Published Tuesday, September 10, 2024 / By Ryan Kevelighan
In this week’s podcast episode, Dr. Anita Moss joins us with our director Ryan Kevelighan to speak about the Self Awareness Skills Training (SAST) workshops she founded.
SEASON 1 EPISODE 3, DR. JEAN-YVES KANYAMIBWA AND BENJAMIN LEPKE
Benjamin Lepke 00:00
Hello, everyone, and welcome to episode three of our 1 in Focus series which aims to have a conversation with our working doctors, who we've got good strong relationships with, or our internal staff to get an understanding of what it is, what they do, where they've come from, and what they've been through to get to where they are. So, this week's episodes, I'll be talking to a very good friend of mine, Dr. Jean-Yves Kanyamibwa, who is currently residing in the Sunshine Coast and hailing from Rwanda and in the UK and over here. We're going to have a conversation with him about his pathway to where he is now and what now sits ahead of him. So welcome. We'll call you Yanni.
Dr. Yanni 00:54
Yeah. Thanks, Ben. Thank you very much. I'm honoured.
Benjamin Lepke 00:59
Jean-Yves Kanyamibwa known as Yanni.
Dr. Yanni 01:00
I'm honoured to join you on this podcast. I really appreciate everything you've done for me. When you asked me if I'd be happy to do such a thing, I was very happy to help. You've been very key in my path to where I am here in Australia. So, it's a small price. It's a small token, not even a price. This is a token of my appreciation.
Benjamin Lepke 01:22
Thank you. Well, good place to start, so why don't you tell us more about yourself, Yanni. Where do you come from? What brought you to Australia?
Dr. Yanni 01:32
I was born in the south of France in a town called Montpellier, with my brother who was born a couple of years later, Jean-Hubert moved to Rwanda. In Rwanda there was a war there that happened, so we were refugees for a little while in the Central African Republic, and then flew to Cameroon, then to France, where we settled for a year, then a year and a half in Montpellier again. I did a bit more of my primary school education there, then moved to the UK to Cambridge, hence the British accent from about the age of eight, where I did most of my schooling there. I went to University at St. George's Medical School in London tooting then graduated in 2011. I did my F1 and F2 years, which first was the second year PGY1 and PGY2 in Cambridge and in Kingsland so East Anglian deanery, where I was from. I then moved over to Australia in 2013 in Newcastle, that's how I got here.
Benjamin Lepke 02:38
Very good. Where you taught in French when you were a kid?
Dr. Yanni 02:41
Yeah, I basically spoke just French until I was eight, and then, learned English when I moved to Cambridge.
Benjamin Lepke 02:49
How was that transition to the UK? Do you remember?
Dr. Yanni 02:52
Yeah, it was a culture shock, and it was interesting, you know, like, it's all just the food it was hectic, custards.
Benjamin Lepke 03:01
Like going from snails to custards.
Dr. Yanni 03:05
Going from frogs and snails and like, croissants to sponges, well what the hell's going on there?
Benjamin Lepke 03:14
The joys of British cuisine. Well, so you did that in the UK. Got to F1 and 2, what then? What made you make the decision to move to Australia?
Dr. Yanni 03:26
Yeah, I guess there are definitely push and pull factors. You know, for me growing up in the South of France a little bit and in Africa, the weather is one thing, but the NHS and its dysfunction. I remember when I actually left and had an exit interview with my urology consultant. I remember Mr. Mahesh Kumar, said to me, “Yanni if I were you, I'd go to Australia and not even think about coming back for the next five years’ and that was 10 years ago. So, it was just a sense of adventure, a bit of wanderlust, and just a sense that UK was probably heading for some trouble. It did materialise, Brexit and the rest of it, COVID so yeah, I wasn't really sure whether I wanted to do emergency initially. In the UK, I was more into anaesthetics, maybe paediatrics, anaesthetics, and then I kind of fell into ED well. I fell into ED and then I realised that it's actually a different specialty really. It is practiced differently in Australia and it's more interesting here. Well, I always explain it as if you think of the critical care specialties of ED, anaesthetics, and intensive care - this is just a big generalisation to explain it. If you create a Venn diagram of all those three specialties and think about all those key jobs and procedures within a hospital. In the UK, key critical care skills and procedures that one will be expected to do. In the UK, I found that the anaesthetist had a great proportion of those skill sets in the hospital. So they ran the MET calls, and the retrieval services have a lot more anaesthetists. I found that you're more likely to see intensivists in the UK than you are here, and the intensivists or the anaesthetists, that train and ICU in or vice versa, then you are here. Then your ED and emergency A&E in the UK, it's sort of left to wither on the vine a little bit and you're much more of the term, it's used a lot, as a triage monkey. The KPIs are more draconian, and you're expected to see someone turn them around and sort of kick them off to a specialty social assessment unit or to a medical assessment, within an hour, hour or two. But you're not really seeing people, you're not really using your skills as much. When I came to Australia, I'm intubating, more, doing more procedures, you're spending more time. I just found that the training was more extensive and the clinical acumen, I guess, was more robust. That was my opinion, and that attracted me, and I was oh okay, this is potentially quite interesting.
Benjamin Lepke 04:28
That might be the transition of why you initially wanted to do anaesthesia in the UK, and now moving into ED.
Dr. Yanni 06:08
Yeah, and I still maintain that if I was in the UK, I would have probably done anaesthetics.
Benjamin Lepke
Yeah, why do you think there’s that difference?
Dr. Yanni
Wow, that’s an expansive question, actually one of my last job interviews, actually for the Alfred, they threw that in the interview, they said, "So what is the difference between Australia and England?" I was just like, wow, are you really going to ask me that question? Why? I'll try to answer that question succinctly. I think it is multifactorial, you got to understand it from a kind of socio-economic perspective, sort of outside of the hospital, there are lots of forces. So, the UK has almost 70 million people and older healthcare infrastructure, my impression is that there is less money in the system anyway, and there's way more pressures. So at the point of service, at the point of patient contact, there's so much more pressure in the system to see any sort of unit of patients as quickly as possible and transfer them on. Make sure that those ED clinicians are literally just triaging them, and then making the decisions for where to go. So that's one issue there's just not enough money in the system, there's a lot of red tapes and it's really difficult to change that. I think, my impression is that in Australia, there is a bit more autonomy within the healthcare system, and there's less intervention from the government to try and meet those KPIs. It also feels like the medical bodies are more powerful, comparatively, compared to the medical bodies in the UK. So, you know, yes, we've got the KPIs, yes, we've got the near times, but we don't need to meet them as closely. In New Zealand, they talk for about six hours, anytime, six hours, so that's one example. I also think, there is just more money, I'm not an economist but, I think on the ground, I get everyone has way more money swirling around in the Australian healthcare system compared to the UK. Point and case, like when I was locumming, for example, I noticed, you know, locumming up and down the East Coast, up and down the West Coast new hospitals, they are all less than five years old. All the EDs have got four or five ultrasounds, and there's a 10th of the patients than in any UK Hospital. That is real life. Like, there's way more money going around, and ultimately, it makes you feel much less like a flogged workhorse, working here. You're more respected and you are more valued and part of that is the financial return and that quality of life return, it's important. Why do you think there is a difference? Is that an expansive question?
