Dr Bushera

Interview: Dr Bushra

 

Bushra: So, my name is Bushra Chowdhury and I'm a GP and I have a special interest in Women's Health. 

​

Kate: Why did you choose this particular specialism? 

​

Bushra: Career in general practice really suited meet my personality because I really like people. I like getting to know people's stories, so I think that side of being in general practice when you get to know people basically from cradle to grave, you get to get. Relationships with them see the same people. So that really attracted me to the people's side of it, but also the broad range of different medical pathologies that you can see. So, you see a a variety of different things and no days the same. So, I quite like the variety and the sociable aspect of it. And I and I love the fact that you're in such a privileged position where you know people will trust you with information that they don't tell a single person in the world. But you'll be Privy to that kind of information and. It's quite a. Special place to be in with people because they do generally tend to trust you as their doctor. 

​

Kate: And why specifically, women? 

​

Bushra: Womens Health, I think I kind of fell into it as I may. Best job I always had an interest in it and I was developing it, but my first job was joining a GP practice where there'd been 4 male doctors and not had a female doctor there for considerable number of years. I think it was something like 12 years. So when I joined all of a sudden, I was getting a large volume of the female patients that. And maybe he hadn't felt comfortable to present to the other doctors. Or would you just prefer to see a female? So then I further developed the interest and did some more qualifications in it. And I I I quite like it because. To to be specialised in the problem solving you have greater insight. Being a woman yourself, but also it's all stuff that's going to be useful to me potentially in the future as a potential patient myself. So it's quite nice to have a specialism in. That area, yeah, yeah. 

​

Kate: Sorry, I feel like I've already gone off peace. It was slightly, but I've just got one more question that's a bit random. Not one of the ones I sent you. But yeah, when when I'm, I'm just thinking about Women's Health in general, so. Because you hear lots of news stories about how women are given maybe like, like the same medicine or like all these trials are on men instead of women. I'm just curious about your thoughts about that, you know, like so in terms of like the the inequalities about Women's Health, do you feel like it's? 

​

Bushra: Quite, yeah, I think. The inequalities across medicine are quite apparent. Still just looking at the disparities between the different sexes, when even when it comes down to. A you know access to the top positions, access to management roles within the NHS, so there's disparities against that. And also with regards to ethnicity as well there there is you know they've said there's a glass ceiling but that you know that people don't even get a chance to even progress in certain fields. Because of their things are are basically prejudice against them, but it's it's it is a massive difference with regards to access to trials. I think there's a lot of work being done to try and balance the inequalities and studying. A broad range of the population, not just specific. You know, white, middle-aged men. It it, there is work being done around that, but there's a long way to go I think. And we do need to have more research where it represents the general population as a whole rather than just representing more women because there's intersectionality amongst that as well. 

​

Kate: Yeah, yeah. How did you find medical school? 

​

Bushra: So medical school was brilliant. It was. It's the first time I'd ever like, you know, lived away from home. So I was 18 years old. I moved, moved across, moved towns to to Leeds and studied in Leeds. So it was a a real massive culture shock because I've gone from living quite in a in a very strong family unit and and then. Living with five of the strangers, but it was actually brilliant, so I lived with six girls. There were six of us, all together, and we all got on really well from all from across the country doing different courses. And so it was really great. It was really great from our confidence meeting lots of different people. Medical school was tough. It was tough. In terms of, I had a lot of hard work to do. I also felt like being from an ethnic minority and a female in. At medical school, you were always kind of like felt that you had to work that bit harder or be that much better to shine in order to get recognition. Or to be. Perceived to be doing as well as the others. So that was something that was always at the back of our minds. But I made some fantastic. Friends, I'm still friends with now. Our so this year will be our 25 year anniversary of when we met at university. Yeah. So my best friends. You know, we lived together, we have studied and graduated from Leeds. It was brilliant in terms of the people that I met, the life experiences that we've shared at medical school and since then and. And it's, you know, propelled us into your careers in medicine, which, you know, we all really. Lucky to be in. 

