This post is the opinion and experience of the author
Before starting the STP, I was warned of the challenges that I would face: balancing university deadlines with workplace competencies and learning new clinical skills alongside settling into a new team of colleagues. But nothing could have prepared me for the challenges that I have been through, seemingly for having an introverted personality.
At the STP induction event, the National School (NSHCS) tried to prepare us for the challenges ahead by showing two contrasting images:
Although this was most likely a light hearted joke with a subtle warning of the difficulties ahead, I found it challenging. I wanted to do everything within my power to make sure that my journey was more like the first image than the second. I thought that if I was super organised and attacked the programme with the same enthusiasm that I had tackled everything before me, then I would be able to mitigate unnecessary challenges. Eighteen months later, it would seem that no matter how hard I tried to keep things on track, the combination of my introverted personality with an unsupportive training centre led to the anticipated stress and anxiety associated with the STP.
What is an introvert?
You may have noticed that I keep referring to myself as an introvert, a behavioural characteristic that I used to see synonymously to “shyness”. However, introversion isn’t just about being quiet, it is a personality trait that impacts your mood, energy and how you approach tasks. Whilst our extroverted counterparts thrive in busy environments and exude confidence, social interaction can make us introverts feel exhausted and overwhelmed. However I hadn’t quite realised the extent of my introversion until I was thrown completely out of my comfort zone on the STP.
I entered the STP as a ‘direct entry’ student meaning that I could have been placed at any hospital in the country that held an open STP training position for my specialism. My allocation was largely based on my interview score followed by personal preference of location. Conversely, ‘in-service’ applicants are existing NHS staff working in a recognised scientific speciality that have been nominated by their employer to complete the STP ‘in-house’. As a direct-entry student, I had to get used to a completely new hospital and a whole new team of staff. What may sound easy to some, seemed to take me several months. Simple tasks like answering the department telephone terrified me through fear of not knowing what to say or sounding incompetent. Working in such a large team was also something that I found incredibly difficult and often resulted in me getting on with my work quietly and independently, whilst also over analysing every single thing in my head. I would plan for every eventuality: “what if this happened, what if somebody asked me this, what can I do to prevent that from happening?”. I would even plan conversations in my head that I could have with colleagues so that I didn’t appear boring or antisocial, yet most of the time I felt too nervous to even initiate them. I’d build up the confidence to knock on my training officer’s door, then just walk straight past and email them instead through fear of being a “pest”.
Trying to overcome introversion
After several months of trying to settle, my attention shifted from attacking my shy personality to panicking about my training as it was not progressing as I had anticipated. Outside of the workplace, I had done everything that I could to avoid picture number two from the induction event:
- I had written up my revision cards in between lectures and started revision early to avoid exam stress.
- I attended the local networking event to meet other trainees and get some STP tips
- I had organised my elective module where I planned to do my MSc project so that I wouldn’t have to worry about performing the research at work alongside training and competencies
- I had joined the STEM Ambassador network and gotten involved in outreach projects
However, at work I did not seem to be progressing with my training. I had remained in the same area of the department for several months and this was something that caused me a great amount of stress. I had been trained to perform advanced techniques in my specialism before I joined the STP and although I don’t give myself much credit, I do recognise that I can pick up new tasks fairly quickly. I couldn’t understand why the department didn’t want to put me to better use. I would go to work each day and perform the same basic tasks, which when queried was to “ease me into the department”. The image from the induction event kept haunting me and I was acutely aware of how much I needed to fit into the three year training programme. I just couldn’t see how it was all going to get done at the current rate of progression.
I organised meetings with senior members of staff to try and get the ball rolling. The thought of expressing negative thoughts to my senior colleagues was something that gave me a great amount of anxiety as an introvert but I knew that it was necessary, so I persevered. Often I was given excuses and false promises that were further exacerbated when the pandemic hit. For my specialism, the workload began to decrease but we knew that our Everest would be post-pandemic when normal services resumed and our work would be integral to those patients that had delayed procedures. I thought that the quiet period would be the perfect opportunity to push on with my training whilst staff actually had the time to go through new techniques with me. Yet still nothing changed, I remained in the same area of the department just with a reduced workload.
