The ROADS to Success - CMEC · 6 The Roads to Success I. INTRODUCTION About the book ROADS to Success • Is a practical career-planning handbook for all postgraduate doctors (although

The ROADS to Success

A practical approach to career management for medical students, junior doctors

(and their supervisors).

Caroline Elton & Joan Reid

First published 2007 By the Postgraduate Deanery for Kent, Surrey and Sussex

Second edition published 2008 By the Postgraduate Deanery for Kent, Surrey and Sussex

Third edition published 2010 By the Postgraduate Deanery for Kent, Surrey and Sussex

Third edition formatted for online use 2012 By the Postgraduate Deanery for Kent, Surrey and Sussex

Acknowledgements This book has been produced by the careers specialists in the KSS (Kent, Surrey and Sussex) and London deaneries. It started life as a set of resources in A4 ring binders developed to support the foundation programme run by the South Thames Foundation School. The authors have received help from people in both organisations, plus a number of others, and would like to thank the following people: Karen Allman, Professor David Black, Dr Elizabeth Cottrell, Dr Graeme Dewhurst, Dr Cath Jenson, Dr Arun Kumar, Dr Andrew Long, Dr Melanie Newport, Professor Zoë Playdon, Dr Pam Shaw, Michael Strevens, Jason Yarrow, Maire Shelly, Jonathan Nodding, and Dr Melanie Jones, Dr Darshan Sudarshi, Dr Charles Twort, Dr Jan Welch and Dr Helen Wilson. Dr John Launer from London Deanery gave a particularly helpful critique of an earlier draft, and we are also extremely grateful to Professor Chris McManus for his input on the section on psychometric testing.

Our thanks also to Judy Horacek, and to Scribe Publications, for allowing us to reproduce a selection of cartoons from Make Cakes Not War.

Caroline Elton would like to acknowledge the late Professor Kath Green, who tragically died as the first edition of this book was going to print. Kath was a much valued mentor and someone with whom it was a privilege to work for many years. Caroline would also like to thank Howard Cooper and Rob Nathan.

Finally, both authors wish to acknowledge the support of their respective ‘Andrews’. Andrew Reid provided helpful technical advice at various points and Andrew Franklin offered publishing input, as well as introducing us to Judy Horacek’s cartoons. Both Andrews are probably relieved that the end of ROADS has been reached.

Caroline Elton and Joan Reid July 2010

The cartoons are the copyright of Judy Horacek, 2006, and are taken from Make Cakes Not War, published by Scribe Publications.

Copyright: Caroline Elton, Joan Reid and the Postgraduate Deanery for Kent, Surrey & Sussex.

Do not distribute this book without the permission of the copyright holders.

3Contents

Page No.

I. Introduction: About the book ........................................................... 3

II. Stage 1 of Career Planning: Self-Assessment ........................................................... 9

III. Stage 2 of Career Planning: Career Exploration ..................................................... 33

IV. Stage 3 of Career Planning: Decision Making ......................................................... 45

V. Stage 4 of Career Planning: Plan Implementation ................................................. 59

VI. Guidelines for the Educational Supervisor ............................................................... 81

References ................................................................ 103

Appendices ............................................................... 104

Contents

4

The Roads to Success

5

INTRODUCTION:ABOUT THE BOOK

6


I. INTRODUCTION About the book

ROADS to Success• Isapracticalcareer-planninghandbookforallpostgraduatedoctors

(althoughmedicalstudentscanuseitaswell).

Providesastructuredframeworktohelpallpostgraduatedoctorswiththeirpost-foundation careerplanning. (It isnot just aimedat traineeswhoarehavingdifficultymakinguptheirminds.)

• Includesexercisesthathavebeentailor-writtenforpostgraduatedoctorsandthathavebeentriedandtestedoveranumberofyears.

• Isbasedonarigorousreviewofboththegeneralcareer-planningliteratureandthespecificliteratureonmedicalspecialtychoice.

• Aimstohelptraineesmakerobustcareerdecisions,andtoknowhowbesttoimplementtheirplans.

• Alsocontainsguidanceforeducationalsupervisors,onhowbesttosupporttraineeswiththetaskofcareerplanning.

How this book is organisedThisbookusesastructuredfour-stageapproachtocareerplanning:

Stage 1: Self-AssessmentStage 2: Career ExplorationStage 3: Decision MakingStage 4: Plan Implementation

Therearenumerousreasonswhythisframeworkisused,butonevitalbenefitofthestructuredapproachisthatithelpsyouapproachthetaskofcareerplanninginasystematicway.Togiveyousomeexamples,worryingaboutyourapplicationformsorinterviews(Stage4activities)isawasteoftimeifyouarenotclearaboutStages1–3.Similarly,poordecisionmaking(Stage3)oftenrestsoninadequateself-assessmentorcareerexploration(i.e.Stages1and2).

Theimportanceofastructuredapproachwasillustratedbyalarge-scaleresearchstudyofwork-basedcareerdiscussions(Hirshetal,2001)whichfoundthatiftheprovidersandrecipientsofcareersupportsharedacommonframework,therecipientsfoundthediscussionsmoreuseful.

7So,inthishandbook,whileChapters2–5arewrittenforpostgraduatedoctors,Chapter6isfortheeducationalsupervisor,enablingbothpartiestosharesuchaframework.

(Wewouldalsorecommendthatbothpartiesreadthewholebook.Forexample,Chapter6suggestsquestions,linkedtothefourstages,thateducationalsupervisorsmightwanttodiscusswiththeirtrainees.Inordertogetthemostoutofthesemeetings,traineesmightfinditextremelyhelpfultolookatthesesuggestionsinChapter6inadvance,asawayofpreparingfortheireducationalappraisal).

When this book should be readThetransitionfrommedicalschooltobeingaqualifieddoctorisprettydemanding,andlongertermcareerplanningmaynotseemanimmediatepriorityatthestartofyourF1year.WhilstitclearlymakessenseforyoutogetthroughinductionandtheearlyweeksofyourfirstF1jobbeforeyoustartfocussingoncareerplanning,wewouldsuggestthatyoushoulddipintothisbookandslowlyworkyourwaythroughthechaptersassoonasyoufeelsettledintoyourfirstF1job.Youmightalsowanttoreviewsomeoftheexercisesasyoumovebetweendifferentfoundationjobsbecauseyourviewsaboutyourself,andaboutdifferentspecialtiesmaychange.

Perhapsitalsoneedstobestressedthateventhoughthefoundationprogrammelaststwoyears,youwillbecompletingapplicationsforpost-foundationspecialtytrainingintheDecemberofyourF2year.Sothetimeperiodformakingspecialtydecisionsisactuallyquitetight.Whatthismeansisthat‘lastminute.com’hasnoplaceasacareerplanningstrategy.

Somespecialtytrainingpathwaysalsorequiretraineestoundertakeapost-foundation‘core’trainingblock,beforelaterembarkingonhigherspecialtytraining.Forexample,ifyouwanttotraininamedicalspecialtyyouwillfirstcompletetwoyearsofcoremedicaltraining,andthenapplyforaplaceonahigherspecialtytrainingprogramme.Withover25specialtiestochoosefrom,traineesoncoremedicaltrainingprogrammesstillhavesubstantialspecialtychoicedecisionstomake.Theexercisesinthisbookcanalsobeusedbypost-foundationtraineesonprogrammessuchascoremedicaltraining,aswellasbydoctorswhoarenotcurrentlyinatrainingpost,butwhowanttoapplyforspecialtytraininginfuture.

Introduction – About the book

8


How to use this bookTheexercisesinthisbookcanbeusedindifferentways.Youcancompletethemonyourown,andthendiscussyouranswerswithcolleagues,partner,familyand,ofcourse,youreducationalsupervisor.Insometruststheexercisesarealsoincorporatedintostructuredjuniordoctorcareer-planningsessions.

Butwhetheryoucompletetheexercisesonyourown,oraspartofaworkshop,westronglyadviseyounottotakea‘pickandmix’approach.Althoughitistempting(particularlyifyouhavedecidedonyourpost-foundationoptions)toskipStages1–3andturnstraighttoStage4,thisisnotthemosteffectivewaytoplanyourcareer.Evenifyouknowwhatyouwanttodopost-foundation,theexerciseswithinStages1and2,andthethoroughnessofyourdecisionmaking(Stage3),willgiveyoutherawdatathatyouneedtodrawonforyourapplicationformandinterview.SkippingstraighttoStage4mayreduceyourchancesofbeingsuccessfulinimplementingyourpreferredcareeroption.

About the titleCentraltothebookistheROADSchecklist.Thisprovidesawayofanalysingyourcareerdecision,toseeifitisrobust.Specifically,whenyouhavemadeupyourmindaboutyourpost-foundationcareer,youshouldimaginethatsomebodyischallengingyouwiththefollowingquestions:

Realistic:Areyoubeingrealisticaboutyourselfandaboutthedemandsofthejob?

Opportunities:Haveyougivenseriousconsiderationtoalltheopportunitiesavailable?

Anchors:Haveyoubuiltinthethingsthatprovidesupportinyourlife?

Development:Doesyourdecisionadequatelydevelopyourpotential?

Stress:Haveyouminimisedthoseaspectsofworkthatyoufindparticularlystressful?

Andinadditiontoposingthesequestionstoyourself,wewouldalsoadvisethatyoudiscussyouranswerswithyoureducationalsupervisor,oranotherexperiencedclinician.

9About the authorsWhatexperiencedowebringtothetaskofwritingthiscareerhandbook?

• Betweenthetwoofuswehavebeenprovidingcareersupporttoindividualsandgroupsforover30years,workingforcommercialcareerconsultanciesandinourprivatepractices.

• Bothofusarequalifiedcareersprofessionalsandqualifiedusersofpsychometrictests.

• CEcompletedherPh.D.intheDepartmentofAcademicPsychiatryatthethenMiddlesexHospitalandisacharteredpsychologist.Fortenyearssheworkedpart-timeasadeaneryeducationadviserandspenthundredsofhoursobservingconsultantsteachtheirjuniorsinclinicalsettings.Shehasalsoruntrainingworkshopsfortraineesand/orconsultantsoncareerissueswithinKSSaswellasfortheEastern,London,Oxford,andWestMidlandsdeaneries.SinceSeptember2008shehasbeentheHeadofCareersAdviceandPlanningatLondonDeanery.

• JRiscurrentlyworkingasHeadofCareersfortheSouthThamesFoundationSchoolsandiscourseleaderforthePostgraduateCertificateinManagingMedicalCareers.ShealsomanagesthemedicalcareerswebsiteonbehalfoftheDepartmentofHealth.Shehasprovidedcareercounsellingandcoachingtoawiderangeofprofessionalsatavarietyofstagesintheircareers.

Butneitherofusisclinicallyqualified,soinwritingthisbookwehaveworkedcloselywithseniorclinicians,andalsowithmedicalstudentsandjuniordoctors.Inthisway,wehopethatwehaveproducedapracticalhandbookthatwillassistmedicalstudentsandjuniordoctorswiththechallengingtaskofplanningtheircareers.

Introduction – About the book

10


11

STAGE 1 OF CAREER PLANNING:

SELF-ASSESSMENT

12


II. STAGE 1 OF CAREER PLANNING: Self-AssessmentOverviewInthischapter,afterabriefintroduction,youwillbeintroducedtofourself-assessmentexercises.Theseexercisescover:

• Workvalues

• Achievements/skillsandinterests

• Stressesandstrains

• RoleModels

Therefollowsadescriptionofdifferentpsychometricinstruments.Ifyoudodecidethatthepsychometricapproachmighthelpyouwithyourcareerdecisionmaking,thendetailsofhowtogetyourselftestedareincludedinthischapter.

Finally,thechapterendswithtwodifferentapproachestosummarisingtheresultsoftheStage1self-assessmentactivities.

Introduction: a clinical analogyAlthoughtherearemanydifferentmodelsofpatientconsultation,insomeshapeorformtheywillallcovertakingapatienthistory,examiningthepatient,decidingwhetherfurthertestsarenecessary(andiftheyare,carryingthemout),formingadiagnosis,implementingatreatmentplan,andthenreviewingprogress.

Furthermore,thesetaskshavetobecarriedoutintherightorder:ifanunknownpatientwalkedthroughthedoorofyourconsultingroomyouwouldn’trecommendaspecifictreatmentifyouhadn’ttakenahistory,examinedhimorher,perhapscarriedoutsomefurtherinvestigations,andformulatedadiagnosis.

Modelsofclinicalconsultationcanserveasagoodparallelforacareer-planningframework:

Patient consultation Career planningTakingpatienthistory Self-assessmentExaminingthepatient ExplorationofparticularcareeroptionsFormulatingadiagnosis CareerdecisionmakingImplementingatreatmentplan Implementingacareerplan

13Significantly,inbothclinicalconsultationandcareerplanning,thefirsttwostagesarelinked.Whatyouhaveelicitedduringthepatienthistoryinformsthefocusofyourclinicalexamination.Similarly,intermsofcareerplanning,whatyoufindoutinStage1(self-assessment)informsnotonlywhichdifferentcareeroptionsthatyouexploreingreaterdetail,butalsothespecificissuesthatyouresearchwithineachcareeroption.Forexample,ifyouhaverealisedthatyourcoreworkvaluesincludegreatcontinuityofpatientcareandopportunitiesworkinginaparticularlocationforteaching,partofyourresearchwouldbetofindoutwhether,inthecareeroptionsthatyouareexploring,youwouldtendtocareforpatientsoveralongtimespanandalsowhetherthejobmarketwassuchthatyouwouldprobablybeabletostayinaparticularpartofthecountry.

Inbothclinicalconsultationandcareerplanningtheremightbeacertainto-ingandfro-ingbetweenthestages.So,forexample,aclinicalsignthatisseenonexaminationmightmeanthatyougobackandaskfurtherquestionsaboutthepatient’scurrentorpastmedicalhistory;andwhileyouareplanningyourcareer,somethingthatyoufindoutwhenyouareresearchingaparticularcareeroptionmightleadyoutogobackandundertakesomemoreself-assessment.

Thisparallelbetweenclinicalconsultationandcareerplanningisusefulinthatithighlightstheimportanceofapproachingbothtasksinasystematicmanner,andbeingguidedbyanunderlyingstagedframework.However,wedowanttostressthatitisnotaperfectparallel.Inclinicalconsultationtheaim(althoughitisnotalwaysrealised)istoestablishadefinitivediagnosis–toprovideananswertothequestion:‘Whatisitthatiscausingthesesymptomsinthispatient?’Intermsofcareerplanning,thenotionofadefinitivediagnosiscanbeunhelpfulasitmightbetakentosuggestthateachindividualcouldonlybehappyinoneparticularspecialty.Thisiscountertothewiderresearchliterature(discussedlaterinthechapter),whichstronglysuggeststhatindividualscouldbesatisfiedinanumberofdifferentcareeroptions.

Afurtherproblemwiththeparallelisthatitmightunwittinglyseemtoimplythatthereissomethingwrongwiththeperson(theycan’tdecideontheircareer),andsotheyneedtreatment(findingoutaboutthemselvesanddifferentoptions),tomakethem‘better’.Instead,ascareersprofessionalswewouldarguethatnotonlyisitcompletely‘normal’forpeopletohavedifficultydecidingontheircareeroptions,butalsothefour-stagemodelthatwehaveusedinthisbookappliesequallytopeoplewhoarehavingdifficultydecidingandtothosewhohavealreadydecided,butwanttomaximisetheirchancesofsuccess.

Stage 1 – Self-Assessment

14


Stage 1: self-assessmentAdequateclinicaldecisionmakingcannotoccurifthedoctorhastakenapoorhistory,performedanexaminationinadequatelyororderedthewrongclinicalinvestigations.Similarly,inourrespectivecareer-counsellingpracticesitisstrikinghowoftenitisthatclientswhoaredissatisfiedwiththeirpreviouscareerchoiceshadleaptintotheirchosenlinesofworkwithscantattentiontowhattheywerelookingforinajob(self-assessment)andonlycursoryresearchintowhetherthejobtheywereconsideringwouldmatchtheirparticularcareerneeds(careerexploration).

Startingwithself-assessment,thereisawholerangeofaspectsofyourselfthatyoucouldinvestigate,andforeachofthesetherearedifferentpossiblewaysofcarryingouttheself-assessment.Inthishandbookwefocusonfourkeyareas:workvalues,skills/interests,rolemodelsandthestresses/strainsofwork.Weregardtheseasthebareminimumintermsoftherangeofissuesthatyouneedtoconsiderwhenplanningyourcareer.

Personalityinstruments(suchastheMyers-BriggsTypeIndicator)orInterests/PersonalAttributesInventories(suchastheSelf-DirectedSearchortheSci59specialtychoiceinventory)arealsobeingusedtohelpmedicalstudentsandtraineedoctorswiththeircareerdecisionmaking.Sowealsoprovidesomeguidanceonwhenpsychometrictestingmightbeappropriateandhowbesttointerprettheresults.

Exercise 1: work values

Introduction to exercise 1RobNathan,aleadingoccupationalpsychologistandcareercounsellor,haswrittenanexcellentpracticalguideforcareercounsellors.Inhisbook(NathanandHill,2006),hehasthefollowingtosayaboutworkvalues:

‘Valuesinrelationtoworkrepresentthedegreetowhichapersonregardshisorherworkasworthwhile.This“worthwhileness”includestheamountofpower,autonomy,creativity,learning,altruism,security,statusandmoneywhicharesoughtinwork.’

Clearly‘worthwhileness’isanimportantcomponentofoccupationalsatisfaction,andthusitisvitaltobecomecleareronone’sunderlyingworkvalues.

Theexercisebelowisadaptedfromagenericsetofworkvalues(HobsonandScally,2000).Usingtheexperiencegainedfromrunningworkshopsfortraineesinfourdeaneries,weremovedworkvaluesthatparticipantsfeltwerenotrelevanttomedicine,andreplacedthemwithvaluesthattheparticipantsfeltweremissingfromthegenericlist.Inaddition,therehave

15beenasmallnumberofresearchstudiesondoctors’workvalues,andwecheckedthelistthatwehadassembledagainstthisresearchliterature,toseethattherewasareasonablefit.

WehavealsoadaptedHobsonandScally’sgradingcriteria,inthelightofatrainee’scommentthatitisimportanttothinkaboutthoseworkvaluesthatyoudon’twanttobepresent.(And,infact,thisnotionthatoccupationaldecisionmakingalsoinvolvesthinkingaboutthingsthatyoudon’twantaccordswiththewiderresearchliterature.)

NOT IMPORTANT

QUITE IMPORTANT

IMPORTANT NOT PRESENT

(i.e. important that you

don’t have this at work)

VERY IMPORTANT

PLACE OF WORK Workinginaspecificpart

ofthecountry

MONEY Thepossibilityofearning

ahighersalary

VARIETY havingavarietyofdifferent

responsibilties

COMPETITIVE workinginaspecialtytowhich

entryishighlycompetitive


16


INDEPENDENCE Beingabletoworkonyourown

MANAGING YOUR OWN TIME

Havingsomeflexibilityinwhenyou

carryoutyourdifferentresponsibilities

FRIENDS Formingfriendshipswith

colleaguesatwork

PACE OF WORK Arapidpaceofwork

RESPECT Ahigh-statusjob

MANAGING OTHERS theopportunitytomanage

aclinicalservice

CREATIVITY Thinkingupnewideasand

waysofdoingthings

EXCITEMENT Workinginacontextwhere

youtakeclinicaldecisions

underpressure

CONTACT WITH PATIENTS Workinginthecontext

whereyouhavelotsof

contactwithpatients

TECHNIQUES Workinginaspecialtyinwhichyou

performparticularsurgicaland/or

diagnosticprocedures

COMMUNITY SETTING Workingina

community-basedspecialty

HOSPITAL-BASED Workingina

hospital-basedspecialty

17

RECOGNITION Receivingappreciationfor

theworkyoudo

JOB SECURITY Knowingthatyourworkwill

alwaysbethereforyou

CONTROLLABLE LIFESTYLE Workinginaspecialtywhere

youcanachieveasatisfactory

work/lifebalance

PRECISION Workingattaskswhichinvoive

greatcareandprecision

CONTINUITY OF CARE Workinginaspecialtywhereyou

canprovidecontinuityofcare

foryourpatients

SUPERVISION Havingresponsibilityfor

supervisingothers

HELPING PEOPLE Arolewhichyouhelpindividuals,

groupsorsocietyinsomeway

LEARNING Arapidlychangingrolein

whichyouwillcontinuallybe

learningnewthings

BEING EXPERT Beingknownassomeonewith

specialknowledgeorskills

ORGANISATION Workinginawell-known

hospitalorservice

PROMOTION Workinwhichthereisagood

chanceofpromotion

CHALLENGE Being‘stretched’andgivennew

problemstoworkon


18


PREDICTABILITY Havingaworkroutinewhich

isfairlypredictable

RESEARCH Havingtheopportunityto

carryoutresearch

COMMUNITY Workinginaplacewhereyou

cangetinvolvedinthe

localcommunity

WORK WITH OTHERS Workinginateamalongsideothers

PHYSICAL CHALLENGE Workthatisphysicallydemanding

TEACHING Beingabletoteachothers

FLEXIBLE WORKING Aroleinwhichthereisthepossibility

ofworkingpart-time

TYPES OF PATIENTS Workingwithaparticular

patientgroup

19Instructions for Exercise 11.Photocopy this exercise. Then,using thephotocopies, cutout the four

‘headings’cards:

•VeryImportant •NotImportant

•QuiteImportant •ImportantNotPresent

2.Againusingthephotocopiescutouttheindividualworkvaluescards

a Thensorttheworkvaluescardsunderthefourheadings(i.e.pileupthoseworkvaluesthatare‘VeryImportant’toyouunderthe‘VeryImportant’heading,etc.)

b Trytobealittleselective–so,forexample,don’thavemorethansevenoreightworkvaluescardsunderthe‘VeryImportant’heading.

c Ifthereareanyworkvaluesthatarenotonthelist,butyouknowhaveasignificantbearingonyourcareerdecision-making,thenaddtheminonseparatepiecesofpaper.(Youcanaddtheminunderanyofthefourheadings.)

d Ifyoucan,trytorank-orderyour‘VeryImportant’workvalues.

3.Writedownyour‘VeryImportant’workvalues.(And,ifyouhavemanagedtorankthem,writethemdowninrankorder.)

Lookatyourlistandconsiderthefollowingquestions:

a Isthereanythingthatsurprisesyou,oranythingthathasraisedyourawarenessaboutyourselffromthelist?Ifso,makeanoteofwhateveritisthathasstruckyou.

b Thinkabouthowyourworkvaluesmightchangeovertime.Arethereanyvalueswhicharenot‘VeryImportant’now–butmightbesoin5-10years’time?(‘Flexibleworking’maybeanobviousone,buttheremightwellbeothers.)Ifthisisthecase,thenmakesurethatyoutakeanoteofhowyouimagineyourworkvaluesmightchange.

c Arethereanyworkvalueswhichyouregardas‘VeryImportant’butareunlikelytofindanoutletinanyoftheoptionsyouare

1._____________________

2._____________________

3._____________________

4._____________________

5._____________________

6._____________________

7._____________________

8._____________________


20


considering?(Forexample,artisticvaluesareveryimportanttosomedoctors,buttheydon’tnecessarilyfindanoutletforthemintheirpaidroleinmedicine.)Ifthisisthecase,isthereanywaythatyoucouldfindanoutletforthesevaluesoutsidework?Andifyoudid,wouldthisbesatisfactoryforyou,ormightyoustillendupfeelingunfulfilled?

Exercise 2: achievements, skills and interests

Introduction to exercise 2Inthisexerciseweaskyoutoconsiderthreeachievements–twofromyourworkasajuniordoctor/medicalstudentandonefromoutsidework.

Typically,whenwegivetrainees/studentsthisparticularexerciseoncourses,somewillsaythattheydon’tactuallyhaveanyachievements.Butsucharesponseisbasedonacrucialmisunderstanding.Whenwesaythatwewouldlikeyoutoconsiderthreeachievements,wearenotsayingthattheyshouldbeofworld-shatteringimportanceorenormous,orrare(e.g.aleadpaperinamajormedicaljournal).Instead,whatweareaskingyoutoidentifyissomethingthatyouhavedonethatyoufeltproudabout,andideally,butnotessentially,somethingforwhichyoureceivedpositivefeedbackfromapatient,colleagueorsupervisor.

Itisalsoimportant,giventhatthisexerciseispartoftheself-assessmentstageofanoverallcareer-planningmodel,thatyouranswersaregenuine,ratherthanofthe‘MissWorld/I’dliketosavetheplanet’variety.Thepurposeoftheexerciseistothinkaboutthingsthatyouhavedonewell,andwhichhavegivenyouagenuinesenseofsatisfaction.Itisnotaboutimpressingothers–butratherstartingtothinkmoreclearlyaboutwhatmakesyoutick,sothatyoucanusethisknowledgeasthebasisforsubsequentcareerdecisionmaking.

Instructions for exercise 2D.Read through your e-portfolio and identify two things that you were

involvedwithatworkwhichgaveyougreatpersonalsatisfaction.Whenhaveyoufelttheglowofsatisfactionthatyoudidaparticulartaskwell?

Whenhaveyoureceivedpositivefeedback?

(Seeifsomethinginyoure-portfoliojogsyourmemoryaboutparticularachievements.Butifitdoesn’t,choosesomethingthatyouhaven’twrittenaboutinyourportfolio.Thevitalthingistochoosesomethingthatyoudidwellandyoufoundpersonallysatisfying.)

21Ifyouareamedicalstudent,youmayhavealearningportfoliothatyoucoulduseforthisactivity.Ifyoudonothaveeitheramedicalstudentore-portfolio,thenjustchoosesomethingfromyourmemory.

Inadditiontothework-basedexampleyoushouldalsoidentifysomethingthatyouhavebeeninvolvedwith,outofwork,thatgaveyougreatsatisfaction.Possibleexamplesincludeachievementsinsports,music,drama,localcommunityaction,charities,religiousinstitutions,etc.Sometimes,though,the‘outofwork’achievementsarehome-based.Forexample,ifyouhavegotthroughmedicalschoolwhilesimultaneouslycaringforayoungchild,thenthatisaveryrealachievement–andyoucanuseittodemonstratethepossessionofawholerangeofpersonalskillssuchascommitment,organisation,timemanagement,etc.

B.Foreachachievement,identifyalltheskillsinvolved.Thesecouldbetechnicalskills,communicationskills,organisationalskills,conceptualskills,etc.Teaseoutalltheskillsthatyouusedtoaccomplisheachofthelistedachievements.Moreover,don’tjustlistthebroadtypeofskill(e.g.‘communication’skills),buttrytoanalyseyourachievementsatamoredetailedlevel.(Seetheexamplebelow.)

C.Foreachachievement,describehowyou(and,ifpossible,otherpeople)knewtheachievementwasasuccess.

Example

A.Achievement:

Successfullypresentingcaseatfirstmulti-disciplinarycaseconference.

B.Skillsinvolved:

Summarisingcomplexcasenotes.

Buildingeffectiverelationshipswiththeotherprofessionalspresentattheconference,noneofwhomIhadmetbefore.

Presentationskills–presentingmypointofviewtotheotherattendees.

Standingfirmwhenmyviewpointwaschallenged,butnotresortingtousingasimilarlyconfrontationalapproach.

HowdidI(orotherpeople)knowitwasasuccess?

Feedbackfromotherpeopleattendingthecaseconference.

Despiteinitialopposition,theapproachthatIsuggestedwasacceptedbytheteam.


22


D.Finally, lookat the listsofskillsyouhave identified.Putamarknext tothoseskills thatyouaremost interested inusingatwork.Youcanalsonotedowntheskillsthatyouhavenotdevelopedyet,butthatyouwanttodevelopinthefuture.

Repeattheexercisefortheothertwoachievements.

Exercise 3: stresses and strains

Introduction to exercise 3Nowswitchyourfocustoareasinandoutofworkthatyoufinddifficult.Allspecialtieswillcontaintasksthatyouenjoyless;however,goodcareerdecisionmakinginvolvesidentifyingwhatyoufindstressfulanddifficult,andthenchoosingacareerpathwaythatminimisestheseparticularstresses.

