This year Medical Forum has been going for 25 years.
I was pondering what I had learned about careers and career guidance during that time. Tons as you might imagine - but what is the essence or summary? It wasn't entirely clear to me 25 years ago that career choice, planning and guidance is not merely about looking at the person and at the options and trying to make a fit. That was how I had been indoctrinated by school and higher education. It is much more about finding out what makes a person truly tick and helping them to carve the niche they need to fulfil their potential if that niche is not already there. In other words less of a matching process and more of an exploring process of who one is, who one would like to become, where one would like to go and how. It requires vision and the courage to state what one wants. It requires an ability to look more closely at the self than most people would normally choose to do. But by harnessing all these elements there is a far better chance of developing a career that actually matches who you are rather than trying to fit yourself into a box that others have created. It is all about taking responsibility and empowerment to do so. And that process can be at the same time - scary, cathartic, challenging and fun. And I like being the supportive catalyst!
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A recent Pulse Today article revealed that medical schools may be actively sabotaging GP recruitment
Assuming this is true ( and one can not always rely on media to give the full story) then it MUST be stopped not least because GP recruitment is suffering problems at the moment. There are a number of ways in which general practice doesn't get a fair crack at the whip in the minds of medical students and anyone taking a pop - intentionally or unwittingly at the GP career choice needs to carefully rethink their attitude Problem 1 the amount of time spent in general practice at medical school compared to other specialities is disproportionate to the number of people who will eventually work in it Problem 2 There is a computerised test that many students take which produces a list of career options - indicating which one might be most suited to. However it is to my knowledge not "weighted' appropriately towards the numbers of students who will be GPs. For example the top 10 careers might show general practice as one of the options. This indicates that perhaps one has an equal chance for all these careers - when in fact that may not be true. If the algorithm used in the test was representative for someone where a GP career was well matched - it should appear as 5-6 out of that ten. Problem 3 There is a wholesale lack of career guidance being provided to medical students. Yes there is a careers advisor in most schools but these are either grossly under resourced ( e.g. one day a week for one adviser for 500 students) or they are insufficiently trained in the full picture of selecting people for jobs and the work one needs to do on oneself to be well prepared to make the right choices. Alternatively they may be careers advisors from the university careers department and may have little if any understanding of clinical careers and the nuances of choosing between them. Problem 4 The pervasive snootiness of some hospital doctors towards their GP colleagues and a total lack of understanding just how amazing a GP career can be if it is chosen as part of an overall well researched career plan Problem 5 The deans as referred to above - who really should know better. I regularly see people in hospital medicine posts who would have been much happier as a GP and those in general practice who would have been far more well suited to a speciality. Yet somehow the wrong bums end up on the wrong seats - causing no end of difficulties - financial and health sometimes. So - it is about time that all these elements of student - GP career interactions were addressed. Tackling only the deans will not be enough. If there are any committees working on this - I'd be delighted to be asked to join them. The 64,000 dollar question.
Firstly there is no "should". No really! I repeat - there IS no "should". There is only what you want to do. The word "should" implies that there is some master who is dictating and career planning is not about kowtowing to anyone - least of all sub personalities within you who think you "should" do things. Secondly until you have a clear range of or at least one option that is attractive, motivating and to which you are well suited on a number of fronts - the question is Thirdly there is a better question " would it be helpful to me right now to fully explore my career potential and my career plans?" Yes or no. This question does not pose the questioner with a catch 22 situation with great likelihood of procrastination, guilt, denial, fear as "should I go or stay" does. The answer to the "should" question is very very complex and thus can rarely ever be answered with a yes or no thus at times leading to years of prevarication. The issue of career change - even the phrase "career change" is an interesting one. More often than not career modifications do occur as a result of seeking career guidance but a radical change may not in the end be wanted - even if the person is grossly unhappy where they are. This is because there are many considerations to mull when considering a change in career. In the end a sense of forwards progress, new goals to aim for that seem achievable, a feeling of being more in the driving seat of ones career and "more of what you want - less of what you don't want" is more important than radical shifts. There is such a thing as a "transitional" career too. This occurs when the person is either not sure what their career desires or dreams are but they know for sure they don't want to remain where they are. The transitional career is helpful if it permits more time and energy for career planning. As a result of the transitional career - the final career move can be worked upon over months rather than knee jerk decisions being made. One aspect of career planning we include in the Career Review is to examine the "model" of working that most suits a person. Some examples are
Full time Part time Portfolio Hybrid and also things like Employed/self employed Regular sessions each week vs fluctuating sessions ( latter more like locums) What career model suits each individual at that particular time in their life is key to whether their job satisfaction and engagement with their PDP etc remains high. The term portfolio career has become widely know but hybrid career is a term less used and they may seem similar at first glance. A typical portfolio career might involve four sessions a week traditional general practice, two sessions a week in a private sports clinic, two session a week teaching at a medical school and one session writing some training materials. A hybrid career might involve half the week as a surgeon and half the week in a commercial bioengineering setting. Or half the week as a GP and half as a Health Board adviser. Admittedly there are not that many surgeons working less than full time but there ARE some! ... any road will take you there. No prizes for recalling where that quote came from ( Alice in Wonderland).
