn to act as a shield and as a mega phone. I have thanked those that helped me but I don’t think they will ever really understand the difference they made, so now I honour that by vowing to make that same difference to those who follow behind.

So here I am (successfully?) having broken my way through that glass ceiling. If anything this last year has shown me that this isn’t the end of the journey but the start. If I want others to not have to have the same fights as I did, then I have to work to make sure I keep that hole open and drop a ladder through it to help those who want to follow. Those coming after me will have different challenges but it’s important to share what I’ve learnt to help them where I can along the way. It’s one of the many reasons this blog is so important to me. So as a fitting message in this 100th post I wanted to say that for as long as you guys keep reading, I will keep sharing. Sharing so we can rise up, sharing so we can make change and sharing to make sure that we are seen and to help us all work every day to leave the world a slightly better place than we found it.

All opinions on this blog are my own

Prioritising the Needs of the Many: Great communicators let the message do the talking

Let me start by saying that I am by no way a ‘great communicator’. I’m OK, I’ve never been the one who wins best presentation prizes or anything like that. I have however had the privilege of seeing some truly amazing communicators speak. I’ve also sat through more hours than I’d care to mention of bad conversations,  bad presentations and bad interviews. What these combined experiences have shown me is that truly great communicators focus on the message and not how they want you to perceive them. They let the listener feel like they own the communication and thereby feel like the message is personal to them. They make the audience feel valued and like they matter by creating a shared experience.

We can’t all be great at this, it’s not where everyones skill set aligns. The greats also seem to me to have a bit of magic that probably can’t be taught. For the rest of us mere mortals however there are things we can do, in terms of thinking and preparation, that may make us a little bit better. So what can we do differently?

It’s not about appearing to be the smartest person in the room

We’ve all been there. We’ve probably all reviewed papers or seen talks where the communicator focused on appearing smart rather than the message. They used complex sentences and words to demonstrate just how much of a scientist they are. In some ways it feels like they have done just about everything they can to make it harder to engage with their message, by making it clear that most of the audience isn’t smart enough to understand what it is they are trying to convey.

In fact the real skill with highly complex topics is being able to present them in a way where they don’t feel complex at all. Being able to break down a complex topic into pieces that when combined make the whole process understandable can only be achieved if you yourself really understand your subject. It’s why Feyman utilised trying to teach something as a way to better understand his learning gaps.

Working out what your message is

Before you start the process of breaking down what you want to teach and going into detail you really need to start with the message.  Too many of us when we are trying to plan a lesson or lecture, or even a paper, don’t put in the pre work to think about what it is that we are actually trying to communicate.  What story are we trying to tell.  We don’t often think of communicating science as telling a story but in reality we are, and there is lots to be gained from thinking of it in terms of these structures.  A story has a key theme or message that it is trying to be communicated to the audience.  Stories also build, they are comprised of sections, even if these are simply: a beginning, a middle and an end.  Before starting to communicate we should therefore think the same way about the topic we are trying to get someone to take away.  We can make sure that everything else we talk about comes back to and enforces this key message. 

The next thing is to then flesh out this message by planning learning objectives.  What are the 3 – 5 things you would hope that someone who has attended will be able to know/achieve after they leave.  These effectively are used to give you your beginning, middle and end.  Your learning objectives for sessions delivered to different audiences may be at a high level the same i.e. raise awareness of the work of a microbiologist. In order to maximise their effectiveness however you will need to tailor them for different audiences to ensure that they can be achieved i.e. talking about AMR will be different for lay pubic audiences versus researchers. This is where the specific and relevant components really come into play.  Everything you put into your session should be based around these learning outcomes in order to support the audience have a clear sense of direction with your overall message.

Remember who your audience are

If your message is going to land then designing your way of communicating it and the learning objectives with them in mind is key.  If you have an audience of 4 year olds then your method of communication is going to be very different to if you are talking to a room full of post graduate PhD students.  If you have a drop in 15 minutes with a large group at a science outreach stand you will need to have a very different method to if you have a small group for an hour as part of a workshop.  You also need to bear in mind whether these audiences are ones you have a relationship with because they’ve met you before, or are they a one off encounter.

