- On May 6, 2020
- May / June 2020
Beyond the Theatre Room
Although every clinician is a leader, having a ‘seat at the table’ allows more influence, suggests Dr Tanya Selak, who has enriched her career in anaesthesia by exploring roles that allow her to improve the wider health system.
I ENTERED MEDICAL school in Auckland straight out of high school. I was attracted to a career in medicine due to its fundamental goal of helping people. Although I did not have a clear career direction within medicine, I anticipated that the six-year degree would allow me time to grow up a little and expose me to the range of career pathways.
During year 3, anaesthetist Stefan Shug delivered a series of lectures which caught my attention. I had not previously heard of anaesthesia or anaesthetists, and it seemed to me an incredible speciality where a patient’s physiology could be safely manipulated using drugs to allow a procedure to occur. It was magical. From there I was drawn to investigate anaesthesia as a potential career path.
I pursued anaesthesia attachments where I became inspired by the skills, knowledge and empathy of the anaesthesia experts. I liked the practical nature of the work and the people involved. I was accepted onto the Auckland training scheme as soon as I was eligible after graduation. I completed my primary exam, and then worked in London teaching hospitals for three years. My husband and I then moved to Wollongong for ‘one year’ on the way home to New Zealand where I completed my training. Thirteen years and three children later we are still here.
It’s hard for me to put into words how much I love clinical anaesthesia. We render people unconscious and are responsible for looking after their wellbeing while they are not able to. It is an incredible privilege to care for a patient during what is usually quite a vulnerable day. The work is heterogenous – there are a wide range of patient presentations, ages, morbidities and we work in multiple locations with different teams.
There is something very special about being a part of a vibrant high-trust theatre team where everyone has the opportunity to perform at their best. I adore watching registrars transform from novice anaesthetists into consultants themselves while they cope with the ups and downs of training and life. I’m incredibly proud to have contributed to the workforce of the future, giving back what was given to me. The most challenging part of the role is serious morbidity or death of a patient following anaesthesia and surgery. Fortunately advances in anaesthesia have made serious complications rare, but when it occurs I am desperately sad for the patient and their family. Losing control in anaesthesia is awful, I feel a sense of failure, that I have not upheld my contract with the patient, particularly if unexpected. It’s also upsetting when trainees are not able to complete the training program, usually due to exam difficulty. It feels like we have failed them.
Despite the usual joys of clinical anaesthesia, it became apparent to me that there was a limit to what could be achieved in a wider health context when chained to my anaesthetic machine. Putting things right is very important to me, particularly for socially disadvantaged patients and trainees. Although every clinician is a leader, having a ‘seat at the table’ allows more influence. I therefore became joint head of department where I learnt a great deal about myself, others, hospital systems and negotiating ways forward. I formalised this learning with a Masters of Health Administration. Contributing to Anaesthesia as an International Advisory Panel member has given me an insight into medical publishing. I am an avid social media user where I tweet about medicine and anaesthesia using the account @ GongGasGirl. I enjoy collaborating with others and sharing expertise to improve patient outcomes. I have just been elected to ANZCA Council and am grateful to have been given the opportunity to contribute to the further development of our specialty.
Career advice can be complex and should be individualised. Doctors-in- training tend to have multiple short-term rotations making meaningful mentor relationships difficult to develop. We should instead encourage the creation and maintenance of longer-term partnerships. We need to improve our ability as clinicians of all levels to seek and receive feedback on our performance. I have a number of senior colleagues I turn to for advice when I need to explore alternative perspectives.
Medicine is inevitably full of highs and lows, some expected, some unexpected. With busy workloads and frequent location upheavals it is difficult but vitally important to have trusted friends who can be called upon for support. Training programs can have very competitive entry and can take decades to commence and to complete. Some put their lives on hold during this training, feeling pressure to give work everything. I would gently suggest to not always put life on hold as there is never a ‘good time’ to get married, backpack Africa, runaway to Gibraltar, be present with a sick relative, whatever. It is best to invest time to work out priorities. Work will usually sort itself out, there are many ways to achieve career goals. As we all deal with the enormous unexpected upheaval of the coronavirus crisis, it’s a good reminder that we can’t control everything. Everyone will have a different path, the most important thing is to keep your family and friends close, and find a career which aligns most closely with your beliefs and values.
AMA (NSW)’s Careers Service helps doctors achieve their goals by offering professional support. For more information, contact firstname.lastname@example.org