Transcript

Is there a universal medical school experience? - 150th Episode!

From The BMJ · Episode page · Watch on YouTube

· 41 min · 7,997 words · 91 timestamped sections

This is the full, timestamped transcript of "Is there a universal medical school experience? - 150th Episode!", an episode of The BMJ published January 23, 2026 (41 min, about 7,997 words). It mentions 8 people, works and ideas, including Zana Khan, Thiago Vilva, Neil Chhatlani, European working time directive, medical politics.

What this episode is about

The discussion explores whether there is a universal experience among medical students, featuring insights from former hosts and expert guests as they reflect on their diverse journeys through medical education. Key points include personal anecdotes, challenges faced by medical students, and variations in training across different countries and institutions.

Key takeaways

  • From electives to exams, medical student concerns have evolved, but the pressure remains a constant companion.
  • AI's rapid rise has replaced books; students now search online for answers instead of flipping pages.
  • The irony: as the UK embraced EU directives, student well-being stayed adrift in the bureaucratic tide.
  • Insecurity isn’t new; it’s the medical school rite of passage that generations of students endure.
  • Medical education evolves, but the struggle for confidence and career clarity seems timeless and universal.

Who speaks in this episode?

What is discussed, and when

  1. – 5:00: Thiago Vilva, Zana Khan, BMJ, Neil Chhatlani
  2. – 10:00: Guide to Electives, So You Want to Be a Neurosurgeon
  3. – 15:00: European working time directive
  4. – 40:00: medical politics, Thiago Vilva
  5. – 41:09: Zana Khan

Notable quotes from "Is there a universal medical school experience? - 150th Episode!"

  • Not get taught at medical school. I'm your host, Zana Khan, a medical student in London. And this year, I'm the editorial scholar running all things BMJ Student. Today is an…
    about Zana Khan · at
  • And west Midland Dinery. I practice three days a week clinically and the other two days a week I'm a clinical editor for the education section of the BMJ. I was a Kle Scholar for the BMJ in 2009. and then student editor from 2011 to 2012.
    about Neil Chhatlani · at
  • Standard you know there was no AI nothing. So the internet was just in the beginning. There was this book I don't know if I don't know if he's still around but there was a book…
    about Guide to Electives · at
  • Checked out of the library when I was a medical student. One that was called So You Want to Be a Neurosurgeon. And that is all about different points or different career…
    about So You Want to Be a Neurosurgeon · at
  • In you know in medicine in medicine that's why I mentioned that there was a huge focus on the European working time directive because there was a time when people doctors…
    about European working time directive · at
  • Someone asked me can you cover for me this meeting and then I have left and now I'm the president organization.
    about Thiago Vilva · at

Who and what is mentioned in this episode?

People

  • Zana Khan — Person · Host · 2 mentions · first at
    Hosts the 150th episode of Sharp Scratch and frames the discussion around how medical-student concerns have changed over time, drawing on her role running BMJ Student.
  • Thiago Vilva — Person · Expert guest (former BMJ student editor; GP; BMJ editorial alumnus) · 3 mentions · first at
    Provides a ~20-year retrospective on medical-student priorities (electives, exam resources, EWTD) and describes a career spanning GP work, BMJ roles, and European GP advocacy.
  • Neil Chhatlani — Person · Expert guest (BMJ clinical editor; pediatric trainee) · 1 mention · first at
    Bridges the timeline between earlier and current eras, describing student concerns (career planning, balance, international interests) and discussing strikes as a proxy for system-wide discontent.

Books & papers

  • Guide to Electives — Book · Referenced work · 1 mention · first at
    Mentioned as a valuable resource for medical students planning electives, reflecting the historical context of medical education.
  • So You Want to Be a Neurosurgeon — Book · Referenced work · 1 mention · first at
    Cited as an example of resources medical students use to explore career options in different specialties.

Concepts & topics

  • European working time directive — Concept · Core topic · 3 mentions · first at
    Discussed as a historical and current issue affecting doctors' working conditions and medical students' concerns.
  • medical politics — Concept · Key argument · 2 mentions · first at
    Discussed in the context of doctor strikes, advocacy, and the changing landscape of medical profession.
    Medical students now are more you know are much more engaged in activism and I got engaged into medical politics.

