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 technology advances NHS funding 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. This is a term I use quite a lot. It describes a situation where the person either wants things their current career can not provide or they as a person are not what the career ideally requires - or both.
It can cause huge levels of stress as deep down the person knows there is something wrong yet they may have all sorts of things pulling at them that are causing denial of varying degrees. Part of the role of careers adviser is to challenge preconceptions and assumptions. At times when one does this it causes further entrenchment of the denial so it is really important to go gently. At other times - once the term career mismatch has been outed - there is a palpable sense of relief from the client. Suddenly there is a reason - a good reasons for why they feel so terrible. Typical feelings experienced with a career mismatch are
Not every career problem is a mismatch. Sometimes it is simply poor planning that is at the core of the career situation. Other times it is a personal trait like the inability to say no. There are many other causes of career dissatisfaction. But career mismatch is surprisingly common in medicine. GPs who should have remained in hospital medicine and hospital doctors who would have been much happier in general practice. I stumbled on this bucket list for medics - it could apply to anyone really but I like the fact that it gives examples of doctors who have done some of these things in their own inimitable ways.
Bucket lists are good for career planning because the very act of writing one helps to put the career much more into the bigger picture of life. Any activity in fact that encourages creativity and dreaming is good for career planning. If you have one of your own - already written down - then great! If not then reading this might inspire you to do so. And in terms of goal setting I have found there are two techniques that work really well - they are complete opposites but they work in tandem Technique 1 is Use a pen - don't just keep them swirling around in your head. Then read or even rewrite them every day. This applies to bucket lists and career plans alike. Technique 2 is also use a pen but this method requires that you put what you have written deep into a filing system with a reminder in your diary one year from now to unearth it. This "message in a bottle" technique works in the background as you have "cast it out into the universe" - although perhaps to attach it to a helium balloon might thus be better than hiding it. But whatever floats your boat - the aim is to write it with intention and belief and then let it go. Two very contrasting systems - but in tandem I have found they achieve more than each on their own. Bucket list |
AuthorSonia Hutton-Taylor Archives
June 2021
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