| Description | Interview with David Austin who graduated July 2002 MB.ChB, having previously taken an intercalated B.Sc. recorded on 2 July 2002 by Jennifer Carter.
Transcript of Interview :
JC Okay David going back to when you started at Aberdeen, what drew you to us, or are you a local man?
DA I am actually a local person. I am from Banchory, which is about 20 miles west of here, and having said that though, I was quite drawn to the University at the time, it was the best medical course, I would have said, in Scotland, and I didn't particularly want to go outside Scotland. I'd get lost in the great wide world. It was partially a financial decision , on the part of my parents, that if I got into Aberdeen to do Medicine then that would be what I chose, however I was pretty happy with that decision, because it is quite a nice medical school. It is on the campus. Well you are on this campus for first year, which is very nice, and it was good. Although I did get into Edinburgh and Dundee as well, but I didn't have any great ambition to go to either of those places, so I was pretty happy to come here.
JC Do you think they sussed you out. I mean did you have interviews and things?
DA I had no interview for either Dundee or Edinburgh, I was slightly disappointed that I got an interview for Glasgow, and didn't get in! It might be something to do with me getting into Edinburgh!
JC One never knows, does one! So you said a moment ago, that it was the best medical school you thought at that time. Were you one of those who came in with the new integrated curriculum?
DA I came at second year, third year now, but second year when I started.
JC And that was a serious attraction was it?
DA It was. It was a serious attraction, because at the time, and I think even now Edinburgh still has their old style course, if you like, so we were in the wards from second year onwards.
JC And you thought that was a big plus. That was part of your decision.
DA To be honest, sometimes you make up reasons after the event, and I don't know if there was that much logic going into these decisions. I don't know how much you can tell how good it is going to be, or how bad it is going to be. You can reassess it as the time goes on. It was, with hindsight anyway, it is nice to say that the clinical part of the course is really quite good, and I really quite liked that.
JC Do you have medicine in the family? Or are you a first time medic?
DA My sister is a doctor, but that is it. Really first generation, if you like.
JC She is presumably an older sister?
DA Yes, she is an older sister. She is 2½ years older. She has been a doctor for.. she is going into her third year, when I start in August.
JC And was that a serious influence on you? You know, the fact that you had a sibling who was also interested in medicine?
DA It was as if the territory was charted, if you like, but yes, I am sure it made an influence, but it was probably my dad's influence on both of us, rather than my sister's influence on me. He was quite keen for us to do it. I don't think he pushed us into it, but he was certainly very encouraging.
JC He must have been very pleased that you got in, as of course medicine remains a competitive thing to get into, doesn't it?
DA Yes, I think so. It is even more competitive at Aberdeen now, than when I got in.
JC What is your father's own profession?
DA He is a Biology teacher.
JC Right, so that links closely, I can see that pathway then.
DA Yes. I think he is a "closet" medic, to be honest!
JC And neither you nor your sister were put off, by what I imagine, must have already been the case when you both made your decisions, that is to say the sort of feelings about the Health Service, and you know a lot of people say medicine isn't what it was and it is all bureaucracy, blah, blah. You know the kind of anti-propaganda that is flowing quite strongly at the moment.
DA Yes I have actually just began to think a little more about this since I have finished. No I think that a lot of it is in the media, and it is really started to annoy me, quite frankly.
JC That's interesting.
DA I have just started, just like I said I have been doing my exams, was it last week or the week before, and almost instantly as I finished my exam, there were three stories about how bad medical students were, and I couldn't believe it you know. I thought it had started already. You do get told this all along by your tutors and by the doctors, but I think it still remains at the end of the day, it is still an interesting profession and it is "on-your-feet" problem solving, with people, and although the media might say this, and doctors leaders say this, most of your time is spent one to one with people, in the community, and that is quite nice.
JC And that you enjoy.
DA And that will remain the same no matter what goes on.
JC Did you meet many disillusioned medics as you went through the course. I mean people who were teaching you. Did any of them ever say "Don't do this my lad, it's awful"!
DA No - I don't think so. That is possibly selection bias on the part of the people teaching us, but in general our tutors were quite positive.
