Making the case for support in a complex system

This anonymised account reflects the views of an individual, and not the General Medical Council.

A GP locum with Ehlers-Danlos Syndrome, shares their experience of moving through education in a complex system that offered little support or flexibility.

Making a case for flexible working

I am a newly qualified GP locum. I work as a locum because I have been unable to find a permanent role which can accommodate the limitations that my medical condition imposes. I have Hypermobile Ehlers-Danlos Syndrome and am a full-time wheelchair user, so am unable to undertake home visits.

I faced a lot of resistance from the postgraduate training organisation when applying for supernumerary funding as a GP trainee. I very much had to make my own case to secure this without any advice or support from anyone who knew ‘the system’ and the rules around it. This created a huge amount of stress and pressure for me - this was the only way I could gain access to flexible working hours/on call duties, which would be able to accommodate my disability and not result in repeated injury or worsening of my condition.

Getting lost in red tape while moving through training

Prior to every training post, I had to organise a meeting with supervisors. I also assessed the physical working environment to ensure it was accessible for me and provide as much notice as possible about any adjustments or additional equipment needed to allow me to undertake the required work. This process was not supported by occupational health, other advisors or advocates.

It identified several problems which, if I hadn’t found early, would have potentially delayed my start in the post and subsequently lengthened my training or would have resulted in personal injury. On one occasion, I identified a number of potential issues which could not easily be overcome. These were highlighted to as many people as possible, but I was still placed in the post and sustained multiple injuries. I had to be stepped down and stop work for a significant number of weeks while another post could be found for me.

I had to seek clarity from my postgraduate training organisation on a number of occasions about rules around sick leave, extensions to training, Certificate of Completion of Training (CCT) dates, and allowable amendments to duties/hours. This was because my local training programme directors did not know the answers, or who to approach for answers, because the context of the queries were so unique.

Towards the end of my training, I had queries and last minute extensions to my CCT date. I was also trying to organise ongoing employment and had the pressure of having to undertake such a huge amount of additional work to support my own training. Having to handle all these additional challenges as well as my medical condition and disability took its toll. I asked the postgraduate training organisation to put me in touch with their appointed person who gives support to disabled trainees, after being advised by the Royal College of General Practitioners and GMC that this was their duty. I found that no such person existed and there was no support for me. I felt in desperate need of an advocate, lost amongst red tape and under incredible strain with very little hope of help.

There is a huge psychological burden which comes from being a disabled doctor - this was also completely neglected during my time in training. There are no specific people, groups or organisations to provide disabled trainees with psychological support to help manage the effects of prejudice, stress, loss of professional identity, loss of self-confidence or loss of physical function.

Creating a network of support

I’ve founded the Disabled Doctors Network– a support network for medical students and doctors with long term conditions or disabilities. It provides guidance on a variety of topics and people can get in touch for more advice and support. We’re undertaking a number of projects and providing advice and guidance to key organisations, to improve the situation and make medicine as accessible and inclusive as possible.

What I would change…

A key part of the network I’d like to develop is a ‘buddy scheme’.  This could either be a mentor/mentored pairing or simply a list of people to which new consenting people are added and everyone in the group has access to. This is designed to be a way of reducing isolation and allowing sharing of experiences by putting disabled students/doctors who work in the same area/environment or speciality in touch with each other.

Clearly, it may involve roles which currently do not exist which would therefore require funding to create and support. However, given the inadequacies of the current support structure in place for disabled people within medicine, I would suggest this is of critical importance and is long overdue