Benjamin Lepke 08:56
Absolutely. It's one of the reasons why Australia and New Zealand, aside from the geography and what people want to do, to kind of see the healthcare system is viewed, and quite rightly, as a place to come and work and work within due to quite a lot of those factors you just mentioned.
Dr. Yanni 09:12
Not mentioning the weather, not mentioning travel, red tape, the friction.
Benjamin Lepke 09:18
Well, moving on, let's go back to yourself then so everything that we've just discussed with some drivers for you to come to Australia. So you arrived, and you're in Newcastle, how did you get into training? What was training like? You made the decision to follow the ED pathway, how did that come about? How was the training process?
Dr. Yanni 09:39
Yeah, so I came to Australia straight into an ED job at the Calvary Mater in Newcastle, which was good. I think there were about 30 doctors that had emigrated from the UK.
Benjamin Lepke 09:50
And that is only one hospital.
Dr. Yanni 09:50
That's only for Newcastle, just for Newcastle and at the time, 2013, it was much easier to get on to the program as a UK Doctor. It was just a case of signing up, getting some references from other ED consultants and then you could get on to the pathway. I remember that the closing date was rapidly arriving, like December 2013, I only arrived in August 2013, so I basically got on pretty quickly before the closing date. Then subsequently, it's become a lot harder, you have got to do all sorts of things, and I can't keep up with that. Then I got on pretty quickly and then did my primaries in about April 2014 and it's progressed through to being a junior reg, in early 2015. In that interim, I moved from the Marter to John Hunter and then moved to Port Macquarie, for a better opportunity, to get my anaesthetics and intensive care training. Stayed there for three years, and then moved to the Sunshine Coast for my late-phase training, for my fellowship.
Benjamin Lepke 10:50
So, from Port Macquarie, did you move to do your advanced training in the Sunshine Coast then?
Dr. Yanni 10:55
No, I did my primary written in May/April 2014, I sat my viva, then I had to re-sit it again in 2015. So, I got it on the second attempt then that allowed me to basically get into that late phase, or was it the early phase? I can't remember the terms.
Benjamin Lepke 11:17
So many phases.
Dr. Yanni 11:18
So many phases and it's changing again. I basically progressed to being a reg proper in Port Macquarie and you need your anaesthetics and ICU to progress really into being a competent senior reg and it was easy to get it in Port Macquarie but yeah, I ended up staying three years there.
Benjamin Lepke 11:34
Because getting those critical care terms also opened up other doors and avenues as well in terms of opportunities.
Dr. Yanni 11:39
Absolutely it did, first and foremost, it's just that personal sense of comfort. You know, you're just a bit more reassured as an ED clinician; once you've got those skill sets, once you go onto night shifts and you can handle an airway, it's much better. It does open doors from a locumming perspective, from a senior reg jobs perspective. Pretty much as reg the second or third question that asked you is what airway skills do you have? Can we put you on night shifts?
Benjamin Lepke 12:08
Yeah. Will you work by yourself? - The main question? Well, let's segway slightly then, I've known you for a long time now and worked with you. So, let’s talk about locumming throughout your training. How was juggling locum work and training? How did you manage that? Did you take big chunks of time off to do the work? Did you do it in between? How did you manage that balance?
Dr. Yanni 12:30
How did I manage the balance?
Benjamin Lepke 12:32
How did you manage balance? Would you have done it differently?
Dr. Yanni 12:34
I managed it. I think my perspective on locumming has changed necessarily through my experience. I was perhaps ignorant and naive because I didn't really know about it initially. You know, there's a bit of a school of thought that you shouldn't be doing that, you should just focus on the pathway and just progress and not knowing any better, I probably subscribed to that a little bit but what I did find, I think it happens to a lot of trainees to be honest with you. After doing my primaries, moving around, and having some sick family members in the UK, you do get a bit of wear and tear and perhaps a bit of burnout. I did feel quite exhausted, coming into sort of 2017/18 and actually, I didn't realise I needed to take some time out. I was actually just thinking about it, it took me about three months, three to six months to think, I just need to take time out and when I did, I didn't really know how to make it happen. I didn't really know about the locumming scene that much, it was another consultant that put me onto it, put me on to you and it was actually incredibly daunting to take a year out and to locum, it was very daunting, I felt to say felt like I was failing, I felt like a failure taking a year off.
Benjamin Lepke
You felt like you weren’t progressing.
Dr. Yanni
It's ridiculous to think of it now but I was genuinely petrified of taking it initially, I was thinking six months, I was like, actually, I need to take 12 months. That's what we'll take time out, refresh, and then how do I make it happen because when you're kind of you're really privileged enough to be a doctor, your career path is laid out in front of you, and you kind of have to change gears from automatic to manual and make it all happen. So, it's daunting, but a couple of months into it like this is the best thing. This is the best decision, yes financially for sure but also from a wanderlust perspective, you know getting to see basically every state in Australia now except Canberra via work and I think it gave me a huge bump in terms of genuine acquired confidence because of being exposed to so many different looks of what, excuse my French when the shit hits the fan.
Benjamin Lepke
And who’s around to support you.
Dr. Yanni
Yeah, it exposes you time and time again to your own foibles, your own failings that are covered by the specific kind of by the system that you're in, right. So because your work keeps working in that healthcare system, the specific processes and policies and guidelines and what have you just always seem to protect you for whatever look you go into, the other side of Australia is completely different and then you realise actually I'm not, that's not good enough, I need to be way better. You do that enough times and I remember coming back to Sunshine Coast, it I just felt like a completely different, I felt like a completely different condition and I could see the response in my other consultants, they were like, "Oh, this he has grown". To come back to my initial point of my perspective and my thoughts on locumming it has changed through those experiences. Now, I'm actively encouraging people, I remember one of the very senior facems in the college and Port Macquarie, one of my DMT said to me, rather, I thought rather cryptically in 2016, before I took my year off, I've always thought about it. He said, he said, Yanni, whatever you do, you must locum and locum in as many different places as possible. I don't know if that was an observation on my, for me, maybe? Who knows? Regardless, I think it's true for most clinicians, actually, it's true for most clinicians and regrettably. You can tell when people haven't moved around because they have one, you know, they slice the one school of thought and they skin the cat. Yeah, one or two ways, and not many different ways and human beings are complicated, but I'd be able to come at it from multiple angles.
Benjamin Lepke 16:32
Absolutely. Fantastic. Well, so back refreshed, and reinvigorated, you're ready to move forward and take out the final exam. So, let's talk about return to work and then your progression up towards the written and OSCE.
Dr. Yanni: 16:47
Yeah, so returned to work in progression to written in OSCE. So, I would just make the point in that year out, it wasn't just traveling, looking around. I didn't actually I saved quite a bit of money and I spent that on exams and courses, and I did the back half of the six months. I was ramping up my studies so that was really helpful, I was sleeping normally and that helps your memory helps your capability to study as night shifts, as we all know, it just wrecks you. So, coming back into my normal training program, yeah, I basically, I had two attempts at the written and I sort of fell in that COVID timeframe where my exam was postponed, that kind of affected my timing and the energy and COVID. Anyway, narrowly missed the written. And then I went again and passed it on a second sitting and then pass the OSCE in the next sitting, yeah.
Benjamin Lepke:
Congratulations.
Dr. Yanni:
Thank you.
