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In March 2020 things changed, seismically, both at home and at work. As my 11 year old twins prepared for their first day of home school, I prepared to set off to a new kind of workplace.\u00a0<\/span><\/p>\n \u201cWhat will you be doing at work today Mummy?\u2019<\/span><\/p>\n \u2018Well – it\u2019s mostly about my \u2018Director of Medical Education (DME) \u2019 stuff at the moment.\u2019<\/span><\/p>\n \u2018But what does that job actually mean, Mummy?\u2019 Kids always get to the nub of it so effortlessly, don\u2019t they?<\/span><\/p>\n A moment of reflection. What DOES that job mean? And more specifically, what does it mean right now?\u00a0<\/span><\/p>\n \u2018Well, think of your school headmistress. Its like that. I make sure that our pupils have the best possible environment to learn, and that our teachers have the best possible environment to teach. So\u2026..\u2019\u00a0<\/span><\/p>\n \u2018OK Mummy. I get it now.\u2019\u00a0 I was summarily shut down. Move on. But I didn\u2019t move on.<\/span><\/p>\n <\/p>\n I\u2019ve been cycling to work since COVID-19 arrived \u2013 tantalisingly delightful weather, empty roads, no kids to drop at school, and no regard for what I look like when I get there.\u00a0 I change from jeans, into scrubs, and back again – living in a liberated world of permanent pyjamas. That morning, as I pedalled up through historic Greenwich Park, I reflected on the conversation I\u2019d just had.<\/span><\/p>\n <\/p>\n In my mind the job of DME has always boiled down to welfare – educational, psychological, emotional and physical. It means creating a training environment which optimises all these aspects of working life. Trainee welfare directly correlates with patient welfare so, if we get the former right, the latter will be the corollary.\u00a0 During COVID-19\u00a0 these welfare principles have not fundamentally changed, but the context of their provision certainly has done.\u00a0<\/span><\/p>\n <\/p>\n I remember a conversation a couple of years ago with a close mentor and colleague; \u2019the thing is, Cathy, as DME people will expect you to know the answer to the bigger questions. They will look to you to set the educational direction for the Trust.\u2019 For me, COVID-19 has shone a light on the central tenets of education and training. I can now see it through a different lens, with an image of much improved focus, clarity and resolution.\u00a0<\/span><\/p>\n <\/p>\n Firstly, take good quality supervision; a cornerstone of training. As a huge wave of trainee redeployment crashed in, along with COVID-19, there was a relentless surge of activity. Rules came down from on high. Endless permissions were sought as GPs, Surgeons and even Psychiatrists were moved back into acute medicine, the Emergency Department and Critical Care. As trainees moved into new, and often unfamiliar, clinical areas the need for excellent supervision was put under the microscope. We had never to lose sight of it.<\/span><\/p>\n <\/p>\n Amongst the necessarily generic rules, however, were important exceptions which illustrated compelling personal narratives that ran the risk of getting lost in the deluge. The GP trainee, who was a fully trained Microbiologist in her home country of Italy, felt mandated to use her experience in South London. The Foundation Trainee, who had spent 3 years working in Africa on the epidemiology of infectious disease, felt compelled to use his experience in our COVID Command centre. It was vital to accommodate these individual stories of expertise \u2013 both for the welfare of the individual and for the welfare of the organisation. I was reminded that a \u2018school\u2019 is made up of individual pupils. Rules have to be made but one of the great satisfactions of the DME job is the tangible personal support that can be offered to individuals.\u00a0<\/span><\/p>\n <\/p>\n Some of the most challenging narratives came from the trainees that were particularly vulnerable \u2013 pregnant trainees, trainees with underlying health conditions, trainees with relatives dying of COVID-19, trainees moribund with COVID-19 themselves. Add to that the final year medical students qualifying 3 months early and starting work on the wards as part of the COVID-19 response. The need for maintaining their welfare was paramount. Imagine jettisoning your plans to take a well-earned post-qualification break and, instead, pitching up on a critical care unit in South London in the midst of a global pandemic. These trainees were potentially rabbits in the headlights, but they were desperate to help and it was our job to ensure their adequate supervision.<\/span><\/p>\n <\/p>\n Secondly, take a look at teaching. As the pandemic took hold a dedicated cohort of our trainees set up a Trust medical education group. Swiftly they innovated and collaborated, finding a niche that needed to be filled. Before long, Zoom was up and running, webinars were recorded and WhatsApp groups formed. \u2018Sounding circles\u2019, akin to a virtual doctors\u2019 mess, provided peer-to-peer support \u2013 not to mention \u2018Gratitude Corner\u2019 and \u2018Quote of the Day.\u2019\u00a0<\/span><\/p>\n <\/p>\n Now my role is to encourage these trainees to publish and disseminate their innovations. Perhaps it\u2019s about reframing \u2018learning\u2019. It may not be the learning you were expecting, but things will be learnt that wouldn\u2019t otherwise have been learnt. Indeed, some education genies that have escaped from the bottle during COVID-19 may not have to be stuffed back in again.<\/span><\/p>\n <\/p>\n