We have asked two Muslim women working in the NHS about their experiences:

Taslima Rashid: Role – Registrar: Specialist trainee in sexual health and HIV

1. First realisation when you started practicing Medicine?

Taslima Rashid: One of the biggest surprises to me was how physically and mentally challenging the job was. I remember starting work in my first year and coming home, thinking to myself, ‘I’ll lie down and rest my feet’, and then waking up in my work clothes, boots, coat, scarf, work lanyard, at about 4 in the morning. I was so tired. You’re on your feet all day, on top of which you may end up sprinting to an arrest call, having a ward round that spans 12 floors, or straining with the nursing staff to get a patient into bed. It’s a daily work out (tough, given I NEVER work out).

Amina Hersi: Frankly, I had always assumed that other doctors were like me, people who wanted to work in a job where they help others. I remember how I was so disheartened when I encountered doctors who simply weren’t very nice people. The way we treat one another is sickening at times, thankfully this is starting to improve. But the job is hard enough, we shouldn’t make it any harder on each other.

2. How has race affected your experience?

Taslima Rashid: The NHS has a zero-tolerance policy on racism and that includes if someone refuses to be treated by a POC 1. I once saw a man refuse to be treated by a black A&E doctor. He was promptly ‘red-carded’ and sent away as he didn’t have life-threatening injuries. The specialty I work in champions itself on inclusiveness and non-discrimination which is why I chose it. I’ve been very lucky in that I’ve never had my ability questioned on the basis of my ethnicity – but you will get the odd niggly comment.

Amina Hersi: I am of an black African background and we are still underrepresented in medicine. I would be lying if I haven’t had racist abuse from patients/relatives. But it’s the subtle comments that get me. I’ve heard
colleagues say odd comments, where they assume I'm lazy or aggressive because of my race or how I sound “white on the phone” as if I’m supposed to sound like a race.

3. What’s been your biggest challenge?

Taslima Rashid: Saying you work in sexual health can be perceived differently by different people. Friends think it’s a bit tongue in cheek but also empowering. Muslim people are generally really positive about it but can feel a bit nervous about talking to me about it.

I occasionally struggle to engage with men from similar ethnic backgrounds to me, because they might feel it’s inappropriate to chat about stuff like sexual risk-taking. I’ve never worked in Whitechapel (which has a large Bangladeshi population) but I can imagine it must be quite challenging.

Amina Hersi: Work can take so much out of you. I am generally very sensitive, I often struggle with getting caught up in the emotions and heightened situations that come with the job. I’ve had to work on my ‘housekeeping’ which is looking after ourselves too. Ensuring that I am able to find suitable outlets for my stress. I love giving everything I have to my job and so I experienced burn out quite a few times. I’m better now at recognizing the early signs and making sure I take a breather to recuperate.

4. How was Ramadan with work and life?

Taslima Rashid: It’s much more do-able when you’re not on call (the 5 pm till 9 pm shift) and covering emergencies! In the past, I’ve had to deal with incredibly stressful, life and death situations in the hospital, such as cardiac arrest calls. Luckily, I don’t have to do that as much in my current specialty, but I’ll still have the odd emergency situation with very sick HIV patients on my ward. I spoke to my family about it and made the decision not to fast on certain days, as 1 Person Of Colour I never want to put a patient at risk.

I used to feel really guilty because I know medics who fast regardless of the circumstances. I don’t think like that anymore. I’ve grown to realise that it’s my decision to make, and I have to trust my own judgment. I have a responsibility towards the patients in my care, I don’t take that lightly. On some days, for me, the stakes are too high to risk losing my concentration.

Amina Hersi: Ramadan has been a challenge especially the long hours, but I feel like the NHS has trained me well. Many a 12-hour shift has occurred where I have not had time to eat, drink or pee. I have not had a moment where I’ve felt it has impacted my work. Missing lunch has its perks, I can avoid that carb coma lull which comes after a heavy meal. Funnily enough, people think night shifts are good for Ramadan. However, you end up being so busy in the hours you CAN eat, you can’t have that coffee to help you survive the drive home. So its got its challenges. Obviously, if I felt unsafe/too tired I would take a nap before leaving. I’ve fallen asleep at the wheel once before (not in Ramadan) and it’s a terrifying the danger that doctors need to be mindful of.

