Into my second year in the U.K.

Dear Readers.

Most of you who have read my blog entries over the last year are aware that although I entered this country a year ago as a middle-grade doctor, I have had to scale down myself to the level of a junior doctor and work the same duties as before with the intent of getting back to the level of middle grade with dedication and hard work. 

I am happy to share with you, therefore, that things are slowly but surely working to improve my abilities in the right direction. In the last review I had with my designated "educational supervisor", I was told that there has been a  noticeable improvement in my skills and some improvement in my communication skills as well, but that I have to still do more in that direction. Then, about a week or two later, I had a chat with the line manager, who assured me that the department had taken a stand that they would keep me on till I wished to leave. This message of permanence has really lifted up my spirits as I know now that my job is more or less secure at the Blackpool Victoria Hospital.

I continue to stay in the hospital quarters, but it does look like I might need to move out before the end of February next year. I am hoping to find alternative accommodation before my time runs out. 

I missed doing any locum duties in the month of October as I was on annual vacation. My family arrived from India to spend three weeks with me, and the last week of October got simply washed out with all the excitement and memories of my previous 20+ days. From November, however, I began to get locum jobs once again, and with the help of the earnings from there, my savings accounts are now slowly but surely getting augmented. 

More in subsequent posts. Keep visiting and reading my posts, and if you wish, share your thoughts and comments. Thank you.

A Year in the U.K. - My personal life

I landed at Manchester airport on the evening of the 14th of November last year. The time was around 3:30 in the afternoon, but it looked as if it was nearly dusk in Mumbai around the same evening! It was drizzling and dark. I caught a train from the Manchester airport railway station and reached Poulton-le-Fylde station at about half past five. Outside, it was dark and dreary. It was raining. I caught a cab without a metre, and was dropped outside the A&E of the Blackpool Victoria Hospital, with the driver charging me a whopping 14 pounds! 

From that day, when I was hit by the British winter in full force, until today, as I write this, I have certainly come a long way. I have had some really unique experiences, and am in a life that is quite different from the one I lived in my two previous lives - in India, and in Saudi Arabia. This post is about how my life has changed in the past year.

From the hot, dry deserts of Saudi Arabia to the pleasant monsoon climes of India and then to the temperate Atlantic-weather of Blackpool has all been overwhelming, really, Within a few days of my arrival, I experienced cold winds on the Promenade while doing my first shopping for essentials. The next three months were all new territory for me. In December, I attended my very first Christmas party organised by the nurses of the Paediatric department. It was - kind of - exciting to be able to be in the company of so many people, most of whom I didn't even know. And then, to be asked to join them all in a dance. And to partake of a Christmas meal with prawn cocktail, a drink, a fish entree and then a sinful chocolate dessert. Quite a lot of fun.

The days I have walked 10000 steps ... ahh, wasn't that amazing. I took part in the 5K challenge (running 5 km) on behalf of the Blue Skies Fund (the in-hospital registered charity) - with just 30-40 other participants on a cold, wet morning. And the days I went around Blackpool, exploring its roads, the Promenade, its restaurants, and its unique flavour. Those linger on as really good memories. 

Then there are my peregrinations in and around Stanley Park, the urban park that acts as a nature reserve in addition to being a recreation park in Blackpool. It has football grounds, a cricket ground, gymnasia, children's outdoor activities and a large water body with avifauna all around the year. It allows adults to fish in these waters for fresh-water fish. The park affords the bird-watcher with ample opportunities to observe birds all around the year. This includes the water birds, of course, but also so many tree species, some of which I saw for the first time in my life. I have, of course, tried to document all the birds that I could with my Canon DSLR.

I then joined the Royal Society for the Preservation of Birds and visited many bird parks and reserves around Blackpool. The most memorable one will be the Turbary Woods Birds of Prey and Owl sanctuary at Preston, but others also featured. 

