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Complexity and versatility: the consultant neonatologist

51app 2024; 384 doi: (Published 20 February 2024) Cite this as: 51app 2024;384:q362
  1. Kathy Oxtoby
  1. The 51app

Consultant neonatologist Regina Nalliannan tells Kathy Oxtoby that hers is a specialty where there are miracles every day

“Many of the babies in my care are born prematurely. It never ceases to amaze me how babies are so fragile, yet so resilient. They can go through so much, and sometimes it seems they won’t come through. And then many do—which is a powerful and humbling experience.”

Nalliannan, who works in the department of neonatal medicine at Princess Anne Hospital, Southampton, says she is challenged and inspired by a specialty that is both versatile and complex. “No two babies are the same—they can have the same condition and behave in totally different ways—so neonatology is not something where you can go by the book,” she says.

It’s also a specialty that has made huge advances. “I work with a large team caring for babies as young as 22 weeks, and we can make such a difference to their lives and their chances of survival.”

Nalliannan has never considered any career other than that of being a doctor. “It’s always been a part of my life, and something I grew up with,” she says.

She grew up in Chennai, south India, where her grandparents were doctors, and it was her parents’ dream she would follow that path. Qualifying in medicine from Annamalai University in 2005, she initially chose to specialise in paediatrics. “I love children. But after doing a rotation in neonates I knew I didn’t want to do anything else,” she says.

In 2014, while working as a postgraduate doctor in neonates in paediatric hospitals in India, she was presenting at a conference when she spotted an advert for the Medical Training Initiative (MTI) (paediatrics) programme1 run by the Royal College of Paediatrics and Child Health in the UK. The scheme provides two years postgraduate experience in the NHS for international doctors. Intrigued, she applied. “I wanted to see what was happening to care for babies elsewhere in the world,” she says.

Nalliannan says that during her two years on the programme working at the neonatal unit at Princess Anne Hospital she learnt a lot from the consultants. “In particular, I learnt communication skills, including the importance of explaining to parents and families about options and choices with care, and offering support,” she says. “Parents are advocates for their babies, who don’t have a voice.”

After returning to neonatal jobs at hospitals in India, she missed her work and her colleagues in Southampton. She returned there in 2019 to take up a locum post, starting her current consultant role in 2021.

The consultants who trained her are now her colleagues, and they continue to inspire her. “They’ve taught me the value of teamwork, and how great minds with different ideas can work together for the good of one baby,” she says.

In turn, she hopes to inspire trainees. “Teaching the younger generation of doctors is something I feel passionately about,” she says. “It’s difficult to do in my specialty, because whenever there’s a practical procedure that comes up, as an intensivist you want to do it to keep your skills up to date. But it’s important to let your trainees have those opportunities, just as you had. You’re training consultant colleagues of tomorrow and are responsible for their growth.

“The greatest satisfaction is when you see them doing good clinical work. You feel pride because you’ve helped them to get to where they are.”

As MTI recruitment lead (neonates) she also supports and shares her experiences with new recruits to the programme in Southampton. She is also a clinical effectiveness lead, which involves “making sure that the medicine we practise and the services we provide to our patients are of the best quality and looking at if there is anything we can do better,” she says.

She hopes to have a greater involvement in research and to take on leadership and mentoring roles. “I love my clinical work so much I could never give it up altogether.”

Some of her most fulfilling moments to date are “the feedback from parents,” she says. She recalls caring for a baby whose mother was using drugs. “Some years later she told me how I had played a big role in her deciding to change her lifestyle, because I had ‘treated her as a human being.’ That’s one of my greatest career highlights,” she says.

At home she surrounds herself with animals—another life long passion. She has two cats, as well as numerous rescued pets at her mother’s home in India, where she visits regularly. She also enjoys spending time with nature and in her garden—“That’s my happy place where I destress.”

“And at the heart of my life is my church,” she adds. “My Christian faith helps me cope with the emotional challenges of working in my specialty.”

When doctors in training ask if they should work with neonates she says she would never push them towards the specialty. “I believe whichever specialty you choose you should never feel that you don’t want to go to work. And my specialty makes me want to go to work every day.”

Nominated by Katie Hodgkinson

“Regina is one of those people who goes out of her way to look after every person near her—patients or staff. She believes the absolute best of people and is incredibly encouraging and motivating, involving trainees in all her projects and work.

“She embodies the exact opposite of doctors who pull the ladder up behind them—Regina is only happy when everyone is supported to be as excellent as she is. Despite being an incredibly smart and hard working consultant, she is also approachable and makes time for everyone. She has shaped my whole career—it’s impossible to doubt yourself when a consultant with such exceptional practical and personal skills is cheering you along every step of the way.

“She runs the MTI scheme at Southampton and personally welcomes all the overseas trainees, sorting them out with accommodation and support for their families as well as teaching them the ropes at work. On her on-call shifts she stays late down on the floor, getting to know the trainees and how she can support them, and is the first to decorate the office for birthdays, Christmas, and baby showers. She alone has changed the whole atmosphere of the unit.”

  • Katie Hodgkinson is an ST2 in paediatrics

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