Benjamin Lepke 17:44
What advice would you give to people that are sat in that state of anxiety for the written and the OSCE ahead of them? Like, what did you do in part of your preparing for them, that you felt now looking back on? It was yes, that was great. I'm glad I did that.
Dr. Yanni 18:02
Yeah, I think you've got to understand yourself, I'm very wary to give one specific bit of advice if it's done right because we're so different in the way we learn, and the way we study. When I'm helping registrars, and friends go through the process and they're asking me for help, I actually just try and listen to how they approach, first and foremost to help me understand them. Hopefully, in some way, help them understand how they go about it because, by the time you get to that level, you're actually pretty good at studying. It's more about refining what you're doing to get over this last significant hump. I do think though, a lot of it is, the top two inches, a lot of it is psychological. After you've understood yourself, I think one of the key principles, everyone talks about this being a marathon. If anyone has done long-distance running, and I have actually done long-distance running. The thing that you find very quickly is how well you're recovering. It's about your self-care, it’s about your recovery, and how well you're looking after yourself, whilst maintaining your work-life balance, and your relationships. How you can maintain that so that you can use the metaphor of running to keep up that 100 K, 100 kilometers a week of running for those 52 weeks for the year and a half. It is intense, so you need to be able to recover and stay relatively fresh. I focus really hard on that aspect and how to maintain my sanity and how to avoid or not avoid burnout, but to minimise burnout so that I could maintain consistency. How do I do that? I actually cut back on my hours; I think that's quite important. Night shifts wreck you, and I think it's cumulative by the end, by the time we get to the late phase, you're not as fresh as you were when you were in PHO. I can't tell that to the PHOs coming in that really chipper like I went straight through the prac, you know, you've got a lot of energy but it's actually huge, it's cumulative.
Benjamin Lepke 19:57
It's just that intimate burnout phase.
Dr. Yanni 19:58
You do, you do but cutting back on the hours I think helped me, especially being like, on my own, single, COVID, with no family around me. Therefore, locuming was helpful doing the old shift a month because, by that time, I felt that I had enough of a base clinical, like time on the floor that I didn't need to do full time, I could go and pass my exams. I think exercise is really important, personally, I'd get up early, do something gentle in the morning, get my blood flow going, good food, breakfast, and protein it sounds so basic, but it helps. When I avoided them, I just fell and then it would just be like regimental nine o'clock, I'd be at my desk, good two, three hours, break. In the afternoon, I'd do something more like weights or something, then I do my proper home so gently in the morning, heavier in the afternoon, and then I do an evening session of study again. And then after about five, or six hours of study in that day, my next goal was to be fresh for the next day.
Benjamin Lepke 19:59
To try and get to sleep.
Dr. Yanni 20:04
To be fresh for nine o'clock the next day and, you know, saunas for me just sitting at a desk, regular massages.
Benjamin Lepke 21:15
Keeping relaxed.
Dr. Yanni 21:16
Yeah, keeping relaxed, and being kind to yourself. I would say as well, the other thing that was quite helpful, and actually a surprising number of fellow senior registrars and FACEMU's that perhaps isn't voice is psychologists.
Benjamin Lepke 21:30
Right, okay.
Dr. Yanni 21:30
Yeah. I think it's just we're just not open enough. I think but if you speak to quite a lot of registrars there's a surprising amount that uses them and it's a specific type of psychologist, a performance psychologist, and they tend to focus on elite sportsmen and doctors. They are literally the two clients, and that says a lot about the process. This is the analogy of I just kept coming back to this like a marathon and being like, an elite athlete, and looking at yourself through the prism of an athlete. So if you're an elite athlete, you've got your sports psychology, you got your nutritionist, you've got your physiotherapists, you've got your like your support team and that is what it's like heading into these exams. And for me, I really had to break it down with no support system around me and COVID and being a senior reg, but it was breaking it down that allowed me to understand how to get through it.
Benjamin Lepke 22:31
That's very interesting actually, I hadn't really considered it because it was quite like an athlete or a sports person, because you know, a track runner it’s them, they're going they are training themselves to be the best to win. Everyone else is not it's not a team sport effectively, you know, this a team with your team around you, supporting you as individuals. So, your psychologists and all that becomes your team becoming a team. It's you, yeah, effectively so, it's like building that team for yourself to help you.
Dr. Yanni 22:58
Have you had friends that are like athletes, or professional athletes?
Benjamin Lepke 23:03
I've been involved in sports. I've seen a couple of my friends, they get to a fairly high level in sports, etc. But no actual athletes
Dr. Yanni
Or professional sportsmen.
Benjamin Lepke
Not personally.
Dr. Yanni 23:13
Because it's quite interesting when you get to know them. It helps you understand, like this world. So, I remember in 2008, I did a London Marathon Guinness World Record fastest marathon dribbling a basketball. I know it was crazy, crazy.
Benjamin Lepke
Did you?
Dr. Yanni
I did, yeah, have I not tell you?
Benjamin Lepke 23:30
No, so you did a London Marathon dribbling a basketball?
Dr. Yanni
Yeah. I though told you.
Benjamin Lepke
No. I have no idea you've done that..
Dr. Yanni 23:37
You just haven't read my CV. It's just you just have not read my CV.
Benjamin Lepke
That would be close to beating in one of my favourite things on a CV, which is coming in a certain place in paper rock scissors World Championship.
Dr. Yanni
Who said that?
Benjamin Lepke 23:51
Well, someone did say that on one of their CVs at some point throughout my career, which I quite enjoyed reading.
Dr. Yanni 23:56
Oh really?
Benjamin Lepke 23:57
But I did definitely miss you doing the dribbling at the London Marathon wow.
Dr. Yanni 24:00
I did, that is more another story but what that did is it exposed me to athletes as well. So, in the London Marathon, they had a section for Guinness world record holders and we went in with the athletes. But also, around that time I did, I was doing a lot of athletics and track athlete, and one of my friends was me had a few friends. You just realised there's another level of focus, it's another level altogether. It's all fun and games with amateurs but the professionals are on another level and it's similar, it's obsessive, it's always pathological.
Benjamin Lepke 24:33
Yeah, well, you are now a FACEM. You and our fellow emergency medicine specialist. What doors are opening for you? What's ahead of you in the future at the moment?
Dr. Yanni 24:44
What doors are opening? I think, I'm going to be honest, the first thing is the sword of Damocles is no longer hanging over my head by a thin thread it's just a weight lifted.
Benjamin Lepke 25:00
You must be a humongous weight.
Dr. Yanni 25:01
There is a huge weight but no, just fellow job opportunities, obviously, financially, it's a lot more. I'm not the one paying for lots of courses and exams and getting quite five work properly now for a little bit. But you know, the world does open up, I'm going moving to Melbourne to do my fellowship role in the next few months. I hope to go potentially to London and do some hymns in the year after but also just got more bandwidth and mental space to delve into some passions I've had to keep on the back burner. For the best part of four- or five-years things like a project where we're both working on in Rwanda with yourself with 1Medical, with regards to partnering to do some charitable work and some philanthropic work with 1Medical and I guess that has, there's loads of potential avenues and directions that could potentially go. I'm working with your colleague, Ryan, and yourself to finalise a trip to Rwanda in July for three weeks.
Benjamin Lepke 26:00
Yeah, that's extremely exciting.
Dr. Yanni 26:02
I mean, that is a door that opens up. I could never.
