Hello and welcome to your latest installment in our 24 Hours In The Life Of career series (you can read the rest of them here). This week we’re chatting to Chloe* who graduated from her five-year degree in medicine in 2011 and is now a senior registrar in obstetrics and gynaecology. She earns £63,000 a year.
Chloe* says: “I always knew I wanted to be a doctor and what pushed me into O&G was that there seemed to be no part of it that didn’t involve doing something really wonderful – whether that was delivering someone’s baby safely, offering someone the opportunity to have a baby, or performing life-saving cancer surgery. Even the less glam bits like heavy periods and incontinence treatment can have such an amazing impact on quality of life!”
Chloe* works 48-hour weeks with a mixture of shifts. This includes a mix of normal days (typically 8-5), ‘long’ days (8-20:30), night shifts and approximately one weekend in four.
This is what an average day in her life looks like…
6am: “I wake up as my partner’s alarm goes off before mine. I will either laze in bed with a coffee scrolling through my socials or (very occasionally!) get up and do a yoga session on FIIT (free for three months for NHS staff!).”
6.30am: “I get in the shower and aim to be dressed and out the door for just after 7am. I am an intermittent fasting devotee and recently lost 13kg for my wedding so skip breakfast and will be fueled by black coffee until lunchtime.”
7.45am: “My day changes depending on what clinical activity I am allocated, but today I am doing elective gynaecology surgeries followed by an antenatal clinic. I am covering a colleague in the evening on labour ward so will be a bit late home. I get to work just before 8am.”
8am: “I arrive on theatre admissions unit and start seeing the patients before their surgery. I have looked at the list the previous day so I know what procedures we are expecting to do, why we are doing them and about any other health problems the patients may have. I am quite excited as I am working with a consultant I get on well with, a junior doctor who is training in my specialty so whom will get to do some operating as well, and there are procedures that will be useful for my advanced module. After seeing the patients, we meet with theatre staff and anaesthetic team to go over our planned surgery and anticipate and plan for any other concerns the team may have. Today we have two hysteroscopies ( a camera inside the womb to assess for abnormal bleeding) and one vaginal hysterectomy with a repair to be done for prolapse. I am hoping to do at least one of the camera tests and the hysterectomy as I need more experience doing these procedures.”
11am: “I grab a quick coffee with the consultant and the other junior doctor (she pays – winner!). We have completed the two minor procedures on the list. I did one of the procedures and the consultant assisted the ST1 through her first hysteroscopy – she is delighted. We send for the major case. The consultant checks my knowledge of the procedure and confirms she is happy for me to do it under her supervision.”
1.20pm: “I leave theatre. Thankfully the hysterectomy and repair were straightforward and I was able to complete it with minimal assistance from the boss. I have felt really on the back foot with elective gynae operating during the pandemic as we have only done essential work for cancer surgeries and with staff shortages this has meant that at registrar level we have had to prioritise emergency cover and anatenatal clinics so these have normally been consultant led. I have still been undertaking emergency surgery on labour ward so it’s nice to see that this is paying off! Open my eating window with a cup of tea and some greek salad at my desk in antenatal clinic whilst I wait for the patients to trickle through from their scans. I send my boss some assessments for my portfolio based on this morning’s work.”
3pm: “Antenatal clinic is in full swing and I am super busy! This is a general antenatal clinic which looks after all types of pregnant patients from those who have had complicated pregnancies or births in the past, those with underlying health disorders, and for those who have lifestyle factors that might complicate their pregnancies. I discuss the risks of smoking and obesity in pregnancy, plan birth for a woman who has had a previous caesarean section and wants to discuss her options, discuss induction of labour and review myriad growth scans. I am very mindful women tend to accumulate in clinic as their scans are often not at the same time as their appointment and I need to leave on time to take over from my colleague who has childcare issues tonight.”
5pm: “I skid out of clinic leaving the consultant to review the final couple of scans and take over on labour ward. It’s fairly busy tonight and as well as a consultant present until 8pm, there is myself and a more junior registrar to look after women during their labour, as well as assessing them in maternity triage which is like a kind of A&E for pregnant women.”
“We go through the board and look at who we have in labour currently, what else is going on in the unit and the bed status on our antenatal, postnatal wards and the neonatal unit. So much of getting work done on maternity is maintaining flow through the unit which is dependent on women being delivered and discharged in a timely way.”
“After we undertake a ward round of all the patients on labour ward; my first job of the shift is to assess a woman who has been fully dilated for over three hours to assess if she is able to deliver vaginally. I need to find out if her baby is not low enough or not in the correct position to be delivered vaginally or whether she will need an emergency Caesarean section.”
6.30pm: “I leave theatre to write up my notes. I was able to turn her baby into a better position and successfully deliver her baby with forceps. I give a small cut to help the baby’s head be born (called an episiotomy) and repair this. I write my notes up whilst eating some leftover curry I made last night. I love to cook but when I’m working I rely on The Quick Roasting Tin to keep myself and my husband fed.”
7.15pm: “Since coming out of theatre I have been all over the unit – reviewing women in our emergency triage with complaints such as reduced movements, headaches and lower abdominal pain. I leave the junior registrar and SHO in theatre and walk back to labour ward to review another woman as the midwife has some concerns about the baby’s heartbeat. Before I can make it into the room, the emergency buzzer sounds in another room. When I examine the woman I find that the umbilical cord has descended in front of the baby’s head which means the baby’s oxygen supply is compromised. I make the decision to take the woman for a category 1 Caesarean section which means that the baby should be born within 30mins of the decision being made.”
8.10pm: “I am out of theatre and thankfully the night team have arrived. As I’ve been busy I am not up to speed with everything on the board but hand over what I know about. I am very grateful to hand my pager over to the night senior registrar!”
9pm: “After I have done my notes and got changed, I head home. I pour myself a well deserved glass of wine and chat with my partner about the day. Labour ward is messy work and I prefer not to sleep covered in other people’s body fluids so I treat myself to a bath. I aim to be in bed about 9.30/9.45pm so I can squeeze in some kindle time pre-sleep.”
“The best thing about my job is delivering babies – there is no feeling like that first cry, particularly if you have met and supported the couple antenatally. However with extreme highs like this one you also get extreme lows when things don’t go so well and particularly as I’ve become more senior it’s difficult not to take things personally. The NHS has also been a really challenging environment in which to work given the chronic underfunding and staffing issues and it’s horrible to think that through no fault of your own, you are letting the women down. I try to always remember that I am part of the most memorable time in a woman’s life and hopefully the women in my care know that I recognize what a privilege it is to look after them!”
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