New to the railway

[CS09]

Good Morning all,

I have come for a little bit of advice, but first please allow me to introduce myself. I am a 29 year old male, a type 1 diabetic who is shortly going to be starting a career with Southern.

At age 12 I was diagnosed with type 1 diabetes (I medicate with insulin injections) and was told I will never be a pilot, captain, train driver, taxi driver, bus driver or be allowed to operated any sort of heavy machinery (cranes etc). I was also told to forget about the fire service, military and the police force as well. At 12 years old my career was at the back of my mind but the more I thought about it these sorts of jobs were all things I wanted to do so decided to set out to prove my GP (who told me I would never perform these roles) at the time wrong.

At 21 I joined the police as a civilian and a few years later was offered the role of a constable with the met police. At the point of the job offer I was told I would never be able to join the firearms squad or be insured to drive the fleet vehicles due to my condition. Dejected, I turned the job offer down. I also made it through the recruitment process for the fire service, only to find out the same GP now worked as medical officer for my local station and I was suddenly turned down after interview. I also got through the first stages for a role with the RAF but was told they have a 'no diabetics' rule. I looked at air traffic control but at the time they also excluded diabetics. However I see now they will consider applications from diabetics but my current situation means I cannot afford the pay cut when training.

Fast forward to today and after working in airport security for a while I have been offered a job with Southern as a train conductor. Once my GP (a new one thankfully) sends of my medical history I should hopefully be starting with the company in June. Next month I also have assessment day for the role of a trainee train driver with Southern. Whilst I am very excited at the prospect of being a conductor, I would prefer to be a train driver. I have liased with the occ health team who have told me they have recently started considering diabetics for the role but it is still a grey area. I will have conditions imposed upon me to keep myself fit for the role as a conductor and imagine if I was successful in becoming a trainee train driver similiar conditions would be required.

Which leads me to this, has anyone with diabtes or a similiar condition (or non-similiar condition with similiar methods of control) have experience or insight into being a train diver and what you have done/been advised to do to keep yourself fit for the role?

Does anyone in recruitment or medical fields have any advice or information that may be relevant to a type 1 diabetic looking to become a train driver?

I appreciate the time anyone has taken to read this and look forward to reading any replies. If the train driver application does not amount to a job offer I am still of course very eager to start working as a conductor, so any other diabetics (or non diabetics with medical conditions) who can offer advice in doing this role successfully then please do share.

For what it's worth my HBA1C is currently 6.3% and my general control of my diabetes is good with no hypoglaecemic episodes in over 18 months and only 2 disabling hypos in 15 years.

Regards,

Carl,

 

[E&W Lucas]

Have you declared your medical history?

I'm presuming the following is a reliable source of information. I'm certainly aware of people that developed insulin dependent diabetes, sadly being required to come off footplate duties.
http://www.diabetes.org.uk/Information-for-parents/Growing-up/Work-and-discrimination/

 

[plastictaffy]

I think, in your position, I'd be sticking with the Guard's position for now. You've done very very well to get as far as you have - it's incredibly difficult for someone without Diabetes to get a railway job, let alone someone who's been told in the past that he's pretty much going to end up stacking shelves in Tesco.

Get yourself into Southern, get yourself through the training and settled within the company. Once you have your feet under the table, then start asking the questions and knocking down even more barriers. Enjoy your career with Southern - welcome to the rest of your life!!!

 

[redbutton]

Honestly, this is really something that only the Occ Health office can advise you about, since they would be the ones who pass you as fit to drive trains. However, once you're "in the door" you'll have better access to ask them these questions.

Congratulations on making it this far, and if I could offer any advice it would be to do the best you can in your new role as a Guard. Diabetes or no diabetes, if you're not giving it 100% in your current job, the company won't be likely to consider you for the next one.

Good luck!

 

[CS09]

Have you declared your medical history?

I'm presuming the following is a reliable source of information. I'm certainly aware of people that developed insulin dependent diabetes, sadly being required to come off footplate duties.
http://www.diabetes.org.uk/Information-for-parents/Growing-up/Work-and-discrimination/

Yes, I have given my GP permission to disclose my full medical history. At first stage of diagnosis, diabetes control is likely to be very poor at best so that decision would seem correct. I wonder if those persons could go on demonstrate adequate control to be allowed to return (just thinking aloud). Thank you for the link.

I think, in your position, I'd be sticking with the Guard's position for now. You've done very very well to get as far as you have - it's incredibly difficult for someone without Diabetes to get a railway job, let alone someone who's been told in the past that he's pretty much going to end up stacking shelves in Tesco.