Sponsors

  • BMJ — Company · Sponsor · 1 mention · first at
    The BMJ is the publisher and sponsor of the Sharp Scratch podcast, providing a platform for medical students and doctors to discuss important topics.
    Not get taught at medical school. I'm your host, Zana Khan, a medical student in London. And this year, I'm the editorial scholar running all things BMJ Student. Today is an…

Full transcript with timestamps

Hello and welcome to or welcome back to Sharp Scratch. This is a podcast brought to you by the BMJ where medical students, resident doctors, and expert guests come together to discuss the things that we think you need to know to be a good doctor, but you might not get taught at medical school. I'm your host, Zana Khan, a medical student in London. And this year, I'm the editorial scholar running all things BMJ Student. Today is an exciting episode because it's actually the 150th um of Sharp Scratch which is really cool. Um and I'm honored to announce who we have with us today. So starting off we have um Lara who actually was the first host of this podcast. Lara, do you want to introduce yourself?

Hello, my name is Lara. I was editorial scholar in 2018 to 2019 and now I'm a uh I'm about to be a medical registar in Adam Brooks Hospital. Probably will be by the time this episode comes out.

Exciting. Um and for our expert guests um we also have some previous student editors which is really cool. Um I'll start with Thiago. Do you want to introduce yourself?

Yes. Hello. My name is Thiago Vilva. Uh I'm I'm 45. Uh I'm a GP. I'm based in Lisbon in Portugal. So it all started for me in 2002 when I was recruited as what's called a student adviser which is I don't think a role that exists anymore. And then I moved on to be a collect scholar in 2004 and I was student editor that was the name I was that was the designation at the time student editor of student BMJ back in 2005. I was the first nonUK editor. Um and in 2013 I came back to the UK as editorial registar and I have remained ever since uh working for the BMJ uh research team and I now do freelance work.

Sounds like you like being at the BMJ and Neil what about you? Thank you. Hi everyone. My name is Neil Chhatlani. I'm a UK based pediatric doctor in training with an interest in gastronenterology. I'm currently working across the seven and west Midland Dinery. Um, I practice three days a week clinically and the other two days a week I'm a clinical editor for the education section of the BMJ. I was a Kle Scholar for the BMJ in 2009. Um, and then student editor from 2011 to 2012. Um, I then went off to kind of build up my CV to come back to the BMJ and I worked for another journal for 6 years before returning back to the BMJ.

Well, thank you all so much for joining today. I'm excited to have these conversations with you and also try and like take all your wisdom by osmosis. Um but yeah, excited for today. I thought this could be an interesting episode because we all have this insight through our experiences of being the BMJ student editor at various points into the experiences of medical students at the time, whether that's here in the UK or in Portugal or anywhere else in the world through the pictures that we get sent in and other projects that we may be involved in. So, for example, when I get the pitches, I go through them with my manager every Monday morning, and there are like kind of themes or patterns that I've noticed. Like a lot of the pictures I get are about like insecurity or like there isn't confidence that they're going to have the job that they thought they'd have when they came into medical school.

There's these ideas of competition ratios um or how strikes are affecting learning. That seems to be something that comes up a lot. And also I guess with like AI, we've been talking about the internet, but I guess now it's more like how AI is developing at such a rapid rate and there's a lot of concern from medical students about how that will affect their learning. So I guess these are some things that are affecting medical students right now, but I thought we could go around the room and talk about what kind of things were affecting medical students during your time. Thiago, can I start with you? Like 20 years ago, what were the things that medical students seem to be affected by?

Uh well uh there was a lot of interest in electives uh so doing uh placement in a different different country um all about resources to on passing exams. So the student BMJ was very good at that, you know, giving you, you know, case reports with question answer, things like that. Uh career options, the European working time directive, it was uh you know, it's it's a reminder of that the UK was in the European Union back then. Um and actually the UK was the most uh uh was was the country that ironically took the European working time directive more seriously than all than all other countries. But the focus was mostly on learning uh clinical medicine uh critical appraisal in a non-extbooky way. So that was that was the purpose of this uh student BMJ back then. You learn clinical medicine and critical appraisal skills in a non-extbooky way. So was was all fairly standard you know there was no AI

nothing. So um the internet was just in the beginning. There was this book I don't know if I don't know if he's still around but there was a book which was almost a bible for me. uh I think he he wrote a lot in the BMJ about electives guy called Mark Wilson. He had this um book called Guide to Electives and work in medicine around the world. So he he was this guy had traveled all around the world had done had worked as a doctor all around the world from you know mountain medicine in the Himalayas to working a doctor a rural doctor in Australia you know so he he was like my hero uh back then but but it was all in a book because you had no other way to to learn about things other than books.

