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Friendship, Regret and Finding Your Place in Vet Med with Jenny · Under The Fur

• speaker-0: In this week's episode of Under the Fur, I am so excited to say that I have managed to get my best friend back over from Australia just to come and join me for today's podcast. Jenny is with us today and I'm super, super excited. Eight years ago, I dropped her off at Heathrow to do a couple of years in Australia and she never came back. I have not forgiven her obviously, but I still love her. And thank you so much for joining me finally. As Auntie Jenny to my children, bestie to me. ⁓ I would really like to share your story about how you become the absolute kick ass internal medicine specialist. speaker-1: ⁓ speaker-0: that you are today. Can you tell I'm proud of her? I'm so proud of you. always am. But let's go from where we met in... speaker-1: Feels like a lifetime ago, So fresh this week. speaker-0: Yeah, Fresh is weak. think we literally... speaker-1: Like, day one. Bonded. speaker-0: bonded and were like basically inseparable from then on. ⁓ Which is really good because yes, like with all the fancy people. speaker-1: Who awkward ones feeling? What is happening right now? speaker-0: Yeah. think that's probably what solidified our bond, wasn't it? Cause I know for me it was such a culture shock and for you the same thing. then, yeah, yeah, exactly. So we just kind of like clung to each other. speaker-1: like looking back, you were so young. And we were so different, it's mad. speaker-0: Yeah, really different tastes. Like we'd had different tastes in music and like what we like to do. I was really sporty. You were more like arty, I would say. ⁓ But then again, also the same person. speaker-1: Copy paste different font. speaker-0: And then I always ask people, because it's always asked of me, why did you want to be a vet? speaker-1: ⁓ that question. comes up so much, doesn't it? All the time. All the time. Yeah. I don't know that I did. think I was good at science at school and going to vet school was a vocational course that meant I had a job at the end of it. So it was more like, what else do I do? I liked animals. Obviously we all love animals, but it wasn't this like lifelong dream. I didn't want to be a vet when I was a kid. My youngest. When I was really young, I wanted to be a tree. be a poet. ⁓ speaker-0: Wait, wait, wait, I need a minute. You wanted to be a stream. I'm going to get your mum on this podcast. speaker-1: Yeah, I was young. I I wanted to be a tree. Then I wanted to be a poet. Then I wanted to be an aeronautical engineer. But when I wanted to be an astronaut, I was too claustrophobic to go in the spaceship. So I wanted to be an aeronautical engineer and build spaceships. But these were all like, I didn't really think them through. They were never very serious. The actual concept of doing physics and maths, like to be an aeronautical engineer hadn't crossed my mind. speaker-0: Okay speaker-1: I just liked the idea of it. Hated maths, so obviously that went out the window pretty quickly. But I was good at science. My mom was a science teacher. ⁓ So, I don't know, I was like 14, 15. The idea of being a vet was floated and it was just, I just ran with it because I didn't have another idea of what to do when I went to uni. I was going to go to uni and at least that was not just a degree in something random. So I went to Cambridge, culture shock. Obviously didn't cope very well with that as a lot of us that went to Cambridge struggled. Yeah. Didn't end up carrying on with vet school. Got my degree in the random subject of natural sciences. not what I was intending to do, but it let me have a bit of a breather, finish my degree there, got the master's version of Cambridge stuff. Free masters. speaker-0: Our free masters. speaker-1: ⁓ And then took a year to figure out what I was doing and decided that vet school did seem to make sense. So having sorted out myself a little bit and feeling more prepared for a bit more study, then I went to Edinburgh. Did my vet degree eventually, actually graduated as a vet. speaker-0: So how many years is this now? speaker-1: So three years at Cambridge. Like you've, I think you've probably said before on the podcast, the vet degree at Cambridge is three years of preclinical work and then you get a degree and then three years of the actual clinical vet school. So that's the last three years I didn't do, but I did the first three years and got an honest degree in biological and natural sciences. And then at Edinburgh, I did another four years of vet school there because having got a science degree, I could skip a year. So I finished there. Then I did... I went into practice, yes, I went into practice three and a half years in general practice in the north of England. speaker-0: think I remember visiting you somewhere around near Blackpool. speaker-1: Yeah. Yeah. It was nice. We lived on the coast. was lovely. Yeah. And I was, I was lucky with my first job. Like it worked for me and I quite enjoyed