Youmightthinkthatpeopledothisautomatically,andsomedo.However,wefrequentlyencounterclientswhohavemadechoicesbasedononefactor(e.g.optingforaspecialtythathas‘run-through’training),withoutadequatelyconsideringthewayinwhichthischoicewillinvolveotherfactorsthattheyfindstressful.

Instructions for exercise 3Whatwewouldlikeyoutodointhisexerciseistoidentifytwoexamples(onefromyourworkinglifeandonefromoutsidework)inwhichyoufeltthatyourstresslevelswerehigherthantheynormallyareforyou.

Again,itmayhelpyoutoreadthroughyourportfoliotojogyourmemory.Forthenon-workexample,flickthroughyourpersonaldiary,toseeifanyexamplescometomind.

Havingidentifiedthetwoexamples(onefromwork,andonefromoutsidework),thenanswerthefollowingquestions.(Gothroughthemseparatelyforeachexample).

1.Giveabriefdescriptionofthesituation,outliningthebackground,whatroleyouplayed,andwhatfeelingsitengenderedinyou.

2.Trytoidentifywhatitwasaboutthissituationthatmadeyoufeelthewaythatyoudid.Forexample,forthework-basedscenario,wasitthefeedbackfromothers,thepaceofwork,theresponseofthepatients,etc.

3.Whatcanyoulearnfromthisexampleintermsoffactorsthatyoumightwanttominimiseatwork?

Nowrepeattheexercise,thistimeanalysinganexamplefromoutsidework.(And,ofcourse,youcanrepeatthisexercise,givingmorethanoneworkandoneoutsideworkexample.)

23Exercise 4: role modelsProbablythemostconsistentfindingintheliteratureonfactorseffectingspecialtychoiceistheinfluenceofrolemodels.Acrossalargerangeofdifferentspecialties,andinstudiesfromallovertheworld,doctorscitetheinfluenceofrolemodelsasoneofthefactorsthatinfluencedtheirchoiceofspecialty.

Sometimesthisinfluenceisdirect–traineesreportthattheyhavechosenaparticularspecialtybecausethatwasthespecialtyoftheirrolemodel.Atothertimes,itisnotthattheychoosethesamespecialtyastheirrolemodel–butratherthattheyrealisethattheywanttopracticeadifferentspecialtyinasimilarmannerastheirrolemodel.Itisalsoimportanttorealisethatthisinfluenceworksbothways;positiverolemodelsarerelatedtochoosingaparticularspecialtyorworkinginaparticularway,whilstnegativerolemodelsarecorrelatedwiththedecisionnottofollowaparticularcareerpath,ortopracticemedicineinaverydifferentmanner.

Theexercisebelowaimstohelpyouthinkaboutparticularrolemodels(bothpositiveandnegative)inordertoclarifysomeoftheaspectsofworkthataremostimportanttoyou.

Positive Role ModelsFirst,spendacoupleofmomentsidentifyingaparticulardoctorwhomyouconsidertobeapositiverolemodel.

Then,withreferencetothisparticulardoctortrytoanswerthefollowingquestions:

a Whatwasitaboutthisdoctorthatyouparticularlyadmired?(Forexample,wasitthedepthoftheirclinicalknowledge;theirmasteryofparticulartechniques;theirtemperament;theirenthusiasm;theirteamleadingskills;theirmannerwithpatients,etcetc).Youmightfindithelpfulifyouthinkaboutspecificexamplesofthisdoctoratworkinansweringthisquestion.Andyoudon’thavetolimityourselftooneortwopoints–theremightbeanumberofdifferentreasonswhyyouregardagivendoctorasapositiverolemodel.

b Useyouranswertoquestion(a)abovetoidentifyaspectsofworkthatareparticularlyimportanttoyouandyouneedtobepresentinordertofindworkfulfilling.


24


Negative Role ModelsNext,withoutnamingnames–spendacoupleofmomentsidentifyingaparticulardoctorwhomyouconsidertobeanegativerolemodel.

a Then,withreferencetothisdoctor(butstillwithoutnamingthem),thinkaboutwhatitwasabouttheirapproachtotheirwork,thatyoudisliked.

b Whatdoesyouanswertoquestion(a)abovetellyouaboutsomeofthefactorsthatareimportanttoyouatwork?

Psychometric instrumentsPsychometricinstrumentsaresometimesusedincareercounsellingtoassesspsychologicalattributesrelevanttooccupationalchoice,suchasoccupationalinterests,workvaluesandpersonality.

What does ‘instrument’ mean in this context?Asdoctors,theword‘instrument’conjuresupimagesofthespecialisedequipmentthatsurgeonsuseintheatre.Butapsychologistusesthewordsomewhatdifferently.Forapsychologistthereisadifferencebetweenapsychometrictestandapsychometricinventory,andthereforethegenericterm‘instrument’isusedtodescribesomethingthatappliestobothtestsandinventories.

Toexplainthisinabitmoredepth,forapsychologist,apsychometric‘test’referstomeasuresthatassessmaximumperformance.Theunderlyingassumptionoftheseisthatindividualswillattempttoperformatthetopoftheirform.So,forexample,apsychometricassessmentofverbalabilitywouldbeclassifiedasa‘test’,aspeoplewhofilleditinwouldprobablywanttodoaswellastheypossiblycould.Thiscanbecontrastedwithpsychometricmeasuresoftypicalresponse,whichareoftencalledinventories.Thesearebasedonself-report,withindividualsdescribingtheirlikesanddislikes,orhowtheytypicallybehave.

Themostcommoninstrumentsthatareusedwhencareercounsellingdoctorsaremeasuresofpersonality(suchastheMyers-BriggsTypeIndicator),ormeasuresofpersonalattributesandprofessionalpreferencessuchasSci59.Theseshouldthereforebecalledpsychometricinstrumentsorpsychometricinventories,nottests,astheydonotassessmaximumperformance.(SeeKidd,2006.)Butweappreciatethatusingtheterm‘instrument’inthiswayprobablysoundsstrangetomedicallyqualifiedreaders.

25What makes them psychometric?Nextitisimportanttoconsiderwhatmakesasetofquestions‘psychometric’?

Afterall,thefourexercisesgivenearlierinthischapteralsoaimtoassessinterests,etcworkvalues,andprobablyalsorelatetoone’spersonality.

Withoutgoingintoexcessivedetail,themostimportantpointtomakeisthatwitha‘psychometric’instrument(asopposedtothesortofexercisesincludedearlieroninthischapter)dataareavailableonthemeasurementpropertiesoftheinstrument–inparticular,onitsreliabilityandvalidity.

Takingeachoftheseinturn,thereliabilityofaninstrumentreferstotheextenttowhichtheinstrumentproducesstableresults(assumingthattheunderlyingpsychologicalconstructthattheinstrumentistryingtomeasurehasn’tchanged).

Thevalidityoftheinstrumentreferstowhethertheinstrumentactuallymeasureswhatitpurportstobemeasuring,so,forexample,ameasureofoccupationalinterestsshouldactuallyassessthatconstructandnotsomeotherone.

Boththeseconceptsshouldbefamiliartoyoufromyourstudyofclinicaldiagnostictests,butinaclinicalcontexttheymaybegivendifferentterms.Forexample,insteadoftheterm‘reliability’youmighthaveseentheterms‘precision’or‘reproducibility’,andinsteadoftheterm‘validity’youmightbemorefamiliarwiththeconceptof‘accuracy’.

Butdespitetheconceptualoverlap,therearealsosomesubtledifferencesbetweenclinicaldiagnosticmeasurementsandthemeasurementofpsychologicalconstructs(i.e.psychometrics).Inaclinicalsituationaccuracycanbedefinedastherelationshipbetweentestresultsand‘goldstandard’results,wherethelatterreferstoanindependentdefinitivediagnosisofthepresenceorabsenceofdisease.Inatleastsomeclinicalsituations,the‘goldstandard’actuallyexists,whichinturnunderpinsthemeasurementofdiagnosticaccuracy.Thingsareneversowelldefinedwithpsychometrics,wherethe‘goldstandard’(ofintelligence,interests,values,etc.)isalwaysanothertheoreticalconstructratherthanhavingthemoreclear-cutstatusofaparticularclinicaldiagnosis.Andwethinkitimportanttobearthisdifferenceinmind,whenyouareconsideringtakingapsychometricinstrumenttohelpyouwithyourcareerdecisionmaking.


26


When might psychometric instruments be helpful?Let’sreturntotheanalogybetweenclinicalconsultationandcareerdecisionmakingmadeatthebeginningofthischapter.Whilemostinitialconsultationsarelikelytoincludetakingaclinicalhistoryandclinicalexamination,itisnotalwaysthecasethatfurtherclinicalinvestigationsarenecessary.

Asqualifiedtestuserswewouldsuggestthatasimilarsituationappliestotheuseofpsychometricinstrumentsinhelpingmedicalstudents/juniordoctorswiththeircareerdecisionmaking.Theself-assessmentexercisesandstrategiesforcareerexplorationincludedinthisbookwillprobablybesufficientformany(perhapseventhemajority)ofstudents/trainees,andtheywillbeabletomakecareerdecisionswithoutrecoursetopsychometricinstruments.

However,somestudentsortraineesgetabitstuck.Theystrugglewiththeself-assessmentexercises,orhavingcarriedouttheself-assessmentexercisesdon’tknowhowtotranslatetheresultsoftheexercisesintoideasaboutwhichspecialtiestoexplore.Forthesetrainees,personalityinventoriesormeasuresofoccupationalinterestcan,ifusedappropriately,behelpful.

Butitisreallyimportanttointroducesomewordsofcaution,andforyoutounderstandwhatpsychometricinstrumentscanandcannottellyou.

Introducinganotheranalogymighthelpmakethepositionclearer.

Asqualified(ornearlyqualified)clinicians,youmaywellhavebeenirritatedbyill-informedaccountsofmedicalissuesthatyouhavereadinthepopularpress,orhearddiscussedinsocialsituations.Youknowabouttheimportanceofanevidence-basedapproachwithrepresentativesamples,appropriateclinical-outcomemeasures,adequatetime-scalestomeasuretheeffects,etc.

Similarly,asexperiencedcareerspractitioners,weareoftenalarmed(and,ifwearehonest,sometimesinfuriated)bytheill-informedpronouncementsthataremadeabouttheroleofdifferentpsychometricinstrumentsinhelpingmedicalstudentsandtraineedoctorswithspecialtychoice.Weknowabouttheimportanceofexaminingthepsychometricpropertiesoftheinstrument(i.e.thereliabilityandvalidity),andcriticallyappraisingtheevidencethatthisparticularinstrumentmightbeanaccuratepredictoroffuturesatisfactionindifferentspecialties.

So.Whatistheevidence?

27Personality inventoriesPersonalitymeasuresattempttocastlightonourindividualtemperaments–towhatextentweareforexamplecautious,adventurous,curious,gregarious,competitive,independentorsociable.Thesetypesofcharacteristicsmayhaveanimpactonthekindofworkthatwedowellandenjoyandalsoonthetypeofworktasksorenvironmentsthatwemightenjoyless,andfindmoredifficulttocarryout.

Intermsofevaluatingtheevidenceontherelationshipbetweenpersonalityandmedicalspecialtychoice,thepictureiscomplicatedbythefactthatdifferentmeasuresofpersonalityhavebeenusedwithdifferentgroups,thusmakingcomparisonsextremelydifficult.Furthermore,someofthestudieswerecarriedout20oreven30yearsagoandtheremayhavebeenconsiderableshiftsinthenatureofaparticularspecialtyduringthatperiod.AndasmostofthedatacomesfromtheUSAratherthantheUK,giventhattherearedifferencesintheorganisationofhealthcareinthetwocountries,itispossiblethatthewayinwhichaparticularspecialtyispractisedinthetwocountriesmayalsodiffersignificantly.Sothistoowouldcomplicatethepicture.

However,themostrecentreviewoftheliterature(seeBorgesandSavickas,2002)concludedthefollowing:

• Althoughthereisalooserelationbetweenafewpersonalityfactorsandparticularmedicalspecialties,thereismorevariationinpersonalitytraitswithinmedicalspecialtiesthanbetweenthem.

• Allpersonalitytypesappearinallspecialties.

• Morethanonemedicalspecialtyfitsthepersonalityofanyparticularmedicalstudent.

Butonthebasisofthis,theauthorsdonotinfactconcludethatpersonalitytestinghasnoplaceincareercounsellingmedicalstudentsortraineedoctors.Instead,theyrecommendthatpersonalityinstrumentsshouldbeusedasawayofincreasingself-knowledge,ratherthanasadiagnosticprocessthatwill‘match’aparticularpersonalitytoaparticularspecialty.Anarrowlydiagnosticapproachisnotsupportedbytheavailableevidence,andshouldbeavoidedatallcosts.

WhatthismeansinpracticeisthatifyoucompleteaquestionnairesuchastheMyers-BriggsTypeIndicator(MBTI),youcannotuseittoidentifythespecialtytowhichyouwouldbebestsuited.Butyoucanuseittofindoutabitmoreaboutyourself,andthenusethatincreasedself-knowledge(inadditiontotheself-knowledgegainedfromtheotheractivitiesoutlinedinthishandbook)tothinkcreativelyaboutspecialtiesthatmightsuityou.


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Accessing the MBTINowadaysitispossibletoaccesstheMBTIonline,andaquickinternetsearchwillidentifyalistoforganisationsthatprovidethisservice.However,asthepotentialbenefitofthepsychometricapproachresidesinthequalityofthefeedbackdiscussion,wewouldnotrecommendyougoingdownthisroute.Instead,AppendixAgivesalistofprofessionalbodiesthataccreditcareercounsellors,andtheinformationinAppendixAabouttheBritishPsychologicalSocietyexplainshowyoucanidentifyasuitablyqualifiedindividualwhowouldadministertheMBTI,provideyouwithareport,anddiscusstheimplicationsofthereportwithyou.

Measures of occupational interestsHolland’sSelf-DirectedSearchisthemostwidelyusedmeasureofoccupationalinterest.AndtheconclusionreachedaboveabouttheuseofpersonalityinstrumentsappliestotheuseoftheSelf-DirectedSearch.(SeeBorgesetal,2004.)

Inthislaterpaper,Borgesetalmakethefollowingstatementintheirconclusion:

‘Earlyintheirtrainingmedicalstudentsshouldbedisabusedoftheideathatthereisoneperfectspecialtychoiceforeachperson. Insteadtheyshouldbehelpedtounderstandhowthey could use different specialties to construct satisfyingandsuccessfulcareers.’

GiventhattheMMCchangesmeanthattraineesnowneedtomakecareerdecisionsearlieronintheircareers,itmaybringadegreeofreassuranceforsometraineestorealisethatthereareprobablyanumberofdifferentspecialtiesthattheycouldenjoy.(Andforthecynicsamongyou,itisperhapsworthstressingthatthesefindingswerebasedonstudiesintheUSA,soitisnotapoliticalcoincidencethatsuchdatabecameavailablejustasthefoundationpilotswerebeingdevised!)

Sci59 (previously called Sci45)Finally,thereisourownhome-grownUKinventory,Sci59(GaleandGrant,2002).Thisinstrumentwasdevelopedtomeasurepersonalattributesandprofessionalpreferencesofdoctorsintrainingandbeyondandtomatchthesetothecharacteristicsneededtoprosperinthe59mostcommonspecialties,includinggeneralpractice.

29Asarelativelyrecent‘kidontheblock’,Sci59wasnotincludedineitherofthetwostudieslistedabove.However,thebasicnotionthatallpsychometricinstrumentsshouldbeusedtosuggestcareerideasandincreaseself-understanding,ratherthanto‘diagnose’whatspecialtywillsuityou,isabasictenetofsoundcareer-counsellingpractice,andthusappliestoSci59.

Inaddition,ithastobestressedthattherearenopublishedpredictivevaliditydataonSci59(oronitsearlierversion,Sci45).WhatthismeansisthattherearenopublishedstudiesthathaveattemptedtocorrelateSci45scoreswithanymeasureofoccupationalsatisfactionofpeopleinpost.(And,infact,whiletheoriginallistofitemswasdrawnfrominterviewswithconsultantsandGPprincipals,indrawingupthefinallistofitemsSci45wasactuallycalibratedusingresponsesfromSHOswhohadnotyetembarkedontheirspecialtytraining.)

Asforthepracticalities,somemedicalschoolsanddeanerieshavemadeSci59available,whileothershavenot.SoifyouareinterestedintakingSci59youneedtocontactyourpersonaltutororFoundationProgrammemanager,toseeifitisonofferlocally.

ConclusionsWecannotstressstronglyenoughthatpsychometricinstrumentsthatareincludedaspartofacareer-planningprocessneedtoberegardedastoolsthatleadtogreaterself-awarenessratherthanassimplequick-fixsolutions.

Butpeoplelikecertainty.Andifyouareinthehighlystressfulpositionoftryingtochooseyournextcareermove,youmightbedesperatelyseekinganswers.Soyoudon’tnecessarilywanttohearthatpsychometricinstrumentsareindicativeratherthandiagnostic,andcan’tactuallyprovideyouwithdefinitivesolutions.

Giventhatyoumaywellbedesperateforananswer,feedbackshouldalwaysbegivenbypeoplewhounderstandwhatthetestcanandcannottellyou,andknowhowtousetheresultstoenhanceself-understanding.

Ultimately,whatyouwillgetoutofanyadditionalinstrumentsishighlydependentupontheskillsofthepersonwhoisgivingyoufeedback.Iftheychallengeyoutothinkaboutthewaysinwhichtheresultsoftheinstrumentaccord(ordon’taccord)withyourotherself-assessmentactivities,andiftheyarealltooawareofwhattheinstrumentscanandcannottellyou,thenitcanbeuseful.Ifnot,thenitisatbestuseless,and,atworst,misleading.


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Summary of Stage 1

Introduction to summaryItisnowtimetoconstructasummaryofStage1.(RememberthattheprocessofcarryingoutthecareerexplorationtasksinStage2mightmakeyoureconsidersomeofyouranswerstotheseStage1exercises.ThereforeitisperfectlyacceptableforyoutoreturntoandrefinethisStage1summaryatalaterdate.)

ReadthroughyouranswerstotheStage1exercisesthatyouhavecompleted.Ifyouhavecompletedanypsychometricinstruments,thenreadthroughthereportsummaries,aswell,atthispoint.Thenrecordthekeypointsusingthesummaryheadingsgivenbelow.

1. The doctor-patient relationship(WritedownanypointsthathaveemergedfromtheStage1exercisesrelatingtothedoctor-patientrelationship.Thesemightincludesomeorallofthepointslistedbelow,butyoucanalsoaddyourownpersonalpoints.Thelistbelowisnotnecessarilyexhaustive.)

Doyouwanttoseepatientsinacommunityorhospitalsetting?

Doyouenjoybriefencounterswithpatients,orprovidingcontinuityofcareoverlongperiodsoftime?

Doyouwanttospendasignificantportionofyourworkingdayhavingcontactwithpatients?

Doyouwanttoworkwithacutelyillorchronicallyillpatients?

Whatabouttheemotionallandscape?(Forexample,doyoufinditrewardingtoworkwithpatientswhoareinadistressedordisturbedemotionalstate?)

Doyouhavepreferencesabouttheagesofyourpatients?Anddoyoupreferworkingwithindividualpatients,orpatientsandtheirfamilies?

Doyouwanttocontributedirectlytothetreatmentofpatients,orwouldyouenjoyworkingtosupportthediagnosticprocess(e.g.inareassuchasdiagnosticradiologyorpathology)?

Wouldyouenjoyhavingtoconsiderthewholeofthepatient’sbody(e.g.GP/paediatrician),orwouldyouenjoybecominganexpertonaspecificregionofthebody(e.g.ophthalmology)?

Doyouenjoyperformingtechnicaldiagnosticorinterventionalprocedures?

312. Intellectual matters(SomeoftheseissuesmighthaveemergedintheearlierStage1exercises,butitispossiblethattheyhavenot.Iftheyhaven’t,itdoesn’tmatter–justfilloutthesummarynow.)

Whatareasofacademicworkhaveyoumostenjoyedstudyinginyourundergraduateandpostgraduatetraining?

Whatmedicaljournalsareyoumostdrawntoreading?

WithintheBMJ,whatsortsofarticlestendtoattractyourattention?

Whatsubjectshaveyouenjoyed(ormightyouinfutureenjoy)teachingtoothers?

Whatsubjectshaveyoucarriedoutanauditon(ormightyouplantocarryoutanauditoninthefuture)?

Whatsubjectshaveyouenjoyed(ormightyouenjoyinfuture)carryingoutresearchon?

3. StatusInthissectioninparticular(althoughitactuallyappliesthroughoutthewholeofthisStage1summary),itisimportanttoaskyourselfwhetheryouranswersrepresentyourownviews,orwhetheryouarebeingundulyinfluencedbypressurefromsignificantothers,suchasparentsorpartner.

Howimportantisittoyouthatyouworkinahighlycompetitivebranchofthemedicalprofession?

Howimportantisstatustoyou?

Doyouwanttoensurethatthereareopportunitiesforprivatepracticeinyourchosenspecialty?

Doyouwanttogointoabranchofmedicinewherethereisthepotentialforearningaveryhighsalary?

Isitimportanttoyouthatyouhaveopportunitiesforparticipatinginresearch?

Areopportunitiesfortravellingabroadwithyourworkimportanttoyou?


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4. Quality of lifeWhatsortofwork–lifebalancedoyouwanttohavein5–10years’time?

Whatsortofweeklyschedulewouldyouliketohavein5–10years’time?

What,foryou,areyourcoreworkvalues,fromwhichyouderivemostsatisfaction?

Whatstressfulfactorsdoyouwanttominimiseatwork?

Isthelengthofpostgraduatetraininganissueforyou?

5. Relationships with colleaguesDoyouwanttobeabletospendquiteaportionofyourdayworkingonyourown?

Doyouwanttobeabletospendquiteaportionofyourdayworkinginteams?

Doyouenjoyworkinginmulti-disciplinaryteams?

Doyouwanttobeabletodevelopandmanageaclinicalservice?

Doyouwanttobeabletodoquitealotofteaching?

Doyouwanttobeabletocarryoutresearch?

An alternative way of summarising Stage 1

Instructions for alternative summarySomepeoplepreferdiagramsandpicturestowords.Ifyouwouldprefer,youcouldprovideamorevisuallybasedsummaryofStage1.

Takealargepieceofpaper(eitherA3orpaperfromaflipchart).

Copyouttheoutlineoftheshieldshownoverleaf.

Then,ineachofthefourquadrants,eitherwritebulletpointsofthekeyissuesor,ifyouaresoinclined,youcandevisesymbolstodepictthekeyissues.

Then,underneaththeshield,youcouldwriteabriefpunchymottothatencapsulateswhatitisthatisimportanttoyouinyourwork.

Theexampleonthefollowingpage,wasprovidedbyaconsultantingeneralgeriatricmedicine.

33

Final commentsHopefullyyouhavefoundtheseexercisesuseful.Butifyouhaven’t,wewouldaskyoutobearwithus.

Whenyoucometoapplyforjobs,completingtheStage1exercisesinsufficientdetailwillhelpyouconstructclear,credibleanswersonyourwrittenapplicationforms,andalsohelpyoupreparehowtoanswerthesortsofquestionsthatwillbeposedatinterview.Thisisbecausethequalityofyourcareerdecisionmakingwillbethoroughlyscrutinisedintheapplicationprocess,andyouneedtodemonstratethatyouhavecarriedoutadequateself-assessment(Stage1),andthoroughcareerexploration(Stage2).

Afinalissuetoconsideriswhethercareerdecisionmakingisentirelyarationalprocess(asisimpliedbythe4-stagemodel).RecentoccupationalresearcherssuchasKrieshok(2009)arguethatintuitionalsohasavitalroletoplayincareerdecisionmaking;specificallyhesuggeststhatthroughoccupationalengagement(immersingoneselfinone’swork)combinedwithin-depthreflectiononthatengagement–thecontributionofintuitiveprocessesinoverallcareerdecisionmakingcanbeenhanced.Butthereagain,clinicianssuchasthesurgeonandwriterAtulGawandearguethatintuitionalsohasaroletoplayinclinicaldiagnosis–soperhapstheparallelbetweencareerandclinicaldecisionmakingreallyisausefulonetobearinmind.

Explainingtoeveryone

Work values

Contactwithpatients

ExcitementLearningTeaching

HelpingothersWorkwithothers

Hospital

Skills

Applying‘science’touncertainty

TranslatingsymptomsintomedicalmeaningDealingwithangryorupsetpeople

InterestsExplainingmyclinicalthinking/

reasoningtotraineesWorkingwithwhat’scausingproblemsforapatientwhen

otherscannotExplainingcomplexissues

topatients/carers

StressorsPracticalprocedures

Emergency/hyper-acute,e.g.A&Esituations

Managementdecisions


Figure 1: Shield and motto from a consultant

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35


CAREER EXPLORATION

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III. STAGE 2 OF CAREER PLANNING: CAREER EXPLORATION

OverviewThischaptercoversStage2,careerexploration,indetail.Afterabriefexplanationofwhythisstageissoimportant,thestructureofpost-foundationtrainingisoutlined.Youwillthenbeintroducedtopreliminaryresearchtasksthatyoucancarryoutforanumberofdifferentcareeroptions,andmoredetailedresearchtasksthatyouwillcarryoutonasmallersubsetofoptions.Adviceisalsogivenonhowtonarrowdownyouroptions,sothatyouknowwhichoptionstoresearchingreaterdepth.Thechapterendswitha‘realitycheck’sothatyougivesufficientthoughttowhetherornotyourcareerchoicesarerealistic.

Why Stage 2 mattersTheexercisescoveredinStage1shouldhavegivenyouanopportunitytodevelopaclearerideaofwhatyouarelookingforinyourcareer.

InStage2youexploredifferentcareeroptions,inordertofindouttwothings:

Firstly,youneedtoresearchdifferentoptionsinordertoestablishwhichparticularcareerpathwaysaremostlikelytomatchyourownindividualskills,interests,values,personality,etc.Secondly,giventhefeedbackthatyouhavereceivedfrompeoplesuchasyoureducationalsupervisor,clinicalsupervisor,thetrustClinicalTutor/DirectorofMedicalEducationortheFoundationProgrammeTrainingDirector,youneedtoconsiderwhethertheoption(oroptions)thatyouareinterestedinseemtoberealisticcareerchoices.

AtthebeginningofStage2wewanttostressthatadequatecareerexplorationtakestime.Butitistimewellspent.(Bothofushaveworkedwithmanyclientswhoneverreallyexploredtheircareeroptionsproperly,andthen,overaperiodoftime,cametoregrettheirearlierchoices.)Inaddition,aswedescribedabove,spendingtimeexploringdifferentcareeroptionsisnotonlyimportantintermsofmakinggoodcareerdecisions,butwillalsohelpyoulateronattheapplicationformandinterviewstages.

WealsowanttoemphasisethatStage2isnotcarriedoutinavacuum–but,rather,Stage2followsonfromStage1.Thismeansthataswellasfindingoutthebasic‘facts’aboutaparticularcareerchoice(andbythiswemeanfactorssuchastypicaltrainingpathway,forspecialtytraining,person

37specification,competitiveness,etc.),youwillalsoneedtoresearchthespecificquestionsthatyounowrealise(onthebasisofworkingthroughStage1)areimportanttoyou.

AneasywayofdoingthisistousethesummaryexercisethatyoucompletedattheendofStage1togeneratespecificissuesthatyouaregoingtoexploreinyourspecialtiesofinterest.

AcoupleofotherpointsstemfromthisideathatStages1and2arelinked:

Firstly,thecleareryouareaboutwhatisimportanttoyou(Stage1),themoretargetedandrelevantyourStage2researchislikelytobe.

Secondly,alotofthemorepersonalisedinformationthatyouneedtofindoutaboutisnotavailableinthevariousmedicalcareerhandbooksoronthewebsitesofthedifferentRoyalCollegesanddeaneries.Instead,inordertofindoutwhatitis‘reallyreally’liketoworkinaparticularspecialty,youwillneedtotalktopeoplewhoarecurrentlyworkinginthatparticularfield.Withoutthissortofresearch(called‘informationalinterviewing’inthecareer-counsellingworld),itisdifficulttoascertainwhetherthecareerisgoingtomatchyourcoreworkvalues,skills,interests,etc.

