Becoming a D-doctor

As some of you might know, I recently finished medical school, and in a few short days, I will be an actual, factual, working junior doctor. This is a journey I’m not sure I would have embarked upon if I hadn’t been diagnosed with Type 1 almost ten years back. There are loads of us out there – Type 1s who’ve ended up by some route or another becoming a doctor. And yet more who’ve trained as nurses, as dieticians, podiatrists, working as health-care assistants – we’re a caring bunch!

For anyone out there who’s starting to think about their future – whether that’s what A-Levels to do and what you might want to do at Uni, or if (like me) you’re bored of your current job, and thinking about medical school as an option, Twitter’s very own @DrBeth_ has written a guest post about what it’s like to be a doctor with diabetes.  If after reading this, you want to talk more about doctoring with diabetes or medical school, you can find Beth and me over on twitter – always up for a chat!

Would you like to share info on how diabetes affects your job? Let me know!

A few weekends ago, I was at an event for folk with diabetes. I knew some folk, others were new. A good friend called me over – “Hey, can you come speak to this girl? She’s planning to apply for medicine and wants to know what it’s like being a doctor with diabetes!”

I took a deep breath. I was standing next to a very close friend and previous flatmate who also has diabetes (and is not a doctor.) “BE NICE” she whispered loudly as she pulled a face at me, “She’s just starting out”

I spoke to two lovely girls with diabetes planning careers in medicine that day. They are kind, smart, eloquent people who I think will make fabulous doctors.

I did tell them it was hard, but they already know what living with diabetes is like. I also told them that it’s a different world out there now. I’m old (I’m 31). Tech has made a massive difference: pumps, flash glucose monitoring and CGMs and Twitter.

I’ve thought about our short chat a lot over the last few weeks. I’ve thought about what has been hard, and how to make things better. Here are my suggestions:

• If you want to apply for medicine, go for it. I love my job. That doesn’t mean it’s been a walk in the park in terms of health or anything else… but I do still love it.
• Talk to other people in a similar position – Twitter is actually fab for this.
• Be aware that you are starting med school with some different perspectives to those around you. It’s not their fault, but most 18yr olds don’t know what its like to live with a chronic illness, and they will finish med school and start being a doctor with relatively little additional insight. Most 18yr olds seem to kind of believe they are actually immortal. Learning about illness from that position is very different to learning about it when your body already doesn’t seem to be doing its job properly. Be kind to them, but be aware that some folk are going to make crappy comments. Their problem, not yours. Find us on twitter if you need to moan about it!
• If you can find a supportive doctor/clinic, do so. My biggest support last year (from a healthcare team point of view) when things were awful was actually my GP. I have had a few bad experiences of clinics. Doctors who say things to other doctors who are their patients that they would never say to “normal” patients because they are inappropriate or unkind are not working in a clinic you want to be in.  After some less-than-ideal interactions, when I moved clinic when I moved cities: the new one had a fab and caring consultant and nurse.
• For me, a DAFNE course and a pump helped a lot, especially with night shifts. I’m not saying these are right for everyone, I’m saying check out your options and ask for them. Don’t let anyone pass you over for a DAFNE course with “oh you are a med student/Dr, you prob know all that already” because anyone who says so does not know what it taught on DAFNE and how it is not at all taught at med school!
• A flash glucose monitor makes everything a little easier to fit round a busy day. It really does. They are expensive, I really hope they are available on the NHS soon…
• Look after your mental health, get help, seek advice. It is going to take a bunch of hits from your diabetes, your course, your sleep patterns, your stress levels. It’s ok to not be ok, but please get help from your uni/diabetes team/GP/friends.
• Ask for what you need.  And if you aren’t sure what you need, have a cup of tea and phone a friend to chat about what might work. I’ve not been good at this. Struggling on doesn’t make problems go away. I am eternally grateful to friends and colleagues who have helped me make decisions that fit what I want to do and help keep me well.
• I gave up nights about a year ago. I should have done it earlier. I didn’t because I didn’t want my diabetes telling me what to do. Some people manage nights and diabetes ok; I had to work really hard at it, and they were making me increasingly ill. It took me weeks to get over them, and my diabetes suffered. When this reached a point of not waking for hypos overnight, I finally gave them up. It was a hard decision. It was the right decision for me. Getting this balance is tough – my advice is to take time, think, seek advice from people you trust and weight that advice carefully.
• I’m going to finish with point 1: if you want to do this, go for it. Just remember the other stuff whilst you are at it, and shout if you need help. Other folk who are doctors have all sorts of other challenges that they begin to juggle with their careers… you know at least one of yours ahead of applying? That’s great. Though being a doctor is just one of hundreds of great careers – the most important thing is to find what’s right for you.
• ACTUALLY LASTLY: when you get to become a junior doctor, make sure the reg takes you out for breakfast on the last morning after a run of night shifts. And also remember that you learn lots on night shifts in FY1 and FY2: they are sometimes awful, sometimes grand, often interesting. And if the world feels like it is ending, you are probably just very, very tired and need some tea – unless you are hypo on top of that. In which case, treat the hypo before re-assessing how close the end of the world really is.

Beth is a Rheumatology Trainee, currently doing research in Manchester