A lifelong focus on women’s health

As Professor of Obstetrics and Gynaecology and Dean of Student Affairs at King’s College London, and a consultant gynaecologist at Guy’s and St Thomas’ NHS Foundation Trust, Janice Rymer has many claims on her time.

But right now, as well as meeting the needs of patients, students and administrators, Janice is playing a tense waiting game. Her husband, Roger Jones, former professor of General Practice at King’s and, until recently, editor of the British Journal of General Practice, has spent the past seven months in hospital, after contracting septicaemia from a spinal operation. He is still being ventilated, but “amazingly his spirit is positive”, she says.

In her King’s College office, filled with books and photos, she is happy to talk about her life and work since leaving the University of Auckland in 1981.

Janice and her older sister Judy were born in Australia, as were their parents. The family’s first New Zealand experience was when her father, John Rymer, became principal of Christchurch College in 1966. After four years, they moved to Auckland, when he was offered the high-profile role of Anglican Dean of Auckland, in which he stayed for the next 21 years.

He is well remembered for his role in the completion of Holy Trinity Cathedral in Parnell. As noted in his NZ Herald obituary: “Had it not been for this man, so strong in his beliefs and convictions, the building with its two distinctive – and some would say unrelated – halves might still be far from its present state of completion.”

Sporty, academic and focused, Janice thrived at her secondary school, Diocesan School for Girls. She remembers the decision to enrol in medicine at the University of Auckland was almost made for her, and she graduated in 1982 with a MBChB before adding a diploma in obstetrics and an MD in 1994. “If you were quite bright at my school, there wasn’t much debate about it.”

And if she hadn’t? “Probably physical education of some kind. My mother played tennis for Australia, and I played hockey for the University. I just loved it.”

She stays connected with her alma mater through the UK Friends of the University of Auckland group.

Janice chose her specialty fields, obstetrics and gynaecology, after a chance meeting with registrar Rosie Thomson at Middlemore.

“She pointed out that obstetrics is really exciting, and generally positive. And then you have gynaecology, where there’s a lot of surgery involved. Plus, in hospitals it’s largely old people, whereas with obstetrics and gynaecology, it was largely young women. And I thought, ‘Yes, that makes sense’, so I did it.”

Another influence at the time was Professor Dennis Bonham, who urged her to sit her specialist exams as soon as she could if she wanted to be taken seriously.

“So I did, and he was right. I was also helped by the fact that New Zealand’s clinical training was excellent, so when I came to London, I did a research degree on osteoporosis and HRT. That put me in line for an academic career, as well as a clinical one.”

After two years as a registrar in New Zealand, Janice went to the UK to get a wider range of experience, as many doctors did at the time. After an initial post outside London, she was employed at Guy’s, which then merged with St Thomas’. The trust that runs them is one of London’s most prestigious teaching hospitals, but, like all NHS institutions, is under increasing budget and waiting list pressures. How to address the degradation of the NHS is one of the hottest topics in UK politics.

Janice, 65, is no longer involved in obstetrics; her specialisations are endometriosis, a painful disorder that is difficult to diagnose and has devastating effects on fertility, and menopause. She also has a small private client list, but teaching takes up the larger part of her time.

Just as she is saddened by the erosion of the NHS, she is also concerned about medical students: who gets into this competitive field, how they train, and where they end up.

“I think we could select our medical students better, making it a graduate degree so you would get people who were more mature and motivated. I think this might help with weeding out those who just want to go into The City or get into business. There’s also a real move away from setting up as partners in general practice, with people preferring just to be employed. This isn’t good, either.”

While cognisant of the need to cut back on the brutal 120-hour weeks that junior doctors endured in her time, she fears the effects of EU regulatory changes that, for example, set maximum working hours per week.

“Because of limitations on hours, I get a different person turning up to operate with me each week. So, how can I train someone? And how can I be a role model? The registrars have nobody to bond with, to help support them when there has been a difficulty.”

Janice is pleased that women’s health, which has always been neglected, is now getting more attention.

“We’re all more vocal about it now, but it’s still lagging behind. We don’t get as much operating time as other specialities, and there are terrible delays in diagnosis – seven years for endometriosis. But one good thing is there are more women coming into the area of obstetrics and gynaecology. Patients feel reassured by that. It’s easier to talk about the whole business of their gynaecological health with another woman.”

There have been many changes in the world since Janice was told, in Whangārei in the 1980s, that she was a good surgeon but the problem was, she was a woman.

“I realised then it was just going to be an uphill struggle if I went for general surgery. So, I’m glad I made my decision, and that women’s health is getting the priority it deserves.”

Though perhaps not everyone has received the memo. Recently, Janice had a young male medical school student in her office after he wrote a much-shared social media post in which he mocked the idea of women’s rights. As she trenchantly pointed out, every female patient, teacher and doctor could legitimately refuse to engage with him. He only very narrowly escaped being thrown out of King’s, and he certainly won’t want to be seeing any more of Professor Rymer.

When she’s not insisting on the best from students, or operating to relieve women from pain, Janice leads a full London life. She lives on the Thames, near Tower Bridge, and runs along it regularly. She and Roger also have a house in the Cotswolds, but London is the place for her.

As she says, “Who wouldn’t love it?”