From oil field to surgery

It wasn't so long ago that Neil Browning would take a couple of skiing holidays every year. He had money to burn, a comfortable home and a smart car. Then he gave it all up to train as a doctor in a drab part of south London. Neil is now a third-year student at St George's Hospital medical school in Tooting and receives a bursary of £4,000 a year. Three years ago he was earning almost 10 times that amount as a petroleum engineer working in oilfields from Aberdeen to Abu Dhabi.

The oil industry sounds a glamorous, jetsetting industry, but Neil finds medicine infinitely more exciting. "You experience amazing things as a doctor. I've seen people dying, I've seen people being born. I've met people with difficult psychiatric conditions like M¸nchhausen's and schizophrenia. I've visited Broadmoor hospital. People tell you things about their lives that they'd never tell anyone else."

He is precisely the kind of recruit that the NHS is aggressively trying to attract. As a result of long hours, understaffing, excessive paperwork and huge patient expectation, it has become hard to hire and retain doctors. In England there are around 1,000 vacant GP jobs, leaving nearly two million extra patients to be cared for by existing staff.

The biggest shortage is in London. About 55 per cent of doctors work as GPs, but a recent survey found that only 32 per cent of medical graduates wanted to be GPs. In another survey, a quarter of GPs said they were thinking of changing career. Two-thirds of those who want to become GPs are women.

For Neil, now 33, medicine is a genuine vocation - one that had not been encouraged when he was at secondary school in Richmond. "I did want to be a doctor from an early age, but I didn't think it was open to me," he says. Nobody in his family had been a doctor or nurse, and he thought of the medical profession as a "closed shop". When he left school, he went to Bristol University to study physics.

After taking a master's degree in engineering at Imperial College, London, he got a job as a petroleum engineer with the French company Elf Aquitaine. "I chose a career in the oil business because it seemed adventurous, exciting and fun, and would involve a lot of foreign travel. If you are young and you don't know what to do, the oil industry is great, why not?" He worked in the North Sea in drilling, and as a reservoir manager co-ordinating all technical aspects of work in the oilfields.

The skills he learned were useful - surprisingly, they have some connection with his current studies. The job was about daily problem-solving with pipes, oil wells and oilfields. "Reservoir engineers have been described as oilfield doctors," says Neil.

"The oilfield is the patient: you monitor it, measure its pressure and its temperature. You inject fluids and take fluids out." In spite of the high salary for a man in his twenties, the pleasures became routine. Even the regular ski trips had a dullness about them.

He got tired of the frequent travelling and admits he couldn't imagine being in his job for another 10 years. His pay was going up and up - but in reality he was being locked into a pair of golden handcuffs. "The more I got paid for doing something I didn't really want to do, the more difficult it got. Being a doctor had always been in my mind." The breakthrough came when he heard about a fast-track medical course for graduates about to start in London.

It would take students four years instead of the traditional five or six, students would receive a Department of Health bursary, rather than struggling to find the course fees, and the emphasis was on clinical experience. He instantly knew he wanted to do it. Luckily, he could afford to take time off. "While other engineers were driving around in Lotuses and Ferraris, I'd been hoarding my money so I could steer a way out if I wanted to."

Having passed a demanding exam, Neil started the course, along with a seismologist, an archaeologist and people who had followed careers in the Treasury and the City. Neil had a girlfriend, but says it was an advantage that he wasn't married with a family. He was able to cut costs by moving into his parents' home in Richmond and had time to devote to a demanding full-time course.

"This course came along in God's good time. Medicine is even more interesting than I thought. I never imagined that I'd be so fascinated by the minutiae of a kidney, but I am, especially when I meet the people who own the kidney."

He describes it as a real job. "If you have a good day it's for the right reason, if you have a bad day it's for the right reason. It's the human side I find fascinating. In the old job, solving a big problem with an oil well gave me less satisfaction than I wanted from my work."

His most satisfying experience was time spent working in a GPs' practice. The students were allowed to see patients on their own and discuss the cases with the GP later.

Neil thinks that older students are more likely to be drawn to general practice. "They tend to be more interested in the person than the organ. Working in general practice is probably the best indicator of whether you're good or not. GPs are really smart. You need to know about lots of subjects, about psychology and the social consequences of illness."

Recent publicity about GPs being demoralised has not dimmed Neil's ambitions. "Being a GP is a great job. It combines practical skills, people skills, teaching and management abilities. It's about running a good practice and being a good community health manager." The view that there is little career progression in general practice does not concern him either.

With the setting up of primary care trusts, GPs are gaining more influence and power as budget holders and purchasers of services from hospitals. "You can become a better GP or manage a bigger practice. It's a job you can do better the wiser and more distinguished you get."

Neil, reinvigorated by his career change, joins the medical profession at a very interesting time.

There is scope for some optimism. A month ago, GPs voted for a new contract to benefit patients and doctors. The aim is to raise GP standards, employ more support staff and carry out more preventive work to reduce strokes, heart failure and renal failure. The gains for GPs are more interesting work, better pay - with average salaries rising from £65,000 to £82,000 - and more civilised working hours.

Another positive trend is an increase in medical training places. By 2005 there should be 5,894 students starting medicine, 2,000 more than in 1997. Most imaginative have been the schemes to open up medical training for older people, such as Neil, who have already had a career. In America, Canada and Australia there have been fast-track courses "turning ballet dancers into doctors" for 25 years.

Since the St George's course started in 2000, eight more have been set up. From September there will be fast-track, graduate-entry medical courses at the universities of Bristol, Cambridge, Newcastle-upon-Tyne, Nottingham, Oxford, Leicester, Birmingham and Queen Mary, University of London.

Neil says there are many people who would love to become doctors. "I meet an average of one per dinner party, and they can't stop talking about it."

Further details about accelerated medical courses for graduates from www.nhscareers.nhs.uk