EP168: Building a Sustainable Medical Career: Lessons from Dr. Tessa Davis

Thriving in Pediatric Emergency Medicine: Insights from Dr. Tessa Davis

In this episode of The Girl Doc Survival Guide, we are joined by Dr. Tessa Davis, a pediatric emergency medicine consultant at the Royal London Hospital and co-founder of the pioneering educational platform Don't Forget the Bubbles. Dr. Davis shares her unique journey from Glasgow to Sydney and back to the UK, detailing her experiences in building a balanced and sustainable career. She offers practical advice on medical interviews, public speaking, and leveraging technology effectively. Additionally, Dr. Davis discusses the importance of mindset, self-advocacy, and fostering supportive professional teams for career success. She also highlights the challenges and strategies for managing high-stress situations and balancing family life, including raising three kids and two dogs. This conversation is a rich resource for anyone looking to excel in pediatrics or any demanding medical field.

00:00 Introduction to Dr. Tessa Davis

00:55 Tessa's Journey to Sydney

01:57 Founding Don't Forget the Bubbles

05:08 Balancing Roles and Responsibilities

05:34 Mastering Medical Interviews

13:28 Challenges in Pediatric Emergency Medicine

14:27 Building a Sustainable Career

22:19 Embracing Failure and Learning

25:35 Final Reflections

Transcript

Christine Ko: [00:00:00] Welcome to The Girl Doc Survival Guide. I'm really excited to be joined by Dr. Tessa Davis, a pediatric emergency medicine consultant at the Royal London Hospital, and a senior lecturer at Queen Mary University of London. Tessa's had a fascinating training journey, including four years in Sydney, and she's now leading one of the most respected pediatric emergency programs in the United Kingdom. She's also the co-founder of, Don't Forget the Bubbles, a global resource that's transformed pediatric education online. Tessa shares Practical Tips, from nailing medical interviews to improving public speaking and using tech more effectively, with over 130,000 followers. In today's conversation, we'll talk about what it takes to thrive in pediatrics, how she supports other doctors in high pressure moments, and how she manages all of this while raising three kids and two dogs.

Welcome, Tessa. 

Tessa Davis: Thanks for having me. 

Christine Ko: Could you share a personal anecdote about yourself?

Tessa Davis: We lived in Sydney [00:01:00] for six years, which was fab. I'm from Glasgow. When I was pregnant with my youngest child, we moved to Sydney. We lived right by Bondi Beach, and it was absolutely beautiful, but it was very far away from family in the UK. So we moved back. 

Christine Ko: Why did you move there? 

Tessa Davis: To just experience work elsewhere. It's a great place for family life. It's a great place for work life balance. It was wonderful. 

Christine Ko: Why do you think it's better there for work-life balance? 

Tessa Davis: The culture is very focused on enjoying life. I think the weather does help. Beautiful weather, everyone appreciates the outdoors, enjoying the sunshine. The culture is also when you work more there, you get paid more. It's slightly different culture where you can step up to take more on, but you get rewarded. It makes it a more balanced process for everyone. You can make your own decisions about how much you want to work and how much you want to wander on the beach. 

Christine Ko: How did you come to start Don't Forget the [00:02:00] Bubbles? 

Tessa Davis: Don't Forget the Bubbles started when I was in Sydney, 2013. It was a time when there was starting to be online blogs, this movement of free open access medical education. There were a lot of emergency medicine blogs, but there wasn't a pediatric one. There was starting to be medical Twitter. I was starting to get the hang of social media and thought it would be a good idea to start a peds blog. I sent out a tweet saying, does anyone fancy starting a pediatric blog? There was a lot of tumbleweed, and then three people replied. I didn't know them, but we decided that's who we've got. We got together and set up a blog. Don't Forget the Bubbles. We put a lot of work in. We spent six months writing lots of posts, so we had a hundred posts ready to go before we started. We had a plan for the first three months. We launched it where it was just a blog. It was just to give free education. But over the 10, 13 years, it's grown into a community where we run events. Each [00:03:00] year there's YouTube videos, podcasts. So it is really grown beyond what we initially thought, and it's been fabulous.

Christine Ko: Nice. So it just grew from there.

