Dr Maitra is a specialty registrar in child and adolescent psychiatry at Tavistock and Portman NHS Foundation Trust. She is one of 25 women to be highlighted as part of a special project that celebrates the stories of 25 amazing women psychiatrists.
Dr Maitra's story
I arrived in the UK in 2012, the year London held the Olympic games - and started a marathon of my own, juggling neuroscience, neuroimaging research, child psychiatry training, psychoanalytic psychotherapy training, motherhood, and becoming an advocate for physician mothers of children with complex needs. This marathon started nine years ago and is still going strong.
But before that momentous year, it was Hercule Poirot, the impeccable Belgian detective in Agatha Christie’s novels, who first opened up for me the fascinating world of how the human mind works. I began my medical education at Lady Hardinge Medical College, a historic, women’s only college in Delhi, established in the 1910s. My heart drifted away from human organs preserved in a jar in formalin, to creative pursuits, including editing our student magazine and having an active voice in the student union (we called it the students’ cabinet). Later I was awarded the Annie McKenzie prize for my contributions as President of the students’ cabinet.
But it was my third year in medical school that set the course of my life. Our eccentric and lovable departmental head for pharmacology had set us a project to explain the rationale of treatment for any patient in our wards. I went to our psychiatry inpatient unit, and the big eyes of an adolescent girl, who was experiencing catatonia after a viral illness, tugged at my heart. I visited her every week for quite some time as I tried to understand the world she experienced and how we altered it with the treatments we provided. As she improved, we celebrated by having a meal together, lovingly made by her mother, sitting on the floor of a small inpatient ward in Delhi. My project report on her pharmacological treatment received one of the highest marks. It also set me on a path to pursue psychiatry, and I have never looked back.
After graduating in medicine, I spent a rewarding two years as a resident trainee at the historic Christian Medical College in South India. This was established in 1900 and incorporates a Mental Health Centre started by a Canadian psychiatrist, Dr Florence Nichols, in 1957. There, families live together with the patient for weeks in small residential units. Doctors in training also live on the campus and learn to weave the medical model of suffering with compassionate care.
Some of my professors there instilled in me a love for research and psychotherapy. In my final year of training, a close family member experienced his first psychotic episode. In trying to help, I realised the gaps in my knowledge and felt compelled to train in neuroscience to develop an understanding of psychosis and treatments that could change lives for the better. So, although I passed my exams with distinction and was awarded the Florence Nichols prize as the best outgoing trainee in psychiatry, I left clinical psychiatry and joined the only neuroscience institute at the time in India.
Neuroscience was fascinating; learning with students from backgrounds as diverse as biology, physics and engineering brought a rich mix of knowledge and perspectives to our work. I pursued my training first at the National Brain Research Centre in India, followed by a research post in neuroimaging at the Florey Institute for neuroscience and mental health in Melbourne, Australia.
Encouraged by a professor of physics and neuroscience who was also a friend, I was thrilled to be selected for a Marie Curie Fellowship in neuroimaging at Friedrich Schiller University in Jena, Germany, where I found more beautiful friendships and the first real opportunity for me to travel the world and to delve into structural abnormalities in the brain that might underlie vulnerability to psychosis. I worked in a hospital steeped in history – where Hans Berger pioneered the EEG, and where Nietzsche was admitted for his mental health difficulties – and soaked up the history and philosophy of the human mind as well as neuroscience.
Life and love took over, and after a lovely wedding, I then went on to join my husband (a beautiful, kind person) in the UK. The UK system required me to re-train in psychiatry, in spite of my experience and developing expertise. I started as a core trainee with a dual post in adult psychotherapy in a complex needs service, and in a CAMHS outpatient department. The post in psychotherapy helped me understand the nuances of early emotional development, gave me the language of pauses and the power of silence in creating a space for one’s fears and anxieties to breathe. It also fostered the skill of unhurried gentle questioning with genuine curiosity, which imparts courage to enable one to explore those fears and anxieties. Who knew then that I would soon need all of these tools for my own little child to help make sense of his challenging world?
Still on maternity leave, I went back to Germany to defend my MD thesis and share my little bundle of joy with my friends. My thesis for the Doctorate in Medicine was awarded a Magna cum Laude and my supervisors, knowing my love for child psychiatry, presented me with a daisy and a book on child development called Marvellous Minds. Soon after, our child developed a serious illness, and our one-week holiday became a four-month stay in and out of intensive care. I read Marvellous Minds when I could, holding on to a desperate wish to be the best mother I could be, to protect my child from the horrors of his experiences and help him experience a marvellous childhood.