JC And GP's you met socially? Or perhaps your own practitioner?
DA We spent time in general practice, we spent 12 weeks in general practice. Both the GP's that I was with - there are obviously bureaucratic problems, like you put it, especially in the rural areas. I was in Golspie, that was my last medical-clinical attachment before my exams. I was in Golspie, and she was a .. well there were two people in the practice, and they have a lot of problems with cross-cover for the area. It is a huge area, with a very small number of GP's' and they were haemorrhaging GP's whilst I was there. We lost three in the Caithness & Sutherland area, and that's, it doesn't sound a lot, but it is very significant in an area like that.
JC And when you have got a lot of distance to cover, it's not easy. So that was a slight downer, but that was the only experience during your training which suggested there were problems which might face you when you were a qualified medic?
DA The only other thing that I would say, that springs to mind, was that certain specialities were downing consultants in Aberdeen Royal Infirmary, which kind of knocks on to the teaching aspect of it, and often we were getting decreased bedside teaching, which you are told is the staple of medical education, but actually I haven't had that much bedside teaching I would have said until my final year.
JC Really! That's interesting, because I thought under the new curriculum it was ..
DA Well, we got.. what I mean by that is, by consultants.
JC Oh by consultants! Oh yes I see.
DA In their own specialities, and that doesn't really happen. We got taken round by more slightly junior members of staff, and we would get shown how to do something, but actually clinical bedside teaching we never got much of, particularly in our fourth year, which was one of the biggest years.
JC That's very interesting. I hadn't heard that comment before. And that you would regard, from your own experience, as being the absolute key, would it?
DA Well - I learnt most in my seven weeks of my medical block, in which I was very lucky, I got probably one of the best ones, it's really pot-luck! I got one of the best ones in Aberdeen Hospital, with the oncology team, in haematology. That was really excellent, and I probably more in that seven weeks than I have done in any other seven weeks in the last six years.
JC So that was very interesting. So that was just the quality of the person you were going round with was it?
DA Yes absolutely. It is to do with their charisma and their ability to teach and their willingness to teach probably more than anything else.
JC Who were the people concerned if you can name them?
DA Dr. Hutcheon, the oncology doctor, ..
JC Is he the one who has just had the bad accident, falling off a mountain or something?
DA No - that was Dr. Bissett. No Dr. Hutcheon, oncology, Dr. Nicolson is oncology, Dr. Watson is in haematology, Dr. Culligan is on haematology, Dr. Tighe on haematology. There is lots of … there are quite a few people who taught us, but they had a lot of clinical academics who also came and taught us, and it was just really well organised. Three or four times a week for two hours a day. Really I don't think many people can say that at the end of their course.
JC So that was pure luck that you happened to get that particular assignment. I mean it wasn't a case that you had applied ?
DA Oh no - I did apply to that. I knew that was good, and I knew that whole Anchor Unit block in the hospital was excellent for teaching, so I chose that.
JC So it was a deliberate choice on your part. Interesting. So, sorry we have got rather into the nitty rather quickly. I would have asked you some simpler things first, like you said your first year was mostly on the King's campus, is that right?
DA King's and Marischal.
JC Between them. They still do Anatomy down at Marischal presumably?
DA Yes. We used the lecture theatre down there as well. Which was one of the most unpleasant lecture theatres in the university. It wasn't big enough for our class either! It was lucky that a good proportion of them didn't turn up to lectures in first year!
JC And then after first year, you moved onto the Foresterhill site.
DA It was pretty much full-time.
JC Except if you took blocks of time in places like Inverness and so on?
DA That would have started in fourth year. Full-time in second and third year, in the lecture theatres there and the wards there. It was mainly lecture based in second and third year, but like you said, clinical teaching in between. Yes. - three or four times a week. Then in fourth year, in Aberdeen, moving around different hospitals in Aberdeen, Woodend, Maternity Hospital, Childrens Hospital, Main Hospital and ten weeks in Inverness.
JC And did you have the opportunity of an elective to go abroad for example.
DA Yes. This year I went to Singapore. To do neurology and neurosurgery.
