“In everything that I have done, and in everything that lots of us do to our professional lives, we know it’ll be a challenge but maybe we don’t know quite how much of a challenge it’s going to be. And if we did, we probably wouldn’t do it.”
Louise Dubras, Professor Emeritus, led the creation of a new GP focused Graduate Entry Medical School, at Ulster University.
Lousie joined Ulster University as Foundation Dean of the new medical school in 2018, developed the curriculum, put together the educational team., and the first cohort of medical students graduated in 2025. During this time she continued to work as a general practitioner one day each week, and immersed herself in the local community.
She was born and grew up in Jersey in the Channel Islands. She was lead GP for a homeless service. addiction and mental illness in Southampton where her increasing involvement with the University of Southampton led to her running the medical degree programme. She became Deputy Dean of Medical Education King’s College GKT homas’s medical school in London at a time of huge curriculum change and later became Interim Dean of Medical Education. She was recognised by the award of MBE in the King’s Birthday Honours in 2025.
“I didn’t want to be a doctor. I actually loved words, the power of words, and I wanted to be a journalist. That probably combined my fascination with language and narrative with my interest in people and why they do what they do.”
Welcome to MedicsVoices.com where we talk to the key opinion leaders in health and medicine around the world. I’m Domhnall MacAuley and today I’m talking to Louise Dubras at a very exciting time in her career as she moves on to new horizons but, let’s start at the very beginning because you were born on another small island. Tell us about growing up on the Channel Islands.
Louise Dubras: That’s a lovely place to start. I was born in Jersey, in the Channel Islands about 15 years after the end of the Second World War. And the reason that matters is because my childhood was shaped by my father’s experiences, living under enemy occupation in the war. My dad left school, very young, and went straight to work. His family were of humble beginnings and his ambition was just to own a house that he could walk around. My mother had been through the bombings in Birmingham during the war so, my parents were shaped by the war, and that shaped me.
They were absolutely committed to us and ensuring that my sister and I had a good education, and to do the best for us. When, perhaps, I was being naughty at school, probably ADHD undiagnosed, my parents were keen to do what they could do to enable that education. And that led to them supporting both my sporting activities and my academic activities. And, I have said repeatedly, I was very lucky because in those days, women weren’t encouraged to do a lot of things. People would say, you can’t do X or you can’t do Y. But, my parents just said, yes. And that was one of the reasons that I was able to go to medical school. It was one of the reasons that I learned to sail, which very much shaped my journey through my adult life. That’s a sense of the roots of how I grew up.
DMacA: Let’s talk about the academic world first. Tell us about school and what first attracted you to medicine?
LD: I didn’t want to be a doctor. I actually loved words, the power of words, and I wanted to be a journalist. That probably combined my fascination with language and narrative with my interest in people and why they do what they do. But I was also good at science. So, I took sciences at school and thought that perhaps I wanted to be a scientist and do medical biochemistry. And then by chance, at a family wedding, I met a doctor who said, “well, if you want to be a scientist, and you want to do research then, why don’t you train as a doctor”. It was a bit of a last-minute decision to apply to medicine but that’s what happened. I’ve never lost that fascination with the humanities and the value of words and stories.
DMacA: In parallel to your academic career in school and in college, you had this sporting career. Tell us about it.
LD: I’m not sure career is the best description. I’m really bad at sports because I can’t see properly. I have amblyopia so I’ve got no 3D vision. The money that my poor parents spent on tennis coaching was always going to be wasted because I might as well have had no strings in the racket. I was a swimmer. Was I competitive? Yes. My children will tell you I’m a bit competitive. When I was particularly naughty at school, the head teacher summoned my mum and dad and said, “I think Louise is bored. You better do something with her excess energy.” So, my dad and I took up sailing together and it was the sailing that informed so much of what I’ve learned and done in my life because, they encouraged me and didn’t say no. There was an opportunity for me to go off and do some sailing with the Sail Training Association, which was a fantastic charity. I went off and spent two weeks sailing on a ‘tall ship’ and I guess they saw that I had some leadership qualities. They invited me back as a watch leader and I did a couple of trips with them in that sort of leadership role. I was probably 15 or 16 year old at the time, and I think I was the youngest watch leader that they’d ever had. And, then I just did bits and pieces, I was always keen to sail, always enjoyed the physical side. There is something about sailing and horse riding, which didn’t require me to see properly because I did it all by feel. And, it enabled me to form healthy relationships. I had been to a girls school and, all of a sudden, I was having a healthy relationships with boys through sailing, which was probably, a great relief to my parents. That shaped what I was doing as a young doctor too.