My travels took me to the Peak District where I walked part of the famous Monsal trail, and to Cumbria and the Lake District, where I visited Windermere lake and town. I also saw a lot of Preston, Manchester, Liverpool, Buxton, Silverdale, Lancaster, and a few more towns near about me. My travel was limited, of course, by the fact that I own no car, and I get a few days of weekend leave to do my travelling. Be that as it may, I have travelled more in the last 1 year in the UK than I did in India over the previous 50+ years (I am, of course, talking of travel on foot, and only for leisure).

Next, on to my culinary adventures. Well, I have mostly persisted with Indian style cooking, but occasionally, I have tried English cooking, and it has nearly always turned into a less than satisfying experience. Eating out, on the other hand, has been very fulfilling. I have tried, for the first time in my life, authentic, low-price Greek, Italian, Jamaican and French food. And I have enjoyed every such encounter. The most memorable one for me will be eating at Nuncio in Blackpool, an Italian restaurant where they served me excellent seafood risotto. Another one to not forget would be the Greek food I had at Othello's in Blackpool.  Among Indian restaurants I visited, how can I not recall the food I had at Manchester at Chennai Dosa, or the one I had at Imli in Lytham? There are others too, but this blog post would run into several pages if I carried on.

Shopping is a treat in the U.K. There is something for every budget. There are numerous pound shops that deal in thousands of articles that sell for a pound. Then, there are mid-level places where you can find decent merchandise for a low price. You won't have to pay a king's ransom for shopping at such outlets. They include H & M, Primark, TK Maxx for clothes, Sainsbury's, Morrisons, Lidl, ASDA and others for groceries, Boots for Pharmacy, the thousands of corner shops run by Asian guys that sell recharges, newspapers, daily provisions and so on.

The major difficulty I have had is in terms of finding regular company when I am not working. This is the price you pay when you decide to work in a foreign country without your family and friends. I have made a lot of casual friends, and tens of Facebook friends, but when it comes to real friends with whom you can spend an evening over dinner or invite to your place to have fun, I have had just a few of them. One of them, a certain Michael Siong, was a gem of a person. I miss him, as he moved on from Blackpool, first, to London, and now, he is in Scotland. 

And that's about it for this post. Do let me know your opinions on how you found it. Comment, if you wish, in the space below. Share it with your friends if you wish, Thank you so much.

A Year in the U.K. Looking back on my professional life

I would be fooling myself if I said I am at the top of the world. Well, yes, I am in a much-coveted place, that is true. However, when it comes to defining where I am on a professional level, I must say that I have a way to go, indeed. The reason I am writing thus is that it has been a challenge for me to adjust to the way the NHS works and the way the British people communicate with each other. 

Of course, I have "improved", which means I am now doing things the way they should be done in the U.K. (which is not always the right way of doing things) and the process of unlearning what I previously knew about Pediatrics has been more than a little difficult. To make light of it, I am now practising "Paediatrics" and not Pediatrics. What this means is that the British method of healthcare is different not just in the spelling, but also in the details. I have often wondered how it is that medical care can vary so much in the details even though both systems of medicine across the Atlantic rely on much the same sources of knowledge and the same sources of research. Then I realised the difference lies in the basic way of approaching illness. Whereas the American system of medicine relies heavily on acute care, the British method is all about hanging in while the patient roughs it out through the ups and downs of his/her illness. Also, the NHS is a government-facilitated system where the citizen pays nothing. Hence, a cash crunch causes a very difficult problem of not being able to deliver healthcare where it is needed most. On the other hand, the American system is mostly based on private enterprise. 

But beyond all this, at the root of it all, is the way the healthcare is tailored in consonance with the wishes of the patient. In this most important respect, the NHS is completely different from medical care anywhere else I have worked. The patient has the right to agree to, disagree with, question, and critique any care they may be receiving or be about to receive. They can, if they are mentally competent, reject treatment of any kind, no matter how strong the evidence for the use of that modality of treatment may be. The only exception is when the patient has lost their mental faculties or where a certain treatment is life-saving. This act of "putting the patient first" and keeping them in the "centre" of care makes the NHS so different. A woman may not want to breastfeed her baby even if she has a lot of milk coming in, and that is her right. In the same way, if a patient chooses not to have chemo for his malignancy, that is his right. The fear of medico-legal issues is very strong too, so if you as a healthcare giver goes against the patient's wishes, you can be penalised or even prosecuted. 

