Clinical DCS Report Dr Catherine Swales

Clinical School Update: Emerging from the ashes - not quite a phoenix, but still flying

Dr Catherine Swales

(Wadham College, 1997) Director of Clinical Studies

I’ve started this paragraph umpteen times, and then thought “But is ‘business as usual’ really worth saying?” and deleted whatever I’ve written. This time however I’ve had a small epiphany, or reframing, or realisation, and will leave that line in place. After the last few weeks, months and years, ‘business as usual’ is absolutely worth saying. The more familiar steadystate has been woefully lacking of late, and toddling along is a welcome pace. That said, whilst it feels that the COVID waters have (at least temporarily) receded, there is much debris left behind, with which we all struggle. Many students feel underprepared due to COVID-limits in the early clinical years, anxiety and stress levels are high, and faculty are stretched to try help in limited time. On the NHS side, staff are worn out and bruised, but still having to pitch extra-hard to keep services afloat: staff absence is at an all-time high due to ill health and stress, many trainees are asking to work at less than full time, rota gaps are deep and wide, and the backlog (a dreaded word in any clinical meeting) is at toppling heights. The emergence from the worst of it is perhaps not the resurrection we were all hoping for – but good things, happy stories, successes and joys are still to be found, not least amongst our students. They bring good news in so many unanticipated shapes and forms: the unsolicited emails from colleagues to tell me a 4th year stayed late in the night to sit with a patient until their family could make the drive down, from a 5th year to ask for a year off to become Editor of Student BMJ, or another for 3 years to do their dream DPhil, from an IMT to explain that when the F1 had to go off sick the students shared out the tasks and bloods and clerking to cover, that Oxford won the Duke Elder prize in ophthalmology again (we had 5 candidates in the top 10%!), and perhaps best of all “they are just such a joy to have around, so committed and kind”… That last one sticks in my mind most of all. I get a lot of those, and they make me smile every single time. Many readers may remember Basil Shepstone, who taught generations the whys-and-wherefores of radiology. He used to say: “Everyone here is clever, but you also need to be kind”. I’m paraphrasing a bit, but over 20 years have elapsed since he said that to me so a) I think that’s ok and b) I know it’s what he meant. Wonderful chap, and wasn’t he right?

And it is more ‘business as usual’, at least on the wards and in GP practices. Alas, face to face teaching is still facing a stuttering start however – so much of our teaching space is embedded in Trust property and subject therefore to different, more stringent social distancing rules than University space alone. I think I speak for all our faculty and most of our students (!) when I say that online has its advantages, and hybrid learning is here to stay, but we’d love to actually be together in 3D, at least for the Patient Doctor and F1 Survival courses, Laboratory Medicine, and DCS teaching each week. I daren’t quite hope yet, but the new academic year, just round the corner now, might bring such things.

And as for those students who don’t have a new academic year just round the corner – the finalists with a new job, a new city, a completely new phase of life starting in August, thank you for everything. For your grit, and fun (bordering on the anarchic!), your intelligence and compassion – and for holding us to account. My colleagues are right: you are a joy to have around, and I’ll miss you when you’re not. Take care out there and stay in touch!