Dr Minot is a consultant in addiction psychiatry at Camden and Islington 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 Minot's story
I am not your average high-flying school leaver who was always at the top of the class, but someone who really struggled at school and battled through their professional training. I have severe dyslexia and have had to overcome barriers constantly along my educational pathway – throughout school, when gaining a place to study medicine, being successful in membership examinations, then gaining entry onto the Specialist Register. Only through the support of others, my own self-belief, grit and determination have I managed to achieve success.
I had to re-sit A-levels and found it hard to gain a place at medical school; my first application was met with five straight rejections. This was tough as my friends all went off to university, whilst I stayed at home and re-sat two of my A-levels. Fortunately, on my second application, I received an offer and gained the required grades at A-level.
Whilst at medical school, thanks to the wonderfully supportive and enthusiastic psychiatric consultants, I became more interested in psychiatry. I qualified with an honours degree in medicine, then focused on training in psychiatry. I completed my first year of house officer posts and went on to gain a place on a psychiatry training scheme in London. I found the training incredibly interesting but struggled to pass my MRCPsych examinations1. After the third failure of the Part 1 examinations, I spoke with my supervising consultant and opened up about my dyslexia. He instantly called the College to ask about the guidance relevant to my situation and how they could support a trainee with dyslexia.
Whilst I had been allowed additional time for examinations at school and medical school, I had not considered that this was possible for professional examinations. Following an updated assessment report, I was granted 25% additional time to sit my examinations. I sat them at the College with another trainee with dyslexia – this time I passed! I then succeeded in the written papers of Part 2 on the first attempt, but just missed out on the clinical examinations by a matter of two marks on one of the components. Spurred on still by my other examination successes, I was delighted to pass in both components in the next sitting, gaining MRCPsych in autumn 2006.
Following the completion of my MRCPsych, I was looking forward to starting higher training, but came up against MTAS2 and was not successful in gaining a higher training post. This left me feeling deflated and frustrated. I really did question my training path and I had career counselling. Ultimately, I decided to leave the NHS in 2007 and work for a third sector substance misuse organisation. I was happy in this post for a few weeks before there was more bad luck with the loss of a service contract, and a few months later my contract was transferred back into the NHS. At this point, I decided that I was going to pursue the CESR3 route to a consultant post, and with the support of my consultant and liaison with a neighbouring NHS Trust, I devised a partial job swap with an Associate Specialist in a similar position. I thus created my own training scheme comprising addiction psychiatry, assertive outreach and general adult psychiatry, to add experience to the locum higher training post I had already undertaken.
I also took on additional roles within my service, such as managing the internal Continuing Professional Development programme for doctors, managing the doctors’ diaries and arranging regular meetings. Following the submission and review of my clinical competencies and evidence, I was successful in gaining entry to the Specialist Register in 2010; unusually, I achieved this in equivalent time scales to higher trainees in a standard training scheme. At the time, I was pregnant with my first child, so I enjoyed my maternity leave and came back to my Associate Specialist position. Within a short space of time, I decided that I did wish to apply for consultant posts. I applied for locum positions to gain experience and was successful in gaining a locum consultant post in a newly formed substance misuse service for Camden and Islington in 2013; within a matter of months I secured the role substantively.
I have used my experience to give advice and guidance to numerous specialty doctors about the CESR route to entry onto the Specialist Register, as my success gives other hope that it is achievable. Helping colleagues to achieve their potential is hugely rewarding. I know that my husband and family have always been supportive of my plans and ambitions, and it is lovely to be able to guide others and share my learning of CESR with colleagues to help them reach their goals. I was also lucky to meet other Associate Specialists in a previous Trust who felt the same as me, and we encouraged each other along the way. They too had their own stories of why they had not progressed along the well-trodden training route to become consultants. As a body of non-trainees, we carved out meetings for ourselves and shared ideas. This was an immensely powerful and inspiring forum.
