An interview with Senior Doll Fellow Laurence Leaver
Green Templeton has been renowned for its strength in medicine since the founding of predecessor Green College in 1979. In this interview, first published in the 2021 issue of Observatory, Senior Doll Fellow Dr Laurence Leaver reflects on his life and career to date, training doctors of the future, and his long association with college.
Could you start by telling us a little about yourself and how you initially became involved with college?
First, thanks for asking me for an interview. I was the first in my family to apply to university, and really I wanted a year off to have fun; so I only applied to one college in Cambridge, not expecting to get in. I’m still waiting for my gap year. After three years I defected to Oxford – one of 45 Cambridge medics to join the 40 or so remaining Oxford medics in my year and several from other universities. I arrived at then-Green College, with my friend Derek Roskell, who is now Clinical Director of Pathology and Laboratories at Oxford University Hospitals. He also had the much more difficult job of best man at my wedding.
I was much more privileged than today’s students. I got a full grant, a bursary from the college and there were always free lunches at departmental meetings in the hospital. Also, I got paid to ‘invigilate’ in the library (where I would have been studying anyway), then in the east wing of the Observatory. In those days lecturers used 35mm slides in carousels which jammed regularly – I managed to get paid to be the projectionist (to unjam the slides) at many high-profile lectures that I would have attended anyway, and that often led to attending free dinners with visiting speakers. I also worked in the college bar and I shared college life with lots of students of applied social work, medical sciences and forestry as well as clinical medics and others.
I was secretary of the student MCR committee before a failed bid for President the following year, where I was pipped to the post despite a recount! I have sat on Governing Body since 1989 on and off! In 1990, when visiting a friend on the Isle of Wight I was in an accident while driving a motorcycle and sidecar which crashed with an oncoming car. It was a serious injury and I was unable to walk for basically a year of my time at Green, but I had great medical care (including four operations) from various doctors, particularly in Oxford. I had an external fixator for six months. I covered the sharp spikes with champagne corks and made my own additional contraption that helped avoid a ‘foot drop’, which John Kenwright, a Professor of Orthopaedics, commended.
I should probably have taken a year off, but I didn’t and instead lived all three years in the Doll Building on the main site. This meant propelling my wheelchair across the gravel to get to my attachments, including ENT (Ear, Nose and Throat) at the old Radcliffe Infirmary just south of college. College was great to me in this period, including Domestic Bursar Gerald Chambers who gave me a key to the kitchen gate to help access. The year was a great education in being a patient, which although valuable would be difficult to make compulsory for all medics!
As a student I also went to the Ugly Bug Ball on crutches, with Fiona Cullington who was very kind to me when I was disabled – the ball was a regular annual collaboration between Green College and Osler House at that time, attended by most of the college, including many senior members, and the vast majority of the clinical school.
You now work as a GP just around the corner from Green Templeton, at Jericho Health Centre. How did your early career lead you on a path to general practice?
Yes! I’ve come a long way in the world – about 400 metres. Immediately after graduation I lived and worked at the Churchill Hospital in Headington, where I met my future wife, Ro. It was very Mills & Boon as she was a nurse on the first ward where I was a doctor. Our eyes met over the catheter trolley for our first mutual contact with latex. Ro moved to Aylesbury for midwifery training and I applied for the first job available at Stoke Mandeville to be near her. This was in spinal injuries.
It was in that role that I first really felt I got to know patients and their families, which increased my desire to pursue a career in general practice. I was also exposed to the enormous benefits of rehabilitation and some amazing people who had successful, purposeful, active lives with major disabilities. This experience significantly shifted my mindset about tetraplegia.
I then trained as a GP in Luton and Leighton Buzzard. We were keen to come back to Oxford and I joined Jericho Health Centre in 1996, back in the days when GPs did their own ‘on call’, and even delivered babies, but still had time for lunch, most days.
You’ve been Senior Doll Fellow at college for the past two decades. Could you tell us about that role and how your election came about?
I always tried to maintain a relationship with the college – I was a Common Room Member as a House Officer, and then again as a GP, and I got married in the college in 1993. In 1999 I applied to be a Doll Fellow and was rejected in favour of Chris Pugh (a good call in my view). Chris did make me a Teaching Associate, of whom there were only a few, who were mostly already Common Room Members like me. A couple of years later I applied again and was rejected again, but in 2004 I was asked to apply – I nearly refused, after two rejections, but then Warden Sir John Hanson charmed me into it by reminding me it was for the benefit of the students. At interview, now-Emeritus Fellow John Sear asked me how I would find time for the role. I said I didn’t know but was appointed anyway. I still don’t know!
Initially I was the only Doll Fellow with a small band of keen Teaching Associates, including Dougy Noble who soon became a Doll Fellow too. We’ve now grown to five Doll Fellows and 30 Teaching Associates. When I first started we often had less than 10 first-choice applicants for medicine, but since 2007 we have had more applicants than the 32 places almost every year.
How does the Medical Teaching programme operate and what are your overarching objectives?
When I started in this role I asked students what they wanted from college, and have tried to give them what they want ever since. I see collegebased learning as about growing a community so that each cohort of students can help and support one another. This is by learning together, but also by doing other things together. Having a larger cohort helps. Having lots of senior members in medically related fields also helps with elements including teaching, projects and electives.
I have always sought to develop a culture where the college is here to help students, not to judge them, and a key part of that is that no questions are deemed ‘stupid’. It is also important that the students have continuity of tutors whom they get to know and can freely ask for help at any time.
The college now has a strong network of Teaching Associates, not just in medicine and surgery at the Oxford University Hospitals but also in district general hospitals, which provides relationships and reassurance when students are on rotation. It is a useful resource when students are thrown into different environments. There is, of course, a risk of the medical community becoming a clique, but with college’s wider strengths in healthcare, medical sciences and other areas, I find this isn’t a problem at Green Templeton.
How do you see the role of the college in developing doctors of the future alongside the university Medical School?
I don’t see any monopoly on who defines the best clinician – but it is clear to me that exams alone are a relatively limited test. Clinical exams are by their nature vocational tests and so are about passing, not relative merit. To me, the long-term focus is less about an additional couple of marks at the point of qualification, and more about fostering a striving for lifelong learning. We must try to give students the confidence that they can do something else if they wish – such as a research project or learn sign language or play sport or have fun to stay sane. Developing empathy, compassion and other personal qualities are more important in being a good doctor than an extra couple of marks above the pass threshold. While the Medical School would agree, this is not usually the prevailing culture. Colleges can help with this.
I’m confident our college-based teaching is first-rate, but I’m strongly of the view that it is the collaborative and enabling environment that is at the heart of what Green Templeton offers. The added value of college teaching provision is definitely good for the Medical School as a whole. GTC attracting students from other colleges drives up investment in provision across those colleges and the university, and that is good for the future of medicine and ultimately for patients too.