Academic Careers Spotlight: Taking the scenic route – why I stepped off the training conveyor belt

Dr Jessican Katanga talks about when she did something that terrified her – turning down her first-choice CT1 post in psychiatry – and why it was the right career decision for her at the time.

Why I took a break

In 2023, I did something that terrified me at the time: I turned down my first-choice CT1 post in psychiatry.

I had done well on the MSRA and secured the training place I wanted, but after two foundation years shaped by the pandemic, the first round of strikes, and a pervasive sense of burnout among my peers, I felt that I needed something different.

Rejecting my post meant I’d have to apply all over again in future, but I decided to take the risk. What followed was the best 18 months of my career so far: I locumed, concentrated more on my social media, and eventually took up a global health fellowship in Uganda. That experience changed not just my practice, but the way I think about psychiatry and about my career.

Applying for the Fellowship

The opportunity came via a friend who sent me the link to a diaspora global health fellowship scheme in Uganda. Because I was on my “F3” year (the informal term for time out after F2), I could apply without needing to request TOOT (time out of training).

The process was straightforward: a written application, interview, and presentation. The fellowship was a leadership post, so I spoke about my previous leadership experience and how I hoped to grow further. Importantly, the scheme was aimed at encouraging more applicants from the East African diaspora. As a Black doctor, representation matters to me, and so I’d encourage others from the global majority to also go for leadership, research, and tech fellowships etc as these opportunities are not just for one type of person.

Our project in Uganda

I was based in Gombe, a rural town two hours outside Kampala. Together with a colleague, an occupational therapist from the UK, we focused on embedding mental health screening into the antenatal clinic.

We observed first, listening to staff and gathering ideas. Eventually, we trialled using emoji-based cards with simple Luganda words to screen pregnant women for mood. Women who indicated low mood went on to complete the Edinburgh Postnatal Depression Scale (EPDS). Those scoring highly were able to access same-day counselling with the psychiatric nurse.

The challenges were real. There was no centralised data system, so we had to think creatively about how to capture and track our outcomes. And because transport was expensive, we learned quickly that any intervention had to happen on the same day.

But the positives outweighed the obstacles. Outside of the NHS, we could implement and adapt changes quickly, test them, and learn in real time. Working alongside midwives, nurses, and student midwives gave us insight into how small workflow changes can make a big difference. And the dedication of the psychiatric nurse, often pulled to the paediatric ward yet still making time to support patients in need, was deeply inspiring.

What I learned

Living and working in rural Uganda slowed me down. Long walks, new friendships, and a different pace of life expanded my perspective. Professionally, I grew in adaptability, cultural humility, and leadership. Personally, I came to appreciate both the resourcefulness of colleagues abroad and the privileges of working in the NHS.

The cliché is true: being in a resource-limited setting makes you appreciate the NHS. But more than that, it reminded me that psychiatry is about people first, systems second and that clinicians everywhere share a commitment to putting patients first, no matter the context.

Why you should consider the scenic route

This fellowship abroad changed my life, my practice, and my outlook. But more importantly, it showed me the value of stepping off the beaten path.

In medicine, we often feel pressured to move as quickly as possible from F2 to consultancy. Yet the scenic route, pausing to explore fellowships, leadership, or research can enrich us in ways that formal training alone cannot.

If you’ve ever had the niggling sense that there may be more out there, listen to it. Look into fellowships, leadership roles, or research projects — whether through RCPsych, the NHS, or colleagues who have done it before. The opportunities are there, and they are for you.

Rejecting CT1 once felt like a mistake but it turned out to be the best career decision I’ve made so far!

Written by Dr Jessican Katanga