Did you did you get pictures from students? Did medical students write in physically on email? Yeah, you know, you but you have to note that email was at the beginning uh back then. Yes. Uh you did there and we we were just starting to use this um this article management system was called I think bench press uh back then I mean looks compared to scholar one these days it looked very rudimentary you know it was very very very basic uh uh software. Yeah. So but you know we had to do the we had to do the the monthly print issue. So it was you mostly you know receiving the submissions editing them and then make sure they fit the pages. So because of the emphasis was all on the print issue.

Um so you had to work very closely with uh with the tech heads and the and the print issue people in the uh in the office. Yeah. There was some journalistic content about like some person went to do an elective in Kenya. Uh and then some someone writing about a career option in as a medical journalist or or or in the pharmaceutical industry or something or or or or tips on how to do the MRC GP or other or passing you know you know things like that. That's interesting though cuz it's like I'm seeing quite a shift because that most of the pictures and stuff that I get sent in are more like opinion based or about like like events that are occurring around the world. So more like political I guess or things about like change to the curriculum where it sounds like back then 20 years ago a lot more of it was based off like the content like how to pass exams, how to be a good doctor.

Yes. Yes. With these resources. Yes. Because you know that there was no you know the word globalization 20 years ago was was it was just it was a a concept that was just beginning you know there was a talk oh we're going to have this the global world it seems something so far away you know so your your life as a medical student was you know I would say very parochial

quite a smaller bubble it maybe Neil what about you what do you think like I don't know how it was for you were you receiving pictures or back in like 2012 what do you think medical students cared about? What were they affected by?

Yes, I was listening very eagerly to to your experience in as now and Thiago's 20 25 years ago and I feel like I my experience sat right in the middle of that continuum and I I feel like medical students evolve very much from Thiago's years to to your years and and and I was kind of a checkpoint just just there. So, I think medical students still had a lot of very similar concerns to Thiago's experience. For example, the concept of how do I get into specialty training? Um, how do I make the most use of my time when I'm at clinical placements?

How do I make use of my time now to optimize my choices in the future? I think those are forever questions of medical students. It's a very existential question, but it's certainly one that I saw a lot about. And we would have different sections in the journal that would speak to that area. So we'd have career sections or we'd have uh life sections in the journal that would really try to capture some of those elements. And I I was thinking about what books I was um what was always checked out of the library when I was a medical student. One that was was called So You Want to Be a Neurosurgeon. And that is all about different points or different career profiles of different specialties in the UK and abroad. And I think that's just very classic, right?

So you're in this quite intense position. What are you going to do next? Right? As medical students, a lot of them are are kind of planners. They want to move on to the next thing. They achieve and then and then what's in the future. But it was interesting also the the life element of it. There was a lot of clinical content when I was there as a student um BMJ submitted by by students. But but there was a lot of life and opinion and editorials as well. and and despite um about 80% of the submissions of the student BMJ at that time probably being UK based 10 to 20% being internationally based that might those ratios very well might have changed in in in future years I think there was a lot of questions and a lot of interest and discussion about well how do I balance this with my personal interests

um what are the opportunities to integrate medicine um outside of a clinical career so how can I use medicine on the weekend and I remember a front I was very proud of a front cover I was able to published which was a pitch following a student on um mud music and medicine uh healthcare for festival goers.

So it's that perfect blend of I'm a bit curious. I'm a bit interested in medicine but I want to make this work for me. I want to go to a festival as well and I want to do a bit of a shift but but not too much. I don't want to lose myself within this. uh there was a lot of interest in um how do I balance this with my part-time job or my extracurriculars and even if those extracurriculars weren't medical or clinical in nature. So, so I think and I think medical students from what I know and from what I teach probably still have lots of elements of that. But I wonder if if it shifted the other way.

it's now the potentially a priority of how do I make medicine fit into my wider life rather than how do I make my personal life fit into my career and I'd be really interested in in kind of Lar and your views on that. I think if there is an element of that at all then it's in a big way due to the sort of the having to pay more for university increases this transactional element increases this element of you know not not that I you know if you if you are training if you're at university for free medical school for free you have a sense of um perhaps vocation having a a privilege to learn something and having lots of resources at your fingertips whereas if you're paying n grand um or more then you might have more of a sense of what am I getting out of it? Is it really worth it? And and having this constant having to sort of really assess the sacrifices you're making against what are you getting out of it, which

can maybe tip the tip the scales in the way that you were describing, Neil, which is interesting to think about. I think one one thing that neither of you mentioned, but when I was a medical editorial scholar, a lot of the pictures I received were about mental health. Mhm.

