Confessions of a career guide - BLOG

This blog aims to raise and expand upon important career topics and tips. We comment on matters arising in recent weeks which have inspired us to pontificate upon or present recurring issues worthy of sharing - for everyone's benefit.
In each entry - the theme of that offering will be within the blog in bold italics.

June 24th 2010

Why is it that people in general but particularly doctors have difficulty selling themselves? I see this almost every day in the workbooks, workshops and one to one career planning programmes at Medical Forum. It is a reflection of several things. Firstly "selling" in the NHS is almost a dirty word - partly because we feel we are above it (or maybe because we are naive and don't have day to day contact with the reality of money). Secondly, when one doesn't receive regular constructive feedback on ones skills, personality,day to day work etc it can be hard to know what these are. So many times I hear anecdotes about people's huge achievements but in a "put me down" or "lets minimise this" phraseology. Now I am the first to admit no one likes a braggard - but there is such an important though fine line between arrogant boasting that is not backed up with anything resembling reality and a genuine description of exceptional abilities. More often than not I hear descriptions which either grossly "big up" someones achievements (their attempt to "sell" but missing the point somewhat) or badly undersold massive achievements. This has important implications for career progression, career diversification (when the humdrum of an original route gets too much) and general all round self confidence. And what is more - merely telling someone to "sell themselves better" does not do the trick in general - perhaps because they don't understand the whole concept of selling - let alone self selling. If anyone wants to understand "selling" more than they do and are prepared to invest some time and money - I can recommend the "psychology of selling" audio programme by Brian Tracy. It can also help with persuading ones partner/spouse that one needs a new car/laptop etc ;-)

May 23rd 2010

Todays topic is all about uncertainty. Every day pretty much - I speak to doctors who are either havering about between two extremes or who can't seem to find a goal or vision that they truly want to work towards. They are thus uncertain which route to take or uncertain what it is they want. Both of these situations can be extREMELY disabling, very time consuming and very stressful. The reasons why they have got themselves in these situations are many (notice I say "got themselves" - 100% responsibility HAS to go to the individual). However the solution is  A) the same for everyone and B) dead simple (though not easy!!)...... turn off ALL programmes/beliefs/thoughts that are negative,stop looking naval gazingly like at the current "wrong-ness" and see solutions ahead - not disasters. Easier said than done of course! At Medical Forum we have a range of workshops, distance learning programmes, DIY learning materials and face to face consultations - all of which are designed to move you inexorably towards a greater self awareness - through which you can access thoughts of what you want. what would fire you up and stop you wasting time looking at the hole you are in rather than the rope ladder that is already dangliing elusively (or invsibly) within your reach. Career guidance therefore is as much about  helping an individual to disallow or stop old ways of thinking as it is about providing a structured approach to career planning. Do what you have always done - get what you have always got. So external change in circumstance generally starts with a change within (and not with ruminative, circuitous, trapped thinking and not by looking "out there" for a magic solution). All a bit philosophical perhaps - but the point I am making is absolutely seminal to gaining career progress down a route that is truly well matched. If you don't like treading water or feeling trapped in your own self generated uncertainty - I can recommend taking some action to change this as currently your energy is haemorrhaging down the plughole. If you don't know what to do - join one of our programmes as a starting point.

April 4th 2010

The issue of when to take a year out and relating to that -when to consider having career guidance to best effect - arose today. In fact it comes up quite regularly. On balance it is perhaps safer to take a year out when you already have a plan for returning. But not everyone wants "safe" - some enjoy the unknown so it is hard to be didactic about this.

When people take a year out of their clinical careers, they usually do so for one or more of the following reasons

* feeling too stressed by work life so far to continue (perhaps due to a personality-career mismatch or some bad experiences at work)

* thinking that deferring the decision will make it easier

* running away when there are significant career doubts

* a very strong pull towards travel and the personal growth and fun (and new work experiences) this affords.

* a desire to make up for the lack of gap year pre med school

So - a mix of potentially positive or negative reasons.

Whether to seek career guidance before the year out or on returning from it is a big question.

The only way to define this is to look carefully at your reason/s for wanting a year out and to be very honest with yourself about your overall career strategy. The main advantage of seeking guidance before departing is that the time away can be more relaxed with less soul searching. It is also possible sometimes to use the year out in a productive way to enhance career pathways on ones return.

