Dr Rob Verheul has worked with the charity for the past twelve months. Originally from the Netherlands, he’s taken a slightly different route to Magpas Air Ambulance compared to his UK-based colleagues. We sat down with him to find out more…
Where abouts in the Netherlands are you from?
I grew up in a little place called Bussum, which is about 15 minutes from Amsterdam and actually a bit like Cambridgeshire… All flat and green! I moved to Amsterdam for medical training and completed my anaesthesia specialty training there too.
Why did you decide to become a doctor?
It’s a bit cheesy, but the most honest answer is because I like working with people. You might not expect an Anaesthetist to say this, but I really enjoy chatting to patients and colleagues; getting to know each other’s stories. I guess this is also part of my character—I love a good conversation with friends!
Communication is such an important part of medicine, especially in critical care. Some say that medicine is the easy bit and it's managing everything else that's hard. I definitely think the biggest challenge of this job is people management, and knowing how to communicate with your own team, patients, bystanders and everyone in between.
What made you pursue pre-hospital emergency medicine and how did you come to work with Magpas Air Ambulance… For the first time?
It started when I did my master’s thesis during medical school, focusing on the pre-hospital treatment of traumatic brain injury. I began doing extra internships in anaesthetics to find out more, and I got a tip from a colleague who said if I wanted to know more about PHEM, the UK was the place to be. This was because they were turning it into a subspecialty of emergency medicine at the time—something Magpas Air Ambulance was pioneering.
I'd visited the UK a few times before. I used to be a rower and had gone to things like the Henley Regatta. I always found the UK a great place to be, so decided to give it a go!
I did an elective with Magpas Air Ambulance in 2017, which saw me learning what the charity was, what they did, observing shifts and learning about their research and so on.
Was your experience with Magpas Air Ambulance then what made you want to come back and work with the charity now?
Definitely! That period with the charity showed me how dedicated people are here, and it’s no different now I’m back.
Of course, the charity’s interesting and pioneering medical history drew me here first, but something else I’ve always kept in mind is everyone’s genuine interest in each other, as well as their passion for the work. It’s really family-like and that hasn't changed at all. You have to do long shifts in this role, but that makes you all talk and properly get to know each other, and I really like that.
Is it possible to work in pre-hospital emergency medicine (PHEM) in the Netherlands?
There are multiple helicopter emergency medical service (HEMS) teams in the Netherlands similar to the UK, but they differ in organisational aspect: they are not charity-driven, and PHEM is currently not a recognised sub-specialty like here in the UK. But it's the differences that made it extra interesting to explore PHEM here.
Doctors always say the switch from working in hospitals to working in the pre-hospital setting is tricky. Can you tell us about the additional challenges you’ve had to face?
My start here was quite hectic: when I found out I got the job, I had three months to get everything arranged, move to the UK and understand a new healthcare system and all the care pathways I didn’t know of beforehand. Suddenly switching from thinking in Dutch but obviously having to speak in English was challenging as well. Especially in this setting where you have to think fast and make sure everything is accurate and succinct.
When you first join Magpas Air Ambulance you go straight into the two-week PHEM training course, which the charity is renowned for and is very hard work. Luckily, I quickly realised that the medicine is mostly the same.
The next challenge was to work on my regional geographical knowledge, including the lay-out of different hospitals. Thankfully I got to work with all our highly experienced critical care paramedics to guide me through the first months!
So it's been quite a rollercoaster… But it has got much easier and I feel quite chilled now. I've even caught myself thinking in English!
Has it all been worth it?
Definitely. There are two aspects to this role that I love.
One is the job itself. I really enjoy the unpredictable nature of it and how dynamic it is. When you start the day at 7 am, you have no clue what the day will hold; whether you'll be out all day; whether you'll spend most of the day at the base training; where you're going to end up, and who you'll end up seeing.
The second is the team aspect. Working in such small teams means you really get to know each other. You experience great days and less happy days together, but sharing such a close connection within these small teams really is a privilege.
Your role is split between working with Magpas Air Ambulance and working with the Paediatric and Neonatal Decision Support and Retrieval Service (PaNDR), can you tell us more about that?
PaNDR facilitates the transport of critically unwell paediatric patients, from premature babies to teenagers. We see all sorts of illness and injuries and can take calls from hospitals and provide advice, but predominantly transfer children between hospitals. Depending on who we're called to, we can be required to stabilise patients or provide interventions at hospital, as well as looking after them in transit.
Doing both roles has been really useful as critically unwell children make up about 10% of our jobs at Magpas Air Ambulance, so this has been a great way to feel more comfortable treating this group of patients. There's a lot of skills that complement the two roles and we learn from each other. I've actually organised a night of simulation training for PaNDR colleagues at Magpas Air Ambulance recently to create more cross-over learning between both organisations.
What do you think of Magpas Air Ambulance as a whole?
It's really impressive to see how much the organisation has grown since I last worked with the charity—and I'm not just talking about the facilities! The training's gone from strength to strength, the learning opportunities are amazing and the passion for patient care is unmatched.
When a few friends from the Netherlands came to visit I took them to the base to see what I do, and they were all so impressed by the organisation. You tend to forget when you're here every day but seeing it through eyes of others brought it home for me.
To get this opportunity has been amazing, and I hope I've been able to give something back during my time here. I've been teaching people bits of Dutch, bringing in Dutch food and have built lasting friendships… When I go back to the Netherlands, I hope I’ve left a little piece of me behind. And I’m still going to come back for shifts with Magpas Air Ambulance from time to time!