If one is at position A and one knows that position Z is the goal and there is a clear vision - then it is much MUCH easier to plan towards it. If however one is at position A and merely dissatisfied with it - there can be a tendency to 1) spend more time than is healthy or useful bemoaning ones lot 2) take the first thing that passes ones nose in order to "get out" of where you are ( this has a strong tendency to result in frying pan into fire situations) 3) grasp at straws - in the blind hope that something ... anything else will be better 4) scattergun - where multiple poorly targetted efforts - again aimed primarily at "getting one out of where one is" 5) go round in circles or end up in the same place despite lots of effort expended It must be emphasised that NONE of these approaches remotely resemble anything like career planning. Yet they are often used and the individual cons themselves into thinking they are doing some proactive careers work. Proper career planning on the other hand is never desperate, always planned, not rushed and carefully targetted after extensive researching. The questions of where to start and what to research are perhaps where career guidance can really make the most impact. The moral is - to not spend time naval gazing and looking at what is wrong with ones career but to start a process of discovering what it might look like if it were a lot more of a fit to who you are at present. Most people underestimate the amount of time required in the planning stages for career reevaluations.
I'd go as far as to say that for some there is a need to have a "preparation to plan" stage ( see easy career change - good career choice workbook). The Career Review Programme we run takes a minimum of 6 hours and for some people up to 10 spread over a couple of weeks ( we don't recommend longer). It has to be said that finding this time is probably one of the biggest challenges - even for part timers as the reason for being part time is invariably because there are other demands and responsibilities in the person's life. Reclaiming some "me time" back can often be the very first step in career planning as without some protected time specifically allocated to the career - little is going to transpire. This time requirement is not just to complete our programme - but in which to complete all the things that will come out of the programme. So the 3-4 hours a week for two weeks to tackle the Review is the rough time frame that will be needed but for six months or more. To join a Review without first thinking about this is folly. Why is time for one's career so difficult to find? Firstly one is busy "doing" the career and fitting in all life's little tasks like tax returns, dentist appointments, car servicing and supermarket shops. Secondly there is a tendency to batten down the hatches (denial) and focus on whats wrong ( negative mindset) in the career. It is common for people to either spend more time at work ( even though this is the very thing they are not happy with) or spend more time on things that are comforting ( expensive holidays, spending time with the family). Neither of these options actively make changes to the thing that is causing discomfort. The other thing that is very common - people also wait for an inordinate level of discomfort before seeking career support. This is another "time" related issue and for another blog another day as I have run out of time! This is a very interesting subject.
If a person is ready for change, emotionally stable and with time and resources they can allocate to doing all the things that are required for forging radical change in ones working life - then it is reasonable to offer a career change programme. If on the other hand the person is not well prepared for change, is mentally in a bad place and will find it really hard to allocate any time or resources on a consistent basis ( i.e. 6-12 months) and if they resist or do not engage in any of the recommendations - then a career change that is well matched and well researched is going to be hard to achieve. So if a person falls into the second category above yet still yearns for a career change - what can be offered. I think the key thing is to address the basic things that perhaps are not being addressed first. For example - if a person's job is so very stressful and time hogging that they can not give appropriate time to career planning then the first step is to move to a post where perhaps the work is roughly the same but there is a slightly more flexible timetable. Alternatively they may need to get some assertiveness training as saying no can be an important first step in career planning. If a person is demonstrating signs of burnout and or depression or anxiety - these things need to be addressed BEFORE any effective career planning can take place. This is where there is a slight catch 22 as if the current role is causing the strain then there can be a deep desire to cease that role ASAP. What is realistic and achievable is different in every person. But it is true that at times the first step in a career change is not the career change itself but preparation for doing so. This is extremely important to acknowledge as joining a career change programme without first grasping this point is going to lead to disappointment when a new career is not conjured out of the bag or taken away in a carrier bag. I have written an workbook "easy career change - good career choice" as a preliminary learning element before someone delves into the Career Workbook.... which i hope will go some way to preparing people well before they begin to take any actions for their new career plan. It's still common for sick dctors to be expected to discuss their health diagnosis with employer My view .. Do not discuss health with anyone but your GP. http://php.nhs.uk/confidentiality-and-patient-safety/ |
AuthorSonia Hutton-Taylor Archives
June 2021
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