Post-foundation trainingPost-foundation,ifyouwishtopursuetrainingwithinaparticularspecialty(includingGeneralPractice)youwillneedtoapplyforaspecialtytrainingpost.AllspecialtytrainingprogrammesleadeventuallytoaCertificateofCompletionofTraining(CCT),assumingsatisfactoryprogressandachievementoftherequiredcompetences.ACCTenablesyoutoapplytotheSpecialistorGeneralPractitionerregisterheldbytheGeneralMedicalCouncil.

Therearetwobroadtypesoftrainingprogrammesinspecialtytraining–‘run-through’trainingand‘uncoupled’trainingprogrammes.A‘run-through’programmeisonethatoffersthetraineestructuredtrainingthatwilltakethemthrough(assumingsatisfactoryprogress)tothepointwheretheycanbeawardedaCCT.

An‘uncoupled’trainingprogrammeisonewhichofferstwoyearsofcoretraining(threeinsomespecialties,e.g.psychiatry)followedbyopencompetitiontoenterhigherspecialtytrainingprogrammesleadingtoCCT.SecuringacoretrainingpostinanuncoupledspecialtydoesnotguaranteeyourprogressionthroughtoCCT.Youwillhavetogothroughanotherroundofcompetitionforpostsattheendofyourcoretraining.Entryforpostsatthisjunctionbetweencoretrainingandhigherspecialtytrainingwillbeopentoalleligibleapplicants(includingthoseworking

Stage 2 – Career Exploration

38


innon-trainingposts).Thismeansthattheremaybesomeopportunitiesinfutureyearstoentertrainingatahigherlevel,forthosepeoplewhowerenotpreviouslysuccessfulinsecuringacoretrainingpost.But,again,inhighlycompetitivespecialties,itislikelytobeextremelydifficultforanapplicanttosecureatrainingpostatST3/4,iftheyhavenotpreviouslybeeninacoretrainingprogramme;theywillneedtodemonstratetherequisitecompetences.

Thefollowingdiagramisanoverviewofthecareerstructureforfoundationandspecialtytraining:

Figure 2

F1

Run-through postsST1, 2, 3, 4, 5, 6, 7 (8)

CT1, 2, (3)

ST3-ST7 (8)

F2

FoundationTrainingCorespecialty

trainingHigherspecialty

training

CompetitionforST1/CT1post(allspecialties)

Competitionforhigherspecialty

training(uncoupled)

Certificateforcompletionoftraining(CCT)

The flowchart below outlines the career structure for foundation and specialty training. This is an overview only. There may be other points of entry which aren’t shown here, depending on which vacancies are available at different stages of training

Specialtiesofferingrun-throughtrainingmayalsooffersomefixed-termspecialtyappointments(FTSTAs).Thiswillmeanthattheremaybesomeopportunitiesfordoctorstodeveloptheirtrainingexperiencesothattheymightbesuccessfulatalaterdateinsecuringaspecialtytrainingpost.ButithastoberecognisedthatinmanyspecialtiestherewillbehighlevelsofcompetitionandtakinganFTSTAinahighlycompetitivespecialtywon’tinanywayguaranteelatersuccessinobtainingatrainingpostatST2orST3.

Under-graduatemedicaltraining

(DiagramadaptedfromimagebyDavidRice,KSSDeanery,2008)

39The application processApplicationstospecialtytrainingprogrammesareeitherthroughaRoyalCollegewebsiteortheleaddeanerywebsitedependingonthespecialty.GPrecruitmentismanagedthroughthenationalGPrecruitmentoffice(http://www.gprecruitment.org.uk/)andAcademicClinicalFellowshipsthroughtheNationalInstituteforHealthResearch(http://www.nihrtcc.nhs.uk/intetacatrain/).TheModernisingMedicalCareerswebsite(www.mmc.nhs.uk)containsthemostuptodatepictureontheoverallprocessandtimetableforspecialtytrainingrecruitment.

Therearealsoopportunitiesfordoctorswhoeitherdonotsucceedinsecuringatrainingpostorwhodecidethattheywanttogainmoreexperiencebeforechoosingaparticularspecialty.Furtherinformationisavailableonthemedicalcareerswebsite(http://www.medicalcareers.nhs.uk/postgraduate_doctors/specialty_doctors.aspx).JobopportunitiesareoftenadvertisedinNHSjobsandBMJcareers.

Entryforpostsatthisjunctionbetweencoretrainingandhigherspecialtytrainingwillbeopentoalleligibleapplicants(includingthoseworkinginnon-trainingpostsorotherwisenotoncoretrainingprogrammes).Thismeansthattheremaybesomeopportunitiesinfutureyearstoentertrainingatahigherlevel,forthosepeoplewhowerenotpreviouslysuccessfulinsecuringacoretrainingpost.Butagain,inhighlycompetitivespecialties,itislikelytobeextremelydifficultforanapplicanttosecureatrainingpostatST3/4,iftheyhavenotpreviouslybeeninacoretrainingprogramme.

Thedescriptionoftherecruitmentandselectionprocessiscorrectatthetimeofgoingtopress(July,2010),butitisimportantthattraineesrefertotheMMCandnationalmedicalcareerswebsitetokeepabreastofanymorerecentchanges.


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And in future years?Itisnotpossibletoprovidedetailsoftherecruitmentandselectionprocessesthatwillbeusedbyparticularspecialtiesastheyarecontinuingtoevolve.Howeveritispossibletomakesomegeneralcommentsthatshouldstandthetestoftime.

1. Keep on top of the system

Post-foundationtrainingcontinuestodevelopandchangeandtheonlywayyoucanensurethatyouarenotdisadvantagedbyfailingtofindoutaboutcriticalinformationistocarryoutregularchecksonsixdifferenttypesofwebsite:

a TheModernisingMedicalCareerswebsite(www.mmc.nhs.uk)whichproduceskeydocuments,outliningandupdatingdetailsofpost-foundationtraining,e.g.applicanthandbookandpersonspecificationsforeachspecialty

b TheMedicalCareerswebsite(www.medicalcareers.nhs.uk)whichcontainsinformationaboutspecialtiesandarangeofcareerplanningtoolsandresources

c Deanerywebsites,ofanyDeaneriestowhichyoumightapply

d RoyalCollegewebsite,ofanyspecialtiestowhichyoumightapply

e GPrecruitmentwebsiteforopportunitiesinGPspecialtyprogrammes

f NIHRwebsiteforopportunitiesinacademicmedicine,e.g.AcademicClinicalFellowships

2. Begin early

Don’tleaveyourcareerexplorationtothelastminute.Thishasneverbeenawisestrategybut inthecurrentsystemofflux it isparticularlyunwise.Instead,fromthetimeyoustart inyourfirstfoundationpostyoushouldberegularlycarryingouttheself-assessmenttasksdescribedinthepreviouschapter,andthecareerexplorationtasksdescribedinthischapter.

3. If you are uncertain – ask for help

Asajuniordoctoryouwillhaveaneducationalsupervisor,aswellasaccesstootherseniorclinicianswithadditionaleducationalresponsibilitiessuchastheDirectorofMedicalEducationorCollegeTutor. Ifyouareunsureabouttheimplicationofwhatyoureadonthesedifferentwebsites(orinthemedicalpress),thenaskforclarificationfromoneofthesepeople.Itisknownthatthesystemisparticularlyconfusingatthemoment,anditisbettertoseekclarificationearlyon,ratherthanwaituntilthepointwheneverybodyisfillingintheirapplicationforms.

41Preliminary research tasksThesortsofissuesthatyoumightwanttobeginbyresearching(andinfactyoumaycarryoutthismorebasicdesk-boundresearchforanumberofdifferentoptions)includethefollowing:

Entrycriteriatothespecialty:thisisclearlylaidoutinthepersonspecificationswhichareavailableontheMMCwebsite.YoucanthenreviewyourStage1assessmentsagainstthepersonspecification,toseeifthereisaclosefit,orifthereareanyskillsorexperiencesthatyoumightneedtoacquire.

Ifyouarenotcurrentlyonafoundationprogramme,youneedtocheckthatyouareapplyingforentrytothecorrectlevel.YoureducationalsupervisororClinicalTutorshouldbeabletoadviseyouonthis.Alternativelyyoucancontactthecareersspecialistsatyourdeanery.Ifyouhaveaveryunusualquery,youcanalsoemailtheMMChelpdesk:[email protected]

Theapplicant’sguidetoSpecialtyTraining(availableontheMMCwebsite)containsdetailedadviceforoverseasapplicants,anditisimportantthatalloverseasapplicantsreadthisinformationcarefullybeforesubmittinganapplication.AndifyouhaveanyqueriesthecareersspecialistsatyourdeaneryortheMMChelpdesk(seeabove)shouldbeabletohelp.OverseasapplicantsshouldchecktheMMCwebsiteregularly,sotheykeepuptodatewithanychangestothelaw.

The C word (Competition)Inthepastitwasverydifficulttogetinformationabouttherelativecompetitivenessofdifferentspecialties.Oneofthedeaneries(theWestMidlands)pioneeredtheproductionofdataonthecomparativecompetitivenessofdifferentspecialties,butthesewerelocalratherthannationalfigures.Nationaldatafromthepreviousroundofrecruitmentarenowavailable(typicallyontheMMCwebsite)anditisimportantthatyoufamiliariseyourselfwiththisinformation.Informationaboutworkforceplanningdataisavailableonthenationalmedicalcareerswebsite(www.medicalcareers.nhs.uk).

Youalsoneedtodiscussthepossibleimplicationsofthecompetitivenessofyourspecialtychoiceswithyoureducationalsupervisor.


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Beyond preliminary researchSomeofyoumayknowimmediatelywhichoptionsyouwanttoexplorefurther.Ifthisappliestoyouthenskiptothenextsection.Butothersofyoumaybefarlesssure.

Ifyoufallintothislattercategory(i.e.youdon’tknowwhichoptionstoexploreindepth),thenthefollowingsuggestionsmighthelp:

1.Completearelevantpsychometricinstrumentinordertogeneratelistsofspecialtiesthatmightsuityou.(Remember,though,thatinthepreviouschapteritwasarguedinsomedetailthatresultsfrompsychometricinstrumentsshouldneverberegardedasnarrowlydiagnostic.)

2.DiscussyourStage1summarywithyoureducationalsupervisor,clinicalsupervisor,theClinicalTutor/DirectorofMedicalEducationortheFoundationProgrammeTrainingDirector,toseeiftheycanhelpyouwithideasofcareerstowhichyoumightbesuited.

3.ReadthroughoneonthespecialisedmedicalcareerhandbookbooksmentionedinAppendixBandreviewthespecialtyinformationprovidedonthemedicalcareerswebsite(www.medicalcareers.nhs.uk).Fromthese,chooseanumberofcareeroptionsthatseem,oninitialreading,tobeinteresting.

4.SearchthroughtheBMJCareerswebsitewhichcontainnumerousarticlesoncareersindifferentspecialties.

5.CheckthewebsiteofdifferentDeaneriestoseewhatinformationtheyprovideaboutthedifferentspecialtiesintheirregion.

Isn’t there another way of identifying suitable careers?Perhapsyouaresurprisedthatthereisn’tamore‘scientific’methodthanthesuggestionslistedabove.Butbasedonourprofessionaltraining,andalsoonourexperienceofhelpingpeoplemakegoodcareerdecisions,weknowthatthisprocessisasmuchanartasitisascience.Socalled‘scientific’approaches(particularlytheuseofpsychometricinstruments)canbeusefulingeneratingideas,buttheydon’tholdalltheanswers.Andoftentheanswersstarttoemergethroughfollowingupthesuggestionsofcolleaguesandsupervisorswithwhomyouhaveworked,coupledwithafairsmatteringofbackgroundreading.

Andfinally–ifyouhavedonealloftheabove–andnothinggrabsyourattention,perhapsyouneedtoaskyourselfwhetheryouactuallywanttoremaininmedicine.Ifthisisthecase,westronglyrecommendthatyou

43eitheraskforareferraltothespecialistcareersadviser(ifyourdeaneryhasone),oryouseekoutsomeprivatecareercounsellingwithanappropriatelyqualifiedcareerscounsellor.

(SeeAppendixAforalistoforganisationsthataccreditcareersprofessionals.)

How to research options in further depthHavingdecidedwhichoptionsyouwishtoexplorefurther,youthenneedtoworkoutwhatitisyouwishtofindout,andhowyouwillgoaboutdoingso.

Often,thebestwaytofindoutmoreaboutaparticularcareeroptionistotryitout,asoneofyourfoundationprogrammeplacements.Butifthisisnotpossible(eitherbecausethespecialtyyouareinterestedindoesn’tofferfoundationplacements,orbecauseyouweren’tsuccessfulingettingtheplacementyouwanted),thenseeifyoucanarrangea‘taster’weekideallyearlyinyourfoundationyeartwo.AgoodplacetostartwouldbetodiscussthiswithyoureducationalsupervisorandFoundationProgrammeTrainingDirector.

Informational interviewingLookatthesummaryyouconstructedattheendofStage1.Foreachofthefivedifferentsections,writedownalistofspecificquestionsthatyouaregoingtoaskofthepersonwhois(orpeoplewhoare)currentlyworkingintheoptionsthatyouareinterestedin.

Youthenneedtoidentifyatleastoneperson(andpreferablymorethanone)workinginthatspecialty,inordertoputthesequestionstothem.Askyoureducationalsupervisorforsuggestionsastowhomyoucanask.Inaddition,youcanapproachcollegetutors.Itishelpfulifyouareabletotalktopeopleatdifferentlevelsofseniority,soaskamongyourfriendstoseeiftheyknowSpRsorconsultantsworkinginyourfieldofinterest.

Finally,setyourselfasuitabletimescaleinwhichtheseinterviewswillbecarriedoutandarrangetodiscussyourfindingswithyoureducationalsupervisor,orotherexperiencedclinician.


44


Person, phone or email?Ideallyyoushouldtalktopeoplefacetoface.(AndsomeDeaneriesorganisecareersfairswhereyoucantalktopeopleinallsortsofdifferentspecialties,andtheBMJCareersFairsarealsousefulwaysoftalkingtopeopleinparticularspecialties.)

ClearlyifyouaredoingafoundationplacementinalargeteachinghospitalyouwillhaveeasieraccesstoabroaderrangeofspecialtiesthanifyouareinaspecialisedpsychiatrichospitalorasmallerDistrictGeneralHospital.Ifyoucan’tmanageaface-to-faceinterview,thenseeifyoucanarrangetotalktosomebodyonthephone.

Andifallelsefails–emailpeople,andaskifyoucansendthemalistofquestions.

Butwhateveryourmodeofcommunication,youneedtoapproachthetaskofinformationalinterviewingasanimportantresearchproject.Youarenothavinganaimless‘chat’;instead,youaretryingtogetanswerstosomeofthequestionsthathaveemergedfromtheStage1self-assessment.

(BeawarethatsomeoftheresponsestoquestionswillbequitesubjectiveThereforeitisusefultospeaktomorethanoneperson.Findoutwhattheintervieweeenjoysabouttheirwork.Notonlyisthisinterestinginformationtoelicit,butiftheygiveyouaverycynicalresponse,thenyouknowthatyoumightbegettingasomewhatjadedopinion.Andwhileitisclearlyimportanttogetabalancedratherthananoverlyglossyviewofthespecialty,youdowanttoavoidbeingturnedoffaspecialtybecauseyouhavetalkedtoaburnt-outclinician.)

Finally,it’sworthwhilegoingbacktothelibraryandspendingabitoftimewithyournoseinthejournals.Choosethemajorjournalsinyourspecialtyofinterest(ifyouareunsureaboutwhichjournalstheseare,askthelibrarian)andspendsometimehavingagoodreadthroughsomerecentissues.

Ofcourse,asyouhaven’tbegunspecialisttrainingintheseareas,manyofthearticleswillbetoospecialised.But,ingeneral,askyourselfwhetheryouaregrippedbysomeofthearticles,orwhethertheyleaveyousomewhatcold.

Inadditiontotherelevantjournals,youcanalsoaskthelibrariantodirectyoutosomeofthecoretextsinthefieldsthatyouareexploring.Andagain,poseyourselfthesamequestion.AmIreallyinterestedinreadingmoreaboutpsychiatry(cardiology,pathology,etc.)?Becauseifyouare,thatisagoodsign.Butifyouarenot(assumingthatyouhavechosenatextbookatapproximatelytherightlevel),thenyouneedtoaskyourselfwhetheryouaremakingagoodcareerdecision.

45Reality check: is your career decision realistic?Thisisprobablythetrickiestissueofall.

Duringcoursesforconsultantsweoftengetaskedaboutthebestwaysofapproachingtraineeswhohave‘aninsightby-pass’.Andtheconsultantsthenstarttogivedetaileddescriptionsoftraineeswithseveredyspraxiawhowanttotraininmicro-surgery.

But,ontheotherhand,wealsooftenhearfromconsultantswhohadbeenadvisedatanearlierstageoftheircareerthat‘theywouldnevermakeit’asaradiologist,gastro-enterologist,etc.Andtheretheyare,15yearsintotheircareersasconsultantradiologistsorgastro-enterologists.Iftheyhadlistenedtothe‘advice’thathadbeengiventothemearlieron,theywouldhaveperhapsdeniedthemselvesthechanceofsucceedinginthecareerthattheyhadsettheirheartson.

Asatrainee,youhavetoaskyoureducationalsupervisorwhethertheythinkthatyourcareerplansarerealistic.(Andifyoureducationalsupervisorknowslittleaboutthespecialtyyouareconsidering,then,havingcompletedsomeofthecareerexplorationtasks,youshouldbeabletofilltheminwithdetailsofthepersonspecification,trainingpathway,competitionratiosetc.)

Clearlyiftheyfeelthatyourplansarerealistic,thenthereisn’taparticularproblem.(Althoughinthecurrentclimateoffluxyoushouldrealisethatthissupportfromyoureducationalsupervisordoesn’tguaranteethatyourplanswillbesuccessful.)

Butifyoureducationalsupervisorthinksthatyouarenotbeingrealistic,thenyouareinastickierposition,andyoushouldalwaystrytogetasmuchinformationaspossibleastothespecificnatureoftheirconcerns.

Ifyouthinkthattherehasbeenabreakdownofcommunicationwithyoureducationalsupervisorandthatyouhavebeenunfairlyjudged,thenyoucanasktodiscussyourplanswithanotherconsultant,orwiththeFoundationProgrammeTrainingDirector.(Inthefinalchapter,wewillrecommendtoallclinicianswhomaybetakingpartinthesesortsof‘secondopinion’meetingsthattheyalwayshaveacopyofallthepreviousassessmentsandalsoabriefreportfromtheeducationalsupervisor.)But,byallmeans,askifyoucanhavea‘secondopinion’fromanotherclinician.

Perhapsyoufeelthatyourdifficultiesinacertainplacementwereduetothingsgoingoninyourpersonallife,andyouareconfidentthatyoucouldhaveperformedbetterifcircumstanceshadbeendifferent.Ifatallpossible,discussthiswithyoureducationalsupervisororFoundationProgrammeTrainingDirector.


46


But,ifyoufeelunabletodoso,thenthiswillbesomethingthatyoutakeaccountof,butisnotsharedwithyoursupervisingconsultants.

Ultimatelythedecisionastowhattoputdownonyourapplicationformisyourown.Andifyoudecidethatyoureducationalsupervisorisbeingunfairorundulypessimistic,thenyoucanofcourseactagainsttheiradvice.Butwewouldurgeyou,attheveryleast,torespondtoanycommentsthatyougetaboutnotbeingrealistic–bysayingtoyourself:‘HowdoIknowthatitisrealisticgiventhefeedbackthatIhavereceived?’Andyoushouldalsoaskyourself:‘HowamIgoingtobeabletoconvincetheshort-listingpanelandinterviewingpanelthatIamasuitablecandidate?’Toavoidchallengingyourselfwiththesetwoquestionsistoadopttheostrichapproach.And,asyet,therearen’ttoomanyostrichesinseniormedicalpositions.

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DECISION MAKING

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IV. STAGE 3 OF CAREER PLANNING: Decision Making

OverviewThischapterguidesyouthroughthedecisionmakingprocess.

Therearethreeexercisesinthischapter.Thefirst(‘ConstructingaLifeline’)providesyouwithanopportunitytoreviewsignificantdecisionsthatyouhavemadeinthepast.Thesecond(‘TheDecisionTemplate’)offersastructuredapproachforcomparingthedifferentoptionsthatyouarecurrentlyconsidering.

Butwhatevermethodyouuse,bytheendofStage3youwillneedtohavereachedadecisionaboutwhichoption(oroptions)youwillbeapplyingfornext.

ThethirdexerciseinvolvesyouusingtheROADSacronymtochecktherobustnessofyourcareerdecision,andthechapterendswithbriefadviceforthoseofyouwhoarefindingitdifficulttomakeupyourmind.

Exercise 1: constructing a Lifeline

Instructions for exercise 1Thinkabouthowyouhavemadeimportantdecisionsinthepast:forexample,career-relateddecisionsaboutA-levelsubjects,applyingformedicalschool,electivechoices,etc.,orpersonaldecisionsthatareunrelatedtowork,suchastakingagapyearbetweenschoolanduniversity,startingorendingasignificantpersonalrelationship,etc.

Then,followtheinstructionsbelow.(AndseeFig.2foranexample.)

1.Takeasheetofpaper(ideallyA3orflipchartpaper.ButA4willworkifitisallthatisavailable).Turnitroundsothatitis‘landscape’ratherthan‘portrait’.

2.Drawahorizontallineacrossthemiddleofthepaper.Notedownyourageattheright-handendoftheline.Then,putina‘plus’(+)abovethehorizontalline(tosignifytimesthatyoulookbackonwithpleasure)anda‘minus’(-)belowtheline(tosignifythosetimeswhenthingswerenotgoingwell).

493.Beforeyougoanyfurther,thinkverycarefullyaboutthecoursethelinewilltake.Wherearethehighpointsandthelowpoints?Whichpartsoftheline(ifany)arerelativelystable?

4.Nowmarkinthesignificantlifeevents.Includeexperienceswhichinfluencedyou,achievements,andbothgoodandbadeventsthathaveoccurredinyourlifetodate.Allowyourselfsufficientspace,asincludingoneeventmaytriggeramemoryofanother.

5.Connectupthepointsthatyouhavemarked.

6.IdentifyacoupleofdecisionsthatyouhavemarkedonyourLifelinewhichyoufeel(inretrospect)haveworkedoutwell.Whatmadethemgooddecisions?Howdidyougoaboutmakingtheseparticulardecisions?

7.Now,identifyacoupleofdecisionsonyourLifelinethatyoufeel(inretrospect)didn’tworkoutsowell.*Whatmadethempoorerdecisions?Howdidyouapproachthesedecisionsthatdidn’tworkoutsowell?

8.Amuch-favouredadageofpsychologistsisthatthebestpredictoroffuturebehaviourispastbehaviour.Bearingthisinmind,canyouusethisanalysisofpastdecisionstothrowanylightonhowyoushouldapproachthecareerchoicesthatyouarecurrentlyfacing?(Onewayofdoingthisistolookatyouranswerstoquestions6and7inordertoidentifythebestwayforyoutoapproachyourcurrentdecision,aswellasapproachesyoushouldavoid.Forexample,doyouseemtobesomebodywhomakesgooddecisionswhenyourelyonyour‘gut’feelings,orareyousomebodywhohasmadeyourbestdecisionswhenyouadoptamorestructuredapproach?)

________________________________________________________________

* When we have used the Lifeline exercise in workshops (with both consultants and trainees), we have often heard the comment that there is no such thing as an entirely ‘bad’ decision, as good elements can emerge even from decisions that didn’t turn out at all smoothly. We would both entirely agree with this, and have examples from our own personal career histories that illustrate the point. Moreover, in our professional practice we often hear clients describe career decisions that they regret taking, but which they do realise also allowed them to develop certain useful skills. However, in terms of the Lifeline exercise, we do think that it is possible to identify decisions that you have taken that, in retrospect, you feel were not the best ones. These are decisions where, even though you can see that some good things have emerged from them, you have a sense that a different decision at that point in your life would probably have been a better option. It is these sorts or decisions that we would like you to identify in question 7.

Stage 3 – Decision Making

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9.HasanythingelsestruckyoufromcompletingthisLifelineexercise?(Andincaseyoudon’tunderstandthisquestion,itmighthelpifwegiveyouanexampleofthesortofinsightthatcanemerge.Oneofusonceranatwo-daycareer-planningworkshopforahousingassociationthatwasmakingalargenumberofstaffredundant.Thestaffattendingtheworkshopwere,forentirelyunderstandablereasons,angry,de-motivatedandanxiousaboutthefuture.Oneparticularmemberofstaffwasverywithdrawnduringthefirstdayoftheworkshop,andwasreluctanttocontributetothediscussions,orcompleteanyoftheactivities.FollowingtheLifelineexercise,therewasanoticeableshiftinhisattitude.Whenthefacilitatorremarkedonthis,andenquiredwhathadhappened,thememberofstaffrepliedthathehadfeltoverwhelmedbytheforthcomingredundancy,andhadconvincedhimselfthathewouldn’tgetanewjob.Butwhenhereviewedhislifelineasawholeherealisedthatthecurrentdilemmawasjustoneofaseriesofobstaclesthathehadfacedinhislifeand,ashehadovercomethepreviousones,henowfeltmoreconfidentthathewouldn’tbedefeatedbytheforthcomingredundancy.Thisisjustoneexample.ButitgivesaflavourofthesortofinsightsthatsometimesemergefromtheLifelineexercise.)

Figure 3 Lifeline Example from a consultant

+

__ _

_

+

+ +

Diagnosed withchildhood RA(RheumatoidArthritis)

Accepted forCambridge

Good

decis

ion

Marry, LifetimeFriendSupport

Work innegativeunrealisticexpectation ofspecialty-wrongarea, wrong specialty

Appointed asgeriatric trainee.Good decision!

Appointed as consultant

DeaneryPost!

Post too busyReduced supportPressure toorganise research

Correctcareerchoice!

0 7 26 27 29 34 48 50

Age

51Exercise 2: a more structured approach to decision making

Instructions for Exercise 2IftheresultsfromtheLifelineexercisesuggestthatyouwouldbenefitfromamorestructuredapproach,thenyoumightfindtheexercisebelowhelpful.

1.WithreferencetotheStage1Summary,andusingthefiveheadings(Doctor-PatientRelationship,IntellectualMatters,Status,QualityofLifeandRelationshipswithColleagues),writedownyouranswerstothequestionslistedinFig3.Then,alongthetop,writedowntheparticularcareeroptionsthatyouarecurrentlyconsidering.(Ideally,thisshouldnotbemorethanfour,asotherwisethedecisionmakingbecomesratherunwieldy.)

2.WithreferencetoyourStage2research,notedownwhetheragivenfactor(e.g.seeingpatientsinacommunitysetting;continuityofpatientcare,etc.)ispresentorabsentinthedifferentspecialtiesyouareconsidering.

3.Countingthenumberof‘ticks’ineachcareeroptionmaywellbemisleading,becausethedifferentfactorsarenotnecessarilyofequalimportance.Instead,wewouldsuggestthatinitiallyyou‘eyeball’thechart,andseewhatconclusionsyoureach.Havingdonethat,wewouldrecommendthatyoudiscussthechartwithsignificantpeopleinyourlife(partner,family,closefriends),andalsowithyoureducationalsupervisor,oranotherclinicianwhoknowsyourclinicalwork.Inthisway,thebestcareerdecisionshouldbecomeclearertoyou.Inthisexercisewehaven’tincludedtheprecisedetailsofhowmanyoptionsyouhavetochoosefromatanyparticularstage(i.e.thedetailsofapplicationforfoundationyear1orpost-foundationtraining).Wecannotgazeintoacrystalballandpredicttheprecisedetailsoftheapplicationprocessintofoundationyear1,orintopost-foundationtrainingthatwillbeinplacenextyear,letalonetheyearafter.Thuswetookthedecisiontodescribeagenericapproachtodecisionmakingwhichcanbeappliedtoanysituation.


