Becoming a doctor MPBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7084 (Published 04 December 2013) Cite this as: BMJ 2013;347:f7084
- Krishna Chinthapalli, associate editor, BMJ
Every day doctors use the skills needed for a career in parliament, according to Sarah Wollaston, who left her role as a GP to become a Conservative MP. She tells Krishna Chinthapalli that more doctors should enter politics and that now is the time to consider applying
It starts off like most practical exams in medicine. Several candidates are called to a conference centre. A series of timed stations are set up to assess their competence, ranging from communication skills to role plays. Senior professionals and potential future colleagues mark the candidates’ performance at each one.
At the first station you could be handed a mailbag, asked to sift through all the correspondence, and plan how and when you would respond. This could contain “a whole series of issues, be it somebody complaining about potholes right through to a wider policy issue,” according to Sarah Wollaston, the current member of parliament (MP) for Totnes and a former general practitioner. A candidate could, for example, choose to respond by email, issue a press release, or discuss the issue with colleagues. “Because just as with medicine, if you can’t prioritise and spend too long dealing with minutiae—then you’re not doing your job properly,” she adds.
Parliamentary screening test
The exam in this case is the Parliamentary Assessment Board (PAB) of the Conservative party. If the Professional and Linguistic Assessments Board (PLAB) is the gateway for an international medical graduate to work as a doctor in the United Kingdom, the Parliamentary Assessment Board is a gateway to working as a UK Conservative MP. Other political parties have similar screening processes to test candidates’ abilities before even considering them as prospective parliamentary candidates.
As a former examiner for the Royal College of General Practitioners, Wollaston thinks that these screening tests play to doctors’ strengths. “The ability to prioritise, to work collaboratively, to be able to explain, to be comfortable communicating with people who are very angry, and to be able to speak in public and explain what you’re doing—all are skills that many doctors use every day and perhaps they don’t realise that they have had all the training needed to be an MP,” she says.
More doctors needed
Wollaston is one of only six MPs who are also doctors and she is keen to see more people apply (box). She says, “One of the critical issues here is that so few MPs understand medicine. Most of them don’t ‘do’ medicine, if you like. They have very little understanding of how the health service works and so I’d say we definitely need more doctors to consider applying.”
Sarah Wollaston’s advice for prospective MPs
Don’t do it too early in your career, and get your clinical experience first. Bear in mind that politics is very uncertain—I could be looking for a job in 2015
Be involved in medical politics or policy making, for example, with commissioning decisions
Decide which party you want to stand for, and bear in mind that there’s never going to be a political party with which you’d have an exact fit. That shouldn’t put you off. The chances of succeeding as an independent are vanishingly small
Approach your local party and ask if you could be considered as a candidate. All political parties are keen to have applicants with medical backgrounds
The Parliamentary Assessment Board is a series of processes assessing the kinds of things you would have to do as an MP, from public speaking to doing something with very little notice. These are all the kinds of things doctors would be familiar with, but it is quite a demanding day of assessment
Try and do what you can if you don’t agree with bits of the party or government policy. At least you’re closer to the point where you can actually help to influence decisions
Go into it with your eyes open, recognising that inevitably there are compromises and you won’t get everything you asked for
It’s not for the fainthearted—don’t apply if you want people to be nice to you
If you have never considered being an MP, consider it now because time’s running out until the next election.
About a fortnight after the Parliamentary Assessment Board, candidates find out if they have passed or not. If they have, they are allowed to contact the local party association in a number of constituencies. The local association may hold selection interviews or even a primary ballot, as was the case for Wollaston in Totnes, to choose the party’s prospective parliamentary candidate for the next general election. After that, the weeks and months leading up to a general election are spent on the campaign trail against the other parties’ candidates, with one winner being announced on election night.
When Wollaston first entered parliament in 2010, she was staggered by the lack of training offered. “You arrive on day one and you have no office and no staff and you’re given a laptop and told to get on with it.”
Duties of an MP
Soon she was facing the choice of being able to influence government health policy or to scrutinise it. Her medical credentials made her an obvious choice for the health select committee, an elected group of MPs who oversee the Department of Health on behalf of parliament. She was also offered government positions as a bill committee member for the future Health and Social Care Act 2012 and as a parliamentary private secretary to the health minister. Both of these could be seen as stepping stones for MPs who want to become ministers. They require unswerving party loyalty, however, which Wollaston was not prepared to accept. She thinks that this is a failing of current politics and contrasts it with the open discussion and debate that happens in medicine.
Her duties as an MP are wide ranging. In Westminster during the week, she could be in the House of Commons during debates, in health select committee hearings, or at other briefings, meetings, and events. She also puts her point across to those in power. “We have this rather archaic system where every time there’s a vote, you’ll spend 20 minutes hanging around in the division lobbies,” she says. “One advantage of that, as I see it, is that it’s a very useful opportunity to catch government ministers.”
On Fridays and weekends, most MPs have duties in their constituencies. For Wollaston, a recent Friday involved going to a primary school in the morning to promote a conservation project involving pupils, then a naval college meeting, followed by going to another school to look at a cycling course set up by volunteers. Finally, in the evening she gave a talk at a local cricket club.
Many MPs also run surgeries in their constituencies, in which they see the public in one to one meetings—again something many doctors would find familiar. “They’re very similar to GP surgeries in that very often you’re seeing people who have a number of complex problems for which there’s no easy solution. For example, to look at one end of the spectrum, it might be somebody who’s had a parking ticket which they feel is completely unfair right through to people just wanting to give you background information about an issue. Just like general practice anyone could come through your door with any issue. It’s hugely varied and sometimes surprising.”
Wollaston warns that people thinking of entering politics should be aware of some of the harsh realities. “It is undoubtedly a harder life being an MP than being a doctor. You spend a lot of your time away from your family,” she says.
“You get a huge amount of scrutiny here that you never get as a GP,” she adds. “People really can get quite aggressive with you. It’s not for the fainthearted—don’t go into this job if you want people to be nice to you. If you see the messages I get on social media you’ll realise it’s pretty tough. I’m working the kind of hours I worked as a junior doctor, and I took a very significant pay cut. It’s not an easy choice to make if you’re in a secure job with a good income. I’m probably not selling it too well!”
She ends with advice for BMJ readers: “If you want to apply, send me an email. We need more doctors to apply for this job. My message would be to say if you have never considered being an MP, consider it now because time is running out for most of those selection processes—do it now.”
Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.