Alice from the VDM spoke to Captain Rich Elston - a University of Bristol Graduate and Junior Doctor. Rich gives his advice to Junior Doctors about how to sign up (either full time or as part of the reserves), what the training involves and what opportunities are available.
What is your role/job?
I’m a General Duties Medical Officer (GDMO) in the Army. I’ve been in the reserves for the last three years but have recently transferred to the regular Army.
What does being in the reserves mean?
Being in the reserves means you are in the Army but not full time. It’s a great balance between maintaining a civilian life and career while benefiting from the many great things the Army has to offer. 243 (Wessex) Field Hospital is Southmead’s local reserve unit, there is a two week training camp every year as well as training every other Tuesday evening and one weekend a month. You don’t need to attend it all, but it’s often challenging and enjoyable meaning most want to attend as much as life allows.
What was the best thing you did with the reserves?
Last year I lead a team of eight during a two day patrolling competition. We had to navigate through the training area to different stands where we were faced with situations like a mass casualty scenario, fighting in an urban environment or prolonged field care. It was physically and mentally demanding but very rewarding and the build-up training was excellent, we learnt a lot. It’s definitely made me a better leader and clinician. There are lots of opportunities like this in the reserves.
How could I get involved in the Army?
There are two different ways to join, the regulars or the reserves. There’s a reserve field hospital in Bristol (and many more all over the country) who will recruit anyone from medical students to consultants, for more information phone 01179 863571 or don’t hesitate to ask me any question (Alice will be able to pass on my details). Or you can join the regular Army, this can be done during medical school, at the end of F2 or as a consultant.
What do you do now you are in the regular Army?
Essentially I’m a post foundation junior doctor working in a supervised military GP role. Our job is incredibly varied. The default when we’re not deployed is working in a military GP practice running supervised clinics. During the week we also have sessions when we run training for combat medical technicians, do physical training with our regiment and advise our unit on occupational health. We can also use our time in the week to do QIPs or research.
What about deployments?
These are just as varied. We can be deployed on exercises or operations. There are many UK based exercises but the Army also trains abroad in places like Kenya and Canada. On these exercises we either provide real life support i.e. treating all the injuries and illnesses which come with deploying a large number of soldiers abroad in physically demanding conditions. Alternatively we might be part of the exercise and train by treating simulated casualties. There is also the opportunity to be deployed on operations to places like South Sudan or Afghanistan.
How does supervision work for a GDMO?
We are in a training post so everything we do is supervised. Often this is straightforward as we are working with a fully trained GP. At times though we might be deployed to remote parts of the world as the only clinician. We have a robust telemedicine system which allows us to reach back and ask pre-nominated specialists, we can send clinical information and photos securely.
Do you have specialists in the Army?
Yes. There are lots of consultants in the Army. Some join directly as a consultant but most start speciality training after three years as a GDMO. There are lots of consultant GPs who do a mix of clinics, exercises and operations and many consultants in secondary care. They spend much of their time working in an NHS hospital but will also spend time away on exercises or operations.
What training have you had?
After F2 all the new GDMOs attended Sandhurst for eight weeks. This was challenging but I learnt a lot, met some great people and loved it. After Sandhurst we went on to phase two training, a four month course aimed to turn us from civilian doctors used to working in a hospital to military doctors prepared to work in remote situations across the world. It was a great course and covered a huge range of topics like pre-hospital care, obstetrics and medical planning.
Room ready for inspection
What was Sandhurst like?
Hard but fun! It started with basics, so up at 0530 to iron our beds ahead of the morning room inspection (everyone’s room had to be immaculately neat and identically laid out, down to the way our toothbrushes faced). During the day we learnt to march, use weapons and navigate, often lessons wouldn’t finish until after 2100.
As the course went on we got more freedoms and were tested in different ways, mostly in the field. The culmination was a five day exercise, it was hard work living outside for that length of time especially as we were busy with attacking and defensive action during the day and night. The situations felt very real. The lows, such as a 2 mile march with all our kit (circa 25kgs) in the driving rain on the morning of the rugby world cup final, were also the highs, especially to look back on! We certainly learnt how to look after ourselves and our kit and how to get warm again.
Why did you join the Army?
When I was a student I did a week long expedition medicine course, one of the faculty was a reservist who had just returned from Afghanistan. She was very inspiring and showed me that there is so much more to medicine than just working inside a hospital. It made me realise how accessible it was to join and how many great opportunities there are within the military.
What advice do you have for Junior Doctors in challenging circumstances?
Take things one step at a time and pain and discomfort will be temporary. It sounds cheesy but one thing I’ve definitely learnt from being in tough situations is that no matter how much pain you are in, how wet and cold you are or how disordered a catastrophe may seem, the moment will pass. Work through it methodically and it will be over at some point, you’ll get back to your warm bed and in a few years it will just be a memory.
What is your favourite social distancing activity?
Has to be cycling. We’ve been blessed with some great weather and it’s such a great way to get out into a different head space. It’s also great because you can plan all sorts of post lock-down cycling trips.
What one book would you recommend to Junior Drs?
Turn the Ship Around – David Marquet. “We take intelligent young people, put them through rigorous training and then just make them follow algorithms” This line could be about medicine as much as the US submarine on which it is set. Marquet took over the worst performing boat in the fleet and made it the best by giving power back to his crew and encouraging them to make decisions. We should all aim to work in an environment like that and to help facilitate it. If everyone followed its principals I think hospitals would be a much better place to work and job satisfaction would massively increase.
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