Dr Stuart Allan recently got in touch to describe his move from full time GP partner to the wider world of mountain medicine. Here's what he wrote...
"General practice is hard. 10-minute appointments, any person and problem can come through the door. My practice was a high visiting practice with an elderly demographic which adds to the rising workload. Paperwork (all digital now) and the movement of care from secondary to primary care, with the increasing silo nature of teams added to the problem. I can’t remember the last time I spoke to a health visitor!
Friends and colleagues would come in at weekends and on their days off to complete paperwork, or worse still, connect their home PC’s to the practice computer system in order to avoid coming in. Working from home: a slippery slope.
This was never a route I followed: work completed at 6.30pm and then home. And it was done, but at a cost. I could see how turning 50 in January this year, would rapidly turn into passing 60 ‘tomorrow’ and I would be bewildered as to where the last 10 years had gone. I could also see that I had collected many incurable patients over the last 15 years as a partner, and I didn’t think I was helping them. They needed a friend, a social worker (where are these people now?) or possibly a priest.
Fifteen months ago I informed my colleagues that I was leaving in March 2019. I just also happened to be going through a separation and moving house! All of this was coincidental and a positive move. I had better explain. There was not a hint of work-related stress, ‘nervous breakdown’ and the like. This is not to say that I have not seen this in colleagues, both in primary and secondary care, many just counting down the days to retirement.
Relaxing during the 2019 Meribel Advanced Course.
I couldn’t help thinking that there must be another way. And there was. Inspired by this cohort we call Millennials, I started considering a portfolio career. I’d already started picking up a few things, like volunteering as the doctor for Kendal Mountain Rescue team. Unpaid, doesn’t matter. The team and the people within it are payment enough.
Just as I was re-arranging my life last summer, I learnt that the Diploma in Mountain Medicine (DiMM) had a vacancy for leading Module 1. I spent a lot of the next 4 months working on this with another great team at the Royal College of Surgeons (Edinburgh) and the DiMM who are too numerous to mention here. Mike, Jeremy, Sarah and the rest of the gang - you know who you are!
At the same time had to start thinking about work streams. Locum agencies were a dead end as you can’t pay into a pension. I started paying into my NHS pension at the age of 35 after working around the world for 10 years, so I've figured I’ll be working until I’m 102 already!
I went to the GP Best Practice conference at the NEC in Birmingham in October 2018, which combines education with clinical and political updates and is well organised. Definitely worth a visit. It is also a bit of a careers fair. The Army Reserves were there as well as BUPA. I now work every Tuesday in Manchester for BUPA and I have my officer selection in July!
Teaching hypothermia management to the 335 Medical Regiment with members of the Kendal Mountain Rescue Team.
Close contacts are important as this helps foster trust and relationships, especially in mountain medicine. It’s also important to promote yourself. In February, I sidled up to the owner of Ourea Events who just happens to be in my mountain rescue team. I said that I was available from March to work for him. It just so happened that there was a paid vacancy to work as mountain rescue support on the Dragons Back Ultra in Wales in May. Sign me up, please!
I recently did a kind of ‘careers talk’ for the Diploma students in Wales. My key message was to encourage the students to say ‘yes’ to any opportunities that arise and worry about the consequences later. The risk with mountain medicine is that it can take over your life a bit. Preparing a talk for a conference or a diploma module takes a lot of time but highly recommended if you get invited. The BMC/BMMS Mountain Medicine Course is a great opportunity to get involved with the Diploma faculty and hopefully act as a springboard for contacts in this strange subspecialty we work in. Thanks to Aliki, Matt and Hannah, who all worked with me this year. I hope they had as much fun as I did.
Helicopter training with Kendal Mountain Rescue Team
Other events that I’ve got involved with include being mountain rescue examiner for the RAF mountain rescue team (paid!) and doing a careers talk on mountain rescue and general practise for the Liverpool Medical School GP Society (definitely unpaid!)
My main income streams remain through General Practice: working freelance for the out of hours group that is based in Kendal and Barrow-in-Furness; as well as daytime shifts via Cumbria Chambers (a small group of experienced GPs that pay collectively for administration support). Again, contacts matter. The doctor who is clinical lead for this organisation also works in my MR team.
The 2019 Dragon's Back Race Medical Team. Abbi Forsyth, Mountain Medicine Clinical Fellow at Chesterfield Royal Hospital, is second on the left.
So, with working for Ourea events, marking exam papers, mentoring diploma students, running Module 1 and paid work through mountain rescue activities with the RAF, I am beginning to get a small income through mountain medicine.
We are all on our own journey and medicine remains a fantastic career pathway for seeing the world and accessing a multitude of weird and wonderful lifestyle opportunities. But I would advise, take inspiration from our younger colleagues and follow your heart into an insecure but very exciting future!"
Thanks Stuart for contributing to STDZ!
The British Mountain Medicine Society (BMMS) are organising a Science Day in the Peak District on the 13th November 2019. Why not come along? Details can be found here.