When you are writing items like lay summaries for research grants and papers this is especially important.  Most lay summaries should be aimed at an audience with a reading age of 12.  You need to be very conscious of abbreviations and scientific terms that we may all use without even thinking about them.  There are some good websites that can be used to check wording and language, but even more simply you could ask a member of your family (or even ideally a lay focus group) to read through it and see what the message is that they take away vs the one you think they will take away. The same is true for verbal presentations as well. Think about the language you use and whether it invites the audience in or acts as a barrier for engagement.

Try out a metaphor or two

I’m presenting tonight at an AMR event and I have one slide to talk about my work.  The audience is likely to be mixed and I want to talk about the differences between phenotypic, fragment based sequencing and whole genome sequencing, and how different techniques are best in different circumstances. These are challenging concepts to describe in under 5 minutes and so I’ve picked something I think most people will be familiar with for them to hook their knowledge onto…………cake. A good metaphor puts your audience at ease as you are discussing something familiar. You are also able to take shortcuts in explaining some concepts as you are hooking new knowledge onto a pre-existing framework. Hopefully your audience will walk away with your message and if you’re really lucky as someone they will remember.

Take it one step at a time

No one wants to sit in a talk and feel lost or read an article that makes them feel stupid for not understanding it. It makes the person engaging feel bad about themselves. It also makes them disengage which can be distracting for the audience as a whole, depending on how they behave when it happens. I’ve been that person in immunology talks at conferences. I’ve been fully engaged and listening for 15 minutes and then the presenter either takes a step assuming knowledge I don’t have or I blink for a second and miss something and I spend the next 30 minutes with no idea what on earth is going on playing with my phone.

The lesson for me here is twofold. Make sure that every progression step your audience needs is present, you can rarely make assumptions about your audience. If the information is key to understanding the information to come, make sure you give it however briefly. This is where we come back to knowing your message and learning outcomes. By only having the info in your session that is essential to serve those you buy yourself time to spend on the blocks of info needed. The second lesson is to make sure you refer back to previous building blocks of info in your talk. That means that if someone misses something they are given a repeat opportunity to contextualise and understand prior to you moving on. It also means that you are embedding the previous knowledge because the next step builds upon it.

Know when to present yourself vs your CV

Connection between yourself and the audience is always key to getting your message across. There are times when, as much as I wish it wasn’t, that standing in front of an audience as a living version of your CV is required in order to be taken seriously. When establishing your credentials before you start communicating is key to your message being heard. At these moments I’m Dr Elaine Cloutman-Green who leads X and has Y amount of research funding. When you are trying to speak in a lot of other settings however it’s important to remember that credentials can in fact get in the way of the message you are trying to present. Remember it’s about the message and not about you. If I stand in front of audience to talk about science being for everyone and reel off my list of fellowships and leadership roles I have immediately moved myself into a box of ‘other’. Someone not necessarily like them, someone with different professional experience who doesn’t share their experiences and aspirations, someone that it is hard to connect with. When doing sessions like these I’m definitely not my CV, I’m Elaine or Girlymicro.

The best way to get better is to practice

As I’ve said I encounter people all the time who are so much better at all of this than I am and I’m always super attentive when I hear them speak, not just to hear their message but to also learn ways to do it better myself. There are obviously some people out there who are born great at this, but even they needed to learn and improve how they did it. The best way to do that is to practice. Write blogs and get involved in writing papers with others who you think are good at this. Try out thinking about messaging and designing learning objectives, until it becomes easier because you’re used to it. Most importantly practice talking to people, practice one on one conversations with those you supervise, with your colleagues who are in different disciplines and with your friends. See what bits interest them, which bits they respond to. Be brave and book in to do some outreach and volunteer to give that departmental seminar you’ve been dreading. Doing is in essence how we learn, you can only get so far by reading about something. Once you’ve had a go its then important to take the time to reflect in order to learn how to do it better next time.

The other key part of practicing and learning how to communicate better is to make sure that you are building evaluation into your sessions/activities. We often try to guess at what well, what audiences actually heard and what we could improve upon. Guessing is fine to a point but you will never have the backgrounds of everyone you are engaging with. The only way to really know what they are responding to, what worked well and what didn’t is to actually ask them. This is where the measurable part of your learning objectives is important. As scientists we respond well to data, it gives us concrete direction in which to improve. Lets apply that to the way we communicate so that we make the most of every opportunity, every moment, in order to succeed in getting our message across.

