Laura Hipple
First SAS Vice President of a medical royal college
“You realise you’ve actually built up quite a wealth of experience, because SAS tend to work very collaboratively across specialties and a lot of the issues SAS face are the same in different specialties… I’ve also been working for over 30 years as a clinician.”
Dr Laura Hipple’s journey to becoming Vice President of the Royal College of Obstetricians and Gynaecologists (RCOG) – the first SAS doctor to be made a VP of any medical royal college – was not planned. “I always feel my career has been a bit of a happy accident,” she says.
“I nearly fell off my chair,” is how Laura describes her reaction when a previous RCOG President first approached her about becoming a VP. She felt honoured but not yet ready to take on the role. Instead, she reduced her clinical responsibilities and focused on her other leadership roles. She was SAS/LED lead for the RCOG, a vice chair of the SAS Committee of the Academy of Medical Royal Colleges (AoMRC), local SAS Tutor and a SAS lead for North Cumbria Integrated Care Trust. The SAS lead post was a new position created as part of a Medical Directorate Development Faculty to support SAS doctors and create SAS leadership positions – see box.
Laura felt better prepared to put herself forward for election for VP the second time she was approached. “I thought if I don’t do it now, I’m never going to do it, and it also seemed a glass ceiling that I should try and break for SAS and locally employed doctors [LEDs]”, she says. She resumed her clinical practice and stood for election. “I was up against all these amazing people with publications and international awards. But the thing I had that was unique, of course, was all this SAS and LED knowledge.” She adds: “The SAS Tutor role, the SAS Lead role, the leadership development, doing appraisals, educating others, the college role, all really helped to build up my portfolio and give me a broad range of experience.”
Choosing an SAS career
Laura had not anticipated becoming an SAS doctor. She was attracted to obstetrics and gynaecology (O&G) in her final year as a medical student. Having attained her MRCOG whilst an O&G registrar at the Cumberland Infirmary in Carlisle (part of North Cumbria Integrated Care NHS Foundation Trust), she expected to do her final year on rotation elsewhere, before continuing the traditional pathway to a consultant post. Laura decided to stay an extra year in Carlisle for personal reasons. When a consultant colleague asked if she would be interested in a local staff grade post, working a 48-hour week, with no weekends, a fixed 24-hour resident on-call and the next day off, she says, “I nearly bit his hand off because of the geographical stability to continue to work full time in the place I wanted to, without the worry about moving on”. She describes how becoming a staff grade “was really the only way I could continue to work in my specialty and do everything else that was going on in my life. So, it was a win-win. And in those days, a 48-hour working week was considered part time”.
“It’s the perfect work life balance. But there was still this feeling amongst consultant colleagues that somehow, I was taking a lesser career.”
Having been appointed to the staff grade post, Laura secured a place on a diploma in advanced obstetric scanning in Sunderland. This equipped her with scanning skills that she was able to use in clinical practice locally and to train other staff. She helped to run a local fertility clinic alongside a consultant. When the consultant retired, the Trust began to code these patients in her name, as she took fertility referrals from GPs and other consultants. Her early pregnancy clinics and operating lists also gradually moved under her own name. “During the day I was working pretty autonomously. At night I was still working resident on call on the middle grade rota,” she says.
Recognising her increasing autonomy, the Trust promoted Laura to become an Associate Specialist. Laura recognises that other SAS doctors may not be afforded such promotions under the current contractual arrangements, saying: “I do feel really sorry now for the experienced specialty doctors that are stuck at that level because of a lack of new senior SAS (Specialist doctor) posts to progress to”.
An awareness that she cannot single-handedly represent the diversity of SAS and locally employed doctors is driving Laura in her new role as RCOG VP to draw on a breadth experiences, particularly international medical graduates, for a newly created RCOG SAS/LED Committee. As VP for Membership and Workforce, Laura, together with four other VPs, will support the RCOG President to advance the specialty and champion women’s health, whilst continuing to provide a platform for SAS and LED voices.
“I’m right at the beginning of my VP journey,” says Laura. She would encourage any SAS doctor to apply for leadership roles, particularly if a colleague suggests it, adding: “they might be seeing something in you that you can’t see yourself”.
Laura’s career journey
North Cumbria’s Medical Directorate Development Faculty (MDDF)
“The MDDF works as a team to support all SAS and locally employed (LE) doctors, and to support and advise their managers and clinical directors.”
North Cumbria Integrated Care NHS Foundation Trust created the Medical Directorate Development Faculty (MDDF) to demonstrate its commitment to the approximately 170 SAS and LE doctors in the organisation. Its purpose is to provide dedicated support for these doctors, including identifying opportunities for progression, and to help managers and clinical leaders understand the roles they can play.
The MDDF comprises an SAS lead, CESR lead, LED tutor and an International Medical Graduate (IMG) tutor who focus on issues such as IMG induction (approximately 40% of the Trust’s doctors have come to the UK from abroad).
The creation of the SAS Lead role arose when Laura was an SAS tutor and before the SAS advocate role was launched nationally. “We were ahead of the game and there is quite a lot of overlap with the SAS advocate role,” she says. The SAS Lead role involves consideration of contractual issues, such as job planning, pay progression and the specialist grade contract; SAS advocates tend to focus predominantly on SAS wellbeing. The SAS tutor focuses largely on education and career development for SAS doctors.
All the MDDF posts have programme activity (PA) allocations in their job plans. Health Education England North East (HEENE) devolves SAS development funds to the Trust, which fund the SAS Tutor and administrative support to the Faculty, as well as SAS development days and associated resources.
“We’ve got this band of four of us working collaboratively. We have good admin support and a clear governance structure for reporting. We have quarterly whole team strategic meetings and we each have one-to-ones with the Deputy Medical Director for Professional Standards every six weeks.”
Laura writes to SAS doctors when they first join the Trust, signposting a dedicated SAS website and serving as a point of contact. She highlights the uncertainty that often arises over whether new starters are SAS or LE doctors, adding: “What we’ve agreed is that whenever we get a new doctor, we assess whether their needs are more LED or more SAS-like and then try and support them accordingly”.
The MDDF’s impact is demonstrated by the following examples:
- Helping the Trust to implement the new specialty and specialist grade contracts, including by creating local generic templates.
- The LED Tutor is working to achieve greater consistency across the Trust through generic LED contracts.
- Most LEDS have a clinical supervisor and access to departmental teaching.
- There is a strong CESR programme, which is now being provided at regional level with HEENE.
- IMGs receive a bespoke enhanced induction and access to a UK practice support programme.