On a more personal level, how has it been for me. It has been a year of mixed fortunes, but I am, as I said previously, slowly inching towards professional competence. I still have some issues that need sorting out, but I am hopeful I will be able to cross those hurdles over the next several months. At some point, I should be able to return to my middle-grade level. I am hoping this does not take more than six months more, or else, it will be difficult to sustain myself at a junior level. It will also make future promotions and move to any other country that much more difficult. So, let's see how that goes. 

And that's it for this post. Do share your views and comments if you wish. Thank you for reading this and for your encouragement that I will constantly need. 

Back on the job, and advent of winter

It has been over a fortnight now since my family vacation ended. And yet, it seems as if it was only yesterday! What a time I had. We had never taken such a long vacation and it was definitely worth it. And the funny part is that we never realised how time flew. We saw over 15 different places, and some of them were unplanned route diversions where we saw and did amazing things. Above all, this hugely enjoyable vacation did not even cost a big amount of money. I must have spent about 6500 GBP in all, a very reasonable sum indeed. 

And now, it's back to work. The autumnal fall of leaves is now done with, and trees are almost barren. There is a cold nip in the air, the more so in the past few days. In fact, it has rained quite a bit in the past 48 hours or so. Darkness descends upon the firmament as early as, say, 5 o'clock in the evening. When you wake up in the morning, you just don't feel like shrugging off the duvet and rising and shining! What keeps you going, though, is the awareness that if you don't wake up and start soon, you will most likely be late to reach your place of work. This can be a tricky situation, especially if your bosses are aware that you pretty much stay on the hospital campus - and are still late, even if by a few minutes. 

It has been a busy week or two, with the Paediatric ward filling up with infants and children experiencing breathing problems right, left and centre. The best thing that happened to me was that I was placed as the only junior doctor looking after the neonates in the special care newborn unit. Of course, there was a consultant who took the rounds with me, but on a couple of days, no consultant was available, and I took the entire round by myself. On that particular day, I felt as if I had stepped up a bit. I continued doing the neonatal rounds until the end of the week, which was earlier today. 

And that is how it goes. I will probably not be gainfully employed over the weekend, but, as they say, tomorrow is another day. 

Brief note on my last month - vacation and fun with family in the U.K.

My family arrived to spend three weeks with me in the UK on the 30th of September. We had a great time travelling across thousands of miles of England, visiting over 10 destinations. We even saw a bit of Scotland. It was three weeks well spent. I returned to my duty on the 18th, but my family stayed with me in Blackpool for a further two days, enjoying the local attractions and going on a spree of shopping. When I finally left them at Manchester airport on the morning of the 21st, it was a bitter-sweet parting. My return to work had already effected a few days earlier, but on those last two days, my heart had been with my dear wife and daughters. When I returned to work on the 21st, I plunged myself again into my work, and it has been over a week now. 

Where did we go? We visited Bath, Oxford, Stonehenge, Castle Comb, London, Cambridge, York, Durham, Edinburgh, Ambleside, Windermere and finally, Blackpool. We also made day trips to Liverpool and my family went to Manchester as well. We also visited Preston to see the Birds of Prey Sanctuary at Turbary Woods and Hadrian's Wall and the Roman Vindalonda Village while we were en route to Edinburgh. Finally, we did a day-long bus trip to the Scottish Highlands to reach the southern end of Loch Ness. A really fantastic schedule - and it all went off without any major hitch. 