it, but I got really frustrated in general practice. always had an interest in medicine, I guess. I actually thought for a while I was going to do oncology, but I speaker-0: For the eternal optimists. speaker-1: Well, I realized I wasn't probably emotionally stable enough to deal with everything that's always going to die, at least in medicine, some of them recover. But in oncology, they're often sicker. Now I'm like, I sort of changed my mind about that, I think, because if you know that they've got something terminal, anything that you do that gives them good quality of life or time, you're winning. Whereas with medicine, they should be fixable. So when you can't fix them, it's almost worse. speaker-0: It's just for the optimists. Yeah, upsetting. speaker-1: ⁓ Anyway, went and did an internship in down near London after three years or whatever, and then got a residency there. So then I did my residency. That was at Dick White's. So I did my internship. I actually left at the end of my internship and went back into general practice because I'd applied for a couple of university residencies and not got them. And I was feeling a bit demoralized ⁓ and the residency at Dick White's came up, it was like it started. speaker-0: And that was at Dick White's. speaker-1: two months after my internship finished. They didn't line up the dates, which was weird and kind of silly in hindsight. So I went back into general practice and got offered the residency about a week after I started a permanent job in practice and had to resign again, which was really awkward. speaker-0: I don't know why I'm acting surprised. I was actually here for all of this. I just have a really terrible memory. speaker-1: Yeah, yeah, yeah, yeah. So I went back to Dick White's, did my residency, finished that in 2018, sat boards, managed it, moved to Australia. Got the hell out. speaker-0: Not angry about you going there at all. So happy for you. speaker-1: Well I moved on a one-year contract. Yes. But with no real plans after that thinking I'd do a year in Perth and then maybe go to the East Coast or go to Singapore or Hong Kong and travel and then I extended my contract after the first year for another year or two and then all the borders closed so I got stuck there for a couple years long. speaker-0: and you couldn't come to my elopement. Which I guess is the point of an elopement when I eloped. I'm not supposed to have people with me, but I did ask if you would come. speaker-1: and I couldn't come to. And it's probably one of the things I regret. It is the thing I regret the most about moving to Australia. ⁓ speaker-0: or you felt very far away. speaker-1: Very far away. Yeah, that was hard. speaker-0: Yeah. All right. So I'm going to rewind a little bit to Cambridge because I just remembered this really funny story. So part of the reason that we both really struggled in our first year. Do you remember? mean, partly just because we weren't ready for university. had no idea what was coming for us, how hard you have to work, where the boundaries are. Me and you partied so hard. Do you remember that the cleaner reported me for having a boyfriend because they're like that Cambridge and they report you for stuff. And was actually just that you slept over in my room every night. she's like, ⁓ Vanessa's always got someone over. That's probably why she's failing. And I was failing. But the one I remember just now was the histology class. speaker-1: It's always me. with the water bottles. speaker-0: The one we got banned from. got banned. I don't even remember what we did. Do you remember? Just being us? So I think my memory vaguely is that we were just laughing. All I remember is laughing a lot. Like we might, may or may not have been throwing stuff around, but we were definitely rowdy and ⁓ we got kicked out. Yes. Now we didn't realize we were like actually kicked out. We thought we'd just left the room. So off we went to get our iced buns from Greg's and like enjoy our day. But it turned out we were then banned from the class and we had to... No, we were so bad. This poor lady that had to deal with us. And then we had to write the apology letter. Do you remember that? So we had to write an apology letter to this lady that we had upset. speaker-1: Yes, we were. speaker-0: I had so forgotten to let us back speaker-1: It was anatomy. speaker-0: I mean, it's all the same to me at this point. we had to beg to be let back into the class. So that's the other part. So we both failed badly at anatomy. Yeah. That's I shouldn't admit that as a surgeon. Yeah. We didn't go to the classes. We were busy with life. speaker-1: It's the virgin, it's not the same thing. Because we didn't go. speaker-0: ⁓ And then we did the resets ⁓ and I think I was fortunate to pass them and you didn't. And then hats off to you. I think I would have ran away at that point and you were like, do you know what? No, I'm going to make something of my time here. And you finished your degree. But what do you think? Like you're such an intelligent person. You're very quick. You're