All opinions on this blog are my own

An Homage to Douglas Adams: Reaching 42 and therefore becoming the answer to life the universe and everything

I’ve been lucky enough to make it to the big 42 this year. 10 years more than my sister and according to the wise, funny and wonderful Douglas Adams the number which is the answer to life the universe and everything. So as an homage to this great writer and to celebrate I thought I would share the knowledge I have gained whilst turning this wonderful number.

It will never make sense, that’s part of what makes it brilliant

When I was a kid I thought that adults knew it all. When I was a teenager and in my 20s I thought I knew it all, whilst simultaneously knowing I was out of my depth and knew nothing. In my 30s I felt like I needed to know it all and put myself under all the pressure that came with that to succeed and to be seen as knowing. Now I’ve reached my 40s I’ve realised that one of the biggest joys is in the not knowing and enjoying that there is still so much more to learn, explore and achieve.

Its not about how fast you get there, its about remembering to enjoy the ride

I spent my 20s and 30s racing towards an imaginary finish line. I had a list of tick boxes and I ticked fast and I ticked hard. Having reached my imaginary line I now realise that the joy was mostly in the journey and not in the completion. I know a lot of people right now in the ticking phase and the thing I most wish they knew was the boxes WILL get ticked, but that they should get the most from ticking them. Sit back and smell the roses, feel the sun and enjoy the pleasure of each achievement for its own sake, rather than immediately looking towards the next.

In a world where you can be anything, be kind

I don’t remember the smartest people, I don’t remember the people who had the most experience or the most knowledge. The people I remember for having the most impact on me and my career are the ones who were kind. The ones who took the time, the ones who lifted me when I stumbled and the ones who had faith in me when I had none in myself. If you want to maximise the impact of your time on this planet then being kind is the way to do it. Be kind when it’s the last thing you want to be, be kind to the people who are pulling you down. People are fighting battles you know nothing about and one act of kindness can change a day or life.

Not everyone will like you and that’s OK

I find this truth hard as I am, by nature, a people pleaser but its true. No matter how hard you work, no matter how hard you try, not everyone is going to love or even like you. That’s ok you won’t love everyone either, the key thing is to not let that drive you. I’ve been described as ‘marmite’ and it taken me some time to grasp the fact that someone doesn’t have to like me to work with me, we just have to set differences aside and find enough common ground to focus on a shared goal for a time. Not everyone needs to be a tea and cake buddy.

Understand what aids you and let the rest of it go

Sadly I don’t think anyone gets this far in life without having some challenges and quite frankly dealing with some shit. These are the fires that forge us. The thing is knowing that those fights and struggles that have got you here have made you who you are, honour that but don’t let it define you. It’s all too easy to carry our scars with a little too much pride and to give them a little too much weight in our present. I’ve learnt to acknowledge the drive they have given me, the armour they have provided, to try and take the good but leave the bad. To let them help make me but not to let them tell me who I am.

Understand what matters to you

What matters changes over time, it isn’t always a static state of being and requires regular reflection. I’m often described as driven but I mostly think that’s a nice way of people saying I’m following my own path, all I do is put one foot in front of the other. What I do know is that there is a continuous signal amongst the noise of my life and that is that what matters most to me is my family. The people I love are my world, they are my centre and keep me grounded. They are the calm in my storm. What I want most is time with them and to live my life without drama, I did ALL the drama in my teens and early 20s and I don’t enjoy it.

My husband and I have a phrase that we use with each other ‘let me just check my bothered pocket’. When I’m getting into a shame spiral when I’m panicking about the conversation I had yesterday or the imagined upset I might have caused him or visa versa it’s a phrase we use to bring some reality back. The answer is almost always ‘its entirely empty’. Everything is almost always completely OK and there is almost always nothing to worry about. This simple phrase grounds me and enables me to focus on what matters most, the people I love.