Um so a lot of um perhaps opinion pieces or life pieces or experiences of people um managing imposter syndrome, managing mental illness whilst at university um or experiencing major life events and sort of dealing with clinical clinical placement whilst experiencing grief or loss

um and how to manage those. maybe sometimes a sense that they weren't talked about enough but obviously you know that time 2018 2019 is during this kind of pro process of increasing awareness of mental health at university increasing services and charity charity services whilst you know across all um subjects and degrees as well um and I think that that um spotlighting of mental health has been positive in terms of um helping you know letting people know sort of you acknowledging that it's normal for for medical school and and and clinical school to be stressful

and for those pressures, you know, where when are those pressures sort of when are you managing it with resilience and when are you actually simply not coping? You need more support and help and having more ways to access that, more freedom to talk about it and more ways to access it. I think that's was a really important shift um that I I didn't it was it was it happened perhaps before I started but it was well underway you know and and that was reflected in the kind of pictures I was receiving.

Yeah. I think it's even a Oh, sorry. You go. Yeah. No, I I I it's interesting because I think that those issues were kind of a bit stigmatizing back in in my days. Um so we we didn't have we didn't have a content on on that.

I was going to talk about in terms of the stigma. I feel like I think that it is decreasing because even in the pictures that I get when it the conversations we have around mental health, mental illness, there seems to be more systems in place um from what students are writing. Um which is a good thing because I guess I was thinking like back in the days would people have felt comfortable having their name published alongside this thing that's saying I'm struggling in XY Z way but I feel like hopefully there is more opportunity to talk about these things now. Um

yeah because I think I'm I'm I'm at I was at the tail end of the of that generation which worked very long hours in you know in in in medicine in medicine that's why I mentioned that there was a huge focus on the European working time directive because there was a time when people doctors worked you know 80 100 hour 100 100 hours a week so there was there was a this big push towards you know reducing uh working hours of of of doctors

that's interesting because I think people continue to be interested in improving quality of working life and [clears throat] safety, you know, for doctors at work and things like that. That

hasn't changed. It's interesting. You're talking about the European working time directive back then and now we're talking, you know, in 2016 there were the strikes that resulted in the new junior doctor contract with different changes to rotor making and the hours we could work. And still now medical students are concerned with um how do we uh work towards safer hours for doctors and better working conditions so that we can do our jobs better.

Yeah. It sounds like it's almost like a universal thing where it's like the work is worth doing and we all want to reach that end and you know do this career but it's sort of like making it feasible to actually get to that point. It seems to be like it's been an issue or something that medical students have been thinking about throughout all of the different time periods we're talking about here. So Lara, I wanted to ask you between when you were at medical school and now like almost becoming a registar, have you noticed any changes like what has been different from being a student to a doctor? What changes?

Those years are nearly exactly the years that you're at medical school, right? What year did you start? uh 2020

and I finished in 2021. Okay. Yeah. So me my time as a doctor almost perfectly overlaps with your time as a student I think. And something I really noticed in that period of time is when I started my F1 job, my foundation years were in a hospital with completely paper charting.

Everything was on paper. Um except um I suppose except images, blood test requests, and that was honestly it was a nightmare. 12 different apps on the computer. You had to open every single one. And they all took 5 minutes each and they didn't talk to each other. It was a disaster. Anyway, paper charting, so prescribing, note takingaking, different forms and stuff, you know, VT assessments, things like that you have to fill in.

After foundation program, I went to a different hospital, Adam Brooks, where I currently am where everything was electronic. And

just as I left that previous hospital, they switched to a more, you know, to electronic note takingaking and things like that. So I I think if I went back to there now, there'd be a lot more electronic documentation, things like that.

Yeah. I don't think I've ever seen a paper thing like that. The only time I've ever seen paper prescribing is when we're practicing for OSKYs. Um and I guess in an ECG when you're printing the thing other than that, everything has been electronic in my time.

Absolutely. And and it makes a big difference, I think, to medical students learning because when I was a med student, if I wanted to assess a patient, I could just see them and then write it down. And even if I hadn't encountered a doctor, you know, my assessment or history or whatever I'd done might be, you know, in the in the paper notes, whatever, you know, I could participate in that um sort of continuity of care very easily physically. Similarly with prescribing as I reached sort of my final um apprenticeship stage, I could practice prescribing and I would sit there with my junior doctor mentor, my resident doctor mentor, and I would write out the prescription. The resident doctor would look at it and then sign it.