very smart. ⁓ Why do you think that is? Why did that happen to you? speaker-1: So I actually failed two, I failed anatomy and physiology. ⁓ God damn. the first year and I had to resit both mostly because I'd either skipped too many lectures and I just didn't have the information. Yes. Cause I was like, partly partying a lot, but also struggling quite a lot with my mental health at the time. And then physiology resit, I mean, we didn't have long before the resits. We had a month or so to learn like a year's worth of material. Yeah. But the physiology resit, I think I got 98 % in the reset because I actually turned up for the exam. The exam the first time for physiology, I'd left after about half an hour because I had a bit of a panic attack. So that's why I'd failed that one. And the second time around, because physiology to me is so intuitive. It's knowledge that you need, quite basic knowledge, and then you can work most of the rest out. You don't have to learn it properly. My brain works for that. So that was easy. Yeah. a reset. Anatomy is literally learning Latin names one after another after another. Yeah. Which to me, like you could, there isn't a shortcut. You can't work it out in an exam. you haven't learned, if you've learned basic principles with physiology, you can just figure it out. Yes. With anatomy, you can't do that. You have, you either know it or you don't. And I just didn't have the time to go through the material. I had to learn literally a year's worth of stuff for that's reset. And I also, I hadn't improved in terms of my life. You know, like the difference between sitting the exams the first time and the second time, I didn't have any additional mental health support or anything as to why it had gone so wrong the first time around. So expecting it to be different a month later was kind of like in hindsight, it was never going to happen. ⁓ So yeah, anatomy didn't work out for me. But it was very much, I'd gone straight from school. hadn't taken any time out. I just wasn't ready to be at uni at that point. I just needed some breathing space. And like you said, like I finished the next couple of years, I got a degree from Cambridge. Like, I'm pretty proud of that. speaker-0: It's funny you say that, but the Latin, I remember the first time we went to the, I think it was the very first anatomy class and I actually left crying and was about to leave Cambridge. Like I was packing my crap and I was getting out of there. And there was a lovely tech guy that worked there that came and found me and he just grabbed me and he's like, are you this unhappy? And I was like, yeah. And he's like, okay, if you are, you can leave, but also don't let them beat you. Like he saw it. And the reason on this particular one was, well, the professors were not particularly nice to me. Maybe partly because of my behavior, obviously, and being a bit rowdy. So I understand it's from both ways, but they had said to me, the first class, go around and translate all of the Latin words into English. Now, cool. If you go to one of them fancy schools where they teach you Latin, happy days, knock yourself out. And I'm just staring like, what? What Latin? the hell? First of I was like, what is Latin? They certainly don't teach that in South Wales. speaker-1: And I think I'd coped at school because my thought processes are quite quick. Like a lot of the time, I don't necessarily need to learn every single bit of information. I can figure it out on the spot because my brain works in that way. Your brain is really rapid. I can figure it out, but you can't figure out anatomy. Like if you don't know the name of a muscle, you don't know the name of the muscle. There's no shortcuts. And I hadn't learned how to study that way at that point. And I have since, obviously. I've gone back to vet school and I've passed the exams and done fine. ⁓ but at the time when I was 17, no, wasn't coping. was very young when I went to uni. Yeah. Not prepared at all. speaker-0: and not prepared at all. So compared to Cambridge, ⁓ then how was your experience at Edinburgh? speaker-1: Better, I was better. I'd figured myself out a bit more. I had learnt just how to be. I knew a little bit about who I was as a person. So I sort of, I settled better. The people that I was with, because I did it as a graduate, there were a whole group of us that all started having done a first degree. So we were all in a similar situation where we'd done some kind of vaguely scientific relevant degree first, and all of us were a little bit older. So we were all in our mid twenties or older than that. And so I think it was easier to find my tribe a little bit. I made, I was going to say I made better friends than I did at Cambridge. I haven't made a better friend than You are the only one. speaker-0: In the heart speaker-1: I made more friends than I made at Cambridge. ⁓ And they were also more stable because most of my friends that I had at Cambridge were also struggling a lot. And I haven't kept in touch with them and some of them didn't finish degrees. it