Michelle Hatch reflects on returning to medicine, finding her place as an SAS doctor and helping others find theirs.

When I returned to medicine in 2014 after a 20-year break, I wasn't sure where I fitted.

I'd spent those years raising my children, completing teacher training, studying interior design and building a life outside medicine. When I came back, I realised that returning to practice was far harder than it needed to be. There was very little support available and, perhaps most challenging of all, I had lost confidence.

Looking back, that experience shaped a lot of how I think about medicine, leadership and supporting colleagues.

A different route into medicine

My route into medicine hasn't been conventional.

I never followed a formal training programme, and I've worked across a range of specialties and roles before finding my place in intensive care medicine. Along the way, I've learned that there isn't one ‘right’ way to be a doctor. Some people thrive on a traditional career path. Others find their own route. Both are valuable.

The years I spent outside medicine taught me things that I still draw on every day. They broadened my perspective and reminded me that there is life beyond hospitals and clinics.

Those experiences didn't make me less of a doctor. If anything, they made me a more rounded one.

The value of continuity

One of the things I value most about being an SAS doctor is continuity.

Modern medicine is increasingly built around shifts, rotas and specialisation. Doctors move between teams and departments, often seeing patients for only a brief part of their journey. As an SAS doctor, I've been fortunate to build longer-term relationships with patients and families, particularly in intensive care.

There is something incredibly rewarding about seeing a patient respond to treatment, supporting them through difficult periods and watching their progress over time.

For me, that continuity is one of the greatest privileges of the job. It reminds me that medicine is about people, not just diagnoses.

Becoming the support I once needed

I didn't set out to become a SAS advocate.

Like many things in my career, it happened gradually. Through my previous role as an SAS tutor, I found myself supporting doctors who needed advice, guidance or simply someone to listen. The more conversations I had, the more I realised that many SAS doctors were facing challenges similar to my own.

Often, the biggest issue wasn't capability. It was visibility.

Many SAS doctors work as the only SAS doctor within a department. They can feel isolated, overlooked or uncertain about where to turn when problems arise. There are still many misconceptions about what SAS doctors do and the contribution they can make.

A large part of my role is turning up and asking: ‘What about SAS doctors?’

Representation matters. If nobody is speaking up, it becomes very easy for people's needs to be overlooked.

Why wellbeing and advocacy go hand in hand

For me, advocacy and wellbeing are inseparable.

The pressures on doctors today are immense. It doesn't matter what specialty you work in. The intensity of the work continues to increase, and many doctors spend their days feeling as though they're constantly trying to catch up.

Doctors are often very good at carrying on and telling people they're fine when they're not.

That's why I believe creating opportunities for people to connect with one another is so important. Whether it's formal support networks, peer groups or simply creating space for honest conversations, people need places where they feel safe to speak openly.

Sometimes support is surprisingly simple.

Sometimes it's just checking in with someone and asking, ‘Are you okay?’

Over the years, I've had doctors tell me things they haven't felt comfortable sharing elsewhere. That tells me there is still a real need for advocacy and peer support across the profession.

Creating a culture where people feel valued

If I could change one thing, it would be culture.

I'd like people to look beyond job titles, career pathways and letters after someone's name, and instead recognise the value of the individual standing in front of them.

Every doctor brings different experiences, strengths and perspectives. When people are recognised, supported and trusted, they become more motivated, more fulfilled and ultimately better able to care for patients.

That applies just as much to SAS doctors as it does to anyone else.

Looking ahead

As I get closer to retirement, I find myself thinking less about titles and more about impact.

The NHS changes slowly, but I do believe progress is possible.

My hope is that future SAS doctors will feel more visible, valued and supported than many of us did. I hope they'll have a clearer understanding of the opportunities available to them and the confidence to make their voices heard.

For me, that's what advocacy is really about.

It's about helping people feel that they belong.

It's about making sure SAS doctors have a voice.

And it's about being the support I wish I'd had when I first found my way back into medicine.

Michelle Hatch is a SAS specialty doctor, intensive care medicine YGC.

SAS advocate, BCUHB, and chair of SAS professional advisory group, Intensive Care Society.