What’s it like Working as a Doctor in the British Army?

RAMCNicola MacLeod, writing in the British Medical Journal, answers questions about working as a doctor in the British Army:

How difficult is it to get into the army medical services?

There are plenty of opportunities to join as a doctor. I joined at university and enjoyed financial support through my last three years of study on the cadetship scheme, which is now known as the bursary scheme. It is possible to join at various stages of a medical career in most specialties.

Is it difficult to leave the army once you’ve joined as a doctor?

Joining the army does involve making a commitment to at least three years’ service on attaining your commission. This can be extended at various stages if you are enjoying the work.

What skills can doctors gain from working in the army that they can use elsewhere?

The army offers a slightly different brand of medicine. I speak largely from the perspective of general practice, which, as with most other specialties, focuses on the core skills you would expect to develop in an NHS practice.

We look after soldiers and often their families, but owing to the nature of our work in diverse environments, many doctors are able to have a more portfolio career. This may include sports and rehabilitation medicine; occupational or aviation medicine; travel, expedition, diving, and altitude medicine; medical education; disaster and conflict medicine; clinical leadership; and pre-hospital emergency care. We are often able to develop these to postgraduate diploma or masters level, and in other branches of military medicine there are similar opportunities.

All doctors also find themselves with responsibility for developing other health professionals, from training soldiers and supervising combat medical technicians to specialty training, education, and research. We gain leadership development and often have responsibility for planning medical support to sports events, expeditions, overseas exercises, and operations.

What is the pay like for a doctor working in the army?

Pay is similar to that in civilian practice. There are also financial incentives available to those who wish to join either as students or fully qualified doctors. Medical officers can get a bonus of £50 000 once they complete a year of probation. There are all sorts of other perks you get as an armed forces member, such as a generous pension and annual leave and cheaper train tickets.

Many army colleagues are reservists who enjoy the best of both worlds. For as little as 19 days commitment a year, GPs, nurses, and a whole range of other medical professionals are practising their roles in a refreshing environment that complements their civilian training. They also receive the same pay as they would while in their civilian role if they are deployed.

Are army medics likely to see combat?

The Army Medical Services join the army wherever it goes to provide health service support, and that is sometimes in conflict zones. There are plenty of opportunities to mould a career to suit personal interests, but many posts take doctors to combat or combat support units, deployed hospitals, or other medical units to provide healthcare to troops.

What do you think are the main misconceptions that doctors have about working for the army?

Some may be concerned about the combat side. But, like any other soldier or officer, we go through basic training to allow us to understand and operate alongside others in challenging environments. In advance of any deployment we are trained to the standard required to be able to do our jobs as doctors.

Others may be concerned about the change in scope of practice. Some of our practice is different, but we train and maintain our skills in the NHS. In primary care our initial training is between NHS and military practice and we retain a number of family and training practices. In secondary care, unless we are deployed, we also work in the NHS. Primary and secondary care in the army are well integrated and we enjoy cross discipline peer support.

Although flexibility in employment and location is not always associated with military life, I’ve found choice to be an important part of why I enjoy this work. Longer term, I have some flexibility to choose the type and location of my practice. Even on a day to day basis we are required to make space in our practice to spend time in diverse activities, such as teaching soldiers, developing our small deployed practice, practising casualty evacuation, or joining unit or army teams for sport, mountaineering, and other training.

Is it more difficult for women to work for the army?

Women have always been well represented in the Army Medical Services. Doctors are employed across all roles on the basis of skill and competence and we enjoy the respect of those with whom we work. There are challenges in the job for men and women alike and, in my experience, peer support is second to none.

What does the future hold for army medics once the military is no longer on active service abroad?

The variety of positions remains wide and rewarding, and the army is certainly no less busy or challenging as the Army Medical Services retains its role in responding to military and civil emergencies. There is a perpetual need for health professionals to keep our soldiers fit and cared for across the spectrum of operations and training. Outside of this, our people and units have a part to play in humanitarian assistance, such as recent deployments to west Africa to help combat Ebola.

Nicola MacLeod

Nicola MacLeod is a general practitioner in the British Army. She is currently working as the regimental medical officer for the Royal Highland Fusiliers, 2nd Battalion the Royal Regiment of Scotland, in her home town, Edinburgh. Nicola graduated from the University of Glasgow in 2003 with degrees in medicine and physiology. She has augmented these with diplomas in sports and exercise medicine and obstetrics and gynaecology and pursued an interest, founded in electives in Johannesburg, in prehospital emergency care. After junior hospital jobs in Glasgow, North Yorkshire, Frimley Park, and Headley Court, she completed general practitioner training in Warminster. She has been involved in a broad spectrum of clinical and non-clinical work, from UK primary healthcare to responsibility for healthcare in remote Kenya, expedition medicine, and work as an infantry medical officer on tours of Afghanistan and Iraq.

AMD-Rec@mod.uk

Reference

MacLeod, N. (2015) Becoming A Military Doctor in the British Army. British Medical Journal. 17 January, 2015. 350:1-38 No 7991, pp.4-5.

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