“I joined that crew which was a fascinating experience in that no women had done that before. There was nothing written about how you do it, no textbook, no journal article about you set up a medical kit for a boat to go around the world and into the Southern Ocean.”
DMacA: You then went on to become part of a pioneering group of women who pushed out the boundaries in sailing. Tell us about that.
LD: Well, I blame Gloria Hunniford (A radio presenter at that time). It genuinely wasn’t part of the plan but life throws things at us, doesn’t it? I was a junior doctor working in London doing my GP training but life had thrown events at me and I was looking for something to help restore my confidence.
A friend had heard the skipper of this yacht being interviewed on the radio and she was looking for a woman doctor who knew how to sail. My friend thought- I know who that person is. So, I contacted the radio show and tracked down the skipper, a lady called Tracy Edwards, who was trying to put together a project, an all female crew to compete in what was then the Whitbread Round the World Race. She was trying to pull together sponsorship, the boat, and the crew. She got the boat and I joined that crew which was a fascinating experience in that no women had done that before. There was nothing written about how you do it, no textbook, no journal article about you set up a medical kit for a boat to go around the world and into the Southern Ocean. I spoke to a couple of people who had done it before and contacted a Norwegian chap who had done it twice. He was a kind of pioneering type who just said, oh, well, just do this and that…. And so I had to do a lot of thinking about what it means to be a doctor in that environment. And, what does it mean to be a woman doctor in that environment, caring for other women? We then had to launch ourselves in the face of not terribly good publicity. The press were scathing. But, we proved we could do it. And I learned a lot about being in a team in that setting. I learned that when you have to trust your life to a functioning team and, when that team isn’t functional, you have to learn to make a decision about where your priorities lie. After two Atlantic crossings with them, I didn’t feel that team and I fitted together. I was looking after them but I needed them to look after me as well. I needed, also, to give them a chance to find somebody to replace me and there weren’t many women around who wanted to do that so I decided to leave the crew after two Atlantic crossings- 6000 miles was probably enough!
DMacA: This pioneering spirit, and this team spirit, stayed with you for the rest of your career. You would go on to become a GP, but you looked after a particular group of patients….
LD: Life catches up with us, doesn’t it? And, if we think about our careers as doctors as in some kind of hermetic kind of bubble, somehow divorced from the rest of what happens to us as people, I think we’re being disillusioned. I was working as a partner in a practice in the south of England. I had two children and the requirements of the partnership just didn’t fit with what I was able to give as a mum with two young children so I stepped away from the partnership, and then thought, now what? A job was advertised for one half day a week looking after homeless people in Southampton in the south of England so I applied for that, got that post, and it was just the most amazing opportunity. And I loved it. I loved the authenticity of that role. I loved the patients. And although I didn’t think about it at the time, it probably comes back to the narrative stuff, the stories that people have, their backstories, their personal journeys, and I could feel a real connection with those patients in a way that perhaps I hadn’t with the middle class, fairly well-off people, in the practice. The other thing that was wonderful about that was working with the team. It was a fantastic team, a nurse led team, and we did a load of initiatives. We were one of the second wave pilots of personal medical services practices within the UK because we needed to have proper funding to deliver a 24 hour service for those patients. We also we set up alcohol day detox and we set up a pilot for transitional care for patients coming out of hospital. Sadly, the funding for both of those came to an end, but it was just such a wonderful time and its now nearly 20 years since I did that work.
“… I’m a very practical person, and I know that if you are going to take some great ideas, you have to give people the right structures, and you have to have the right oversight and governance to make that real and meaningful for students, and also to make it deliverable.”
DMacA: You then moved into undergraduate teaching, and were looking after the curriculum in Southampton. Tell us about that experience.