was very, it just wasn't a healthy time. Whereas at Edinburgh, I was a little bit more together and I really enjoyed it. I learned, like at Cambridge, think I'd got quite demoralized. Failing an exam was never, I had never failed anything before I got to Cambridge. I had breeze through straight A's all the way through school. I didn't know what it felt like. No, no, not at all. And it was, I found it really hard. found Cambridge just, it just wasn't for me. Edinburgh was much more what I expected university to be. So I enjoyed it. I embraced it a bit. I worked like several jobs. I had three jobs through uni. But I, I enjoyed it more. And the city is amazing. Like Edinburgh is so fun. speaker-0: learn to deal with that kind I used to come up on the train to you all the time. speaker-1: was such a fun place to live. So yeah, I did enjoy that. And I realized that I wasn't that bad at being a vet student. I could do it. So it was almost a bit healing to go back to vet school and then pass. And I didn't have to reset anything at Edinburgh. ⁓ no, I did. We had an exam on how to wash your hands. speaker-0: Which is actual exam. speaker-1: An actual exam on hand washing. And I thought, I don't need to study for that, but it's very specific as to how you wash your hands. When you're going into surgery. I don't know what guidelines. Obviously I didn't read them. So I did have to reset how to wash your hands, which was a 10 minute practical exam where you literally go in, you wash your hands in front of somebody and you leave again. And I had to do that one again. But that was entirely on me because I did not take it seriously because I would. speaker-0: the whole guidelines. So the one I had to reset, and you might remember this because you were still at Cambridge at that time, was the statistic. And I remember I failed it three times and then I had to write another letter. They love letters at Cambridge. I had to write a letter asking for special permission to reset it again. And then suddenly ⁓ my tutor was like, Vanessa, why are you failing these? speaker-1: Yes. speaker-0: module, the most basic things. And I was like, well, see, ⁓ the thing is that, ⁓ the classes are on Wednesday afternoons and she's like, right. You haven't been to a single lecture of yours. I was like, And then she goes, have you read the notes? And I was like, ⁓ so no. I just like, it took me three times to realize I couldn't wing that. Yeah. speaker-1: Bye! Sometimes you just have to actually know the answer. speaker-0: And then I had this lovely lady that just taught me in the evenings how to do it and I was like, ⁓ is that it? I can do that. And then they finally passed it. But they said to me, if you don't pass it, you can't stay on the vet course. speaker-1: That's what happened with me with anatomy. Yeah speaker-0: you have to pass it. And then I was like, but I failed at the maximum number of times. Oopsie. then, cause it was such a small thing. was literally, what was it? 10 lectures max. ⁓ they were like, okay, we're not going to kick you off for this. speaker-1: These were so... What are we like? speaker-0: Yeah, apparently we don't learn a lesson. That's what we like. And then, so I remember that residency was hard for you. Yes. I think it's hard for a lot of people, but you struggled. Maybe you can talk to us a little bit about like your mental health issues. speaker-1: Yeah, think going from Edinburgh, like going from general practice where I'd done a certificate, I was enjoying myself, I'd like worked, I had sole charge of a couple of different branch clinics in a bigger kind of ⁓ organization. And I was kind of doing relatively well within two or three years of coming out of vet school. And I felt like I was already like getting frustrated with not being able to do more in clinics. We didn't have, I think it's different now, but this was 10 years ago. longer. When did we graduate? we're where? Graduated like 16 years ago. Okay. And we didn't have in general practice, there wasn't like the facilities of having endoscopies and you know, anything that needed further work up beyond the basics had to be referred basically. And I got frustrated at not being able to do good medicine workups in patients. Every time something got interesting, I had to ship it off to a hospital. So I decided to do an internship, which was the first step of getting a residency. That speaker-0: I think we're like speaker-1: was a decision that was at the time felt quite selfish in some ways. Like it caused a relationship breakdown because I moved away from where I was living with my partner at the time down to London, but not in London where they wanted to be outside of London. So we couldn't live together. The relationship broke down towards the end of my internship. So then when I got the residency, it was a bit bittersweet because that I was sort of starting after a bit of a... hard time. And I was so excited to have a residency. it's such a big deal to get. It's so hard. There's so few programs to get a residency is like, you feel like