UCL website, adapted)
Dr Jessica Carter is currently a GP with special interest in Infection, having studied medicine at University College London where she also completed a BSc in the History of Medicine. She has an interest in refugee health and infectious disease prevention, diagnosis, and management in primary care. She is an NIHR clinical fellow based at the Infection and Immunity Department of St George’s University supervised by Professor Friedland and Dr Hargreaves, currently studying for an MSc at the LSHTM, and is involved with the Chagas Hub and quality improvement at the Islington GP Federation.
She has been involved in research into the diagnosis of malaria in primary care, barriers to STI testing and alcoholic liver disease and is pursuing a combined academic and clinical career.
Could you briefly describe the jobs you have had since medical school in global health and infectious disease?
Initially I had always wanted to do infectious diseases (ID) and went through medical school thinking that I would pursue this as a hospital speciality. I did my elective in Senegal and was part of IFMSA exchanges, helping to arrange exchanges programmes in Rwanda. I took a year out of medical school which I spent in Bolivia and Ecuador, and always loved travel medicine and infectious disease. I went into my foundation years thinking I would pursue ID training so I arranged a taster week with the ID team which is a great experience to get as an F1, as a lot of rotations are not flexible and might not offer the specialities that you want to do or are interested in. I shadowed the team there which I really enjoyed. Following that I had 6 months of jobs in A&E and Sexual health, and found that I actually really enjoyed every rotation that I did – I particularly enjoyed the autonomy I experienced during my sexual health rotation where I was able to see my own patients, and make clinical decisions, rather than the standard experience of following the ward round and instructions. I wanted to find a way to combine all these areas that I enjoyed, with having a sense of autonomy which is why I began to look into the possibility of being a GP. I looked further into GP and realised that, particularly if you worked somewhere very diverse like London, you would see a whole range of infections and possibly more than even on the ID ward.
So I decided to pursue GP training and went to royal free, where they had a 4 year scheme where you could choose the 4th year to be different – I personally chose to do academic research, in infectious diseases. I always knew
that I could always swap back and go into core medical training, and approached the career path with flexibility. I think as trainees after medical school we can be quite one-track minded and think that there is only one path to follow and a specified set of hoops to jump through – but nothing bad happens if you take a step back or a year out to give yourself extra thinking time and do something you enjoy, in fact that is important!
I have managed to do research into malaria and delays in diagnosing it in primary care as well as attending interesting courses and conferences in ID. I find that people tend to be quite interested to hear what you have to say because at these events there are not many GP- and as a GP you have got quite a valuable perspective from working in primary care to add to the conversation. Through that I have carved out a niche in primary care with infectious diseases and migrant health, and I am hoping that with the Hospital for Tropical Diseases we can turn that into a formal role. I have volunteered for medical justice, which provides medicolegal resources to refugees and asylum seekers. I am also involved with the Chagas Disease hub, where we advocate for testing, treating, and migrant rights for Latin American patients. At the moment I am also doing my MSc in Tropical Medicine at the LSHTM.
How do you find a balance between clinical work and academia?
After completing GP training, I got an NIHR academic fellowship which meant that I could spend 2 days a week doing research and 2 days working in primary care. I think with this kind of pathway you can really make it work for you, and tailor it to fit your research and personal interests. In terms of balancing clinical work it can be tricky, but it is essentially about finding a clinical team where you feel supported, and can take on flexible options such as evening work. It is just about being flexible and finding a team where you enjoy your work. You can also make sure your clinical work and academic research complements each other – for example working in an area with a huge amount of ethnic diversity, you can take on HIV lead for your practice or be in charge of TB screening. It is great to be able to bring together your passions – for example teaching at practice meetings and quality improvement on increasing ID screening in primary care. I think the flexibility has been great for me, because I also have a 2 year old!
What makes you most proud of doing the job you currently do?
I am proud to have been able to follow what I wanted to do and create a job combining all my interests – not just settle for one, and have a huge amount of flexibility in pursuing this, rather than a more ‘tick-box’ standard training pathway – and also proud of being able to bridge the gap between primary and secondary care, as most people tend to see ID as a very hospital-exclusive speciality.
What advice do you have for medical students interested in being involved with your area in future?
Don’t discount GP as an option! It is such a great career, and there are so many amazing GP training programmes which can fit your interests. For example a friend of mine was able to get his DTM&H funded as part of a year of global health out-of-programme experience within his GP training. GP is exceptionally flexible and almost one of the best jobs for global health, such as if you want to volunteer for MSF one of the groups of doctors that they are always looking for is GP. So do look seriously into General Practice!
Also talk to people after lectures, say yes to every opportunity, don’t be afraid to send emails to professors because so often they are warm and invite you to become part of the team when you express your interest – remember to be confident in your value to a team.