Well... how did I get here? How working in healthcare is shaping my medical studies

Michael James Allcock is a 1st Year Graduate Medical Student at St. George’s University of London, Acute Medicine and Paediatric Healthcare Assistant. Prior to starting Medicine he worked as a Discharge Tracker, facilitating complex discharges from an Acute Frailty Unit as part of the Frailty MDT at Stockport NHSFT. He Tweets at @MichaelJAllcock

Growing up, I’d never really given medicine as a career any serious thought - to 16-year-old me medicine was all a bit too posh for a boy from Salford and it wasn’t until my second year of studying biology at Aberystwyth University that I realised medicine was something I was actually passionate about.  

After attending a talk given at a graduate entry medical school, I was given a piece of advice by one of the medical students that stuck with me. I was advised to get as much experience as possible within the NHS and if I still wanted to do medicine after that, then it might actually be the career for me.  

To that end, before finally securing a place to study medicine, I worked in various roles within the NHS across a four-year period. From volunteering with play specialists and hospital library services, to working as a healthcare assistant (HCA) both in paediatrics and acute medicine (which included a fair stint working across suspected, confirmed and high acuity COVID areas) and then finally, working as a discharge tracker on an Acute Frailty Unit.  

The nine months I spent working as a discharge tracker on an Acute Frailty Unit (AFU) were some of the most eye-opening and inspiring of my career so far. Being part of an amazing multidisciplinary frailty team to ensure the safe and efficient discharge of patients living with frailty was a privilege. I was lucky enough to spend my days talking to patients about their needs and their circumstances and then coming up with a plan to try and get them back home, where they really wanted to be. I think it was because of this experience, despite the challenges, the fast-paced environments and even despite the global pandemic, that I knew I still wanted to be a doctor. 

It was about four months into the discharge tracker role that I found out that I'd been accepted to study medicine at St George’s University of London, and while I was absolutely ecstatic that I’d finally secured a place, I was devastated that I'd have to leave the Frailty Unit. It was especially bittersweet as I am almost certain that it was talking about my experience working with the frailty team and the discharge team that gave me the edge at interview.  

So now I’m finally where I wanted to be. Four years after I first realised I wanted to study medicine, I'm here at St. George’s, currently taking a break from preparing for the next problem-based learning (PBL) session, to write this article.  

It’s been strange, adapting back to student life after working for what seemed like an age at the time and it’s taking a lot of willpower not to slip back into the old student routine of a mid-afternoon nap following the morning lectures. But, strangest of all, I think, is just how little I am relying on my biology degree, and how much I am relying on my experiences working in healthcare. It has been fascinating to see how different my perspective is, compared to students on the course who perhaps haven’t worked in the NHS before. I think I expected to be the student in PBL talking about complex biological pathways, but there are so many talented scientists on my course that I mostly end up talking about complex discharge pathways.  

Not only has my experience given me a bit of a head start when it comes to things like medical terminology, how wards work and the role of the MDT, but it has equally, if not more importantly, given me the confidence and ability to communicate with patients, to empathise at times when they are feeling most vulnerable or nervous. I rely on my discharge planning experience and understanding of the importance of a good social history and the difficulties and barriers that patients, especially those living with frailty, may face whilst in hospital.  

I'm certainly finding that for PBL, Clinical Skills, and Communication Skills sessions, having an understanding of the social side of patient care and knowing some of the practicalities of hospital-based medicine and common clinical signs/symptoms is where I am able to contribute the most. Hopefully my peers find my contributions helpful, although I do often have to stop myself from going on for too long about discharge planning, otherwise we’d be there all day! 

As for next year, I’m looking forward to not feeling like a lost sheep on the wards. Hopefully having worked for so long in a hospital setting I’ll actually be able to hit the ground running and make the most of placement. But I'm sure I'll still be following doctors around like a duckling and mainly being responsible for opening and closing the bedspace curtains on ward round.