The struggles you feel now will fade and change into new and different ones

You have probably gathered that I’m not a very chilled out person, as my husband says ‘my mind is a hell to me’. The biggest lesson I’ve learnt is to step back when I’m in the midst of my storm to try to get the distance to understand whether this is something that actually really matters. The ability I have to focus and be tunnel visioned is great to achieve tasks but is somewhat of a hinderance in this and it’s something that I have to practice. I sit and ask myself if the worst case is true would this matter in the way it feels now next week? next month? next year? in ten years? By asking myself these questions I give myself the structure to work out quite how important it is, or if in fact it is not important at all. This also helps me choose the battles that I want to engage in and the ones that I’m happy to walk away from.

Finding your tribe makes it all worth it

We talk a lot about making sure that you have insight from beyond your echo chamber, and this is true. Right now though I’m going to talk about the joy of finding people who just get you, people who are part of your tribe. None of us are strong all the time, none of us can always be our own advocate. Life is an exhausting merry-go-round and sometimes we all need help. Find the people that see you for who you truly are, good and bad, and who like/love you anyway. Find the people who will see your worth even when you can’t and who will lift you when you fall. Once you have them life will never be quite the same as you will be able to share the load. Once you find them never let them go.

Have the courage to choose the unconventional path

We spend a lot of time getting told what should matter to us, where we should want to be, who we should want to be with. I’ve never been very good with instructions. I’m a strong believer in ‘you do you’ as long as what you are doing isn’t hurting others or taking away their right to choose the same way. I don’t really believe in doing things the way others have done them. I’m the only one that wears this skin, I’m the only me, therefore only I can choose the right path for me. Being different, being you takes courage and self belief, but it’s worth it. Choose the right path for you, otherwise you’ll spend your whole life questioning what might have been and that’s a cage that’s hard to escape from.

Travel the road using the 3 Ps and you won’t go far wrong

The 3 Ps are my rules I set myself to live by: purpose, passion and principles. They apply across my professional and personal life. Do the things that make you wake in the morning with a smile on your face, do them consciously and in a way that doesn’t hurt others. For me, if I live by the 3 Ps I don’t question my life choices because I’m following a path, no matter how challenging, that I’ve set on because I believe in it. When life gets hard therefore, and believe me it does, I know at the core of my being why I made the decision I did and it makes it easier to carry on. These Ps are mine but you have a whole alphabet of choice to decide on what your guiding stars might be!

All opinions on this blog are my own

I’m Not Lucky, I’m a Badass: The importance of owning your success

It’s Heathcare Science Week 2022 and I wanted to start the week by posting about something very close to my heart – owning it. I believe very strongly that we should own our failures and use them as learning experiences to make us better. I also believe that we should own our successes, but this is something that I struggle more with getting comfortable with.

Like many people my first response to any form of compliment linked to my career and the success (I feel) I’ve had is to say how lucky I’ve been. This is true, I’ve been incredibly fortunate, I’ve had amazing opportunities and great success. The thing is,  I’ve been thinking recently is this luck? Is it luck or is it because of hard work, tenacity and opportunities made?

The other thing is this. Claiming success and owning it as anything other than luck is a thought process that makes me feel uncomfortable. Not just that but I’ve worked in teams with some amazing people in order to achieve it and so is it mine to own? Just privately thinking how good my success make me feel also makes me realise how much acknowledging that openly would not be a good look. It could be seen as being arrogant. Being considered arrogant we are taught is never a good thing, especially as a woman.

Then I saw the tweet below and it really made me stop and think. What is the problem with us owning our success and the work it took to get there. Is being happy with your success really arrogance? Or is it, in reality, about having the confidence to own it?

Where Does the Fear of Owning Your Success Come From?

Working in healthcare means that very little we achieve is as individuals, we work in teams and I think most of us are very aware of team dynamics. We succeed and fail within those teams and therefore I think it is often difficult to see ourselves as individuals and having individual success within those team dynamics. Now I’m not in anyway saying we shouldn’t be good team players, I’m all about collaboration but I do think it’s OK to recognise your own role in the success that your team has and to be OK with acknowledging that (with due credit given to others). It takes a lot of voices to make a chorus after all.

