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Angharad Spencer: Interview With The Right Fit HIPster Award Winner

The 2016 Right Fit HIPster Awards is a collaboration between Medelita and FemInEM with the purpose of celebrating and rewarding women EM residents who have identified a problem facing physicians, patients, or their community, and who have done something about it. With over 45 submissions from highly qualified applicants, our judges selected the top five winners who we felt most strongly have embodied this goal.

This week, we sat down and spoke with winner Angharad Spencer, MBChB, MRCEM, DRCOG, DTM&H, who has been recognized for the development, implementation and study of two training programs for pre-hospital emergency responders in Malawi.

Name: Angharad Spencer

Age: 33

Residency program: UK Emergency Medicine Training Program

Medical school: Sheffield University

Passion project: Trauma care in rural Malawi

Favorite movie or TV show: Anything that’s easy watching and cheerful after a long shift – particularly Friends and The Great British Bake Off!

Favorite or current book: Barbara Kingsolver’s the Poisonwood bible.

Favorite hobbies: Well, I have a toddler daughter, so if I’m not at the hospital you’ll likely find me at the park, swimming or tidying up mess! Travel is my other big love so I’ve been trying to develop some photography skills to make the most of that.

Now for the real questions...

What would you have been if you weren’t going to be a doctor?

I think I might have been a travel writer or photographer. I really enjoy adventures - exploring, meeting interesting people, learning about different cultures. That’s one of the huge appeals of Emergency Medicine for me: I am always meeting new people and seeing insights into how they live their lives.

Best advice for people considering a career in medicine:

Healthcare is a difficult topic in the UK right now. Our healthcare system is entirely nationalized, so it’s quite a bit different than healthcare in the States and the current government are using the NHS as a political football. My advice for another person in medicine would be: don’t let the politics put you off.

It would be easy to get caught up in the negativity surrounding medicine in the UK at the moment but I still believe that we have the best job in the world.  We have the privilege of caring for people at their most vulnerable, we engage our brains and learn something new daily, have the camaraderie of teamwork and no day is the same. There is always a new challenge, and that’s what makes medicine so interesting.

Best words of advice you’ve received:

“Don’t be nervous and just do it ‘ and ‘always treat everyone with respect, no matter who they are’. My mum worked in a male dominated field and she always impressed on me the idea that I shouldn’t hold back from any opportunities but that I should treat everyone I work with from the cleaner to the boss with the same kindness and respect, as attitude will always come back to you. She often told me that a man will apply for a job when their CV is 70% there and get the rest of the experience on the job, whereas a woman will have 90% and hold back because she thinks she’s not quite ready. I thought of that when I set up this project!

Most inspiring role model in your medical career:

Both my own mum and my husband’s mum have had a huge impact on me. My husband’s mum is from Malawi, an incredibly strong woman in a region where it’s unusual for women to have that kind of role. In Malawi she works as a receptionist at a clinic, which happens to be the clinic where I met my husband! She is also staunchly pro-women’s education and supports dozens of children around her. It’s amazing for me to witness how her joyfulness and hard work have such a huge impact on the children and health of the local community in Malawi.

What is the most important skill you’ve developed on your path to becoming a doctor?

I’d say communication and compassion. Many people begin medical school because they want to make a difference and help improve lives, but a lot of times that human contact is lost during the treadmill and intensity of training. It’s important to learn how to hold onto your compassion so we don’t forget why we’re really in the job and without good communication skills its hard to achieve anything else.

What do you love most about what you do?

That’s easy: the patients. People are just so fascinating, and getting to meet so many different people from so many different backgrounds is a huge privilege. It’s never dull and every shift has its new challenges, but I always have at least one patient a day who I feel I was able to make a difference for, be it large or small, and that makes it all worthwhile.

What is the most inspiring patient or clinical experience that you have had?

Two cases really stick with me for different reasons. The first was in Malawi when I saw an emergency paediatric case where the child was really struggling to breathe. She had a high fever, drowsy, ‘sick, sick’ as we call It in my department. I struggled to find out from the mum how long she had been unwell and it turned out she had been sick for a week but they had had to wait to find the small amount of money needed to access to the clinic.  The young girl had malaria and superimposed chest infection and the nurse and I spent all night trying to stabilise her and improve her breathing with the few resources we had but sadly she died by the next morning. The mother had such dignity, thanked me for trying ‘so hard’, wrapped her up and walked with her the rest of the way back to her village to bury. That girl was the same age my daughter is now and I still think ‘if only they had been able to come sooner’ or ‘if only we were able to do more’.

A few months later I was back in the UK and treated a young man who walked in ‘intoxicated’. He suddenly deteriorated and was found to have a ‘hidden’ stab wound, which turned into a massive haemothorax, we stabilised him and I accompanied HEMS (slightly terrified as I was relatively junior!) on transfer to a trauma unit where I watched trauma surgeons immediately find the bleed with a thoracotomy while teams of anaesthetists, nurses and intensivists saved his life. He walked back into my ED a few months later to thank us.  That case inspired me to want to be a better resuscitationist but also highlighted the reverse culture shock to me, the fact that as a medical profession we are capable of so much but so few have access to our resources and services.  That is what motivates me in what I do. Sadly the first story is a daily occurrence in Malawi, all of my husband’s family and many friends are there, and we have lost too many people we love to lack of healthcare and inequality. There may not be anything we can do about many of the causes of inequality but this project was our way of trying to make a difference.

What is the biggest challenge you’ve seen for women in healthcare?

From my point of view, childcare and family life is a huge challenge when you work in medicine. This job can be very emotionally trying, and as a doctor work takes up a huge part of your life. In emergency medicine particularly, shifts and schedules are often very intense, and I know that my family sacrifices a lot for me to be able to do my job. I have such appreciation for my husband, who is a full-time dad, because it simply would not be possible for me to have a child, study, take on voluntary projects and do the shifts that I do without his support.

What is the biggest challenge for healthcare system today?

There are a lot of challenges for healthcare in the UK at the moment. There is strong feeling the current government is deliberately underfunding healthcare and the NHS in order to push privatisation of the system. This has resulted in many doctors leaving, major staffing problems, rota gaps, lack of beds and social care and made front line work extremely difficult. Which all takes away from the real issues: how we manage an ageing population, increased demands on healthcare and rising inequality. UK and Malawi have similar problems in that regard.

What do you plan on doing with your $500 award?

I’m going back to Malawi to continue my work this December; I’m in the process of planning that trip now. Since my project is completely self-funded, I’ll be using my prize winnings to offset the costs of the first aid equipment I need for that trip, which the team there are all excited about. There is so much opportunity in that region to improve healthcare, and my work goes towards making those improvements more sustainable through ongoing training of emergency responders.  

How do you try to convey a professional appearance at work?

My lovely husband irons my scrubs every day before I go to work as apparently my ironing is not up to scratch, so he’s excited about the prospect of Medilita iron free scrubs! Trying to look professional and having a professional attitude is definitely part of the job.