Making the Jump to a Medico-Legal Career

Guest Post by Daniel Sokol

On a number of occasions, I have been asked by early career ethicists about the move from ethics to law, or the wisdom of seeking a legal qualification to supplement their ethical knowledge. In the UK, this can be achieved remarkably quickly. This blog post is an answer to those questions, based only on my own experiences.

In 2008, I was a lecturer in medical ethics and law at St George’s, University of London. I had no legal training, and felt uncomfortable teaching law to medical students. Some of the graduate students were former lawyers and it must have been obvious to them that the limits of my legal knowledge extended no further than the PowerPoint slide.

That year, an old school friend, a solicitor, encouraged me to become a lawyer. “I can imagine calling you ‘My learned friend‘ in court”, he said. And so the seed was planted, and with each soul-sapping marking session, and each article published and quite unread, the seed grew until, in 2009, I resigned from my lectureship to study on the law conversion course, now called the Graduate Diploma in Law (GDL).

Plan B was a return to academia, so I arranged an honorary position at Imperial College to maintain my links with the academic world. “If the law is not for me”, I thought, “at least I’ll have a legal qualification under my belt”. There can be little harm, and much benefit, in a medical ethicist holding dual qualifications in ethics and law.

Over the 9-months of the GDL, we were force-fed vast quantities of law – crime, tort, land, equity and trusts, EU law, contract, constitutional and administrative law – like geese fattened for foie gras.

The GDL covers the fundamentals of the law and the English legal system, but offers little time to reflect on the principles underlying the law. A question on the philosophy of law would result in confused looks by the lecturer, whose holy text was the teaching manual. At the end of the GDL year, we sat written exams for each major topic, with pass-merit-distinction classifications. The syllabus was vast and, for the first time, I sympathised with those bold medical students who would ask in lectures “Excuse me, is this likely to be in the exam?”.

The GDL is a gruelling course, with much of it unrelated to medical ethics (but useful when reading contracts, buying a house, setting up a Trust, and so on). There is little time or incentive to read case law, which is a shame as it now takes up a decent proportion of my time. A good lawyer should be able to read a case, identify the key points, and use it as effectively as possible in winning the case; or, if the case is unfavourable (in practice, handed by an opponent shortly before a trial), distinguish it from the actual case and limit the damage.

Armed with a GDL, an ethicist should feel more comfortable when teaching law, mainly because of greater familiarity with the legal system, legal terms and concepts. However, on balance, I would not recommend the GDL to those with no intention to practise law. More focused, palatable, and cheaper alternatives must exist for non-practitioners.

 During the GDL, students must decide whether to go down the solicitor or barrister route. I chose the latter and embarked on the Bar Professional Training Course (“BPTC”). The BPTC, like the GDL, can be done part-time over 2 years.

The BPTC is a practical course, covering evidence, civil and criminal procedure, oral advocacy, conference and negotiation skills, and drafting advices and pleadings for solicitors. Students are expected to know the law, or how to find it. There was a compulsory module on ethics, which was little more than learning the rules of the Bar Code of Conduct. Two specialist options can be taken in the latter part of the year, including professional negligence (which covers medical negligence). If you pass the BPTC, you can then be called to the Bar. The aim of the Bar Course is to prepare you for the first year of life as a barrister: pupillage.

Obtaining a pupillage is competitive – there were fewer than 400 pupillage places this year in the country – and may require several attempts, although an academic background should give you an edge. The scarcity of pupillages and, for aspiring solicitors, training contracts must be taken into account when evaluating the risk-benefit ratio of going into law.

In pupillage, pupils work for established barristers in Chambers for the first 6 months and can take on their own cases in the second 6 months. You are unlikely to specialise in medical law until several years into your career. I am now “4 years’ call” (i.e., I was called to the Bar in 2011) and approximately 30% of my practice is medical law. The rest is predominantly personal injury.

As an academic, much of my work in medical ethics was about creating and analysing arguments on ethical topics. With luck, those would end up in publications in academic journals. Now, I still deal with arguments but the focus is on people and their problems, and finding practical solutions to these problems. The arguments are a means of achieving a positive outcome for the client. Many practising barristers look upon academic lawyers with puzzlement, as the law only comes alive in the context of actual cases.

The pace is faster than in academia. It is not unusual to write a 3,000 word ‘skeleton argument’, persuading the judge why you should win the case, in half a day. The papers for a case, spanning several files, may arrive on your desk the evening before trial. In an average week, I am in court 3 or 4 times, with cases brought under the whole range of the law – they are sometimes to do with medical law, sometimes to do with personal injury, but sometimes to do with things like the enforceability of credit agreements.

But I do other things, too: today, I gave a lecture on consent to some Ear, Nose and Throat surgeons in Liverpool, telling them how to stay out of trouble following the landmark case of Montgomery v Lanarkshire Health Board. 

There is never a dull moment, but the hours are long and the pressure high. As a barrister, you are self-employed and future work relies on good results and happy solicitors. Social and networking skills are helpful in forging relationships with solicitors. At times, losing a case can have devastating consequences for clients, whether it’s a business that will go insolvent or an injured person left without compensation and an eye-watering costs bill.

Would I recommend a move to the law? Absolutely. A firm grasp of the law and, better still, the practise of law will add an extra dimension to your writing and thinking about medical ethics. It will open doors, with invitations to speak and write, especially to doctors and other lawyers. If planning a return to academia, it will set you apart, in a positive way, from competitors.

However, be aware of the challenges ahead: financial, personal and professional. It may be worth approaching a solicitor or barrister specialising in medical law, and asking them if you could spend a few days shadowing them.

If you do take the plunge, I look forward to calling you “my learned friend” in the near future.