Benjamin Lepke 26:05
You've not had time to do that.
Dr. Yanni 26:06
I can, I can think about that now.
Benjamin Lepke 26:08
You can start planning holidays.
Dr. Yanni 26:09
I can start planning holidays, I can start reading non-medical books. Oh, my God, I can start watching a Netflix episode without getting guilty all seasons, that type of stuff, but the doors have opened, I mean, I've only been a FACEM now for two, three months so the doors are open, but I'm still in the wake of feeling, what's the radio-friendly term?
Benjamin Lepke 26:09
Free?
Dr. Yanni 26:24
Free, there we go.
Benjamin Lepke 26:36
Excellent, so if any of our listeners are now junior doctors thinking about embarking on a path, you know, is there any advice you give to people? If you can talk to yourself, back at PGY4? Was there any advice that you would give?
Dr. Yanni 26:49
It's really hard to give advice that's generic for everyone.
Benjamin Lepke 26:54
Let's change that then. What would you tell yourself?
Dr. Yanni 26:56
I think that can actually be more helpful to everyone. I think to be kind to yourself, I say it a lot. Just, take it easy relax, alright it's not about smashing out incredible days just try it. I sometimes just tell some of the junior regs to try and go for 80% every day 8/10 is good enough every day, and you don't have to be 10 out of 10 because you burn yourself out real quick. Take plenty of breaks, and advocate for your own well-being because the healthcare system will take more out of you than you will out of it. Do look after yourself and advocate and be aware of limitations of your own, I guess, burnout. I read a stat, 50 to 80% of the care staff clinicians experience burnout in their career and it has many guises, it has many forms, with regards to I think it's important to have many allies. I'm a diversity and inclusion representative for ACEM, myself and two others in Australia and three others in New Zealand. I work with Claire Skinner, the college president, and the incumbent president Stephen Guney on issues relating to discrimination, bullying, and sexual harassment, as well as a diverse sort of gamut of issues relating to DNI. I think it's important to have allies, it's important to collaborate to speak and share your experiences, specifically for me, in my experience as a black doctor, in the healthcare sector, it took me a while to realise how to maneuver the space in my own skin, especially as a junior doctor. Again, being a junior doctor often means that you're also a young person, so those two things are happening at the same time and what does it mean? How do I sort of feel comfortable in my skin? Being other and different? How do I find my voice? How do I navigate what can be perceived and what can be real institutional racism? It can be very challenging, very, very, very challenging, and part of the reason why I ended up seeing a psychologist in the end. What I would say to a younger self is to listen, to be aware, and listen carefully. Don't discredit what people are saying or what you're feeling, that is often true. You can get gaslit very easily when you are othered and it may take time for you to find your voice and to find your true self but just keep plowing that and keep pushing forward in that direction. Use friends you got to crack at some eggs to make omelets. You do have to trust people and that can be hard when you feel othered and yeah, just be kind to yourself.
Benjamin Lepke 29:36
Be kind to yourself, the resonating point behind, throughout this conversation.
Dr. Yanni 29:40
I can't agree more, be kind to yourself. It is brutal you know, it's a difficult career being a senior reg in an emergency, I think is one of the most difficult jobs in the hospital. It's one of those and on top of that you're doing the fellowship exam and on top of that, you're moving this, that and trying to support yourself doing that locumming, you're doing night shifts. It fries, your nervous system, be kind to yourself.
Benjamin Lepke 30:02
On all of that, final point, tell me the feeling of when you open that email and you had a pass mark, to make all of what you just said worth it. Can you even explain that feeling?
Dr. Yanni 30:12
For those not watching, I'm taking a deep breath. It was emotional, it was deeply emotional, it was very sort of still, the peace it was. I opened it, but I actually didn't, I just sat there for an hour before I opened it. I opened it on my own, it was raining, and I was in Mooloolaba by Mooloolaba Beach on the sunny coast and opened it. They have this, you open the email, and it's a notification with a red cross and three lines, so the first thing you see is the red cross. But that's just the notification. It's like, once you read the notification, you press the red cross, but yeah, big red cross. So, like, one more blow but it was very validating, very relieved. I think the initial one of the initial feelings is like the absence of that pain, that worry. That's the joy that comes but it's the absence of it best and then the joy takes a while to come.
Benjamin Lepke 30:45
Because you realise, it finally breaks through.
Dr. Yanni 31:25
You're no longer pushing against, that's no longer defining you, because it defines you for like, three, four years. I describe it to one of my friends who one of my Vascular consultant friends who passed his exam in the UK, it's like you're in a rocket ship, and you're at peak velocity trying to break through the final atmosphere, and you're just hurdling for years and finally you break through into space.
Benjamin Lepke
It’s serenity.
Dr. Yanni
And it's like, what do I do? That's what it feels like.
Benjamin Lepke 31:54
Excellent.
Dr. Yanni 31:55
I hope it didn't sound too dreary and negative; it is good. And it's not all bad it's just you've got to have your wits about it, you got to be smart. You got to buck smart, you've got to seek a lot of advice from different people, think carefully, about how it's going to work for you, and reflect a lot. There's a lot of like, self-reflective work that, you know, you're asked to do as part of your CPD. And I think you see the use of it as you progress, but I would urge people to reflect early on, think carefully, but reflect continuously on every interaction, especially if it feels wrong, or it feels like you can't quite put it, put your finger on it.
Benjamin Lepke 32:33
That's a very important point that, in all walks of life. I actually do that in here, with the team and the junior consultants I have, I tell people to reflect on conversations. So, you know, active listening that we do, but you're actively understanding what's happening and if something doesn't go in the direction you're expecting, it reflect and go, well, where was the breaking point? How did that happen? Where did that? How did I end up here, you analyse that part and think about how you could do that differently. Without reflection, you would then just potentially meander on and make that mistake again. But if you do self-reflect, it's an extremely powerful tool.
Dr. Yanni 33:06
There's not enough lessons, there's not enough pages in a textbook that they give you a medical school to give you the lessons that you need to learn to progress in business or in medicine. I would ask you one question, from your vantage point, what I want to ask the same question you asked me but sort of from your vantage point. So, what do you think are the lessons learned, the pointers you would give to someone starting off in emergency medicine in Australia, to progress through the training program and to make it to become a FACEM? Because you interact with a lot, you've got many doctors.
Benjamin Lepke 33:41
I do, I've spoken to hundreds, thousands of doctors throughout my career.
Dr. Yanni 33:46
I think your perspective is interesting as well.
Benjamin Lepke 33:48
Yeah, my perspective is the same as yours, to be honest. But I saw I didn't have to find it, I just knew it. And what I mean by that is, is that I'm not a doctor, I'm not medically trained however, upon speaking with thousands of doctors, and I only ever talk to emergency medicine-trained doctors, I do find that a varied career and work experience, whether that may be full-time all the way through or indeed locum work, working in different hospitals, different settings, rural and remote, regional, etc. however, it may be, different states because different states practice differently as well. Getting out there, I tend to find gives doctors a lot more confidence, which then I find from speaking to them that they tend to progress better throughout the course of the fellowship, etc. because they do house that confidence. They have, as you were saying before that breadth of knowledge and experience, and they've been put in difficult situations and they've been put outside their comfort zone and they've managed to deal with it. Importantly, they've learned about themselves they've learned that yes, I can actually do this because as we all know the exams for the emergency medicine college and fellowship are extremely daunting. So, you can't not of put yourself severely outside your comfort zone multiple times before that and with the hope of getting past it. So, I find that having a varied career in terms of emergency medicine, I do find that doctors who take the old the six to twelve months out, what that also does is it relieves quite a lot of stress in the personal life, mostly financial. So, like you did, you started to get burnout. I've personally burnt out myself, I'm not a doctor, I've burnt out in recruitment, and I sprinted for 10 years and then fell off, fell sideways. I then took time off and I travelled the world, and then came back and started again is exactly the same thing. You're sprinting from university all the way up to becoming a reg, you know, you're talking nine years, eight, nine years?
