Personal Views: I just wanted to be a doctor
Authors: Tara Hunt
Journal: BMJ (2006)

When I decided at the ripe old age of 26 that I had had enough of waitressing, bar jobs, doing arts degrees just because they sounded fun, and teaching English as a foreign language, I thought maybe I was finally ready to make a proper career choice. Maybe, just maybe, the time had come to put away childish things. I went for coffee with a friend. She asked one pertinent question. What would you do if you could do anything you liked? Regardless of time, money, peer pressure, parental pressure, qualifications, intellectual, or physical capacity... what would you do if you could do anything? I pondered for quite some time. There were so many things I wanted to encompass. I wanted to do something good. Something that was worth doing. Something that was interesting. A good laugh. Something that gave me a sense of self respect. Something that made me want to get out of bed at some ungodly hour. Something that my mum would be proud of. I mean, it's such a big part of your life, your job, isn't it?

“A doctor,” I said. “If I could be anything I'd be a doctor.”

And that was that. It had only taken me 26 years. But there it was. I didn't know it to be true until that moment. But now it was out there. Great. Decision made.


When did my job become about making sure the trust could insure itself?


So I set about becoming a doctor. I gave up my job as a teacher. I went back to school (my arts degree counted for little, I discovered). I got a couple more A levels and I got into medical school.

It was everything I dreamt it would be. There was actually something to this subject, medicine. It was interesting, and hard (although not as hard as those A levels) and I was proud to be a part of it. It was to a good end. I made some good friends. And I can't deny I had a few beers and a few laughs along the way. It was worth every penny of the best part of the £40 000 (€58 500; $74 500) it cost. And I would do it all again given half a chance.

I graduated and started work in Westonsuper-Mare. The blur of house jobs passed me by in a haze of suddenly having two pennies to rub together, and not having two minutes to spend them in. I started work in accident and emergency. And I felt like a doctor. A real live one. It was great. I still had huge amounts to learn but occasionally I could see, treat, and discharge a patient all on my own. Sometimes I would actually know what was wrong with them. And sometimes I could do it well. My mum was proud. And so was I for that matter. Proud to be a part of an enthusiastic, well meant profession.

But it struck me today that I am not always proud these days. Maybe it is that end of job feeling that you haven't audited the thing you positively promised you would audit at the beginning. But I have this sense of unease. When did it all become about getting published, about audits and research, points on your curriculum vitae, and ticking the right boxes? In one appraisal I was told it was for the trust, it was just so it could get insurance. A trust cannot insure itself if it is not seen to be appraising us. When did my job become about making sure the trust could insure itself? I thought I was a doctor.

Now don't get me wrong. On any given day I can see the rational argument for auditing, and I think clinical research is of ultimate importance for the betterment of medicine. But I wasn't taught (nor did I sign up for) audit at medical school—I was taught auditory hallucinations. I didn't attend lectures on cluster allocation—I attended them on cluster headaches. I don't know how to do sequential analysis of data, but I'm getting quite good at sequentially taking a history and examining a patient. Maybe I'm naive, but doesn't the audit department like doing audits? Aren't people who are genuinely researching something busy in a lab somewhere researching? Why would anyone want me to do it? Shouldn't I be busy updating myself on published best practice rather than trying my best to get published?

As I sit here writing this (instead of the case report that I am supposed to be writing) it crosses my mind that perhaps this is not a particularly good career move and that it will be something of a handicap at future interviews. I can imagine the questions now “... so Dr Hunt, you're averse to the idea of scientific research, are you? You don't value the benefits of self appraisal either? And closing the audit loop's not a favourite then? Hmm... interesting.” But it is not that at all. It is just that sometimes I have an overwhelming need to be honest about it all and say, but I just wanted to be a doctor. What happened?