Get yourself into Southern, get yourself through the training and settled within the company. Once you have your feet under the table, then start asking the questions and knocking down even more barriers. Enjoy your career with Southern - welcome to the rest of your life!!!

Very good advice, perhaps the high of being offered the conductor role led to some delusions of grandeur on my part. Thank you, at 29 I may finally have found the company to retire with!

Honestly, this is really something that only the Occ Health office can advise you about, since they would be the ones who pass you as fit to drive trains. However, once you're "in the door" you'll have better access to ask them these questions.

Congratulations on making it this far, and if I could offer any advice it would be to do the best you can in your new role as a Guard. Diabetes or no diabetes, if you're not giving it 100% in your current job, the company won't be likely to consider you for the next one.

Good luck!

Very true, I did speak to occ health but they themselves were quite unsure. It does appear to be untested waters with regards to type 1 diabetic train drivers. I have had quite in depth discussions with the recruitment lead as I was hoping to start in April, but there was a delay in my GP's clinic responding to the request for my records so I will be unable to start until June. Please don't believe my interest in becoming 'patient zero' for driving will deduct from my effort and enthusiasm for the conductor role. I had never prepared for an interview in such depth my entire lift. I cannot wait to start my new career.

Thank you again for the encouragement

 

[455driver]

So you have basically applied for every job you were told you couldnt do! Why?

My 20 year old son applied to the RAF and was declared permanently unfit due to having 2 doses of steroids when he was born, he has just completed the Plymouth half marathon in under 2 hours and 10 minutes, he is that unfit, after the shock he started looking into jobs that are available to him and is doing very well.

You will not be accepted as a train driver (or any of the other jobs on that list) because of your injections, it wont change anytime soon so just accept it, life isnt fair and trying a one man crusade against it wont change anything but will eat away at you leaving you very disillusioned with life. If you did get through by withholding the information and the company didnt get the info from your doctor then when they did become aware of it you would be sacked, if you were involved in any sort of incident where your type 1 could have been a contributing factor then you would end up in front of the Judge on some very serious charges. The railways rely on honesty, if it is proved you have been dishonest then dont expect anyone to help you!

Why dont you spend your time looking into the jobs you can do rather than the ones you cant!
--- old post above --- --- new post below ---

For what it's worth my HBA1C is currently 6.3% and my general control of my diabetes is good with no hypoglycemic episodes in over 18 months and only 2 disabling hypos in 15 years.

So with over 30 years working left in you there is the potential for you to lose consciousness 4 times when at the control of a train!
Yes this is a worse case scenario but do you see the problem?

A conductors role, while still safety critical, wont have the same potential for problems.

 

[CS09]

So you have basically applied for every job you were told you couldnt do! Why?

My 20 year old son applied to the RAF and was declared permanently unfit due to having 2 doses of steroids when he was born, he has just completed the Plymouth half marathon in under 2 hours and 10 minutes, he is that unfit, after the shock he started looking into jobs that are available to him and is doing very well.

You will not be accepted as a train driver (or any of the other jobs on that list) because of your injections, it wont change anytime soon so just accept it, life isnt fair and trying a one man crusade against it wont change anything but will eat away at you leaving you very disillusioned with life. If you did get through by withholding the information and the company didnt get the info from your doctor then when they did become aware of it you would be sacked, if you were involved in any sort of incident where your type 1 could have been a contributing factor then you would end up in front of the Judge on some very serious charges. The railways rely on honesty, if it is proved you have been dishonest then dont expect anyone to help you!

Why dont you spend your time looking into the jobs you can do rather than the ones you cant!
--- old post above --- --- new post below ---


So with over 30 years working left in you there is the potential for you to lose consciousness 4 times when at the control of a train!
Yes this is a worse case scenario but do you see the problem?

A conductors role, while still safety critical, wont have the same potential for problems.

I applied for the jobs I was told I could not do because it is my opinion that a straight refusal is presumptuous and that I should be given the opportunity (if I met all the other minimum requirements) to demonstrate I can safely perform the role. It may be a personality flaw of mine but I have no malicious intent.

The role I applied for in the RAF was very similar to the civilian role I had with the police. There are roles the RAF will refuse a diabetic on medical grounds that a diabetic could be accepted for in an identical civilian role.