My mental health was starting to suffer. I couldn’t help but fear that I would be either a) unemployable after the programme due to my lack of technical skills or b) I would somehow manage to attain a position but would be too incompetent to fulfil my role. It was time to take serious action. I organised a meeting to discuss my training progression which was attended by three senior members of my department. This alone was a prospect that I found terrifying, never mind the fact that I was about to confront them about the lack of structure and delivery of my training. Before the meeting, I planned extensively what exactly I was going to say and had even devised my own training plan. No amount of preparation could have prepared me for comments such as “maybe you need to take a more proactive approach” or “you can’t just have it handed to you on a plate”. I found the interview panel-style meeting seriously intimidating, I just wanted to escape so I selflessly took the blame for my lack of progress. My senior colleagues used my non-assertive nature as a scapegoat for their unwillingness to provide training or any kind of support. Unfortunately for a time, I started to believe them despite being described as conscientious and regimented in my previous roles.
I took their comments on board and tried to organise training sessions, but with colleagues asking me on an embarrassingly regular basis “what is the STP” and “so where do you actually work?”, I was becoming hopeless. I was starting to feel as though I was losing my mind. I’d spoken with other training centres that were prepared to train me in line with National School’s curriculum and I couldn’t see how I could possibly do any more in my current department to get the training that I required. So I contacted the National School with the hope of a departmental transfer.
Plucking up the courage to actually phone the National School and express my feelings about the delivery of my training was a mammoth task for me. I knew that as soon as I spoke with the National School the situation would start to escalate but I did not want to compromise my mental health or my future career any longer. And afterall, the National School did recommend that trainees should contact them if they have any problems or concerns…
The first phone call left me feeling deflated. I was assertively asked “why was I just bringing up this problem now after ten months since starting the programme?”. This was followed by seven months of difficult conversations with various members of the National School, all whilst trying to remain focused on my STP competencies and enthusiastic within the workplace that I was covertly trying to leave.
Unfortunately, after several months of meetings it was clear that the transfer was not going to be feasible. This was difficult to swallow but it did lead to some positive changes that finally led to some training progression. After many awkward conversations with the senior staff in my department, I identified the route of the problem. It seemed as though my diplomatic approach to the matter had done me a disservice with several members of staff appearing oblivious to my concerns until the National School became involved. I felt as though I was going insane, and it wasn’t until I confided in a fellow STP graduate colleague that I realised that this experience was not specific to me and that it hadn’t been caused by my supposed lack of proactivity and introverted nature. It was reassuring to know that the struggle to initiate training was not actually because I was incapable of communicating effectively, but my department had some issues with the expectations of the current curriculum. I am now trying my best to work around this to get the most out of my time remaining on the programme.
So there we have it, my STP journey so far! And although it has been a bumpy ride to say the least, it has made me a stronger, more assertive person both in and outside of the workplace. I now feel like some sort of freedom fighter for other trainees in the department and when a colleague comes to me with a concern, I will do everything that I can to help them. When I do qualify as a Clinical Scientist (and I will!), I feel passionate about supporting the next generation of trainees and giving them the tools not only to reach their potential, but to exceed it. I will adapt my training approaches to those of the trainee and recognise that everyone has different challenges, but with the right support they will overcome them and excel. And finally, I will not make my trainees feel incompetent because of their personality type; I will never assume that loud is strong and quiet is weak.
I hope that if anything this post can help trainees to realise that they are not alone with their training struggles. And although the National School did not magically not solve my problems (as I had naively first anticipated), their support has led to positive changes that have improved my training experience. My best advice would be to speak to the National School as soon as you encounter any training problems. It may seem an extreme measure but in my experience, the sooner the school are aware of the problem and it has been recorded, the better it will be not only for yourself, but also for future trainees entering the department!
The editors would like to stress that you can and should contact the NSHCS (via firstname.lastname@example.org) if you are struggling. All emails are triaged to the appropriate people who are able to help, all contact is treated fully confidentially and a properly trained member of staff will respond to you.