DR WALA: The practice of medicine is not for everyone

Dr Elizabeth Wala has over 14 years’ experience spanning the fields of health care policies, health system management, pharmaceutical medicine and clinical research.

She is also a mother, farmer, blogger and motivational speaker.

Are the existing policies in the practice of medicine conducive for both the medical worker and patients?

To practice medicine, there are six major pillars that have to be in place: human resources for health (personnel), the infrastructure to execute the practice (hospitals and other necessary facilities), commodities (consumables such as drugs and oxygen), health information systems (networks used to communicate within the healthcare profession as well as research), healthcare financing (resources being pumped into the system) and finally, good leadership and governance (decision-makers who understand issues in this field). When even one of these pillars is not in place, it means that the practice of medicine is not conducive.

In Kenya, we are in a situation where the human resources do not feel that their welfare is being taken care of. Most times, it is hard to even practice what you trained to do because the environment is not conducive.

We do not always have the right people to represent medics at the policy level because many medical personnel think that positions like these are for politicians. We need to step up and fill these positions so that we do not end up being represented by people who do not understand the issues.

Is this what you wanted to do?

In my time, we did not have proper career guidance. The options for top students such as I was law, medicine, dentistry, pharmacy, commerce and architecture.

I initially wanted to be a lawyer, although I do not regret studying medicine; I am satisfied when I see the impact that I have in the society in which I operate.

I practiced clinical medicine for six months after which I resigned from frustration and went to work in other areas such as research, pharmaceutical medicine and health care policy when I became the first female and youngest vice chair of Kenya Medical Association and later on the first ever CEO of the Association.

These diverse experiences have made me understand the dynamics of the medical profession better and why it is important to have flexibility about career prospects.

How did you determine your specialty within the medical field?

I left clinical medicine in public health after only six months of practice. I happened to suffer a gynecological emergency whose treatment I could not afford yet I offered the same care to others, daily.

Thankfully, my family helped with the hospital bill. I got an opportunity to work on research for HIV vaccine trials and that is how I branched off from clinical medicine. Today, what I seek most in my career is being in a space where I can have a social impact to the society irrespective of the field of practice.

Speak to medical students – what should they expect as they find their footing in the academics and early careers?

First, it is a myth that medical practice makes you rich. Second, you must have the personality for medicine: I would recommend personality tests before immersing yourself in the study. Forget the romanticised version of the medical career depicted in Greys Anatomy.

You need to have the grit to endure the challenges that sometimes come with the profession, as well as the stamina to survive the training. Work smart and read broadly about the opportunities that are available to you past the clinical space.

How can younger doctors/medical students influence healthcare policies for the better?

Understand their role as citizens of the country and elect proper leaders. Secondly, understand what the constitution says about health.

That said, there are many clubs seeking to influence the direction of health in the country; join them. It is also important to link up with your parent association, Kenya Medical Association; they have programmes of benefit to medical students.

Finally, give back to the community via medical camps, health talks in churches and schools to build awareness at the grassroots level.

What mentorship opportunities are there for young doctors/medical students?

I am a founder of a company called BTS Global: Beyond the Stethoscope, a space where medics meet and learn complimentary skills, such as brand positioning, public relations skills and presentation, entrepreneurship, the changing digital space and how this affects their practice and so on. It is also a platform for networking and a space to meet mentors.

Respective medical associations are also a good way to meet mentors, and this underscores the importance of networking and basically being present where things are happening.

Also, start gathering experience as soon as you can, do not wait until you graduate – make use of the long holidays – I have worked in a pharmacy and in a morgue too.

This exposed me to how budgets are done, as well as writing reports. Amref also offers internships quarterly, so be on the look-out for such opportunities.

What do you consider your most hilarious memory of medical school?

In first year, a cheeky student got into one of the body-bags that we were using for the anatomy/dissection classes. We thought that a dead person had come back to life.

I was a class representative in third year, and one day, I found fifth year students occupying our lecture class; I managed to kick them out much to their chagrin! I think my activism started here.

Do you know now, what you think would have made a difference to the professional you are today if you had known it earlier?

Knowing that there are so many other things that I can do with a medical degree outside clinical practice – I learnt this along the way.

What was your greatest mistake as a young doctor?

I performed a delicate caesarean section without guidance, and the baby’s arm broke in the process. This was, luckily, easy to correct, but the experience taught me to always follow rules, to be vulnerable, own up to mistakes and ask for forgiveness.

I learnt that every once in a while, we all make a wrong call. The most important thing is to face our mistakes and avoid the blame games or try to cover up.

The perception is that medical students are extremely busy people; did you have time to date, have a social life?

Balance is important. I dedicated my week days to books and the weekends to relaxing.

A few of my classmates were discontinued because they couldn’t cope with the pressure. I dated, yes. It is important to, of course, focus on what took you to school, but working smart is key.