As it is possible to join a Personal Career Programme at Medical Forum at any time up to a year after a Career Review is completed - it is possible to do a Career Review at the start of a year out and progress to a PCP if this is needed -  on return.

March 2010

I have recently been referred (from deaneries) some doctors whose mental wellbeing was being adversely affected by work. On analysis of these situations several things become clear....

* at times the way in which doctors are expected to work is really not ok

* the doctors themselves are not always very good at or empowered to speak out when support or resources are grossly inadequate to allow them to do their work (and some doctors compensate for this lack by running themselves into the ground)

* at times there is a fundamental mismatch between the doctor's personality and the route they have chosen to follow . At times an unrecognised mismatch can literally cause (or tip a vulnerable person over into) mental illness

So when a career situation becomes unsatisfactory or performance is flagging one has to look at three things : the workplace setting - the ability of the doctor to speak up (and be heard AND be understood) -  whether the person is truly well matched to the work.

Without looking carefully at all three - one can easily miss the cause of poor performance, illness or deep career doubts.

December 12th 2009

Been a bit quiet on the blogging front - no point in writing if one doesn't have anything of great note to say. But now I do!

Someone I saw recently for some career guidance really sparked a strong realisation for me. And that is.... one needs three things to gain career success - a clear career "vision", the skills/talents one needs to make it happen AND (and this is where it seems most people get stuck) to take off the straight-jacket connected to a bungee chord that holds one back (better known as self esteem/self belief).

Lack of self belief is a MAJOR holding back factor in pretty much everyone's career... even those who are in fact doing pretty well.

Admittedly some are held back by the lack of "vision" (ie if one hasn't a clue what one is aiming for - this doesn't help in achieving it) and occasionally there are some skills that, if gained, would really help things along... but even then the issue that may well be holding the person back in even achieving a basic vision or attempting to gain an additional skill - is their negative thinking patterns.

This is all so very important that we have developed a new Personal Career Programme entitled "shaking off the beliefs holding back your career". It is the same price as the other programmes but for some people this one will produce results far faster than any of the others.

September 17th 2009

The sheer diversity of what medics want from their careers never fails to amaze me. Within clinical medicine what highly motivates one person is a nightmare for another. Some thrive in high risk life-death situations all day long, others want to handle end of life issues with sensitivity,yet others would find both of these immensely stressful but are in their element advising teenagers of STDs. We have had doctors become successful investment bankers or venture capitalists (and one who managed to combine this with a professorship) and those who become gardeners or dog walkers.

And what of starting one's own business ? There are corporate raider/investors like Hugh Osmond (wealth over £300 million) who studied medicine at Oxford. At the other extreme we know a doctor who is marketing her own hand made cards through the web. Still further diversity is found in medics who combine medicine with another career. Radio programme director and part time GP, jewellery designer and full time GP to name but two.

What I am getting to in a roundabout way is that "take a 100 medics and you have 100 different individual careers, career pathways and career ambitions/needs". The point of all this is that a greater acceptance and even encouragement of medical career diversity would I think be of great value to everyone. However, there appears to be a cloning process going on with some of the training changes that have been afoot over the past few years. My prediction is that doctors simply won't be cloned and if they can't find the diversity they need and a tailored approach to their own career - they are sufficiently intelligent to find it outside medicine. All I know is that when I trip down the icy front steps of my cottage in winter and sustain a dinner fork deformity - I would like to find a hospital populated by doctors who are happy in their work, fulfilled and in the right job for them with sufficient career diversity of whatever sort floats their boat to remain motivated as doctors. Medicine has the potential to provide some wonderful careers but it also has the potential to become a ball and chain if one doesn't keep an eye on the individualistic requirements of medical career planning.

August 30th 2009

I met the brother in law of a friend at a BBQ this weekend. He was in a big city financial firm nine years ago and got totally fed up with internal politics and unmeritorious promotions. He took the almighty leap and left the security of a regular salary to "go it alone". By the sound of things this was not an easy thing to do. Nine years later however and his small investment firm is one of a handful that has not lost their investors money despite the finanical meltdown all around.

Anyway - his story reminded me of how precarious is was to "leap" from a medical career and set up something that had never existed before - a career guidance outlet for doctors (and now other professions too). So much of our stories were in parallel and I idenfied with every milestone he mentioned.

