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Diplomatosis – masochism or emancipation?

Once upon a time, far too long ago, in a distant careers advice lesson, a group of school pupils were asked what they wanted to be. There were the predictable car mechanics, fashion designers, firemen, teachers, etc. One girl, out of boredom or cheek perhaps, stated that she wanted to be a professional student, so she could just keep on learning, and if that didn’t work out then maybe a doctor.

Two years later, university application forms completed to set off on a path to maths and philosophy – a perfect launch pad to a lifetime as a ‘student type’ – a close encounter with a gangrenous appendix changed the course of this young woman’s life forever. Then, whilst lying on an old Nightingale ward hooked up to a multitude of tubes, watching the young and old doctors on their daily rounds and chores, came the fateful thought ‘I want to do what they’re doing…’

Two decades on, with all the junior doctor years past, the professional qualifications completed, and a few other useful College diplomas, surely it was now time to sit back and just use what learning had been accrued. There were plenty of opportunities to read a little more here, update a bit more there – medicine is, after all, a constantly evolving, life-long-learning profession. And now, with a family to focus on, that’s enough to keep anyone occupied… So why, then, jump into yet another post-graduate diploma course?

As people, and as doctors, our interests and skills are varied, something that makes primary care such a rich and diverse career. There is literally something for everyone, with opportunities to develop skills and portfolios in almost every aspect of healthcare, from teaching, to research, sports medicine, geriatrics, pre-hospital care… the list is endless. Not all interests require a post-graduate qualification, but for many it helps. For other doctors the drivers are their patients’ needs, perhaps to fill a perceived gap in services. And then there are those that relish the challenge, or the potential career opportunities that a particular qualification may open.

To be honest, for me, it was a bit of all of that, and something of a ‘perfect storm’. As an ex-pathologist I wanted to use my specialist experience to directly help patients, and dermatology was an obvious choice. Then I moved to Arran, where the visiting dermatology service had been withdrawn five years earlier, resulting in a clear unmet clinical need and an opportunity to develop an extended role. And then, of course, there was that burning desire to keep learning, keep challenging my limits.

The Cardiff University diploma in practical dermatology was never going to be easy – 10-plus hours of study per week (on the part-time course), stressful assignments, all while working full-time and out-of-hours, and with a daughter in primary school. Thank goodness for a very patient and supportive partner and colleagues. And it was expensive, though I was lucky to have the financial backing of the trust Primary Care Developments Team, which paid the full costs.

So, diploma certificate in hand, and more letters after my name than in it, what did I get out of it? Knowledge, to develop a local enhanced service desperately needed by our patients; national and international contacts, on whom I can call for moral and clinical support; trust, in my abilities and limitations as a doctor; enhanced evidence-based decision-making skills, for when the guidelines don’t fit neatly; and the self-awareness and confidence to recognise and develop my natural abilities and dreams…

…and the satisfaction of doing what I said I would all those years ago!

 Dr Cathy Welch is a GP on the Isle of Arran and a professional student of life