Should the UK doctors strike? I don't know but they have.
A TV news reporter said something that irked and rankled last night
"It might backfire due to public opinion"
Public opinion my a*** (as per TV show Royale family).
I don't suppose many trainees are at the point where public opinion matters any more as it takes a LOT to get a medic to strike. Public opinion won't pay the mortgage.
But hey I am getting a tad political here and I don't thing thats helpful - so I will desist! But not before sharing a video
When I am in need of medical care - I'd like to think that these lads and lassies will be practicing medicine.
It is worth me pointing out that Medical Forum does not exist to drain the NHS of its personnel but to facilitate as many as possible remaining in clinical practice but in a way that gives them the work life balance they need to continue - whether as GPs, consultants or trainee. Occasionally for health or other reasons a radical change of career is needed or wanted. We help that too.
As a result of this work we are in an unique position to see what is driving some doctors away from the practice of medicine but also - what might bring them back!!!
Medicine never fails to amaze me - or rather its brethren do
Today there are doctors on strike
Some are so fed up they want to leave but most just want to pursue the career which has taken them a long time to create.
And yet others are keen to join the profession - some as mature entrants - even in spite of all the disillusionment stories that abound.
I am often reminded that one persons dream career is another person's nightmare. It all depends on the level of match between who you are as a person right now and what you are being expected to do.
I don't suppose I am the first person to come up with the concept of career mismatch - but I certainly did before I had read it anywhere.
People are attracted into medicine for all sorts of reasons - some of them valid - some not.
Not only this but the job changes as one proceeds. Not only this but the person changes too and what they want or need from work changes. Yet the medical behemoth just keeps on going and at no time are you ever asked whether your job or workstyle or content actually now fits you. The potential for job mismatch is huge.
Sometimes I speak to people whose sole reason for joining our programmes is "to leave medicine' yet when we go through in detail what it is they are so disillusioned with - there sometimes emerges - unexpectedly for them - options for remaining in medicine yet in a modified way.
I am thus often reminded that if only someone would do this in the natural course of medical careers - maybe more doctors would say they have their dream career instead of suffering burnout and dismay.
Asking someone how their work could be improved is of course only the first step - it would then need to be implemented. But how much money or resource is lost to the NHS through not asking the question "what can we do to improve your job".
Should the doctors strike? I don't know but they have.
A TV news reporter said something that irked and rankled "It might backfire due to public opinion"
Public opinion my a*** (as per TV show Royale family). I don't suppose many trainees are at the point where public opinion matters one jot. Public opinion won't pay the mortgage.
But hey I am getting a tad political here and I don't thing thats helpful - so I will desist!
It is becoming a pandemic
Doctors thinking about not being doctors any more.
This is not a good situation for any of us.
When any of us are in a car crash - don't we want the local A+E department to be well staffed with interested and well trained medics? When our child has a persistant fever don't we want to be able to book into see the GP.
Well - if we aren't all very careful - these privileges will no longer exist.
This impending exodus has happened because of a series of issues that include
government interventions in training, income and working styles
media portrayals of medicine and health
expectations of working life
So what should a medic who has had it with the above do?
Should they leave medicine?
Well some are on strike trying to protect their careers and hats off to them.
Leaving a vocation and something that you have worked so many years to achieve involves all sorts of heartache and yes - grieving.
But could "should I leave" actually be the wrong question
A better question might be
"should I explore all my career options?"
And I think the answer to that is yes.
I must say that even with consultant level medics who join our programmes - it is not uncommon for the presenting complaint to be "I want to leave medicine". However with a better career plan a surprising number then end up remaining ( although perhaps not full time) in clinical practice. Why? Because once a person no longer feels trapped and has other sources of income and there seems to be an interesting and motivating career plan ahead - the practice of medicine can easily start to be enjoyable again. Paradox perhaps - but I have seen this dozens of times.
Some posts ask a LOT of their personnel
Some push people to the edge of the tolerable envelope
There is nothing wrong with a demanding job per se.
The is nothing wrong with stretching people - indeed it helps to build resilience if done sensitively.
But here is the caveat - one does need to check that people are not being constantly overstretched
and that the demands being made of them are not pushing them beyond what they can reasonably manage... day after day after day
And this is where many employers - including sadly the NHS ( an organisation one might like to think had health and healthy workplaces high on its agenda ) simply fail to deliver.
