Médecins Sans Frontières is career suicide for an aspring O&G registrar? I think not 💁

Interviewed by Avi Bart

Written by Jefferson Tang

Kate Tyson is the current Chief Registrar of Obstetrics and Gynaecology at Western Health at the Joan Kirner Women’s and Children’s Hospital. Following an unsuccessful first attempt at applying for the O&G training program, she applied to work with the MSF with the support of a consultant supervisor. She found this unconventional career step, which many considered to be career suicide, to be the most rewarding and diverse experience in her entire career.

How I came to work with Médecins Sans Frontières | Doctors Without Borders 👩⚕️

My best friend at uni wanted to do obstetrics and gynaecology (O&G). I always thought that she was cool because she also had a Masters degree in Italian Language, and so I thought, “Oh if she wants to do O&G, it must be really good.” I was initially pursuing the GP training track, did a rotation in O&G along the way, and just loved it. I found everyone really friendly and the environment really approachable.  I loved the engagement of women at critical times in their lives and found it really stimulating.

After that I did a senior resident O&G year and applied to the O&G training program. I had a really bad interview and so I didn’t get onto the training program the first time round. I had done 18 months of O&G up to that point, and I had reached the point where I was not that keen to spend much more time working in the Australian medical environment. So I approached the Professor of Obstetrics and asked him for career advice on what I should do.

We looked at all the mainstream options and I found the MSF option enticing. I then told him that I really wanted to work with MSF and did he think that it would be acceptable for someone who’s keen to do O&G training in Australia - he thought it would be. With his support I went through the rigorous application process for working with MSF. I got in and agreed to work with them for nine months, which is the minimum amount of time you need to commit. And off I went to Afghanistan on my first MSF mission.

A lot of people told me that MSF was ‘career suicide’ ☠️

I think there’s always this pressure in medicine, definitely in Australia, that you need to continuously doing things that progress your career, and keep your name and face known.

When I was looking at my options of what to do for the year that I didn’t get onto O&G training, most of the people I knew were looking to do six months of critical care, or six months of paediatrics, or another year as an unaccredited O&G registrar. Jumping out of that system, and going off the radar to do something different was thought of as career suicide by many trainee doctors who thought you would never onto training in Australia if you did that.

I guess I’m lucky in that I had the support of the Professor of Obstetrics at the hospital I wanted to work at, who saw that working with the MSF would be a good thing for me to do. Personally I felt that it was the best thing for me do at that point in time. To me the purpose of being a doctor is to be able to help people, and I felt that continuing to work in Australia at that point would have just been for the sake of getting onto the training program, and not actually helping myself or anyone else. Over the next few years I experienced the great need for people with even basic medical skills; common sense and basic knowledge is exactly what is needed in many contexts to save lives. Part of why I was attracted to MSF was because at the time I wanted to deliver the most benefit to people in greatest need.

With MSF I had the most diverse and rewarding experiences 🌈

I could not value my experience with MSF anymore highly. They’ve made me the person and clinician that I am today. I’m a firm believer that all growth comes through adversity, so certainly the lessons didn’t come on a silver platter. There were lots of frustrations and difficulties I had to confront during my time with MSF. For example most missions are in highly insecure locations so you are not free to go where you please. You also only have your expat colleagues to socialise with; you don’t always get along and it’s sometimes difficult to resolve conflict when you come from diverse cultural backgrounds. But the ability to make a real difference throws all of that out of the water - you realise that you save lives everyday by the teaching and training you do, and the legacy you leave behind overweights the burdens of being there.

MSF as an organisation is an outstanding organisation that abides by their values 100%. They are a secular humanitarian non-government organisation whose aim is to help the people in greatest need at any one point in time. They are not challenged or threatened by saying it’s too hard. They will go to the hardest places at the hardest times.

I’ve made some beautiful friends along the way because no matter your differences, you share the same values. You face the difficult situations together in the shared spirit of working to help people in greatest need.

Diversity of experience, diversity of skills and diversity of engagement all only make you a better clinician because you can approach things with a more broad perspective. You are able to understand a broader range of patient feelings, thoughts and attitudes. So no matter what it is, committing to a pursuit outside of medicine will only improve your clinical practice by giving you a better breadth of human experiences.

If you work hard at your job, your job will give back to you

You get energy back by going that extra mile and doing something extra for the patient. The patient will recognise this and they’ll send you a card, or their relative will phone you and say thank you, or someone will say, “You did a really good job at that.” That gives you energy back. Also, if you take time to notice and appreciate it in other people, it will pay for it as well. If you work towards generating that climate of gratitude and positive reinforcement around you, it comes back to reward you with enhanced energy and purpose.

We can do better in supporting our colleagues when they go through challenging phases 💪💪💪

When you’re really under the pump, and someone else says to you, “Hey, you’re really under the pump, you’re doing a good job” - that will make a world of difference. It makes a difference when you identify someone going through a challenging phase and you take the time to sit down with them and tell them “What you’re going through is actually really hard.”

We have official training supervisor roles, but it’s just not the same as taking the time to sit down with someone and chat about how difficult something was. We don’t always make the right choices and medicine is inherently difficult. Bad things happens all the time because bad things just happen, not because you did a bad job.

Personal regrets - I would have been bolder with my aspirations 💥

For personal perspective, my mom is a hard dresser, my dad is an electrician and I came into medicine through the rural entry scheme. I had an inferiority complex coming into medical school, and I was delighted to actually like my work and that people seemed to like me and the work I did.

But I was really a bit intimidated by people who dreamt really big, who really wanted to do all the big and wonderful things in medicine. I would tell my younger self to “let go of that insecurity and just dream big. Be bold and reach for things. It’s fine if you don’t get there, just do you best. Do whatever you want to do and don’t be afraid to approach it.

The other advice I would give is that you don't have to know your vision immediately 🤔

Your vision will change as you grow. So many of my friends have started on one path and ended up on another, and that’s a great result. When I was in medical school I aspired towards being a GP. Coincidentally most of my friends have coincidentally become GPs and they have a wonderful practice and a wonderful life. They find it really fulfilling.

The most inspirational people I’ve worked with during my career are the people who have done multiple things over the years, and have taken time out of medicine to pursue other passions in life.

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