JC Was that a good experience?
DA Clinically it was a good experience, I am not sure whether it was a culture, social success, but clinically I learnt an awful lot, and I'll probably remember that more than the … No, I went on holiday with my friends, beforehand, to Thailand and Malaysia, and I ended up in Singapore, but it's not the easiest place to meet people. It is a very hard working society. A very successful society, but very hardworking, quite sterile.
JC And people are very guarded I would imaging about spending time with foreigners and so on.
DA Yes, I wouldn't describe it as a racism, I wouldn't say , I wasn't persecuted, and you have to be persecuted for that, but there was a certain, you know, you are white and I'm not, sort of thing about it. Except for the people who had been across here, funnily enough. Because there are a lot of Malaysian-Singapore doctors who train here.
JC And they were very friendly were they?
DA They were understandably a lot friendlier.
JC And of course the climate is very difficult in Singapore isn't it? With the heat and the very high humidity.
DA It is very humid there.
JC Right, well that is all very interesting, and then what did you do for your intercalated degree, your B.Sc. ?
DA Public Health with Professor Russell, who has just retired. That was probably a highlight, of being here. It was really good. I did ..
JC We have had three highlights so far ! So that's good !
DA Well, I will try and limit them!
JC Oh, you don't have to, I was just teasing you.
DA It was really good actually. Professor Russell was really excellent. I did a project on aged-based rationing, or ageism in the National Health Service.
JC And what conclusion did you reach? That ageism was prevalent or not?
DA Age-based rationing : is it ethical? I think the answers were, no, it is not ethical, and probably is happening.
JC To some extent.
DA To some extent, yes.
JC Not least, I would imagine, because so many medical procedures are very expensive now.
DA Well that's the thing, and that's the crux, isn't it? Do people have a fair innings? That's the argument. Do you get to a point where you no longer deserve medical treatment? All the stops shouldn't be pulled out because people are at a certain age.
JC And what did you find that age to be, as a matter of interest?
DA Well, it is not one particular age, it is across the board, but we did a database project, which means it is really difficult to say, because you need people to speak. You need to do something like this, but as you know this is time consuming.
JC Sure.
DA People need to be honest as well, and you know, how many people would agree to say that. But we did note that the levels of treatment dropped off, of chemotherapy treatment for colorectal cancer dropped off about the age of 75, 70 even, and your weights of chemotherapy are really very low after that. I have tried to correct for other factors, such as co-morbidity, and just general health, but you know you can't correct for the fact, you can't correct it up so much that it means that nobody is getting ill. But chemotherapy is a particularly, well at the moment, and I don't know whether that will change in the future, but at the moment it is quite a punishing regime of drugs, and a lot of people look at a frail older person, they would say, this person is not going to cope with it, without maybe making a deep enough assessment of that person. That's my opinion, I don't know whether that is true or not, but our data showed that the levels of chemotherapy dropped off as the patient got older.
JC Yes, one can understand that. Interesting that 70/75 was the sort of age that it began to show. As a lay person I would have suspected that it would have applied in the 80's rather than the 70's.
DA Maybe for other treatments it does apply in the 80's, but for chemotherapy, which can be quite punishing…
JC Interesting. So where do you think you will go in medicine, once you have done your year of house-man-ship, or whatever it is now called.
DA Yes, first year house-man, I am going to try and apply for medical rotation. They are quite competitive, so we will wait and see. That is what I want to go down first of all is the medical side of things, like physician. Try and sit my exams, MRCP, that is another difficult thing to get through, but then after that I think I will try and get … I am not actually decided after that. I could see myself staying in clinical medicine for a while, but I think I would also need something else to do in that I quite liked my BSc. project, I wonder if I might do something along these lines. Not necessarily on ageism, but health services research. I think that is quite nice and certainly an area of interest for me and it's not really a widely held interest among my peers, so I wonder if there is a niche!
JC Well, that sounds interesting. Because, you know, the way in which things are going with the health service, one imagines that more and more studies of what is cost effective and … will be needed.
DA Absolutely, Aberdeen has already got two research units dedicated to that.
JC That's right HERU is one, what ever the other one is...