And that's not something that really translates to e prescribing very well at all. Um but it it gave me lots of opportunities to participate in the life of a resident doctor especially towards the end of clinical school. Whereas um I see now with medical students if you're only in a hospital for a couple of days having your login up and running the amount of time you have to spend on the phone to it if things aren't working

Yeah. compared to how much you can get out of that login in a couple of days is really tough balance to strike and and it can really shut you out of some of the sort of aspects of independent learning on the ward. You know, looking through notes and understanding what's going on, seeing a patient, examining them, looking through the notes to see if your exam match what previous people had said. That aspect you you can very easily be shut out of that as a medical student.

So, that's one thing that's really changed a lot. And then of course I mean we had co I don't know if you're we've we've talked about that on chart scratch before um and I'm sure we will again about the impact that had on clinical school at the end of mine at the beginning of yours. Um and then of course over the last couple of years you've had strikes and that I think that started during my first first year in foundation school. Um Zay have you found that strikes affected your medical school a lot? So when did strikes I think the strike started in my first clinical year.

Um so it was interesting though cuz we were already only in hospital placement once a week but then to have it cancelled. Um which obviously valid and I understand the situation but like it was always so last minute like it's like we've tked all the way to placement. It's like oh yeah by the way you're not going to have this simulation teaching or whatever. And it's like oh well I'm here now. Well now what? So you just go to the library, but you've like come all the way. Um,

yeah, that's heartbreaking. Um, so it was kind of frustrating in that sense, but yeah, I guess strikes have been something that we speak about constantly because it seems to be like on our minds, thinking about what our working conditions will be like in the future, but also whether they'd happen again.

Um, which I guess it's interesting now thinking about whether the ones we had in December, if they were the last ones that would happen.

Absolutely. with a ballot going on right now. But it seemed interesting as well cuz even in the December one, it seemed like from the first set to the last

there there was like a protocol I guess made cuz by the end it's like oh yeah, we know what strikes are like. This is what happened. This is what we're going to do. But like in the first one it was like pandemonium. Like nobody knew what was happening. Nobody knew where to go, what they're supposed to do. Um

and you're kind of just sat there like I don't know. Absolutely. the sort of hospitals and other health care um systems have seemed to they've got their strategies now. They've got their sort of plans plans of action. Um and it is really interesting to see how politically activated doctors have become.

Mhm. I think about so 2016 that was whilst I was at medical school and the resident doctor strikes were happening back then um protesting particularly about working conditions.

Mhm. Um, and I was not aware of them as in I don't remember as a as a so I was pre-clinical, so that made a difference. I didn't see I didn't inter interact as much sort of it was I was on a traditional course with a big split.

So, but I do not remember being particularly um activated or aware or concerned about the strikes happening at the time. And it was only when I was adopted sort of during foundation program striking again that I understood what had really happened during those strikes. I sort of started to get more appreciation of how hard work it was to activate doctors to be willing to strike, the kind of negotiations that happened thereafter and then of course the um junior doctor contract uh TCS terms and condition of service that came out of that that made a huge impact on my working condition as a foundation doctor

and I think wow I know lots of people had were dissatisfied at the time with what had happened but

as someone who was came into sort of normalized exception reporting you know self-reporting at overtime and the sort of the kind of rotors that you know maximum four nights in a row, things like that. Wow, those definitely made a massive impact to my quality of life 100%.

And so it's interesting, you know, those those strikes were did not go on as long as these current strikes. And it's really interesting to sort of look back and observe how differently politically activated the doctor body in the UK as a whole is. Neil and Thiago, did you see doctors striking or protesting

in your times? No, because well it's interesting because doctors had a better life back then. I mean there was less social unrest. Okay. Okay. Doctors worked very long very long hours but their pay was better back then. Uh their working conditions were better back then. The health care system was working better back then. And there was also then medicine was a guaranteed job. So uh you would you would leave medical school and you know you had a guaranteed position to continue. you're going to have a position for specialist training.

Now that that that the ratio between medical students and training positions is large. So it means you not all medical students will uh be able to get a a training position. So there's much more uncertainty, you know. I I I was able to have tranquility throughout medical school because I knew I would have I would I would have a guarantee I would have a guaranteed a guaranteed job. Now that's not the case anymore.

That's that's not the case anymore. That's not the case anymore. But but at the same time people have more options now because medical students now at least here they are now learning languages from the outset in medical school because they're considering to move to another country when they so they start learning German or French because they know that they will not get a training position um and they have to think about going going elsewhere because all all around Europe all around the world uh that there's there's shortage of of doctors because medicine is be is is becoming an increasingly less popular option.

I think that's interesting though like Thiago you're saying that you had that tranquility so you could become because you had that confidence. I think that's probably the main difference like I feel like now maybe medical students are becoming a lot more like politically aware or keeping up to date with all these strikes and stuff because there is none of that confidence.