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Figure 3: Exercise 2 – Questions to consider for each option1.Doctor-patientrelationship Options

(pleasetick)

1 2 3

Doyouwanttoseepatientsincommunityorhospitalsetting?

Do you enjoy brief encounters with patients,or providing continuity of care over long periodsoftime?

Do you want to spend most of your working dayhavingcontactwithpatients?

Do youwant toworkwith acutely ill or chronicallyillpatients?

Whatabouttheemotionallandscape?(Forexample,doyoufinditrewardingworkingwithpatientswhoareinadistressedordisturbedemotionalstate?).

Do you have preferences about the ages of yourpatients?Anddoyoupreferworkingwithindividualpatients,orpatientsandtheirfamilies?

Doyouwanttocontributedirectlytothetreatmentofpatients,orwouldyouenjoyworkingtosupportthediagnostic process (e.g. in areas such as diagnosticradiologyorpathology)?

Wouldyouenjoyhavingtoconsiderthewholeofthepatient’sbody,(e.g.asaGP/paediatrician),orwouldyouenjoybecominganexpertonaspecificregionofthebody(e.g.ophthalmology)?

Do you enjoy performing technical diagnostic orinterventionalprocedures?

532.Intellectualmatters Options(pleasetick)

1 2 3

Whatareasofacademicworkhaveyoumostenjoyedstudying in your undergraduate and postgraduatetraining?

What medical journals are you most drawntoreading?

Within the BMJ, what sorts of articles tend toattractyourattention?

What subjects have you enjoyed (or might you infutureenjoy)teachingtoothers?

What subjects have you enjoyed (or might youenjoyinfuture)carryingoutresearchon?

What subjects have you carried out an auditon (or might you plan to carry out an audit oninthefuture)?

3.Status Options(pleasetick)

1 2 3

Howimportantisittoyouthatyouworkinahighlycompetitivebranchofthemedicalprofession?

Howimportantisstatustoyou?

Doyouwant toensure that thereareopportunitiesforprivatepracticeinyourchosenspecialty?

Doyouwanttogointoabranchofmedicinewherethereisthepotentialforearningaveryhighsalary?

Isitimportanttoyouthatyouhaveopportunitiesforparticipatinginresearch?

Are opportunities for travelling abroad with yourworkimportanttoyou?


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4.Qualityoflife Options(pleasetick)

1 2 3

Whatsortofwork-lifebalancedoyouwanttohavein5-10years’time?

Whatsortofweeklyschedulewould liketohave in5-10years’time?

What,foryou,areyourcoreworkvalues,fromwhichyouderivemostsatisfaction?

What stressful factors do you want to minimise atwork?

Is the length of post-graduate training an issueforyou?

5.Relationshipswithcolleagues Options(pleasetick)

1 2 3

Doyouwanttobeabletospendquiteaportionofyourdayworkingonyourown?

Doyouwanttobeabletospendquiteaportionofyourdayworkinginteams?

Doyouenjoyworkinginmulti-disciplinaryteams?

Do youwant to be able to develop andmanage aclinicalservice?

Doyouwanttobeabletodoquitealotofteaching?

Doyouwanttobeabletocarryoutresearch?

55Crunch Time: Making the DecisionFromExercise2youshouldhavegotsomesenseofwhathashelpedyoutomakegooddecisionsinthepast(andperhapstoo,offactorsthathavecontributedtoyoumakinglesssuccessfulchoices).ItisworthbearinginmindKrieshok’sfindings(mentionedinChapter2),thatintuitioncanalsobeimportantincareerdecisionmaking.ButitisalsonecessarytobeclearaboutwhatKrieshokissayingwhenhedescribesintuitivedecisionmakingprocesses.Hecertainlyisn’ttalkingaboutcrystalballornavel-gazing.Insteadhearguesthatthewaytohelppeoplemakegoodcareerdecisionsistoencouragethemtogetstuckindifferentcareer-relatedactivitiesandthenstepbackandreflectontheexperience.Atthispoint(andnotbefore)–astrong‘gutfeeling’thataparticularoptionisright(orforthatmatterwrong),maywellbeofvalue.

Exercise 3: how robust is your career decision?ThefinaltaskthatwewouldencourageyoutocarryoutistointerrogateyourcareerdecisionusingtheROADSchecklist.Initiallywewouldsuggestthatyoushoulddothisonyourown.Butthenyoushouldtalkthroughyourconclusionswiththesamepeoplelistedabove.(And,ofcourse,theresultsofallthreeexercisesdetailedinthischaptercouldbediscussedwiththerelevantpeopleononeoccasion,oronseparateoccasions,dependinguponyourownparticularcircumstances.)

Good career decisions: ROADS

Realistic–areyoubeingrealisticaboutyourselfANDthedemandsofthejob?

Opportunities–haveyougivenseriousconsiderationtoalltheopportunitiesavailable?

Anchors–haveyoubuiltinthethingsthatprovidesupportinyourlife?

Development–doyourchoicesfullydevelopyourpotential?

Stress–haveyouconsideredthoseaspectsofworkthatcreateparticularstressesforyou?


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If you can’t make up your mindThereareanumberofpossiblereasonswhyyoumightstrugglewithadecision.(Andinfact,thesereasonsarenotmutuallyexclusive.)

1.Youarestillunclearaboutyourskills,interests,achievements,values,etc.

2.Yourcareerresearchtodatehasn’tenabledyoutobecomemoreclearabouttheextentofthe‘match’betweentheworkfactorsthataremostimportanttoyouandthedifferentcareeroptionsthatyouarecurrentlyconsidering.

3.You’vegonethroughStages1and2thoroughlybutyoustillcan’tmakeupyourmind(perhapsbecauseyouaresomeonewhoalwaysstruggleswithdecisions).

4.Youareuncertainwhetheryouwishtoremaininmedicineatall.

If1and/or2applytoyou,andyouhaven’treallydevotedmuchtimetoworkingthroughthestructuredexercisesoutlinedinthishandbook,thenitmightbeusefulforyoutogobackanddoso.Butif3applies(i.e.youhavecompletedtheexercisestothebestofyourability,anddiscussedthemwithyoureducationalsupervisor,butyoustillcannotdecide)wewouldadviseyoutoaskforareferraltothedeanerycareersteam.

Andif4applies,thenwewouldstronglyrecommendthatyouseekprofessionalhelpfromanexperiencedandappropriatelyqualifiedcareersprofessional(seeAppendixA).Bothofushaveexperienceofworkingwithindividualswhofallintothiscategory,andasaresultweknowthatthedecisiontoleavemedicineisamajorone,andthattheindividualsconcernedhaveenormouslyappreciatedtheinputfrompeoplewhohaveaprofessionalgroundingincareerplanning.

57Some final thoughtsAnumberofclinicalcolleagueshavegivenustheirinsightsintothedecisionstheymadeontheirspecialtychoice–seeTable2below.

Table 2: specialty choice – some reflections from some consultants and a GP

“ I have made a sequence of specialty decisions throughout my career and I realise that where I am now could have been reached by several different routes. My decision to go into anaesthesia was because it combined an in-depth knowledge of physiology with practical skills and I loved the specialty. The challenge of intensive care took the knowledge and skills combination to a new level for me with the additional elements of teams working together in a critical situation and communicating with patients and their families. Then, when an opportunity to develop my interest in medical education came along, I jumped at it. Certainly, my career plans have changed with my circumstances, the system and the opportunities available.”

“ I enjoy new challenges; being open to changes and flexible enough to take advantage of them is important to me… Nothing stands still; my career has been a fantastic journey – and it still is!”

“ My career owes more to serendipity rather than planning, and I am grateful that medicine has supplied me with so many diverse opportunities… Advice? Think about what you like doing and how to engineer change. If you consider that something could be done better, make constructive suggestions and ask for support to improve it. Be aware, though, that you will probably end up running it and more…”

“ I have been a consultant anaesthetist for just over 20 years. During that time my clinical work has changed and evolved giving me the opportunity to develop and improve services for patients, and participate in training new entrants to my speciality. My non-clinical work has enabled me to be involved in postgraduate medical education and NHS management, as well as contribute to national organisations and specialist societies.


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Many of the roles I have undertaken have come about because I have volunteered and got involved in areas not traditionally associated with my clinical role in a District Hospital in Wales. I have found that if you feel strongly about a subject, are enthusiastic and demonstrate a willingness to work hard and implement change, all sorts of things are possible. My career is always developing and has plenty of challenges – six years ago I was the President of the Medical Women’s Federation and Flexible Training advisor to the Royal College of Anaesthetists. Today I am an Associate Dean for Careers and Less than full-time training in Wales and a Special advisor – Careers to the UK Foundation Programme Office. I even went back to formal study and obtained a PG certificate at the age of 53. Who knows what tomorrow may bring, Finally, my supportive partner and children have certainly helped along the way.”

“ I am a geriatrician. Like most of us, I think I made my decision quite late as I realised that I liked general medicine and didn’t really want to specialise. I was also very aware of a work-life balance. I think I would have been happy in most specialties – most of us enjoy having specialist knowledge and being able to make a difference.”

“ When I commenced my PRHO year, I had been quite determined to become a surgeon. During my stint in surgery, this interest strangely ebbed and disappeared, perhaps out of a realisation that I did not possess the appropriate mindset. I then considered paediatrics, which I had enjoyed as a medical student, but had concerns with pursuing, having had little personal experience of dealing with children. Two weeks as a PRHO in paediatrics proved sufficient to rekindle this interest and any anxieties were dissipated by paediatric trainees, who advised me to trust natural paternal instincts! Twenty-six years on, I have no regrets whatsoever.”

“ You may want to use my quote as an example of how not to do it. I applied for chest medicine in the early 1980s for two reasons. Firstly, I and my contemporaries were assured that there would be lots of jobs in chest medicine in the late 1980s, when all the chest physicians appointed shortly after World War II to sanatoria posts would be retiring, and, secondly, I thought that my father, who died in my first year at medical school, was a chest physician and I wanted to follow in his footsteps. The sanatoria were closed down in the mid-1980s, and so jobs were extremely scarce in the late 1980s, and it turned out that my father was a cardiologist!”

59“ I made my specialty choice largely on the basis of work-life balance. I wanted a career that in the future would be flexible enough to fit around having children and possibly moving around the country (depending on my husband’s work). This sounds quite old-fashioned and unambitious, but having subsequently gone on to be involved in running the GP Flexible Career Scheme, I know it is something a large proportion of female (and some male) doctors aspire to once the reality of having children hits home. It is very hard when choosing a career path in your mid-20s to think ahead to having a family, but I would encourage anyone who wants to do so (and has a partner with a career) to talk to as many doctors as they can who have attempted to combine career and family. I suspect many wish they could work part-time, but have been unable to do so in hospital specialties. As a GP you maintain ultimate responsibility for the care of the whole patient and the role has endless variety and stimulation. It is sometimes possible to negotiate a contract for “school hours only” for a few years, which is invaluable if you have small children and a partner who works long hours.”

“ There are also many opportunities for outside interests; I have been able to develop a career as a GP educationalist while my children are still young, doing much of my work in the evenings when they are in bed and fitting the rest around school runs, sports days and all the rest of family life. It was definitely the right choice for me.”


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61


PLAN IMPLEMENTATION

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V. STAGE 4 OF CAREER PLANNING: Plan Implementation

OverviewThischaptercoversthenitty-grittyofputtingyourplanintoaction.Itbeginswithadescriptionoftheapplicationprocess,andthenincludesdetailedadviceonhowtofillinapplicationforms.Inaddition,CVguidelinesareincludedinAppendixC.Thechapterthenmovesontoexplainingpreparationyoucandoinadvanceoftheinterview,andalsocoversadviceonperformingwellontheday.

SomespecialtiesalsorequireapplicantstomakeapresentationaspartoftheinterviewprocessandwehaveincludedsomebasicguidelinesongivinganinterviewpresentationinAppendixD.

Thischapterendsbyreferringtosomecontemporaryresearchoncareerplanningwhichhighlightstheroleofluckandchance.Inendingthechapterinthiswaywearenotsuggestingthatyoucanrelyonstrikingitlucky–butatthesametime,theresearchdoesflagupthealmostinevitableinfluenceofchancefactorsinlifelongcareerplanning.

Application formsInrecentyearstherehasbeenanenormousshiftintheapplicationprocess.Notsomanyyearsagoapplicantsfilledinastandardhospitalapplicationform(whichwasoftenthesameforadministrative,clericalandallhealthcarestaff),andtheyalsoincludedaCV.Intheoldsystemverylittleweightwasattachedtothebriefpersonalstatement’onthestandardapplicationform,andeverythingwentontheCV.

Buttimeshavechanged,andstructuredapplicationformshavelargelyreplacedCVs.Oneofthedifficultiesinthischangeisthatsomeconsultantshaven’tquiteregisteredthisit.Thismeansthattheymightnotalwaysprovidethemostusefuladvice.Itislikelythatapplicationformswillcontinuetoevolveandshort-listingwillprobablystilltakeplaceonthebasisofsomesortofstructuredform.Sothinkingabouthowbesttoapproachtheseformsisstillanecessarytask.

63Initial preparationAlthoughinthecurrentsystemyoudon’thavetocompletetheapplicationinonesitting,itstillhelpsifyouarethoroughlypreparedforwhentheapplicationprocessgoeslive.

Oneusefulwayofmakingthetaskoffillingintheseformseasieristoprepareanup-to-dateCVinadvance(seeAppendixC).Thismeansthatallthebackgrounddata(datesofexams,ofelectives,ofdifferentposts,etc.),iswellorganisedinadvance,andinoneplace.

Intermsofhelpingyouanswerthemorediscursivequestionsontheforms,theanswerstotheexercisesthatyouhavecompletedinthishandbookshouldprovidegoodrawdata.Inaddition,juniordoctorswillalsoneedtorefertotheirlearningportfolios,whilesomemedicalstudentswillhavesimilarcollectionsofreflectivewritingthattheyhadtofillinfortheirundergraduatecourse.Thebetterorganisedyouarewiththesethreedocuments(i.e.yourCV,youranswerstotheROADSexercisesandyourlearningportfolio),theeasieryouwillfindthetaskoffillingintheapplicationform.

Overview of the application processAsdescribedinchapter3,specialtyrecruitmentiseithernationallyordeaneryleddependingonthespecialty.Whatthismeansisthatyouhavetofamiliariseyourselfwiththedeanery,RoyalCollegeandMMCwebsites,inordertobeontopoftheprocessusedinthespecialtiestowhichyouintendtoapply.Ifyoulookatthesewebsitesyouwillfindoutwherethepostsareadvertised.Inaddition,youwillalsofindoutaboutthetimelineforapplications.Thesedatesareimmutableandyouwanttobeawareoftheminadvance,sothatfillingoutyourapplicationformsdoesn’tbecomeahorrendouslast-minuterush.Thisisparticularlyimportantifyouintendtosubmitanumberofdifferentapplications.

Adetailedapplicant’sguidetospecialtyrecruitment,toassistapplicantswiththeprocess,isavailableontheMMCwebsite.YouwillneedtomakesureyouhavereadthroughthisguideandthoughtaboutitsimplicationsassoonasitismadeavailableontheMMCwebsite.

Stage 4 – Plan Implementation

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Figure 4: Overview of the application process for foundation and specialty training programmes

65Some golden rulesManyofthepointslistedbelowwillseemobvious.Butoneofushashadexperiencescoringapplicationsforfoundationprogrammes(andtheotherhasconsiderableexperienceofmedicalrecruitmentandselection,particularlyatconsultantlevel)–andbothofusknowthatanumberofapplicantsdisregardsomeofthesebasicpoints.

1. Preparation, preparation, preparationMakesurethatyouunderstandthepracticalitiesoftheapplicationprocess.

Thisinvolvesreadingthroughthewholeformextremelycarefully.Whenisthedeadline?Lookingatallthequestions,howlongmightittakeyoutodevisereallygoodanswers?Willyouneedtofindadditionalinformationthatyoudon’tyethavetohand?

Youshouldn’tstartansweringanyquestionuntilyouhavestudiedthewholeform,becauseanexamplethatyougiveforonequestionmightbeonethatyoufindyouwanttore-useforasubsequentquestion.

2. Understand what the recruiters are looking forFamiliariseyourselfwiththepersonspecificationforthetrainingpostasshort-listingwilltakeplacewithreferencetothisspecification.(Afterall,youmightbakethebestchocolatechipcookiesontheplanet,butiftherecruitersaren’tlookingforchocolatechipcookiebakersitprobablywon’tdoyouanygoodtosayso.)Youalwayshavetoconstructyouranswerstothequestionswiththepersonspecificationinmind.(Butthisdoesn’tmeanasimplereiterationofthepersonspecificationonyourapplicationform.Thatapproachbecomesextremelytiresomeforthereader.)

3. Check, check, and then check againMistakes(inspellingorgrammar)willmakeitharderforyoutogetyourpointsacrossandcanleadtothelossofmarks.Youmightfeelthatthisisunfairasyouareapplyingtoworkasadoctor,notanEnglishteacher.Butwewouldcounter-arguethatthedifferencebetween0.25and0.025mgforaparticularmedicationcouldbeamatteroflifeanddeath.Attentiontodetailmatters,andbeingsloppyonyourformwon’thelpyougetyourmessageacross.

4. A note about plagiarismTherehavebeenanumberofcasesrecentlywhereapplicantshavebeenreferredtotheGMCforplagiarism.Sobearinmindtheguidancegivenin‘GoodMedicalPractice’that:‘Youmustbehonestandtrustworthywhenwritingreports,andwhencompletingorsigningforms,reports


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andotherdocuments.’Italsogoesontosaythat:‘Youmustalwaysbehonestaboutyourexperience,qualificationsandpositions,particularlywhenapplyingforposts.’

Completedapplicationformswillbecheckedforplagiarismandtheanswersontheformmustbeyourownratherthancopiedfromtheworksofothers.Usingacommercialservicetoprovideanswersforyourformswouldnotberegardedascompatiblewiththerequirementthatyouwritetheanswersyourself.Andifthecommercialservicesendupwithanumberofapplicantswritingverysimilaranswers,thenthisisthesortofsituationthatmightbedetectedbytheanti-plagiarismsoftware.

Theissueofhowmuchhelpfriends/supervisorscanresponsiblygiveyouisafargreyerarea.ButinChapter6(thechapterforeducationalsupervisors)weadviseconsultantstogiveyougeneralfeedbackratherthanmentioningspecificwordingthatyoushouldincludeontheforms.

How to approach the short-answer questionsTherewillbeanumberofquestionsontheformthatrelatetothepersonspecification.Youcould,forexample,beaskedaboutyourexperienceofteam-working,leadership,time-management,makingdifficultdecisions,oryourlongertermcareerplans.

Typically,thespacetoanswerthesequestionsislimitedtoaspecificwordcount.

Someconsultantsmayberelativelyunfamiliarwiththesesortsofquestions,andmaystrugglewithgivingyouthebestadvice.(Certainly,theadvicethatyoucandashoffanyoldanswer,becausethesequestionsaren’tthatimportant,isnotadvicethatyoushouldfollow.)

1.Asawayofpreparingtowriteyouranswer,youmightwanttousetheSTARstructure.Bythiswemeanyoucouldbreakdownyourexampleinto:Situation/Task Provideaconciseoverviewoftheexampleyouareconsideringusing,ensuringthatitisrelevanttothequestion. Actions Whatexactlydidyoudo?Whatwasyourroleandcontribution?Whatskillsdidyouuse?(Thispartwillprobablyformthebulkofyouranswer.) Results/Reflection Whatwastheoutcome?Whathaveyoulearntfromit?

67TheSTARacronymisaveryusefulwayofanalysingtheexamplesthatyouintendusingintheshort-answerquestions.However,dependingupontheactualwordingofthequestion,youmightnotactuallyincludeallthedifferentparts,oryoumaywanttoemphasiseonepartmorethananother.SointheactualansweryouwillhavetotailortheSTARcomponentstothespecificsofthequestion.ButSTARisanexcellentstartingpoint.

2.Asmentionedabove,gathertogetheralltherelevantpersonaldatathatyoumightneedtoreferto,inoneplace,beforeyoustartansweringthesequestions.Andbythiswemeanyouranswerstotheexercisesinthisbook,yourCV,yourlearningportfolio,informationonanyauditsyouhavedoneand,forjuniordoctors,theassessmentsthatyouhavecarriedout.

3.Beforeyoustartwritinganything,readthroughtheGMC’sguide‘GoodMedicalPractice’(whichcanbeobtainedfromtheGMCwebsite).Thiswillremindyouofthequalitiesandvaluesthatthereaderwillbelookingforinyouranswers.Scoringoftheapplicationformmayrelatetotheelementsofgoodpracticeoutlinedinthisdocument.

4.Readthequestionextremelycarefully.Youneedtomakesurethatyouanswerallpartsofthequestion,aseachpartwillbeallocatedseparatemarks.Ifthequestionhasanumberofparts,structureyouranswerinalogicalwaysothatitmatchesthedifferentpartsofthequestion.Inthiswayyouwillmakeiteasierfortheshort-listertorecognisethatyouhavefullyansweredalltheparts.Inaddition,youranswersalwaysneedtoberelevanttothequestionthathasbeenasked.(Whenwearerunningseminarsonapplicationformsweoftensaythatyoushouldimaginethateachwordyouwriteisfightingforinclusioninyouranswer.Ifitdoesn’t‘addvalue’,itshouldn’tbethere.)

5.Whenthequestionasksforexamplesofachievements,orinitiative,orleadership,itisnotrequiringyoutohaveextraordinaryexamples.Inotherwords,theshort-listersarenotexpectingyoutohavewrittentheleadarticleinNature,orhaveclimbedtothetopofEverest.Instead,theyarelookingforanswersinwhichyoureflectintelligently,andwithinsight,onthesortsofexperiencesthatyouwouldbeexpectedtohave,atyourparticularleveloftraining.

6.Youwillfinditeasiertowritegoodanswersaboutgenericskills(e.g.time-management,communicationskills,teamworking)ifyouhavehadsomebackgroundtrainingintheseissues.Ifsessionsonthesetopicsareofferedaspartofthegenerictrainingprogramme,wewouldstronglyadviseyoutoattendthem.Thiswillgiveyouabasictheoretical


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underpinningthatyoucanusetostructureyouranswer.Ifthesesessionshaven’tbeenoffered(orifyoumissedthem),thendoabitofbackgroundreadingbeforefillingouttheform.

7.Whenyouareconstructingyouranswerstrytothinkaboutwhatanobserverwouldnoticeiftheyhadbeenwatchingyou.Forexample,ifyouwereaskedtoexplainhowyoucommunicatedwithanagitatedpatient,agoodanswermightdescribehowyouremainedcalm,andrespondedtothespecificconcernsthepatientraised.Ifthepatienthaddemandedtoseetheconsultant,youwouldalsoexplaincarefullytothepatientthattheconsultantwasnotonsite,butyouwouldbedoingawardroundthefollowingmorningandtakepersonalresponsibilityforaskinghim/hertospeaktothepatientwhens/hewasontheward.Ananswerlikethisdemonstratestothereaderthatyoudoinfactknowwhatconstituteseffectivecommunicationwithanagitatedpatient.Incontrast,ananswerwhichsaidsomethinglike‘ImadesurethatthewayIrespondedtothepatientdiminishedtheirlevelofagitation’doesn’tconveytothereaderthatyouwouldhavethefirstcluehowtodothisinpractice.

8.Youwillprobablyneedtoedityourfirstattemptatwritingtheseanswers.Wesuggestthisbecauseoftenthefirstdraftmissespointsout,orincludesirrelevantdetail,butitisdifficulttospotthisatthetime.Instead,ifyouwritethefirstdraft,andthenleaveit(foratleastafewhours),whenyoucomebacktoit,itisfareasiertoseewhatchangesneedtobemade.

9.Whatyouneedtoavoidissomethingthatreadslikeareiterationofthepersonspecification.Incontrast,whatyouwanttoaimforissomethingthatengagestheinterestofthereader.Withthebestapplicationformsnotonlyisitclearthatthecandidatehasthenecessaryabilitiesandskills,butthereaderalsobuildsupaninitialsenseofwhatthecandidateislikeasaperson.It’saveryhardbalancetostrikebecauseyoudon’twanttosoundtooconfidentorover-familiar.Butyoualsodon’twantyouranswerstobearidortosoundasiftheyhavecomeoutofatextbook.

Inourexperiencethebestwayoffindingthemiddleroadandwritinganswersthatengagetheinterestofthereader(andare,ofcourse,alsohighlyrelevanttothequestion)istowriteaboutexamplesthatmattertoyou.Withtheseexamples,itiseasiertoconveyyourinterestandinvolvement,andinturnthishelpstoengagethereader.Butyoualsoneedtoallowsufficienttimeforfillingintheapplicationform.Ifyouhavereadthequestioncarefully,chosenyourmostappropriateexamples,andthenfine-tunedyouranswersthroughsufficientediting,youaremaximisingyourchancesofsuccess.

69So how long is long enough?Therearenohardandfastrulesonhowlongittakestofillinyourapplicationform.Butinourexperienceitusuallytakeslongerthanyouwouldthink.

Wewouldcertainlyadviseyounottoleavetheformstothelastcoupleofdaysbeforethedeadline.Instead,lookatthemassoonasthesystemgoeslive,andapproachfillingthemininthesystematicwaythatwehavedescribedabove.Itmightalsobehelpfultoaskmoreseniorcolleagueswhohavealreadycompletedtheseformshowlongittook.

Portfolios and CVsDuringbothfoundationandspecialtytrainingyouwilluseaportfolio/e-portfoliotosupportyourlearning,collecttogetherinformationaboutyourassessmentsandotherachievements.YourportfoliocanhelpsupportyouwithcareerplanningandyourPersonalDevelopmentPlancanbeusedtohelpyouconsiderwhatyouneedtodotoprogressyourcareer.

Keepingyouportfoliouptodateisessentialasitisusedasevidencetosupportsign-offasyouprogressthroughyourtrainingprogramme(FoundationandSpecialty)andcanbeusedtohelpsupportyourapplicationsforspecialtytraining.Itisoftenreviewedduringtheselection/interviewprocessintospecialtytraining.Doensureyourportfolioiscomprehensiveandcontainsyourreflectionsonyourtrainingtodate.ItshouldalsoincludeaCVwhichisausefulwayoforganisingdataaboutyoureducationalcareerhistorytodateandwehaveincludedsomeadviceonwritingCVsinAppendixC.

Long listing and short listingOncetheapplicationdeadlinehasbeenreachedthenextstageintheselectionprocessislonglisting.Theapplicationswhichhavebeenreceivedarecheckedagainsttheessentialeligibilitycriteriainthepersonspecificationforthespecialtyandlevelappliedfor.Thenextstageisshortlisting.ForGPrecruitmentthisinvolvesMachineMarkedTests(MMT)inClinicalProblemSolving(CPD)andSituationalJudgement(SJT)anddetailedexplanationsofthesedifferenttests,togetherwithsamplequestions,areavailableontheGPnationalrecruitmentwebsite(www.gprecruitment.org.uk).Forotherspecialtiesshortlistingiscarriedoutbyconsultantsinthatspecialty.SomespecialtiesarereviewingtheirselectionmethodologyanditlikelythatMMTswillbedevelopedandformanincreasingpartoftheselectionprocessinthefuture.


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Interviews

IntroductionItisusefultobeginbythinkingaboutthepurposeofinterviews.

Aformalansweristhatthepurposeoftheinterviewistoassesseachcandidateagainstthepersonspecification,andthusidentifywhichcandidate(orcandidates)isbestsuitedtothepositiononoffer.Butitisalsoimportanttorealisethatyou(astheapplicant)andthepanelmembersallsharemembershipofthehumanrace.Aninterviewshouldnotfeellikeamechanisedprocessofqualitycontrolbut,instead,aprofessionalconversationinwhichyoubuilduprapportwiththepanel.

Ofcourse,buildingupsuchrapportiseasiersaidthandone.Andnearlyeverybodyisnervousbeforeaninterview–particularlywhenthereisalotatstake.Butitisusefultorememberthatyouwanttoconveyasenseofwhoyouareasapersonduringtheinterview.Afterall,thepanelwillbeaskingthemselvesifyouarethesortofpersonwhomtheywouldwanttohaveasatrainee.

