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From Medicine to the Law: a reasonable course of action?

Featured ArticleFrom Medicine to the Law: a reasonable course of action?

Dr Urmila Roy, Barrister, North Square Barristers

By way of background, I qualified as a doctor in 2008 and have worked in the NHS since. I completed pupillage in 2023 and although initially kept up practices in both disciplines out of necessity, I do so now out of personal interest and an opportunity to bolster a unique selling point.

I am frequently approached by doctors asking about a career at the Bar. Overworked, underpaid and irritated, they wonder if the move to the law will solve their problems.

I am yet to be contacted by a lawyer wishing to make the change in the opposite direction.

Amongst several questions I am asked by my medical colleagues, the million dollar one is whether or not ultimately, I’d recommend the transfer.

At this point I am to make a firm determination on that point; I am proverbially adjourning the judgment to a date not before I’m not sure when. But what I am able to do is offer a brief comparison (and I stress, brief; the issue not being capable of significant debate in a short magazine article) between the two, leaving the reader to form their own view as to whether this application has a reasonable prospect of success.

I will openly confess an inherent bias towards a medical way of thinking; several years of training will indoctrinate you that way. To that end there is much about a career at the Bar, that simply baffles me.

The road to becoming a barrister for example, is to me, an unfathomable beast.

Medical school is notoriously difficult to get into (I doubt I would make the grade today). But once accepted and subject to completion of a not insignificant medical degree, the guarantee of a career awaits. It comes with its significant drawbacks (the long hours, unreasonable demands, remuneration wholly insufficient for the degree of expertise, short staffing and low morale being but a few issues that spring to mind), but therein lies the security of plentiful work, a steady income, a pension, sick and maternity pay and a prestigious qualification widely recognised throughout the world. Complaints aside, the years of study and financial investment into your Batchelors of Medicine and Batchelors of Surgery will pay dividends. That stethoscope affectionately gifted by proud loved ones on the first day of university will be well utilised throughout the entirety of one’s profession.

The converse is true at the Bar. Undergraduate LLBs are comparatively ubiquitous and law schools eager to take on bar students for a handsome fee. Whilst scholarships are available, there is no getting round the fact that a few years of study and a tidy sum are required to pursue a career as a barrister.

That is before one even embarks on obtaining the elusive pupillage, application numbers for which are fierce, opportunities for which are few. There are always inspiring stories about individuals who make it against the odds, but the sad reality is that, rightly or wrongly, many simply won’t get there. That wig and gown, similarly excitedly purchased on call day by a doting relative, sadly gathering dust.

To an average medic, used to making decisions that can literally mean the difference between life and death, the concept of risking time and money to train in a field with no guaranteed end game is simply too overwhelming. To those doctor colleagues who hear this and decide against the law, that’s very sensible. To my legal friends who both did and didn’t make it, I applaud your courage.

Then there is the job itself. The first thing that struck me when I began on my feet was the training, or more accurately, the lack thereof.

I stress, this is not a criticism of my supervisor, but rather an observation that one can prepare and discuss in good time, but much as we are schooled that patients do not present like in textbooks, clients and situations are rarely compliant with the white, red, or whatever colour book one wishes to refer to.

 

The unforeseeable presents itself at the eleventh hour and spanners are thrown in the work with alarming regularity. Courts are frantic places and Judges busy people; the likelihood of phoning a friend is, frankly, limited. To summarise, one is effectively solo.

In stark contrast, the terrifying first days on the medical ward are quite appropriately, mitigated by that the fact that one is at the bottom of a distinctive chain of command of doctors and surrounded by other healthcare professionals who can pick up the ball that you have inevitably dropped. Doctors are actively dissuaded from acting out of their comfort zone and asking for help at an early stage is duly encouraged.

Independent working as a medic comes after several years of intensive postgraduate exams, training programmes and thousands upon thousands of hours of patient contact later. Even then, the only truly autonomous practitioners are GPs, working without the benefit of immediate blood tests, radiological investigations, reliable histories or clinical time. Contrary to popular opinion it’s an extremely difficult and risky job: many doctors can’t stomach it.

I in no way compare mistakes in court resulting in a scolding by a judge, a disgruntled solicitor and a bad outcome for the client to that of the devastating result of sending a patient home with a diagnosis of indigestion which later transpires to be a myocardial infarction which is fatal. I do observe however that it takes a certain kind of individual to manage that level of anxiety without the requisite experience or support. To that end, the steeliness and strength of character required by barristers is repeated.

As aforementioned, there is much to be said on this topic; I simply cannot cover all the differences herein. However, what I can state is that whilst there is much I find peculiar, there are many things that are comfortingly familiar.

Like medicine, the law is vast in offering something for every temperament, each specialism with its own quirks and stereotypes. The more procedurally inclined for example might lean towards civil practice; those preferring the cut and thrust and the unpredictable are better suited to crime and those who are pragmatic, collaborative and realistic have a role within family law.

The same can be said for medicine; palliative care clinicians have very different priorities to orthopaedic surgeons. Doctors enriched by pontification choose psychiatry in contrast to those that make quick adrenaline fuelled decisions within emergency medicine.

Judicial decisions also share a commonality with medicine. Courts have to consider difficult and finely tuned balancing acts, medics too have to cogitate the principles of beneficence, non-maleficence, autonomy and justice.

In care proceedings, the risk of returning children to potentially abusive or neglectful caregivers has to be weighed up against a family’s article 8 rights; getting it wrong can endanger a child, but being too cautious denies them of their parents and makes them a product of the state; circumstances rife with their own set of problems. In the same way, the decision of a psychiatrist to section a patient under the Mental Health Act deprives them of their liberty and, perversely, further exacerbates a diagnosis by way of institutionalisation. But not doing so runs the potentiality of significant and undesirable consequences.

There is also the recognisable realism of working within public and private organisations. The protracted delay for trials and the derisory sums in legal aid are comparable to NHS wait times and rates of pay. Working for privately paying clients comes with its own issues of high stakes and higher expectations. People want their day in court as much as patients are fixated on the existence of a magic pill; the fact that they’re paying for the service crystallises these already hair-brained ideas.

So at the risk of repetition, the law and medicine are very different, but ultimately, the same. Lay clients’ dramas, professionals’ egos, large workloads, unpredictability, questionable work/life balance, the highs of success and the dismay of losses are as consistent on the wards as they are in the court room.

To many medics the crossover to the bar therefore seems like an obvious choice; the skills required in one makes for a seamless transition to the other and afford a distinct competitive edge.

For others, it’s just an unpredictable leap into the same predictable problems, not worth the hassle, risk or finance of retraining, and more importantly, leaving behind the years of commitment already invested in a notable profession.

So, in summary, is the switch from medicine to the law a reasonable course of action? If I’m forced to nail the colours to my own personal mast, my indication is that it absolutely is. For all its quirks the Bar is thoroughly enjoyable.

Sadly I’m not sure many of my medic friends can say the same about what they do, but as for whether it’s worth taking the plunge and joining the other side? The jury is still out on that one.

 

Dr Urmila Roy, Doctor and Barrister, North Square Barristers

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