Tessa Davis: It just happened. We didn't go with an intention of doing anything, but we were persistent. It was just the four of us at the beginning, probably for the first five years, and then we realized we can't keep doing it by ourselves. So we started to think about how we could bring in other people and involve other people, which is hard because when it's your thing, everyone used to think of it as being the four of us. We knew that wasn't sustainable. So we worked hard to bring in other teams, and now we've got an amazing people doing it. It also needed to be financially sustainable as well, because writing a blog with four people's fine, but when you've got one and a half million views a year on the website now, there's costs that come with that, editing, hosting, all of the things that come with it. And that's part of the challenge with free open access medical education. It's free for the user, but it's not free for the creators. So then we [00:04:00] started doing some online courses, which people pay for. It's run as a not-for-profit, but it means that we can sustain ourselves and still run the things that we want to run for the community. Like the conference, which doesn't make us money, but is a community event where everyone can get together face to face and really have this amazing connection for a few days each year. And it's really special. 

Christine Ko: How would you find people?

Tessa Davis: The best way that I find people in the teams I work is when you work with someone and you just, it feels right. You just feel like they work the same way you do. You have a laugh, it has to be enjoyable. None of this is for financial gains. So it has to be enjoyable. When we find these people in every team, I really try and hang onto them and work out what they want, how to use their skills. That's how we did it. And over time we just attracted more excellent people, and it's worked out really well.

Christine Ko: How much time would you say you spend right now on, Don't [00:05:00] Forget the Bubbles? 

Tessa Davis: Right now it's not a large amount of my time. I'm mostly involved in running the conference, and then we make, strategic decisions.

Christine Ko: So you mainly work in pediatrics emergency. 

Tessa Davis: I have three main roles. I work in pediatric emergency in a trauma center in London. I run the Master's program in Pediatric Emergency Medicine at Queen Mary. That's an online master's. And then I do interview coaching for doctors in the UK, prepping for their senior job interviews. My week is split between these three things. And some Don't Forget the Bubbles. And it's a good balance. 

Christine Ko: How did you get into coaching people for these high stakes interviews?

Tessa Davis: I was applying for jobs in pediatric training in the UK. I. I thought it would be fine. I was young. I just thought, I want to do pediatric training, so I'm gonna do pediatric training. I'll just do the interview, and it'll be fine. But when I went for the interview, I was terrible. I was really terrible. I didn't know how to interview, I didn't know what to expect. It was a [00:06:00] disaster, and I couldn't get onto a pediatric training post. For a number of years. It wasn't just like a one-off. I was really bad. Eventually I did get onto one, but I always carried this weight. If you've ever been knocked back from a job interview, it really knocks your confidence. I carried this with me that I'm a terrible interviewee. And it was true. It wasn't just in my head, it was true. And when I got to the other end of my training and needed to get a consultant job, I knew the job I wanted. This was it. In the UK, the job might come up once every five years or something. If you don't get it, that could be the job gone. And potentially you might have to move somewhere else in the country. So I just really wanted to do well. So I essentially worked out what the panel were looking for, how to streamline my prep, and it was a combination of what I knew from the education experience I'd done at Don't Forget the Bubbles. And then when I was able to work out how to optimize my time too, to prep in the right way and not waste time going down rabbit [00:07:00] holes of the wrong things and just really focus on how to score points in the interview, then I was able to help other people do that on a one-to-one basis. I've brought together my community building skills from Don't Forget the Bubbles, and my online masters into something fun, a community for people, and good online education.

And so that's what I do with my interview prep. I love helping other people because they're all experiencing the same things that I've been through, and I know what it feels like and it feels scary and bad when you get negative feedback. So I really enjoy that aspect of my work.

Christine Ko: Definitely when I was younger and looking for jobs and things like that, I had a number of interviews for fellowships and different training opportunities. With what you've learned through your own experiences and through coaching, what do you think are some common traps that people fall into when they're preparing for an important interview? 

Tessa Davis: The first common trap people fall into is thinking that there's someone else who's the [00:08:00] favorite for the job. I've got no chance of getting this job. It's something we tell ourselves to protect ourselves. It doesn't help your performance because you go in thinking you're not gonna get it. And that comes across in your performance. I see people who talked themselves out of jobs before they even get in the door. Even though it seems like a fluffy thing, the mindset is really important, because if you can go in believing, I'm ready for this. I'm gonna do my best as a level playing field, and I'm gonna do my best to smash it on the day, that's very different from, this isn't for me. I'll just go in and have a practice, and it's not gonna be mine. And so that's a very common thing.

Although there might be someone who looks better on paper, in the end, the interview process is not a perfect process. Realistically, you're not finding who is the best clinician or anything like that. It's literally just who can score the most points on the day. Whether that's fair or not, it's probably not the best way, but it's the way that we've got. If you can perform better on the day, then it makes a massive difference. It's confidence, and I [00:09:00] love seeing people build their confidence. That comes with practice, with understanding what they're looking for and what they're gonna ask you. 

Christine Ko: So what else do you think helps people when they're preparing for an interview? 