Doctors had a better status back then. You know the status of our profession has eroded uh significantly. Also the the public the general public is much more vocal now with social media. Uh back then there was no social media so doctors were much more protected you know there's there was not this name and shaming that there is nowadays you know.

Yeah that's true. It's like almost like this cancel culture online with celebrities but there's like a constant fear that you are being surveyed. So that cancel culture could trickle into your professional life as well.

Um Neil what about you? How were you affected by strikes or did that happen during your time or

It's it's interesting thinking back. So I remember um publishing articles um in 2011 about strikes but actually not about strikes in the UK. I remember Europeanbased strikes. I remember kind of more international based strikes for for medical stu for for doctors rather than medical students. I was a junior doctor for the first lot of the 2016 strikes. Um, uh, I was just began specialty training and it's interesting thinking about strikes and and and how they've come over time because like Lara, I think they're a proxy for discontent, right? So the currency is is money or striking, but but the the ethos and what it represents is so much more than that. It's it's change in systems, it's change in policy, it's change in the world, right? You know, people are stressed. They didn't have as high volumes as us. When you really kind of get into the strikes now about w with senior doctors, they say it was very

different time back then, you know, and a lot of them didn't really have the right to strike in the same way that we do. I mean, a lot of countries don't allow doctors to strike full stop. Yeah.

So it's interesting what this movement represents now and what facts have led into it which is of course not just at a institution or professional level but but you know at a global level you know how we're caring for patients differently how how workload pressures have changed how where we sit with resources etc etc so I can't remember certainly as a medical student I don't know if it would have been on my radar for the reasons that Lara said anyways but

but you're hearing the voice and if you're reading kind of not only student BMJ uh you know broad sheets or the BMJ's letters you're hearing voices from medical students we're here we're keeping an eye we're you know we want change to happen we want a better life for ourselves be

for all sorts of reasons and you know here's how we're going to voice our concerns to get there. So I think I think the ability to do that is amazing and I think that kind of comes into some of the confidence elements I've said about students now compared to where I felt they were um or even I was you know 15 20 years ago. Uh and I think you know watch the space because because they're the next generation and and they're the ones that policies now need to serve. It's interesting, Neil, what you me what you said about this discontent because I remember earlier you said that um one of your experiences clinical school was being in a firm.

Yes. And you were editorial you were student editor in 2012 and and then I was there at sort of 2018 2019 and by the time I was there firms didn't exist anymore

just in that very short period of time. And for me I think that's a huge experience a huge factor in discontent amongst um resident doctors and also medical students in terms of the loss of this feeling that you belong to something belong to a team that you especially and then the way that trickles down to medical students even more it's very difficult to integrate into a team to have continuity professional relationships and things like that. So it's interesting even in just that short time we had that big change.

Absolutely. in the way you were fostered in the way that you kind of had responsibility chain of events and I think we've lost that even in hospitals to a certain degree with the introduction of European working time directives better and safer practices uh for shift work without necessarily more resource you see over time is a loss of continuity and and who's holding on to that well it goes to the person above or the person above because and that's a very challenging um concept to rectify by across the world.

I guess Neil, I want to ask you, this is something that you spoke about earlier, but outside of being a doctor, what other opportunities has medicine offered for you? I think I think my time as a medical student I look back and it's a very very unique time for lots of reasons uh and some of which we've discussed before but I think as I mentioned briefly before with medical school you get this whole pass that you you're a medical student and you get this badge of honor and and you know go off and learn and and come back in five six years and you'll be a doctor type thing and I think that badge is really really special and I wish um I knew more about how to use that badge effectively at that time

because you're not constrained by necessarily or most of us aren't constrained by kids at that time or necessarily a relationship which makes you geographically bound or different financial contracts or different kind of home um issues. So just use it, just use that badge really really um efficiently. You know, go go places, use your electives, spend your holidays if you can, gaining new experiences that may or may not help inform your career choices. But for every experience I had that did help me have form my career choice, I had about 10 that didn't. And and that was really important for the way I learned. And and I was similar as a as a res as a foundation doctor. I had to try every single specialty once. tried lab medicine and anesthetics and pediatrics and GP and and and what you know medicine and surgery over time psychiatry and that was again really important for me to know what to do

next. I had to try and fail or try and succeed and and and that's what medicine is really really good at. there's so many adjacent medical jobs um publishing pharmaceuticals research um uh there's lots and lots of alternative medicine career conferences and I think if you're interested to to just go see what's out there a clinical career is really really um suitable for some and really appropriate for some and and not having a clinical career is really really important for a lot of other people and that's absolutely fine I think I think your medical degree gives you this beautiful badge of honor that you've been through a hard bit of work and you can achieve when you can focus. Um, and that is a very usable currency uh for the rest of your life.