LD: Again, it’s always started with patients. It started with my homeless patients who’d got a bad deal, in relation to their opioid use, when going into hospital. And I felt that we needed to do better for the patients. You could go and talk to ward staff or, you can do something a bit more fundamental, which is to help educate students so that they are more confident in managing those patients from an early point in their careers. So I negotiated and we set up a subject in the curriculum called alcohol and addiction, which I believe is still part of the offering. And it grew from those experiences and from doing some GP teaching for third year medical students. I never had a plan but I was able to demonstrate that I could do things and I could be innovative, I could lead a team and have an impact. So I went from GP teaching and subject teaching to leading the third year. And then I was asked to lead the review of the curriculum and lead the program. I think I was just in the right place at the right time.
DMacA: You moved on to King’s College, which was a shotgun marriage of three medical schools. That must have been an interesting experience.
LD: Oh, my word, it was. And, you’re right, one of the first things I was told was that while King’s College London was my employer, I was at the GKT School of Medical Education, which was Guy’s, King’s and Thomas’s, and never to forget that. I had applied for a job in Southampton and not been successful. I’d put my energy into developing my skill set, and written my CV and then, for whatever reason, wasn’t the right fit for that job. But having put in all that effort and thinking what can I do, that was when the job came up as the Deputy Dean of Medical Education. They were engaged in a huge curriculum review, and they’re also a huge medical school so I went from a year group of 270 medical students in Southampton to a year group of 400 students, a total of 2000 of medical students. And the pace of that review was fast. There was some fantastic innovation being proposed, but there hadn’t really been any work done in thinking about how that would be implemented and who was going to do it, and the detail behind writing the curriculum. When I hear myself saying that I think, goodness me, I was never a very good detail person. But, equally, I’m a very practical person, and I know that if you are going to take some great ideas, you have to give people the right structures, and you have to have the right oversight and governance to make that real and meaningful for students, and also to make it deliverable.
I put a huge amount of effort into pulling that team together and into writing the curriculum. When I say writing, it needed a huge amount of doing. I negotiated to bring everybody to a hotel for a weekend and, basically, I wouldn’t let them leave until they’d come up with all of the outcomes, and all the curriculum oversight.
And, then I took a week and went from home and wrote it. I took out all of those flip charts, and all of those mind maps, and made that happen. And then we went through the university processes and began. It was an adventure. But what I was able to do, working in that setting, was to connect with some really amazing people and, right back to where I started, it was all about where are we going to put in the humanities, where are we going to connect students with, not just quality improvement and not just the science of medicine, but how are we going to enable them to connect with the arts of medicine? So I was very fortunate to have those opportunities at that time.
DMacA: Curriculum development, as all academics know, is incredibly technical and incredibly difficult, but what jumped out at me from in your interest in curriculum is that, at one stage, you introduced a new module for students where they took on the role of nursing auxiliaries.
LD: That was something that we did in Southampton and it was a way to try and manage the issues that students face regularly. If you think back to educational theory and about legitimate peripheral participation, they didn’t even feel like legitimate peripheral participants when they went from theory based time into clinical settings. Students were like rabbits in headlights. There’s a huge amount of literature about that kind of transition and that growth of professional identity and how that happens, and some of the traumas that students experience when they’re parachuted into clinical settings in a very ill prepared way. So, that came from the idea of placing students into a clinical setting with a different focus. We wanted them to learn about being in the clinical environment without the additional cognitive work of learning medicine. That was the rationale behind that initiative. We piloted on a very small scale pilot, and then we grew a bigger pilot. And then we implemented it for a whole year group, but with a massive amount of work with the Trust in Southampton and, I have to say, fantastic collaborative working there because, if they hadn’t been willing to enable that for us, it would never have happened.
I remember some of the student evaluations from early on in that work. For example, a student who’d just been asked to do one to one nursing with an elderly patient with Alzheimer’s, talking about they had no idea how demanding that was. And another student said – I had no idea how back-breaking nursing was. So I think that they gained enormous insights into what was entailed in the care of patients, and watching how teams function in a ward when the doctors aren’t there.
“And what I love most about the team, and growing the team, is that anybody who commits themselves to coming to a new medical school and doing something like this, every single one of them is brave, every single one of them is prepared to take a risk.”
Professor Dubras meets with the Princess Royal when she visited the new medical school in 2020
DMacA: So, you bring all this knowledge of academic curriculum development, the practical experience of students, and your interest in team building, to your new role here in the University of Ulster. That was a challenge.
