Saika Hussain describes the barriers to practising medicine that she has faced since acquiring a disability
Around 14 million disabled people live in the UK. I am one of them.
Disability can strike at any time, as I discovered during my specialty training. As a GP ST2, I acquired a disability. I now use an electric wheelchair, which I operate with my left hand. My right hand is not functional. I can see, hear, and speak very coherently. My cognitive abilities are unaffected.
According to the General Medical Council’s (GMC’s) Good Medical Practice guidelines, a doctor must “never discriminate unfairly against patients or colleagues.” The Equality Act (2010) legally protects people from discrimination in the workplace and in wider society. Yet as a doctor eager to continue practising medicine, I am being discriminated against.
It has taken me years to build up the courage and mental strength required to accept what has happened and approach the challenges of life as a disabled person. I have encountered pity, negativity, and at times discrimination. Conversely, some people have offered real assistance. A career planning and support service called Medical Forum, founded by Dr Sonia Hutton-Taylor, has been particularly helpful in helping me explore and plan my career options. The former head of GP training at my deanery suggested this, for which I am very grateful. With the right support in place and creative solutions, I strongly believe that I can still have a successful, rewarding medical career. For this to happen, I need the system I worked for to develop the same conviction and fulfil its responsibilities as an employer.
I have been trying to resume my career for some time now and, despite the barriers, I still passionately want to work in medicine. However, even in this age of digital/assistive technology and advances in modern medicine, there appears to be no impetus from within the profession to enable me. Often when I approach people for training advice and job opportunities, they commend my determination and resilience. Some genuinely want to help, yet they come up against a system that is not equipped to handle my level of disability.
Doctors with an acquired disability like mine have no positive, systematic approach to enable them to return to work. Instead, I’ve come across many obstacles—even before getting to the stage of working out reasonable adjustments in the workplace. Whether it’s trying to arrange taster sessions that are accessible, to getting information on eligibility criteria for applying to specialty training, I’ve been unable to make progress. When I’ve tried to collate information and make the necessary arrangements to do these things with individuals involved in career planning and training, they have, despite trying to help, failed to establish and adhere to clearly outlined time frames, and my efforts stall.
I’ve also encountered a lack of open mindedness at times and a tendency to assume that being fully able bodied is essential for practising medicine. Guidelines on how to support the training needs of disabled doctors are scarce and, consequently, I’ve had educators encourage me to consider alternative careers.
Different organisations are involved in setting the curriculum (the Royal College of General Practitioners in my case) and delivering training (usually the deanery or employing trust). The GMC’s involvement in this area is also essential. Knowing who to approach and when is very difficult and at times daunting. One is often left waiting for long periods of time, only to eventually be advised to seek further advice from or approach a different body. This is very demoralising.
The GMC has recently recognised that UK health services may be missing out because doctors with disabilities and health issues don’t always get the support they need. It has drafted a revised version of its Gateways to the professions guidance called Welcomed and valued. This intends to guide medical educators on how to support disabled students and doctors so that they can fulfil their potential. Currently I do not feel welcomed or valued. More needs to be done.
In other industries things are changing for disabled people much faster than within medicine. Disabled people are increasingly seen in the media: Masterchef, Great British Bake Off, Strictly Come Dancing, Countryfile, and BBC Watchdog spring to mind. This is all very positive but this enlightened inclusion needs to be extended to medicine.
The area of remote medicine/telemedicine/digital healthcare is growing rapidly and has the potential to transform healthcare, including within the NHS. This is an area where disabled doctors could work on a level playing field and excel—possibly advancing the role of remote practising doctors.
I would like to see guidelines produced specifically for disabled doctors and a review of the clinical examination and procedural skills competency. For example, only one of the 13 workplace based competencies in GP training is significantly influenced by manual dexterity, and there are current and emerging technological solutions to this apparent limitation. A more positive, inclusive approach looking at how assistive technology and equipment can be adapted to enable disabled medics is necessary.
Other areas of the world, such as the USA, are training quadriplegic medics. In the UK, there are disabled people among today’s medical students and I wonder what training options they will have. Money is also being invested in recruiting doctors from abroad.
Despite all the indications that disabled doctors are present, of value, and needed, I still sit here . . . available, wanting to work, yet not being enabled to.
Given that the UK is experiencing a shortage of doctors, plus the cost and time constraints of training anew, facilitating an already trained medic to continue seems like good workforce planning. Not to mention the valuable insight and diversity that disabled doctors bring to medical practice. Patients may benefit from seeing a clinician who can uniquely empathise with their situation. More broadly, having disabled doctors as part of the workforce sends a very positive message to society about the values of the NHS.
I want to see this problem addressed not just for me, but for all the current disabled medical students in training and all the future doctors who will acquire disability.
Saika Hussain lives in Buckinghamshire and is trained to GPST2.
I would welcome hearing from anyone in a similar position to me or in a position to spearhead/ influence the necessary changes, as well as developers of remote /adapted examination equipment:
Competing interests: None declared.