My evolutionary psychology days are some time ago, but when I think of how we are taught lessons linked to pride and arrogance I always think back to my days studying primate behaviour. Group behaviour, especially female group behaviour, is about co-operation and fitting into hierarchy. Essentially it’s about helping others and not sticking out. Females that stick out make themselves available for conflict and are considered to be challenging the hierarchy. Now, I haven’t studied in this area for a long time but it feels like a lot of our early behavioural lessons are still based on this structure and if, like me, you are not very comfortable with conflict then your position should be ‘to be seen and not heard’.

I was told repeatedly as a child that ‘Pride comes before a fall’. It was drummed into me from a young age that pride/arrogance was a sin and to be frank it just wasn’t a good look. This definitely plays into, or maybe is, part of the source of my imposter syndrome – where I believe that people actually believe I’m not very good at what I do and the only reason I’m here is that people are being kind to me. If you put those two things together you end up with a belief system where you know that being prideful could lead you to screwing up and embarrassing yourself AND that others may cease to like you and so you may also be called out as not being very good. The pressure we place on ourselves to be liked in order to succeed may therefore itself get in the way of us owning the very success it creates.

Confidence is a tool. Arrogance is a weapon. Confidence invites people in and arrogance pushes people away. People use arrogance as a wall to prevent others from challenging them. 

Amy Cuddy 2018

You all know I’m a bit of an Amy Cuddy fangirl and I like the quote above. We live in fear of being considered prideful or arrogance but that is different from being confident. Confidence builds trust, it enables others to feel they are in a safe pair of hands. To me the big difference between confidence and arrogance is how it deals with failure. People who are confident acknowledge their failures and failings and use them as a learning tool, whereas those who display arrogance are about denying weaknesses and failures and therefore don’t learn from encounters. I for one need to accept these differences between arrogance and confidence, acknowledge that there is a fine line to walk, but know that if I don’t display confidence I am doing myself and others a dis-service. Owning my successes is part of this.

Changing Your Mindset

There is a certain irony in trying to work on this at a time when my I’ve been feeling particularly stressed and anxious and therefore my imposter syndrome has been on over drive. I’m working on the internal validation piece in order to see my own self worth but I’m also really glad of some of the external recognition I receive which aids me in benchmarking in a more neutral way. Some of that is from twitter, awards, committee work etc. All of it is important to me as it stops me getting too much into my own head, I think this is something that people who don’t have a strong critical voice struggle to understand. At the same time as needing this validation to help me manage at the moment I struggle to respond all the nice things people say as I don’t want to come off the wrong way. It’s also hard to know how loud to shout about things like grant success as others who are struggling could be placed in a more challenging head space if this information isn’t shared in the right way.

In order to make the leap into owning my success therefore I’ve needed to work out how to change my mindset #workinprogress. Some of this is linked to being in a safe space where you can try on and practice some of the changes in order to feel comfortable. As I’ve decided that a lot of the barriers to me owning my success are linked to my imposter syndrome it’s been important to practice this within the aspects of my role where I feel more confident first. It’s also been important to look at how others are doing this in public spaces, how do they share in a way that is inspirational not challenging?

The biggest shift for me has been trying to move from a position where the best thing to do is not be seen to ‘rub others faces in it by talking about success’ to ‘you can’t be what you can’t see’. As leaders if others can’t see what we are managing to achieve how are we supporting the aspirations of those following behind us? How are we supporting them to dream bigger than we ever have? I’ve given myself permission to be seen by others.

Women often suffer from being said to display arrogance when displaying confidence when if they were male this would be seen as a more positive character trait. That is something that is not going to go away and I for one am not someone who feels confident enough to challenge it on a daily basis. I am however going to be purposeful in owning things linked to me and my success, not in a way to discourage others but as a way to empower them and help us all to shine. My pledges for 2022 are therefore to:

  • Be open about my successes and not hide them from others
  • Not agonise about posting things linked to success on social media
  • Amplify others successes by sharing them, talking about them and congratulating them
  • Encourage others to challenge themselves by talking about routes that I have undertaken which have been successful (and also where I haven’t) to support those coming after me
  • Stop down playing my own successes by defaulting to luck narrative

Our success does not diminish others, it gives us all permission to shine, so pledge like me to own your success and support others in choosing paths to their own. From now on when someone congratulates me I will not respond with ‘thank you, I’ve been so very lucky’ I will respond with ‘thank you, its been a brilliant journey’ and maybe if I’m feeling strong ‘thank you, turns out I’m a bit of a badass!’