I am now a well-respected consultant in addiction psychiatry, and I put clinical care at the heart of everything I do. Throughout my time as a consultant, I have taken opportunities and looked for ways to develop my skills. Most years I have taken on additional roles: becoming a consultant representative on the Local Negotiating Committee, then later Deputy Chair; becoming an appraiser; being appointed to the Care Quality Commission as a Specialist Advisor, and taking on the role of Guardian of Safe Working for my Trust in 2019.
I have also taken on various roles in internal workstreams within the Addictions Division and the Trust. I was also successful in securing a place on the NHS Improvement Aspiring Medical Directors Programme; this is a one-year programme which I completed in 2019. It felt a great honour to be put forward for this programme, especially as this was only a few months after returning to work from maternity leave, having had twin boys who were long hoped-for siblings to my eldest son. I have also recently been appointed as the College Engagement Network (CEN) representative for my Trust and I am really looking forward to being part of this new initiative between the RCPsych and individual Trusts.
When thinking about why psychiatry and why addiction psychiatry - I always say that people and their stories are incredibly interesting, I really do feel humble to be able to hear them and help them. I was so lucky to come across such kind, caring and compassionate consultant psychiatrists at medical school; they really made the specialty come to life for me. I did not always want to go into addiction psychiatry; I was actually focused on psychotherapy. I had started to do psychotherapy training outside of work and have my own analysis. My first addiction post was more by chance - it was a one-year combined psychotherapy and addiction post. That one-year post was particularly challenging, as it was the year of the London bombings and terrorist attacks in 2005. I was trying to learn about the importance of containment and a safe space when there were literally bombs going off, as I was working in King’s Cross and UCLH. The psychotherapy department also moved four times over the year due to the building of the new UCLH.
By the end of the year the seed for addiction psychiatry had been sown. I am now the consultant of the service that I first worked in! I always feel with addiction psychiatry that there is an incredible opportunity to radically alter people’s lives. The stories I hear are about trauma, hardship and adversity. Substances become a means of self-medication, escape and survival. Supporting people to tell their stories, receive help and gain stability in all aspects of their lives really can allow them to recover and reach their potential. If my own story is one of reaching my full potential, then I hope in my working life I help others to achieve their goals too.
Whilst the journey has not been easy to travel, I have achieved my aspirations to become a consultant in my chosen specialty and so much more! Over the years, despite the setbacks and disappointments, I have grown in confidence. I know that my team values my commitment to our clients, respects my work ethos and my drive for improvements in care.
I thoroughly enjoy my work and am incredibly pleased to have achieved my current status. It feels like all the hard work and refusal to settle for less at every stage of my life is paying off - in terms of my position, feeling of self-worth, and the ability to help and inspire others, such as through my contact with junior doctors as the Guardian of Safe Working. Writing this piece for the 25 Women project is a wonderful opportunity for me to say to others that you can make it. Even after multiple setbacks, with patience and determination you can shape your career into the one you want if you are resilient and never lose faith in yourself. When I tell people my journey, they always say how inspiring it is, and how they wished they had heard stories like this when they were thinking about careers, as they might have considered studying medicine.
My story is one of self-belief, never taking “no” for an answer and always striving for new challenges. I keep going because this is simply ‘what I do’; it is my default position and I am used to ploughing on through difficulties in various aspects of life. I do not like others telling me I cannot do something; there is a stubbornness to me, but I think that has served me well so far! I also know from experience that I do always get there eventually, and this gives me the strength to continue. I am not sure where this journey will end, but I know that I have not reached the top yet!
- Membership of the Royal College of Psychiatrists, which is awarded after a series of exams, is required to move from the early years of psychiatric training to the higher years of training.
- Medical Training Application Service was an online system used in 2007 for training post allocations nationally; it was subject to heavy criticism owing to multiple problems with the system, which led to lasting difficulties for the significant numbers of junior doctors who missed out on posts in specialities and areas of their choice.
- Certificate of Eligibility for Specialist Registration is an alternative route for experienced doctors to demonstrate they are ready to practice as consultants, instead of completing a training scheme.