you've made it. If you want to be a specialist, getting onto a residency program is like, that's the last step. It's such a big deal to get it. You go through so many applications. I think I applied to seven in total. And you just, it's so rare to get one the first time you apply that I thought I didn't get demoralized the first couple of times, but you can't help but get demoralized as you keep getting rejections. And I got interviews at everything I applied for and then I wasn't getting them and I was getting like, and the feedback was like, there's just too many good applicants. There's nothing more you can do, which is just really frustrating then. You're like, well, yeah. But when I started my residency, I was like, this is amazing. I'm in this like world-class hospital. speaker-0: What do I do? speaker-1: It's such an opportunity. I've made it. I just have to finish three years and I'm a specialist. Yes. And the first kind of six months or so is you start very enthusiastic and then the first six months is basically realizing how little you know. I thought I was a really good vet. I'd done certificates. So was, you know, I felt like I was great. was, people would refer stuff to me as a GP. And I got there and I realized how much more there is. And that felt so daunting and so terrifying. So after about six months, it just feels like an uphill battle. You're only six months in, you've got two and a half years to go and you feel like you know absolutely nothing. It's so hard to manage that emotion. And then at the same time, your caseload is crazy and your on-call is beyond a joke. So you're completely sleep deprived, completely exhausted. And depending on the program, there's not always a lot of support because everybody else is just as exhausted. The rosters that we had, rotors, whatever they thought in England, were demanding. So we would do a one in four on call from a Monday to Monday. So every fourth week I would start on call at eight o'clock on a Monday morning. speaker-0: you speaker-1: And I would be on call until eight o'clock the following Monday. And we didn't have an emergency service at our hospital. So medicine basically was the triage service for the entire hospital. Bearing in mind, this is the biggest private hospital in Europe. So you were based on ECC? No, there is now it's changed a lot since, but at the time I didn't go home. Yeah. I lived half an hour away from the hospital and an hour round trip wasn't worth driving because I often only had a couple of hours off between finishing overnight and starting my shift again the next day. Because during the days. speaker-0: There was no. speaker-1: we were working on normal hours. So I was emotionally exhausted and physically exhausted. And it was a bit of a perfect storm. So I think I handed my resignation in twice in my first year. And they just gave it back to me. But I had a little stationery cupboard that was ⁓ next to the admin office, which people rarely use. So that was my cry spot. So when I felt overwhelmed, I'd just go and have a bit of a tear, pull myself together and go back to work. speaker-0: That's too hard, it shouldn't be like this. speaker-1: It was so much. was so much. I think, no, it shouldn't be like this. It shouldn't be like this, but it was for some reason it had got to this point where that was just the normal. To be a specialist, you had to go through this like rite of passage of trying to push you to your limits. I had done, when I was at Edinburgh uni, I was in the reserve army. Yes, I remember. So the training for that, I went through officer training and I did a fair bit in terms of like sleep deprivation and training to go through Santers to be a commissioned officer. And I think that sort of helped a little bit in terms of having a bit of resilience, it doesn't matter how resilient you are. If you're pushed emotionally when you're already exhausted, it is so hard. yeah, and I am a person that is a bit of a tendency to be quite morose. Yeah. So speaker-0: Well, how did that affect you? Did it affect you long term? Is it just... speaker-1: I no, long term. speaker-0: Now, what were you feeling? speaker-1: Yeah. I think a sense of... ⁓ not, I think I always have a tendency to feel like I'm not good enough. And I think a lot of us in our profession are perfectionists. want to be able to be the best we can be. We want to do the best we can. Very hard. ⁓ And when I think I really struggled with the emotional load of speaker-0: Pick failure very hard. speaker-1: taking other people's emotions and the compassion that you have for both animals and their owners, caregivers, whatever you want to call them. The emotions that those people have. I don't think I had any concept when I left general practice and went to do a residency that when you work in specialist work, you're their last hope. When you're a GP, you can always offer something more. You can offer them referral, whether or not they can take it, then the onus is on them. When they come to see a specialist, they've tried everything else