All opinions on this blog are my own

Healthcare Science Week 2022 – Join us on Friday 18th March to talk about blogging, communicating and the importance of drama

Healthcare Science Week performance based on the weekly ‘Girlymicro’ blog by Dr Elaine Cloutman-Green, followed by a discussion on blogging

“So, this is my first ever blog post. Bear with me as I don’t really know what I’m doing. I’m what is known as a Clinical Scientist and I work in Infection Control.”

Thus began the first blog post by Dr Elaine Cloutman-Green, Lead Healthcare Scientist at Great Ormond Street Hospital, in December 2015. It would be five years and one pandemic before her second post, in October 2020, began her weekly blog as ‘Girlymicro’ (‘scientist changing the world one swab at a time’).

Girlymicro blogged at first about the job, to promote Healthcare Science, offering professional exam or interview advice for HCS trainees, before ranging more widely, into women in science, the challenges facing HCS, exploring the limits of what overstretched teams and individuals can achieve, saving lives in labs through insight, accuracy and interpretation.

Each blog written in a snatched hour, Girlymicro became a mental space populated with personal reflection, meditation on loss, favourite microbes, special guests, puppet shows, and… zombies; always with Elaine’s trademark humanity and humour.

‘All Opinions In This Blog Are My Own’ is a showcase of a devised work in progress based on the Girlymicro blog by The Nosocomial Project, adapted by Nicola Baldwin, performed by two actors, Becky Simon and Peter Clements, and two Healthcare Scientists, Anthony De Souza and Dr Elaine Cloutman-Green.

The short performance will be followed by a conversation on writing and blogging. Why blog? What might you learn along the way? Does writing create a safe space for reflection? Or create new pressures? To blog or not to blog…. That is the question.

All welcome

Date and time

Fri, 18 March 2022 15:00 – 17:30 GMT

Location

South Wing University College London

IAS Common Ground, South Wing

UCL Gower Street London

London

WC1E 6BT

please register to attend on this link, please take a lateral flow prior to the event and wear a mask

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Two Years On and Responding to Changes in SARS CoV2 Guidance: What can you do now to impact your transmission risk

Its pretty much 2 years today since a pandemic was declared. A lot has changed since then and there are very big other things happening on the global stage. Its tempting to think that with so much going on that COVID-19 is effectively over. I don’t want to be the voice of doom and gloom here, but I do wanted to take a moment to point out that just because the legal situation has changed it doesn’t mean that the pandemic is over.

For us working in healthcare actually nothing has changed at all, I had to do a briefing last week where I basically said the phrase ‘nothing has changed’ on repeat for 45 minutes. In fact although the legal side of things have changed in the community the actual guidance hasn’t changed at all, it’s just its no longer a police matter. The government website still says:

Although nothing has changed, apart from not being fined for non compliance, this doesn’t seem to have been the focus of communication. SARS CoV2 levels are still high in the community, in fact they are likely even higher than being reported as many people aren’t reporting positive lateral flow tests and so these aren’t included in any numbers. The latest ONS survey numbers are looking like ~1 in 25 people are back to bring positive, with the numbers much higher in some regions.

What Can We Do As Individuals to Prevent Spread?

As the government have decided to make the political decision to remove legal measures and the communication strategy in terms of maintaining public health measures is poor, what can we do to have an impact and reduce risk to ourselves and others?

Know the current symptoms

I have regular calls with people who aren’t aware that the omicon symptoms are pretty different, even when speaking to healthcare professionals. The current  variant often has much more generic symptoms associated with it than those seen when we first encountered SARS CoV2. This means that we need to change our risk assessment and also be much more aware of what to look out for, rather than relying on the triumvirate of Anosmia (loss of taste and smell), temp >38 and new onset cough.

I know how tricky this is because actually so many respiratory viruses have similar symptoms. In many ways its starts more like a general ‘flu like’ illness. Using testing to support making decisions is therefore still going to be really important in working out the cause.