5. Has there been a defining moving moment that put life into
perspective?

Taslima Rashid: Too many! I have watched too many young people my age die from HIV related illnesses. It was cruel and painful for them and their families. But the worst situations are when there are no family or friends.I recently treated a very young patient who passed away in incredibly sad circumstances. In the four months that we got to know her, not a single person came to visit. Her story upset me more than any other patient I’ve ever gotten to know, because she didn’t deserve to die like that, alone. We were there, we supported her and we cared for her very much – not as a patient but as a human being. Still, it wasn’t the same, and it wasn’t enough. You feel angry about it. It makes you grateful for having people around you that love you and would be there if you were sick.

6. Were you supported or did you feel any opposition when pursuing
this career (family, friends, and community)?

Taslima Rashid: My parents were never opposed to my decision to go into sexual health and HIV. They trusted my judgment in choosing a career; it felt right to me in terms of work-life balance, beliefs, and interests. Obviously, it would be disingenuous of me to say that my parents scream from the rooftops that their daughter looks at genitals all day, but they are proud of where I am.

Amina Hersi: I remember my parents were very surprised with my choice but they have always supported my dream. I heard lots of discouragement from my school. I was told I would never get in, that I should seek an alternate career.  I remember certain teachers who would try to derail my plans. One of whom tried to predict me a grade below what I’d actually attained in AS levels. I even remember being interviewed by medical students who also told me not to bother. I was actively told not to apply. Out of the 15 medical applicants from my school, I was the only one to get and meet my offer to medical school. But I also remember those who supported me tirelessly, mum and dad and shoutout to my biology teacher Mr Wood! And many others along the way. Moral of the story, don’t let anyone tell you can’t do anything! If you have a dream, grasp it with both hands and don’t let go.

7. When did you realise you wanted to be a doctor?

Taslima Rashid: I was in my final year of medical school and had to choose from a list of topics to study as a specialist interest for about 4 weeks or so. I thought ‘we never learn anything about HIV and I’d like to learn about it more’ – and I’ve never looked back. I sat in on clinics and learned so much from the team, who were brilliant. I ended up presenting a poster at a national conference and an oral presentation at the World AIDs Conference. For a lowly med student, that’s pretty epic.

Amina Hersi: I decided I wanted to be a doctor when I was 4 years old. I’m not sure where the idea came from. But I remember drawing my dream job and being asked if that was a nurse, before I curtly responded with no way! As I got older it became more determined to fulfill my dream. I decided I wanted to be a GP in my final year of medical school. I noticed I seemed to like knowing a little about all the specialties, GP seemed like a good fit for me. Funnily enough, I started medical school wanting to be a surgeon but dissecting cadavers told me that it wasn’t a good fit for me.

8. Have you ever thought about leaving?

Taslima Rashid: Sometimes I wish I had more free time to pursue other passions; learn languages, get the chef diploma at Le Cordon Bleu, hang out more in Bangladesh with my family, do more relief work. I’ve been really lucky to secure a career break over the next six months and will hopefully try and get at least a few of those things done! But despite that, I can’t actually imagine being anything else. This is the only thing I’ve ever known and it is who I am as a person.

Amina Hersi: I’d be lying if I said I didn’t. There have been times when I’ve burnt out, where I’ve been so exhausted that I stopped seeing the point. I would think of things I wish I could’ve done instead. Burn out is a serious thing, we spend so much time at work, it consumes us. It’s times like that where you need a holiday/a breather from work and to take time to look after oneself.