already. And if you can't do something, you have to be the one that says we've run out of options. And that is, for me, I find that really hard emotionally. ⁓ So there were so many aspects to why a residency was so difficult. Like the sleep deprivation, the caseload, the panic, the overwhelm, complete overwhelm, but also that aspect of suddenly not having a backup. ⁓ Like when you get your third year of your residency, the supervision that you have obviously becomes less and less. Like they're training you to be able to stand on your own two feet as a specialist. And when you work in a really busy hospital, that supervision also isn't always as good as it sometimes could be. speaker-0: It's just like, mean, I see it sometimes with the new grads that I've got. I want to give them a lot, actually when they're busy, I don't have time to teach them and it's not fair to them. speaker-1: And when you start a residency and you've got this case that comes in, by default they're complicated. We don't see first opinion cases in specialist hospital. So all of them have come in that have already seen at least one vet that doesn't know what to do next or can't do what is needed, like facilities wise. So they're not immediately simple cases. And that first six months of the residency where you suddenly realize how much you don't know also gives you a really... ⁓ Like it makes you really insecure because you suddenly feel like you don't know anything. And even basic cases then feel really overwhelming and really hard because you don't know what you're missing. You realize how much you didn't know and what you could have been missing when you were in GP. And then suddenly you have to know it all every time you see a Yeah. That is, ⁓ my God. Like panic inducing. Yeah. And then at the same time, you're also studying for exams. You have to publish papers. You have to present at conferences. So I was traveling internationally to present my research at a conference in the States, in Holland, because you have to as part of the program. And that's also absolutely bloody terrifying. speaker-0: But did you feel, did you not feel like super proud of yourself when you were doing that? After, after, okay. speaker-1: But I think in the moment, it's just overwhelming. It's so overwhelming. speaker-0: I remember when we first started university actually presenting for the first time and it was not something I'd ever done before or had any training in. And it was awful. And I'm actually a really confident person and I just thought this is horrendous. ⁓ And then I then stopped. I refused to do it until a few years ago. I started now talking at conferences and things. ⁓ speaker-1: I enjoy it now. I love sharing and educating and I love that. I love having my own residence now and having interns and being able to go and speak at, you know, doing webinars or speaking at conferences or whatever. I love it. But when you are feeling insecure about your depth of knowledge of a subject and you have to present on it, that's entirely different, especially when you're being judged on it. You you go... and present an abstract at a conference of your research, you know it's going to get picked apart. You know that there's going to be people there who are absolute experts in their field and have been for 30 years. They're going to be in the audience. And when you're a resident still, you don't have that experience and confidence in your knowledge base. speaker-0: Do they then speak up and interrogate you? Yeah. ⁓ they do. speaker-1: Yeah, there's time for questions at the end of everything. Beyond terrifying. Yeah. So it's like grin and bear it. So there was just, there's a lot behind the scenes, like the thought of taking exams when you're on clinics in that way is just like, just exhausted. speaker-0: How was that? I've long thought, and I think a lot of people will actually disagree with me that our specialist gatekeep knowledge. I don't believe that to be the case with you. meet my vets, even though we're on completely different time zones. You meet my vets every Monday and give them an hour of your time to help them through medical cases. But I do feel there's a bit of gatekeeping of knowledge. And particularly when it comes to wanting to be a specialist, ⁓ So you know, and I know that I went for residency and went, hell no, that's not for me. And went back to general practice. Forged my own path and the way that I wanted to do it. But I don't know if I told you, asked, so I've personally got to a level in general practice where I'm sort of at the top of where I can be and there's no one to teach me because I can go to... speaker-1: isn't so demanding. speaker-0: training sessions, but they're very much aimed at people less experienced or newer, newly qualified, not at my level. So it's hard to get that next level of CPD of training. And I approached quite a few specialist centers and I said to them, can I do ⁓ like a residency, but part-time and for free don't pay me. I don't want to be paid. I want to come two times a week. and I'll do