Jonathan Fitzsimon interviews doctors who have incorporated interesting, adventurous and unusual aspects into their clinical careers.
Simon Hornby (pictured) is a Royal Navy doctor and is currently training to be a GP. He recently returned from a military expedition to the Antarctic Peninsula, during a break from his training as an Out Of Programme Experience (OOPE).
Jonathan Fitzsimon: What made you decide on a career in medicine and as a Navy doctor in particular?
Simon Hornby: Well when I was young, I wanted to either be a spaceman or a doctor. I was given some toy doctor’s equipment and then my mind was made up. My parents were both ex Navy and so I was aware of the sort of things that the Navy could offer. I had thought about an adventurous gap year before medical school but the financial implications did play a part in my decision and if I am completely honest, the prospect of a Navy cadetship through medical school was pretty alluring.
JF: How did being a Navy doctor differentiate you from other junior doctors once you left medical school?
SH: I completed a standard foundation programme alongside non-military doctors in NHS hospitals. I had a compulsory A+E rotation in my programme. I attended some additional short courses in aviation medicine and diving and some training around chemical, biological and nuclear warfare. I had a seven week course at the Britannia Royal Naval College in Dartmouth and then I really did deviate from the path of my peers. Whilst they started their specialty training programmes, I deployed on HMS Cornwall as the ship’s doctor, responsible for 250 people. I spent the next two years on a constant round of deployments around the world and I absolutely loved it. I also managed to cram in the All Arms Commando Course, the Arctic Survival and Warfare Course and a three month expedition to Makalu in the Himalayas.
JF: How did your training change once you decided to become a GP?
SH: I started my specialty training rotations in Plymouth. I have four hospital rotations of four months each and two GP rotations of ten months. The Defence Deanery has an agreement with Severn Deanery which is why I am doing my current GP rotation in Bristol.
JF: Tell me about your out of programme experience (OOPE).
SH: I learnt about a tri-service expedition to the Antarctic Peninsula. This year is the centenary of Captain Scott’s epic attempt to get to the South Pole. To mark this, the military organised an expedition in the spirit of Scott and his team, to perform research and exploration to this remote region. We spent 55 days on the Loubet coast. We went to places that no other human has ever been to and where satellite images are the only records. We worked closely with the British Antarctic Survey to update their limited mapping of the area and were able to carry out vital scientific measurements to help improve knowledge of weather and temperature variations connected to climate change.
JF: What sort of conditions did you have to deal with?
SH: When we arrived in January there were 24 hours of daylight. The temperature ranged from +5 to -15°C and we faced winds of up to 80 knots. One day, there could be virtually zero visibility and then the next day you could see forever! It was an incredible experience to be taking in views that nobody had ever seen before me. Once we got past the 21st of January we lost almost one hour of daylight per week so there were over 4 hours of darkness by the time we left the peninsula.
JF: Did you have any specific medical responsibilities?
SH: The expedition consisted of 24 people split into three teams. Each team had a medic and part of my role was to provide medical attention to my team. I had been responsible for the expedition’s medical planning and training before we actually left the UK and I am pleased to say that the work on how to deal with extreme cold, prevent hypothermia and even recognise carbon monoxide poisoning training paid off. I did not have to deal with any major illnesses or injuries whilst we were there.
I was able to carry out research on two key areas: Nutrition and anthropometric monitoring and a study in conjunction with the University of Portsmouth about the psychology of team dynamics in extreme conditions. We had structured daily diaries for all team members, to collate their individual feelings about emotional and social support. We are in the process of interpreting all of that data and hopefully it will not be too long before we can publish the findings. On the nutrition side of things, it was fascinating to see the diversity of changes. Whilst my own body weight did not really change at all, there were other members of the team who lost 10kg over the three months.
JF: How did you feel when you came back to the UK and started your rotation in Bristol?
SH: I was excited to come back to GP. This is definitely a new chapter in my life and I am looking forward to the new challenges ahead of me. I suddenly find myself having to deal with a sick two year old one moment and then a patient in their eighties the next. Every day has been interesting and I hope it continues that way.
JF: What advice would you give to medical students and junior doctors?
SH: Keep your options open. It is definitely best to see how things go for you personally in the early stages of being a doctor. I am a firm believer that the career chooses the doctor and you have to give yourself the opportunity for this to happen.
JF: And if anyone is thinking of expedition medicine?
SH: The old adage is definitely true, Proper Preparation Prevents P**s Poor Performance!
You can read more about the expedition to Antarctica at www.bsae2012.co.uk