At the ABN 2024 conference, ACNR Publisher Rachael Hansford spoke to a number of delegates to get their views on current topics in neurology. In this interview, Asha Bissessar talks about her experience of training as an international medical graduate.
Asha Bissessar
I’m an International Medical Graduate. I’ve come from Trinidad, from the Caribbean. Nice warm sea, a warm atmosphere, nice blue seas. And I have been in the UK, I’ve basically done my training in MRCP. And I’m now in neurology.
Rachael Hansford
How many times have you been to the ABN before?
Asha Bissessar
This is my first ABN.
Rachael Hansford
Okay, so what made you decide to come to the ABN this year?
Asha Bissessar
I think it was a combination of like, my colleagues were discussing this, and it was very intriguing. And then, I’ve kind of just been enlisted in the field of neurology since I’ve started training. And even before, it was something I was always interested in. And I think when I saw the programme for ABN, it looked so good, and so interesting. And then lots of my colleagues and some of my consultants were coming as well. So I thought it would be a really good event to attend.
Rachael Hansford
It’s a really strong community. So what on the programme in particular appealed to you?
Asha Bissessar
I like the varied topics. Of course, there are some that are more niche, which, you know, hopefully, with my years in training, I would be able to appreciate a bit more. But I found that there was a nice balance of topics, and there was a training day on Monday, which was really helpful. I think the topics that discuss the things we encounter in clinical practice. I think getting the experts’ opinions on lots of things we have, you know, as trainees, you know, it was really, really good. So I think the variation of topics, that was one good point.
And I think some of the topics thus far would be the acute medicine section, when we’re talking about encephalitis, stroke, and cognition.
Rachael Hansford
We were talking earlier about your experience in training in neurology, and how’d you found it here in the UK.
Asha Bissessar
It is quite different from back home. You know, we don’t have that sort of specialty training. But it’s still admirable that my colleagues back home, you know, they work with limited resources. Here, it’s obviously, there’s a lot more that you can do, there’s a lot more content that I can, you know, get my hands on.
I think one of the things we were discussing earlier, while it’s improved, I think still, there’s a lot of gender bias in some cases, just with the general public, sometimes as a female physician, they may not see you as a doctor sometimes. And I find that still happens, it’s less so now, but I find that still happens. You know, I may go into clinic, sometimes, I’m with a male medical student, and someone would be speaking to him as the doctor just not presuming that I am the doctor. But I think it’s much better now. Yes, it’s much, much better now. And it’s very few and far between that I found that, and as evidenced by ABN here, there’s so many female colleagues, and a lot of them are really leaders in their own particular field, leaders of their own hospitals. And I think that’s where it’s fine.
Rachael Hansford
Yes, because I know that that is one of the focuses of the ABN, diversity. So it’s nice to hear that it’s actually paying off. It’s certainly changed over the last few years. Definitely.
So how do you feel about the new curriculum?
Asha Bissessar
I think I can see, obviously, overall, I think that there’s a lot of good benefit from the new curriculum. That being said, it’s not without its challenges. So the new curriculum is basically incorporating an additional year to pursue general medicine. And it actually helps because obviously, a lot of our conditions that we do see, they do have a lot of reach for all the systems, right? So CMS is linked to so many systems in the body. And it’s helpful to appreciate that sort of, you know, generalising the group sometimes, as opposed to just looking into one direction, helps you not miss things and it’s probably overall, the learning is probably more enhanced this way.
But there are challenges because it’s obviously a new curriculum. So therefore, there might be teething problems. One of the things I’ve had problems with would be access to practical skills, procedural courses, because obviously, there’s so many people doing GIM, and then, you know, not all hospitals are probably put to the simulations, or ready for that. Additionally, you know, things that might have to be looked at would be, is about neurology trainees would need more study time, because it’s neurology, stroke and GIM, as opposed to just two specialties. Therefore, we’re expected to have training in all three. So that might be another thing that might need to be looked at. Attending clinics, as well, because, I think it’s a good idea, and I think I understand where it’s coming from. And obviously, as with everything there are pros and cons, and there will be challenges when you first start, as it’s a fairly new addition to the curriculum. I know some colleagues have expressed that the additional year may impact their decisions to do further neurology training, because it just means the training has just been a lot. So that’s another thing I’ve heard from colleagues, and you know, the length of time for the training is obviously now longer, so it’s like five years compared to four. So that’s another consideration some people do have.
