Raj Nirula
Lead Associate Dean for SAS doctors for the Conference of Postgraduate Medical Deans (COPMed)
“In Wales, SAS doctors are a very important part of the infrastructure and if they are not supported the NHS couldn’t really survive without them. It is in the interests of SAS doctors and employers to support these doctors to develop themselves and progress.”
It was never Mr Raj Nirula’s intention to settle in Wales. Having undertaken his postgraduate surgical training in India, he planned to undergo a urology fellowship in the UK, before returning to India. Raj’s plans changed when he found his route to a urology fellowship was blocked as he could not get a senior registrar post in a teaching hospital. Having taken several surgical posts, Raj settled at the Princess of Wales Hospital in Bridgend (now part of Cwm Taf Morgannwg University Health Board). An offer made to Raj to become a GP, prompted a discussion with a consultant colleague who was keen not to lose Raj’s surgical expertise, and led to the creation of a permanent staff grade post for him. He says, “I was probably one of the first staff grades to be appointed in Wales”. Soon after, Raj became an Associate Specialist.
When the CESR process was introduced, Raj achieved his CESR in urology. Opportunities arose to pursue a consultant post but Raj was dissuaded by two factors: consultant colleagues (who did not want to lose him); and his wife and young children (who did not want to move from the area). He says: “I didn’t want to disrupt the whole family infrastructure, and to be honest, I haven’t regretted it. My career has been very satisfactory. I have enjoyed it. My work has been very good. I’ve practically been doing autonomous practice for a long time. I always ask for help when I need it and that’s always been provided”. Raj now has his own clinics and theatre lists and was on the consultant on-call rota for 15 years. He is the only urologist to undertake paediatric surgery at the Princess of Wales hospital for the last 15 years.
“I decided to stay here, but at the same time I wanted to progress. So, then I started looking into the management side of things.”
Raj equipped himself with the skills to step into management roles, including a diploma in leadership and courses run by the British Medical Association (BMA). He became an Associate Dean with the Wales Deanery, and Joint Deputy Chair of the BMA Staff, Associate Specialists and Specialty Doctors’ Committee. He was recognised as Wales SAS clinical teacher of the Year in 2013 by Wales Deanery.
In January 2021, Raj was appointed to the post of Lead Associate Dean for SAS doctors for the Conference of Postgraduate Medical Deans (COPMeD). He says, “Even once they offered me the job, I wasn’t sure whether I should take it. I spoke to my medical director and he said ‘Raj, you must go for it, we’ll give you the time, whatever is needed, it’s a big opportunity’… I was probably the first Associate Postgraduate Dean for SAS doctors in the UK.” As Lead Associate Dean, Raj chairs quarterly meetings of associate postgraduate deans for SAS doctors across the UK. He relays issues relating to SAS doctors to COPMeD.
“I think the support behind you has to be there and that’s how you can basically help others.”
Raj emphasises the importance of the support he has received from colleagues at Health Education and Improvement Wales (HEIW), as well as from the Medical Director at his Health Board. In his role with HEIW, Raj has supported other SAS doctors to progress, including by running courses to assist CESR applications, an SAS support group, mentorship, and by sharing his personal experience. Other SAS doctors are in turn paying it forward: one SAS doctor was funded to attend a course in ultrasound and now trains other SAS doctors and consultants.
Advice for SAS doctors on progressing your career
Find out about the opportunities – “Opportunities are there for SAS doctors, you have to grasp them. When I first started, the opportunities were very restricted. Now, if somebody wants to take up the opportunities, there’s nothing stopping them”, says Raj.
Prepare yourself – Raj says, “You have to be prepared to work for it, to compete for it, and prove that you’re capable of doing it.”
Seek feedback – If you are not successful in securing a position you apply for, request feedback. Raj advises asking: “What do you think I’m lacking?” This will provide insights into any skills or knowledge gaps that need addressing.
Raj’s career journey
Advice for SAS doctors on confronting bullying or harassment
Report it – anonymously if you wish, to leaders within your organisation. In Raj’s Health Board, there is an anonymous telephone number that staff can use if they feel harassed or bullied. He says, “We will never eliminate racism or harassment, but I think it is certainly coming down. For SAS doctors, I think the majority of the time it is more gradism than bullying.”
The NHS has produced guidance on how to identify if you’re being bullied at work, how to stop it, and advice on getting support. Go to: https://www.nhs.uk/mental-health/advice-for-life-situations-and-events/support-for-workplace-bullying/
