Jon Simpson
Consultant in Respiratory and General Internal Medicine
Manchester Royal Infirmary
How did you train in Respiratory Medicine?
I was a medical student at St Andrews for three years and then at Manchester for three years. I qualified in 1989 and became a House Officer in medicine for six months (Withington & Christie Hospitals) and then in surgery for six months (Withington Hospital). I then spent a year at Wythenshawe as SHO in cardiology and respiratory medicine, then just over one year at Manchester Royal Infirmary on the general medical rotation completing my general professional training and passing my MRCP (UK). After this I became a Research Fellow at the North West Lung Centre (Wythenshawe Hospital) under the supervision of Professor Pickering. During this time I gained experience in respiratory and occupational medicine and carried out a research project, which led to an MD. I also became an associate of the faculty of occupational medicine.
I returned to Manchester Royal Infirmary as a clinical lecturer in General Internal Medicine and Respiratory Medicine for almost 2 years. I was then appointed as a Senior Registrar in respiratory and general internal medicine. During this time I spent a further 2 years at Wythenshawe. I gained experience in the sub specialties of Respiratory Medicine. During this time changes to higher training occurred (Calmanisation).
Prior to taking up my appointment at Stepping Hill Hospital as a consultant in respiratory and general internal medicine I moved to Trafford General Hospital for six months of general internal medicine. On the 31st March 1999 I was awarded a CCST in respiratory and GIM and on the 1st April 1999 I became a consultant at Stepping Hill Hospital. I worked at Stepping Hill Hospital for two and a half years before moving my present position at MRI on the 5th November 2001.
What is your working pattern like?
It is both in and out patient work, including general and respiratory medicine. Generally the week is as follows:
Monday a.m. Administration. p.m. Private work.
Tuesday a.m. Ward rounds. p.m. Clinic at Withington in GIM and Respiratory medicine.
Wednesday a.m. TB clinic once a month. p.m. Cancer clinic.
Thursday a.m. Bronchoscopy list. p.m. Ward rounds.
Friday 8.00a.m.-10.00a.m. X-ray meetings.
10.30a.m.-12.00p.m. Teaching students.
p.m. Lunch time meeting. Clinic GIM & respiratory medicine.
Other activities are fitted in around these commitments. When on call I have 2 extra ward rounds one in the evening and one the following morning. My on call commitment is currently 1 night in 15. During this time approximately 25-30 patients with acute general medical problems will be seen and assessed. Increasingly time is spent speaking to relatives who are interested in and are often knowledgeable about a patient’s illness.
I am also asked to give opinions on patients with respiratory problems under the care of other consultants form other specialities. Teaching is an important commitment we have attachments of 3rd, 4th and 5th year students. Formal and informal teaching sessions occur. I am also involved in teaching House Officers and SHOs preparing for their MRCP. Time is also spent on service development, it is ongoing and important to keep up to date. Most days I am in work by 8.15 a.m. and leave at 6.00 p.m.
What attracted you to Respiratory medicine?
I enjoyed my time spent at Wythenshawe as a SHO and worked with some very good physicians. The choice of speciality is often influenced by who teaches you and whether you are made to feel enthusiastic about the subject when working with them. Having passed my MRCP, I was aware of the possibility of a position as a research registrar in respiratory medicine at Wythenshawe. I was delighted to be appointed to this position and from this point I started my higher training in respiratory medicine.
The other factors, which attracted me to respiratory medicine, were the patients. A large number of people have chest problems, respiratory disease is a common cause of illness and mortality. This can occur in both the young and old. The types of illness are very varied and when practised with general medicine you are never short of challenges. In addition patients often have chronic illnesses so I get to know them over a long period of time.
Are there any disadvantages to working in Respiratory Medicine?
It is frustrating to see the lack of progression in preventing and treating smoking related chest disease. This accounts for a large part of my work and could be prevented if people stopped smoking. I do not think there are any specific disadvantages to working in respiratory medicine. As with all specialists there is at times pressure/conflict between speciality and general internal medicine. There are problems with ever changing work patterns, administrative changes and a general lack of resources.
What personal qualities are needed for the job?
Patience and good communication skills are needed to converse with both patients and staff. Respiratory clinicians also need to be conscientious and hard working. They also have to be skilled at breaking bad news. They need a lifelong commitment to learning. Teaching skills are essential as most consultants will be supervising/teaching medical students HOs, SHOs and SpRs. In more senior positions management and leadership skills are needed.