Dr Anjum is a consultant general adult psychiatrist at Midlands Partnership 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 Anjum's story
A school friend, Professor Mowadat Rana, who himself is an eminent Pakistani psychiatrist, describes me as ‘the champion athlete who ran the 100 metre hurdles and won’. According to him, life threw many challenges at me, but I kept ‘running and jumping’, never to give up.
I started my psychiatric journey as a trainee in Pakistan when stigma applied both to psychiatric illness and to psychiatry as a medical specialty. Being a married Pakistani female medical student who was already a mother, along with numerous other social and cultural hurdles, was not an easy task to overcome. Despite all of that, I managed to become the sixth ever female to become a psychiatrist in Pakistan.
During medical school, we happened to visit 'The Mental Hospital', and it was painful to see the patients in the asylums and locked wards. I wondered why families left them there, not knowing that this stemmed from their lack of understanding about mental illness and seeking treatment very late. This was down to the stigma surrounding mental health. As a trainee, listening to patients’ stories was heart-breaking. On the other hand, I consider myself fortunate that I joined in an era when psychiatry was beginning to move forward. Asylums were slowly being transformed into teaching institutions. General hospitals also evolved to include separate psychiatric ward spaces.
I started my psychiatric training in an outpatient clinic with the late Professor Sharif Chaudry. This clinic grew from a few patients a day in its infancy to 40-50 a day within a few weeks. The number of trainees increased too. There was a surge due to the prevalence of heroin addiction as a result of the Afghan war at the time, which added to the plight of the poor families, and accelerated our dual diagnosis training.
In the midst of this I was blessed by working with Dr Saad Malik, a consultant psychiatrist. He was a charismatic and enthusiastic leader who had returned as a young psychiatrist from the UK. He put into practice developments he observed in the UK, with only a few changes for cultural adaptation.
Along with my regular job I became involved with Dr Saad Malik’s Mental Health Non Governmental Organisation (NGO). To be the only female psychiatrist on a team working in an NGO to offer psychiatric treatment to men, women and children chained to shrines, and who had been tortured with draconian methods by faith healers, were not just mere hurdles. These experiences taught me the value of life, and I believe this was start of my real education in compassionate care and putting the patient at the centre of everything we do. The NGO also ran a project in the local asylum to rehabilitate patients to get them back to their families. This was an extremely rewarding experience, witnessing the gleaming smiles of the families reunited.
Then a few years later came my life-changing decision. Should I call it serendipity? Yes, I believe so. I was sat in the rehabilitation unit and was visited by the ever-smiling late Dr Quasim and a colleague, who had come to attend a psychiatric conference and visited the project. They mentioned a sponsorship programme to the UK, which I brushed off at first. With three children aged 14, 11 and 6, and a husband with a respected career in a prestigious institution, this was most certainly, definitely not an option! Or was it…?
I am to this day still surprised and grateful for all the support I received from my parents, who gave me their unconditional blessing, and my extended family and friends, who encouraged and reassured me that a move to the UK was the right decision to make. But above all I have to salute my husband. He chose to sacrifice his career ambitions in favour of mine. Without this complete understanding from him and our amazing children, I would not be where I am today.
After a whirlwind period of preparations with the invaluable help of my school friend Professor Mowadat Rana, on the 27th of January 1996, I travelled to the UK with my colleague and future mentor, Dr Asif Atta. Over here I started my training on the Coventry and Warwickshire rotation. I am grateful to have had Dr Sharon Binyon as my college tutor, who helped me through the personal challenges of settling in. Somehow, and I don’t know how she did it, but she could always read the stress behind my smiling face. Looking back, it was a survival mission of sorts. The toll of post-graduate training alongside helping our three children settle into a new education system was sometimes too much to handle, but nothing was going to get in the way of my goal with an incredible husband and support system backing me.
In December 1999, I completed my training and joined Tamworth as a Senior Clinical Medical Officer and then Associate Specialist doctor. I worked with Dr Hasan Jawed and his team in Tamworth, and got the best experience of personal growth along with clinical exposure I could have asked for. At times it gave me the true meaning of life seeing that although our patients were struggling, they were still smiling and hopeful. The second success was doing my MRCPsych1 exam in 2003. I would love to name everyone who helped me along the way but there would not be enough space for that.
In 2004 I was asked to act up as locum Consultant in Tamworth by Dr Abid Khan. This was both an exciting and nerve-wracking opportunity. The relationships that I had built with the team already provided me with the confidence to seize the moment and then in 2011, I took up the substantive consultant post in Tamworth.
In my time as a consultant, the landscape of mental health services in my area has undergone several changes. During this time I have been given fantastic opportunities in the trust not only to hone my clinical skills but in a wide range of areas. I have worked both as an inpatient and community consultant. I have cherished the role of being a Clinical Supervisor for Foundation Trainees and have managed to inspire many to take up psychiatry. In 2011 I established an ADHD service for Adults within the Trust. I have served as a medical staff Governor and been a Principal Investigator on research projects including the TRD, the GLAD and the BALANCE studies2. I was one of the first to take the lead to support the development and progression of Consultant Nurse, non-medical Responsible Clinician3, and non-medical prescriber roles in my trust.
I have been working in Tamworth for 20 years now. The one constant during all these changes has been that the Trust, including all senior leaders, has always been fully supportive. This fact was brought home when a few years ago I developed an autoimmune disorder and had to adapt how I worked. After a period of ill-health, I managed to return to my full-time role, but with the support of the wider team I adjusted how I approached the job so I could manage my health well alongside. The combination of all my invaluable clinical experience, opportunities in wider areas of psychiatry and the support from all my colleagues and family and friends are key ingredients in the recipe that has kept me going all these years without burning out or losing any of my original passion.
Looking back through my current lens as a long-standing servant to the field of psychiatry, I always think about the amazing people that have directly and indirectly helped me on my journey. I believe that my role is to continue to learn, study, discover and unlock the potential that lies deep within every single junior doctor. A comment from an early teacher, “Rubina, you will waste your career if you choose psychiatry!” has certainly not materialised. It gives me great satisfaction that I believed in my dream and had the brilliant support structures to help me follow it. It was humbling when the College Tutor nominated me as, “The consultant that has inspired a lot of Foundation Year doctors to take up psychiatry”, and also when later I was nominated and became a Fellow of the Royal College of Psychiatrists. As I enter the twilight years of my career, I feel contented with the fact that I have had the opportunity to contribute as fully as I could to this highly interesting discipline and thrived by beating the odds, which to me has made the journey far more interesting.
- Membership of the Royal College of Psychiatrists exams, which are sat in the first three years of training in psychiatry.
- Treatment Resistant Depression study (European Cohort); Genetic Links to Anxiety and Depression (GLAD) Study, Bipolar Affective Disorder: Lithium/Anticonvulsant Evaluation study.
- Responsible Clinicians make decisions for leave and the renewal of detention under the Mental Health Act. This role was only filled by medical staff until quite recently and it is still rare for non-medics to hold this role.