​

Kate: How has the NHS changed since kind of starting out? Since like you're at medical school and like the first early years, yeah. 

Bushra: I think there's been a lot of changes. It seems that there's there's a. Lot of. Sorry for the interruption, this is my mum, mum. It's OK, I said that you were in the garden. 

Bushra Mum: I was doing some how are you? Yeah, yeah, I'm good. Do you want to drink? Are you OK? I'm OK. Afternoon. OK yeah. Sorry about that, don't worry. 

​

Bushra: Yeah, sorry, the question was. Yeah, the NHS has changed. Yeah, apologies for the interruption. So the changes in the NHS, I would say that it feels like we've become more understaffed. Workers in the NHS have felt, feel more and more unappreciated, and the workload has got higher and higher. Certainly, within general practice, I'll give you an example and the two of our senior partners retired this year and we've not been able to recruit to replace them. So we've got a a massive increase in our workload, but we are really struggling to recruit and and it it's across the board in in different specialties. As well, a lot of people, especially doctors who I know are, are moving abroad for better working conditions, better pay and also better work life balance. So I think that the working conditions are getting more difficult for us to. And a good enough income versus having time off versus being able to afford the things that you do and with the cost of living prices that's made it a. Lot more difficult for. A lot of people in the NHS. And so unfortunately, I think that there's been a lot of changes that it boils down to underfunding and also the appreciation. So during the pandemic, you know the doctors and the healthcare staff were the good guys. But now few years later, you know, we're all the bad guys. People are striking for better pay and and yeah, so it seems like, you know, the attitude. Has changed or the media reporting of it has changed, so it's difficult to gauge what people think. 

​

Kate: How did you feel about the claping for the NHS during the pandemic? 

​

Bushra: So at the time, you know, we thought, yeah, it was a really nice thing to do. Gay, gay people, a sense of community because we were doing it together during the pandemic. You know, people often didn't know their neighbours before them, but during the pandemic, people got to know their neighbours. It really did bring people together and and and support. At work I like where I grew up and I grew up here in an end terrace house and you know, we knew everybody on our terrace St. all our neighbours, the kids, we would all play together, we would all know each other really well and and you know, now that you know, we live and live in in the suburbs, we live in a semi detached house. You know, you only know your neighbours. Maybe across the road to you and the either side. Yeah, but even then, it wasn't on on the same level as as where I grew up. But I think the car coming back to your question it it was heart warming at the time, but then it just feels like was it disingenuous because yeah, it's soon forgotten. 

​

Kate: I'm curious about just what you were saying. So I've gone off peace again. But so I've noticed in teaching for example, recently I'll go to I'm a supply teacher sometimes and I go to lots of different schools and so many of the staff are also supply. But it's like long term supplies, so they're hired by agencies, blah, blah blah. Yeah, but it means everybody's paid a lot less. And you can also just be like, let go in a day, so. I think like. Work ethic is like less because people aren't like hired and engaged. I'm just wondering if it's a similar situation in the NHS. Do you have like lots? Of almost people that aren't on, like correct contracts, things like that. 

​

Bushra: I know that in the in the nursing there was a lot of nursing staff who are doing bank shifts and it it's it's better for them to do those ad hoc shifts cause they've got that flexibility of choosing when they can work. Yeah, because they're not slave to a very grueling schedule. With the doctors, it's a slightly different you can be a salaried Dr. or a partner where you own the business and you work out how you're going to be. Do seeing the patients or you can load them where you do like a bit a bit like yourself, like a supply you would be just do set pieces of work. So you might cover maternity looking for a few months, or do a few weeks of summer holidays and and you choose when you get to work, you get paid slightly more, but then you don't have sick pay and yeah. Things like a holiday pay cause it's just as. You pay as. You earn, yeah. And you get paid as. 

​

Kate: How have you been affected by the strike action and what are? 

