Medical Protection speaks to Clara Munro, one of the creators and presenters of Doctor Informed, an upcoming podcast from The BMJ that aims to keep hospital doctors equipped with the skills to develop their daily practice. 

Hi Clara, can you tell us at little about yourself and your professional background? How did you initially get involved with The BMJ?

I am a general surgical registrar, based in Newcastle. Originally from the south I went to Durham University and then Newcastle University, and I’ve never found a good reason to leave the North East! I am also the proud owner of two whippets and when not at work spend as much time in the mountains or by the sea as the weather will allow!

I then became one of the National Medical Director’s clinical fellows where I was seconded to The BMJ as the editorial registrar in 2020. I return to clinical training in October 2021 but will be staying on a less than full-time basis as a Clinical Editor at The BMJ.

I had always been interested in combining writing with a medical career but as someone who didn’t lean particularly towards research and academia in medicine, I was not sure how I would achieve this. A colleague alerted me to the Editorial Registrar role at The BMJ and it sounded perfect – I applied through the Faculty of Medical Leadership and Management and was fortunate enough to get my first choice of secondment. During my year I have rotated through a number of sections in the journal and developed my skills as a clinical editor. 

We’re really excited to listen to this brand-new Medical Protection-sponsored podcast, what can our members expect to hear?

We hope to provide thought provoking conversations with subject experts about some of the ‘softer skills’ involved in professionally and personally developing as a senior hospital doctor. Much like how our BMJ student podcast Sharp Scratch is the unseen curriculum of medical school, we hope that this podcast series will cover the unseen curriculum of being a hospital doctor – the coffee room conversations that develop us professionally but are (thankfully!) never formally assessed. 

We hope that, rather than feel like work, our podcast will link principles from humanities or social science subjects in a practical way that we might use them in our day-to-day practice. 

One thing we were all unanimous about is that we want these podcasts to feel practical and useful and to be a buzz-word free zone. We cover topics like how to tackle microaggressions, cope with perceived failure or what to do when we inevitably make mistakes to ensure we learn from these events and ultimately improve care for patients. I strongly believe that if we function well as humans, we will be able to provide better care for the people we are looking after.  

What kind of issues for hospital doctors on the frontline are you particularly passionate about?

My particular interest is looking at cultures within departments and hospitals, such as:

• How do toxic cultures begin? How can we dismantle them?
• What can we do individually as doctors working in difficult teams to curtail the affect this has on us and our patients?
• What are the levers that exist to protect patients from harm caused by toxic cultures and how we enact them?
• Why do people bully others?
• How can we call out bad behaviour in a professional way and ensure that we guard against becoming bullies ourselves?

Ultimately all these things will inevitably bleed into clinical care and affect the care we provide to patients. They are almost always the source of issues when there are inquiries after things go wrong and many doctors feel inadequately prepared and powerless to protect themselves or their patients from these issues.

The pandemic had a significant impact on the lives of doctors and clinicians, and continues to do so, will the challenges of COVID-19 feature in the podcast?

There is a big focus on wellbeing and burnout among doctors, particularly in the wake of the pandemic. I suspect at least some of this is from the burden of ‘moral injury’ at doctors feeling they are powerless bystanders within a huge system that has the potential to fail patients. Doctors and indeed all clinicians working at the coal face are often the first to see weak points in the system where there is the potential for harm to be caused or where harm is being caused repeatedly and can feel like their voices are not heard if and when they speak up.

Conversely these same people are often best placed to come up with novel ways to solve problems but can become frustrated when they don’t know where to start or are met by resistance. If people feel like their ideas are making a difference it can be hugely beneficial, making them feel more valued and ultimately improving their professional wellbeing. I hope that this series can go some way to provide tools for doctors to enable them to feel more empowered in a system than can often leave doctors feeling disenchanted and powerless. 

Our Medical Protection members are keen to understand and anticipate emerging areas of risk in their professional lives, how can Doctor Informed assist them?

We explore issues around patient safety, namely how can we improve it without becoming defensive in our practice. We also look into the bureaucracy around patient safety and making mistakes in the UK – looking at which organisations and groups exist, what their roles are, what to expect if invited to attend a coroner’s court and how investigations work.

We also explore making mistakes both from a personal and systems point of view and look at how doctors can ‘make mistakes better’ as I feel that we are often not taught this, or indeed set up to understand that mistakes are inevitable. In our career, we will not always be perfect but learning from mistakes and learning to ‘fail better’ is essential to developing as professionals.