Tessa Davis: Saying it out loud definitely helps. Another thing I see very commonly is a nervousness about practicing out loud, which I understand why, because if you're not used to, it's awkward, it feels weird, you don't wanna do it. People often just write stuff down. You could look through a hundred interview questions and write down all your very good points, or think about them in your head, but in reality, it doesn't sound the same when you say out loud for the first time. And what you don't wanna do is all that writing, reading, all that sensible stuff, but then the first time you say it out loud is in your actual interview because you're gonna be so nervous 'cause it's a big deal. And of course you're gonna be nervous. So it's just not gonna come out well. That process of saying it out loud helps you realize where you're going wrong. Is your answer [00:10:00] too short? Is it too long? So a lot of what we do is try to push people gently, but give them that nudge to just do it and say it out loud. It is the same as any procedure that you learn.

If I think about the first time I put a cannula in a kid, it was terrible. I didn't know what I was doing. My hand was shaking. It was a disaster. But now I'm confident I'm an expert at it. Doesn't mean I always get it, but I'm an expert at it. And that's not come by reading a lot of textbooks or drawing diagrams of cannulas. It's because I've done it thousands of times. Practice is really important like any other skill. We try to just get people to say things out loud in different ways, under pressure in different ways, and that really makes a difference.

Christine Ko: I like that a lot because interviewing can just be thought of as a skill, and like any skill, it's not something that we can just turn over in our minds or even write down on a piece of paper. We actually have to practice the skill, and interviews are conducted in general face-to-face, or at least video, [00:11:00] orally. You have to be saying the words aloud. You don't send a piece of paper across the desk to someone. 

Tessa Davis: No one's naturally a great interviewee. For most of us, we don't just stroll into an interview room and give amazing answers. You practice and you learn it. And there's no one who is not able to get up to speed to do well in their interview. When you practice and when you streamline your prep, you can have confidence going and you feel completely different when you walk into the interview room.

Christine Ko: Do you think that interview situations are uniquely stressful to women or other groups? 

Tessa Davis: Definitely the part about having to sell yourself is more challenging. We're not used to bragging or having to sell ourselves, and it feels weird. It can be hard for people to be brought out of their shell to do that.

What I say to people is, it's an interview. It's a weird situation. You're not having a coffee with someone. You are trying to get them to give you a job. And the only way you're gonna get 'em to give you a job is by scoring more than the other people going up against [00:12:00] you. And the only way you're gonna do that is by telling the panel what you have to offer. If you go in and you don't know what you're bringing, or you're not sure what you're bringing to the team, the panel won't know either. There's no way. If you don't know, they won't know. It is a performance you are giving for 30, 40 minutes of your interview. You have to come out and sell yourself. And so a lot of what we do with people is help them to identify what it is that they're bringing to the team. People often aren't sure, commonly people will say to me, I'm just the same as everyone else. I'm just a trainee. I've done the same training as everyone else. There's nothing special about me. But when you recognize what you've done, you're gonna showcase that you feel very differently. Not just 'cause you can say it to the panel, but because you feel good about it, and you're excited to tell them. So it definitely is an issue of selling yourself.

I also find there's a lot of women I have in my academy who are on maternity leave while they're trying to prep for an interview. This can be very challenging because you feel like you're not in the workplace, and so you feel like you're out of touch. That's a confidence issue. There's no [00:13:00] reason why you can't get a job in that situation. It's just building your confidence with the same things I mentioned. You prep, you streamline your prep, you know what you're bringing, what they're looking for. One of the things I love is having women on mat leave come into my academy and being able to turn them around very quickly so that they go in feeling great and get the job. 

Christine Ko: It's hard to go back to work after maternity leave in general. That does sound challenging. I'm glad you can help coach women in that situation. Segueing to one of your other roles, you're a consultant in pediatric emergency medicine. Do you see certain stressors that you and your colleagues face? 

Tessa Davis: The stressors are probably not unique to pediatric emergency, and it's about the general busyness of the service that we're providing and how to balance that with two things. One is being able to provide a meaningful experience for the trainees that we have with us, and the other is being able to have sustainable [00:14:00] careers for ourselves. If you're working flat out in a busy emergency department feeling like you're getting slammed by the busyness all the time and not able to look after yourself, that might be fine for five years or 10 years, maybe even 15 years. But in 20 years, is it gonna be okay? We want to build sustainable careers for people. So I think these are the biggest challenges, the trainees experience and our own long-term careers. 

Christine Ko: With all your experience in coaching, do you have advice for people on how to create a sustainable career?

