Professor Nandini Chakraborty
Professor Chakraborty is a consultant in early intervention in psychosis at Leicester Partnership NHS Trust and the Associate Dean for Equivalence here at RCPsych. She is one of 25 women to be highlighted as part of a special project that celebrates the stories of 25 amazing women psychiatrists.
Professor Chakraborty's story
I wanted to be a geologist. I loved volcanoes (I still do) and the sense of adventure. My parents did not consider it a suitable profession for a woman. Coming from a family of doctors in a middle-class Bengali background, my vocation was chosen for me. I entered Calcutta Medical College in 1991 with one determined point - I was going to be a psychiatrist. In the next five years, as I settled into medical college, with the love of volcanoes burning in my heart, the view of psychiatry at the end of the road was the only thing that sustained me.
Geology to psychiatry - what was the common thread? They are both areas which explore depths, which bring one closer to the most intricate threads in nature - and they were both areas which were considered not suitable for a woman, where I came from. The number of times I have been asked - why not gynaecology and obstetrics, why not paediatrics? As if psychiatry was full of violence and aggression which would endanger my soft feminine sensibilities.
At the end of medical school, my choice of specialty was non-negotiable. In a class of 150, I was the only one who took up psychiatry by first choice, and was considered slightly eccentric because of it! In the years that followed, many more classmates joined me, both in the specialty and in the prestigious Central Institute of Psychiatry, Ranchi, where I did my MD. Before I joined, most of my classmates had not heard about the Central Institute of Psychiatry. After I joined in 1998, the floodgates opened, with more and more Calcutta Medical College students applying year on year.
The one day I would rather forget is the 17th of April 1999. Riding my new bicycle on campus, I skidded on a corner and crash-landed on my face. Long cuts crisscrossed my face and a gaping hole exposed my nasal bone. An excellent plastic surgeon made all the difference. I remember him taking photographs after taking off my stitches, so pleased were we both. Not sure whether I made it into any plastic surgery textbooks, I might have!
Some sympathetic comments still stick in my mind. ‘What a pity. What a pretty face you had!’ ‘Lucky you have a good boyfriend. Another man might have refused to go ahead with the marriage’. And most of all, my mother’s worry, ‘You are to be married in eight months’ time. What will I tell the guests?’
I learnt a few lessons. Your pain can be very personal. People can sympathise, but no one truly understands unless they have been through the same experience. You can learn to ignore the reflexive looks of horror on other people’s faces when they look at you, but it still hurts. It is not a lived experience of mental illness, but there are parallels I have not forgotten when I empathise with my patients.
I was seven months pregnant in 2001, when I sat my final MD exams. My colleagues joked that my baby’s first words would be ‘How is your mood today?’ I completed a thesis and passed my exam with flying colours. I was told at the senior residency interviews that whilst my work record had been exemplary, I could not be expected to maintain those high standards in my pregnancy and afterwards. I reapplied and returned to work after a break of 10 months.
I came to the UK in 2003. After passing my PLAB (Professional and Linguistic Assessments Board) and getting my first Senior House Officer job in Scotland, my parents brought over my 18-month-old daughter from India. It soon became apparent that with no family support, and my husband and I in full-time jobs with heavy on-call rotas, it was impossible to manage. Sending my daughter back for six months while I got my less-than-full-time position sorted was one of the most difficult points in my UK career. I felt that I had completely failed to be a good mother and was selfishly putting my career forward. I heard about other friends taking complete career breaks but I could not bring myself to do that.
After January 2004, things rolled on with bumps along the way. For the first time, we were a family. I worked three days a week and managed a household, toddler, job, and exams. Getting the MRCPsych exams over in 2006 was a huge relief. Then things sped up. In 2007 I entered higher training; in 2008 I applied for CESR (Certificate of Eligibility for Specialist Registration)1, and in 2009 I became a Consultant in EIP (Early Intervention in Psychosis).
Over the years I held a multitude of educator, clinical leadership, and training roles. The main role that brought me close to the College was becoming Associate Dean for Equivalence in 2016. As someone who knew the CESR route in and out, becoming a CESR evaluator in 2012 was as natural as becoming a clinical and educational supervisor and CASC2 examiner. A relatively less known role in the College, it was one I believed in with a passion from the start. I worked hard to understand the process and was fascinated by the variety of professional journeys which led to a CESR application.
Becoming the lead for CESR in psychiatry was a natural progression. During the last four years, I established bespoke training for applicants and evaluators for CESR in psychiatry, speaking widely to make CESR more transparent and reduce the notion of it being a lesser qualification to the specialist register. My main aim now is to make the guidelines consistent with the new psychiatric curricula, so that we will be set to direct applicants in the best possible way for years to come.
The other role which gave me international recognition was being a trainer in SCAN (WHO Schedules for Clinical Assessment in Neuropsychiatry) at the University of Leicester. Previously best known as an instrument used in research, I promoted it widely as a way to look at psychopathology and phenomenology in-depth for clinicians. I have worked with an international panel of colleagues on a revision that is close to completion and trained people from around the world.
SCAN led to closer working with the University of Leicester where I worked my way through honorary titles, finishing with Professorship in October 2020. I have done this as a full-time clinician. It is possible with the right approach and an eye to analysing the right data to publish as a clinician and contribute to academic literature. Practice as usual provides a huge amount of data that can be examined.
Along the way, I met and learnt from wonderful colleagues, had some strong mentors and sometimes travelled difficult learning curves. But experience has taught me that your best friends stick with you and relationships are important. You do not travel alone. My husband and daughter are my rocks and I do not need to deny that to be an independent woman. Is it difficult to be a woman in a professional world? My honest answer is yes. I think I would have found it easier or might have achieved even more if I was a man.
We recognise the inequalities and the more difficult fight a woman might have in balancing home and work, but we are yet to acknowledge the extent of gender discrimination that exists. It can be undermining, subtle and difficult to prove. The conversations about gender discrimination need to be more open alongside the continuing conversations on homophobia and racism. Discrimination is a complex multi-layered phenomenon. It might be years until I talk about certain events more openly but till then I will say: women need to support each other, listen to each other and believe in order to fight. Deepa Narayan’s ‘Chup’ beautifully describes how women often unconsciously perpetuate the guilt, the notions of what makes a ‘good woman’. The successful woman is one who balances home and career. A successful man can be all career. We have set the bar high for ourselves.
My journey in psychiatry continues in trying to understand people, cultures and more importantly how women stand in different societies. My passion for nature continues in hiking, travel, travel writing and solo female travel. I attract curiosity as an Asian woman in her 40’s travelling solo, as I do not fit the stereotype. I do it, not because I want to stand out, but just because I want to. How most of the world views the ‘average Asian female’ is a revelation.
For many years my parents had a well-meaning joke that alluded to my love of volcanoes. ‘So when are you climbing Mount Kilimanjaro?’, my Dad would ask with a smile every time I passed an exam or stepped up another rung in the ladder. My 40th birthday present to myself was a Kilimanjaro hike. As I sat on the rim looking down into the crater floor, I felt more grateful than ever for all the opportunities life has given me. I have taken them all and mean to ask for more.
- This certification allows experienced doctors who have not followed the more common route of a higher training programme in psychiatry to show that they have equivalent competencies and are ready to practice as consultants.
Clinical Assessment of Skills and Competencies is the final exam in a series sat by trainees in psychiatry.