Emotional toll of being a doctor

How I got through a crisis

Location: UK
Audience: All doctors
Updated: Monday 7 September 2020
Topics: Your wellbeing
Marianne Poirier is a junior doctor. She writes under a pseudonym.

I wanted to write anonymously about my experience of being referred to the GMC and calling the Doctor Support Service because, when I received the letter I genuinely thought my life would completely fall apart and that I would never be able to cope with this, but although it is a bit of a challenge, I am definitely OK.

A bit of background - I am an SHO and I was an SHO at the time of the incident.

I recently received a letter from the GMC. The letter related to a clinical incident that occurred over a year ago in which a patient died. I had given a statement more than a year ago to the trust I worked in at the time and heard nothing since. The letter therefore came as a shock.

On receiving the letter I worried about being suspended or never getting a job once I had finished my training. The fact that I had been using work as an escape from personal problems did not help things. I did not know how I would deal with this as well as my personal problems.

I had been thinking about suicide but had been fighting those thoughts for a long time. Being referred to the GMC did not help, because I was convinced that now I had failed as a doctor as well as in my personal life. I felt too ashamed to confide in friends or family.

I had in the past been told about the Doctor Support Service. I called the number because it meant I could talk to someone I did not have to ever meet face-to-face, so I felt it would not matter as much if they judged me.

It was very helpful for several reasons.

I had in the past been told about the Doctor Support Service. I called the number because it meant I could talk to someone I did not have to ever meet face-to-face.

Firstly, I could not face looking through the letter from the GMC again. However, the doctor at the end of the phone asked me to read through the first page. After going through it over the phone, I realised this was a preliminary investigation. The doctor explained that this case may well be closed by the GMC without even progressing to a full investigation.

Secondly, I really couldn't think clearly; the person I spoke to convinced me that speaking to my defense union would help me feel calmer because I would start to feel in control.

Finally I didn't feel judged when I spoke about the complaint. This was really helpful because when I went to work the next day, it was difficult to concentrate; but I felt able to tell a nursing colleague and request them to double-check prescriptions and other things with me, meaning I was safe at work.

Two days later, I spoke to my defense organisation. They said that it may progress to a full investigation. This was difficult to hear. Again, because I was made to feel like this is not something to be ashamed of, I was able to speak to a colleague; this time a doctor who was senior to me; being able to vent my emotions again allowed me to work safely.

 

The person I spoke to convinced me that speaking to my defense union would help me feel calmer because I would start to feel in control.

With regards to the clinical incident, I had believed my actions to be appropriate at the time. Now that the GMC was involved, I started to question all my clinical decisions. I felt like I was over investigating patients and causing them and myself unnecessary anxiety. I spoke to the doctor about this and it was useful to know that this is quite normal and that it was OK to ask for a second opinion.

After speaking about this, I felt able to speak to my educational supervisor very openly and also to my clinical supervisors because I realised it was best to ask for help with this issue. Again, people were much nicer than I expected.

I still feel embarrassed when asking about simple clinical scenarios because I worry the doctor I am phoning must think I don't know anything; but I phrase it as: 'Sorry to bother you, it's been one of those days, I apologise for this'. I still don't like that I am not as decisive as I was, but I am hoping this will come back with time.

As a trainee, I have always disliked writing formal reflections. My reflections were usually something like: 'I was nice to the patient. The patient was therefore happy. Learning point: Be nice. The end'.

My educational supervisor asked me to write a formal reflection on how I would ensure I would not allow this and the personal issues to affect my fitness to practise. This was useful for two reasons, firstly, the GMC can see that I am self-aware; secondly, writing quite openly about how I would deal with this has helped me remain calm.

I also really want to highlight two other amazing sources of support I had. There is a forum on Facebook called 'Butterfly', it's a closed group for NHS staff who have been faced with an investigation. Talking to people on there also calmed me down as I was reassured that being investigated is unlikely to stop me getting a job (as it has not stopped others) and I was reassured that no one would judge me.

There is also a forum called 'Tea and Empathy'. It has 2,000-plus members who are mainly doctors but also other health care professionals. It's a great source of support for work related issues, life issues and health issues. You can post anonymously or ask someone and also message other people in similar situations.

My educational supervisor asked me to write a formal reflection on how I would ensure I would not allow this and the personal issues to affect my fitness to practise.

Marianne Poirier, Junior Doctor

Both these forums made me feel less alone. Also, my current supervisors felt unable to comment on the clinical issues as this was not their area of expertise; using the 'Tea and Empathy' forum, I was able to talk to a senior doctor working in the specialty where the incident occurred and ask her to critically review my reflections on the incident (my thinking was, better people criticise me now so that I am self-aware and show insight if I have to talk to the GMC).

Having talked through the GMC referral with my defense organisation and the Doctor Support Service and also receiving support from colleagues and the Facebook forums: I had realised all that was required was that I was self-aware and showed insight into what I had learnt from the investigation.

Of course I have not heard from the GMC yet - but I am thinking, if I do not appear defensive, if I state what I have learned (even if you do not feel it is your 'fault', there is always something to learn) and if I state that I have had this in detail with people responsible for my training and taken all relevant advice from them, what could the GMC actually do? Hopefully very little.

Of course if they do take action, at least I won't be dealing with it on my own.

The most important thing I have learnt is a GMC referral is nothing to be ashamed of. You cannot stop someone complaining. If I am not judging myself it makes it very difficult for friends, colleagues and potential employers to start judging me.

I hope the GMC continues to fund the Doctor Support Service. Speaking to someone helped me stay safe at work, reflect on the incident and show insight - which are all the things they want doctors to do to protect the public.