Tessa Davis: I wouldn't say I've got the magic solution. That would be disingenuous. I do think having a portfolio career in the UK where you're doing more than one role. I've tried to have a number of roles, and it is busy, but definitely having a balance. I think the people who work full-time clinical work, it can be hard by the time you're in your late forties, fifties. It can be hard to keep going. So I really think part of the way things are moving in the UK is [00:15:00] that people have different roles. You might do part-time clinical and then take on an education role or a management role or a nonclinical role. Having that balance is really important. For me it is as well. I do two shifts a week currently in the emergency department, and the rest of the time I'm doing other roles which are, flexible. Often I can work from home, and I can be around when my kids come home from school. Having that balance is important, and I think that's the way that more and more people will be going in medicine.

Christine Ko: And so your two shifts in the UK, what are they like, what does that mean? 

Tessa Davis: So I'm there two days a week. I do shifts of varying lengths. They're not overnight, but can be late into the evening. It's a very busy trauma center. We're a pediatric major trauma center. We've got helipads on the roof and retrieval teams bring trauma to us. We also have regular patients walking in or referrals from primary care. It's a very busy unit to work in. 

Christine Ko: Is it generally 12 hours even, or...? 

Tessa Davis: It would be shorter. Eight hours. Eight hours in [00:16:00] length.

Christine Ko: Okay.

Tessa Davis: The shift length definitely is good for sustainable careers. Particularly as you get older, the reality of very long shifts is probably not realistic from a sustainability point of view. Our shifts are a good length, I think. For being able to come in, be focused for the time you're there, be present, give it your best and then go home. 

Christine Ko: Do you have particular methods for stress management before you start a difficult shift or another type of difficult task? 

Tessa Davis: I don't feel stressed when I go into work to be honest. I love it. I love working in that environment, which is why I keep doing it and why I want to keep doing it. On a regular day, when there are stressful things that happen, the things that I fall back on are my colleagues, having trusted colleagues who I can debrief with and chat to about anything. I think that's why the team is so important, because you need to feel safe. When something goes wrong or when you're feeling [00:17:00] stressed about something. Maybe you've done something wrong, maybe someone else has. You have someone who's got your back and your team. I'm very lucky to have people on all of my teams that are these people for me. We can go for a cup of coffee, a cup of tea, and have a chat. That honestly is the thing that makes it great. Otherwise you're floundering on your own. Obviously I've got my family, I've got my husband, and I can talk to him. But having someone there who understands what's going on in the team that you can talk to makes a massive difference. 

Christine Ko: Yeah, I like that. That's important to have that safety, as you mentioned, to be able to be honest, because in medicine, things are going to be stressful at times. People are sick, sometimes very sick, and it's not always easy to know what is wrong with someone who is very sick. No matter how much experience you have, there are going to be times where you feel like, oh, maybe I should have done this or that, or [00:18:00] I could have thought of this or that.

Tessa Davis: Yeah, and I think for the junior team, our trainee doctors, it can feel very isolating for them. When I was a trainee and made mistakes, it was horrible. It's a horrible feeling, and you feel so vulnerable. Having senior people on the team who can be vulnerable themselves, not in an oversharing way, but in a, I've been there. It's okay. In the team that I'm in, we're all very good at saying, this is what's happened to us. We've been in this exact situation. Not it being a, oh my goodness, you've done something terrible. I think that makes a big difference for trainees as well, because you want your resident doctors to feel safe in the environment as well as you feeling safe. That's very important part in a stressful, high pressure clinical environment. 

Christine Ko: What you said is true as a trainee. You do feel very alone when you make a mistake. I think you do later on too. As a trainee you feel just more, just everything's a little more new. To make a mistake just feels, I think, worse. [00:19:00] Definitely helps to know that people who are ahead of you in experience have experienced similar things.

It sounds like you've get done a great job of creating the career you want, knowing what you want, but also being able to advocate for yourself to get what you want.. You called it a portfolio career. Do you have general advice for people on how to know what they want and advocate for themselves? 

Tessa Davis: It's hard to advocate for yourself for all the reasons we've discussed. You don't wanna be pushy. You wanna be collegiate. You wanna be a good team player.

It's balancing your needs versus the needs of the teams you're in and your family. . I think it's taking opportunities when they come, even if they're a bit left field. Because if you see something that you think could be good, even if it feels out of your comfort zone, some of them will work, some of them won't. But if you do enough of them, you'll find the things that work. You'll find the teams that you love, and when you find them, you do more of them. And that's what I've tried to do. When I've found the people I like working with, I work with them more. [00:20:00] When I find the roles that I love doing, then I do them more.

