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Why I chose... Naval medicine

Surgeon commander Funmi Chirnside explains why she chose to work for the Navy

Name: Surgeon Commander Funmi Chirnside, Royal Navy

Title:  Principal Medical Officer

Location:  Northwood Headquarters

Background

I left the NHS in 2001 after a career of ten years in obstetrics and gynaecology, and if anyone told me at that time that I would end up a GP in the Royal Navy, I would have laughed until I cried.

The change in career was a result of my increasing disenchantment with the NHS with an increasing pressure to do more with fewer staff. I was so unhappy working in the NHS. I had wanted to be an obstetrician for as long as I can remember but, after a lot of soul-searching, I decided to see if I could find another career in or outside of medicine that would offer me a new challenge. 

At my first BMJ Careers fair, there was a stand manned by Armed Forces personnel from the three services. I must have looked lost because a few people on the stand asked if I wanted to find out about working in the Armed Forces. My immediate thoughts were, ‘What on earth would an obstetrician do in the Armed Forces?’

To cut a long story short I joined the Royal Naval Reserves in late 2000 - and yes, I joined as an obstetrician. Within a few weeks I felt as if I belonged. I looked forward with anticipation to my weekly trips to HMS President, my local unit, and visits soon became the highlight of my week.

In 2001 I attended the Admiralty Interview Board (AIB), as all potential officers have to do. I spent two and a half days demonstrating my verbal reasoning, knowledge of Naval history, general knowledge and leadership. I succeeded in the tasks set to me, and was offered the chance work fully in the military rather than part-time. I had been through the same process as potential regular officers and I was told that, if I found myself a job within six months, I would not have be presented to the board again.

The medical recruiter in Portsmouth told me that the Armed Forces were not recruiting gynaecologists or obstetricians at that time but, he added, they had opportunities for a general practitioner. 

It only took me five minutes to make a decision. My displeasure with the NHS surpassed my promise to myself not to take any more exams after I passed the MRCOG in 1995.

I joined the Royal Navy on 1 October 2001 and obtained the MRCGP in December 2004. I have been working in the Royal Navy for just over eleven years. 

What I do

Each appointment generally lasts between two and three years, which means that every doctor works in a variety of places and it is extremely difficult for boredom to set in. Appointments may be shore-based or at sea. 

A deployment at sea means being the medical officer onboard whilst the ship is deployed to a variety of locations, some in the UK but many overseas. Although there are clinics to run, a medical officer also has to be flexible and see any patient that needs to be seen - any time, day or night. I have been fortunate enough to visit many coastal locations in the UK and overseas locations including Tenerife, Athens, Goa, Mumbai, New York and the Bahamas. But before you all leave your jobs to join the Royal Navy, it isn’t like being on a cruise-liner. It can be really hard work being the only GP onboard with anything from 180 - 1,000 potential patients. You’re on call 24 hours a day whilst away from the home port.

The team onboard consists of a medical officer, who is appointed to the ship as a permanent member of staff, along with a small team of medical assistants, who are a bit like physician’s assistants, an operating department practitioner and a laboratory technician. 

For longer deployments away from the UK and especially overseas, the team also includes a surgeon, an anaesthetist and an operating department assistant in case any emergency operations have to be performed when the ship is operational and or too far away from land. On board the ship we are provided with all our meals, a little shop, church services and social events. An appointment ashore, except in places like Iraq or Afghanistan, is very similar to being a GP in the NHS. The work is carried in sickbays (medical centres) which are usually manned with at least two GPs and sometimes general duties medical doctors.

Advantages

I have the luxury of having 15-minute appointments for fresh cases and review appointments, and 30-60 minutes for occupational health assessments but with an inbuilt flexibility to see any patients that are deploying abroad at short notice.

My gynaecology skills have come in very handy (thank you, NHS) as there are quite a few women in the Armed Forces who require my help. I am also a GP trainer and appraiser. My job includes line management to the 20 or so staff that work in the sickbay and medical advisor to command. My job offers so much variety that I can honestly say that boredom has not been an issue since I started.

The highlight of my career has been my appointment to HMS Illustrious, an aircraft carrier, as the Principal Medical Officer.

Challenges

Being away on deployment for anything from a few weeks to six months (or longer if the deployment has to be extended for operational reasons) means being away from our families which may mean that we miss special family events. A military doctor may have to be deployed to hostile environments at short notice and when we are deployed to hostile environments our families often go through a very anxious time until we return.

Some of the sailors live in quite restricted quarters and so contagious diseases can be difficult to manage. Usually this can be overcome by placing people with the same illness in the same mess deck. The sickbay has a few in-patient beds and if more patients need admission than there are available beds, but it might need some lateral thinking (such as using the mess decks) to be able to give every patient a bed.

At sea a medical officer is never off-duty. Occasionally when the tempo is non-stop, you work on adrenaline. Although the medical assistants are very knowledgeable there are some jobs that only a doctor can do. Being the only doctor onboard sometimes means missing out on planned visits whilst the ship is ‘alongside’ overseas, if a patient needs an appointment. 

In common with some other areas of medicine such as occupational Health doctors, the military doctor has dual loyalties - to the patient and to the chain of command. As with other doctors registered with the GMC, the military doctor may have to break confidentiality under some circumstances.

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