Ensure you have capacity to test

Sadly we are losing the ability to access the more sensitive and specific way to test i.e. PCR, as you can’t order these in advance, store and keep for when needed. Even the free provision of lateral flow kits (LFTs) ends at the end of the month, but for right now you can still order a new 7 day kit every 72 hours.

https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests

Make sure that you have ordered enough for you and your family. How many depends on your circumstances, which drive your need to test (see list below).

Being able to test is important for a few situations:

  • Enables you to test before you see people who are vulnerable, regardless of whether you have symptoms
  • Supports risk assessment by enabling you to test if you get generic symptoms so you know when to self isolate
  • Helps you know when you are safe to see others again if you test positive. Your risk will be lower (though not non existent) if you are lateral flow negative. I would also advise being symptom free.

NB I am not supporting stock piling here just being sensible.

https://www.gov.uk/coronavirus

Remember that if you test positive you should (under guidance but not law) be undertaking daily LFTs to reduce your risk to others and you will need enough in case this happens to you.

Having testing supplies is especially important if you are a healthcare worker. Currently if you are a SARS CoV2 contact you still need to get an exemption to work and LFT test daily. You should also still be testing twice weekly and I haven’t heard how these will be supplied post switch from .Gov ordering.

Remember that not socialising with others when you feel unwell is key

Visualising how viral spread works can sometimes be tricky, afterall viruses are invisible to the naked eye. Most people can imagine coughs and sneezes spreading as we’ve all been in a room where a cloud has been visible when someone has sneezed. I think its harder with Omicron, where you might just have a runny nose and sore throat, to imagine how it could spread so far. Myth Busters have done a great job of this in the video below. They set up a 30 minute dinner party and show just how far the virus could spread.

It’s really important that we are all sensible about how we interact and what we do if we have symptoms. Top tips from this video include:

  • Remember to undertake regular hand hygiene
  • Limit touching:
    • Don’t share cups or other high risk items
    • Be aware of face touching and the need for tissues etc to minimise the temptation
    • Limit physical contact (if appropriate for the scenario – hard to do this with your kids)

Make sure you still have a plan

My vulnerable mum and brother have just caught COVID-19 for the first time. Something I definitely blame on the change in guidance BTW. They had been prepared in terms of a plan but even they have struggled because they weren’t as prepared as they had been as they had avoided it for the last 2 years. Like them a lot of us had plans early on but have let them lapse. Now with the switch from public health to personal responsibility it is important we prepare for what the means for us as individuals and dust off those plans.

If like me (and until recently my close family) you have managed the last 2 years without catching SARS CoV2 and it all feels a bit inevitable now what can you do?

  • Have a plan for getting food brought to you, either via a support network or via delivery
  • Have pre-planned what that food might look like. Easy food that can either be put in the oven without further prep or food that doesn’t require cooking. COVID-19 brain is real and you may struggle to make decisions whilst unwell
  • Ensure you have all the medications you might need (both for COVID-19 and otherwise) for 2 weeks. Think symptom relief paracetamol/lemsip etc
  • Plan for distraction, especially if you have children. If you have a short attention span and are bed/sofa confined how will you distract yourself. Personally im planning to re-watch the whole of the Golden Girls on Disney Plus. I’ve deliberately held off 😁
  • If you have to split your household into exposed and non exposed how could you do it – the answer may simpky be that you can’t but its worth some thought

Keep risk assessment in your mind

Most of what this post is about is linked to risk assessment and risk control. If you work in healthcare should you be having that lunch with your colleagues? If you are going to see your grand mother have you recently been to a night club? If you’re commuting in an area of ever increasing prevalence i.e. London should you be wearing a mask on the tube? If you haven’t found time to get that booster, now is your moment!

The decision to move to personal responsibility is just that, it’s about every one of us thinking about our own risk and choosing to take responsibility to protect both ourselves and others. We can’t be passengers in this, the govenment change doesn’t mean there is no longer risk, just that it is our risk to own and control. We can only do that by working together. So listen to the science rather than the politicians and make sure we continue to protect those who are most at risk. After all that is what a civilised society is supposed to do.

All opinions on this blog are my own