Choosing your future career in medicine
Choosing your future career is an exciting time. The world is full of possibilities and opportunities. It is also a stressful time, and doctors often put themselves under enormous pressure to “get it right”.
Let me begin by asking you a question. Whatever job you end up in, how much can you influence your job satisfaction? The answer is really quite a lot. You can be a passive person who turns up and expects the employer to spoon feed them success and make them happy. Or you can be someone who actively manages their career and workplace in a way that allows them to work in accordance to their values, making their own successes themselves and not relying on anyone else to make their career flourish.
I’d encourage you to be the person who actively makes theirs a flourishing career, no matter what. This attitude will help you deal with the inevitable challenges that come up. It also means that getting your career choice “right” is much less important. In fact, medicine may already be a second career to you, and many doctors later in their careers search for additional roles to enhance the pure patient-facing role. You get out what you put in. Every day that you turn up for work, you have a choice in how you behave, what you do, and how you treat people around you, and that is irrespective of the job title that you actually have.
Yes there are some people who know exactly what they want to do (hopefully they get it, as if they don’t then acceptance may be difficult). And there are many many many others who don’t know exactly what they want to specialise in; career indecision is a common reason for taking an F3 year. You may have a general idea, but in reality you can most probably be happy in any one of several different jobs. Unless you are leaving medicine, whatever path you choose will most likely have fairly similar pressures, responsibilities, and rewards.
I’m assuming you are here to help you decide what specialty to choose. So start by taking the pressure “to get it right” off yourself, chose to be the person who actively finds ways to flourish no matter what, and get ready to work through the upcoming questions to help you decide.
What are you doing in your dream job?
Imagine I wave a magic wand and move us 20 years into the future, and you now have your dream job. We set up a video camera and record your life over a week. Once we’re back in the now, we settle down on the sofa, press play, and watch the recording. What did the camera see you doing? What is the effect of those actions?
Make a list of things that the camera records you doing. Focus on the things that you are doing and can be seen, rather than on how you are feeling.
Another way to create a vision for your future career is to ask what you want your life to be about? What do you want people to say about you? What would you like to achieve?
What are your career values?
Values describe how we want to behave now and always, and indicate how we want to treat ourselves, those near to us, and the world around us. They help us grow and develop, and create our present and our future. They inspire us, motivate us, and make our lives meaningful. Living by our values means consciously choosing to focus on what matters to us. When the going gets tough, choosing to behave according to our values motivate us and keeps us going. Values are different to goals. Goals are what you want to complete, achieve, have, or own. Values are how you want to behave as a human being.
You may already be very clear on these. If not, here are a few questions to help you:
- What are the really important things that matter to you in your career?
- When you are having the best day ever at work, what are you feeling?
- If you had a brilliant job and someone approached you with another offer, what would it take for you to go?
If you are still stuck, have a look at the list of values and identify the most important ones from the list. There are also questionnaires that could help you. Have a look also at my page on motivation.
What are your values relating to your health, your family / relationships, and your leisure time?
The values in other aspects of your life don’t have to be the same as your career values. However, if you end up in a job that is at odds with what matters to you in your relationships / family, health or leisure, then finding a good overall balance in your life may be challenging.
What are your strengths?
It’s much easier to do a job that uses your strengths well. Imagine doing something that you do well, it comes naturally, time flies when you are doing it, and you can’t get enough. If your strengths are not used, you may find yourself bored. It is quite possible to learn and develop set attributes also; however, whilst you may become good at them, it is possible that using these learned strengths may leave you feeling drained rather than energised.
You may know your strengths already. If not, coaching can help you discover them, or there are a variety of online questionnaires or books that can help you find them.
What can your past career successes tell you about your future direction?
How can those around you help decide?
The people you work with may be an invaluable source of data to help you choose a career. You can ask them what they think, invite suggestions, and remember to ask a variety of people. Another way of asking would be to get feedback on how you are at work, and then use this to help you choose. For example, ask colleagues three simple questions:
I am trying to decide what career to pursue. I would welcome your views formed from working with me. In relation to my job / career:
- What do I do well?
- What should I do more of?
- What should I do less of?
A face to face question from you may be effective, but sometimes an anonymous online survey or an interview by a third party can get more information. You also need to make sure that you are up to receiving such feedback, as sometimes you might not like what you hear. Being supported by an experienced supervisor or coach is often useful to ensure that you get the most out of this process when you are opening up and seeking people’s honest views.
