Shermina Sayani
Consultant Paediatrician in Community Child Health, Designated Doctor for Looked after Children
Tell us about your journey into a medical career?
I decided I wanted to do medicine just before my A-levels, mainly because I never thought it possible before. I grew up in a 
fairly deprived area. The only doctor we knew locally was the family GP. I went to a comprehensive school and the careers counsellor at the school told me they had only had one previous applicant for medical school some 5 years ago. However, my family were big on education, they pushed me hard and I worked hard. I got my GCSE results and topped the school… even I thought they had made a mistake. Suddenly it opened up possibilities for me that I never believed existed.
I did have doctors in my history. My grandfather was a doctor in what was formally East Bengal, India, now Bangladesh. He worked in a variety of villages running community hospitals. I did not remember much of him, he died when I was 7 years old However, the stories I was told about him, were very remarkable. Medicine was a vocation, a calling. He believed healthcare should be accessible to all, regardless of creed, caste, religion and indeed, ability to pay. He made contracts with the employers of his poorest patients, so that their healthcare was paid for – a type of health insurance if you will.
He lived through and migrated during, partition. However, he had a general compassion for people, he did not see the divisions of religion. All were his patients, all were part of a wider humanity that he served. It was also very important to him to continue to learn as much as he could. However access to medical journals were limited. My father, told me, when he was starting his life in the UK, that he was given the task of seeking out back-dated BMJs and sending them back home.
Though I probably didn’t realise it at the time, it was these stories of my grandfather that influenced me to go into medicine.
What led you to choose paediatrics?
In medicine, we all find our tribe. Mine were the Paediatricians.
I remember sitting in clinic, as a medical student, with the consultant paediatrician sat cross legged on the floor, playing with the toys and the child in front of him. As this little person giggled at his silly faces, he expertly examined this toddling bundle of mischief, being mindful that teddy had to be examined first.
That scene seemed a far cry from the more formal, often overwhelming ward rounds of adult medicine, where a grand looking senior doctor would intimidate the crowd of juniors behind him, asking them unexpected questions at the bedside while the confused patient tried to pull up the covers and hide from the multiple staring eyes.
Admittedly, with our emphasis on patient centred care now, no part of medicine should be like that anymore, but I knew that I preferred the more informal, child and family centric approach of paediatricians. It felt familiar, comfortable and positive.
When you were a medical student, how did you envisage your life as a doctor?
I looked upon many of the senior doctors I met as role models. I hoped that I would be as self-assured, thoughtful and wise as they appeared. I wasn’t quite sure how that would happen. like some magic and wisdom descends, all of a sudden, the moment you get on the specialist register. I wondered how they coped with family life, did they see their families? Were their children sobbing into their cornflakes because Mummy had already left for work? I hoped my life as a doctor would be balanced – family, friends, vocation, but I worried that it might not be possible. Maybe medicine and the rest of life were not very compatible.
How does the reality match or differ from that?
The reality is challenging. Balancing the demands of all parts of life isn’t easy but part of it has been about changing my own mind set. Particularly, when I became a single mum during my Paediatric training. Accepting that going on a night shift as a junior, is not neglecting my own child but contributing to his well-being, up keep and future. It was about learning to be proud of what I do and sharing that with my child. As someone close to me once said “super heroes have to be on call”. I learnt to repeat that and try to leave the guilt behind.
I also learnt wisdom doesn’t magically descend – it comes with time, experience and hundreds of patients stories, to teach you the nuances of medicine. I am also continuing to learn and will always do so, much like my grandfather and his back-dated BMJs.
What do you love about your work?
The children and the remarkable families. The way they cope with often difficult and life altering diagnoses. I am a paediatrician in community child health. We don’t experience the wonderful ‘bouncing back’ you see in a child being treated on the acute ward but there are other joys. The same smiles and giggles I saw in those early Paediatric clinics as a student. The quirks of my fabulous children on the autistic spectrum. From the in-depth conversations we have about dinosaurs to the non-verbal child who offers you a small window into their world, a smile, when you say the right words or bring out the favourite toy. The resilience of the Looked after child, that is putting their lives back together again, after the traumas of their early years.
I am so lucky to work in a very multidisciplinary setting. I am learning from other health professionals all the time. From the physios that teach me about joint angles and movements, to the speech therapists that teach me about the pyramid of communication and play. This makes for very interesting, varied and dynamic learning.
What frustrates you about being a working mother?
It doesn’t feel like the system is set up for working mothers. Though paediatrics offers the valuable job share/part time option, the system, sometimes like a conveyor belt, can’t always tailor to the needs of your family. During my training, when I became a single mother, I asked that I might train in one of the hospitals a bit closer to home rather than commuting significant distances and the requisite child care issues that creates. No one could find a way around the problem or swap me into another job. I was left to just ‘sort it out’ or drop out of training. Of course I found a way, but it was tough.
Do you feel having children has affected your career?
Yes, of course. I think it increases the balancing act.
Are there positives to that impact?
Empathy with the parents you meet. An increase in compassion for the anxious mum in A&E waiting to see you.
Are there negatives to that impact?
Mainly the guilt of not getting the balance right, missing out on the important things, not spending ‘enough time’. Though it is hard to know what “enough time” is. I did not have models of professional women working in the previous generation of my family or friends parents and certainly no single professional mothers to learn from.
Do you have any tips for getting the most out of a medical career whilst still having time for your children?
Choose the career path that suits you. Some acute paediatricians like the days they get off in exchange for nights and weekends they do, so they can be at the school gates. Others choose a job like community paediatrics without an on call component for this balance. Some job share or go part time.
It’s about quality not quantity. You have to know that being fulfilled in yourself and in your vocation will positively benefit your children. Having a mother who is happy, content and fulfilled in her career is better for a child.
Share what you do with yur children, be proud of who you are and let it inspire them.
Do you feel female mentors have helped you manage your expectations or realities of being a paediatrician?
Definitely, particularly because as I said, I did not have role models in my childhood and family life.
Listening to how these women coped and succeeded has definitely helped me. Listening to them talk expertly about their specialism in one sentence and about the challenges of multiple after school activities in another breath, made me realise it was possible to be both and do both, though not without some struggle on the way.
Would you recommend your job to other working women?
Yes, because it’s interesting, fulfilling and rewarding though the strains of a resource constrained NHS take their toll.
What would you say to your 14 year old self?
You can be whoever you want to be. Use you talent, your potential, your gifts to make a mark on the world and do good for others.
What would you not survive without?
My other interests, in reading, in poetry, in theatre. These help me to humanise medicine, to reflect on my work, before it becomes mechanical or emotionless.
Is there anything that particularly helps you when things are getting difficult?
Reflecting, talking, learning from family and friends and having authentic conversations. Meeting a variety of people and knowing that we all struggle, our lives are all demanding but we bumble through, capturing and reflecting on the joyous bits that pull us through the dark bits.