“I loved my clinical work, but I was so fed up of filling rota gaps.”
Azra and I sit in the plush, modern looking office area of the Cass Business School, sipping cups of ginger and lemongrass tea. Walking here, past the skyscrapers of central London with the smart-looking commuters in suits, I felt a world away from Medicine.
Dr Azra Chang was an ST5 in Anaesthetics in the London Deanery, but in August 2014, that changed. Azra quit her job and started working as a Management Consultant for Deloitte. A year later, a research opportunity came up at theCass Business School, and Azra jumped at it.
As she spoke about why she left Medicine, she voiced what has been echoed by so many doctors in the last few months: how the NHS takes eager, optimistic medical students and turns them into bitter, exhausted cynics.
“The NHS culture is hierarchical, controlling and commanding. I did well in my training, in ARCPs and in exams – but I still felt infantilised. I had no autonomy. I was pulled into a brainwashing culture where you do as you’re told, regardless of whether you think it’s right. I hated how the system abused its workers.”
Dr Azra Chang
Azra grew tired of constantly being put in dangerous situations:
“One night I had to hold both the ITU and the Med Reg bleep. There was no way that was safe for patients! And if anything had gone wrong, the finger would have been pointed at me. I was miserable and sleep-deprived. I ended up cutting corners. That was the turning point for me.”
Azra knew she needed to take time to think.
She took an OOPE (Out of Programme Experience). If you have a training number, you’re entitled to a maximum of 3 years out while still retaining your number. It can be related to your training, or research, or can be completely non-clinical.
“I was lucky. My Programme Director was supportive, but I know many are not. It can be difficult to get approval unless it’s for something clinically relevant, like research or training abroad.”
Applying for an OOPE can be dauntingly complicated. Azra had to speak to the London Deanery, the Regional Advisor from the Royal College and the Head of School for Anaesthetics, and all this had to be completed a good 6 months ahead of her leaving date. You also have to reapply for an extension after each year.
“But if you put it the right way, it can be done. I’m able to extend my OOPE because it fits in with the management curriculum for my training programme.”
Working in Management Consultancy at Deloitte, Azra found herself using the same skills she used as a doctor: intellection, systematic thinking, information processing to make decisions, organisation and many more.
“As a doctor you perform under pressure all the time. You work in teams, meet deadlines and tailor your language to suit a range of people every day. So if you go for a non-clinical job, don’t go in at a graduate entry level. Go for an ‘experienced hire‘ position, where you can develop new skills while being valued for the ones you already have.”
The cooperate world was a culture shock for Azra; her employers expected her to negotiate her working terms and salary, and for medics who often don’t even see their contract, let alone keep tabs on their income, this can be a struggle. She had to learn to be her own best advocate, and it paid off:
“At Deloitte I felt like I could innovate. I felt looked after and appreciated. The job was creative, challenging and rewarding.”
As the year went by, Azra realised that corporate culture was not for her, and moved on to the Cass Business School, where she’s currently researching the optimal ways in which to harness talent within the medical profession. She seems happy there, so I asked her why, after everything she’s been through, did she want to return to her anaesthetist role?
“When I left Medicine, I honestly thought I would never come back. But I think you have to decide whether it’s Medicine itself you don’t enjoy, or whether it’s the system. Taking time out helped me realise that, for me, it was the latter. I loved my clinical work, and it was great to work in a team of people who all have the same mission in mind: to help the patient.”
Aware that she might be a bit ‘rusty’ when she comes back, the Deanery will provide a return to work programme for Azra as part of her OOPE. She knows she’s going back to an NHS where the working conditions are getting worse, but she’s determined to be more conscious about how work affects her health. She’ll be going back part time so that she can continue to work with the Cass Business School, and feels that her new found skills outside of Medicine allow her to contribute in a way that wasn’t possible before.
“I feel empowered to go back on my own terms. I have no long term goal, but that doesn’t matter, as I now have more options. I passionately believe in the vision of the NHS, but I’ve got the reassurance that if it ever becomes unbearable again, I can walk away.”