Rachael Hansford
So you think that the longer training might discourage some people from going into neurology?
Asha Bissessar
Not necessarily discourage them from going into neurology per se, but more like within neurology, probably taking time out to do research might be. Because with that, you know, there’s an extra year that you have now, that they may now think, well, it’s already long, you know, going on to training to do something else might make it longer. Or, some colleagues have also expressed that they feel sometimes like your attention is now spread across so many things, that you’re finding that sort of feel in neurology for what you really want to focus on might be delayed in some cases, or might even not be something that might be put at your top most idea in your head, just because you’re trying to fill the tick boxes for everything in the curriculum. So it becomes obviously a lot more. Obviously the workload is more. But our colleagues in other specialties have been doing it, but their programme is still four years. So Rheumatology, Diabetes and Endocrinology, they still have like a four year course.
Rachael Hansford
Is research something that you’re interested in?
Asha Bissessar
Yes, I am. I mean, I’m still finding my feet into which particular specialty. I mean, they’re all lovely in their own right and obviously, you get blown away by your consultant colleagues who have devoted their lives to some of these specialties. So I’m still figuring out which particular field I would like to do some research in. So far things like MS and cognition that really interests me as well as stroke. But yes, there is a consideration. I’m just saying with respect to the new curriculum, some people might find that it’s going to be even longer, because you’re looking at an additional two to three years to train. So I think lots of people have to balance things like quality of life, getting some stability, because a lot of these training, you move around a lot, which is one of the challenges I’ve had personally, not insurmountable, but I think if you add all of that into the mix, you literally have someone who would be in their prime, juggling all these things and then now additional years of study. I don’t think it’s insurmountable, I just think everyone has their own priorities.
Rachael Hansford
You mentioned that moving around was difficult. You said you moved here, so you don’t have family here? You don’t have a support network? So moving around the country, that must be really challenging?
Asha Bissessar
Yes. I mean I should just retract saying I don’t have a support network. I mean, I’ve been very fortunate that I’ve met so many wonderful kind people. I think kindness is so under-scored these days, I found really, really nice people, and both in and out of work very kind individuals. And my current neurology family, or my work family, have always been very supportive, and I can’t underestimate that at all.
So yes, I don’t have any family here. That was one big move across the Atlantic. And then, you know, also moving around the UK, where I’m still not very familiar, as someone who’s literally been born and grown up here. So I think, obviously, it’s exciting in some respects, as you’re seeing new places. But also, it can be challenging, because a lot goes into moving. So that has been one of my personal challenges. And you know, it’s just about dealing with this. But frankly, it’s good that I have my colleagues, my seniors, even friends, and that’s very helpful. But I can see that being, hopefully not going to continue to be a challenge as I go on. But it is one of my challenges.
Rachael Hansford
Is there anything that you think could have been done by either employers, or maybe anyone else to help trainees like you have support in moving around the country? Because it might be difficult for everyone?
Asha Bissessar
Yes, exactly. I mean, I think so far, I know there are lots of funds and access to resources to help. I think maybe more, probably more publicising what is available to help. Because I think it’s only when you’re in this situation, then you start looking, I think that might be one avenue that needs to be explored, like, what is available for trainees to access (if there is anything of course). I’m not sure what resources are there. But, I mean, I’m already starting the journey. So, you know, I might, I might let you know what I find. But I think yeah, I guess maybe also highlighting as well, because there might be other people who are going through the same thing, and probably just accepting it, as I have, and, you know, running through like everyone else has done. It is acknowledging that it’s not obviously the most stable of lives. And obviously some people have their entire families that they need to move around. So something such as a magnifying glass on this might be really useful.
Rachael Hansford
Thanks for chatting to me Asha.
Asha Bissessar
Thank you for having me, it’s very awesome and I’m very privileged to be here.