​

Bushra: So initially with the was the junior doctors strike and and I'm fully supportive of them because from when I graduated at that time you would it was the first time you were earning but we didn't have the massive student debt that. What union doctors have now. So you as a a nearly qualified Dr. you know you're graduating with at least 30 to £40,000 worth of debt as a minimum and you're being paid. Need a small amount and from that you've got. To pay your rent, pay your bills, your Council tax, and also pay off your student loans and have some money to actually enjoy your life. And you do sacrifice many years of your life working in the hospitals or working towards your specialism, where you have to. Move where you live. Every six months because you're on different rotations and different. Areas they might not all be close together, so there's a lot of work that you know you put in. And I think that they should be rewarded enough to be able to have a comfortable life and not be struggling. You know, we've heard of lots of doctors using, like food banks, you know, junior doctors is not not being able to afford to live or to. Afford rental to even look at getting on the housing market, so there seems like there's something definitely broken with the system. There and and and now all the way up to the consultants are now striking for better working conditions. Seem like there's thousands of doctors every year who are actually moving to Australia, Canada, because with the qualifications in the UK, they are recognised in other in other places and the money is part of it, but also. The work life balance because you're working very, very long hours here as well. So and then when you finish working, you know you've got very minimal time where you can get to enjoy, enjoy your life. So I think a lot of. And a lot of the consultants are moving abroad as well for that balance, like fully supportive of the genius and the consultants. It's slightly different for the GP's because as a GP partner you are self-employed so you are and then you're given a contract, you deliver it as a self-employed, so we're not. 

​

Bushra: Employed as like the hospital consultants from the the junior doctors are so slightly different, but there are a lot of grumblings amongst the general practices as well.

​

Kate: Are your working hours more flexible? 

​

Bushra: Then is it so you are basically work as as much as you need tea tea you get say like a pot of money to deliver the services for your patients. So whether you decide to do those yourself or employ other doctors or other healthcare professionals to to help with seeing their patients. That's how you run the business, but I know there's a lot of practices. Who are struggling to deliver the services with the money that they are getting so that like GP practices are actually handing the contract back because they're not able to fulfill them. So I think that's gonna happen more and more in the future if things get worse with the cost of living crisis and things, yeah. 

​

Kate: Yeah, it's really sad to hear that doctors are going to food banks. 

​

Bushra: Yeah, I heard that with some junior doctors about that. They were just struggling tea with with the cost of living crisis and they are on on, not on a a massively high income when they first graduate so. 

​

Kate: UM. Have you or a colleague that you know ever experienced sexism, homophobia, or racism within the workplace? 

​

Bushra: Yes, I have. I would say that when I first qualified as a GP in my surgery, like I mentioned, I was the first female GP there for very many. Years and also being like quite a newly qualified Dr. I had a lot of patients and not really trusting my medical opinion at that time or they would assume that they'd see me and I wasn't a doctor, that I was a nurse. So actually they would then phone. Up and see the other doctors for a second opinion to check. What I'd done was correct or they wouldn't want to see me because they perceived me to be too young and inexperienced, which I kind of understand. But I think some of it was to do with my age and also maybe they they didn't see me as being a qualified Dr. Yeah. And and. I think. As a junior doctor, you know there were. There were some instances where I felt like I was treated. I had differential treatment because of the colour of my skin and it is sometimes it's very difficult to prove because when somebody's overtly racist towards you, that's actually quite easy to handle because you know all this person has said this and it's very black and white. It's a very subtle things that it's really difficult to sometimes explain, but you know that that you you get this. Sense of this person is not treating me the way I should be treated because they don't like me because they've made a judgment on something and it might not always be the colour of your skin, but sometimes it it you feel like it could be and you can't prove that. But I do know that a lot of my colleagues and some of my friends have experienced quite gross. Of Islamophobia and also racism working in the NHS, where there's being bullying amongst managers and from their managers and also from from peers as well. And and I think that it is something that. Should be challenged and I do know some. I'm a trainer now, so I train other junior doctors to become GP's and I've had talks with some trainees who have experienced quite significant racism, both from patients and also. The seniors in in their teams and and that's really upsetting to hear. But it does happen and you know and often those people who have told. Me about it. Don't want to say anything because of fear of what it would mean for their future careers. They just want to put it behind them and not have to deal with it again, which I completely understand and respect, but you can understand why, you know, they don't challenge it. 