DA The other one is … I would have known this 2 years ago! It is gone!
JC Never mind! And do you hope to stay in Aberdeen for your house-man year?
DA Well I have got a first job here for six months and then my second job is in Glasgow. So I think I am going to spread my wings a bit after that.
JC Go and see a bit of variety. Anything else on the academic side that you think we should cover? Before we move on to the sort of social side of the University?
DA Academic side ..
JC Because you have brought some points that were very interesting, some of them novel to me.
DA Yes the clinical side, yes. I think, the only other thing I would like to say about clinical medicine, because it is so fresh in my mind as I have done it this year. I mean it is difficult to comment on first year now, but I would say that we were trained to be house officers in our 5th year, and a lot of it is just doing the job, rather than learning things, and I think that sometimes our tutors get disappointed at how little we know actually, but I think they would have to recognise that's the way the course is taught, rather than the students that are in it. I think that is where the emphasis is in our final year. Although like I said, I was fortunate to get both. I learned how to be a house office for an extra year, and I also got this. Which improved my clinical skills this year.
JC Yes, it sounds almost like an apprenticeship, doesn't it?
DA Yes, that is exactly what it is.
JC Go out and do it and we will tell you if you make a mistake!
DA And it very much depends on the people who are round about you during that time.
JC Yes, I can imagine. Interesting. Good. Well, thinking now, not so much about the academic side of your time here, but how the rest of it worked out. Did you stay at home in Banchory and travel in initially?
DA No. I have always stayed in Aberdeen. That was one of the provisos of my coming here, was that I stayed here as long as we could afford it, my family could afford it. So yes I stayed in Dunbar Halls, now defunct. And then I..
JC Was that your first year in halls? Did you enjoy that?
DA Yes. It was very good. Just good for meeting people. It was good to meet everybody in the same position . Very good. Always something going on, but I couldn't have stayed there for more than a year! In fact by the end of the year, I was beginning to think I need to get of here!
JC Because of the sort of relentless socialising?
DA Relentless! Yes. I mean I used to go the library quite often in first year. I was quite studious in first year ! I used to go to the library maybe, Monday, Tuesday, Wednesday and Thursday, just to get away from the constant noise. I couldn't study in my room , and nobody needed to study quite as hard as we needed to study, I don't know if that is a faux-pas or not, but we needed to study reasonably hard in first year, well I felt that we did, and then I went to the library. I went to Queen Mother Library, although it meant that we could feel like a student for a while. A real university student, around people doing other degrees, which was nice, and you got friends who did other degrees, and I've still got friends who are from the Halls in first year. In fact I was staying with one of them at the week end. So I think that is good. It broadens your mind much better.
JC Very important I would have thought. Yes I was going to ask you that. Whether you made non-medical friends, and Halls was an obvious way to do that.
DA It becomes extremely difficult. It really does, because, well I am six years at university, and all my friends who started in the first year, left two years ago and they are working in London, Edinburgh and Aberdeen. So it is good to get friends that are not medical students, and I have got friends who are into Politics and International Relations, and I was always quite interested in that, but it is quite nice to get people who are doing it professionally almost, you know, to get a bit more of a perspective I think.
JC So first year Dunbar Hall, and then what after that ?
DA I moved to Spring Gardens, which I consider to be a bit of a mistake now! At Spring Gardens I lived with 6 other people and it was…I was surprised I managed to get through the year without contracting some deadly disease, it was quite disgusting at times! That was 6 people at Spring Gardens, and then…
JC That was then a University flat, was it?
DA Yes, I paid to the University. Centre of Aberdeen. A very nice situation, although living with 6 other people, my marks suffered even more, because I wasn't even near a library that year, so I was struggling. Then after that I moved to Ashgrove. I actually moved to a council house. We bought a flat. My family bought a flat in an old council estate, up at Carnie Drive, which is where I stay now, and I've stayed there from third year, four years now.
JC So that was a sort of home from home, wasn't it ?
DA Well it is now. It is my flat now, but I think I will sell it this year probably.
JC Is it in your name, is it? You are the landlord. Did you get other students in to share?
