Making difficult career decisions
Struggling with your medical career choices?
The sort of career decisions that many people worry about for years include
choosing a clinical specialty ( even once one has been chosen - years later this can resurface)
taking time out of programme
letting go of a career dream
When faced with helping someone make a career decision that they are finding difficult - there are about 20 different methods and techniques or exercises that can really help the individual to confidently make a decision and feel happy about it - often after months or years of dilly dallying about.
A massive amount of emotional energy and time are literally sometimes completed wasted over a period of YEARS when in fact some straightforward career support would have resolved it quickly.
Thus the time spent in "panic/worry/stress" mode regarding the career - had it been spent in logical career planning methodology with some personalised reassurances via a neutral sounding board perhaps as well - there would have been a swift resolution.
Here are some of the basic career planning principles as applied to career decision making...
If the above is not helping - you may really benefit from an objective evaluation by an experienced medical careers adviser where we can apply the other 16 methods and offer a neutral yet challenging sounding board and an objective view of your career and how you fit it and it you. Book in for our Career Review Programme perhaps?
There are a myriad of other options for doctors - some involve clinical work and some like medical informatics may not - but the main thing to keep in mind is - what do you love doing and what would you like more of ( NOT what would you like LESS of - as latter is negative and one can not easily persuade a brain to work towards negatives - it is simply not motivating - Oh and that is technique number 5 !!).
or - why goal setting is hard
I speak to clients from time to time who appear to have a real problem with goal setting and it has prompted me to muse a tad on the topic.
I see it as absolutely critical to achieving progress in career planning.
It is a useful life skill to have.
So why would someone not wish to adopt it
A feeling that somehow it is not "nice" to set goals or to want or to achieved
Where might that come from - possibly parental attitudes, school experiences or religious influence inculcating that somehow it is not OK to earn a comfortable living or that one should not be motivated by money. I happen to disagree with the first point and agree with the latter but thats another blog post.
A dislike of the process of goal setting could on the one hand merely be a preference.
But given that it is a crucial part of career planning one has to question - why a dislike? It is perfectly acceptable to dislike things. I dislike the idea of jumping out of a plane - and I have reasons. I get very motion sick, I have a mild BPV which means that tumbling through the air might well cause me to become very unwell - not great if one has to recall to pull the parachute chord. Even if I didn't have a good reason I would still be entitled to not want to jump out of a plane - merely as preference. However if I wanted to get a certificate of skydiving - then one would need to examine in more detail the reasons to see if any of them could be overcome.
Similarly if a person dislikes making money - that is their choice. However in our society - most of us have to earn money and earning it in the best way for our particular blend of skills and wants from work will lead to a greater sense of satisfaction and enjoyment. This in turn increases our wellbeing outside work and facilitates work life balance and more. So it makes sense to like making money if it is a byproduct of a career one truly enjoys and feels well suited to in all aspects. Taking this a bit further - conversely not like making money could adversely affect ones ability to find the career that best matches as the attitude of "I don't want to make money - its bad to make money" could well be sabbotaging ones decision making regarding career choice or career planning or indeed setting career goals. Thus one possible cause of hating anything to do with goal setting is that it relates to achieving ( ie if achieving has been somehow programmed into you as something you should not aspire to)
I can think of many other reasons why a person might not want to set goals and whilst I am accepting that the whole world may not be motivated by goals - my own experience of setting them has been very positive, my experience of encouraging clients to do so has also been very positive too. Thus if a client appears to have some difficulty with or dislike of goal setting - I always feel I have to explore this further.
If there is resistance - there will be reasons for resistance as a person who is open to trying new things and learning new skills would normally accept that for their career path to be decided or to change direction - some goals are going to need to be set and that to attempt career planning or career change without addressing any rusty or vestigial goal setting skills is to court a very long drawn out career reevaluation and one that may easily drift off course.
One of many key techniques within goal setting is that of "writing them down". Rather simplistic you might think. However the process of actually writing them ( and I feel that handwriting them does more to imprint them than typing but each to their own - I also use a vision board app ) seems to do something interesting to the subconscious.
So why don't we all have our key life goals written down and refer to them daily? Probably because no one has suggested to you that it might be a useful thing to try. Or because you are someone who needs a bit of help with not only deciding what they should or could be but with the process of the setting them too ( there is a methodology).
Is there anything wrong with or painful about setting goals? Plenty. A whole separate article could be written on problems relating to goal setting. For example - one needs to know what goals to set and this can be a huge and anxiety provoking challenge for some people. Some people become obsessive about their goals - their choice - its probably what makes Olympian gold medalists. However there is so much more to career and life planning, feelings of contentment and happiness than merely setting goals and reaching them. This is why it is possibly to reach the pinnacle of ones career yet still feel empty and unsatisfied.
So my advice on goals is - learn how to set them - it is a skill - one of many that are needed for career planning but do not assume they are the be all and end all.
Career change for doctors
When I first set up Medical Forum - I was focused more on career change away from medicine because the people I was hearing from were experiencing major health or career obstructions.
The emphasis has changed and the challenge is now more about assisting doctors to remain being doctors or to use their medical and health care knowledge and skills in more creative and effective ways. There is still an element or "career change" but somehow more organic.
I still say to people "its not about changing career - its about finding out what you want more of in life and then getting a plan for achieving that". Of course at times this incorporates change. But at the end of the day - most doctors did medicine because........ they want to work as doctors. Not rocket science you may say. The trouble is that so much of how people are expected to choose careers and then work in them is not addressed in the career guidance or recruitment process.
