He was the first person to become a doctor in his family. Pursuing a career in medicine was incidentally only an accident for he wanted to be a nuclear physicist. Thus, he had enrolled into India’s premier engineering colleges the Indian Institute of Technology. But the medical journey that started after leaving IIT to now being elected dean of the Royal College of Psychiatrists (RCPsych) for a five-year term was no accident for Dr. Subodh Dave.
It was during his early years in medicine that Subodh had his first interface with psychiatry and there has been no looking back ever since.
Speaking about his college years, Dr. Subodh says, “I remember my Professor telling me that given I did not enjoy surgery- Psychiatry might be my destination! It was obviously meant as a joke –but after I had done my House Officer posts – I could only think of Psychiatry as a real profession for me.”
Subodh and his wife moved to Wolverhampton in 1995. Recalling the transition from a bustling Mumbai to the relatively desolated streets of Wolverhampton, he highlights the challenges that International Medical Graduates (IMGs) often face while tasked with working at the NHS.
“I know that for many IMGs, they are thrown in at the deep end – and unsurprisingly that then leads them to have poorer career progression than they might have otherwise had. Mentoring and an early induction into how NHS works – would be ideal but this is often missing even now for many new IMGs.”
Addressing Differential Attainment
Structural and institutional racism within the NHS has never been under this acute a scrutiny as during the course of the pandemic. This is not a hyperbole but a series of rather disturbing revelations that surfaced only as deaths of black, Asian and Minority Ethnic (BAME) doctors at Covid-19 frontlines stacked up. Dr. Subodh was part of the taskforce set up by the RCPsych that examined the disproportionate impact of the coronavirus on BAME communities. Their series of recommendations have been widely applauded and actioned.
Speaking about the detrimental impact of workforce inequalities, Dr. Subodh says, “Negative impact on the staff members impacted by the inequalities can also result in a negative impact on patient-care. Addressing these inequalities is therefore everyone’s business.
“We know that IMGs underperform in key high-stakes examinations by a significant margin. There is also a difference in attainment levels seen between UK graduates of BAME origin and UK non-BAME graduates. These differences in outcomes based on ethnicity and other protected characteristics are referred to as DA. Over the past five years, in my previous role as Associate Dean, Royal College of Psychiatrists, we have made significant progress in addressing DA. We have organised mentoring for IMGs, provided national induction and made changes to the exams that might have unfairly disadvantaged IMGs (in Psychiatry). More recently, the GMC has commissioned me to provide simulation-based training to Educational and Clinical Supervisors to help them understand and tackle DA. We are evaluating this formally to understand what really helps us address DA.”
Improving person centred care and psychiatric training
Keen on enhancing community engagement to enable the delivery of person-centred care, he has authored various studies and reports on Person Centred Care and involved in developing national guidance on community care. Equally, he is passionate about patient involvement in Quality Improvement and in teaching and has been the architect for the award-winning programme of volunteer-patient teachers in Derby, UK. He has co-authored the undergraduate textbook “Hundred Cases in Psychiatry” and has extensively lectured on the subject of medical education, global mental health and ethical medicine.
Discussing his future aspirations around psychiatric training and practice, he says, “I am keen to ensure that scientific advances are reflected in psychiatric training and curricula. This needs to include both neurosciences as well as social sciences. We also need to make sure that we learn from our patients and so I would want to increase the scope of Expert Patient Educators in post graduate psychiatric training. We need to empower our trainees and trainers so that they feel that the training they are involved in – makes a direct difference to patient care. We know that when training makes a difference to patient outcomes, it is not just patients who benefit. This also has a significant benefit on doctors’ own mental health and well- being- an important point when we know that stress and burnout in medics is rising.”