9. What does a day at work look like? What does a day off look like?

Taslima Rashid: I get to work for 8:30 (tube permitting). I do a mix of sexual health clinics, HIV clinics and specialist clinics in contraception. I may be on call, or on a late clinic which means I’ll be at work until at least 9 pm that evening. If not, then I technically finish at 5 pm, but I rarely get to leave at that time as there’s a lot of extra admin, research and side projects that come with being in my field of work! It’s a long, punishing work day, and I couldn’t do it if I didn’t really love the work. One thing that does annoy me a lot is that I rarely find time to eat lunch. However, a lot of our wonderful patients will bring sweet treats for the staff which usually keep me going!
Currently, a day off is either studying for my last exam, admin for my upcoming wedding or meal prepping for the week – I love to plan dinners ahead as it takes some of the stress out what is always a busy work week. Very boring, unfortunately.

Amina Hersi: A day at work involves waking up a disgusting o clock, snoozing the alarm multiple times before peeling myself off my bed. Skipped breakfast due to snoozing. Grabbing a coffee and a piece of fruit instead. Ward round – writing plans, doing jobs (chasing scans, blood test results, writing letters) for the rest of the day. Sometimes no time for lunch, find the time to speak to 16 sets of relatives in the afternoon. Sometimes you might have a few unwell patients who need stabilization, urgent scans and blood tests. Over time, again but you have to because the patient comes first and you’re happy to stay to ensure their safety. Lather, rinse and repeat.

A day off consists of a lovely lie in! Spending the day catching up on the things I should’ve done all week, laundry, cleaning, and self-care. I might read a book with a relaxing face mask. Find time to see my family and friends who I’ve neglected all week.  I’ll use my expensive gym membership for the first time that week.

10. What’s the nicest thing someone has said?

Taslima Rashid: Patients that say I’ve made them feel at ease after a consultation is always nice to hear. It can be really nerve-racking coming to sexual health clinic if you’ve never been before, so it’s great to think I’m helping
take some of the stress out of that for someone.

Amina Hersi: I’ve had nice flattering compliments about being pretty etc. But the best compliments are the ones where they say thank you for being kind, compassionate and for working so hard. These are the compliments which have me welling up. These are the ones that build up morale, so please if you see a hard-working doctor please let them know.

11. Have you had any unpleasant interactions with a patient?

Taslima Rashid: Yes, anyone who tells you otherwise is lying! Everyone in the UK needs a check or treatment at some point in their lives, so your patient could be anyone. That includes mean people, rapists, paedophiles, racists, etc. You have to treat them regardless of who they are. The key is to speak up when a difficult patient has crossed the line. Now that I am older, I feel much easier calling people out for unacceptable behavior. I deserve to be treated with respect. I just wish I knew how to do that when I was younger.

Amina Hersi: Of course, I have had many an unpleasant interaction. I remember an elderly gentleman who needs IV fluids. I was asked to cannulate him for his fluids. I was then bitten, scratched and spat at. All whilst he called me a black B***h and a dirty towel head. Days later I comforted him as he died. That’s the thing, you see people at their most vulnerable but also their most unfiltered state. They are sick, in pain and sometimes confused. It can be really disheartening when you work yourself flat out, but to some people who don’t appreciate the NHS, it is never enough. That’s why it’s important not to seek validation from the patients. They don’t always understand the sacrifices we’ve made, the behind the scenes battles, the dinner reservations we’ve cancelled, the trips we’ve cut short, the weddings/christenings/funerals we’ve missed.

12. Is your name well received?

Taslima Rashida: I’ve heard examples of people abbreviating or changing) I abbreviate my name. I suppose it would be nice to use my full name with my patients, but if I’m honest, abbreviating makes things easier given my consultations are often rapid, with a high turnover. Although I know I shouldn’t make excuses for people – everyone I meet should make the effort to use my full name!

Amina Hersi: Thankfully my name is short and relatively easy to spell, so no changes but I do get the odd anglicization of my name to Hirst, Hersch, Hershey and Anna, Nina or Amelia.

13. If you were PM for the day what 3 changes would you make to the
NHS?

Taslima Rashid:

1. Stop cutting sexual health funding!
2. Allow PrEP to be prescribed in the UK
3. Increase spending on health care generally, and invest in tackling mental
health issues – we fall woefully short compared to other countries.