Uh, but what you don't get over time is is the time to use that as well as you did as a medical student. That's what I think I try to tell people now because uh right now you have the least obligations you probably you probably will ever have for the rest of your life. It's to use that wisely. And so, and so I ended up doing uh a PhD and and and medical publishing and lots of research, but I'm also kind of in a personal and family situation where where that demands a lot of my time as well. And I I I think that's really important for me to be good at my job clinically and even my nonclinical job to have a lot of that time at home. And and and there's been lots of choices that I've had to make to get it to that balance. Um, and that that's not a lot of, you know, that's not the same challenge or problems that other people face, but it's one um that I think that doesn't get talked about as much as when

you're a student. That is definitely hugely important um as you progress throughout your career.

That's really interesting, Neil, because I often end up giving slightly different advice to medical students who say who who feel overwhelmed by the number of choices, the roads they can't travel down. I often say something quite different which is that at the moment with foundation program and training programs as they are it it looks rigid and it is quite rigid. It's quite difficult to make interdenery swaps hub partway through a program things like this but what you but what I what I tell people and I I know lots of examples from colleagues friends who I've done foundation program with who are now doing different things taking very nonlinear tracks is that those opportunities do stay in different forms and there are lots of one-year opportunities to do more education or research or another out of program kind of thing. You can chop and change. You can take time out in the middle of a

program. You can change your mind about your career. You can make career swaps even quite late in training. People do these things. And if you want to, those opportunities will continue to be there. And I think that that can for different medical students that can be quite important to hear because there are so many opportunities during medical school as well as a lot of content, a lot of things to learn and so many resources to try and choose from that those there are opportunities that remain. And you make a good point, Neil, that there'll come a time where you can't travel as easily, you can't relocate as easily. Um, and definitely medical school is a special time um, in many ways, but but also although um, the road after university can look rigid and fraught and you might be worried about not having a job, but there are different kinds of things you can do. And if you're not sure what you

want to do now and you you think you might you want should I do research? Should I switch career, should I do something different? If you want to start foundation program, there's time to change your mind a bit later and go and explore other you know sort of parallel careers later on as well. And those opportunities will keep being there if you if you want to look for them as well.

Absolutely. I and I think um and I think part of that is a change of the times. Uh there's so much opportunity now um as well. There's a lot of fellowships, there's a lot of one-year positions. Yeah. Uh, I'd say 90% of everyone I've ever worked with in since I've qualified in 2013 has been part-time.

Okay. So, so I've worked in a huge part-time specialty between 60 and 80% for most pediatricians. And that

is for a lot of reasons, but um that has changed as well since even 10 years ago and and certainly since 20 years ago uh the allowance of those that type of freedom to develop yourselves on your off days. um and that presents other challenges but but lots of other opportunities. So certainly if you're a curious medical student there will be time to explore that. When you want to explore that is up to you by the sounds of it.

Yeah Thiago what about you? What opportunities do you think medicine has helped you find?

The first thing was that my medical school was very hospital ccentric. You know it was a big university hospital. my experience. It was a very traditional curriculum, very hospital ccentric and and from early on I I felt it was I I didn't feel that I belonged in that world of very hierarchical rigid hospital medicine which almost seemed like military style um setting and and that's when I discovered community medicine which led me to be to become a GP and also my undergraduate and post-graduate experiences were much better in in in general practice. So it first of all was finding my my field that that there was more to than just hospital medicine and then of course I I remained connected to after the student BMJ experience I that little bug never left me. So I found a way to come back to BMJ roughly almost 10 years later as editorial registar and that was what 12 13 years ago and and I remained with the

BMJ uh ever since and and I've never left since since then working in the in the research team and and the experience with the BMJ uh also led me to become um a frontr runner candidate to take up the position of editor-inchief of the Portuguese medical journal. They're very different kind of job. Uh you have to deal with

it's pretty cool. You have to deal with things that you didn't have to deal with as student editor. You have to navigate politics and met uh you deal with difficult people.

So much drama. Um but also um and also you were speaking earlier about activism and how medical students now are more you know are much more engaged in activism and I and I got engaged into medical politics. Uh I was dragged into medical politics uh because someone someone needed um to be replaced to go to attend a meeting at a European organization of GPS and someone someone asked me can you cover for me this meeting and and then I have left and now I'm the president organization.