DA I wouldn't say I was a landlord. But technically speaking, yes, I am the name on the mortgate, but my parents guarantee it. So they are the landlords. I stayed with my sister in 3rd and 4th year, and my brother in my 5th and 6th year. We have all gone to Aberdeen you see, but during the first two years, my friend that I was just staying with this weekend, he stayed with us as well, so there were three of us, but since he left, we have just stuck with two people.
JC And did that work out well?
DA Yes. It has been very good.
JC And financial terms, a good investment?
DA Very much so. It halved the amount of accommodation costs we would have had to pay. It was a money-saving tool really. It is cheaper to buy than to rent. We just took out a very long term mortgage, a 35 year mortgage, and kept the premiums to the lowest, because it is cash flow while you, well from my parents point of view, when you have three children at university, it is a short term investment, and it is just a question of getting us through it.
JC And will it hold its price when you come to sell it, do you think?
DA With any luck! It will not have depreciated too much I don't think. But it is not … like I said it is in a council estate, it is good quality housing without being in a particularly fashionable area, or anything like that, but I don't think it will .. There will always be people looking for houses like the one I am in, so well touch wood.
JC Sounds like a very sensible decision. So other than Dunbar Hall and obviously your medical classes, what were your other social networks in the university? Sport or politics or what?
DA Yes, sport. I toyed with joining a political party. I am sorry to say that I joined the SNP for a short time in 2nd year, but we never made it to any meetings. They were giving us a dram of whisky for joining, so I think we joined! But my main interest from 2nd year to 6th year, was football. I played for the University football team.
JC Do we play good football? I don't know. One tends to hear of the rugby rather.
DA Well, that's you university bias, I am afraid! Yes, we are a good football team. I didn't play for the first team, I played for the second team, but no, we have a good football club. While I have been here we have been successful. Not entirely due to me. Just in general we have been successful!
JC Were you the only medic on the team, just as a matter of interest?
DA There was one other. Which as a proportion of the university is not really equal.
JC But that is presumably because of this time factor we talked about, when other people felt they couldn't even spare that much time.
DA That is certainly possible. The other thing is the selection of the medical students, maybe I am wrong, in fact I probably am wrong, about the amount of people that are coming from private schools and things like that. They don't tend to be footballers.
JC Oh, I see. I hadn't thought of that.
DA Maybe that's my bias as well though!
JC Is that a perception, that a lot of the medics are people who have been educated at independent schools ?
DA I think that probably is the perception. I think that the standards required to get into medicine are very high, and to get these standards in a state school is really quite difficult. Not because I think state school teachers are any different to independent school teachers, it is just that the way that the schools are set up. In independent schools it is to send people to university. My school, fortunately for me, I lived in the leafy town of Banchory, and it is very middle class, but it has an ethos that everybody goes to university there. It is like an independent school, and I was fortunate in that respect, but I don't think that is the universal truth about state schools. That is quite sad, because people loose their potential a wee bit, and it is maybe not to the point where people, maybe it si at the fringes where people go to university, or people don't go to university. But I think there is also within that, some people would be very suited to medicine and never get the chance because it is difficult to get in, and it is difficult on a CV or a 10 minute interview to prove that is the case, you know. So I think that is how that works out, and whether my perception is true?
JC No that is very interesting, and I think you are right about Banchory, about the school, I mean. Oddly enough if you go back a bit further, about 20 years, it wasn't so good then.
DA No, this is the oil.
JC But is certainly good now, and it has certainly had the advantage of a couple of good heads. They bucked it up.
DA Yes. I don't know about the head teachers … I am slightly sceptical about them… this is my dad again . I can hear my dad almost speaking right now! He teaches at Banchory. That is the reason we stay there, but I think it is more to do with the clientele. I think teaching is important. I think teaching is very important, but I don't think bad teachers and good teachers are distributed fairly evenly across the spectrum, and okay, you may be lucky to get a head teacher, but I think it is just window dressing at the end of the day. I think often what the head teacher does. You know our head teacher you might have been referring to brought in the school blazers and things like this, while I was there, and I just thought - why do we need this? We all rebelled. We were all in 6th year by that point, so we didn't bother, but you know a lot of it is window-dressing. I don't know really what that does for a school. I think it is more external impressions of the school rather than a feeling within the school. I don't know.