​

Bushra: And quite often it's because they're international. Graduates so they have a a perception that it, you know it will be really detrimental towards their career. So there's that extra fear. Yeah, so often it's not always talked about. 

​

Kate: No, it's it's it's. It's an interesting one cause it's we had experienced a lot of. Sexism in one of the schools I worked at, and it was very difficult to speak to the head about it, and he was very much like, no, no, no, this isn't happening. There's just like under the rug. So I was just curious was you're kind of talking about how? You know with I guess with yourself, these women feel comfortable talking to you, but what's the sort of system like the structure like? Is there much? Port in terms of this? Or is it just kind of like most people just actually rather just not talk about it? 

​

Bushra: Yeah, I think that there are support structures that you know and and I think of over recent years at the Royal College of GP's and other like the training schools they, you know, pushing on equality and. Diversity training and you know, trying to be more inclusive and making sure that they're. You know, providing much support for people who are experiencing that, but I think there's also. A bit of naivety that I don't think that they understand the scale of the problem. Yeah, that. But it's something that is being looked at and and I think there's lots of external groups who are trying to, you know, really push that agenda forward and working with people who've experienced that level of racism. But also things like even the GMC you know, you're more likely to be reported to the GMC if you are from a, a, an ethnic minority background and more likely to be struck off or have much heavier. If you are from an ethnic minority background. So it's something that, you know, that we all all feel that is unfair. But it's when your regulatory body is also to be deemed to be unfair. Then it's just, yeah. It's like, who do you trust? 

Kate: Yeah, that's quite shocking, isn't it? But it's also in the same way. It's also not. Do you know what I mean? Like it it. Yeah, it's so sad. UM. Do you feel there is kind of sort of briefly touched on this, but do you feel there is sufficient mental healthcare for medical professionals? So, for example, if you're, if you experience something maybe quite traumatic with a patient or or or just something that's, I don't know, you might need to talk to somebody else about it. Is there kind of like a support network in place? 

Bushra: I think there are support networks. It's like if you feel that you are suffering with mental health issues and need some counselling, there are support things like that. But we do know that there's a very, very high rate of suicide amongst medical practitioners and and often you know that sometimes it can be as a on the back of a complaint. Or some kind of disciplinary through work, for example, people who are being referred to the GMC, they used to be of quite a long wait for them to get an outcome of the investigation and as a high portion of people who committed suicide while they were waiting for this GMC investigations. I would say like you know there is a level of transparency if you have a hard day, you see patients and you know you hear some really harrowing or upsetting things. So it depends on the environment that you work in, cause general practice can be quite isolating. Sometimes if you're working, you're you're working on your own in a room with people coming in now. So unless you sort out one of your colleagues and I've just seen this, which we tend to do and talk to each other about difficult cases of someone. He's just stuck in your. I think having like a a peer support group is quite good. You know people who are medics who under. Stand so so like if I told my husband to say he's non medical about something, he'd be absolutely traumatized and horrified and probably would lose sleep over it. So I would be very selective of what I would tell him. I tend to tell him, like good cases are happy cases or, you know, pick this up or something like that. But the difficult ones are probably wouldn't tell him because. The impact it would have on his mental health, yeah. But if he's speaking to other doctors, usually my friends in a in a a peer group and tell them about a case, obviously not giving any confidential information, but just general discussions around a case that can be be really helpful. 

So I think it's probably more. In your individual support. Groups, but there are groups available for people who are suffering with their mental health, but it's not something that I really know too much about, some that access them. But there are definitely support, yeah, more so available now for practitioners who are struggling. Yeah, yeah. 

​

Kate: UM. What would you do if you had? The power to change elements of the NHS. 

