Returning after a nine year break

This blog post is an interview with Dr Maria Casserly and is part of the 2023 Choose Psychiatry campaign.

Dr Casserly is a Specialty Doctor working in Addictions Psychiatry in Aberdeen and has recently come back to work after having a nine year career break from psychiatry and from medicine in general.

In this interview she discusses her reasons for taking a break, her feelings about returning to medicine and what led her to come back, and her thoughts about Higher Training.

Please can you start by telling us why you chose psychiatry at the beginning?

I didn't go into medical school thinking about psychiatry and probably hadn't thought about it at all until I did psychiatry placements. I had really inspirational teachers who showed me the joy of working with patients in psychiatry.

I think it probably suits me quite well. I love to communicate with patients. I have always been interested in what makes people tick and how societies function. And obviously I am also interested in medicine and how the body works.

I think it's just perfect for me, that whole combination - I'm quite passionate about psychiatry and choosing psychiatry as a career.

You took a break - please can you tell us the circumstances around you taking that break?

I took a semi planned break because of my husband's career.  We knew he would have to spend some time abroad and I thought that it would be better for me to leave psychiatry in between Core Training and Higher Training in order for me to take a sort of natural gap.

Then I could return to Higher Training without being disadvantaged or without having to go back to the beginning, or do Foundation competencies or anything like that.

I completed Core Training from 2010-2013. I passed my exams, got my membership and then I was heavily pregnant. So I took a job, a locum appointed to training post as an ST4 in child and family psychiatry.

My idea was that if we didn't go abroad, I could come back to that job after maternity leave and I could bank that time towards higher training.

 So again, I was always thinking about how I could take a break, but how can I keep my career path? How can I juggle both of them, which I think is really tricky in medicine?

I had a baby and then we went to live abroad. I didn't work abroad in medicine or psychiatry because we went to the United States and I was really conflicted about that. Obviously the work's a bit different there and with my husband's job you never know whether you're going to be somewhere for six months or for years. As it turned out, I had a really lovely break from medicine.

I had three children. We returned to the UK and then unfortunately we went into the pandemic and I was at home with a baby.

I didn't return to work, then began to feel very guilty about that. I'd talked to colleagues who worked at my old workplace about getting back to psychiatry. And then in 2021, when the vaccines were developed, the GMC started asking doctors who were on the register without a licence to practise, to go back to work. 

 My confidence was pretty low when thinking about what I could give after so many years out of practice.  And I thought, I can vaccinate and actually this might be a step back to work. I was employed as a vaccinator. This was really useful in terms of getting my skills back, getting some confidence. I met lots of interesting people who were also returning to work.

And then I started to put feelers out then about about, about how I would get back to work from that.

So where do you go now? You mentioned Higher Training - what do you see as the benefits being of applying to Higher Training?

Yes - so you can tell by the way I've structured my career pathway, I've always thought about keeping my options open and still being eligible to apply to Higher Training.

To have the competencies and the exams to be able to do that because that's always been my aim. And I suppose it's a lot of people's aim.

Obviously we have very good quality, well organised, higher training. All our registrars rave about it! They seem to be enjoying themselves. They seem to get a lot of opportunities to expand their skills and particularly with the special interest or research day, and it does seem to be something you'd like to be involved in. 

 So what I've done in the interim is a return to work. I did a six month clinical observership. It was an unpaid observership and was quite useful for exploring different areas of psychiatry. I've actually ended up in an area I'd never thought about, which is addictions.

And I've come back to work as a specialty doctor, really to test the water in terms of skills and knowledge and also for my family life. I wanted to have the option that if this didn't work out after six months or a year, I would leave and I wouldn't have taken a training number.

I'm at a crossroads now where I'm one year back, things are going quite well and it's approaching time to think about whether Higher Training is for me at the moment.

 I wasn't sure when I left psychiatry about what Higher Training programme I'd go into and that made leaving and career break very easy. I think it's also been quite helpful to do this observership and to do this specialty doctor job to explore different areas that I hadn't done as a Core Trainee. And now I suppose I would probably think of a different path into Higher Training. But as you can tell, I'm not quite there yet!

 I've got myself into this position and been helped by my colleagues around me and I'm now being encouraged by my colleagues in Aberdeen to think about Higher Training as a path.

For me, I would say it still seems a little daunting, but at the same time I wonder, would it be the best place for me to be able to grow in my knowledge and strengths as a psychiatrist while being supported? There would be a good structure to it and having done what I am now doing I think it would probably be the ideal way to return to work.