Ifyouareverynervous,itisfinetosaytothepanelthatyoufindinterviewsquitestressful.Similarly,ifyouareaskedanextremelydifficultquestionyoucanbeginyouranswerbysayingsomethinglike‘That’satoughone.ButI’llgiveitago.’Inthese–andotherways–youcanconveysomethingofyourpersonalitytothepanel.

Weoftenremindourclientsthatinterviewsforjobsarenotlikepoliceinterrogations.Bythiswemeanthatwhereas,ifthepolicewereinterviewingyoutofindoutifyouhadcommittedacrime,youwouldbeunwisetocommentthataquestionwasveryhard,orthatyouneededabitoftimetoprepareananswer,suchstrategiesareentirelyappropriateinajobinterview.Because,inthelattersituation,respondinginthiswaybothgivesasenseofyourownpersonalityandalsoshowsthatyouhandlepressurewell.

Preparing for an interviewMostinterviewswillbestructuredandtime-limited.Therewillalmostcertainlybemorethanonepersonpresent.Ifthereisapanel,onememberwillbeappointedasChair,andisthepersonwhoislikelytowelcomeyou,introducetheotherpanelmembers,andoutlinethestructureoftheinterview.Ifthemantraforestateagentsis‘location,location,location’,asimilarrefrainforcareercounsellorswouldbe‘preparation,preparation,preparation’.(Andthisapplies,ofcourse,asdiscussedabove,totheapplicationformstageaswellastointerviews.)

71Thereasonwhythisissoimportantisthatmanyquestionscanbroadlybepredictedinadvance.Soifyoudevoteadequatetimetopre-interviewpreparation,youshouldbeabletoimprovethequalityofyourperformanceontheday.(Ofcourse,youmightstillbeaskedsomequestionsthatyouhaven’tconsideredbefore.Butifastructuredinterviewprocessisused,atleastyoucanreassureyourselfthatallthecandidateswillhavebeenaskedthisparticularquestion.)

So how should you prepare?Forstartersitishelpfultorealisethatquestionswhichareaskedatinterviewsareusuallydividedintothreebroadareas:

1.Questionsaboutyou.

2.Questionsaboutthejob/specialty.

3.Questionsaboutthewidercontextofhealthcare.

Eachofthesethreecategorieswillbeconsideredinturn.

1. Questions about youThelistbelowgivesexamplesofthesortsofquestionsaboutyourselfthatyoumightbeasked.

1.Describesomeofyourkeyqualities/characteristics.

2.Tellmewhatyouhavegainedfromyourtrainingtodate?

3.Whatareyourkeystrengths?

4.Whatdoyouthinkisyourgreatestachievementtodate?

5.Tellmeaboutyourapproachtoworkinginateam.

6.Describeasituationatworkwhich,inretrospect,youthinkyoucouldhavehandledbetter.Whatdidyoulearnfromthesituation?

7.Whatsortofdecisionsdoyoufinditdifficulttomake?

8.Whatdoyouseeyourselfdoinginfiveyears’time?


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General guidance on these questionsItisalwaysfarbettertorefertospecificexamplesthantotalkingeneralities.So,forexample,ifyouareaskedaboutyourstrengths,mentionperhapstwotofourpoints,butlinkeachofthemtoaspecificexample(whichcanbefromworkorfromoutofwork).Ifyoujusttalkingeneralities(I’mcompassionate,organised,thorough,etc.),alittlevoicepipesupintheheadofthelistenersaying,‘Well,youwouldsaythat,wouldn’tyou?’Butifyousupplytheexamples,theanswerasawholehasmuchmorecredibility.

(Andasanaside:that’swhyworkingthroughtheexercisesinthisbookisimportant,becausetheysupplyyouwiththesortsofexamplesthatyouwillneedtodrawoninyourapplicationformsandatinterview.)

Notonlyshouldyouhavethoughtoutexamplesofallyourpositivepoints,butyoushouldalsohaveplannedwhatexamplesyouwillgiveifyouareaskedaboutyourmistakesorareasofweakness.

Thekeythingtoconsiderwhenyouareaskedaboutmistakesorareasofweaknessistochooseanappropriateexample.BearinginmindtheelementsoftheGMC’s‘TheNewDoctor’youcannotrefertoanyexamplethatwouldcausethepaneltohavedoubtsaboutyoursuitabilityasadoctor.But,equally,youdon’twanttorefertoanythingtootrivial,ortobetoocleverbysneakinginapositiveundertheguiseofanegative.Forexample,ifyouareaskedaboutyourweaknesses,respondingbysayingthatyouworktoohardmightbeoff-puttingforthepanel.Everybodyhasareasofpersonalweakness,andtheyshouldbeabletodiscussthem,withinsight,ataninterview.

Wewouldsuggestthatthebeststrategyistochooseamiddle-of-the-roadsortofexample,andthen–whetheryouareaskedforthispartornot–tellthepanelhowyouremediedthesituation.So,forexample,youcouldsaysomethingsuchasinitiallyyoufoundithardtoswitchofffromwork,anditwasaffectingyoursleep.Butyourealisedthatyouhadtobeabletorechargeyourbatteriesattheendoftheday,soyoustartedgoingforarun,playingthepiano,readinganovel,orwhatever,andthathelpedyoutoswitchofffromworkandgetagoodnight’ssleep.(Thisisonlyoneexample–therearehundredsthatyoucoulduse.Butitillustratesthepointthatyouneedtopicktheeverydaysortsofexamplesthatwillhaveactuallyhappenedtoyouaspartofyourmedicalschool/foundationtraining,andthendescribetothepanelwhatyoudidtoremedythesituation.)

732. Questions about the job/specialtyQuestionsinthiscategorymightincludethefollowing:

1.Whydoyouwantthisjob?

2.Whyhaveyouappliedtothisparticulartrainingprogramme?

3.TalkusthroughyourCV.

4.Whatskillswillyoubringtothisspecialty?

5.Describeyourviewsonwhetherlessthanfull-timetrainingispossible?

6.Whatdoyouthinkittakestoexcelinthisparticularspecialty?

7.What’sthemostusefulcoursethatyouhaveattendedinthelast12months?

8.Tellusaboutaresearchpaperthatyouhavereadrecentlythathashadanimpactonyourclinicalpractice.

ForquestionsofthistypeyouwillbedrawingonyouranswerstotheStage1andStage2exercises,includinganypsychometricinstrumentsthatyouhavecompleted.Ifyouhavegivensufficientthoughttoboththesestagesyoushouldbeabletogivecoherentanswerstothesesortsofquestions.Thisisbecause,essentially,mostofthesequestionsareassessingthematchbetweenyourpersonalqualitiesandthedemandsofthejob.

Beforeyougoforaninterviewyoushouldbefamiliarwiththepersonspecification,andanyotherbasicinformationontrainingissuedbytherelevantRoyalCollege.Inaddition,youshouldalsotrytogetsomesense(eitherthroughCollegeliteratureorthroughtalkingtopeopleinpost)oflikelydevelopmentsinthatspecialty,because,withtheintroductionofnewtechnologies,somespecialtiescanexpectsignificantchangesinthefuture.(Awell-knownexampleiscardio-thoracicsurgery,wheretheriseininvasivecardiology–performedbymedicallytrainedcardiologists,notsurgeons–hasmeantthatmoreproceduresarebeingdonethroughcatheters,withearlierinterventioninacutemyocardialinfarction,andthereforelessopen-chestsurgeryisrequired.)Socheckforlikelyfuturedevelopmentsinyourspecialtyofinterest.

Asforgoodwaysofansweringquestionsaboutthespecialty,youneedtodistinguishbetweenquestionsofdifferentsorts.Forexample,ifyouareaskedwhyyouwanttotraininaparticularspecialty,youshouldn’thavetopauseforalongtimebeforeyouanswer.Infact,youshouldexpecttobeaskedwhyyouareapplyingforthepost,andagood,well-thought-outanswershouldbeonthetipofyourtongue.


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However,youmightalsobeaskedtodiscusssomemorecomplexscenariosrelatedtoyourspecialty–orindeedtothepracticeofmedicineingeneral.Inthissituation,youwillnotbeexpectedtohaveananswerimmediatelyanditisperfectlyacceptabletopausebeforeyourespond.(Moredetailedguidanceonansweringquestionsofthissortwillbegivenbelow.)

Questions about the wider context of healthcareTypicalquestionsinthisthirdcategoryincludethefollowing:

1.WhatdoyouthinkabouttherecommendationsoftheTookeInquiryintoMMC,andtheDepartmentofHealth’sresponsetotheserecommendations?

2.Describehowyouthinkappraisalwillhelpimprovethequalityofcarethatdoctorsdelivertotheirpatients?

3.WhatdoyouthinkarethemainchallengesfacingtheNHS?(ThesecouldincludePaymentbyResults,MMC,NHSDirect,FoundationTrusts,etc.)

4.Shouldpatientsbeinvolvedindecisionmakingabouttheircare?

5.HowmighttheEuropeanWorkingTimeDirectiveaffectyou?

6.Whatisaudit,andhowdoesitdifferfromresearch?

7.Canyoutellmeaboutanauditprojectthathasinfluencedyourpractice?

InansweringthesequestionsyouarenotexpectedtobeanexpertonhealthpolicyorhaveanMBAinhealthcaremanagement.However,youareexpectedtohaveabasicunderstandingofthewiderhealthcarecontextinwhichyouwouldbetraining.

Asabasicminimumyoushouldlookatthefollowingwebsites:

1.TheDepartmentofHealth.

2.TherelevantRoyalCollege.

3.TheDeanery/FoundationSchooltowhichyouareapplying.

4.TheMMCwebsite

Inaddition,youmightalsowanttolookthroughtheon-linearchivesofBMJCareers(tofindrecentarticlesaboutyourspecialty),HealthServiceJournal(togetshortarticlesonhealthservicetopics)andperhapseventheKing’sFund(whichhasgoodcoverageofrelevantNHSpolicyissuessuchastheestablishmentoffoundationtrusts).

75Ifyouareverykeenonmanagementissues,andseeyourselfassomebodywhomightwanttomanageaclinicalserviceinfuture,seeifyoucangettotalktosomebodyinyourTrust(orPCT)whohasaseniormanagementposition.Theywillbeabletogiveyouafeelforhowinitiativeswhichyoureadabout(e.g.PaymentbyResults)arebeingimplementedinpractice.

Questions that you can’t easily anticipateYoumightfindthatyouaregivenparticularclinicalscenariosandaskedtocommentonthem.Or,alternatively,youmightbeaskedaboutyourviewsontrickyethicaldilemmas.

Asmentionedabove,don’trushintoansweringquestionsofthissort,andtakeamomentortwotogatheryourthoughts.Asregardstheclinicalscenarios,thepanelwillbeinterestedinboththecontentofyouranswerandalsowhetheryoudemonstrateasystematic,well-thought-outapproachtotheproblem.Ifthereisonefactthatyouareunsureabout,thenacknowledgethistothepanel,buttryyourbesttoprovidealogical,well-reasonedanswerthatdemonstratesanabilitytodistinguishbetweenessentialandnon-essentialclinicaltasks.

Incontrasttotheclinicalscenario,ifyouareposedacomplexethicaldilemma,youdon’tnecessarilyneedtogivethepanelahard-and-fastanswerastoexactlywhatyouwoulddo.Instead,youcansaythatthatisaverytrickysituation,andonethatyouwouldhopethatyouwouldneverfindyourselfin.Ineffect,youdescribethefactorsthatyouwouldtakeintoconsiderationwhenapproachingthesituation,ratherthannecessarilycomingupwithsomethingcutanddried.

(If,though,thepanelsaysthatyouaresittingonthefence,andtheyneedyoutobemoreexplicitinwhatyouwoulddo,thenofcourseyouwouldhavetocomedownononesideofthefenceortheother.)

Structuring your answerInthesectionaboveonapplicationforms,itwassuggestedthatyoucouldusetheSTARapproachasinitialpreparationforyourapplicationformanswers.

Torecap:theSTARapproachsuggeststhatyoushoulddothefollowing:

1.Brieflydescribethesituationortask.

2.Brieflydescribeyourownactions/activities–i.e.whatyoudid.

3.Brieflydescribetheresults(and/oryourreflections).

4.TheMMCwebsite.


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Itcanbeusefulinterviewpreparationifyoureadthroughyourportfolio,andtheanswerstotheStage1and2exercises,inordertoanalysebothpositiveandnegativeexamples,usingtheSTARstructure.However,wewouldnotsuggestthatyounecessarilysticktotheSTARstructureinhowyouwordyouranswerininterview–orthatyounecessarilygiveequalweighttothedifferentcomponents.

Youcertainlydon’twanttogivetheimpressionthatyouareparrottingpre-preparedanswers,asthisisunlikelytobuildarapportwiththepanel.

Instead,bythinkingthroughclearexamples(ofbothpositiveandnegativeaspectsofyourwork)priortotheinterview,youcangivemoresuccinctandfocusedanswers.

General advice on interview technique1.Ifyouarebeinginterviewedbyapanelyouneedtomakesurethatyou

buildarapportwithallthepanelmembers.Althoughyoushouldfocusyoureyecontactonthepersonwhohasaskedyouthequestion,youmightalsowanttomakeeyecontactfromtimetotimewiththeotherpanelmembers.

2.Ifyoudon’tunderstandaquestion,theninthefirstplaceyoucanaskforittoberepeatedorclarified.Ifyoustilldon’tunderstandaftertherepetition/clarification,itisprobablybesttoindicatethisinyouranswer.Forexample,youcouldsaysomethinglike:‘Iamnotsureifthisiswhatyouarelookingforintheanswer,butIthinkthatthekeypointsherearex,yandz.’Ifthereisanypossibilitythatyouhaven’tproperlyunderstoodthequestion,itisbettertoalludetothisinyouranswer.Givingacompletelyoff-the-wallanswer,withoutindicatingtothepanelthatyouknowyoumaybewayoff-track,ispotentiallyfarmoredamagingtoyourchances.

3.Itistobehopedthatthepanelwon’tbegivingyoushort,closedquestions(exceptwheretheyneedtocheckoutparticularfactualdetails,suchaswhenyouwouldbeabletostartinpost).Butiftheydo,resistthetemptationtogiveone-wordanswers,andexpandontheansweralittle,regardlessofthequestion.

4.Ifyoudon’tknowtheanswertoafactualquestion,don’trambleoninthehopeofdivineinspirationarrivingmid-answer.Inourexperience,ittendsnottobeforthcoming!Instead,itisbesttoadmitthatyoudon’tknowtheanswer,smile,andexplainthatyouhaveforgottenit,orthatitissomethingyouhaven’texperiencedyet.Ifyoucan,offerananswertoamoregenericsituationrelatedtothequestion,butthatdoesn’trequireyoutorememberaparticularfactualdetail.(Forexample,ifyouareaskedaboutthemanagementofaparticularconditioninan

77elderlypatient,andyouhaveforgottenthedetails,orneverknewthem,wewouldsuggestthatyouadmittoyourignorance,andthensaysomethingaboutgeneralapproachestocareoftheelderly.)

5.Longramblinganswersarebestavoided.Assoonasyourealiseyouhavestartedtoramble,pause,gatheryourthoughts,provideabriefsummary,andthenfinishoffyouranswer.

6.Lookthroughthesuggestedinterviewquestionslistedaboveandpractisegivingsuccinctanswers.Wewouldsuggestthatyousaytheseanswersoutloud,ratherthanrunningthroughthepointsinyourhead.Ifyougetintothehabitofvocalizingyouranswertothemirror,itcanbelessanxiety-provokingtohearyourselfspeakingintheactualinterview.Inaddition,youcanalsopractisenotrushingthroughyouranswers,butusingaslightlyslower,clearer,rateofspeech.

7.Thinkaboutyourbodylanguage(notonlyeyecontact,butalsohowyouaresitting,whetheryouappearsufficiently,butnotoverlyrelaxed,etc.).Ifappropriate,alightnessoftouchcangodownwell–butobviouslythisdependsuponthesituation.So,forexample,ifyouarepresentedwithascenarioinvolvingaverydistressingsituation,wewouldnotadviseyoutotreatitinalight-heartedmanner.Butifyouareaskedaboutyourweakness,youcan(afterfirstdemonstratinginsightthroughanappropriatediscussionofaparticularweakness)addacommentlike:‘Ialsohaveaweaknessforchocolate’,orManchesterUnited,orwhatever.Butyouhavetouseyourprofessionaljudgementastowhethersuchcommentswouldbeappropriateornot(justasyouuseyourjudgementwithpatientsastowhether,ataparticularmoment,alight-heartedcommentwouldeasethesituation,orcausegreatoffence).

When it’s your turn to ask questionsAttheendoftheinterviewyoumaybeaskedifyouhaveanyquestions.(Ifyourinterviewisonly10–15minutes,thismightnothappen.)

Iftheydoaskyouforyourquestions,avoidputtingaquestionforthesakeofit.Interviewsaretiringforthepanel,aswellasforthecandidates,andinterviewersdon’tappreciatebeingaskedpointlessquestions.

Ifyoureallyhaven’tgotasensiblequestion,saysomethinglike:‘AllthequestionsthatIhadplannedtoaskhavebeencoveredinyourexplanationofthepost.‘Thismeansthatyoudon’tendtheinterviewbyrespondingwithacurt‘No’.

However,itisagoodideatohaveacoupleofsuitablequestionsupyoursleeve.Possibilitiesincludethefollowing:


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1.Whatimpactdoyouthinkthechangestomedicalcareerpathwayswillhaveonthetraininginthisdeanery?

2.Arethereanyopportunities,atalaterdate,forsub-specialtytraininginx,y,orz?(Butmakesurethattheanswertothisquestionisnotcoveredinanyreadilyavailableinformationaboutthetrainingprogramme.)

3.Whathavethetraineeswhohavejustfinishedtraininginxspecialtyinthishospitalgoneontodo?

PresentationsPriortotheMMCreforms,interviewsforentryintoaspecialisttrainingprogramme,orforconsultantposts,typicallyinvolvedyougivingapresentation.Atpresentyouwouldprobablynotbeexpectedtogiveapresentationduringaninterviewforentryontoafoundationprogramme.However,youmaybeaskedtogiveapresentationduringaninterviewforabasicspecialtytrainingprogramme.Andstartingin2008,somespecialtiesrequiredtheapplicanttodevisethepresentationonthedayoftheinterview–i.e.theydidnotsupplythetitleofthepresentationinadvance.WehaveincludedguidelinesforpreparingapresentationtobegivenaspartofaninterviewinAppendixD.

Selection centresOneoftherecommendationsoftheTookeInquiryintoMMCwasfortheneedtodevelopmorerobustselectionsystems.

Anumberofspecialtiesarenowusing‘selectioncentres’aspartoftherecruitmentandselectionprocess.Thisapproachisbasedontheideathatyouendupwithmorerobustselectiondecisionsifyoupresentapplicantswithtasksthatreflecttheactualactivitiesthattheywouldhavetocarryoutinthejobtowhichtheyareapplying.Soforexample,theselectioncentrethatisusedinGeneralPracticeincludes3exercises:anencounterwithasimulatedpatient;agroupexerciseandawrittenexercise(www.gprecruitment.org.uk).Theseactivitiesareobservedandassessedbytrainedassessors.

Ifthespecialtytowhichyouareapplyingisusingaselectioncentreapproach,youwillbeprovidedwithinformationabouttheselectioncentreaspartoftheinformationavailableforapplicants.Thereisoftenlittlespecificpreparationthatyoucandofortheselectioncentresabovemakingyourselffamiliarwiththepersonspecificationofthepostforwhichyouareapplying.However,youmayfindithelpfultolookataDVDproducedbytheAssociationofGraduateCareersAdvisoryServicesentitled‘SelectionCentresforSpecialtyTraining’.AsktheCentreManagerinyour

79postgraduateeducationcentre,orthecareersspecialistsatyourdeaneryforfurtherinformation.

Final commentsInwritingthischapter,wefeelasifwehaveleftyouonsomethingofacliffhanger.Wehavegivendetailedguidanceondecisionmakingandplanimplementation–andafterthatyoucan’tprogressyourplansanyfurtheruntilyouhaveheardtheresultsoftheselectionprocess.

Ifyouaresuccessful,wehopethatthestructuredadvicegiveninthishandbookhashelpedyoutomakearobustcareerdecision,andthatyouarelookingforwardtogettinggoingwiththenextstageofyourcareer.

Ifyouareunsuccessful,youmightbeinaverydifferentstateofmind.Inourexperience(bothpersonal,andalsofromourclientwork),weknowhowdemoralisedandhurtpeoplecanfeelwhentheyhaveputahugeamountofworkintoanapplicationprocesswhichultimatelyendsupinrejection.It’softenaverydepressingpositiontobein.

But,intime,youwillhavetopickyourselfup,dustyourselfdown,andworkoutyournextsteps.

Thefirstthingtodoistotrytogetasmuchinformationaspossibleaboutyourunsuccessfulapplication,becausethemoreinformationyouhave,thebetterpositionyouareintoreviewyournextstep.

Afterthis,wewouldadviseyoutogothroughabriefreviewofthecareer-planningframework,toseeifyouwanttochangeyourchoicesornot.Ifyoudecidenotto,youwillthenneedtoconcentrateonStage4,toseehowyoucanincreaseyourchancesofasubsequentapplicationbeingsuccessful.

Wewouldalsoliketoaddtwofurtherobservations.

Thefirstisthatamythhasbeencirculatinginmedicalrecruitmentthatforeachdoctorthereisreallyonlyonecareeroptionthatwouldsuitthem.Inpart,wethinkthatthisisaby-productoftheolddayswhen,atinterviewsforhigherspecialisttraining,youhadtodemonstrateyourundyingdevotiontothatspecialty,andnoother.

Butthismythdoesn’thavepsychologicalvalidity.Instead,aswedescribedinChapter2,thepsychologicalliteraturesuggeststhateachdoctorcouldbewellsuitedtoanumberofdifferentspecialties(althoughtherewoulddefinitelybeothersthatwouldnotsuitthemwell).Sowewouldencourageyoutobeflexibleinyourthinking–inparticularaboutthe‘O’intheROADSacronym,i.e.‘opportunities’.Gobackandseeifthereareotheroptionsthatyouhadn’tconsideredpreviouslytowhichyoumightalsobesuited.


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Thesecondobservationrelatestothefirst,andisthatevenwithinspecialtiesthereisenormousvariationintheday-to-daydetailsofwhatpeopleactuallydo.Forexample,aGPinasingle-handedruralpracticeandaGPinalargemulti-partnerhealthcentrepracticewillhavesomedutiesincommon,butotheraspectsoftheirdailyworkwilldifferenormously.

Whatthismeansisthatevenwhenyouhavesuccessfullynavigatedyourselfthroughthemazeofspecialtytraining,thedemandsofcareerdecisionmakingarenotover.Quitethecontraryinfact,asyouwillhavetomakeimportantcareerdecisionsthroughoutyourprofessionallife,uptoandincludingthetimeyoudecidetoretire.(Examplesincludewhetheryouwanttodosub-specialtytraining,becomeaGPwithaSpecialInterest,developingteachingormanagementresponsibilities,flexibleorpart-timeworking,etc.)

JohnKrumboltz,aneminentpsychologistatStandfordUniversityhasarguedthatchangeisaninevitablefeatureofcontemporarycareers–andtherealchallengeofcareerplanningislearninghowtoidentifyaroutethroughanunpredictablecareerlandscape.WhilstKrumboltz’sresearchisbasedontheAmericanemploymentsituation,andcoversthejobmarketasawholeratherthanjustmedicalcareers–medicalstudentsanddoctorsintheUKcanprobablyidentifywithhisconclusionthatcareerpathwayscontainanelementofunpredictability.

Krumboltzhasevencoinedatermforhispreferredapproach‘plannedhappenstance’whichhedefinesashelpingpeople‘togenerate,recogniseandincorporatechanceeventsintocareerdevelopment’.(Mitchell,LevinandKrumboltz,1999).

It’sbeyondthescopeofROADStolookindetailathowtomakethebestofchanceeventsinordertomaximisecareersuccess–butwewillletKrumboltzhavethelastwordinthischapterbecausewhathesaysseemsparticularlyrelevanttothechallengescurrentlyfacingdoctorsintheUK:

‘Someluckliesinnotgettingwhatyouthoughtyouwantedbutgettingwhatyouhave,which,onceyouhavegotit,youmaybesmartenoughtoseeiswhatyouwouldhavewantedhadyouknown’.(KrumboltzandLevin,2007).

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GUIDELINES FOR THE EDUCATIONAL

SUPERVISOR

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VI. GUIDELINES FOR THE EDUCATIONAL SUPERVISOR

OverviewThischapterbeginswithabriefdescriptionofthekeyplayersinpostgraduatecareersupportattrustlevel(namelyClinicalTutor/DirectorofMedicalEducation,theFoundationProgrammeTrainingDirectorand,insomedeaneries,theFacultyCareersLead).Itthenmovesontodescribingboththebroaderandcareersupportresponsibilitiesoftheeducationalsupervisor,andlooksindetailatthespecificconcernsthatconsultantsoftenexpressaboutthecareersupportaspectsoftheireducationalsupervisoryrole.Specificguidelinesaregivenaboutsupportingtraineeswhosecareerplansyoubelievetobeunrealisticaswellassupportingtraineeswhoarecontemplatingleavingmedicine.

Thechapterthenprovidesguidanceonhowtoapproacha1:1career-planningdiscussionwithyourtrainee,andgivesexamplesofthesortsofissuesyoumightdiscussineachofthefourcareer-planningstages.Althoughtheemphasisofthechapterisontheprovisionof1:1support,thechapterendswithguidanceonrunninggroupcareer-planningworkshops.DetailedsuggestedteachingplansfortheseworkshopsareincludedinAppendicesEandF.(Furtherelectronicresourcescanbefoundonthemedicalcareerswebsitewww.medicalcareers.nhs.uk).

Key players in the delivery of career supportItcanbehelpfultothinkabouttiersofcareersupport.

Thefirsttierofsupportwilltypicallybeprovidedbyeducationalsupervisorsastheyaremostlikelytobeabletotakeamoreinformedandconstructiveroleaboutaparticulartrainee’sstrengthsandweaknesses.ThesecondtierofsupportistypicallyprovidedbythetrustDirectorsofPostgraduateMedicalEducation(DMEs),whichisthenewtermfortrustClinicalTutors.SittingalongsidetheDMEs,theFoundationProgrammeTrainingDirectorsand,ifyourdeaneryhasthem,theFacultyCareersLeadscanalsobecalledupontoprovidesecond-tiersupport.

Thethirdtierofsupportisthatprovidedbythedeanery-basedcareersteam.

Typicalreferralstothisteamincludeatraineewhoisstrugglingtomakedecisions,someonewhoishangingontoplanswhichallconcernedfeelaredesperatelyunrealistic,oratraineewhoisseriouslyconsideringleavingmedicine.

85Inaddition,seniorclinicianswithintheFoundationSchoolsometimescalluponthedeanerycareersteamwhenaparticulartraineeiscausingconcernandseemstobefindingithardtosettleintotheirroleasajuniordoctor.

Ideally,everybodywhoprovidescareersupportshouldbeappropriatelytrainedforthelevelofsupportthattheyprovide.Withinmanydeaneries,basictraininghasbeenprovidedforeducationalsupervisorsonhowbesttosupporttraineeswiththeircareerplanning.Somedeaneries(e.g.N.WesternandLondon)havealsoproducede-learningresourcesforcliniciansonthistopic.Forthesecondtier,theNationalAssociationofClinicalTutors(NACT)providesrelevanttraining.Asforthethirdtier,thesearepeoplelikeuswhoarequalifiedcareersprofessionals,sothetaskthereiscontinuingprofessionaldevelopmentratherthanbasicskillstraining.OrganisationssuchasAGCAS(AssociationofGraduateCareersAdvisoryServices)provideprofessionaltrainingthatishighlyrelevanttostaffofferingthird-tiersupportandtherearealsoanumberofprofessionalnetworksforMedicalCareersAdvisors.

