Medical Careers
Career Support Resources..?
Andrew Long
Associate Dean
Head of School of Paediatrics
London Deanery
Medical Careers
Workshop outline
• Background
• Career challenges
– personal experiences
•
•
•
•
Resources – who?
Resources – what?
Potential Risks
Significant benefits
Medical Careers
Career Advice - MMC
“…rigorous counselling and career advice should be
available throughout training”
“…underpinned by practical career advice and
coaching, there should be opportunities to change
direction later on”
“…they should match the choices of individuals with
career advice, assessed potential and, importantly,
the demands of the NHS for particular specialists
and for GPs.”
Modernising Medical Careers: The Next Steps, 2004
Medical Careers
• all four Departments of Health in the UK (plus CMOs) must be involved in
any moves to change medical career structures
• DH should have a coherent model of medical workforce supply
• DH should urgently review its medical workforce advisory machinery
• content of higher specialty training and the numbers will be informed by
dialogue between the Colleges, Deaneries, employers, and medical
workforce advisory machinery
• career aspirations and choices should be informed by accurate data.
Medical schools should play a greater role in careers advice
Implementing the Tooke Report: Department of Health
Update, November 2008
Medical Careers
Postgraduate training – Inquiry recommendations
Postgraduate trainee
Medical
student
Provisionally
Registered doctor
Medical
Degree
Medical
School
Full GMC
registration
Registered Doctor
Specialty
assessments
at selection
centres
Core Speciality Training
Specialist Registrar
Competitive
selection
process
with limits
Specialist
Registrar
‘Stand Alone’ Practitioner
Optional higher
credentialling/subspecialty exams
CCT
Specialist
F1
‘Higher specialist
Training’
• 1 year
• Attends
‘Graduate’
school
PMETB
CESR
• ~ 4 Core Specialty
stems
• 3 years (fixed term)
• Guaranteed
• 4 - 6 month positions
place for
UKMG
• Integrated ‘Masters’
‘Staff Grade’
programmes available
- Research
- Education
- Management
- Global health
* stems include for example Medicine, Surgery, Acute
Common Stem and GP training. NB the term ‘specialty’
has no formal legal significance in these examples
GP Specialist
Registrar
GP
Consultant
Medical Careers
• trainees must be involved in the
decision-making and implementation
of training innovations that affect their
present and future careers
• support to assist the individual in
day-to-day activities and decisions...
should be carried out by someone
with whom the individual works and
who can be a positive role model for
them.
• Mentoring could be undertaken by
someone outside the specialty or
even profession, the purpose being to
provide an individual with career
guidance and expertise.
Time for Training
Sir John Temple, 2010
Medical Careers
Issue 6: Perceived deficiencies in
careers information and advice
11. All of the appropriate
organisations must work together to
define good practice for the
provision of careers information and
advice. Such information must be
easily accessible, simple to
understand and contain transparent
data on each specialty, including
competition ratios and a potential
applicant’s “likelihood of success”.
Foundation for Excellence: An Evaluation
of the Foundation Programme.
Professor John Collins October 2010
Medical Careers
“Although extensive careers information is
available it would appear that the quality of
careers advice may be lacking. Those in
established medical practice often tend to
support their own specialty area or, through the
“hidden curriculum”, deter trainees from
pursuing certain careers in medicine, such as
general practice."
“The optimal timing of careers decisions
remains the subject of debate. Of
those doctors who in their first year after
graduation were definite about their specialty
choice, 74% were in this specialty ten years
later.”
Foundation for Excellence: An Evaluation of the Foundation
Programme. Professor John Collins October 2010
Medical Careers
‘Informing Choices’
Medical Careers
Personal experiences
• discuss with your neighbour
– your most challenging experience in career
guidance
– what was the outcome
– were expectations realistic
– what resources would you/trainee have found
most valuable
• other people
• information
Medical Careers
Who is/might be involved?
• undergraduate – personal tutor, careers service,
undergraduate Dean
• postgraduate
– Educational Supervisor
– College Tutor/Specialty Programme Director
– Clinical Tutor (DoME)
– Training Programme Director
– Deanery Careers Adviser
Medical Careers
Medical Careers
Stage 1
Self-help materials
Workshops
Stage 2
ES Guide
ES e-learning
Workshops
Medical Careers
Medical Careers
Shared career planning framework
an extensive survey of the components of effective
career discussions in the workplace identified the
importance of preparation (of both parties) and of
having a simple shared framework to structure the
discussion.
Hirsh, W., Jackson, C. and Kidd, J. M., (2001). Straight talking: Effective Career Discussions at
Work. Cambridge. National Institute for Careers Education and Counselling (NICEC).(Hirsh et
al, 2001)
Medical Careers
Four stage career planning framework
Psychometric
Tools
Medical Careers
Medical Careers
www.mmc.nhs.uk
Medical Careers
Competition Ratios
Application ratios for ST1 in 2010
Programme
Neurosurgery*
Posts
17
Apps
117
Ratio
6.8
Clinical radiology
Core Medical Training
Obstetrics and Gynaecology*
179
1171
249
1251
2455
1,252
7.0
2.1
6.02
Histopathology*
Paediatrics*
62
340
165
1,386
3.0
4.0
General practice*
2,783
4850
1.74
www.mmc.nhs.uk
* Are competition ratios as
1 application made per applicant
Competition Ratios
Application ratios for ST1 in 2011
Programme
Neurosurgery*
Psychiatry
Posts
16
481
Apps
175
357
Ratio
10.9
0.7
Clinical radiology
Core Medical Training
Obstetrics and Gynaecology*
177
1201
265
587
2475
597
3.3
2.1
2.3
Histopathology*
Paediatrics*
60
407
137
753
2.3
1.9
General practice*
3251
5541
1.7
www.mmc.nhs.uk
* Are competition ratios as
1 application made per applicant
Medical Careers
Medical Careers
www.
medicalcareers
.nhs.uk
Medical Careers
Medical Careers
Medical Careers
Stage 3
Training Faculty
Postgraduate Certificate
Stage 4
Interview Skills/cv workshops
Individual careers support
Medical Careers
Medical Careers
Potential Risks
• no guarantees
• relies on self-awareness, motivation,
performance etc
• role of the ego!
• honesty can hurt!
• mis-direction
• current inflexibility
• time commitment
Medical Careers
Significant benefits
•
•
•
•
•
•
•
better workforce planning*
contented workforce
full rotas*
scheduled migration
no panic in Foundation training*
fewer trainees in wrong specialty
fewer trainees in difficulty
* mythical
Medical Careers
Any questions?