There were a few minor issues, though. At Bath, while checking out, I fell down a flight of steps, my large bag following me down the steps and staying just short of landing atop my head. My back took a beating, though, and even as I write this, I still get the odd jolt of pain down the spine. The other setback was that I had a minor scratch on a rented car ... and had to pay some damages to the rental company. Other than these two incidents, a great time was had by us all. 

To read more about this phenomenal trip, do await the link backs from my travel blog. Thank you for your patience. 

To see a few snapshots from the long vacation, do visit this link.

Learning and Teaching - two sides of the same coin

There is a student inside all of us. And a teacher as well. Everything that we see is a form of learning. Everything that we do is a form of teaching, provided there is someone who is with you at that moment. For me, the presence of anyone who is receptive enough is stimulus to want to teach. Conversely, if I think I need to learn something, I would explore whatever is happening around me to seek the best and imbibe the information.

Guys, you all know me. I am always curious to learn. My chief go-to sites are www.coursera.org and www.edx.org. They conduct several MOOCs - (Massive Open Online Courses) in all areas of teaching and from universities from all over the world. Joining and auditing the entire course is, of course, free. The courses run for about 5-10 weeks. It consists of mandatory stuff  like taking a pre-course survey, attempting the end-of-the-week writing assignments or quizzes, watching all the video lectures, etc. The amount of time you need to do the "homework" is about 4-7 hours/week. If you want to collect an authentic certificate of having done the course, you might need to send a payment using your credit or debit card etc. These payments are really not large. For example, in the UK, it works out to around 40-60 pounds for the "Verified Certificate".

So, which courses am I currently doing? On Coursera, I am doing a course on Astronomy. On FreeLearn, I am currently doing a Patient Safety and Quality course from the University of Bath. And, finally, from the  edx site, I am enrolled on the "Humanitarian Response to Conflict and Disaster" - a close look at the global problem of providing effective humanitarian aid to those at the forefront of a war that they did not bring upon themselves. 

Three courses simultaneously, did you ask? The answer to this is YES. It does get a bit busy sometimes, but I am coping with it all. And really enjoying myself. 

Which brings me to the second side of the coin of education, i.e, teaching. As I am not a trainee, I do not do formal training. However, I do a lot of informal teaching. I taught a pair of IIIrd year medical students today itself. It was a bedside teaching on lumbar puncture in neonates. When you teach, you get the immense satisfaction of sharing your knowledge with others. It almost feels like you are donating to someone else. A sort of charity, if you may call it that. But it's more than that. When you teach, you also learn. And this line is for those who teach. You revise your knowledge, of course, but you are also forced to check your knowledge in real time. By doing this, you become an even better teacher than what you had been before.

Tell me your own experience as a teacher and as a student. Thank you for reading this installment.

My first drive in the UK

It was something I had to do in preparation for my family's upcoming visit to the UK next weekend. I already had an International Driving Permit. Now, all I had to do was to rent out a car. The previous week, I had gone to the one and only car rental agency located in the town - Enterprise Rent A Car - but I was refused a car as they did not have a car to spare. Hence, I booked a car online on last Wednesday, and I picked it up as per the online booking on Saturday morning at around half past nine. 

It was an Opel (Vauxhall in the UK) Corsa with manual transmission, but this is where its simplicity ends. It was a 3-door hatchback, with one door on the trunk and two side doors. It was in excellent condition. I attached a satnav from Garmin on to its front glass and drove it initially to the hospital and to my home, and then, all the way via Motorway to North Manchester, where I had to go to do a locum shift for one afternoon. 

The car performed very well. I reached my destination in about an hour and a half, and this included a few stops - once for petrol and once for a few purchases from a convenience store. My duty shift ran from 16:00 hours until 23:00 hours. My return to Blackpool was from 23:15 hours until 00:40 hours. I reached my home safely, and without any major difficulties. 

The entire journey and the two extra days that I kept the car with me (from Saturday morning until Monday evening) cost me about 80 quid. But at the end of it, I am confident I can drive anywhere in the UK with, or without family.