Defining ‘you’Thepreviousfivechapterswerewrittenforthejuniordoctorormedicalstudent.Incontrast,thischapteriswrittenwiththeeducationalsupervisorinmind.(Ineffectthe‘you’thatwehaveinmindwhenwritingthishandbookhasswitched.ThroughoutChapters1–5,the‘you’hasrepresentedtherecipientofcareersupport,whileinthischapterthe‘you’becomestheeducationalsupervisor.)

Shared frameworkWewanttoreturnbrieflytothefirstchapter,wherereferencewasmadetoastudybyHirshetal(2001).Inthisstudyitwasfoundthatinworkplacecareerdiscussions,ifbothparticipantshadacommonframeworktherecipientsfoundthecareerdiscussionsmoreproductive.Bearingthisfindinginmind,itshouldbeclearthatyou(theeducationalsupervisor)shouldreadthroughand‘digest’thecontentsofthefirstfivechapters.(And,infact,youmightalsowanttotryoutsomeoftheexercisesyourself,asthatwayyouwillbeinabetterpositiontodiscussthemwithyourtrainees.)

Guidelines for the Educational Supervisor

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The role of the educational supervisorTheguidetospecialtytraining(the‘GoldGuide’)publishedin2008andavailableontheMMCwebsite,outlinestherolesofeducationalandclinicalsupervisor.Itisclearfromthisguidethatthesamepersonmayprovideclinicalandeducationalsupervision,althoughitisalsoacceptableiftherolesaresplit,aslongasthereisappropriateliaisonbetweenthetwosupervisors.

Digressingforabriefmoment,itisnecessarytorefertosomeeducationaltheory,inordertoclarifythedifferencesinroles.

Ifyoulookatastandardtextbookonthetheoryofassessment(e.g.FreemanandLewis,1998),youwillfindexplanationsaboutthedifferencebetweenformativeandsummativeassessment.

Formativeassessmentaimstoprovidefeedbacktothetrainee,sothattheyareinapositiontobeabletoimprovetheirwork.Ittendstobeprovidedduringaperiodoftraining,ratherthansimplyattheend.Formativeassessmentattemptstouncoverboththestrengthsandweaknessesinatrainee’swork.

Incontrast,summativeassessmentcountstowardsorconstitutesafinalassessmentorqualification.Itinvolvesmakingaprofessionaljudgementabouttheadequacy(orotherwise)ofdifferentaspectsofthetrainee’swork.

Applyingthesetermstothecontextoffoundationtraining,withintheoperationalframework,botheducationalandclinicalsupervisorshavetobetrainedtocarryoutcompetenceassessmentsofjuniordoctors(i.e.summativeassessment).Inaddition,educationalsupervisorshavetoprovideeducationalappraisals(i.e.formativeassessments),toenablethetraineetoreflectontheirlearning,andthenjointlyagreeonappropriateeducationalgoals.

Itisalsothetaskoftheeducationalsupervisortohaveregulardiscussionswiththeirjuniordoctorsabouttheircareerplans,andreferthemtosecond-(oreventhird-)tiersupportifnecessary.

Educational supervisor as provider of career supportHavingruntrainingworkshopsforconsultantsinanumberofdeaneries,weknowthatconsultantsoftenexpressconcernaboutthefollowingissues:

1.Theirlevelofexpertiseacrossthewholespanofmedicalcareers.

2.Cantheyprovidehigh-qualityadvice?

3.Thetraineewithunrealisticcareerplans.

4.Thetraineewhoisconsideringleavingmedicine.

Eachofthesewillbeconsideredinturn.

87You’re not an expert across the whole range of medical careersOncourseswhenconsultantssaythattheyareworriedaboutgivingcareersadvicebecausetheydon’thavesufficientinformationaboutallthedifferentoptionsavailable,weoftendrawparallelswithourowncareer-counsellingpractices.Currentlyinourownprivatepracticesweareworkingwithindividualsinpublishing,medicine,thewinetrade,healthpolicyresearch,journalism,financialservices,veterinarymedicine,telecommunicationsandproductionengineering.Andwhileweknowquitealotaboutsomeofthesefields,wemightknowrelativelylittleaboutotheroccupationsonthelist.

Butourroleisnottobean‘expert’ineachandeverypossibleoccupation(therearetoomanyofthemtoachievethis).Instead,weneedtoknowwhereourclientscanfindmoreinformation–printedandweb-based(e.g.www.medicalcareers.nhs.uk),andalsoknowhowtheycangainaccesstopeoplewhodohaveexpertiseinthefieldofinterest.

UsingthesuggestionsoutlinedinChapter3,youshouldbeinabetterpositiontodirecttraineestoappropriateresources,sothattheycanbegintoaccesstheinformationthattheyneedinordertodecidewhetherthatparticularoptionmightsuitthem.Bearinmind,too,thatifthetraineehasworkedtheirwaythroughtheStage1exercises,theyshouldbeinabetterpositiontoknowthesortofinformationthattheywanttofindoutaboutwhentheybegintoexploreparticularoptions.

Concerns about the quality of careers adviceWhatabouttheconcernthatyoumightinadvertentlygiveatraineepoorcareersadvice?Weunderstandthatthisisadefiniteareaofconcernandwealsoknowthatyou–theeducationalsupervisors–areinfront-linepositions,intermsofreceivinganxiousandoverwroughtrequestsforhelpfromyourjuniordoctors.Inreality,makingdecisionsishardenoughatthebestoftimes,andinthecurrentclimateoffrequentchangesinpost-graduatemedicaltraining,itcanbecomeevenharder.

Infact,currentlyitisextremelychallengingtogive‘advice’astherearesomanyunknownsinthenewsystem.However,wewouldsuggestthatadvicegivingisnotyourkeyrole–evenifthesituationwasmuchmorestable.Instead,yourroleistoprovidea‘routemap’forthetraineethroughtheroughterrainofcareerdecisionmaking,butitisuptothetraineetopickthefinaldestination.Ortophraseitratherdifferently,yourroleistoaskchallenging,insightfulquestions–butnottoprovidetheanswers.


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Oncourseswhenweintroducethisideaofprovidinga‘routemap’,butnotthefinaldestination,wearefrequentlychallengedbyconsultants,whotellusthatitisunrealistic.However,havinghadmanyheateddiscussionswithconsultants,overanumberofyears,wefeelthatmuchofthedisagreementcomesfromanunderstandableconfusionbetweentwodifferentaspectsoftheeducationalsupervisoryrole,namelythatofassessor(ifyouarecarryingoutasummative,competenceassessment)andcareersadviser(whenyouhaveaformativedevelopmentaldiscussionaboutthetrainee’scareerplans).

Imaginethefollowingscenario.Inyourroleasclinicalsupervisoryouhavegradedaparticulartraineeas‘borderlineforF1completion’onsomeoftheassessmenttools.Inparticular,theirperformanceseemshighlyvariableonsomeDOPS(DirectObservationofProceduralSkills)assessments.

Butyouarealsoaneducationalsupervisortothistrainee,andduringtheireducationalappraisaltheytellyouthattheywanttoapplyforbasicspecialisttraininginsurgery,withalong-termgoaloftraininginaparticularlycompetitivesurgicalspecialty.Whatshouldyoudo?

First,ifyouarebotheducationalandclinicalsupervisortoaparticulartrainee,whenyouaresittingdowntohaveanappraisalmeeting,youneedtothinkaboutwhathatyouarewearing.Intermsofyourroleasasummativeassessor,youcannot(andmustnot)alteryourprofessionaljudgementthatyourtraineehasbeen‘borderline’onthesecompetencies,justbecausetheyhavesettheirheartonacareerinsurgery.Butintermsofyourroleasacareersadviser,ratherthanagonisingwhetheryoushouldadvisethetraineetoreconsidertheircareerchoices,youshouldfocusonaskingthefollowingsortsofchallengingquestions.

Whatdoesthetraineeseeastheirkeystrengths?

Howdoesthisself-assessmentoftheirkeystrengthsfitinwithsomeoftheassessmentevidenceintheirlearningportfolio?

Inwhichareashavetheybeenassessedasbeinglessstrong?Areanyoftheseareasimportantintermsofdemonstratingsuitabilityforsurgicaltraining?

Isthereamatchbetweentheirareasofpersonalweaknessandareaswhicharecriticallyimportantintermsofsuitabilityforsurgicaltraining?

HavetheyresearchedthelikelycompetitivenessforBasicSurgicalTraining?

WhataretheirthoughtsonthefactthatcompetitionforentryintoBasicSurgicalTrainingisgoingtobeverytough,buttheyhavenotscoredhighlyontherelevantkeycompetencies?

HavetheythoughtthroughtherobustnessoftheirdecisionusingtheROADScriteria?

89Andwecouldgoonandon…

Typicallyconsultantsthenchallengeusandsaywhynot‘callaspadeaspade’,andjusttellthemthattheyarenotsuitedforfurthertraininginsurgery?Wewouldarguethatthechallengingquestionsapproachoutlinedaboveismorerobust,forthefollowingreasons.

1.Thedirectiveapproach(i.e.‘IfIwereyou,I’dditchsurgery’)absolvesthetraineefromtakingresponsibilityfortheirowndecisionmaking.

2.Posingchallengingquestionsratherthanprovidinganswersmakesitmorelikelythatthediscussionwillbeopenedup,andthetraineewillstarttothinkcriticallyabouttheirposition.

3.Ifyougodownthe‘IfIwereyou’route,itistemptingforyourownpetlikesanddislikestoinfluencetheadviceyougive.Thismeansthatyoumightbemorelikelytoencouragethetraineetoreconsiderspecialtiesofinteresttoyou,andtoavoidthoseyouparticularlydislikedatmedicalschool.Butofcourse,the‘IfIwereyou’routehasabasicflaw:thetraineeisnotyou.

4.Youropinioncouldpossiblybewrong.(Forexample,perhapssomethingisgoingoninthetrainee’sprivatelifethatmeansthattheyhavebeensleepingpoorly,andinturngettingpoorassessmentresults.Butthetraineeknowsthatatmedicalschooltheyreceivedhighlyfavourablefeedbackontheirpotentialforsurgicaltraining.)

Wewanttoreiteratethatinsuggestingyouavoidthe‘IfIwereyou’advice-givingapproach,wearenotadvocatingthatyouavoidchallengingthetrainee’scareerdecisionmaking.Butwearesuggestingthatyouencouragethetraineetoreflectontherobustnessoftheircareerplansbyposingchallengingquestions,ratherthanpointingouttheanswers.Andifyougodownthisroute,anyconcernaboutprovidingpooradviceshouldbemuchlessacute.

Infact,whatyoushouldbeconcernedaboutisposingquestionsthatareinsufficientlychallenging.


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The trainee with unrealistic career plansThelengthyexamplediscussedaboveisobviouslyalsorelevanttotheissueofthe‘unrealistic’trainee.Butitmightalsobehelpfultomentionacoupleofotherpoints.

First,ifyouarefacedwithatraineewhopersistsinwantingtopursueacareerplanthatyoufeeliscompletelyunrealistic,wewouldsuggestthatyouaskthetraineetogoanddiscusstheirplanswithanothercolleaguewhoisinthatparticularspecialty,orwithsomebody(eitheraclinicianoracareersadviser)whohashadadditionaltrainingincareersupport.Youshouldthendoabriefsummaryoutliningyourownconcernsabouttherobustnessoftheircareerplansandgiveittothepersonwhowillbeprovidingthisadditionalsupport.

Secondly,oncourses,weoftenendupdiscussingthedifferencebetweenbehavingresponsibly‘to’butnotbeingresponsible‘for’thetrainee.Asoutlinedabove,wewouldsuggestthatpartofbeingresponsible‘to’thetraineeinvolvestheprovisionofclear,constructivefeedbackabouthowtheyareperformingintheircurrentrole;encouragingthetraineetocarryoutstages1–3ofthecareer-planningprocessandchallengingtherobustnessofproposedcareerplansusingtheROADScriteria.Allofthesearewaysinwhichyouarebehavingresponsibly‘to’thetrainee.

Butyouarenotresponsible‘for’thetrainee.

Ifyourtraineewantstoignoreclearfeedbackthatyouhavegiventhemabouttheirbelow-averageperformanceinthecurrentjob,orignorethefactsonhowcompetitiveitistosucceedintheirchosenpathway,orignorethefactthattheycan’treallygiveaclearandcoherentreasonastowhytheyfeelthattheyaresuitedtothespecialty,then,ultimately,thatisthetrainee’sdecision.

Thisdistinctionmighthelpyoufeellessanxiousifatraineeinsistsonfollowingwhatyoufeelisanill-advisedcareerpathway.Becauseifyouhavebehavedresponsibly‘to’thetrainee,thatisallthatisrequiredofyou,anditisnotalwayspossibletostopsomepeoplefrommakingpoorcareerdecisions.

The trainee who is contemplating leaving medicineTraineesmayconsiderleavingmedicineforavarietyofreasons.Forsome,thenotionthattheymightnotbesuitedtotheprofessionhadalreadystartedduringtheirundergraduatetraining,whileforothersitisthedemandsofbeingajuniordoctor,ratherthanamedicalstudent,thatmakethemwanttoreconsidertheirplans.Andyetothersmightbeinfluencedbyfeelingunsupportedinaparticularplacement.

91Inaddition,whilesometraineeswhoareconsideringleavingtheprofessionexperiencedifficultieswiththeirtraining,andareperhapsregardedbytheireducationalsupervisorsaspossiblynotbeinguptothejob,othersmaybehighlyregardedbytheirsupervisors.

Workingthroughthestructuredapproachtocareerplanningoutlinedinthishandbook,shouldhelpthetraineestarttobecomeclearerabouttheircareerplans.Andifitseemsthatalackofsupportinacurrentplacementiscontributingtotheirdissatisfactionwiththeprofession,youwouldneedtoliaisewiththeFoundationProgrammeTrainingDirectorinyourtrust(orspecialtytrainingdirector,ifitisapost-foundationtrainee).

However,asbothofusareprovidingindividualcareercounsellingtotraineeswhoareconsideringleavingmedicine,weknowfromexperiencethatmanyofthesetraineesgreatlyvaluespecialisedcareersupport.Wewouldthereforesuggestthatifatraineecomestoyousayingthattheymightwanttoleavetheprofessionyoubeginbyusingtheapproachoutlinedbelowinthischapter,toseeifitisatemporaryissuethatcanberesolvedrelativelysimply,oranissuerelatingtospecificdifficultiesinaparticularplacement.Butif,afterfurtherdiscussion,itseemsthattheyareseriouslyconsideringleavingmedicine,wewouldsuggestthattheyaccesstheadditionalthird-tiercareersupportorinvestinsomeprivatecareercounselling.

Currently,giventheflurryofactivityaroundmedicalcareercounselling,anumberoforganisationsarebeingsetuptoofferservices.Justaswithothersortsofcounsellingorpsychotherapy,wewouldstronglyrecommendthatyourtraineechecksthatthepractitionerisadequatelyaccreditedbyasuitableprofessionalorganisation.AlistofappropriateprofessionalbodiesisincludedinAppendixA.

Wewouldalsoliketoaddonefurtherobservation.Inourexperience,consultantsoftenfeelasenseofpersonalfailurewhenatrainee(particularlyagoodone)admitsthattheyareconsideringleavingtheprofession.Wewouldcertainlywantyou,inyourroleaseducationalsupervisor,tobehaveresponsibly‘to’yourtrainee,inallthewaysdetailedabove.Thusiftheycometoyousayingthattheyareunhappyandmightwanttoleavemedicine,wewouldwantyoutoprovideasupportive,structuredresponse,inordertoseeifitisatemporaryproblemthatcouldberemediedinsomeway.

Butif,afteryouprovidethissortofresponse,thetraineestillpersistsinwantingtoleavemedicine,thenyouarenotresponsible‘for’thisdecision,anditdoesnotrepresentapersonalfailingonyourpart.

Whatweoftenpointoutwhenthisissueisraisedintrainingworkshopsisthatifselectionintomedicalschoolwasacompletelyfoolproofbusiness,andifpeopledidnotchangeduringtheirfiveorsixyearsofundergraduatetraining,youwouldberighttofeelthatthetraineehad,insomecrucial


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way,beenletdownbythesystem.Butofcourseselectionintomedicalschoolisnotcompletelyfoolproof,andpeoplechangeduringtheirundergraduatetraining.Soforbothofthesereasonssometraineesmaycorrectlyconcludethattheydon’twanttostayinmedicine.

Yourresponsibilityistoensurethattheyhavethoughtthroughthedecisionadequately,andwhereappropriatereceivedspecialisedcareersupport.Butyoushouldn’tautomaticallyregardtheexitingtraineeasapersonalfailure.

How to approach a 1:1 career-planning session with your trainee Oneoftheresponsibilitiesoftheeducationalsupervisoristohaveregularfeedbackmeetingswithyourtrainee.Thismeansthatyoushoulddevotesometimetodiscussingyourtrainee’scareerplansateacheducationalappraisalmeeting.However,dependinguponhoweachparticulartraineeisfurtheringtheircareerplans,youmightwanttoconcentrateoncareerissuesduringonesessionorevenarrangeaseparatetimewhenyouspecificallyfocusontheircareerplans.

Atallcosts,whatyouwanttoavoidisthetraineefailingtoengagewiththenecessityofidentifyingtheirnextcareermove–andthengoingintopanicmodeatthebeginningofthesecondfoundationyear,whenrecruitmentforspecialtytraininglooms.

Use the four-stage approachItwasarguedabovethatyourcentralrole,intermsofsupportingcareerplanning,istoprovideyourtraineewitha‘routemap’throughthecareer-planningstages.SoinyourfirstsessionwithyourF1traineewewouldsuggestthatyouchecktheirunderstandingoftheoverallfour-stagecareer-planningframework,andthenconcentrateonStages1and2.

Wecannotemphasiseenoughthatgoodcareerdecisionmakingrestsonthefoundationsofadequateself-assessmentandcareerexploration.Itisthereforeimperativethatyouencourageyourtraineestospendadequatetimeonthesefirsttwostages.

Insubsequentsections,waysofsupportingyourtraineethrougheachofthefourcareerplanningstagesaredescribed.

Askyourtraineestobringtheirlearningportfoliosand(iftheyhaveone)theircareer-planningfoldertoalloftheirmeetings.Thiswillhelpthemtoreviewtheirwork,andalsohelpthemdevelopasystematicapproachtotheircareerplanning.

93Wewouldalsoliketoemphasisetheimportanceoflisteningcarefullytoyourtraineeinthese1:1meetings.(Andafavouriteadagethatweoftenuseontrainingcoursesisgiventhatwehavebeenequippedwithtwoearsandonemouth,weshouldusetheminthoseproportions.)Onehelpfulwayofmonitoringwhetheryouarelisteningwithenoughcareistotrytomonitorwhoisdoingmostofthetalking.Theremightbetimesina1:1educationalappraisalmeetingwhenyou(theconsultant)shoulddomostofthetalking.Butingeneral,incareer-planningsessions,youshouldbeaskingthequestions,andcontributingyourfeedback,whilethetraineeshouldbedoingmostofthetalking.

Intermsofhelpingthetraineereflectontheirdevelopingcareerplans,inthesectionsbelowweoutlinethesortsofquestionsthatyoushouldbeposingtoyourtrainees.Butitisimportanttoremembertheparallelwithclinicalconsultationsdescribedatthebeginningofchapter2:justasitispointlessworryingaboutthedetailsofatreatmentregimenuntilyouhavetakenaclinicalhistory,examinedthepatient,andatleastformedapreliminarydiagnosis,sotoodoyouhavetoensurethattheearlierstagesofcareerplanningareinplacebeforeyoustartdolingoutadviceonhowtosucceedattheapplicationprocess.

Yourtraineemightalsofindithelpfulifyouagreeonspecificcareer-planningtasksthattheywillcarryoutbetweenthe1:1meetings,togetherwithappropriatetimescalesfortheircompletion.

Weaving in your feedbackInyourroleofguidingyourtraineethroughastructuredframeworkofcareerplanning,youalsohaveavitalroleintermsofprovidingthemwithfeedbackontheirperformancetodate.

Usingthelearningportfolio(andanyotherrelevantdata),youneedtoweaveinyourownunderstandingofhowtheyhavebeenprogressing.Ifthisunderstandingaccordswiththeirself-assessmentordevelopingcareerplans,thenyouneedtosayso.Equally,whenthereisadiscrepancybetweenwhattheyaresayingaboutthemselvesandyourownopinion–thenyouneed(asdescribedabove)tohighlightthesediscrepancies,inordertodiscussthemasfullyaspossible.

Whileweareadvocatingthatyoushouldencourageyourtraineetoengageinrigorousself-assessment,wearenotadvocatingthatthisshouldtakeplaceinavacuum.Instead,itisyourtasktouseyourunderstandingofthistrainee’sperformancetoconfirm,ortoposeconstructivechallengesto,whatthetraineeissayingabouttheircareerplans.


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Asummaryofthekeypointsfora1:1meetingwithyourtraineeisincludedinTable3.

Table 3: Summary of key points for a 1:1 meeting•Spendsometimediscussingyourtrainee’scareerplansateacheducationalappraisalmeetingandifnecessaryarrangeanextrameetingdevotedtocareerplanning.

•Encourageyourtraineenottoleavecareerplanningtothelastminute.

•Inyourfirstsession,reviewtheoverallfour-stagecareer-planningmodel.

•Askyourtraineetobringtheirlearningportfolioandiftheyhaveone,theircareer-planningfoldertoall1:1meetings.

•Listeningiskey.Remember!Wehavetwoearsandonemouth–tobeusedinthatproportion.

•HelpyourtraineetolaythegroundworkbyspendingsufficienttimeonStages1and2.

•Attheendofeachmeeting,askyourtraineetospecifywhichcareer-planningtaskstheywillcarryout,andwithinwhichspecifiedtimescale.

•Ensureyouprovidethemwithclear,constructivefeedbackontheirperformancetodate.

•Encouragethemtousethelearningportfolio(andanyotherrelevantdata)toenhancetheirunderstandingofhowtheyhavebeenprogressing.

•Ifyouareconcernedthatthetraineeisbeingunrealistic,focusonchallengingquestionsratherthandirectiveadvice.

•Ifnecessarysuggestthattheytalkthroughtheircareerplanswithacolleague.Beforethismeeting,provideyourcolleaguewithabriefreportthatoutlinesyourconcerns.

Helping your trainee with their self-assessments (Stage 1)Yourtaskhereistoencouragethetraineetoconductathoroughself-assessmentoftheirworkvalues,skillsetc.aswellaspossiblycompletingapsychometrictestofinterestsorpersonality.Youalsowanttohelpthetraineetoreflectontheresultsoftheseself-assessments,sothattheyareabletoidentifytheimplicationsoftheseexercisesfortheirfuturecareerchoices.

95Wewouldnot,however,recommendthatthetraineecompletestheseexercisesduringthe1:1meeting.Instead,wewouldsuggestthatthetraineeshouldcompletetheexercisesintheirowntime(orinacareer-planningworkshop),andthattheyshouldbringthecompletedexercisestothe1:1sessionforfurtherdiscussion.

Inthetablebelow(seeTable4),wegivesuggestionsforthesortsofquestionsthatyoucouldhelpfullyposetoyourtraineeabouttheStage1exercises.(Theseareonlysuggestedquestions,socalled‘Startersfor10’.WearenotadvocatingthatyouploughthroughthequestionsinTable3likeasemi-structuredpsychiatricinterview,but,rather,thatyouusethequestionsbelowtogetafeelforhowyoucanhelpyourtraineebecomeclearerabouttheircorevalues,interests,skills,etc.)

Table 4: Good questions to pose to your trainee about the Stage 1 exercises

Work values1.Whatdoyouseeasyourcoreworkvalues?

2.Whatarethepossibleimplicationsofanyofyourcoreworkvaluesforthecareerdecisionsthatyouarecurrentlyfacing?

3.Thinkingbacktoatimewhenyouparticularlyenjoyedyourwork,whatlinkscanyouseebetweenthereasonsforthisenjoymentandyourcoreworkvalues?

4.Whatabouttheopposite,i.e.whatlinkscanyouseebetweenatimewhenyouwereparticularlyunhappyatworkandyourcoreworkvalues?

5.Howmightyourcoreworkvalueschangeovertime,andhowmightyouadjustyourcareerplansinorderthatthereisanappropriatematchfortheseanticipatedchangesinworkvalues?

Achievements/skills/interests1.Usingtheresultsfromtheexercisewhereyouexaminedspecific

achievements,whatkeyskillsdidyouidentify?Ofthese,whichareyouparticularlyinterestedinusingatwork?

2.Arethereanykeyskillsthatyouaren’tusingatworkthatyouwouldliketobeabletouse,inordertofindworkmoresatisfying?

3.Whatkeyskillsdidyouidentifyinyournon-workexample?Arethereanytherethatyouwouldbeinterestedinusinginaworkcontext?

4.Whatfactorscontributetoyoufeelingstressedatwork?


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Psychometric instruments1.(Before.)Whatareyouhopingtogainfromtakingthisparticular

instrument?

2.(After.)Whatareyourthoughtsabouttheresults?Towhatextentdotheresultsaccordwithwhatyoualreadyknowaboutyourself?Canyougivespecificexamples?Andtowhatextentdotheresultsconflictwithwhatyoualreadyknowaboutyourself?(Andagain,canyougivespecificexamples?)

Role ModelsThinkingaboutadoctorwhomyouregardasapositiverolemodel,canyouidentifyaspectsofworkthatareparticularlyimportanttoyou.

Summary of Stage 11.Ifyouwereaskedtogiveasummaryoftheself-assessmentexercises

thatyoucarriedoutaspartofStage1,whatwouldyousay?

2.Canyoudescribeexamplesfromyourcareertodatethatillustrateyourindividualpatternofvalues,skills,interests,rolemodels,etc.thatyouhaveincludedinyoursummary?

3.Ifyoudonotfeelatallclearaboutyourkeyvalues,skills,interests,etc.,whatareyougoingtodoinordertoenhanceyourabilitytocompletetheStage1exercisesinsufficientdetail?

Helping your trainee explore different career options (Stage 2)Thekeytaskforyouinthisstageistoencourageyourtraineetoconductasystematicexplorationofdifferentcareeroptionsthatinterestthem.Furthermore,ashasbeenarguedthroughout,thiscareerexplorationdoesnotinvolveresearchingeachoptioninastandardisedway,but,instead,youneedtoencourageyourtraineetoconstructapersonalisedlistofqueries(derivedfromtheStage1self-assessments)andthenapplythispersonalisedlisttothespecificcareersthattheyareexploringfurther.

Allthepointsdiscussedinthesectionsabove(e.g.goodlisteningcombinedwithaskingchallengingquestions)alsoapplytohowyoushouldsupportyourtraineethroughtheirStage2activities.

GoodquestionstoposetoyourtraineeinthisstageofthecareerplanningframeworkareincludedinTable5(overleaf).

97Table 5: Good questions to pose to your trainee about the Stage 2 exercises1.Haveyouidentifiedtwotofouroptionsthatyouwanttoexplore

further?Ifyes,thengotoquestion3,ifno,thengotoquestion2.

2.Whatspecifictasksareyougoingtocarryoutinordertobeabletoidentifyasuitableshortlistofpossibleoptions?(ThismightincludegoingbacktoredotheStage1exercisesinmoredetail,arrangingtocompleteapsychometricinstrumentsuchasSci59ortheMyers-BriggsTypeIndicator.Oritmightinvolvegettingsomeadditional1:1supportsuchasarrangingasessionwiththeFacultyCareersLeadortheSeniorCareersAdviserinyourdeanery.)

3.(Iftheeducationalsupervisorhasconcernsaboutanyofthechoicesbeingexplored.)OnthebasisofwhatIhaveseenofyourwork/yourassessments,itseemsasif(nametherelevantcompetence)issomethingthatyoustrugglewith.Yetthiswouldbeseemtobeakeyaspectoftrainingin(namethespecialty).Howdoyoureconcilethesetwofacts?

4.Havingidentifiedtwotofouroptionsthatyouwanttoexplorefurther,haveyouconstructedalistofspecificquestions(linkedtotheStage1self-assessmentactivities)thatyouaregoingtoexplore?Havingdonethis,foreachquestion,haveyouworkedoutwhatyouaregoingtoread/whomyouaregoingtoask?Whattimescalehaveyousetyourself?