Dr. Yanni 35:49
Through uni as well for me.
Benjamin Lepke 35:51
Yeah, exactly. So you've got all of that don't be scared of taking that six to twelve months out, and then you enter it back in refreshed, less debts, seen the country you've made sure you want to do ED. More importantly, you've made sure you want to know where you want to live for the next three or four years while you train and you've learned more about yourself and then you enter the new stage of confidence.
Dr. Yanni 36:13
Some things require it's a bit like that, you know, podcasts, the long form conversations become really popular across the world, because some conversations, be it with yourself or with other people, just require a long form and time to breathe. You know, that's why taking that time allows part of your own self to just marinate and just, without having to do a night shift on Thursday. You know, and just to be, it's really healthy, I think.
Benjamin Lepke 36:41
Yeah absolutely.
Dr. Yanni 36:43
Agreed.
Benjamin Lepke 36:43
Brilliant. Well, thank you very much for your time.
Dr. Yanni 36:46
No, thank you.
Benjamin Lepke 36:47
I look forward to working with you, moving forward as you mentioned, the charitable piece for Rwanda, which we'll be discussing in a lot more detail when people find out about it.
Dr. Yanni 36:56
TBC, to be confirmed.
Benjamin Lepke 36:58
Indeed, so have a great day.
Dr. Yanni 37:00
Likewise, more locum paperwork to do now.
Benjamin Lepke 37:04
You need to give me all your documents. Cheers, buddy.
Dr. Yanni 37:07
Thank you.
Benjamin Lepke 37:08
Thank you. Bye bye
Dr. Anita Moss has been working as a GP Obstetrician for 23 years. She currently has two clinical lead roles in Victoria and is a non-executive director on the board of SANE.
Having recovered from mental ill health, she was inspired to share her lived experience and learnings with others, in the hope that people who are suffering will access support and health.
Tune in as Dr. Anita Moss shares her journey on how she developed the SAST workshops for medical students and doctors to increase their self-awareness and emotional intelligence skills to better cope with stress.
In this episode, we cover the following topics:
For more information and to book the SAST course, click here: https://www.1medical.com.au/events/events/self-awareness-skills-training-workshop/
1Medical doctors, if you are interested in being featured in our next podcast, please contact Ryan Kevelighan on ryan@1medical.com.au.
[00:00:00] Ryan: Hello everyone. Welcome today. It's another episode of our podcast with 1Medical, 1 in Focus, and I'm really excited to be sat here today with the lovely Dr. Anita Moss, who landed into our office this morning here in Sydney, fresh off the plane from Melbourne, I believe, last night is where she flew in from.
And Anita, we're here today to talk mainly about your passion project, which is your Self-Awareness Skills Training course, which was designed by yourself for doctors to help them with their own self-awareness around multiple areas. Including their own mental health, and we know that mental health is a very important topic that's often overlooked.
Just a quick brief intro on yourself before I hand over to you to a more in-depth intro. So, you're a fellow GP obstetrician, qualified in Western Australia, and I believe you've worked in many places, and you are now based in Victoria. We, as 1Medical have had the pleasure of working with you as a locum, but unfortunately not that much because you are a lady with many, many fingers in many pies, as they say, as you are the advocate for the College of Obstetricians, well-being, and non-exec director of the SANE peer ambassador program, and of course the facilitator of your own course, which we're here to talk about.
So, would you like to give us a more detailed overview of yourself and your background and your career, Anita?
[00:01:14] Anita: Yeah. Sure. Ryan, thank you so much for having me. I'm delighted to be here and I'm really thrilled that you're 1Medical have been supporting this program since, uh, you heard about it at the end of last year, uh, when I did my locum in Ceduna, which was really exciting for me.
It was the first ED locum I had done in a while. So, after upskilling with my ALS2. So just a little plug, I had a great time as well supported by Verity and your team.
[00:01:41] Ryan: And if any of the doctors listening to this would like to experience the same joy that Anita had, then please don't hesitate to get in touch.
[00:01:47] Anita: Absolutely. Yes. I can only say good things. So, yes, me, I've been working as a GP Obstetrician for 23 years. I, uh, trained mostly in Western Australia, finished my fellowship here in Victoria, moving back with a small child and to be with family. I currently have two clinical lead roles in my day job, two organizations in Victoria and a GP practice and a sexual and reproductive health service.
So they're both very fulfilling and rewarding roles that I have. I'm mum to two young men, one still in high school, the other one's 19, about to leave and go and study in South Australia. And yes, I am a non-executive director on the board of SANE, which has been a very great journey for me.
They are an organization providing advocacy and support for people living with complex mental health and illness. So, I have been with them since 2018 as a peer ambassador and now board director. I also completed my yoga and meditation teacher training during COVID mostly to deepen my own practice, but ironically, I've brought some of that teaching into the SAST course as well.
[00:03:00] Ryan: Yes. I, I forgot that you were a yogi or certainly… certainly qualified in yoga. So, you mentioned all of the different roles and activity that you're involved in there. How do you manage to juggle all this with regards to managing to find the time to do all this? Because I know you've put a lot of effort into getting this SAST course off the ground.
[00:03:20] Anita: It's a long game. I … I guess I do things slowly, but try to invest in them well. So, the Self Awareness Skills Training Workshops, I started developing those in 2021 through the Future Leaders Program through the RACGP, but it was probably an idea long before that. So. It's been three years and I will have run four by end of this year.
So actually, it's been quite a slow burn, but it is my passion project. And I think if you're going to do anything well, then it needs the time that it needs. And as for the day job and being mum and, you know, we all do that, right? All humans are probably juggling many balls in the air. So, I... yeah, I feel like I'm doing the things that I really love. That makes it easy. And I have to look after myself in terms of the basics when it comes to sleep and exercise to make sure I can fit things in.
[00:04:19] Ryan: Well, I suppose that's where some of the potential background of this course actually came from. It does actually tie in well with people that do have these very busy and demanding lives like … like a lot of doctors do, as we know.
And the course is designed around sort of the basis of ensuring that people are being aware of their own self-awareness around mental health. You mentioned you've done the course four times now, so that would be… that would be including the occasion that you did it here in the office in Sydney.
[00:04:48] Anita: Yes, that will be this year. By the end of the year, I will have run it twice for 1Medical and twice for RANZCOG. Last year I ran it for RACGP Future Leaders Launch, so the new group of future leaders in Canberra. That was in March last year. I've run it for an Aboriginal medical service in Western Australia and also for their exec and for medical students from the Australian Medical Students Association.
So, quite a wide variety of individuals at all stages. So, I've had student doctors all the way through to consultants in their 70s, which is really exciting that people … that it's resonating, I guess, and everyone takes something away from it and yeah, it's, it's exciting.