JC Anyway you were through it by then.
DA I was through it by then.
JC And it didn't matter.
DA I was at the other end.
JC Interesting. And your interest in politics which you have spoken about. I mean is that going to be a serious one, do you think in your life?
DA Meaning, this might come back to haunt me when I am prime-minister! I don't know!
JC Well I wondered! A number of medics have made it into politics and done well, haven't they?
DA There's a few at the moment. Well there is the Health spokesman for the conservative party.. Liam Hawkes, Dr. Jack Straw, who is, I am not very keen on. I can't think of any others at the moment.
JC That guy who writes in the Times all the time. Stuttaford, was an MP for a time.
DA I think Law is a better profession if you want to become a politician.
JC But it might tempt you perhaps?
DA Not party politics. I would consider a job in certain things like in a decision making context, say for example like a chief medical officer, kinda politics within medicine. I think sometimes it is more powerful in a way, and I think what we will see in the next, and this is another a prediction, that will come entirely true, will be entirely plausible I think we are going to see a bit of a de-politicisation .. a loss of the party political power of the health service, because it is really quite destructive. Political priorities and clinical priorities are rarely the same thing and what we are going to see is, I think over the next ten years , 5 - 10 years, the NHS will become like the BBC if you like, and it will be a state run sort of interest, but not under the direct control of the ins and outs Party politics. Bank of England, as well, there is another good example of.. and I think BBC , Bank of England have done quite well without the government. Thank you very much !
JC Of course there has been de-politicalisation in a different sense too, hasn't there that in your generation relatively few people vote in General or Local elections, particularly Local elections, but even General elections have a low turnout.
DA I have always voted, I have never missed the chance to vote, but I can see why people don't vote. I mean I must say I was really seriously not voting at the next election, but not from a point of view of apathy, it was more of a point of view of - I don't like any of the main political parties, and I can't think of any them deserve my vote, and I think that there is a bit of that about it as well, and it very much a much-ness. I think we have lived through a very superficial era. The late 90's, early millenium, I think we have gone through a very superficial world where we don't really see political debate and commitment. We don't see much principle, I think we see not that only in politics, ..I think politics are reflecting rest of society, and I think that what we get is a lot of gloss and not so much substance if you like. I am mixing metaphors there! But yes, spin is the word! and it just turns people off, and behind the PR just what is there? This present government has got a well- run economy, we will wait and see, and that is about it. We will wait and see what happens. Maybe there is something going on behind it, but they certainly let us see it. I would be interested to see if there was any deep thinking and it was just all reactionary and media management.
JC Well very interesting indeed. Anything we haven't put on the record David, that you think that we ought to have done? Anything like when you were thinking of coming here, and was there anything ….
DA I wondered if you might ask me what were the main world events when I was at University!
JC No, No. That would be at the quiz level, wouldn't it!
DA The Scottish Parliament I would say would say was quite a ..
JC Did you come down here and see it?
DA I was in Golspie. I would have loved to have come down, but I was up there at the time.
JC That's a development you welcomed, is it, the Scottish Parliament?
JC You were saying when the tape ran out, you were pro-devolution, for the Scottish Parliament?
DA Yes, pro-devolution as a general idea . I don't know as a start that the Scottish Parliament is particularly impressive, but I don't think that is the point really . I think too many people use that as a stick to beat it with. Okay the first few years have been a bit problematic possibly, but I don't think it should be judged over such a short period of time.
JC I suppose that the long term test will be whether it persuades the people of real ability to stay in Scotland, instead of beating the door to you know, like Gordon Brown and the rest of them, down to Westminster.
DA I think if we had all our Scottish talent in parliament we would have quite an incredible debating chamber.
JC Overwhelming if they had all stayed north of the border. Well thank you very much indeed, that has been a very interesting conversation. For me anyway.
DA Thank you I have enjoyed it.
JC Thanks very much then and we will sign off.
End of Interview
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