Back in the UK, I began a lonely professional journey, combining motherhood of a very special child with the arduous task of getting back to work and training – all in a new country. With frequent hospital admissions for my son’s serious medical complications, and no opportunity of working remotely in a clinical capacity – now of course our bread and butter during COVID – I had to chart out a phased return to work, often working unpaid just to keep up my skills and to be able to build up the number of working days necessary to meet the minimum requirement for training. I had to depend on charitable organisations to fund my MRCPsych examination fees. It was a kind consultant child psychiatrist at the historic Maudsley hospital who opened the doors for me to refresh my skills in child psychiatry, and to continue my professional development at a pace that accommodated my exceptional circumstances.
The complexities of a challenging motherhood, and a consequent but unplanned career break, blur how one sees oneself. It took tremendous self-belief in my capacity to parent, resilience to help my child through the challenges, and self-compassion not to lose my professional identity through the uncertainties and inflexibility of the training system. But this journey cannot be made alone. I have found I need peers who can conceive and understand the agony, colleagues who can remind me of my strengths when the future seems an impossibility, and family who value the significance of my profession in my life.
I found my voice to highlight these challenges as a member of the Trainee Support Group at RCPsych. I conducted a workshop at the first Return to Practice conference at the RCPsych. At this workshop, a mum of four who was trying to return to work was inspired by my message and connected me to other strong women in medicine who were also juggling life as mothers looking after children with complex needs. I was surprised to learn how similar our lives were, how we hang on to our dreams despite the challenges, and how resourceful and resilient we are as both mothers and professionals.
I felt compelled to advocate for mothers like me. I wrote letters to the BMJ highlighting the unique working needs of this resilient workforce, which does not feature on HR or Health Education England radars yet. I raised the particular needs of this group with the Wellbeing Committee at the RCPsych. I liaised with the Psychiatrists’ Support Service at RCPsych and the Psychiatric Training Committee, and the first output of this is a parental guidance help-sheet, soon to be published. I highlighted the needs of this group to the CEO and MD of the Practitioner Health Programme (PHP), and a therapeutic group for physician parents with children with complex needs has now started. My lifelong commitment to physician parents continues through my role in the Women and Mental Health Special Interest Group at RCPsych.
My career now is a story of supportive and compassionate colleagues who recognise my journey and my achievements, and are not blinkered by an insistence on linearity. A chance meeting with a most generous professor led to a post-doctoral opportunity in the Cognition, Schizophrenia and Imaging lab at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. I have been able to develop my teaching portfolio by contributing to their Masters courses. I continue to collaborate with my former colleagues in Germany and am grateful for the opportunity to contribute as an advisory board member for a UNESCO project on social-emotional learning in adolescents in India.
It has taken me more than a decade to become a higher trainee, but I now have the opportunity to train in Child and Adolescent Psychiatry at the Tavistock, and also train in Child Psychoanalysis. Life has let me know the gut-wrenching taste of trauma, the power of our will and our minds, and our power over our bodies. I have been at the threshold of the nuanced play of nature and nurture. The perfect place for neurobiology and psychotherapy to meet, to try and unravel the ingredients that help us stand strong.
My greatest challenge as well as my greatest achievement has been to be fully present for my patients and create the safe and nurturing space they need, while separating my needs as a mother whose child is battling life and death – while also being fully present for my child, taking career breaks when necessary. While I try to raise awareness of unpaid carers in the NHS workforce – especially physician mothers with children with complex needs – I dedicate my clinical life to achieving a world for children where no child feels unloved; and no child becomes so unwell that they lose touch with reality and experience psychosis. My journey has made me realise our immense capacity to love, and to rise above hardships.
I am grateful for this nomination to be able to share my story, and hope that it inspires women psychiatrists and others in our profession never to give up: to hope; to rebuild, to believe. Without Dr Hamideh Heydari, Dr Nicola Byrne, Professor Subodh Dave, Dr Richard Corrigall, Professor Sukhi Shergill, Dr Mihaela Bucur, Dr Daljit Jagdev, Dr Laura Forrest, Dr Parvati Rajamani, many other wonderful supportive colleagues, my husband, and our tough, brave and beautiful child, my journey in this country might have halted before it had any chance to blossom.
Why Dr Maitra was nominated
“Her perseverance and passion for psychiatry, her interest in the union of neuroscience and psychotherapy, and her personal hardships have equipped her well to support her patients and their families. She wishes for others to be more aware of the difficult lives that trainees can have, and for there to be more flexibility and support for them. It is with the help of those who went out of their way to support her when the system was trying to keep her out, those who chose to walk alongside her in her journey rather than dismiss her as being unable to work, that she has been able to get to where she is now. I cannot say how much longer her training will take, but I can say that our profession is all the richer for having her.”
Dr Henna Qureshi, ST6 CAMHS, Tavistock and Portman NHS Trust
“Raka truly understands and cares about trainees and doctors; she recognises their needs and responds fast. She is keen to improve working conditions by discussing experiences and thinking of solutions that work for the doctors. Her unique skills and roles have been key to understanding retention issues for women in medicine.”
Dr Laura Forrest, Consultant in Child and Adolescent Psychiatry