Oh okay. Yeah. I'm serendipitous. So the so basically we doing lobbying and lobbying with the European um decision makers, you know, um advocacy for for GPS and and I'm happy to say that we've never had as much advocacy for GPS as we as we have now. And that politicians unfortunately they really don't know they don't really know much about medicine outside the hospital. Um, so we really have to teach them basic general practice 101 and primary care and uh and so on.

Such cool things you're up to. And I think it's really reassuring for me listening to as someone who's still at medical school like hearing from you, Thiago, Lara, and from Neil about these opportunities that are available. Cuz sometimes when there's so many things going on with like job insecurity and things, it can feel a bit disheartening. like I've gotten myself into a system that

is changing while I'm here and is no longer made for me. Um it feels like you're a bit trapped sometimes, but I don't know, it makes the commitment feel worth it cuz you know that there are so many wonderful opportunities available and it's not just one way like clinical medicine. It sounds like your experiences are really great, but it also sounds like there's so many other avenues that you can venture into. So medicine does open a lot of other doors to explore things that you might be interested in.

Definitely. I think um now you have much more opportunities than we had back back then. It was so much harder to venture out of the beaten path 20 20 years ago and I've always felt like a person who had to venture out of the beaten path uh you know and it was so much harder 20 years ago but there was less less volatility than there is now less uncertainty. Everything was very linear. uh and now there because this was before globalization so things there was much more serenity but at the same time there there was more limited opportunities so yeah it's a trade-off

I've been really encouraged hearing from you Thiago and Neil about how some things hearing some themes that haven't really changed and that is that medical students remain curious remain wanting to yes wanting to pass exams but but also you know wanting to um uh find uh opportunities and balance and things like this. And I I find it really encouraging because that's something I see at work now that yes, things are tough and they've changed and they're evolved and we're striking and we're postco and there's discontent, but fundamentally people remain in this job and choose this job because they want to practice medicine. They want to treat people. They want to help people recover from illness. And a lot of the time we're working in a system that seems to not let you do the best of your job. But nonetheless, people keep persevering, keep trying. And that's a common theme across medical students, across doctors.

I think across the last 20 years from our discussion that I'm hearing people are enjoying and trying to do their do their best at work to help patients recover in whatever ways they can despite the limitations despite the challenges. At the same time, we're also continuously over time from the European time directive to striking now, continuously also advocating for ourselves and trying to help increase doctor safety at work so that we can do our jobs better. And that is something that really encouraged me at work as well.

Mhm. One thing that I noticed is that medical students now are much more entrepreneurial uh than we were back then. You know, that they create their own jobs and their own opportunities. For example, I was hearing yesterday about this doctor here that created her own business in lifestyle medicine, you know, because people aren't medical students now are not afraid to they don't they don't want to do the linear road that we did 20 year years ago. So, they create their own opportunities and they open their their own businesses and yeah, so it's a completely different game. Yeah.

Sounds like we're all taking the road less traveled by. Um, and it's going well. Well, this has been a really reassuring episode for me, I guess, seeing all the different changes and getting all your wisdom and insight into the experiences there and I guess hope for the future now. Um, I want to thank you all for joining this episode. I've been very grateful to have you. And to the listeners, I hope that you are also able to enjoy this. Make sure you subscribe if you want to listen to another episode. They come out every 2 weeks. Um, and follow us on all our social media which will be linked below.

Um, for now I've been your host Dana and I'll catch you next time. Until then, stay sharp. Bye.

Questions about this episode

Who speaks in "Is there a universal medical school experience? - 150th Episode!"?

Zana Khan (Host), Lara (Guest), Thiago Vilva (Guest), Neil Chhatlani (Guest).

What is "Is there a universal medical school experience? - 150th Episode!" about?

The discussion explores whether there is a universal experience among medical students, featuring insights from former hosts and expert guests as they reflect on their diverse journeys through medical education. Key points include personal anecdotes, challenges faced by medical students, and variations in training across different countries and institutions.

What is mentioned in this The BMJ episode?

8 people, works and ideas are mentioned, including Zana Khan, Thiago Vilva, Neil Chhatlani, European working time directive, medical politics, Guide to Electives. Each one on this page links to its own page with every episode that mentions it.

How long is "Is there a universal medical school experience? - 150th Episode!"?

The episode runs 41 min; the transcript is about 7,997 words in 91 timestamped sections.

More from The BMJ

About this transcript: the episode's spoken words as captioned on YouTube, split into timestamped sections. Reclip.Me locates every person, work and idea in the text, keeps the time it is first named, and quotes the words around it verbatim. Last updated January 24, 2026.