To say I will not be accepted as a train driver is unfair, especially when I have already had discussions with occupational health who have informed me they will consider applications from diabetics, providing they can provide proof that it does not pose a risk to them performing the role of a train driver. I am unsure to what depth your knowledge of diabetes goes, but it is different for every individual. Each individual diabetic will respond differently to carbohydrate intake, insulin ratios and the risk of hypoglycemic attacks without warning. There is always a risk with diabetics, however certain individuals can be capable of looking after their diabetes to a point where the risk is no greater than that of a non diabetic. When I become a conductor I have been told that I must test my blood glucose every two hours whilst on duty and inform a relevant supervisor if the results fall outside my safety threshold. This means the risk is acceptable to allow me to perform the role. I imagine similar conditions could be incorporated into a train driver role and with consultation with doctors, diabetic and nutritionists this role could be opened up to diabetics.

No, life is not fair. Accepting this and living within the limitations is perfectly fine but I find this difficult. I am not on a one man crusade and I am not a bitter person having a sulk. The fact that the role of an air traffic controller was recently opened u to diabetics if they could prove themselves fit enough to perform with minimal risk is proof that with a bit of determination and patience opportunities can be created for persons living with limitations they have had imposed on them. There are risks in all aspects of life, I have to prove my ability to drive and prove I have not had any issues with my health. The fact I have suffered two episodes of hypoglycemia may disqualify me from being a driver, but another diabetic who has not could go on to be successful.

I assure you I have been 100% up front with everything in my applications.

Yes I see your worst case scenario but as I have alluded to, a good diabetic can reduce these risks to a similar level as a non diabetic driver.

Thank-you,

 

[455driver]

A very nice clear reply, thank you!

my knowledge of diabetes is okay but obviously nowhere near as good as yours.

if an air traffic controller collapsed then although it would be very inconvenient you would just have a lot of planes in holding patterns while another ATC takes over, if a driver collapses at the wrong time then a train could collide with another train or the buffers which is a far more serious problem.

I agree about you being able to manage your condition, but you state you have had 2 disabling hypos in 15 years, where as I have had none (I would hope no train driver has ever had one).
Who do you think will sign you off as fit (and put their name to it) knowing that there is a small (but still present risk) of you collapsing at the controls and them ending up in Court explaining their actions?
The risk is very small but it is still there!

You never know you might get on with the Conductor role and thoroughly enjoy it, I know many guards that have no intention of going driving while others will only do it when they get bored of the guards role.

 

[Islineclear3_1]

As a T1, you have excellent control and balance your food with the correct dose of insulin...right?

Have you ever had a hypo? Have you ever considered what might happen if you had a hypo at the controls in the cab? Have you ever forgotten to inject or left your insulin at home (i.e. leaving in a rush etc)?

 

[CS09]

A very nice clear reply, thank you!

my knowledge of diabetes is okay but obviously nowhere near as good as yours.

if an air traffic controller collapsed then although it would be very inconvenient you would just have a lot of planes in holding patterns while another ATC takes over, if a driver collapses at the wrong time then a train could collide with another train or the buffers which is a far more serious problem.

I agree about you being able to manage your condition, but you state you have had 2 disabling hypos in 15 years, where as I have had none (I would hope no train driver has ever had one).
Who do you think will sign you off as fit (and put their name to it) knowing that there is a small (but still present risk) of you collapsing at the controls and them ending up in Court explaining their actions?
The risk is very small but it is still there!

You never know you might get on with the Conductor role and thoroughly enjoy it, I know many guards that have no intention of going driving while others will only do it when they get bored of the guards role.

Of course, and just to clarify I fully support that those who could pose a risk should not be considered for the role. This isn't about letting me personally drive a train as my two past episodes of disabling hypoglycemia will present a risk, but about a diabetic who could demonstrate a level of control that offers no greater risk in driving a train than the hypothetical scenario in that a tired driver might fall asleep at the controls.

The fact a blanket ban has changed to some form of consideration being given is exciting and whilst I probably seem to present it as hyperbole I do appreciate the insight from those in the know.

I am certain I will enjoy the conductor role, I have an anticipation about starting I have not experienced with any previous job I have held.

As a T1, you have excellent control and balance your food with the correct dose of insulin...right?

Have you ever had a hypo? Have you ever considered what might happen if you had a hypo at the controls in the cab? Have you ever forgotten to inject or left your insulin at home (i.e. leaving in a rush etc)?

I do have excellent control, I calculate how much insulin I require based on my food intake, I know how much insulin will lower my blood glucose and know the effects of exercise. For example I could wake up with a certain blood glucose reading and plan a breakfast meal and insulin dose that would keep my sugar levels within a safety threshold for any amount of time. It takes less than a minute to perform a test to ensure it is still within that threshold.

Of course I have considered the consequences, and again I fully support that anyone posing a risk should not be considered.

I have never forgotten to take my medication out with me.