whatever you need to be done. I'll do the research, whatever. Obviously I'll take longer to pass it. But financially I couldn't come and do the residency because I now have my own clinic and every single person said, no, they wouldn't even consider it. Wouldn't even consider it. And I think it's so outdated the way that they do it. We have a shortage of specialists. I think more specialists can only be amazing in the veterinary industry. Clients want more and more from us. They want specialism. They realize that that is what they can get for their pets now, and it's really hard to give it. Additionally, there's a barrier to killing the costs of going to a specialist. ⁓ Of course, there's so many tests to be done or anything, but just think sharing a bit more of that knowledge in general practice would do wonders for the industry. speaker-1: Yeah, I think it's hard because I don't, I haven't worked in the UK for 10 years. Yeah. And where I am now, I mean, there are alternate track residencies, but they are hard to get. Most of them are full time because of the way the clinics run. They need people there all the time. I think, I think it's really in Australia. I think there definitely is a shortage of specialists for sure. Yeah. Did we talk, did we say I'm in Australia now instead of in the UK? Yes. speaker-0: We all know left me and never came back. speaker-1: You been working in Australia now for eight years as a specialist. And I think there's, I get what you're saying and I hear that. I don't think it's necessarily the case as much in Australia and maybe it's quite different in terms of the setup. In terms of gatekeeping knowledge, maybe it's different for surgeons. For us, like most of my job is education. And like, I do 50 % of my time on clinics. So I do two days a week on clinics, seeing cases that are referred to me and every single case gets a detailed report that goes back to the GP. So they get feedback on when we saw the case, what our thought process was, what tests we did to make a diagnosis, a full assessment, ⁓ our interpretation of results and a treatment plan to go back so that there is an opportunity for them to learn from each case. think the vast majority of the time, GPs don't have time to read those letters, but I spend ages writing a full clinical case report that goes back to the vet so that it's not just us taking a case and never giving any feedback. But I also spend two days a week working remotely consulting for a different company that's not clinical work at all, that is purely advice to vets. So they can call and get free... medicine specialist advice for cases they have in the clinic on anything. It can be about lab results, could be about imaging, could be about, you know, these are the clinical signs and we don't know what to do next. And that is available in the UK as well. So there's definitely, from a medical perspective, I think there's a lot of availability for support for GPs if they know where it is. Yeah. ⁓ speaker-0: Actually, that's come more recently. I know a lot of the labs, the external labs, offer that now. It's lovely. And I guess maybe it is surgical because it's very hands on. You need to be there and need be scrubbed in and whatever. There was one point, because I have raised this with some other people, because I'm not trying to be antagonistic. I'm trying to make doors open. Probably not for me now. I don't think I would do it now, but for others, want to. speaker-1: Exactly. It's a in a residency. it, it, led to the breakdown of a relationship for me. Yeah. speaker-0: Yeah, and I think it would have done for me if I'd done one. speaker-1: So it was very much career or life. And I with career at that point. I've definitely changed my priorities since then. And I've managed to find a way to have my career as a specialist. That also gives me downtime. And I found a much better way. speaker-0: you have to get to that. I think mine was sports that I would, I basically looked at and I was like, I have to give up all of these sports I'm playing. I was just like, this is a hard no. speaker-1: ⁓ Apart from I managed to start a sport when I was in my residency and I mean my third year of my residency decided I was going to become a runner. And signed up for London Marathon the year I also sat my exams. Yeah. Which I think in hindsight actually was a good, everyone thought I was completely bloody crazy having to go and do these like three or four hour runs alongside trying to study for boards and finish my residency and publish my papers. But that probably- speaker-0: That's true. what helps. speaker-1: I think that was what got my mental health back to a level that was manageable. speaker-0: Sport is amazing for that. always been my outlet. ⁓ I think one of the things that the specialist said to me was we need you here full time because that's how we can train you and we need to be able to dedicate our time to you. speaker-1: Yeah, for sure. I think, mean, there are officially, there are alternate track residencies where you can do it part time for