But I could write about this until the cows come home. In summary - career change doesn't always mean radical change but it does always mean changing "something" - from location to attitude, from colleagues to work content. from workstyle to hours worked. Radical change has its place but is not something anyone should leap into - so career planning "prior to any resignation" is always my preferred way forwards if only because at times the resignation is not timely or not even needed.
Career distress - what to do
The first thing to say is that you are not alone if you feel in distress regarding your career. You are not the first and you won't be the last.
The second is that if you feel things are in an unsustainable situation or that your health is deteriorating you must seek help. YES - seek help.
A trusted colleague is often the best but if that feels as if you are letting the side down or risking anything - then the following could be considered.
Visit to GP
Visit to Occupational Health
Start taking care of yourself better ( fit in a weekly yoga class if you can or an art class or similar)
Obtain our eworkbook "easy career change good career choice"
It is far better to take these steps than
go off sick ( though that may sometimes be needed - though its best taken under the umbrella of a supportive clinical consultation as you may not take long enough to recover otherwise)
to resign prematurely or out of desperation ( there is a place for resignation but it is so much better done under controlled conditions rather than knee jerk)
At Medical Forum we have an occupational health consultant who works for us and who can provide a half hour phone consultation in complete privacy and confidentiality. So if there is no OH where you work or you don't feel comfortable going to see your GP/local OH you can still access some OH support.
This sounds like a crazy idea and what would they all do. However it is possible that they could sell their services back to the NHS on contracts that each one of them negotiates separately. This of course would be an adminstration nightmare but it means that not only would the health service return to its previous state but also that 20,000 juniors do not flood the market for jobs that are non medical.
I have been mulling the huge dilemmas faced by both sides in this crisis and its not an easy situation to resolve.
With regard to doctors changing career - I have never found any difficulty helping a medic diversify their career - portfolio wise or radical change away from medicine. However - could I do this for 20,000 all in one week - or even staggered over 6 months - no. At the end of the day most medics just want to be good clinicians and do what they have trained to do. It would be a soul destroying task to attempt to redeploy that number of medics.
What would need to happen for mass resignation to take place? Firstly trainee hands in notice then goes away for a short sabbatical or holiday at the end of their notice period ( for some this will be one month and for many - three) and writes to their department to say that they are available for work from x date and here is a provisional contract.
Is this a good idea? Well it has pros and cons.
Pros - trainees cost a lot to train - so it makes sense to retain them
Trainees would get contracts that they themselves have negotiated ( with help from BMA perhaps)
Cons - a hiatus where trainees not earning and most will have outgoings and not have huge savings so this will be difficult for some, impossible for some and possible for some
The negotiation of 20,000 different contracts would not happen fast.
Having everyone on a different contract is not going to make life easy for anyone.
Is the whole situation merely going to lead to privatisation?
But- mass resignation does achieve one thing - the boot on the other foot.
However its outcome is unpredictable.
Bit like Brexit
Only this is Docxit.
Other career options for doctors
The pull of the clinical career - the worthwhile nature of the work combined with the status and security and demonstrable evidence of ones "stickability and brain power" can all combine to make it almost like a drug. One that we can easily get dependent upon.
However laudable and rewarding being a clinician is - at the end of the day is it not "you" . You are not "a doctor". You work as a doctor. Your income comes from your role caring for the health of others. Studying and practicing medicine may be a vocation but it is also merely a vehicle - one in which you have chosen to travel through life.
I always recoil very slightly when I hear school children say they want to "be" a ......
Whether that is a fireman or a train driver, an astronaut or a doctor.
You don't "be" a career. You do, work in, study, earn from a career. You "be" who you are. A career is not who you are and does not have to be your identity. In fact having worked in the field of medical careers now for 26 years I am pretty sure that it is NOT healthy to have a self image that is totally embroiled within ones work and that it is perfectly possible to be very dedicated to ones work without it becoming who one is or taking over ones identity.
There are all sorts of psychological overlays and interactions going on if one over identifies with the activity one does to bring in income. A big one is - if you find that the workstyle or role no longer suits you for any reason - because you have a young family, your health has changed or the job has changed - then it can be extraordinarily difficult to even begin to think about an alternative career. Trying to give effective career guidance or coaching to someone who is in some ways addicted to their self image being a certain way - is a very challenging and usually fruitless task.
Given that anyone can be placed in life changing situations through illness, injury and social change - it makes sense never to be "chained" to the self image and identity of ones work. Yet people do immerse so deeply in the self image of doctor that if and when the time comes to need to look at life and work differently - this can precipitate huge anxiety and deep depression. This is not just true for medics I am sure - but it is quite common amongst medics. I can even confess to having had a touch of it myself a few decades ago.
I am not saying that every medical person wanting to diversify their career a little ends up unable to do so because of their medical self image. For some people however - the merest thought or hint that they might need or want to do something different sets of a level of denial and resistance that can completely sabotage any normal career exploration and catapault them into years of procrastination.
Thus a person's level of "weldedness" to their career and how much of "them" it has either consumed or swamped, hidden or replaced - is for some people a major element of the work we need to do with them before career options can be unearthed and pursued.
How to leave medicine
What else can a doctor do?
January 13th, 2016
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!!!
Strike, leave or join
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!