He also recommended a book " Who moved my cheese?" which I have just found was written by Spencer Johnson (a co-author of on the "One Minute Manager" series and with an MD  from the Royal College of Surgeons Ireland!). This little book is all about change. " Change can be a blessing or a curse, depending on your perspective. The message of Who Moved My Cheese? is that all can come to see it as a blessing, if they understand the nature of cheese and the role it plays in their lives"- says the blurb on the book anyway. It is available through us here (and every book ordered through this link will contribute a small amount into a charity fund we are starting to provide career guidance support to doctors and other professionals who fall on hard times).

August 18th 2009

I heard this week from a doctor who wants to be a musician. I was reminded of Hank Wangford - who appears to have been able to combine a musical and medical career very effectively.

This sparked me into considering the whole issue of combicareers (like combi boilers!) which I suppose impinge on the portfolio career model. The main difference being that the portfolio career - to me anyway - has a number of features/options within it - one of which at any time might be dropped or replaced by something else. Whereas the "combicareer" suggests two very serious interests - but the "owner" of them being unwiling to let either of them drop by the wayside.

I suspect the combicareer arises because of two strong passions - whereas the portfolio career is more likely to arise due to the need for flexibility or a strong desire to keep constant change and variety. Clearly the two career "modes" overlap somewhat. But defining the contrasts between them is interesting.

Are some medical career pathways more suited to the combicareer model than others. At first glance it would appear so. However, having come across a consultant surgeon many years ago who used to spend one night a week as a chef in a restaurant - I am reluctant to put constraints on people's dreams and creativity. The point is - if you are sure what both elements of the combi are - then the next step is to work out some ways forwards. However, for sure - many people don't know what the two passions are - even though the idea and concept of a combi career is appealing.

That all said - medical careers known to be more "sessional" are probably easier to link into a combicareer plan - but I wouldn't want anyone to think that eg. because they are a consultant surgeon that there is no way on earth they could spend a month each year working in underdeveloped countries. Or because they are a trainee in anaesthetics - they can't combine that with a career in international repatriation. Or because they are a pathologist they can't also be a journalist. We have examples of doctors doing just such things. Some degree of creativity,determination and flexiblity is required from the person - but when the goal is clear it is quite amazing what can be achieved.

August 11th 2009

Fast career decision making and personality. The speed at which some visitors make the decision to join one of our programmes sometimes blows us away. Career concerns are often big issues and it is understandable when someone takes weeks, months or even years to get around to accessing one of our services - even after having registered on the web site. Then every so often a visitor joins the guest reception, starts an e-course, orders a Career Review and asks when they can book a Personal Career Programme - all within the space of what seems like minutes! It is great to see someone so definite in their actions but it prompted me to ponder why some people seem so proactive and why others tread around the edges for what seems like ages before jumping in. My conclusion is two fold. Some visitors know others who have benefitted - so that increases their confidence. For those who don't know anyone who has been through our doors - then it comes down a bit more to personality. There are loads of different ways of categorising personality types - but we have identified the "director" - who is very goal focused and fast at decision making but who may occasionally benefit from slowing down; the "processor" who likes a lot of information before deeply analysing any decision pending; the "connector" who responds faster when their peer group approves or recommends or when they have perhaps met one of us in person at some point (eg a workshop or conference presentation) ; and the "explorer" who loves to dip a toe into any new waters at every opportunity but who can easily get distracted by all the options on this site. You might like to ponder which of these four main personality types you are and how this impacts on career decision making and planning all round (not just when visiting Medical Forum!!). We have some more blurb on personality in the memberships.

August 3rd 2009

This week appears to be a week of flexible trainee issues... one after the other in fact. Must be in the air.... both finanical irregularities/inequalities in payments and  in terms of part time trainees feeling that they have not been given equal opportunities to learn - it seeming that their full time colleagues are constantly muscling in on cases that should have fallen to the flexible trainee.

With regard to payments there are several steps you can take

* firstly, bone up and keep abreast of payment entitlements in flexible working. I know... it is not rivetting stuff (unless you love facts and figures and number crunching) and is very tempting to overlook - but if and when you discover that other colleagues are being paid more than you and it is partly your fault - that stings! The moral is - don't expect the system to be fair to you - it is up to you to see that you are being treated with equality.

