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This Doctor Can: Championing flexible working

Dr Sarah Logan FRCP, deputy director of the Medical Workforce Unit at the RCP, talks about how her personal experience led her to champion flexible working for everyone.

Coming from a family of physicians, which included my grandmother, imagining life as a doctor was not a struggle for me. In fact, I couldn’t really think of anything else I could do.

The early part of my career as a budding physician went well. I ticked all the boxes, went through house jobs, senior house jobs and fellow posts, and finally made a decision on my specialty. Infectious diseases felt like the right combination of generalism, academic challenge and possibly an opportunity to work abroad.

As I progressed through training, I became conscious that there weren’t many female academic clinicians in infectious diseases who had managed to combine a career with having children. I looked around for role models and struggled to find any. I was so in awe of those I did find, that I could never imagine myself in their positions. Professor Alison Rodger and Professor Margaret Johnson are among those who spring to mind.

I started to explore opportunities to do a period of research while I was pregnant with my first daughter. It became very clear to me that although I was encouraged to apply for a PhD, no-one felt that I could do this while working flexibly. I decided to postpone decisions about academia and went on maternity leave.

Our first daughter has learning difficulties and our second came along soon after so to be honest much of the following 2 years are rather hazy. I was totally exhausted, attempting to work at 60–70% in a variety of models while also trying to be a mother navigating the world of special educational needs. I relied heavily on the support of my peers, an increasingly female bunch of infectious diseases trainees. The constant foggy-brain moments were much helped by a quick text or email for advice.

I became conscious that there weren’t many female academic clinicians in infectious diseases who had managed to combine a career with having children. I looked around for role models and struggled to find any.

Dr Sarah Logan

Now that I had children, I found the idea of taking time out to undertake research daunting. I simply did not have the mental capacity to focus on anything for long enough to commit to a research proposal. I remember seeking advice from a senior colleague: ‘How can I possibly be an infectious diseases consultant without a PhD?’. His advice was along the lines of ‘sometimes you just have to accept that you cannot wear all the hats you would like to’.

I am passionate about keeping doctors accrediting in general internal medicine so I became involved in a project called ‘The role of the medical registrar’ at the RCP. This project was such a great opportunity. I learnt a bit about qualitative research, had the chance to meet peers across the UK and was able to contribute to an acute care toolkit that highlighted some of the challenges trainees face in undertaking the role. Some positive changes to the way acute medical units are run in 2019 came out of this work. This project was pivotal in regaining confidence in myself. I then went on to undertake a little research alongside my clinical training, using one of the days when I was not meant to be in the hospital to run a prospective study in HIV patients.

Working less than full time and having the financial support of a non-medical partner has been an incredible privilege. The nature of physician working (particularly in general internal medicine) means childcare needs to be flexible. I am in awe of medical couples that somehow manage with nurseries or grandparents. After a couple of unsuccessful attempts at other models of childcare we came to the conclusion that the only way it could work for our family was to sacrifice most of my 60% FTE salary to pay for a nanny who was able to be as flexible as me. I feel really strongly that we need to address the cost of childcare for those working antisocial hours in the NHS.

I emerged from the toddler haze with my completion of certificate of training (CCT) looming. I found that the experience I had in undertaking projects in a flexible way where I had autonomy, as well as learning to fight the corner of a child with SEN gave me the confidence to approach colleagues about consultant posts. I was able to proactively discuss working at less than 10 PAs (programmed activities). I found I was describing and designing a model that I could see working for the trust, my colleagues and, most importantly, my family. I was appointed in 2013 to 6 PAs with weeks of full-time when working in acute medicine or infectious diseases. A model that would not work for many but feels like the best fit for me.

6 years on – another maternity leave, another daughter. I am still championing working flexibly, now continuing to work flexibly at 70% of full time, including as clinical lead, education lead and with a role at the RCP in the Medical Workforce Unit. Lots of hats, lots of juggles, lots of battles to change a culture. Sometimes it does all feel a bit much, but ultimately, I feel incredibly privileged to be working in the way I do. Some of those female peers from a decade ago are out there championing doing all of this with an academic role too. All my hats come off to them!

Would you like to share your experience of becoming a doctor? Get in touch on Twitter via @thisdoctorcan.