Building a resilience culture starts from acknowledging that people are not workhorses but individuals with differing needs, personalities, skills, comfort zones, risk aversion ( I could go on).
Training in resilience and avoiding burnout are now becoming common place in the USA as they have twigged that they are losing physicians and I don't just mean to the commercial world. 400 doctors a year in the US commit suicide. Admittedly they have more doctors than we do in the UK but this is bad because it is nearly 3 times the average rate of suicide in the population.
Chicken and egg - are more suicide prone people attracted to medicine?
Are medical training courses and working patterns more likely to cause their trainees to develop mental problems?
There are many questions to answer.
But it is vital that more training of resilience and self care and burnout prevention skills take place.
Few medics I have spoken to have received any training in these areas.
How long should one leave feelings of being on an unsatisfactory or unsustainable career path before seeking help?
This is a challenging and deep question.
On the one hand - day to day ups and downs are inevitable in any job and developing a certain degree of resilience to those is vital in any career.
On the other - leaving things until levels of stress, burnout or frank depression regarding a career that is not feeling "right" often results in a spiral downwards and at times this even precludes seeking career guidance. Why? Because the process of undergoing career guidance really effectively is one where a person needs to be in the right frame of mind - namely - relaxed, open minded and creative with time and energy to put to it. Rather too often we see professional people who are worn out and quite down about their career situation. In these cases we need to do some work with the individual to ensure they are not just wanting and needing career support but that they are ready and able to engage with it.
It is my view that our workbook is almost a diagnostic tool for depression in that when a person is suffering low mood - they find it almost impossible to complete it. This is because there are searching questions within it that require some deep mulling and if a person is struggling merely to function day to day then adding what seems like just one more stress is not sensible.
This is why timing for career guidance is far more important than people may at first realise. Yes of course an unsatisfactory career situation needs addressing but if you are not in the frame of mind most likely to help you address this - then joining our programmes are in short - a waste of money.
To try to help combat this need for "pre - career guidance" warm up - I wrote the ebook "easy career change good career choice". It covers a range of things to think about way way before getting to the career guidance stage. It seems logical if one is going to spend time and money investing in ones career to be well prepared for this rather than lurching into it without much thought other than "I am a doctor get me out of here".
So the answer to the question I think has to be this. If you have career doubts or feelings of mismatch or a sense that you are not on a pathway that is sustainable or attractive - the sooner you start to address this the better. You may discover ( as a fair proportion do) that you ARE in fact in a good career path but you are not handling your career or planning it ahead as well as you could be. Conversely you may discover that there are some fundamental areas of dissonance between who you are or would aspire to be and what the career path you are on can bring. Either way - the discovery process will aid things along. In short - I would say don't leave any feelings of career disappointment, drift, dissatisfaction, plateau or mismatch as they generally don't get better. They need to be acknowledged, flushed out in full and addressed in a sensitive, realistic, structured yet creative way.
?People often ask me what career planning I do for myself.
It could of course be the shoemaker with no shoes!
However I do use most of the techniques I espouse to others. A couple are particularly useful.
I think these might well be called "advanced" level career planning - not to blow my own trumpet you understand - but because these are techniques that do not always sit comfortably with those just joining a career guidance programme and undergoing perhaps what might be the first in depth career guidance they have ever had.
1 The first technique is to simply think what I want. Ahhaaa - but that is NOT so simple if one is overwhelmed by frustration and exhaustion or if other people are muddying the waters. When I ask that question point blank 'what do you want" - I am often met with a blank look or a despairing one or the phrase "I just don't know". This presents a minor barrier to career guidance but it can be overcome . However without addressing this issue the person is likely to want you - the career guide - to define this for them.
RULE number one in career guidance - do not make other people's dreams and decisions for them!!!!
It is important to facilitate THEM to do this for THEMSELVES.
2 Having decided what I want more of ( or less of - but the more of is generally better in terms of motivation - ie carrot not stick ) I think creatively about all the possible ways in which that might be achieved and then I visualise how each way might end up or look like.
Sounds simple enough but if a person is anxious or even depressed or burnt out - thinking creatively might ( even for a highly creative person and not everyone is) be extremely difficulty.
This is why I don't recommend these approaches unless a person seems truly ready for them.
I would like to teach these techniques more as they are very effective. The challenge remains that in a room full of people - at any one time only a handful will be truly ready to engage with these techniques.
So - part of the career guidance process must involve a plan to get into a better place where one CAN adopt these techniques - even if only in part and occasionally to begin with.