​

Bushra:I think it I would diversify the top level workforce so people in the boards and CEO's who making management decisions about it, I would make sure that there was a accurate representation of different populations, including ethnic minorities. Are more women. In the top positions because there is that disparity and I think they may make more inclusive decisions and have better systems for everybody if the voices of everybody are heard. So I think that would be one of the main things I think and also diversifying the. Doctors who are training so at the moment, as as we're getting on, is getting more and more expensive to go to medical school. So you tend to get people who are from very rich backgrounds going. I I'm from a working class background. My parents both worked and it was incredibly lucky to be able to go to university and not have to pay extortionate tuition fees. So you know, if it was my time again, I might not be. I might be put off and not be going to medical school because of those high levels of debt. That and borrowing that would have to occur. So I think having a look at you know the people who are becoming the future doctors, is it if we're going to have just like people from very rich middle upper class families and we're gonna have a very different workforce, it's important to have people from all walks of life who are definitely capable. It's just about the opportunities. To be there. So I think diversifying the populations from where they come from, so we've got more representation across the board really I think that's the way to change the attitudes and I think. You know, we haven't got enough doctors or nurses and all the healthcare staff and and you. Know we go. We often recruit from abroad, which is great, but we also need to time, like encourage like homegrown, you know, nurses and make it easier for people to train as nurses and. More attractive as a as a career because. But previously you were able to have a bare sweet tea trained to become a nurse, but that's been removed, so it's naturally going to have an impact, a negative impact on the number of nurses we're gonna be able to train at home. So I I think that would be another thing like more resources for people to train here to access those kind of. 

​

Kate: How do you feel women are represented within the NHS or medical profession? 

​

Bushra: So I would say like. Considering that the women make up a large proportion of the workforce, especially doctors now in medical schools is a large amount of women, there's more women than men training to become doctors. I would say that it's still. Doesn't seem to be like the PR of. It doesn't seem to be getting across like you know, the the women are a higher proportion of the of the workforce. It still seems like it's a very much male dominated profession that they're it needs to be the the males are the ones who are making all the big decisions. I think the. The perception when old women have to go on maternity leave to go away and have their babies as deemed as a a. Negative and it does have a negative impact on women's careers as well when they're of childbearing age. Whether what specialty they going to go into if they are seated, they're gonna go away and have children. It's like a negative thing. But and it's sometimes, it's not very well supported. I think more so in hospital, but that might be. An assumption of mine. And I would say that. The famous women in medicine are not well known because they're not just talked about. So I think there's probably some learning to do for like, you know what famous women have done throughout the years for for the the field of medicine, I would say there's definitely. Some learning there. For me personally as well, yeah, yeah. 

​

Kate: That kind of leads perfectly to the next question. So when you're thinking about the history of medicine and the NHS, is there a particularly influential woman that you would consider a hero or idol? And if you can't make anyone in the NHS or medicine just in life, or in general, who's kind of an idol for you and why? 

​

Bushra: So I would have to look closer to home and and I would say like two people, two significant women in my life would be my mum. Because my mum is came to this country when she was 18 years old and very young and when she got married and and then went on to have six children and you know, really fought hard and pushed us all to do well and and my older sister. Was the first female doctor in our whole family and my eldest sister was the first female in our whole family to ever go to university. And further education. She's a head teacher, so I think that's because of my mum to, you know, we're an immigrant family, first generation British, born in the North West. And thanks to my parents, especially my mum, to push her daughters to do well. And then my older sister Nyla, he is a she's a GP as well, where she that she, her and my older sister were wheel Trail Blazers. Like they moved away from home, went to university and a different. Town, which was very much unheard of and back then, and it was a very new thing, like being a a male and going to university was a big thing. But as females, it wasn't very much. It wasn't unknown to a lot of people, and people were scared about that. But my my parents. And put their trust. In in my sister's. So when it was, you know, my turn to be applying for university, it was very easy because they'd already. In that path and it was never questioned that I would go wherever I got a place and where I wanted to go. So I was more closer to home. That would be my mum and my sister's. Just, you know, propelling us onto this path of better education and and achieving our potential, yeah.