[00:05:34] Ryan: Out of interest, just my own curiosity. How nervous were you the first time that you did it in front of a group of strangers and facilitated it for them?
[00:05:42] Anita: I had huge imposter syndrome. I was very, very nervous and, lucky for me, my best friend happened to be doing that course. She was in the cohort, so she was in the audience sort of sparing me on. But the content is out there, right?
It's about emotional intelligence and how to increase our self-awareness and why that's important and developing a self-reflection in practice and why that's important. I've condensed it and I'm delivering it, but really it's how it lands with everyone and how they're applying it to their own lives.
So, as they work through exercises over the day, it ends up being applied to their own individual circumstances, which is why I think it's having such positive feedback.
[00:06:30] Ryan: Yeah, because I mean, it's a very interactive experience for the people that attend the course from what I saw and what I heard as well myself speaking to people afterwards.
So, Anita, before we get into the specifics of what a doctor might expect on the day when they attend the course, could you maybe give us some background into maybe the origins of the course and where it came from and how you came about to actually creating this for people?
[00:06:53] Anita: Yes, Ryan, I can.
Eight years ago, I became part of the statistics that was the one in five Australian doctors to suffer an episode of mental ill health. I experienced an episode of major depression with suicidal ideation after a series of traumatic life events that occurred over a two-year period. I was divorced, young, trying to co-parent and raise two small kids with my ex-husband.
And going back to work full time, there was sort of a lot of, you know, pretty normal standard adjustments and transitions to work through these days. It was a lot, I guess. And so I think I was probably already moderately depressed, but young enough and fit enough such that I didn't really… I had a GP practice for all the usual things, but no one was really checking in on me.
And then I lost my brother in an accident. And he was just 41 and it…you know, it was really, really difficult. Broke… broke my family. And it really tipped me over the edge and it happened so quickly, this sort of slide into this dark place that I had no insight, I think, because I'd started probably from that baseline of being moderately unwell, and then just slipped into…well, now I'm severely unwell and I just had no idea.
And so my lived experience was just this sort of tsunami of pain and grief and it was really difficult to do anything. And I wasn't really aware of that, like … it was such an inner experience, I guess. So anyway, lucky for me I had … I didn't actually want to die when I think back to thinking that I wanted to end my life. I just wanted the pain to stop. I just wanted to have a reprieve and I wanted some peace, which just shows how impaired my judgment was that I actually thought that was a reasonable and sensible option.
And lucky for me, a very dear friend called me out on it. She could see how unwell I was. I couldn't. And when she did call me out on it, I said, “Do you think I'm depressed?” I mean, I really had no idea. I was so overwhelmed and sort of drowning that, I couldn't see it.
So anyway, that led to a two-year recovery with lots of appointments with GP, psychologist, medication. I saw the psychiatrist, a psychiatrist once who said to me, the only thing that surprises me about this story is that you didn't crash six months ago.
And I … looking back in that two-year recovery, that was the thing that I thought about the most. How did I get to 10 out of 10 on the level of distress? And don't remember what I looked like or felt like when I was three out of 10, four out of 10, five out of 10, and perhaps still well enough to implement changes to catch myself, to get back on track. To ask for help when I felt like I had insight.
Does that make sense?
[00:10:08] Ryan: No, it does Anita. And thank you very much for sharing that with us again for the benefit of people listening, potentially the first time they've heard it. I've heard that story from certainly, I think the first time that we spoke. And I do recall it quite vividly because I think that's what attracted me the most to your ability to explain your experience and then how it led to this course and just having that level of honesty around, you know, your personal experience and why you're doing what you're doing now.
[00:10:35] Anita: Well, it's really interesting and it's not … it's never easy to tell it and, and I still feel lots of feelings, I guess, mixed feelings when I do tell a story, but I feel like it's important because if one person hears that story and makes a different decision because it resonates with them, and that has happened, that has happened.
So people are approaching me after the course saying things like, “You've inspired me to talk to my GP about my mental health, or this has happened to me, and I'm now getting treatment, and, you know, there's a lot of shame associated with it.” So, I feel like, you know, at the end of the day, Ryan, we're all humans, and we're all the same. Doctors, lawyers, recruiters, business owners, we all have the same human experiences.
So, it's particularly hushed I guess, in medicine. It's changing and it's getting better and people are talking, which is really inspiring. But it's sort of how … it got me thinking about, you know, how did I get there to that point?
And one of the things I reflected on is that my personality type was perfect for medicine and particularly in the time when I trained 20 years ago because there was no real teaching about this sort of stuff, about emotional intelligence, about self-awareness.
I remember very clearly as a fifth-year medical student being taught how to give bad news. And, you know, we do that a lot. We take people through their really dark, most difficult times. We're taught how to give bad news whether it's saying, you know, you've got a breast cancer or prostate cancer or terminal illness, and here are the next steps or a miscarriage or running a resus, crisis situations.
No one ever told me or acknowledged you're going to have a significant emotional response to those things when they happen and that's normal and no one ever really helped me figure out ways to process that or even to understand that it just needs time to process and that doesn't necessarily mean days off needs time.
[00:12:47] Ryan: It's fairly hard to believe that the medical training even to this day potentially because this is what you and I have spoken about previously in this course is that the medical training doesn't include a significant component around dealing with these types of realities of being a doctor and what the actual job entails, because it's the same, it's the same way with soldiers when they go to war and they're in that level of crisis on a battlefield.
I'm not comparing the two directly, but I'm just using it as an example, because the mental trauma that comes from witnessing certain things at war and that type of thing, it’s not too dissimilar to being in an environment where you're having to deliver news, you know, news like, “I'm very sorry, sir, but you've got three months left to live. I'm very sorry, madam, but your husband's dead.” You know, like, that's a total different world to 99 percent of other occupations.
[00:13:36] Anita: Absolutely. And it's really interesting that you say that. Well, first of all, I just want to address that. I think it is changing. I think that the junior doctors now and medical students are getting more training around emotional intelligence and self-awareness and mindfulness. I think trying to whether people invest in developing their own practice, that becomes a part of their every day is a different story.
And the second thing is… it's really interesting you brought up the members of the military, particularly special forces.
There is actually studies looking at their ability to dissociate from their emotions in order… or to suppress that to be able to suppress their emotions in order to keep performing at a high level right on the battlefield.
[00:14:22] Ryan: Yeah. to get the job done, yeah.
[00:14:23] Anita: Absolutely. And you look at people in the medical field, we all do it and it doesn't matter whether you're a surgeon, whether you're a GP, what kind of doctor you are, like public health pathologist, we're all dealing with stories. We're all dealing with illness and it does have an impact.
So, the course, I was inspired then to develop, I guess, content to share. As part of it, it was things I learned in my own journey about developing self-reflection practice and implementing that and also around understanding my emotional responses and how that impacts on others. And I definitely have become a better human for it. I've become better in a work sense, in my role as clinical lead in my two jobs. I'm better as a parent. I think I'm better as a friend and… yeah, it's for everybody.
[00:15:23] Ryan: Well, thank goodness for everyone's benefit that your close friend did reach out that time and we are where we are today.
[00:15:29] Anita: Yes, I am grateful every day.
