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Failure is the key for a successful doctor

06 Nov 2015

Prof Orla Hardiman

Niamh Mullen was at the recent Irish Medical Careers Fair to hear Prof Orla Hardiman discuss how young doctors can find their way through medicine without career signposts.

Neurologist Prof Orla Hardiman has successfully combined a clinical career with academia, publishing more than 220 peer-reviewed papers, raising €11 million in research funding and passionately advocating for people with neurological diseases. She shared her tips for career success at the inaugural Irish Medical Careers Fair (IMCF), held in Dublin late last month.

Despite becoming Ireland’s first professor of neurology in 2013, Prof Hardiman maintains that “failing and failing better” is the story of her life. The Beaumont Hospital consultant told attendees at the recent IMCF at the Clyde Court Hotel that no matter what stage your career was at “failure dogs you all the time”.

Her favourite quote, she said, was from Worstward Ho by Samuel Beckett: “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.”

“There is nothing wrong with failing. Failing is really important. It makes you a better person,” she told the audience, before running through a number of failed grant applications and manuscript submissions she had made in the past six months.

“Each of those rejections, and I could paper my entire house with these rejections, led me to look at what I did and redo it and redo it and redo it. We have to keep on dusting ourselves down. That is the story of my life — failing and failing better.”

Following postgraduate training in Dublin, Prof Hardiman moved to Boston to undertake Neurology Residency training at Harvard Longwood Neurology Program as Chief Resident in Neurology. Her Fellowship training was in Neuromuscular Disease at Massachusetts General Hospital and Harvard Medical School. She returned to UCD in 1991 as a Newman Scholar in the Department of Physiology and was appointed as College Lecturer in Physiology in 1994. Two years later she was appointed as a Consultant Neurologist at Beaumont.

Public respect
At the Careers Fair, Prof Hardiman said there was a lot of public respect for doctors and a lot of reinforcement that doctors were supposed to know everything. She emphasised that humility was important, that it was okay to make mistakes and to admit to patients that you didn’t have all the answers.

“We have patients who are very aware now and very knowledgeable and it is okay that the patient sometimes knows more than we do.

The idea that medicine is a hierarchical relationship where we are in charge and the patient does what they are told is not right any more. The patient should be part of the partnership. I don’t think we teach that particularly well in medical school or our training programmes,” she added.

Passion was another ingredient required for career success, in her view. A combination of intellectual curiosity and a motivation to change things led her to become the 11th neurologist in the country. She felt compelled to try to change things because 11 was “just not enough neurologists” and access to services in the 1990s was “appallingly bad”.

Prof Hardiman is known as a passionate advocate and is a founder of the Neurological Alliance of Ireland and of the Doctors Alliance for Public Health Services.

Motor neurone disease
Her research interests include the epidemiology and causes of motor neurone disease (MND). She established the Academic Unit of Neurology at Trinity College in 2011 and is the recipient of numerous international awards for her work. She was also the first Irish-based neurologist to become a fellow of the American Academy of Neurology.

Recent research has focused on whether MND is heritable and Prof Hardiman’s work shows a genetic link. She and her team have also found that families with MND can also have members with other neuropsychiatric conditions, such as schizophrenia and bipolar disorder. “We are very interested in identifying the link between schizophrenia and bipolar disease and amyotrophic lateral sclerosis (ALS). We are doing this by collecting DNA from these families.”

Not being afraid to challenge dogmas was another trait required to get ahead, she said.

She was responsible for setting up specialist, multidisciplinary clinics for MND, multiple sclerosis and migraine, and in 2003 published a paper showing such clinics improve survival in ALS.

When the paper was published, some colleagues wrote to the journal and disputed her research. But subsequently other groups replicated her findings.

Better outcomes
“This has happened in other areas. It is the reasoning behind cancer centres, centres of excellence. If you have critical mass, if you put in the structure for critical mass, you get better outcomes. I feel strongly about this: we should be offering evidence-based medicine, evidence-based care,” she said.

It was also said that rates of MND were the same all over the world, but Prof Hardiman has shown they are four times lower in Cuba than in Ireland and it is now recognised that ancestral origin is important.

It was possible to combine a career in clinical practice with research, she said, and Ireland did not capitalise enough on the “ready-made laboratory” the island provided for epidemiology.

She also believed that young doctors should know it was okay to want to pursue a career path that “isn’t in the book”

However, she added that if you wanted to do research you needed to have no shame about asking for money. “My father said to me, the professional has no pride. It is very good advice. I have kept it all my life. If you want to do this work you should not be afraid to ask people to help you,” she concluded.


Click here to view the full article which appeared in Irish Medical Times