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We are both specialist registrars in geriatrics and general internal medicine in the North East region.

Catherine Dotchin is currently working as a teaching and research fellow (TRF) in Northumbria Healthcare NHS Trust, having taken time out of programme after completing two years of SpR training. Cath Church is a final year SpR and took three years out of her training programme (2001-2004) to work as a TRF in the same healthcare trust.

From the title of the job, it is not hard to deduce that responsibilities are divided between teaching and research. It is an unusual post, as many other ‘out of programme’ posts offer training and experience in just one of these two areas. We were both interested in taking time off the treadmill on the way to consultant jobs and had been exploring what was available when we came across these posts. We knew that we wanted to undertake a research project, but also had an interest in education. We had both been involved in undergraduate and junior doctors’ teaching during our clinical posts but had never had any formal training in teaching, and the changes in the undergraduate curriculum at Newcastle meant that it was often difficult to know to what depth or breadth we were expected to teach. We also both had colleagues who recommended the TRF programme to us.

From a research point of view, we each undertook very different projects. Catherine is researching the prevalence of Parkinson’s disease in an area of Northern Tanzania and spent six months living in Africa doing the fieldwork. Cath undertook a randomised-controlled trial of upper limb electrical stimulation in stroke patients, has been awarded her MD, and is to be published shortly. Our research experience has not only taught us research methodology, critical appraisal and IT skills, but has also given us the opportunity to improve our time management, team-working and communication along the way.

The TRF job entails teaching in all manner of settings, from lectures to bedside teaching, to small groups or student-led tutorial sessions. There are also visits from first and second year students arriving en masse in the hospital for the first time. Patient recruitment, both from in- and out-patient settings, is a vital part of the role and a database was set up for this purpose during Cath’s time in post. The recruitment is shared with lecturer practitioners or clinical skills practitioners, specialist nursing staff involved in teaching. Throughout the year, third to fifth year students arrive to learn everything from clinical skills and basic history-taking to modules in all of the hospital specialities. Teaching is not confined to one’s own speciality. In fact, often we are asked to teach subjects we have had little involvement with since medical school. This can be a very challenging…re-learning what we probably should still remember (or perhaps never knew).

The Certificate of Clinical Education is an integral part of the job, with all TRFs being enrolled to the scheme at the start of their post. It is often the part of the job that generates the most apprehension as one appreciates the time commitment necessary to complete it. We are taught Educational theory (a completely new concept to most or all TRFs!), and we are confronted with the prospect of writing 2 essays (usually the first we have written since medical school). There are two modules: ‘learning’, which is compulsory, and an option of either ‘teaching methods’, or ‘planning a program of learning’. Increasing numbers of clinicians are investing their time in completing this, and it may in the future become a necessary requirement for those of us involved in teaching.

One of the most interesting parts of the teaching is the involvement in discussions on how best to deliver the medical school curriculum. In the department, there is considerable emphasis on how to improve the service we give, to pick up on feedback from individuals, and to look to the future. It seems at times much more dynamic than clinical medicine. We have, on several occasions, been given the opportunity to lead a week of teaching commitments for a particular module, organising the content and its delivery.

Balancing the research and teaching commitments can be tricky, especially if exams or a heavy teaching week falls at the same time as a deadline for a conference or MD assessments. Prioritising is vital, as is planning ahead. Most of these time commitments can be anticipated well in advance, so with good organisation things tend to run smoothly.

We have been able to keep our hand in clinical medicine whilst working as a TRF. Catherine attends weekly Parkinson’s disease clinics in a variety of locations and Cath worked on the SpR on call rota and attended a weekly TIA clinic.

So what advice would we give to others considering such a post? Firstly, we’d both do it again, which tells you something! The post is extremely rewarding, challenging, hard work and lots of fun. It provides excellent opportunities for both research and teaching, which will stand one in good stead for the future. But it isn’t an easy option and shouldn’t be seen as such. It comes with its stresses and deadlines, highs and lows, good days and bad days, as any other post does. One gets out of it what one puts into it. Research rewards will come, but not without effort. And the same can be said of the teaching. If one expects to do minimal preparation in one’s teaching, rushes through presentations and does not take the time to listen to one’s students, one won’t enjoy it. But for those teachers committed to delivering what medical students want and need to learn, and to improving their skills as a teacher, it will be a rewarding and challenging experience. And it won’t just be the students who learn...

Cath Church
Catherine Dotchin