LD: In everything that I have done, and in everything that lots of us do to our professional lives, we know it’ll be a challenge but maybe we don’t know quite how much of a challenge it’s going to be. And if we did, we probably wouldn’t do it. The challenge here was about learning about the environment. When you work in a university, and when you work in the health service, there is a lot of a ‘small p’ politics going on. But I also had to learn about the Politics here. And there was also very much a cultural transition. I hadn’t been prepared for how different Northern Ireland was to the rest of the UK. That ranged from how companies do business to the Politics of the place and the legacy and the history and so on. But I was really well supported when I got here. And I was able to make the connections I needed to make, and I was also lucky in growing the team. I started small and it’s always good when you start small with a core team, and then expand. You are the pioneer but you’ve got that core team around you doing it together.
DMacA: You started with a blank page, and you’ve brought your first cohort of medical students through who will qualify this year. That must be a wonderful, and rewarding experience.
LD: It’s amazing. There were certainly times along the way where I thought, is this actually going to happen? Will we be able to make this happen? It wasn’t a blank page, which is important. I’d love to have started with a blank page but we started with a partner, Saint George’s Medical School, which is now City Saint George’s.We had their curriculum but we did have to adapt for local delivery. There was a huge amount of negotiation with lots of stakeholders and we had to recruit simulated patients who would enable us to deliver on some of the cases we were working on. But nonetheless, it’s been a remarkable journey. And what I love most about the team, and growing the team, is that anybody who commits themselves to coming to a new medical school and doing something like this, every single one of them is brave, every single one of them is prepared to take a risk. And, I have this fantastic team of people who have come from around the world to bring academic rigor and their expertise, and their willingness to do something new to what we have been doing. That’s really enabled the success.
DMacA: Having brought this team together, and you’re now standing on the quay side as they sail off in the future with the medical school, what will you say to them as they leave?
LD: Primarily, you’ve got this. You can do this. You are a really capable competent group of people. And, I have no doubts and no concerns that you can just take it to the next steps.
DMacA: And, the final question must be to ask you, what is the future for yourself?
LD: The future for me is…I’ve actually not really planned it. I’ve deliberately planned to not fill it yet because my life has been so full of work, and so full of everybody else’s agendas, that I haven’t allowed myself time to decide what my own agenda is. I feel a need to be creative in some way but I haven’t actually decided what that’s going to be. I want it to evolve. I want that to be an organic process in my head, and I want the opportunity to get bored because I feel that out of that, I will then be able to start to formulate what it is I really want to do. It won’t be nothing. And I think it’ll be something creative. Watch the space.
DMacA: It’s interesting to hear you say that you’re going to take time to think about what you’re going to do, because I’m not sure that you actually realize what you’ve achieved. To have created this medical school, and launch this new group of doctors having started certainly from scratch, has been a wonderful achievement. And I have to say, I greatly applaud you for that. Thank you so much for chatting to us today.
“my life has been so full of work, and so full of everybody else’s agendas, that I haven’t allowed myself time to decide what my own agenda is. I feel a need to be creative in some way but I haven’t actually decided what that’s going to be.”
Not many people are responsible for creating a medical school. And, after this inspiring conversation, I asked Louise to suggest a few relevant pieces of work. I hope you enjoy this selection:
1. As a wonderful summary of educational theory written by one of the greats. Mann, K.V. (2011), Theoretical perspectives in medical education: past experience and future possibilities. Medical Education, 45: 60-68. https://doi.org/10.1111/j.1365-2923.2010.03757.x
2. Another lovely summary written by Brian Hodges, another person for whom I have utmost respect. Hodges, Brian David MD, PhD; Kuper, Ayelet MD, DPhil. Theory and Practice in the Design and Conduct of Graduate Medical Education. Academic Medicine 87(1):p 25-33, January 2012. DOI: 10.1097/ACM.0b013e318238e069
3. An interesting read about how we aim to bridge the theory-practice divide: Wald, Hedy S. PhD; Anthony, David MD, MSc; Hutchinson, Tom A. MB; Liben, Stephen MD; Smilovitch, Mark MD; Donato, Anthony A. MD, MHPE. Professional Identity Formation in Medical Education for Humanistic, Resilient Physicians: Pedagogic Strategies for Bridging Theory to Practice. Academic Medicine 90(6):p 753-760, June 2015. | DOI: 10.1097/ACM.0000000000000725