Amina Hersi: 

1. I would remove all private contractors and centralize all the companies who supply and run the hospitals so the profit could be reinvested into the NHS.
2. Better support and pay for our staff – including the cleaners who work extremely hard, the nurses and the junior doctors. I would improve the way rotas work and ensure that staff are not overworked and underpaid.
3. More NHS funding – I would move money away from weapons development or other things that don’t really offer the taxpayer value.

14. What can we do to help the NHS?

Taslima Rashid: Patients will often complain about us not being able to offer certain tests or treatments. I completely agree with them. But when I tell them ‘the most important thing you can do is complain to the government, write letters
to your MP, demand increases in funding for a sexual health’, they sort of zone out. But it’s an essential way of getting heard!!

Amina Hersi: FOR THE LOVE OF GOD please don’t rock up to A+E with problems that have been bothering you for months. If you’re not dying/possibly dying, or you’ve not had an accident then please go and see your GP (you can call 111 for more advice). I’ve heard of people attending A+E with hangnails! The NHS is crumbling we need to help reduce the burden by taking on certain costs. I am often asked to prescribe paracetamol for GP patients. It costs a whopping £8 on a prescription when we can go and buy a pack for 16p! The same goes for cough syrups, gaviscon, thrush treatment – all of these are available over the counter.

15. What do you love about the NHS?

Taslima Rashid: Everything. But mainly the people within it and the patients.

Amina Hersi: I adore the NHS, it’s free at the point of access. The NHS supports people through treatments that our neighbours across the pond would fork out thousands for. Chemotherapy, new proton beam cancer treatment, expensive monoclonal antibodies, the latest cutting-edge technology to help us live longer better lives. I love serving the general public, meeting and working with people of all backgrounds Is beautiful. The NHS offers workplace equality, equal pay and I have nothing but praise for this institution. 17. What advice would you give to someone thinking about doing
medicine?

16. Advice for those looking to get into medicine?

Taslima Rashid: It’s a challenging time to go into medicine. When I started it was pretty simple, but we are in a period of drastic change for trainees. Read around the changes and make sure you know what you are getting into before applying. If you are unsure, there are lots of people you can talk to, including me.

Amina Hersi: Medicine is a long arduous road, there are moments when you will feel inadequate, inexperienced and you’ll wonder if it’s for you. Resilience is a trait you’re going to hone. BUT with all this hard work comes a really rewarding job. You will laugh, cry and feel a lot of things but you’ll also experience raw humanity and its incredibly humbling to be there for the beautiful moments of life. A lot of people go into medicine because they’re smart and they think its a challenge. you can tell who these people are because they hate their job. Evaluate your reasons, because you can only cope with all the hardships if you understand why you want to do it. P.S you will do a lot of unpaid overtime, so you have to think it’s worthwhile.

17. If you had to start again would you still be a doctor?

Taslima Rashid: YES

Amina Hersi: Honestly? I often fantasize of alternate careers. Ones where I don’t have to worry about making mistakes that cost lives. I’ve dreamt of being a writer, an architect, a physicist. I have friends with lots of exciting careers in the city, sometimes I feel like I missed out. I wonder what else I’d be good at. There are doctors who branch out into their passions and set up side businesses, it’s definitely something I’d consider. But I was a strong headed little girl and I don’t think anyone could have changed my mind, so yes if I started again I’d still be a doctor.

18. How does Islam impact your career? Does it?

Taslima Rashid: Not really, no. But as previously stated, I feel that the people in my specialty champion inclusion. I don’t know the exact figures, but there is certainly a fairer divide in terms of men and women in leadership roles and refreshingly, more women of colour than I’ve seen in other fields like surgery or medicine.

Amina Hersi: Every morning before work, I try to purify my intentions. I remember why I’m there, to help the sick. There has been times when I’m tired and I don’t feel very energetic. Islam teaches me that I need to do everything I do well, it stops me from slacking, it makes me want to be better.  It also makes me remember the little things. I always go round giving patients water on my ward rounds, because I remember there are blessings in alleviating any suffering even thirst.