people that have families, but they are hard to find. And I think one of the reasons is that the way the hospitals are set up is to have full-time residents. And if they're not there to follow through their own cases, like for us, just wouldn't, it wouldn't work. Like if residents come in on, they're there for two days, anything that's becoming complicated and needs further intervention or work up from a medical perspective, and then off. speaker-0: Right. speaker-1: Like it's just not possible to get the same knowledge base doing it remotely, know, like, you know, intermittently, would just be very challenging. It is feasible, but it's not the way our program set up where I am now. ⁓ And I'm not saying it's impossible, but it's definitely, it's going to be less appealing to the clinic. You know, the clinic is already stretched. There's no specialist hospital that isn't working like paddling. That's my point. ⁓ To then have to change the entire program to accommodate somebody when it's already set up in one way is a lot more work for them as well. So it's not as appealing, I think. Yeah. I don't know. there's, mean, from a different perspective, the whole, I think one of the things that I struggle with in terms of the perception of specialists is the, I think, lack of awareness of how different it is in a specialist hospital. Like, I think there's some people in clinics who are unaware of what more can be offered and don't understand the benefit of referral to specialist centers. Because they don't know what they, this is what, when I first went to be a resident, I had no idea how much I was missing. ⁓ And I think, and also I think there's sometimes a, I have a concern that the general public don't know the difference between. Correct. General practice and people who are very advanced in a field versus a specialist that's done so much more in that field. ⁓ I think that's something that I think should be quite protected still in terms of titles and stuff like that, because there is quite a big difference between a good medic in clinic and a specialist. If they could. ⁓ speaker-0: So, what is it that you like now about being a specialist? We know how you got there. What are you doing day to day? What is great? speaker-1: ⁓ man. speaker-0: What kind of cases do get generally? speaker-1: A real mixture and it's very different in Australia. ⁓ really? Yeah, yeah. What we saw here, there's ⁓ different infections, there's different types of dogs. I love procedures, I love being hands-on. I'm not a desk sort of person much. I love going in and taking things that shouldn't be in places out of places with scopes. ⁓ ⁓ My favorite thing when I was a resident is taking grass seeds out of lungs that have been inhaled. So going in with this bronchoscope and removing like a big, you know the wheat, the ears of corner? Like grass seeds. When I say grass seed, don't mean tiny grass seed, I mean like the massive fields of barley. The huge ones. Because they go in one way and they can't come, but they can't cough them back out again because they're like spiky. speaker-0: Wow speaker-1: So you can go in with a scope and pull them out. And this is the most satisfying thing I've ever done. Where I am now, we have a huge emergency department, so I don't do as much acute medicine, which I do miss. I used to love draining chests and pericardial effusions and all the cool stuff, which I don't do so much anymore, do a lot of kind of endoscopies and things that's just stuff that's less accessible in practice. And I think a lot of clinics now have gastroscopes, but they don't necessarily have, they haven't done a hundred scopes in a year like I did as a resident to be able to be quick and efficient at them. if I do a scope guaranteed, I will get where I need to be. If I need to be in the duodenum, I will be in the duodenum in 10 minutes. Whereas obviously that's not something that I was very good at in general practice until I had the experience of going to a residency. speaker-0: The scopes in my clinic are the most expensive ornament that I have. I mean, I do. I also love to scope, but, like we, what do we have the day? We pulled, ⁓ and some part of an ostrich or something out of an esophagus. And that was very cool. And my girls were so happy when they finally got it out and they were like, yeah, it was really satisfying. speaker-1: It's cool, ⁓ Yeah. But no, I mean, love having a case that has come in that is complicated. The owners are upset, frustrated, sad, don't know if it's fixable, panicking that this is the end of the road. And I can give them a plan, whether that's permanent or whether it's short term. If the quality of life gets better, I'm happy. And it is beautiful, you know, to see these people come in that are losing hope, to be able to give them hope. That's really magic. It's really special. speaker-0: give me the warm and fuzzy. ⁓ that's amazing. Thank you so much for coming in and sharing and we're going to wrap it up because me and you are going for dinner. Thank you so much for coming Jenny. Love you too.