5.Haveyouidentifieda‘backupplan’incaseyouarenotsuccessfulinachievingyourfirst-choiceoption?Ifnot,doyouthinkthatthismightbeausefulstrategy?Howmightyougoaboutchoosingyour‘backupplan’?

Helping your trainee make a good career decision (Stage 3)Yourkeytaskhereistohelpyourtraineemakeafinaldecisionastowhattheyaregoingtoapplyforontheirapplicationform.YoushouldalsohelptheminterrogatetherobustnessofthisdecisionusingtheROADScriteria.

Goodquestionstoposetoyourtraineeinthisstageofthecareer-planningframeworkareincludedinTable6.


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Table 6: Good questions to pose to your trainee about Stage 31.LookingbackattheLifelineexercise,canyouidentifyagoodcareer

decisionthatyouhavemadeinthepast?Withreferencetothisexample,howdidyouarriveatthisdecision?

2.Whatcanyoulearnfromthispreviousdecisionintermsofhowbesttoapproachyourcurrentdecision?

3.Howwouldyouexplainyourcareerdecisionintermsofthematchbetweenwhatyounowunderstandaboutyourself(Stage1)andwhatyouhavefoundoutaboutthecareeroptionsthatyouwishtopursue(Stage2)?

4.HaveyoureviewedyourdecisionusingtheROADSchecklist?Realistic –areyoubeingrealisticaboutyourselfANDthedemandsofthejob? Opportunities –haveyougivenseriousconsiderationtoalltheopportunitiesavailable? Anchors –haveyoubuiltinthethingsthatprovidesupportinyourlife? Development –doyourchoicesfullydevelopyourpotential? Stress –haveyouconsideredthoseaspectsofworkthatposeparticularstressesforyou?

5.Haveyouidentifiedbothaplan,anda‘backupplan’?(If,astheeducationalsupervisor,youthinkthattheplanand/orthe‘backup’failtomeetoneormoreoftheROADScriteria,thenyouneedtoraisethisissuewithyourtrainee.Ifyourtraineedoesn’twanttotakethequestionsthatyouarechallengingthemwithonboard,thenyoucansuggestthattheygoanddiscusstheircareerplanswiththeFacultyCareersLeadortheDeaneryCareersAdviser.)

Helping your trainee with implementing their plans (Stage 4)Atthisstageyouneedtodiscusstheapplicationformswithyourtrainee,andalsoensurethattheyaredoingadequateinterviewpreparation.

99Application formsTheissueofhowfaritispermissibletohelpyourtraineeswiththeirapplicationformsisavexedone.Ifyouaregoingtobeinvolvedinshort-listingorinterviewing,thenitisprobablyadvisableifyousuggestthatyourtraineehasamoredetailedconversationabouttheirapplicationformorabouttheinterviewwithanothercolleague.

Wewouldsuggestthatyouencouragethetraineestoreadthroughthedetailedadvicegivenintherelevantsectionsofthishandbook.Inaddition(aslongasyouarenotactuallyinvolvedintheshort-listingorinterviewprocess),youcanreadthroughdraftsoftheiranswersandmakegeneralcomments.Forexample,itispermissibletomakegeneralcommentssuchas:‘Idon’tthinkthatyouhaveadequatelyansweredthesecondpartofthequestion’or‘Idon’tthinkthatyouranswerclearlydemonstratesthatyouhaveallthenecessaryskills.’Youshould,however,avoidsuggestingspecificwordingthattheyshouldincludeintheform.

Thesortsofquestionsthatyoucouldposetoyourtraineeatthisstageofthecareer-planningprocessareincludedinTable7.

Table 7: Good questions to pose to your trainee about application forms1.HaveyoucarefullyreadthroughChapter3inthishandbook?

2.Areyouclearthatyouaregoingtomeettheapplicationdeadlines?

3.Haveyoucheckedthatyouranswerstallywiththespecificcriteriaasoutlinedinthepersonspecification?(But,equally,haveyoumadesurethatyouranswersdonotinvolvesimplyrepeatingthewordingofthepersonspecificationonyouractualapplicationform?)

4.Haveyoucheckedandre-checkedyourspellingandgrammar?

InterviewsUsingthesampleinterviewquestionsincludedinChapter3,youcanconductmockinterviewswithyourtrainees.Youcaneitherdothisona1:1basis,orcanincorporateinterviewtrainingintoagroupcareer-planningworkshop(seebelow).But,again,wewouldsuggestthatyoudon’trunamockinterviewforatrainee(orgroupoftrainees)ifyouareactuallyontheinterviewingpanel.

Intermsofdiscussinginterviewpreparationduringa1:1sessionwithyourtrainee,thesortsofquestionsthatyoumightwanttoaskareincludedinTable8.


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Table 8: Good questions to pose to your trainee about interviews1.Haveyouthoughtaboutthequestionsthatyouarehighlylikelytobe

asked,andplannedsomestronganswers?(Youcanthendiscussthese.)

2.Haveyoupreparedasmallnumberofexamples(takenfromyoure-portfolio)thatclearlydemonstrateyourkeyskillsandabilities?Haveyoualsopreparedsomesuitableexamplesincaseyouareaskedaboutareasinwhichyouareweaker,oraboutmistakesthatyouhavemadeinthepast?(And,again,youcandiscussthese.)

3.Whatspecificconcernsdoyouhaveabouttheinterviewprocess?Howareyouintendingtoaddresstheseconcerns?Whoelsecouldhelpyou?

Group career-planning workshopsInsomeregionscareer-planningworkshopshavebeenincorporatedintothegenerictaughtfoundationprogramme.

Thisisastrategythatwewouldadvocate;notonlyisitanefficientuseoftime,butalsothetraineescanlearnmuch,andgainencouragementandsupportfromeachother.

Thepersonrunningtheworkshopdoesn’tneedtobea‘careersexpert’,asallthenecessarybasicmaterialshavebeenworkedoutforyou,andaredetailedbelow.Instead,theroleofthepersonrunningtheworkshopistoactasafacilitator.

Manyofthebasicguidelinesdescribedaboveabouthowbesttoapproachthetaskof1:1careersmeetingsalsoapplytothetaskofgroupfacilitation.Forexample,aswitha1:1meeting,inagroupsessionitisalsoimportantto:

1.Outlinetheoverallfour-stagecareerplanningframework.

2.Listencarefullytothepointsthatthetraineesaremaking.

3.Posechallengingquestions.

Butthereareafewpointsthatapplyspecificallytothegroupsituation.Specifically,wewouldhighlightthefollowing:

Avoidthediscussionofhighlypersonalissues(suchaswhetherinfuturetheymightwanttohaveafamily)infrontofthegroup.Thiscanbediscussedbysettingataskforthewholegroup,gettingthegrouptodiscussitinsmallergroups,andthenreconveningwhenyouaskforgeneralcomments.Traineesaremuchmorelikelytospeakopenlytosmallgroupsoftheirpeersthaninlargergroups,inwhichtheconsultantispresent.

101Ifyouareaskingthemtoreflectonnegativeissues(whattheyfindstressful,mistakes,etc.),getthemtodiscussthisinpairs,orperhapstowritedowntheirthoughtsontheirown.Youshouldn’taskthetraineestodiscusswhatcouldbequitepainfulissuesinasmall-orlarge-groupcontext.Forthesetasksusepairedwork,oraskthemtoworkindividually.

Providetimeattheendofthesessionfortraineestocomeandspeaktoyouinprivate.Iftheissuetheyraiseturnsouttobequiteacomplexone,youmightneedtoarrangeanadditionaltime,orsuggestareferraltoanothersource.But,inourexperience,attheendofsessionstraineesoftencomeandraiseissuesinprivatethattheydidnotfeelcomfortableraisinginfrontofthewholegroup.Oneadvantageofagroupcontextisthattheycanlearnfromeachother.Soifatraineeasksyouachallengingquestion,ifappropriateposeitbacktothegroupforcomments,beforeyouwadeinwithyourownanswer.Oftenthegroupwillcomeupwithexcellentanswers,andthetraineesfindthesupportandadviceoftheirpeersparticularlyhelpful.

Final commentsHavingrunalargenumberoftrainingworkshopsforconsultants,weknowthatsomeeducationalsupervisorsfeeldistinctlyuneasyabouttheircareersupportresponsibilities.

Itisourhopethatthestructuredfour-stagemodeloutlinedinthischapterwillprovideyouwithapracticalframeworkforapproachingthetask.Thefollowingfigureprovidesanoverviewoftheactivitieswhichneedtobecovered.


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Figure 6: Foundation programme – overview of activities

Foundationyear1:RunearlyinF1 Foundationyear2:RunearlyinF2

Careerplanningstage

Traineedoctors Foundationprogrammeteam

Traineedoctors Foundationprogrammeteam

Stage1–self-assessment

Interests

Values

Skillsandachievements

Stressesandstrains

Psychometrictests(optional)

Reflectivepractice(e-portfolio)

Personaldevelopmentplans

Careersummarysheets

Rolemodelexercise

Runworkshop1forF1doctorstointroducethecareer-planningframeworkandcoverStages1and2ingreaterdetail–seeAppendixE

Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees

EducationalsupervisortoensurePersonalDevelopmentPlans/CareerSummarysheetscomplete

ReviewStage1and2assessmentsinordertoprepareforStage3

ReflectivePratice(e-portfolio)


Careersummarysheets


EducationalsupervisorstoensurePersonaldevelopment

Stage2–careerexploration

F1TraineetosetSMARTplanafterworkshop

Initialsearchtoidentifypossiblecareeroptions

Morefocussedsearch,includinginterviewingpeopleinthespecialitiesofinterest

Attendevents,includingcareersfairs

Arrangetasters

Runworkshop1asabove

Educationalsupervisorstoreviewin1:1meetingswithtrainees

EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete

Introducespecialtytrainingpersonspecifications

ThetraineeconsiderstheircareeroptionsinlightofanychangesintheirStage1/2activities

ThetraineetofullyconsiderplanB

Arrangetasters

Educationalsupervisorstoreviewin1:1meetingswithtrainees


103Stage3–decisionmaking

EmphasisegooddecisionmakingcomesfromcarryingoutStage1and2

WhenreadythetraineemovestoStage3


IntroducetheimportanceofplanB.TraineetoreflectonStage2–careerexploration

Highlighttimescalesforspecialtyrecruitment

Thetraineeconsiderstheircareeroptions

Decision-makingexerciseROADS

Carryoutfurtherinterviewingpeopleinthespecialtiesofinterest

ThetraineetofullyconsiderplanB

Runworkshop2forF2doctorstoincludeabriefreviewofthecareer-planningframeworkandtocoverStages3and4–seeAppendixF



Stage4–planimplement-ation

F2TraineetosetSMARTplanafterworkshop

Reflectivepractice(e-portfolio):


Careersummarysheets

IntroducelinkageofStages1,2and3onqualityapplicationsandinterviewperformance


Applicationforms

Interviews

Roleofportfolioonselectionprocess

PeninsulaDeanery/AGCASDVD–selectioncentresforSpecialtyTraining

Runworkshop2asabove

Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees.


Reflectivepractice(e-portfolio):


Careersummarysheets


104


Chapter2beganwithaclinicalanalogy,namelycomparingthefour-stagecareer-planningframeworktoamodelofclinicalconsultation,andwewouldliketoreturnbrieflytothisparallel,inthefinalsectionofthehandbook.

Asexperiencedclinicians,yourapproachtoaclinicalconsultationwillbynowbesecondnaturetoyou,asitissomethingthatyoudowithoutthinking,dayin,dayout.Butthesameisn’ttrueforyourmedicalstudents(andwasn’ttrueforyouwhenyouwereamedicalstudent).Thisthereforeremindsusthatlearningacomplexnewskilltakesbothtimeandpractice.

Puttingtheframeworkoutlinedinthishandbookintopracticewilltakeabitoftimetogetusedto,astherearebothinformationtoassimilateandskillstodevelop.Andyouwillalsoneedtopractiseit.Butyouarestartingfromagoodvantagepointgiventhatyoualreadyhaveahighlydevelopedsetofcommunicationskillsthatyouuseinyourpatientconsultations(andalsointeachingandmanagementtasks).

Oftenattheendofworkshopsconsultantsexpressreliefthatataskthattheyhadpreviouslyfeltwasbeyondtheirexpertise(namelytheprovisionofcareersupport)turnedouttobemuchmorestraightforwardthantheyhadinitiallyenvisaged.

Wehopethatbyusingthishandbook,youwillreachasimilarconclusion.

105ReferencesBorges,N.J.andSavickas,M.L.(2002).‘Personalityandmedicalspecialtychoice:aliteraturereviewandintegration’,Journal of Career Assessment,10,no.3,pp.362–80

Borges,N.J.,Savickas,M.L.andJones,B.J.(2004).‘Holland’stheoryappliedtomedicalspecialtychoice’,Journal of Career Assessment,12,no.2,pp.188–206

Freeman,R.andLewis,R.(1998).Planning and Implementing Assessment. London:KoganPage

Gale,R.andGrant,J.(2002).‘Sci45:thedevelopmentofaspecialtychoiceinventory’,Medical Education,36(7),pp.659–66

Hirsh,W.,Jackson,C.andKidd,J.M.(2001).Straight Talking: Effective Career Discussions at Work.Cambridge:NationalInstituteforCareersEducationandCounselling(NICEC)

Kidd,J.M.(2006).Understanding Career Counselling:Theory,ResearchandPractice.London:Sage

Krieshok,ThomasS.;Black,MichaelD.;McKay,RobynA.Careerdecisionmaking:Thelimitsofrationalityandtheabundanceofnon-consciousprocesses.Journal of Vocational Behavior(0001-8791)Dec,2009.Vol.75,Iss.3;pp.275–290

KrumboltzandLevin2007.Luck Is No Accident Making the Most of Happenstance in Your Life and CareerbyKrumboltz,John;Levin,Al(2004)

Mitchell,KE;Levin,AS;Krumboltz,JD.Plannedhappenstance:constructingunexpectedcareeropportunitiesJournalofCounseling and Development(0748-9633)Spring1999.Vol.77,Iss.2;pp.115–24

Nathan,R.andHill,L.(2006).Career Counselling.2ndedn.London:Sage

TookeJ.Aspiring to excellence: final report on the independent inquiry into Modernising Medical Careers.London:MMCInquiry,2008.www.mmcinquiry.org.uk

Bibliography

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Appendix A

Career Counsellors: List of Professional BodiesWithinthecareer-counsellingprofessionthewordsinformation,adviceandguidancehavespecificmeanings:

Information–thisistheprovisionofinformationonlearningandworkwhichcanbeprovidedthroughawiderangeofmedialikewebsites,leaflets,etc.andfacetoface.Withinthemedicaleducationcontextinformationaboutspecialtytrainingopportunities,competitionratios,etc.aregoodexamples.

Advice–thisiswheresomeonemightwishtodiscusstheinformationtheyhavegatheredwithsomeonetodeveloptheirunderstandingofitandfindoutifthereareothersourcesofinformationwhichwouldbeusefultothem.Thepersongivingtheadvicemightproposetheyneedmorein-depthsupportandthisiswhereguidancecomesin.

Guidance–theprovisionofin-depthsupporttoanindividual,oftenfacetofaceorbytelephone.Increasingly,electronicmediaarebeingusedtoprovideguidanceandit’salsooftenprovidedinagroupsetting.

Pleasenotethatcareercounsellorsarealsooftencalledcareeradvisers,careerguidanceprofessionals,careerconsultantsandcareerpractitioners.Increasingly,peoplearealsoofferingcareercoaching.

Institute of Career Guidance:http://www.icg-uk.org/

TheICGaccreditscareerguidanceprofessionalandhasasectiononitswebsitetohelpyoufindacareeradviser.

AGCAS:http://www.agcas.org.uk/

TheAssociationofGraduateCareersAdvisoryServicesistheprofessionalassociationofcareerprofessionalsinHigherEducation.UniversityCareersServicesareusuallymembersofAGCASandyourmedicalschoolmayhaveaccesstotheservicesoftheuniversitycareersservice.

Prospects:http://www.prospects.ac.uk/cms/ShowPage/Home_page/p!eLaXi

ThisistheUK’sofficialwebsiteforgraduatesanditissupportedbyAGCAS.Youcanemailacareersconsultantandalsofindacareercoachifyouwanttoworkwithsomeoneonanindividualbasis.Theseservicesareincludedinthecareersadvicesectionofthewebsite.

107NAEGA:http://www.naega.org.uk/

TheNationalAssociationforEducationalGuidanceforAdultsisapractitionerorganisationrunbymembersformembers.Thewebsitehaslinkstoguidanceprovidersinits‘lookingforguidance’section.

British Psychological Society:http://www.bps.org.uk/

TheBPSistherepresentativebodyforpsychologyandpsychologistsintheUK.

Youcanusetheirmainsitetofindacharteredpsychologist.

TheBPSalsoaccreditspractitionersintheuseofpsychometricinstrumentsandhasaseparatewebsiteforthePsychologicalTestingCentre:

http://www.psychtesting.org.uk/.Thedirectoriessectioncontainsdetailsofqualifiedtesters,andwithinthedirectoriessectionyouneedtosearchforaLevelBinstrument(aspersonalityinstrumentssuchastheMBTIarecategorisedasLevelB).

Coaching

Coachingisanincreasinglypopulartoolwhichcanbeusedtohelpsupportpersonaldevelopment.Itcanalsobeofferedaslifecoaching,careercoaching,personaldevelopmentcoaching,etc.TheEuropeanCoachingInstitutedefinescoachingasa‘simpleyeteffectiveformofpersonaldevelopmentwhereclientandcoachcreateanalliancethatpromotesandsustainstheclient’spersonalgrowthandcompetence’.

Atthemomenttherearenoofficialregulatorystandardsforcoachingandnogovernedtrainingstandardswhichneedtobeattainedbeforeindividualscanbecomeacoach.Therearethoughtwointernationallyself-appointedaccreditationbodiesthataimtoself-regulatetheindustryandwithintheUKCIPD(CharteredInstituteofPersonnelandDevelopment)provideadvicetoHRprofessionalsoncoachingandmentoring.

Herearesomewebsitesifyouwouldliketofindoutmore:

CIPD:http://www.cipd.co.uk/subjects/lrnanddev/coachmntor/

International Coach Federation:http://www.coachfederation.org/icf/

European Mentoring and Coaching Council:http://www.emccouncil.org/

Appendix A

108


Appendix B

Further Resources for Career PlanningGeneral career planning

Hopson,B.andScally,M.(2000).BuildYourOwnRainbow:WorkbookforCareerandLifeManagement.London:KoganPage

(Thiscanalsobeusedasaself-helpguidebytraineeswhowantmorehelpwithStage1.)

Schein,E.H.(1990).CareerAnchors:DiscoveringYourRealValues:Instrument.USA:Jossey-Bass.Pfiefer

Medical career guides

SouthWestPeninsularandAGCASDVD–Selectioncentresforspecialitytraining.http://www.agcas.org.uk/agcas_resources/37-selection-centres-for-speciality-training

Chambers,R.,Mohanna,K.andField,S.(2000).OpportunitiesandOptionsinMedicalCareers.Oxford:RadcliffeMedicalPress

Cottrell,E.,Rebora,C.andWilliams,M.(2006).TheMedicalStudentCareerHandbook.Oxford:RadcliffePublishing

EcclesS.andSanders,S.(2008).SoYouWanttobeaBrainSurgeon?Amedicalcareersguide.Oxford:OxfordUniversityPress

Hastie,A.andStephensonA.(2008).ChoosingGeneralPractice.Oxford:BlackwellPublishing

Hill,E.(2008)Soyouwanttobeamedicalmum?Oxford:OxfordUniversityPress

Kersley,S.(2005).PrescriptionforChange.Oxford:RadcliffeKersley,S.(2006).ABCofChangeforDoctors.Oxford:Radcliffe

Lepnurm,R.,Danielson,D.andDobson,R.(2006).‘Cornerstonesofcareersatisfactioninmedicine’,CanadianJournalofPsychiatry,51,no.8,pp.512–22

MacDonald,R.andHadridge,P.(2003).MyBeautifulCareer.London:BMJPublishingGroup

RoyalCollegeofPhysiciansofLondon(2002).CareersInformationHandbookforTrainees.London:RoyalCollegeofPhysicians

109Careers guidance counselling guides

Ali,L.andGraham,B.(1996).TheCounsellingApproachtoCareersGuidance.London:TaylorandFrancis(Routledge)

Cochran,L.(1997).CareerCounselling:aNarrativeApproach.London:Sage

Kapes,J.T.,Mastie,M.M.andWhitfield,E.A.(eds.)(1994).ACounsellor’sGuidetoCareerAssessmentInstruments.3rdedn.NationalCareerDevelopmentAssociation

Reid,H.andBimrose,J.(eds.)ConstructingtheFuture:TransformingCareerGuidance.InstituteofCareerGuidance

Watts,A.G.,Law,W.,Killeen,J.,Kidd,J.M.andHawthorn,R.(1996).RethinkingCareersEducationandGuidance.London:Routledge

Yost,E.B.andCorbishley,M.A.(1987).CareerCounselling:aPsychologicalApproach.USA:Jossey-Bass.Pfiefer

Coaching guides

Covey,S.(2004).7HabitsofHighlyEffectivePeople.London:SimonandSchuster

Gallwey,W.T.(2001).TheInnerGameofWork.London:RandomHouse

Landsberg,M.(2003).TheTaoofCoaching.London:ProfileBooks

Whitmore,J.(2002).CoachingforPerformance:GrowingPeople,PerformanceandPurpose.NationalBookNetwork

Royal College websites

Thesesitescontainawiderangeofinformationincludingpersonspecifications,informationabouteducationandtraining,flexibletraining,etc.

• AcademyofMedicalRoyalColleges:http://www.aomrc.org.uk/

• CollegeofEmergencyMedicine:http://www.collemergencymed.ac.uk/CEM/default.asp

• RoyalCollegeofAnaesthetists:http://www.rcoa.ac.uk/

• FacultyofDentalSurgery:http://www.rcseng.ac.uk/fds

• RoyalCollegeofGeneralPractitioners:http://www.rcgp.org.uk/

• RoyalCollegeofObstetriciansandGynaecology:http://www.rcog.org.uk/

• FacultyofOccupationalMedicine:http://www.facoccmed.ac.uk/

• RoyalCollegeofOphthalmologists:http://www.rcophth.ac.uk/

• RoyalCollegeofPaediatricsandChildHealth:http://www.rcpch.ac.uk/

Appendix B

110


• RoyalCollegeofPathologists:http://www.rcpath.org/

• FacultyofPharmaceuticalMedicine:http://www.fpm.org.uk/

• RoyalCollegeofPhysiciansofEdinburgh:http://www.rcpe.ac.uk/

• RoyalCollegeofPhysiciansofLondon:http://www.rcplondon.ac.uk/

• RoyalCollegeofPhysiciansandSurgeonsofGlasgow:http://www.rcpsg.ac.uk/Pages/default.aspx

• RoyalCollegeofPhysiciansofIreland:http://www.rcpi.ie/pages/home.aspx

• RoyalCollegeofPsychiatrists:http://www.rcpsych.ac.uk/

• FacultyofPublicHealth:http://www.fphm.org.uk/

• RoyalCollegeofRadiologists:http://www.rcr.ac.uk/

• RoyalCollegeofSurgeonsofEdinburgh:http://www.rcsed.ac.uk/site/0/default.aspx

• RoyalCollegeofSurgeonsofEngland:http://www.rcseng.ac.uk/

• RoyalCollegeofSurgeonsinIreland:http://www.rcsi.ie/

Medical careers websites

• NHSMedicalCareers:http://www.medicalcareers.nhs.uk

• NHScareers:http://www.nhscareers.nhs.uk/

• BMJcareers:http://careers.bmj.com/careers/hospital-medical-healthcare-doctors-jobs.html

• Doctors.net:http://www.doctors.net.uk/

• UKFoundationProgramme:http://www.foundationprogramme.nhs.uk/pages/home

Websites which advertise medical jobs and training opportunities

• NationalrecruitmentofficeforGPtraining:

• http://www.gprecruitment.org.uk/

• NationalInstituteforHealthresearchadvertisejobsinacademicmedicine:http://www.nihr.ac.uk/Pages/default.aspx

• NHSjobs:http://www.jobs.nhs.uk/

• BMJcareers:http://careers.bmj.com/careers/hospital-medical-healthcare-doctors-jobs.html

• HealthServiceJournal:http://www.hsj.co.uk/

• TheLancet:http://careers.thelancet.com/home/index.cfm?site_id=8802

111Essential websites

• COPMeDistheConferenceonPostgraduateMedicalDeansintheUK:http://www.copmed.org.uk/

• DepartmentofHealth:http://www.dh.gov.uk/en/index.htm–canbeusedtoobtainacopyofthe‘GoldGuide’whichregulatesspecialtytraining

• GMC:http://www.dh.gov.uk/en/index.htm–forcopiesof‘GoodMedicalPractice’and‘TheNewDoctor’aswellinformationontheregulationofpostgraduatemedicaleducation.

• BMA:http://www.bma.org.uk/–andensureyouhaveacopyoftheBMAJuniorDoctorsHandbook.

• EqualityandHumanRightsCommission:http://www.equalityhumanrights.com/advice-and-guidance/–theDisabilityDiscriminationAct(1995)introducedanumberofimportantprovisionsforemployees:theguaranteedinterviewschemeandrequiringemployerstomakereasonableadjustmentsforpeoplewithdisabilities.TheEqualityandHumanRightsCommission’swebsitecontainsusefulinformationandadvice.

• BritishDyslexiaAssociation:http://www.bdadyslexia.org.uk/–isacharitywhichprovidesarangeofservicestoemployersandemployees.

Psychometric tests

Sci45/59.SpecialtyChoiceInventory.

AvailablefromtheOpenUniversityCentreforEducationinMedicine

Tel.01908653776

AvailableforBMAmembersfromtheBMAwebsite.Somedeanerieshavealsopurchasedlicencesforthisinstrument.AsktheCentreManageratyourtrustEducationCentre,orthedeanerycareersstaff.

Appendix B

112


Appendix C

Guidelines for CV WritingIntroduction

Thereisconsiderablevariabilityinrecommendedlayoutsandwewouldsuggestthatyoudiscussthismatterwithyoureducationalsupervisorandyourcolleagues.Butwhateverlayoutyouchoose,youneedtomakesurethattheCVmatchesthepersonspecificationoftheposttowhichyouareapplying.

Todootherwisecangivetheimpressionthatyouaren’treallythatkeenonbeingofferedthepost.

Theissueofincludinginformationthatidentifiesyourageisalsotricky.Fromalegalpointofview,youdonotneedtoincludesuchinformation,sonotonlyyourdateofbirthbutalsothedatesatwhichyouachieveddifferentqualificationscanbeomitted.However,althoughrecruiterscannotmarkyoudownforomittingthisinformation,theymightfinditsurprising,asmanypeoplewouldexpecttoputthedatesatwhichtheypassedparticularexamsontheirCV.Again,wewouldsuggestthatyougetlocaladvicefromyoureducationalsupervisor.

Theheadingsbelowgiveonepossiblestructure,anditiscertainlyausefulstartingpointforconstructingyourfinalCV.

Personal details

Yourname,address,telephonenumber,andemailaddress–theseshouldbeatthetopofpageoneofyourCVandcouldbeshowninaheaderonsubsequentpages.

Career plan

Onesentencesummarisingyourcareeraims,andhowthejobonofferwillhelpyouachievethem.

Personal information

IncludeyourGMCnumberandtypeofregistration.Youdonotneedtoincludeyourdateofbirth,nationality,maritalstatusorsex.

Professionalqualifications(fromthecurrenttime,backtomedicalschool,i.e.includemostrecentfirst).

Soifyouhavecompletedadditionalprofessionalqualifications(e.g.MRCPPart1),thisshouldgofirst.Thenlistyourmedicalschoolqualifications.Foreachqualificationlist:

113–Titleofqualification,classofdegree(ifrelevant),awardingbodyand,ifyouchooseto,thedate.

