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Careers

The ophthalmologist who job swapped

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4139 (Published 06 July 2011) Cite this as: BMJ 2011;343:d4139
  1. Farihah Tariq, fourth year medical student and president of the British Undergraduate Ophthalmology Society
  1. 1University of Aberdeen, Aberdeen, UK
  1. farihah.tariq.07{at}aberdeen.ac.uk

Abstract

Farihah Tariq talks to Tim Lavy about relocating continents for an entire year with his family to work at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), while his exchange partner, Richard Bowman, a fellow paediatric ophthalmologist from the overseas disability charity CBM, cared for his patients in Scotland

  • Name: Tim Lavy

  • Position: Consultant paediatric ophthalmologist at Glasgow’s Royal Hospital for Sick Children

  • Biography: Born in Uganda, his father was a surgeon in Mengo Mission Hospital, Kampala. He came to the United Kingdom at the age of 4 and grew up in Kent. Tim graduated from Barts and trained in ophthalmology in Liverpool, Manchester, London, and Edinburgh. As a consultant he has worked in Dunfermline and Glasgow, and he spent three years in Jerusalem. In 2008-9 an exchange initiative between CBM and NHS Greater Glasgow and Clyde allowed him to work in Africa

Why did you choose medicine as a career?

I was exposed to medicine by my father, a surgeon, and considered it a worthwhile profession. I was always interested in science at school and so had the right A levels for medicine. Being born with the desire to “fix” things, I was naturally drawn towards surgery.

What attracted you to ophthalmology?

I have always been fascinated by eyes and the way that biology and physics work in unison to produce sight. The complexity of the visual system and the importance of sight in our lives have maintained and continue to maintain my interest.

How did you become involved with CCBRT?

I heard of Comprehensive Community Based Rehabilitation in Tanzania through reading articles in Community Eye Health, a magazine produced by the International Centre for Eye Health. Having a constant desire to be in Africa whenever possible, I emailed Richard Bowman on the off-chance of interesting him in a job swap, and I was surprised to find him open to the idea.

What inspired you to job swap rather than have a conventional year abroad?

There is no conventional year abroad for established consultants. Sabbaticals are subject to clear rules and are largely discretionary. Our exchange was akin to a sabbatical but was negotiated as a one-off venture without precedent. My health board was receptive to the idea because it came with full support from both my consultant colleagues and my medical director, as well as Richard Bowman and his employer (CBM). This support was crucial, and I am very grateful for it.

What did your typical day in Dar es Salaam entail?

My day usually began with either an early morning meeting or a tutorial followed by an all day clinic or theatre session. Late afternoons were spent again either teaching or on administrative work. On an average day the eye department treats around 300 patients with a small team, comprising two to three doctors and several clinical officers. As well as the huge workload, patients in these areas have a greater degree of disability. For example, retinoblastoma, a treatable tumour rarely seen in the West, is more common in Tanzania, where many children present with later stages of the disease and curative treatment is often not possible. Other treatable conditions with huge associated morbidity include congenital cataracts.

Alongside the day to day clinical work, a vital part of the job at CCBRT was specialist paediatric training of African ophthalmologists. Ophthalmologists from all over Africa were sponsored to come for six months to equip them to set up paediatric ophthalmic units in their own countries. CCBRT is the only centre in Africa providing this training.

Twice during the year I went on a two week “safari” to do paediatric cataract surgery in a very poorly served part of Tanzania.

What have you gained from this experience?

Invaluable skills by performing surgery on rare pathology and in huge numbers, which in the United Kingdom would have taken many years. Also, a wider perspective on eye disease in general, and what needs treating and how urgently.

What advice would you give to the budding ophthalmologist?

Talk to as many people as you can about different career options in ophthalmology as early in your career as you can. Have the courage to follow your own interests where possible rather than trying to fill a position that does not suit you just because it is available.

Can doctors from other specialties become involved with CCBRT?

CCBRT is a non-governmental organisation serving 10 million people across Dar es Salaam and the surrounding area. Other than visual problems, the hospital provides medical and rehabilitative services for individuals with physical impairments (cerebral palsy or congenital deformities such as clubfoot and cleft lip or palate), obstetric fistulas, and hearing and intellectual impairments.

Any final words to those interested in working abroad?

Seriously consider every opportunity to go abroad that presents itself, even short trips. This maintains your world perspective. Be aware that career pressures in the UK often get more rather than less as time passes, and so do family ties. On the other hand, you are likely to be more useful the more trained you are.

Footnotes

  • Competing interests: None declared.