What am I, and what should I do?

What am I? Where am I going? Am I actually achieving anything worth while? What should I be doing?

These questions have grown louder and louder in my mind over the past year, and as I recently read Jemma’s post it did not go un-noticed that some of these might be questions inherently built into being a clinical academic. So I thought I would share my ponderings of these questions, in what seems to have turned out a somewhat personal post.

As a back drop to my musings, I acknowledge that over the years I’ve done my share of poster-girling the NMAHP clinical academic stuff. I’ve done it knowingly in a hope it is helpful for our collective agenda. And I am very open to say it has brought me involved in some interesting and challenging work, and has helped me to grow professionally and personally.

But I’m increasingly wondering if my time is up. In a positive, blurry way. I feel the next generation of clinical academics is ready to take on the batton and become the new faces of this movement. It’s great. It’s progress. I view it as a success of some of our collective work. In my work as a clinical academic poster girl I always felt I stood on the shoulders of the NMAHPs who had gone before us. They had climbed some big hills and gotten us to the place where we picked up from. And in the same way this next emerging wave of people will build on the work we’ve done, as they take on the next big hill. I feel proud we are allowing them to start the journey from that little bit further on, and that we are passing on a healthily resourced ruck sack and plenty of maps. There is a long way to go, but I certainly feel proud for what we have collectively achieved.

But passing on the batton also leaves me with questions about what am I becoming? Am I sliding into the ivory tower (how I hate that term!)? I’m not 50:50 clinical and academic, and I don’t see patients. Some of my good colleagues openly and loudly claim they do not view people like that as proper clinical academics (then sheepishly look at me 😄). Am I becoming a less of a clinical academic? Am I stopping being one all together? Am I a fake?I’ve been a clinician for so long that if I am not one anymore, then what am I instead?

What we do tends to define who we feel we are. And when we change what we do it challenges us to reflect on what we are becoming. It certainly makes me ask questions about my wider sense of purpose and direction.

As a clinician academic, an obvious place for me to look for is in the NHS. When I started my journey in advancing the clinical academic agenda I continued to do hands on clinical work. Over time, I needed to take on more and more leadership, and as things developed it became impossible for me to continue to do direct patient care (one day I’ll write about the reasons). Gradually, I ended up in a strange place, where I am now seen as a clinical academic but with an increasingly undefined NHS role. In the NHS, I am probably closer to an external project consultant than an NHS member of staff. While the NHS recognises my unique skills, it prefers to keep me at an arms lenght. “Maybe I should try to weasel my way back in…” I keep thinking. But I have to also acknowledge that while harking back to being one of the NHS gang remains emotionally very tempting, there are a million little reasons for why I am where I am, and why such an attempt would very likely be counter productive to the big mission.

The other obvious place to look for is academia. While doing the clinical academic work, I’ve continued to very actively grow my reseach, and the next 10-15 years look mega exciting. There is for sure development work for me to do, but I feel very excited about addressing those gaps. And I know it will all be like hopping on fast escalators – once I make the jump we’ll be off! It’s moving forward for me and for the mission.

So the obvious answer to my questions about what should I do is: be an academic, do research.

Yes. But. Anyone who has been a clinician can tell you it just isn’t that simple. Why?

I can give all sorts of answers. Much of them well-rehearsed in the discussions among clinical academics struggling with the questions of how to balance our time and identities. But if I am honest, none of these answers is the real reason.

I am not sure there even is one real reason. Maybe it’s a case of a lot of tiny signals that cumulatively keep alive that call for so many of us to remain engaged within the NHS (not just working as a partner on the outside), even when it leaves us unclear about what we are.

So here I sit, on a fence. What should I do so that it will make me something worth while?

Perhaps I just have to accept the conclusion I have arrived to so many times before. When one tries to lead and create something new it inevitably means doing the unknown, and seeing what will become. It’s uncomfortable not to know what we are or what we’ll become. But maybe that’s ok. Maybe, it’s even part of what being a clinical academic is.

Start that journey today

Nine years ago I attended a big professional conference at which I met a pair. That pair changed my life and career in profound ways, and today has in many ways been a culmination of that change.

I’ve told this story many times, but never this publicly. Now it feels apt to tell.

I still remember that Autumn of 2010 very clearly. Chile, my first occupational therapy international conference. OT World Cup they call it (it’s every four years). Ceremonies like the Olympics they said. It was all true.

But what really stuck out was this pair. Two people who appeared on the stage. They had strange accents I could not place. And their presentation was just wonderful. They stood out in the quality of their reflective thinking, on humbleness, on analytical rigour. They did not claim to be science but OMG were they making a contribution to thinking.

Later that day I saw the pair sitting on a bench, approachable for a lone out-of-place weirdly challenging person like me. I sat down, we chatted, they invited me to join their crew for dinner. We chatted more over dinner. We followed things up after the conference. Met teams. Worked together on some big studies. Supervised projects. Ate curry.

As of today, both people in this pair are now my amazing clinical academic PhD colleagues. From that encounter, and your kind offer to include me in your group, developed a decade long partnership.

It hasn’t always been easy – I am sure each of you have firmly cursed your involvement with me at times. But that’s ok. I’m happy to live with that for the journey and outcomes we’ve gotten.

My point is. We sat in a pub 9 years ago. With hopes, plans and aspirations about how we would change the world. My realistic head says we may not have changed the world that much – yet. But we have changed ourselves. We’ve learnt, developed, acquired knowledge and skills. And for that we are much better placed to advance our aspirations.

My point is. It pays to think long term.

It may seem like the end goal is far away, but perhaps that just means we better start now so as to get there as soon as we can.

“PhD? Nice! (But what is it?)”

I feel we’ve sold PhD as an idea to AHPs. I also feel the next challenge is for AHPs en masse to figure out what a PhD is, and what to do with people who have them. 

I feel that seeking to do a PhD is now largely viewed positively among AHPs, and there is a genuine acceptance that having a PhD is (somehow) a positive thing. I still do hear some occasional mocking, and some unwelcome comments, e.g. about people with PhDs having a different brain size than the rest of the humans, but in my experience people making these comments are now a minority and are seen as making a fool of themselves more than representing a condoned majority view.

What seems to have changed much less is how AHPs understand what a PhD is (what does it make the person competent for), and how we can make use of people with PhDs to advance our practice, knowledge and impact. 

Over the next 12 months I’d like to take further steps to change this. To move more towards a point where people actually understand what PhDs are good for (and what they are not). To this end, I will run some dedicated posts to explore the question of “What do people with PhDs do once they finish their PhD – and what more could they do given a chance?”.

I am particularly hoping to publish posts by people who are at least 4-5 years beyond completing a PhD (but pre-Professors). That is because I want to focus on the experiences of people who are in full swing of hard core crafting of contributions to AHP practice, science and future (and skip the early post-PhD haze phase….).

If this is you, and you’d be willing to write a post – please do email/tweet me and let’s make a plan for your contribution!

Happy, and very exciting, 2017 to everyone! ☺

Forging through a PhD fellowship application

Guest post by Michael Sykes. I ask myself, ‘OK, so you have had your NIHR Fellowship interview; regardless of the outcome, what have you learnt over the last couple of years that might help others?’. It is likely that I will look back at this in a few years and think how little I knew. Just as I now look at who I was when I first started my clinical academic journey all those years ago!  Continue reading