Thank you for the feedback

 

[Islineclear3_1]

I guess if (for example), you are successful in obtaining a position as a guard or conductor, you are usually in a carriage full of people who could come to your aide if the worst was to happen. And if you can demonstrate through the course of of work that you have excellent glycaemic control, then who knows?

All the best of luck!

 

[CS09]

I guess if (for example), you are successful in obtaining a position as a guard or conductor, you are usually in a carriage full of people who could come to your aide if the worst was to happen. And if you can demonstrate through the course of of work that you have excellent glycaemic control, then who knows?

All the best of luck!

Thank you!

 

[Bayum]

So you have basically applied for every job you were told you couldnt do! Why?

My 20 year old son applied to the RAF and was declared permanently unfit due to having 2 doses of steroids when he was born, he has just completed the Plymouth half marathon in under 2 hours and 10 minutes, he is that unfit, after the shock he started looking into jobs that are available to him and is doing very well.

You will not be accepted as a train driver (or any of the other jobs on that list) because of your injections, it wont change anytime soon so just accept it, life isnt fair and trying a one man crusade against it wont change anything but will eat away at you leaving you very disillusioned with life. If you did get through by withholding the information and the company didnt get the info from your doctor then when they did become aware of it you would be sacked, if you were involved in any sort of incident where your type 1 could have been a contributing factor then you would end up in front of the Judge on some very serious charges. The railways rely on honesty, if it is proved you have been dishonest then dont expect anyone to help you!

Why dont you spend your time looking into the jobs you can do rather than the ones you cant!
--- old post above --- --- new post below ---


So with over 30 years working left in you there is the potential for you to lose consciousness 4 times when at the control of a train!
Yes this is a worse case scenario but do you see the problem?

A conductors role, while still safety critical, wont have the same potential for problems.

Train driver or not, this is a disgracefully negative post and I deplore you for it.

Had I followed my doctor's advice as a youngster, I would not be walking, I would be a confined to a wheelchair and I probably wouldn't be a teacher either.

Yes, I understand the railways are different due to the safety aspect. Have you been made aware that 'anyone' can suffer a hypoglycaemic attack at any stage of their life? The risks are there for anyone - surely a diabetic whose disease is well controlled with insulin and diet is better than someone who has no idea what is going on within their system?

 

[plastictaffy]

Thank you, at 29 I may finally have found the company to retire with!

The job, not the company. I think there'll be a fair few franchise changes before guys our age retire!!!!

 

[Islineclear3_1]

Have you been made aware that 'anyone' can suffer a hypoglycaemic attack at any stage of their life? The risks are there for anyone - surely a diabetic whose disease is well controlled with insulin and diet is better than someone who has no idea what is going on within their system?

This is not strictly true. Non-diabetics generally do not have hypos because if the body senses it is low in glucose, mechanisms are in place to convert stored fat to glucose and bring the body back into balance. Type II diabetics usually produce too much insulin and therefore do not hypo. Type I diabetics cannot produce their own insulin and therefore are more prone to hypos if they don't inject enough insulin. There are exceptions of course which is OT for this thread.

 

[ComUtoR]

Evening all,

There is a clear difference between a known risk and an unknown one. Enterring into a role pushes the onus onto the employer and they have to determine what is an acceptable risk. The employer then becomes liable for every action that employee takes. IF, and a capitalised if, an incident was to occur then questions would be asked.

As a passenger I know that the TOC has made sure that the guy/gal up the pointy end is medically fit for duty and fully competent to take me into town. This makes me feel all warm and snuggly inside as well as giving me the confidence to take my kiddywinkles with me.

I am fully prepared to accept that accidents will happen. IF, oh look another big if, a driver hasnt slept, is feeling ill, has a sudden heart attack, randomly drops dead, or whatever. Then that I can accept and any liability cannot be assigned as *£^& happens.

The medical assessment exists for a reason and like it or not we do have to accept it.

I can tell you that there is a diabetes test for drivers and you will be tested regularly as a railway employee. As a diabetic you are also subject to an increased ammount of medicals. This isnt discrimination and other medical conditions require an increased frequency of occupational health medicals.

As far as I am aware. Type 1 will prevent you from becoming a Driver but Type 2 doesn't. I am unsure if it prevents you enterring the grade but I know plenty of Drivers who are Type 2.

Congratulations on joining the railway. I hope you enjoy your new role.

FYI
Grandma (Dad's side) : Type 1 (RIP)
Dad : Type 2 (ex railway)

 

[Bayum]

This is not strictly true. Non-diabetics generally do not have hypos because if the body senses it is low in glucose, mechanisms are in place to convert stored fat to glucose and bring the body back into balance. Type II diabetics usually produce too much insulin and therefore do not hypo. Type I diabetics cannot produce their own insulin and therefore are more prone to hypos if they don't inject enough insulin. There are exceptions of course which is OT for this thread.