And so, you have to be open to it evolving. I don't know how easy it would be to have a, 10 year plan and make it happen. Maybe that works for some people. It feels quite stressful, the idea of doing that. So I think it's being flexible, but also knowing when you see something good and how to hold onto that and embed that in part of your work life.

Christine Ko: Do you think that's the most important thing in building a career that works for you, to be flexible? 

Tessa Davis: You've got to be flexible within reason because you've still got demands on your life and priorities with your family. I don't think you can be fully flexible, but it's having an open mind to opportunities. Being aware and open to what's out there, not ruling things out immediately. Once you start to think that could something, could be a core opportunity, give it a go.

There's lots of things that I've tried that have not been successful. I just tried a lot of things and some of them worked and some of them didn't. The ones that worked, [00:21:00] I went with and did more of them. Usually they were the ones where the teams were best and we all enjoyed ourselves the most. And you make these things a success. So rather than flexibility, maybe that's the wrong word. Having an open mind to the possibilities. 

Christine Ko: I appreciate your sharing all that. So you're saying, be flexible within reason, we all have other demands. Keep an open mind and try things, don't just rule things out because maybe you'll really like it. Recognize that we are all not going to be successful with every single thing that we touch, and there is going to be a failure rate even for someone successful as you are now. Are those kind of the main things that you think are important then in building a career that works for each individual?

Tessa Davis: Yeah. I think what I found is that the more I try then the less stakes there are in things failing because if sometimes if I talk to people they don't realize all the stuff I've done that didn't [00:22:00] work because it just falls by the wayside. I think failure gets easier. It still hurts, but it gets easier the more you do it. But the other thing to add to that list is finding good people. Because the best projects are with the people that I love working with, and we all work well together. That's the biggest reason why projects are successful, that I've been involved in. 

Christine Ko: Just now you mentioned failure, and I think we touched on it briefly earlier. You were talking about how you were not good at interviewing and didn't get the pediatrics position you wanted over, several different interview cycles, yet you kept trying. I think just now you're saying there is an inherent failure rate to trying, putting things out there in the world, and that we need to be able to accept that, that there is a certain failure rate for every single person. I think sports is the best analogy for that, that if you're trying to make a soccer goal, not even the best player in the world is going to make a hundred [00:23:00] percent of the shots. 

Tessa Davis: Exactly. But in clinical practice, the mistakes are obviously higher stakes. In the clinical world, we're trying to accept that we're all human and we make mistakes, but at the same time, we don't wanna make them because they could have significant consequences for our patients, but also for us and the team.

But then if you're thinking about the broader career and other projects, then in that sense failure is a good thing. I don't want it to come across like I brush off failure because I don't. I overthink failure and I spend ages, thinking why, but it is part of a learning process. All of these failures have brought something better because you've learned from it and you can move forward. And I'm by no means perfect to that, but that is what I would like to happen in my life. And so I go forward with that in mind.

Christine Ko: You bring up a really important point when you say that we are trying to recognize more and more that we are human even in our clinical work. That is an area where we [00:24:00] definitely do not want to fail, and yet we are still human, so we are going to make mistakes. Going back to your comment on mindset, I think the mindset in medicine is that we do need to be as perfect as possible. At least, that's my mindset. And I think you just touched on that it's yours as well. So it is hard, maybe harder, for a physician to make that shift in nonclinical work. To be okay with not accepting perfection. 

Tessa Davis: One thing that I've felt in clinical mistakes in the past is that you fight the mistake in your head to try and explain why.

Christine Ko: I used to really berate myself for my mistakes, and I still definitely don't enjoy clinical mistakes that I make. But I am much better at just facing them and looking at it factually. Oh, here's a mistake that I made. Here's an [00:25:00] error. And you're right, it does not feel good in any way. But to be able to face it and sit with it and just be like, okay, I made this mistake, and then my next thing isn't so much like, why did I do it? But it's more like, why did I do that so I don't make that mistake in the future? Which is just slightly different. And I find that to be actually a helpful process in working through the mistakes I make.

Tessa Davis: Especially if you're an overthinker, you just keep going around in circles with the same thing. Explaining to yourself why you did it and why it was okay. I don't think it's very healthy.

Christine Ko: Do you have any final thoughts?

Tessa Davis: It's actually nice to chat and think through things in this way. We don't get a lot of time just to stop and reflect on these things. I've been working in pediatrics for 25 years. Just to stop and think about how your career develops and how you handle the difficult situations is a really nice thing. More people should do it. We should make more time to do it. So yeah, it is nice talking about it. 

Christine Ko: [00:26:00] I agree. Thank you for your time. 

Tessa Davis: Thanks. It's been great chatting to you.