–Inaddition,bullet-pointprizes/distinctionsatmedicalschool.Youmayalsoincludeabulletpointonyourelectiveyear,aspartofthedescriptionofyourundergraduatetraining.

Education

Detailsofyourschoolqualificationswithnameofschoolandgradesandagain,ifyouchooseto,thedate.(Again,mostrecentfirst.)

Professional expertise

Includejobtitle,locationsanddates.Forcurrentandpreviousposts,beyondlistingjobtitle,employingtrustanddates,youcanalsoincludeacoupleofbulletpointshighlightingthekeyfeaturesofeachjobthatdemonstrateyoursuitabilityforthepostonoffer.Ifyouareamoreexperiencedapplicantwhohashadanumberofpreviousmedicaljobs,thenyoudon’twanttogivetoomuchdetailonjobsthatyoudidaconsiderabletimeago,oronjobsinwhichyoubasicallygainedthesameexperience.Thekeypointhereisthatyoudon’tneedtogivethesameamountofinformationoneachandeveryjobthatyouincludeinyourCV;matchingtothepersonspecificationistheimportanttask.

Practical skills

Bullet-pointspecificproceduresyouarefamiliarwithandwhererelevantindicatehowmanyyouhaveperformed.Forexample,‘performedmorethan20chestaspirations’.

Additional courses

ListALSorotherrelevantcourse.

Research

Listyourpublications,casereportsandconferencepresentations(butbewaryofwriting‘inpreparation’asthiscanirritateconsultants,whoknowthatsuchclaimsoftendon’tamounttomuch).

Teaching and audit

Includeacoupleofexamples,andmakesureyoubrieflymentiontheoutcomeofanyaudit.

Other relevant skills

Forexample,youcanmentionforeignlanguagesthatyouspeak,andparticularITskills.

Appendix C

114


Interests

Bullet-pointacoupleofyourintereststhatyoucantalkaboutatinterviewandthataddvaluetoyourapplication.

References

Giveatleasttworeferences.Oneoftherefereesshouldbeyourcurrentormostrecenteducationalsupervisor.Includeaccuratecontactdetailsforthoserefereesandremembertoletyourrefereeknowthatyouhavegiventheirdetailsasarefereeasthisavoidsunnecessarydelays.

IfyouwantmoredetailedguidanceonCVwriting,thefollowingtwobooksareuseful:

AdamPoole.HowtoGetaJobinMedicine.ElsevierHealthSciences.2005

SamMcErin.WritingaWinningCV:EffectiveProfessionalDevelopment.Edukom.2004

115Appendix D

Guidelines for Giving a Presentation at a Job InterviewForsomespecialtiesyoumaybeaskedtogiveapresentationaspartoftheselectionprocess.Usuallythesubjectisgiventoyouinadvancetogetherwiththemaximumtimeyouhavetodeliveritontheday.

Whenthetopicisgiventoyouinadvance

1. PreparationStartyourpreparationbyresearchingandgatheringyourthoughtsonthesubjectmatterofthepresentationandwhatyoucouldcover.Askcolleagues,friendsandothersfortheirviewsonwhatshouldbeincluded.Dobeawarethatitmightbeappropriatetobringinhigherlevelcontextualinformation,e.g.anewpolicyontreatmentforthatparticularspecialty.Onceyouhaveanideaofwhatyouthinkyouwillcover,organiseyourmaterialandstartthinkingaboutthebestwaytopresentit.

2. PowerPointMostpeopleusepackageslikePowerPointandthatisfine.Dokeepyourslidessimple,withacleanlayoutandeffectivecolourscheme.Busyslideswithlotsofdetailareoftendifficulttoreadandflyingbulletpointsandflashyeffectscanbeveryirritatingtointerviewers.Alsoensureyouarefamiliarwiththecontentasthiswillhelpyoudeliveramorefluentpresentation.Keepthelayoutofyourslidescleanandsimple.Diagramscanbeeffectiveandhelpyoutomakeyourpoint.Theyshouldbedrawninsuchawaythatitisclearhowtheyshouldberead.Keepthenumberofbulletpointsontheslidestonomorethanfiveorsixandeachbulletshouldactasapromptforyoutoexplainthepointfurther.

3. Backup Technologydoessometimesletyoudownsodotakealongpapercopiesofthematerialwhichyoucandistributeandrefertoifthetechnologyfails.Thisshowsgoodplanning,andthatyoudon’tfalltopieceswhenthegoinggetstough.

4. Beginnings Thepresentationislikelytobeearlyintheinterviewprocesssomakesureyouintroduceyourselfandthesubjectmattertothepanelbeforeyoustart.Takeadeepbreathandtrytoenjoythepresentation.

Appendix D

116


5. PositioningDuringthepresentationbeawareofwhereyouarestandingandmakesureyoudon’tobstructthepanel’sviewofyourslides.Youwillalsoneedtomaintaineyecontactwiththepanel.Thefocusofyourpresentationisthepanel–solookatthemandnotthecomputerortheslidesonthewall.Ifyouneedpromptsforyourpresentation,prepareasetofnoteswhichyoukeeptohandandcanreferto.Inaddition,fluencycomesfrombeingveryfamiliarwiththecontentsofthepresentation.Avoidatallcoststurningyourbackontheinterviewersandreadingthepointsfromtheslides,anddon’tpaceupanddown!Itcanmaketheinterviewingpanelnervous.

6. Timing Youwillbeaskedtokeepyourpresentationwithinaparticulartimeframe.Makesureyoucansticktothis,assomepanelsmightstopyouwhenyoucometotime,evenifyouhaven’tfinishedwhatyouwantedtosay.

7. PracticeItisessentialtopractiseyourpresentationoutloudtoyourself,andthenideallytoanaudience.Seeifyoucanfindasmallwillingaudienceoffriendsandfamilytohelpyou.Thiswillalsohelpyoucheckthatitiswithinthetimelimits.Goingthroughitinyourheadtakesalotlesstimethanspeakingitoutloudandwillgiveyouafalseimpressionofhowlongitwilltakeyouontheday.Also,dothinkaboutthewayyourvoicetoneandpacemightbeaffectedbynervesontheday.Youmayspeakfasterorslowersodobearthatinmindwhenyouarecheckingyourtiming.Takingadeepbreathbeforeyoustarthelpsgetoxygentoyourbrain.Ifatanytimeduringthepresentationyoufeelyouarerunningoutofbreathorgettingcarriedaway,finishyournextpoint,pause,takeadeepbreathandstartagain.

8. Questions Onceyouhavecompletedyourpresentationtheinterviewersarelikelytoaskyousomequestionsaboutit.Dothinkinadvancewhattheymightaskandpreparesomesuitableanswers.Thereisalwaysapossibilitythatoneoftheinterviewerswillaskyousomethingwhichisinanunfamiliararea.Youcan’tprepareforthis.Takeamomentortwotocomposeyourself,smileandthentrytogivethebestanswerpossible.

117When the topic is given to you on the dayInthissituation,youobviouslycannotprepareyourpresentationinadvance.

Theonlyconstructivepreparationthatyoucandoistotalkwithfriendsandcolleaguestothinkthroughpossibletopicsthatyoumightbegiven.Arethereanyparticularlyhotcontroversiesinyourspecialtyofinterest?Ifthereare,youmightwanttothinkthroughabriefsummaryofyourviewsontheissue.(Andyoushoulddothisanywayasawayofpreparingforthequestionsthatyoumightbeaskedatinterview.)

Butbeyondthinkingaboutpossibletopics,theotherpreparationyoucanusefullydoistoworkouthowmany‘bulletpoints’youcandiscussintheallocatedtime.(Typicallyyouwillknowhowlongthepresentationispriortotheinterview,evenifyoudon’tknowtheprecisetopic.)Soyoumightwanttohaveadummyrunwithatopicthatyoumakeupyourself–justtoseehowmuchcontentyoucancomfortablycoverinthegiventimespan.

Ifthetopicisgiventoyouonthedayyouwillbeprovidedwithacetatesandpensratherthanbeingexpectedtodoan‘on-the-spot’PowerPointpresentation.Makesurethatyourwritingisclear,thatyouspellwordscorrectly,andthatyoudon’ttrytostufftoomuchcontentontoeachacetate.

Itisalsoimportantthatyoudon’tsetyourselfimpossiblestandards.Iftheygiveyouthetopiconthedaytheyareassessinghowquicklyyoucanconstructawellorderedcoverageofthetopic–theyarenotexpectingyoutoknoweverylastfact,orhavebeautifullyhand-illustratedacetates.Sotrytokeepcalm,spendmostofthepreparationtimeonorderingyourargument,andthenintheactualpresentationjustincludeafewacetateswithasmallnumberofbulletpointsoneachacetate.

Beyondthispoints4,5and7listedabovealsoapply.(Intermsof7.‘practice’,youclearlycan’tpractisetheactualpresentation,butyoucanpractisegivingapresentationwithatopicofyourownchoiceinordertogetusedtothesoundofyourvoice,speakingatanappropriatepaceandre-startingifyougoblankduringthetimethatyouarespeaking.)Asmentionedabove,thispracticecanalsohelpyouworkouthowmuchcontentyoucancomfortablycoverintheallocatedtime.

Appendix D

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Appendix E

Workshop 1 – Introduction to career-planning seminar for F1 traineesIntroduction

ThisworkshophasbeendesignedtointroducecareerplanningtofoundationprogrammetraineesandshouldbeheldearlyonintheirF1year.Alltraineesshouldbeencouragedtoattendandwillneedtobringalongthisresourcebook.Forthisworkshopyoushouldideallyallocateatleasttwohourstoensurethematerialiscoveredadequately.Thetimingsgivenbelowareforaworkshoplastingtwoandahalfhours.

• Purposeofthesessionandintroduction:15minutes

• Briefoverviewofthefourstages:10minutes;

• Stage1self-assessment:60minutes;

• Shortbreak:15minutes;

• Stage2careerexploration:30minutes;

• Plenary:20minutes.

Thetimingscanbeamendedtocoverthematerialinatwo-orthree-hoursessionbyeitherreducingthebreakandplenarysessionforatwo-hoursessionorincreasingthetimespentonStages1and2forathree-hoursession.

119Workshop Plan Time Activity Teachingnotes Resources

15mins Explainthepurposeofthesessionandabriefintroduction

Stage1self-assessment

Explainthefourstages:

1.Self-assessment:workvaluesandskillsandinterests.

2.Careerexploration:researchintodifferentcareerpathways.

3.Decisionmaking.

4.Planimplementation.

Introductorycomments:a.Thefour-stageframeworkisonethat

appliestocareerdecisionmakingatanystageofone’scareer–itisnotrestrictedtothecurrentcareerdecisionsthatthefoundationtraineesarefacing.

b.Thisintroductorysessionwon’tprovidethetraineeswithalltheanswers,i.e.theywon’tbe‘sorted’bytheendofthesession.Instead,thesessionaimstoprovidetraineeswithasenseofthequestionsthattheyneedtoaskthemselvesoverthecomingweeks/months,pluswaysoffindinganswerstothesequestions–sothatbytheJan/FeboftheirF2yeartheyaremorelikelytomakeasoundcareerdecision.

c.ThesessionwillconcentrateonStages1and2,butwillalsotouchontheothertwostagesinmoredetailinsubsequentsessions.

d.Thisintroductorysessionisstillusefultothosetraineeswhoalreadyfeedthattheyhavemadetheirmindupabouttheirpost-foundationcareer.Why?Firstofall,itisusefultocheckiftheircareerdecisionmakingisrobust.Secondly,Stage4(planimplementation)dependsonthepreviousstages.Ifthedecisionrestsonafirmfoundationofself-assessment(Stage1),careerexploration(Stage2),andhowthesematchtogether(Stage3),thetraineewillbebetterequippedtowriteaconvincingapplicationformandprovidegoodanswersatinterview.

RuntwoStage1exercises:workvaluesandskills/achievements

Traineestohaveaccesstothisbookandbringtheirownfoundationportfolios.

ChapterII

Appendix E

120


30mins Stage1self-assessment

Exercise1:workvalues

Explainthatworkvalueshavebeenfoundtobeanimportantpredictorofoccupationalsatisfaction.Thenexplainhowtodothecardsort.

Aftethetraineeshavesortedthecards(ontheirown),encouragethemtopairupandtalkthroughthequestions.

Reconveneasagroup,andaskthetraineesforanycomments.

Youmightalsoaskthemtothinkabouttimesatworkwhenthryhavebeenparticularlysatisfied(or,forthatmatter,particularlydissatisfied),andtoseeifthereisalinkbetweenhowtheywerefeelingabouttheirworkatthispointsandtheirworkvalues.(theexerciseonstressesandstrainshasnotbeenincludedintheseminarguidelinesbecauseitisprobablybettertodoamoredetailedassessmentofdifficultiesatworkina1:1ratherthanagroupsetting.)

ChapterII.Copytheworkvaluescardsandhavescissorsandenvelopes.


Exercise2:skills/achievements

SeeChapter2forinstructions.

Howmanyexamples?Workinginpairs,thetraineesshouldanalyseoneworkexampleandonenon-workexample.

ChapterII.Traineesfoundationportfolio


PuttingtheStage1exercisestogether

Oncethetraineeshaveworkedthroughthevaluesandskills/achievementsexercises,encouragethemtodrawoutaheraldicshield,dividedintofoursections.

Worksvalues/interests

Skills/stressors

Askthetraineestoputafewbulletpointsineachofthefourquadrants.Refertoexampleinthebook.Theycanwriteapersonalmottointheylike.

(Andiftheywantmoreself-assessmentexercises,directthem,forstarters,totheHopsonandScallybookincludedintheresourceslistinAppendixB.

ChapterII.

15mins 15-minutebreak

12130minsintotal,includingtheexercise

Stage2careerexploration

IntroductiontoStage2

Thenextstageistoexploredifferentcareeroptionstofindouttwothings:

1.Whichparticularcareerpathwaysaremostlikelytomatchthetrainees’skills,interest,valuesetc.

2.Givenfeedbackfromtheeducationalsupervisorand/orDirectorofMedicalEducation,thetraineeneedstoconsiderwhethertheoptions(s)theyareinterestedinseemtoberealisticcareerchoices.

Otherpointstoshow

• Adequatecareerexplorationtakestime

• Stage2isnotcarriedoutinavacuum–rather,Stage2followsonfromStage1.

• SothetraineecanusethesummaryexercisefromStage1togeneratealistofspecificissuestobeexploredintheirspecialtiesofinterest.

• Theclearerthetraineeisaboutwhatisimportanttothem(Stage1),themoretargetedandrelevanttheStage2researchcanbe.

• Traineeswillhavetoaugmenttheirreadingaboutdifferentoptionswithtalkingtopeople–atvariouslevelsofseniority–whoarecurrentlyworkinginthisspecialty.Withoutthis,itwillbedifficulttoascertainwhetherthecareerisgoingtomatchtheircoreworkvalues,skills,interestsetc.

• Theremaybesometo-ingandfro-ingbetweenStages1and2.So,forexample,somethingthatatraineefindsoutaspartoftheirStage2researchmightcausethemtore-thinksomeaspectoftheirinitialself-assessment.

ChapterIII

Appendix E

122


Stage2careerexploration

Exercise3:whatresourcesareoutthere?

1.TheresourceslistattheendofChapterIIIcontainsalistofusefulbooksandwebsites.

2.TheMMCwebsitecanbeusedtoaccessalldeanerywebsites.TheCOPMeDsitehaslinkstoallRoyalCollegewebsites.Checktheseforrelevantjournalsandeventswhichgivetheopportunitytofindoutmoreaboutthespecialty.

3.Checkthenoticeboardinthepostgraduatecentreforotherusefulinformationanddetailsoflocalevents.

Activity:identifythreecareerresearchtaskswhichfollowonfromtheStage1self-assessmentsthatthetraineeisgoingtoundertake.Thetraineeshouldwritethesedown,committoadatefortheircompletionanddiscussthetaskswithacolleague.

ChapterIII

20mins Plenary Recapthepurposeofthissessionhasbeentooutlineaframework(andthusprovidequestionsratherthananswers).

Remindthemthattherewillbefurthersessions,aspartofthegenericprogramme,whichwilllookatStages3and4(andwillalsolookatpost-F2trainingroutesinmoredetail).

Encouragethemtospendsufficienttimeontheircareerplanning,ratherthanleavingitalltothelastminute.

Dealwithanyotherquestions.

123Appendix F

Workshop 2 – Introduction to career-planning seminar for F2 traineesIntroduction

ThesecondworkshopisforF2traineesandshouldberunearlyintheirF2yearasitcoversapplicationformsandinterviews.ThesessionshouldlastthreehourstoensurethematerialiscoveredadequatelyTheworkshopshouldberunbyaclinicianwithexperienceofhelpingtraineeswiththeircareerdecisionmakingandwhohasbeeninvolvedinrecruitmentandselectiontoposts.Anoutlinesessionplanisasfollows:

• Purposeofthesessionandintroduction:5minutes

• Briefreviewofthefourstages:10minutes.

• Stage3decisionmaking:30minutes

• Stage4applicationforms:45minutes

• Break:15minutes(thiscanbetimedtosuitlocalarrangements)

• Stage4interviews:50minutes

• Plenaryandquestions:25minutes

Appendix F

124


Workshop planTime Activity Teachingnotes Resources

15mins Purposeofthesessionandbriefoverviewofthefourstages.

Explainthefourstages:

1.Self-assessment.

2.Careerexploration.

3.Decisionmaking.

4.Planimplementation.

Introductorycomments:

a.Thefour-stageframeworkisonethatappliestocareerdecisionmakingatanystageofone’scareer–itisnotrestrictedtothecurrentcareerdecisionsthatthefoundationtraineesarefacing.

b.ThissessionbuildsontheintroductorysessiontheymayhavehadintheirF1yearandspecificallyfocusesonStages3and4ofthecareer-planningframework.Itwon’tprovidethetraineeswithalltheanswers,i.e.theywon’tbe‘sorted’bytheendofthesession.Instead,thesessionaimstooutlinethepreparatorytasksthattraineesneedtocarryoutpriortofillingintheirapplicationformsandbeforeaselectioninterview.

c.ThesessionwillconcentrateonStages3and4,andwillonlytouchontheothertwostagestosetthecontext.

d.Stage4(planimplementation)dependsonthepreviousstages.Ifthedecisionrestsonafirmfoundationofselfassessment(Stage1),careerexploration(Stage2),andhowthesematchtogether(Stage3),thetraineewillbebetterequippedtowriteaconvincingapplicationformandprovidegoodanswersatinterview.

Traineestohaveaccesstothisbook.

Stage3decisionmaking

IntroductiontoStage3andanexercise.

1255mins Stage3decisionmaking


Peoplemakedecisionsindifferentways.Somemulloveradecisionforawhileandthen,onthebasisofagutfeeling,becomeconfidentthatonepathwayistherightoneforthem.Othersliketobemoreconcreteintheprocessanddrawupcostbenefittables.Eitherapproachisvalid.

Somepointsthatyoumightwanttoraiseincludethefollowing.

•Askthemtoreflectonpastcareerdecisionsinordertoidentifywhathelpedthemreachadecision.Isthisapproachvalidfortheircurrentcareerdecision?

•Iftheyareconsideringpost-foundationtraininginaspecialtywhichisverycompetitive,itmightbeadvisableforthemtohavea‘backup’planforalesscompetitivespecialty.

•Advisethemtodiscusstheirplanwithacolleague,andalsowiththeireducationalsupervisorortheFacultyCareersLead.Then,introducethemtotheideaoftheROADScriteria.

ROADS–asystematicwayofreviewingcareerdecisions

Realistic–areyoubeingrealisticaboutyourselfANDaboutthedemandsofthejob?

Opportunities–haveyougivenseriousconsiderationtoalltheopportunitiesavailable?

Anchors–haveyoubuiltinthethingsthatprovidesupportinyourlife?

Development–doyourchoicesfullydevelopyourpotential?

Stress–haveyouconsideredthoseaspectsofworkthatposeparticularstressesforyou?

Ifyouhavetime,takeacareerdecisionyouhavemadeinthepastandreviewitwiththegroupusingtheROADScriteria.(itisbettertousethefaciliatorsexamplethantoaskforexamplesfrompreviouscareerdecisionsfromthetrainees,assometimesthiscanleadtoquiteapersonalissuebeingunwittinglyopenedupinfrontofthegroup.)

Appendix F

126



Lifelineexercise

ThisexercisecanbeusedwithbothindividualsandgroupsandisincludedinChapter3.

Exercise1:Lifelineexercise

AsktraineestocompletetheLifeline,thenaskthemtosplitintopairsforthediscussion.

Askthetraineestogettogetherinpairsanddiscussthefollowingquestions:

1.Whichchangesrepresentedgoodcareerdecisions?

2.UsetheROADScriteriatodescribethewaysinwhichtheyweregoodcareerdecisions.

3.Werethereanydecisionsthat,inretrospect,werenotsogood?Ifso,usetheROADScriteriatodescribethewaysinwhichthedecisionturnedoutnottobesofavourable.

4.LookingattheirLifelinesofar,cantheyseeapatternintermsofwhathelpedandwhathinderedanydecisionsthattheyhavemadeinthepast?

Ifthetraineehasmadeadecisionabouttheirpost-F2training,thentheycananalysethedecisionusingtheROADScriteria.

ChapterIV.

Blankpaper.


Stage3plenary

Askthetraineesiftheyhaveanycomments.Youmightalsowanttoaskthetraineeswhattheyhadlearntaboutthemselves,intermsofhowtheyapproachthetaskofmakingdecisions.

5mins Stage4planimplementation


byStage4(whichtraineesneedtoreachwellinadvanceofthetimethattheywillhavetofillouttheirapplicationforms)traineesshouldknowwhatpostorspecialtytrainingprogrammetheywishtoapplyfor.

Thepurposeofthisstageistowriteexcellentapplicationformsandprepareforinterviews.Sometraineeswillalreadyknowwhattheyareapplyingforbutothersmaybeundecided.Eitherway,theycanusetheworkshoptopracticetheirtechniques.

ChapterV

127Applicationforms

Thetimingsforthissessionare:

10minutes:provideanoverviewoftheapplicationprocess

20minutes:askthetraineeseachtodraftananswertoonequestiontakingfromthequestionbank,andthencritiquetheiranswerinpairs.

10minutes:sharehintsandtips.

ChapterV

10mins Applicationforms–overview

Overviewoftheapplicationprocess

Chapter5containsaflowchartwhichyoucanusetowalkthroughtheprocess.DoencouragetraineestoassembleaCV,sotheyhavealltheinformationinoneplace,andstresstheimportanceofaskingtheirrefereesinadvance.

Bringoutthekeypointsfromtheinformationoninitialpreparationandgoldenrules:

Asawayofpreparingtowriteanswersforapplicationforms,traineesmightwanttousetheSTARstructure.Bythiswemeanthetraineecouldbreakdowntheirexampleinto:

Situation/Task

Provideaconciseoverviewoftheexampleyouareconsideringusing,ensuringthatitisrelevanttothequestion.

Actions

Whatexactlydidyoudo?Whatwereyourroleandcontribution?Whatskillsdidyouuse?(Thispartwillprobablyformthebulkofyouranswer).

Results/Reflection

Whatwastheoutcome?Whathaveyoulearntaboutit?

ChapterV

20mins Applicationforms–exercise

Exercise2:applicationforms

Askthegrouptosplitintopairsandtoconsideronequestionfromthequestionbankdetailedbelow.Youwillalsowishtoaddyourownsuggestionsaswell.

Traineesshouldpreparetheiranswerindividuallyandthenworkinginpairscritiquewhattheyhavewritten.IntheircritquetheymightwanttorefertotheSTARacronym.

ChapterV

Appendix F

128


Exercise2:questionbank

1.Givearecentexampleofaclinicalsituationinwhichyoufeelteamworkingcouldhavebeenimproved.

2.Describeyourexperienceofclinicalauditindicatingclearlyyourownlevelofinvolvementandtheclinicalrelevanceoftheaudit.

3.Describeadifficultclinicalsituationyoutackledwell.

4.WhatdoyouconsiderthemostchallengingaspectsofapplyingtheGMC‘GoodMedicalPractice’toyourowncareer?

5.Describeyourexperienceofclinicalgovernanceandindicateclearlyyourownlevelofinvolvement?

6.Describeyourexperienceofworkinginmulti-disciplinaryteams,includingyourobservationsontheeffectivenessofteamwork.Youmaygiveexamplesfrombothinsideandoutsidemedicine.

7.Describehowyoudeploytime-managementskillsinordertooptimiseyourprofessionaldevelopment.

Youmayprefertodevelopyourownquestions.

10mins Applicationforms–groupdiscussion

Bringthegroupbacktogetherandaskthemtosharetheirthoughtsaboutthequestionstheychosetoanswer.Trytoensureeachpaircontributestheirideastothediscussion.

InthissessionrefertoChapters5and6,todrawouttherelevantpoints.

ChapterV

15-minutebreak

Interviews Thepurposeofthissessionistogiveyouanopportunitytodiscussaselectionofthequestionsfoundationtraineesmightbeaskedatinterviews.

Thetimingsforthesessionareasfollows:

5minutes:outlineoftheexercise

25minutes:fortheexerciseinpairs

20minutes:reassembleasagrouptosharebestpractice.

ChapterV

1295mins Interviews–exerciseoutline

Somekeypointsaboutinterviews:

Mostinterviewswillbestructuredandtime-limited.Therewillalmostcertainlybemorethanonepersonpresent.Ifthereisapanel,onememberwillbeappointedasChair,anditisthepersonwhoislikelytowelcomethetrainee,introducetheotherpanelmembers,andoutlinethestructureoftheinterview.

Preparationisall-importantasmanyquestionscanbroadlybepredictedinadvance.Soiftraineesdevoteadequatetimetopre-interviewpreparation,theyshouldbeabletoimprovethequalityoftheirperformanceontheday.(Ofcourse,traineesmightstillbeaskedsomequestionsthattheyhaven’tconsideredbefore.Butifastructuredinterviewprocessisused,thenatleasttraineescanbereassuredthatallthecandidateswillbeposedthisparticularquestion.)

Sohowshouldtraineesprepare?

Forstartersitishelpfultorealisethatquestionswhixhareaskedatinterviewsareusualllydividedinthreebroadareas:

1.Questionsaboutyou.

2.Questionsaboutthejob/specialty.

3.Questionsaboutthewidercontextofhealthcare.

Itisfarbetterfortraineestorefertospecificexamplesthantotalkingeneralities.Thenextexerciseaimstogivethemachancetopracticestructuringspecificexamples.

25mins Interviewsexercise

Exercise3

AsthegrouptosplitintopairsandtoconsideratleastonequestionfromeachofthethreecategoriesinChapter5usingtheSTARtechniquetheyusedfortheapplicationformsexercise.

Checkwhichquestionsarebeingcoveredsothatyoucanensureareasonablerangehasbeenchosenratherthanjustthefirsttwoineachsection.Thereisaselectionofquestionstochoosefromandyoumightwishtoaddsomeofyourownaswell.

ChapterV

Appendix F

130


20mins Interviews–groupdiscussion

Bringthegroupbacktogetherandaskthemtosharetheirthoughtsaboutthequestionstheychosetoanswer.Trytoensureeachpaircontributestheirideastothediscussion.

Inthissessionaimtodrawoutsomeoverallgeneralpointsanddiscussinterviewtechnique.

ChapterV

15mins Finalplenary Recapthatthepurposeofthissessionhasbeentoprovideareviewofthefour-stageprocess,andthenlookindetailatStage3(decisionmaking)andStage4(planimplementation).

Encouragethemtospendsufficienttimeontheircareerplanning,ratherthanleavingitalltothelastminute.

Encouragethemtoidentifyonecareer-planningtaskthattheywillcommittocompletingandthathascomeoutoftoday’sworkshop.Getthemtowritethisdown,withasuitabletimescale,andthenbrieflytodiscussitinpairs.

Dealwithanyotherquestions.

Notes

University of London

PostgraduateDeaneryforKent,Surrey&Sussex

Documents

The ROADS to Success - CMEC · 6 The Roads to Success I. INTRODUCTION About the book ROADS to Success • Is a practical career-planning handbook for all postgraduate doctors (although