* secondly, tie up payment agreements ideally before you accept the post. You will find that there is more incentive for HR to resolve issues if there is a risk that workload won't be covered than there is once you are in post.

* finally, when discrepancies do seem to have arisen - put this in writing (letter not email) to A) your deanery flexible training person and B) cc to HR. Make sure that where possible you quantify the issue clearly and make a clear request to either have it rectified immediately(with backdating) or to have a meeting if there is something you have misunderstood.

* if you believe the discrepancies are not being dealt with appropriately, fairly or swiftly enough - it is possible to involve the BMA industrial relations experts. This is obviously escalating things to a level where it all gets more involved and time consuming for everyone - so there is merit in trying to resolve it by diplomatic means yourself and where there is little response - making it clear that you have no wish to escalate things but that seems to be your only option

With regard to getting an equal bite of the cherry on training - the first time you notice this happening - do not ignore it. Document it and when you have some evidence that this is a consistent problem - alert your supervisor verbally initiatially and then in writing (written not email) with a cc to the flexible training deanery person. We have seen several cases of doctors approaching CCST who are feeling very anxious about their lack of experience and who are now blaming this on the full time trainees. This is something that could have been prevented if the right actions had been taken and assertive communications delivered early on. It is very hard to suddenly "make up" years of deficiency just because CCST is now looming. We have an e-coaching programme that would very much help this sort of situation (or rather prevent it arising) but it has to be joined near the start of the problem - not when only months away from consultant applications. Blaming others is not taking full responsibility for ones career.

So if you have been a flexible trainee and recognise these issues - please alert other flexible trainees you come across that these issues CAN be dealt with and should not be ignored or brushed under the carpet with feelings of "I don't want to cause any trouble".

 July 21st 2009

Repeating contact with Medical Forum yet never taking the plunge. I recieved a phonecall message, about 9pm this evening, from a doctor who has called Medical Forum roughly every 9-12 months over the past five years. Each time they go through the same information in the same dissatisfied way - never seeming to be making any progress although apparently feeling "a bit better after talking ". This time they sort of demanded to speak to me directly and urgently (which given the time of their call seemed particularly out of order). However for once I decided to draw a line and rather than returning the call I ensured they received a message back saying what I have said annually - that before any useful career discussions can take place - it is essential for us to receive the workbook back as part of a Career Review Programme. Needless to say - we have not heard back from them.

But my final conclusion (and not only from this one situation either) is that having free telephone chats with people generally achieves little once significant career concerns have arisen. This is because the individual has not spent any structured, sensible, reflective time on their career thinking before we speak. They have not "invested" in their career - in terms of time preparing or financial - so they have not fully engaged in the process and thus can not benefit. The moral of this story is that preparation is key to seeking effective career intervention. Picking someone's brains (or offloading ones lot) for a few minutes on the phone shows a lack of understanding that accessing expertise for chronic career situations that have taken years to arise is not something that can occur through a brief chat. Harsh but true.

July 14th 2009

Today I received an email from a doctor who had - purely through using the facilities in the guest membership - managed to find and forge an ideal career route for herself outside medicine. This had been something she wanted to do for years but just didn't have the inspiration or "permission" perhaps, until she had engaged with our web site.Sometimes remarkably little career support is needed.

Does it please me that a doctor has left medicine when that happens? Yes and no.

Yes if they have intelligently utilised some simple tools to facilitate career dreams

No because I do feel that there are options in and around healthcare where, given the right career support, doctors can find their niche.

Yes because each person must determine their own route in life - it is up to no one else to define or attempt to unduly influence

No because the health service and society spends a lot of money training its medics

Yes because if the selection and training system hasn't provided sufficient support for the person to make a decision to move towards career goals that inspire them and to which they are suited - then the system doesn't deserve to keep them

No because when I fall off my garden pruning steps and break a bone - I would like there to be a happy doctor who is happy doctoring - willing to put me back together again (rather than all the King's horses and men who presumably wouldn't know what to do!)

Yes because sometimes people choose medicine when in fact it is totally the wrong route for them

So - you can see that I have very mixed feelings about the "leaving" angle (or am I just confused of Hampshire!!?)

It was a little unusual to find someone  who had taken such affirmative action whilst not needing to access the more personalised career support programmes we offer. But it just goes to show that some people need the minimum of career support to instigate changes and others need more. We are all different in how we view the world and in what skills we already have.