[00:15:31] Ryan: Yeah, there's a few things I did want to say on that as well, but we'll maybe come back to it later on because I did want to talk about, you know, how we as a company deal with locums out in the field and maybe some of those extra pressures that locums are under as well, and maybe some of the locums as well that are locuming because they're at a stage in their life where maybe they are going through some form of change.
You know, you mentioned some things earlier on. So, for example, we have Locum doctors that work for us because they’ve missed out on the career opportunity that they wanted to do. So, they're taking a year out, but they're dealing with the emotion of missing out on that career opportunity. We have locums who are out working for various reasons as well.
We have a lot that go through divorces, we have a lot that are dealing with being away from home, being away from their children, missing out on, you know, their children's upbringing and that type of thing. So that adds like an additional layer of complexity and stress on top of what is the substantial baseline challenges of mentally dealing with being a doctor as well.
Just as a side note on it, you mentioned about how like the medical field has changed in terms of like there is training now around awareness and emotional well-being and everything else. The recruitment sector and the locum agency sector has also changed.
Like we as agencies in particular with medical, we do a lot more now with regards to assisting with supporting people and assisting with stuff that would fall underneath the work health and safety and category. Multiple things of support and advice and information that we give to locums and we also then of course have a 24/7 support line that's run by psychologists as a first point of call where any doctor that's working for us can pick up that phone.
They've got the number and all of our correspondence and they can get straight through to speaking to somebody. And we have had some doctors that have used that. And historically when I started doing this, I would have thought that most doctors would never in a million years use that because of the persona of wanting to be the brave face and the show must go on. But now people are open to it and we openly have conversations with people about helping through their personal challenges and how they deal with that in conjunction with their work life. So that's very different now versus 2010 when I first came to Australia and started doing this.
[00:17:47] Anita: That's so supportive of 1Medical. I think it's really smart and I agree. When I think about every time. Most of the times, I've gone off and done locum work is during those transitions in between jobs or…
[00:17:59] Ryan: Exactly, yeah.
[00:18:00] Anita: Right? Yeah, rebuilding, I guess and that has been … even with 1Medical, that's how I came to you obviously. I was so well supported, during that particular locum, and it was over Christmas, Boxing Day and New Year, which is a very difficult time. So, Yeah, it was …I think that's really intelligent and hats off to you guys for doing it because it's great that you've identified that because a lot of doctors may not actually be divulging it and to have that support in the background so that they do have opportunity.
Medicine can be a very lonely place sometimes and whilst going to amazing places doing locums is exciting and it pays well, which gives us some security. It also can be a time when you're by yourself without any support and you might be reflecting on those sort of transitions that you're going through.
So that's great to hear.
[00:18:53] Ryan: Yeah. It is ironic that you are actually being an example of that, how you came across us in that transition. So it's again, it sort of validates what we're talking about here. Just a final piece on it as well. We do have junior staff members that we hire into our business because that's the nature of how you grow a recruitment business.
But for people's reassurance that the senior experienced people are sat in the background and listening out for the warning signs. So, when we hear such … when we hear a sentence like, “Oh, Dr. X has just said Y to us or just said X to us” or whatever it might be, you know, we're listening for those warning signs where we go. Do you think somebody needs to have a chat with them? Do you think they're okay? Is that what's going on behind the scenes there? So we are doing that here behind the scenes.
Moving on, I think, just for making sure that we get through the core bit here. So what can a doctor expect when they come on your course? Can you talk us through the day and how it would unfold for them and what they should be expecting to experience?
[00:19:48] Anita: Yes. So the foundation is that I guess it's confronting that idea that we are often just expected to keep going and that … to keep going and not processing thoughts, feelings, or stress has a cost. And even though over time our intellectual brains might need distance, might need to distance itself from those sorts of things because they can seem overwhelming. The long term cost is leading to a sense of feeling numb or compassion fatigue for others and themselves and burnout.
So, it's not a cure or panacea for burnout. It's really just helping reduce their vulnerability to it by increasing their understanding of where they're at any given time. So then they can actively and intentionally do something about it.
So it's known that doctors and all humans, I would argue, perform their best when their experience of medicine or their work is rewarding and satisfying. And having a strong internal locus of control is intrinsic to this. So, this is the foundation of the workshop, figuring out how do you strengthen your locus, internal locus of control.
So, what to expect on the day? They spend time working through exercises around the topics of emotional intelligence, values, self-awareness and self-reflection to gain a clearer understanding of themselves and their automatic patterns, and to consider where and if there are areas or room for improvement.
It's an invitation, if you like, with knowledge, and then they get to decide whether or not or what suits them in terms of what they'd like to do.
[00:21:29] Ryan: I'm guessing some people would maybe be quite upfront with opening up and getting involved straight away. And then other people might warm up a little bit into it during the day, would that be something that you see?
[00:21:39] Anita: Yes, that is exactly what happens. And I have had people who turn up at the start of the day when I ask them, why are you here? They say, “To be honest, I'm here for the CPD hours because it's really hard to get performance review hours.” And then by the end of the day, they are contributing and sharing.
Yeah, it is. It's really interesting. And I think that the doctors are often surprised that the power of understanding that we're all the same. We're all struggling with the same things, such as a sense of imposter syndrome, feelings of inadequacy, guilt of not doing enough and having expectations of ourselves that are too high and what seems to become apparent by the end of the day that there often is a sense of relief that when they understand that we…
[00:22:32] Ryan: You realize that you're normal. You're part of the same … everyone's going through the same.
[00:22:35] Anita: We don't talk about it and it really mandates that the conversation is honest and authentic and that it has to be if it's going to be effective to facilitate change insight observation facilitates insight, insight allows us to make effective change. So. Yeah.
[00:22:56] Ryan: So the course … You've explained to me in previous occasions, the course actually doesn't have a defined end time either, because depending on how the day unfolds and some people are quite keen to carry on talking, which we witnessed as well, so it can actually go on longer, which is a very good sign of how much people are actually getting from it.
[00:23:14] Anita: Yeah, that's true. And I mean …yes, that's right. We are all out of the building by five o'clock. But yes, I have considered running it over two days or … but because people do … yeah, because they are actually processing and thinking about how to integrate what they're learning from others.
One of the most exciting things is watching junior doctors in the room with the consultants and I didn't think that would work. I didn’t think that would work. So, if I was to talk about success stories and feedback, that's one of the things that has been … that I've learned that's been really valuable watching senior staff who are very confident and self-assured where they're at in their career actually learn from some of the juniors and also to share their own wisdom in a more vulnerable way and the junior is not feeling intimidated by it. So, that's been really interesting.
[00:24:10] Ryan: Well, this is a two-way street. You know the seniors have got a lot to give in terms of the knowledge and experience, but then the juniors, while they might not quite have as much potentially knowledge and experience, they've got entirely different perspective that allows potentially a more senior experienced person to take on board that perspective and then allow it to reprocess and reframe their own thoughts and their own experiences.
[00:24:32] Anita: Yeah, that's been really exciting to watch.
[00:24:35] Ryan: Well, in terms of success stories, so I saw some of the success stories with the last course that was here. So, I walked a chap back to the car park, who was very enthused with how the day had gone.
And he was a senior rural GP as well himself with no doubt many war stories himself from working out in the field over the years. And he took a lot from that day. There was some follow up emails that were sent through as well, but I think yourself personally, you must get lots of feedback from the attendees post the events.