I'd just like to point out that a hypo is a result of sugar levels falling within the body, something that insulin helps to do. Therefore a type 1 is more at risk of suffering a hypo attack just by injecting insulin, if that's the argument you are attempting to put across. Type 1 and 2 diabetics who have too much circulating glucose in their systems. The inability to reduce this leads to a condition known as ketoacidosis, where the body is unable to utilise the glucose for energy, so instead breaks down fats for energy. Whilst a coma as a result of this is likely to occur after 48-36hrs, the symptoms in the buildup can be disabling.

The mechanism of the body releasing glucagon to promote the raise in sugar levels happens in most individuals regardless of their diabetic background. In type 1 and type 2 diabetics this can be impeded because of the nature of the insulin circulating in the blood.

My point about the hypoglycaemic attacks in diabetics vs health individuals is that someone with well controlled diabetes is more likely to notice their encroaching attack. I'd rather this than someone who has no idea what is happening to them.

 

[CS09]

The job, not the company. I think there'll be a fair few franchise changes before guys our age retire!!!!

Ah yes, didn't think of that!

Evening all,

There is a clear difference between a known risk and an unknown one. Enterring into a role pushes the onus onto the employer and they have to determine what is an acceptable risk. The employer then becomes liable for every action that employee takes. IF, and a capitalised if, an incident was to occur then questions would be asked.

As a passenger I know that the TOC has made sure that the guy/gal up the pointy end is medically fit for duty and fully competent to take me into town. This makes me feel all warm and snuggly inside as well as giving me the confidence to take my kiddywinkles with me.

I am fully prepared to accept that accidents will happen. IF, oh look another big if, a driver hasnt slept, is feeling ill, has a sudden heart attack, randomly drops dead, or whatever. Then that I can accept and any liability cannot be assigned as *£^& happens.

The medical assessment exists for a reason and like it or not we do have to accept it.

I can tell you that there is a diabetes test for drivers and you will be tested regularly as a railway employee. As a diabetic you are also subject to an increased ammount of medicals. This isnt discrimination and other medical conditions require an increased frequency of occupational health medicals.

As far as I am aware. Type 1 will prevent you from becoming a Driver but Type 2 doesn't. I am unsure if it prevents you enterring the grade but I know plenty of Drivers who are Type 2.

Congratulations on joining the railway. I hope you enjoy your new role.

FYI
Grandma (Dad's side) : Type 1 (RIP)
Dad : Type 2 (ex railway)

Thank you, I am sure I will enjoy the new role. I appreciate the comment regarding the difference between type 1 and type 2 diabetics - two very different conditions. The non-diabetic often does not know the difference (and no reason why they would be expected to). I can restrospectively assume that occ health at the time of my prinicpal discussions were perhaps responding to a diabetic query (which was correctly answered) without considering the details required for a more specific response differentiating between the two types. Nonetheless you have likely answered my original query so thank you!

I'd just like to point out that a hypo is a result of sugar levels falling within the body, something that insulin helps to do. Therefore a type 1 is more at risk of suffering a hypo attack just by injecting insulin, if that's the argument you are attempting to put across. Type 1 and 2 diabetics who have too much circulating glucose in their systems. The inability to reduce this leads to a condition known as ketoacidosis, where the body is unable to utilise the glucose for energy, so instead breaks down fats for energy. Whilst a coma as a result of this is likely to occur after 48-36hrs, the symptoms in the buildup can be disabling.

The mechanism of the body releasing glucagon to promote the raise in sugar levels happens in most individuals regardless of their diabetic background. In type 1 and type 2 diabetics this can be impeded because of the nature of the insulin circulating in the blood.

My point about the hypoglycaemic attacks in diabetics vs health individuals is that someone with well controlled diabetes is more likely to notice their encroaching attack. I'd rather this than someone who has no idea what is happening to them.

Correct, a well disciplined diabetic can detect hypo warning signs and counter them before they have any adverse effect on said person. It appears people would prefer a known risk to an unknown one, such as an undiagnosed heart condition disabling a train driver. However, anyone could have an undiagnosed condition that a standard medical would not detect so of course this cannot become a deciding factor.

I guess the only way to decide if letting type 1's drive trains is a risk, is to take the risk. Maybe stick us all in train sims for a year and record performance against blood sugar levels

I asked the initial question with very limited knowledge so I appreciate those that have replied giving their insight, I have certainly learned a lot about how diabetes is looked at in the rail industry.

Thanks to all,