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It pays to persevere

thedoctor issue 4
RAGUNATH: 'I'm staying and I can prove them wrong'

When young doctor Krish Ragunath left India to further his career in the UK he was met with disparaging remarks and even advised to return home. Yet, through sheer strength of will, he persisted with his dream until things started to go his way. Peter Blackburn reports

Krish Ragunath was told he wasn’t cut out for a career in the UK two weeks into his first job in the NHS.

‘This hospital might not be the place for you. Perhaps you might need to go back to India.’

These were not the words any ambitious, young doctor would have wanted to hear. For Dr Ragunath, who had left his wife and two-year-old child at home in Chennai, leaving his country on a plane for the first time having sacrificed so much it was particularly dispiriting.

‘It was quite a difficult time,’ says Dr Ragunath thinking back to the locum post in a district general hospital in West Yorkshire where he began his UK working life in 1992.

‘There was no introduction to the whole NHS system, you were just thrown in, having been met by a junior doctor who told you what your jobs were. There was no induction on any of the hospital processes as in how to make a request for an X-ray or blood test or who to contact for what. You had to ask and find out.’

And then there was the accent. Being educated in a top school where English was the medium of instruction, and through medical school, as is standard in India, still did not prepare him for Yorkshire.

‘I was struggling to fit into the system because it wasn’t welcoming’

‘It was like listening to Geoff Boycott commentating. You would get a phone call and I couldn’t understand what they were saying – I had to go physically in person to see people to work it out.’

But despite being told his seniors were not confident in him handling the job – and even offering to continue to pay off the remainder of his two-month contract – Dr Ragunath stuck to the task. He had not toured England on National Express buses and sent hundreds of application forms to hospitals for nothing.

‘It was frustrating, but it built resilience in me to stand up and say “no, I’m staying and I can prove them wrong”.

‘I didn’t have any doubts really, I was quite confident with what I could do but I was struggling to fit into an unwelcoming system.

'It expected me to perform like someone brought up in this country. So much about how the system and processes worked were different, but I was still hopeful that it would work out in time.’


On the up

After West Yorkshire Dr Ragunath found himself working in South Yorkshire in another locum role – this time in a hospital with many Asian doctors, including some former colleagues from Madras Medical College.

A far more successful stint followed, with his first permanent job as a house officer in Leigh Infirmary, a small district hospital in Greater Manchester.

The initial job meant being on call for 24 hours every third day – and sleeping in the ward office – but it was a ‘fantastic’ environment for learning.

‘It was tiring and stressful, but the knowledge I gained there over six months was amazing,’ Dr Ragunath says.

Leigh remained home for a decent spell – after an initial six months Dr Ragunath was given a senior house officer job for a year, rotated through specialties and worked with a consultant gastroenterologist.

‘I kept telling my wife that we might have to go back’

He then won a place as a research fellow in gastroenterology, which took another two years, and completed a postgraduate medical diploma.

‘Those opportunities would have been almost impossible to achieve in India. I would have been working in under-resourced government hospitals.’


Missing out

Another locum registrar post in the North-West followed, and another 12 months went by. But for Dr Ragunath, still living apart from his family, progress was not coming quickly enough. The thought of returning to India was a constant temptation.

‘I was being told I wasn’t the first choice in interviews because I was from overseas – I kept telling my wife that we might have to go back. There were no emails or Skype. We only spoke over the phone. I used to write letters and send photographs.’

Ultimately, as during so many moments in Dr Ragunath’s career, he chose to stay and work in the NHS. He was rewarded for that decision with a training post in south Wales. Finally, the Ragunath family had some certainty, all coming together to make a new home in Swansea.

After five happy years there, Nottingham University was on the lookout for a senior lecturer – it was to be a new academic post and the professor in charge had just one goal: put Nottingham on the map as a centre of excellence for endoscopy.

‘It is all a dream compared to who I was when I arrived’

He took his family, now of four with the addition of a six-month-old son in tow – and once again started afresh.

‘I was a bit nervous taking up something that was a first,’ Dr Ragunath says, ‘but I took it because it was endoscopy.’

In terms of his own career, things could hardly have gone better.

‘It is all a dream compared to who I was when I came across on that first plane flight,’ Dr Ragunath adds.


Will power

‘The point, I think, is that if you have the will you can do it. But you must have the will and really want it.

'Trainees come to me now and say I’m interested in this specialty because there’s jobs there – but that’s not how you should make decisions. I tell them to do what they like and enjoy because that will ensure they will excel.’

There are multiple morals to Dr Ragunath’s story. For individuals – where possible, persevere, a lucky break could be just around the corner.

And crucially, for NHS organisations – be supportive to those coming from different cultures and different systems. You never know how brilliant they might be.

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