My Personal Journey: Patricia van den Berg

For everyone less interested in the personal details, this is my summary of lessons I have learnt on my academic journey so far:

• It’s okay to deviate from your original plan and take some twists and turns. Changing your mind isn’t a sign of failure but just means you keep moving in a slightly new direction.
• Put yourself out there and ask for an opportunity. The worst people can do is say no. You might be treated to a journey and do things you never thought you had in you.
• Research is about finding something you are passionate about and persistence in moving towards finding answers. Being clever helps but you don’t need to be a genius to build an academic career.
• Find a mentor, someone you trust, someone who supports you but will also provide you with honest feedback to help you move towards excellence.
• Don’t let people tell you that you can’t do something. As long as you believe in yourself and give your best you will be surprised at what you are capable of.

Looking back, I had fallen in love with the academic world long before I even started to consider medicine as a career. Graduating from high school in my home town of Berlin in Germany, I was 100% committed to studying chemistry. Combined with a desire for adventure, I chose a BSc in chemistry at the Radboud University in Nijmegen, Netherlands. Learning Dutch from scratch and having moved far away from home, I started my academic journey. But I soon discovered that the chemistry degree was too heavy on mathematics and physics for my taste; this was when I first deviated from what I had thought would be my path.

Having a joint first year between several different BSc programs allowed me to switch to a BSc in molecular life sciences at the end of my first year without needing to start all over again. Diving into a range of biochemistry and biomedical topics, I thought I had found what I was looking for. While I enjoyed the degree and the research placements in the lab, in my second year I started to notice a niggling feeling that I could not see myself doing lab based basic science research for the rest of my career. At this time my mum was diagnosed with a serious form of cancer, which has undoubtedly changed me as a person. It made me realise that I wanted a career in medicine, working with people in their time of need, while still aspiring to an academic career.

Extensive online research led me to discover a 4-year combined research MSc in medicine and clinical research at Maastricht University. Successful completion of my BSc, and of a tough selection process for only 50 spots on the course, soon meant I had taken another turn in my academic journey. While going through the shortened pre-clinical and full clinical training in the four years, I completed an MSc in Clinical Research. Falling in love with Emergency Medicine (EM) as my specialty of choice was a blessing and curse at the same time as the specialty is still in its infancy in the Netherlands, with few opportunities for an aspiring academic. When I discovered that the European Society for Emergency Medicine (EuSEM) was holding a conference in Amsterdam in 2014, I made it a point to attend for a day. That day I serendipitously attended a session about ethics; this was my first encounter with Professor Rick Body, who would become a mentor to me.

Shaping your individual journey

My final year included a 20-week research internship, which my University advised us to pursue at one of their local research schools. Being a bit stubborn, I again resisted doing things the easy way. I was on my obstetrics and gynaecology clinical rotation, which had taken me to Jakarta in Indonesia, when I was ranting about not wanting to do my research placement in the Netherlands but rather somewhere where EM was a full specialty where I could have an academic EM supervisor. One of my fellow students advised me (with typical Dutch directness) “Just drop whoever you want to work with an email. At worst they will say no”. So I went off and sent an email to Professor Rick Body to ask if he would take on a medical student for 20 weeks.

Long story short, he said yes, and after jumping through all the administrative hoops required, I arrived at the Manchester Royal Infirmary for my first day at the EMERGING research office. The people around me made me feel at ease and inspired me to do things I never thought I had in me. Those 20 weeks had a lot of ‘first times’, moments of frustration but also moments of pure joy. Developing my first own research idea from scratch to a finished and submitted manuscript filled me with an addictive mix of pride and joy. At this point I knew I wanted to be an academic emergency physician because I had found something that would allow for a balanced job that I could picture myself doing until retirement.

Fall down seven times, stand up eight

My medical school internship resulted in four published papers, six poster presentations at national and international conferences and very recently, a first invited oral presentation at the European Society of Cardiology congress. There were two key factors that contributed to those achievements in my opinion; one was persistence (or stubbornness some might say) and the second was having a mentor and supervisor that helped me believe in myself, challenged me to do better, sparked new ideas and was a role model to me.

This became even more important for me after returning to the Netherlands. Graduating from my MSc several months later, I took up my first job as a non-specialty training grade doctor in EM at a small local hospital. Without going into detail on the challenges of getting an EM specialty training post, let alone a PhD (welcome to a country without a professor in Emergency Medicine at the time), it’s safe to say I felt stuck professionally.

What kept me relatively sane was attending relevant conferences nationally and internationally. Following EuSEM in Amsterdam, I subsequently became involved with the Social Media and Critical Care (SMACC) conference when a friend told me they were looking for student volunteers for the conference in Chicago. This conference and many others have opened doors for me I wouldn’t even have known about if I hadn’t attended, and have served me with opportunities to present my own work. But more importantly, I have met colleagues from around the world and made some good friends.

I decided I would regret not trying to get into EM training in the United Kingdom, thereby giving myself a chance of becoming the academic emergency physician I wanted to be. Graduating in Europe meant I could not apply for the regular foundation programme in the UK so I applied for locum appointment for training (LAT) posts, the applications for which were a whole new experience for me and ended in a single offer for the Isle of White. As much as I wanted to follow my dream, I decided that this offer wasn’t what I wanted and was too much of a compromise to me. I continued working in the Netherlands, growing my clinical experience but still years away from getting a shot at obtaining a training post, as well as missing academic opportunities desperately. At the time, I felt like giving up my academic journey and ambitious dreams. I even applied for General Practise (GP) training in Maastricht with a heavy heart. It felt like giving up a piece of myself that I wasn’t ready to let go.

Academic Clinical Fellowships and finding what makes your heart sing

Maybe it was meant to be, but a week before the GP interview I found out by surprise that the Alternative Certificate of Foundation Competence had undergone changes that meant my Dutch EM consultants were suddenly in a position to sign me off and were more than happy to sign the form for me. That in turn allowed me to apply for specialty training positions in the UK directly. I turned to Professor Rick Body for some advice on putting in an application and he pointed me to the academic clinical fellowship (ACF) posts in Emergency Medicine. With applications closing a week later, I put mine in for a post in conjunction with Manchester University – not expecting anything, being a foreign graduate with little UK experience. At the same time I withdrew my Dutch GP application, which felt like a massive relief.

Being invited for the interview just before Christmas was a genuine surprise to me. The interview was the most nerve-wrecking thing I have done in my professional career and being appointed the post in early January simply blew my mind. A couple of months into being an ACF trainee at the Manchester Royal Infirmary, it is still early days. Settling into a new job in a different health care system in a different country is a very humbling experience. The current plan for my ACF is to move on from the work I did in my student time, building a case for shared decision making in chest pain early rule out strategies and hopefully generating funding for a PhD.

Whatever happens, I hope it is just the start to a long-term career in academic Emergency Medicine