[00:25:02] Anita: I do Ryan, and it's really humbling actually. Probably the most poignant feedback I've had I think is two doctors who have written on their feedback forms something to be … they've written, “Thank you for sharing your story. You have inspired me to talk to my GP about my own mental health.” That's two.
I've had been approached after presenting this in a talk by another two doctors individually who said, “I'm actually being treated for burnout, for depression. It's been really hard. I understand what you're saying and it resonates with me.”
They’re probably the most powerful… that’s the most powerful or valuable feedback because it does validate, I guess, sharing my experience that … I know six of my colleagues by face, by name, by voice who took their lives and I'm sure all of the doctors listening to this know at least one, if not more and it just breaks my heart that they were in such a dark place where they felt they had no other choice. So that's also part of the inspiration, I guess of talking about it.
[00:26:13] Ryan: Yeah, I mean, that obviously must make you feel great to actually see the direct impact that it's having. But again, not to make it so much about yourself personally, of course, but it's just if any one person can help any other one person, then it's all been worthwhile is the way that everyone sees it, I believe.
Would there be anything else you'd like to say for people that are listening before we potentially wrap up here in terms of, is there anything else you'd like to say, make sure that people understand about the course or anything along those lines?
[00:26:38] Anita: I'm learning from the participants as I go, and I think I've run it for almost … I did a head count this morning, maybe 75 people over the last two, yeah, 18 months.
And what I have learned, there's still a lot of work to do in improving the systems and that is happening. There are some great initiatives by colleges and hospitals to facilitate change. I feel as though this work is personal, is a personal responsibility. You know, there's stuff that other people can do, but really it comes down to us, you, the individual.
Are you willing to have a look at your own patterns? Are you willing to understand the role that you play in designing your life and how you manage your stress? That we all have something to learn for each other, that somehow the workshops seem to be a safe space where people are able to actually show themselves.
And what's interesting is that some of the consultants and registrars are saying, “Oh, we wouldn't say this in an M&M meeting.” Or there seems to be power in sharing who they are and how they're actually coping or not, or what their actual observations are. Yeah. It's of value it seems.
It's really rewarding and fulfilling to see people intentionally try to do this work. And it is lifelong journey as you know, Ryan. So yeah, it feels really great to be able to invite people to think about it.
[00:28:29] Ryan: No, it's good. Yeah, it is a lifelong journey. It's not just a case of going on the course and that's it.
You need to continually be reflecting on this and being aware because as you know from your own experience, it's quite easy to slide from a one to a five to a 10 without realizing, which is the scary thing, especially for strong personalities where the chances of that slide happening unnoticed are more so common because of that strong personality that's there in the first place.
You've done the course now several times over the last couple of years and it's starting to scale. What are your plans for the future? Like do you envisage this turning into your full time occupation, your full time gig and the joys that will come with actually turning it into a business?
[00:29:11] Anita: Well, it's, it's really nice being hosted at the moment, but I love this work and yes, I definitely would love to offer it more frequently for sure. It is my passion project and it's so rewarding to see people grow. I have three senior doctors who I have connected with coaches, and some with psychologists to help with their own growth and personal development.
And I am a big advocate for coaches to help people get to know themselves and to work to their strengths in all domains of life personally and professionally. So, I'm looking at doing my coaching certification in the next part of the year to offer that as well. But yes, I do hope that the Self-Awareness Skills Workshops takes up more of my life. That's probably for next year, I think.
[00:30:11] Ryan: You know, I've had conversations about the challenges of running businesses, so we can carry those conversations afterward, so don't worry.
[00:30:17] Anita: Yeah, I've been very lucky actually to be supported by Royal Australian College of Obstetrician Gynaecologists to present this to their members and by 1Medical.
I am talking in the background with some other organizations about developing and delivering content for their members. So, stay tuned. That's that's in the background.
[00:30:37] Ryan: That's great. Well, hopefully, we get the opportunity to continue supporting you and you do push ahead with expanding this and getting it out there to more people and helping more people.
And so next course in Sydney, to get the details people, it's the 23rd of November, I believe.
[00:30:53] Anita: Yes.
[00:30:54] Ryan: Yep.
[00:30:54] Anita: Yes, Saturday, 23rd of November, 8:30 until 5, we've got the timing down for. Hosted by 1Medical here in Castlereagh Street, Sydney. Registration details on the website www.sast.au.
[00:31:10] Ryan: And we'll have to make sure that the food is as good this time.
[00:31:13] Anita: The food was phenomenal. Thanks to Jenny, yes. Thank you, Ryan.
[00:31:19] Ryan: Well, Anita, I mean, unless there's anything else you'd like to say at this stage, it's been a pleasure talking to you. Would there be anything you'd like to add?
[00:31:26] Anita: Yes. Thanks, Ryan. I would and it sort of ties together the importance of having a self-reflection practice, being self-aware, working on that and improving your emotional intelligence skills. And it's sort of rounded up in this quote by Viktor Frankl. And the quote is, “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”
And I think in medicine, we often feel like our backs against the wall. We're too busy, too tired to make choices that are going to change our lives. But your whole business is built on doctors who are willing to make different choices, right? They're locuming for whatever reason in their life. So, we do have a lot more choice than we think. So that'd be how I'd like to end. We do, we can design the life that we want.
[00:32:26] Ryan: I think a lot of people will be very keen to design the life that they want and it is achievable and certainly for doctors, you know, it is one of those fantastic professions where you do have so much choice, so much opportunity and you can do things that a lot of other people would never get the chance to experience.
So we have some very, very interesting people on the books that are out working and they’re doing some very interesting things that the average person would never see.
[00:32:50] Anita: I think we have the best career in the world. I think there's not many careers where you get to be challenged and stimulated until your last breath, and medicine is like that, and it's such a privilege to be a part of people's best days, worst days and in between days. So, I agree with you and I think we need to be well ourselves in order to feel that satisfaction and reward and joy in our job. So that's, that's what I hope that this course can help bolster in medical professionals’ lives.
[00:33:25] Ryan: Yeah. We when we have people join us here in the recruitment agency, we explain to them, especially if they've come from another form of recruitment that isn't medical, that isn't dealing with doctors.
We explain to them how different this role or career with those is going to be because it's not just a form of recruitment. It's really becoming an embedded part in people's lives and that entire space of being sort of the second line behind the scenes of making sure that the critical workforce gets to work entirely changes the whole premise of the job.
So, we try and explain it to people before they join us, but until they've actually experienced it, they never truly understand it or believe me. Anita look, thank you so much for this. It’s much appreciated and thanks for being great to work with over the last year or two.
And thanks a lot for the previous course. I'm looking forward to the next upcoming course and making sure that we get that out there and get some, attendees on board, and have another great day with it. So, thank you very much indeed.
[00:34:24] Anita: Thank you, Ryan. Well, thank you so much for supporting, a course that openly talks about doctor's mental health.
It's really, really huge. I know you run ALS courses and some emergency medicine courses. It's, it's really great to see that you're supporting this as a part of an all-round wellness for your doctors. So, thank you.
[00:34:47] Ryan: My pleasure, Anita. Thank you very much indeed. And I wish you well.
[00:34:51] Anita: Thank you. See you. Bye. All the best.
[00:34:53] Ryan: Cheers. All the best.