The mandatory 360 degree assessments required for ARCP may similarly be useful. However, as those are part of your summative assessment, in my experience they often end up being a tick box exercise where the goal is to pass, rather than to gain insight.
What do I know about the specialty?
The other questions so far have focused on knowing yourself. When choosing your career direction, you of course have to find out what the job is like. Make a short list of areas, then start your research. Here are some suggestions how you can find out about a specialty.
- Read specialty-choosing books and guides available on many websites
- Talk to as many people as you can, in different practices / hospitals and different grades
- Join societies, groups, read their guides, attend their events
- Attend career faires
- Organise taster days / weeks
- Read medical textbooks / journals / review articles
- Read websites that cover different specialties
- Look at patient organisation websites
What it’s like as a trainee and what’s it like as a GP/consultant?
Your immediate knowledge of the job is likely to be from the perspective of a trainee, but being a GP or consultant may be quite different. You probably won’t be a trainee for much more than 10 years in total (if that), yet will be a GP / consultant for perhaps 30 years. Of course you have to complete the training, but make sure that your career decision-making focuses on the ultimate career destination much more than the intermediate steps. In addition, knowing that there is a goal at the end will help you deal with any adversity encountered as a trainee.
Will you still want to do this in 20 years’ time?
This is linked to above. What you find interesting or acceptable (e.g. shift patterns) when you are 25 may no longer be when you are 55! So base your choices on a whole lifetime career.
How does the career fit into the rest of my life?
Careers do not exist in isolation from the rest of our lives. Medicine is our vocation and our profession, and not something that can simply be switched off. The reality is that there is only so much time, and as much as we want to do everything, at some stage we have to prioritise, time-manage, and make difficult choices. How can you have a career that gives you everything that matters to you in all aspects of your life? Which specialty is best suited to fit into your whole-life balance? Which specialty can enhance what else matters to you? Having a family life is a common balancing act, as is travel, exercise, sport, and voluntary duties.
What kind of a doctor do you want to be? What else comes with the job?
There is more to a career than the patient-facing aspects. As a student or novice doctor, it is likely that the bulk of your time is spent in direct patient-facing roles. However, later in your career, a myriad of other activities might be present. Think about the following aspects:
- What else does the person do other than see patients?
- Does this role even involve seeing patients? What kinds of patients?
- How much admin is there?
- Is there team leading / multidisciplinary work?
- Is the work solitary or part of a team?
- What are the opportunities for education, research, management, leadership?
- What is the work pattern?
What might get in the way?
Many great careers don’t just happen and there isn’t an obvious and easy way. Don’t be afraid of going out and making your own opportunities.
It is worth thinking about what might get in the way. What do you need to get into that career? Do you have the required CV to get onto a training programme? Have you done everything you can to maximise the points when you attend selection interviews? How many jobs are there, and where in the country are those jobs?
What’s your plan B if you don’t get your first choice?
Don’t be afraid of setbacks and failures. Remember my comments right at the start. Career happiness depends much more of what you bring to the career, rather than on what the career brings to you. My personal view is that most of us would be happy and good at doing most specialties. If you don’t get your plan A, don’t beat yourself up, learn what you can, and move forwards to a different choice. Who knows, it may be even better!
Some things are simply out of your control. But what happens next is up to you – you have a choice in what you do and how you behave, and how you take your career forwards.
How will I make the decision?
We all make decisions in different ways. Some people instinctively know, others make a spreadsheet and analyse in details. Here are some ideas to consider:
- Go with your gut instinct, use your emotions to help you decide
- Start with the ideal outcome
- Don’t be afraid of setbacks
- Explore what’s the worst that could happen
- Go for what is right for you, and beware pressure from others especially social media
- Create a scoring sheet based on criteria that matter to you, and rate the choices against the score sheet
- Don’t rush
- Decide what’s important, and don’t sweat the small stuff
I realise that these won’t be right for everyone. So take what works for you, and ignore the rest!
There is a great talk on the paradox of choice here – I think this is very relevant when it comes to choosing careers (we choose what others choose, we try to make the ideal choice yet this is often impossible or unknown, choice involves loss yet we closing doors causes anxiety).
There is a great free career guide written by Elton & Reid here.
Choosing your career steps again and again and again…
We all work for many decades, and often spend more time with work colleagues than friends or family. Careers are a huge part of our lives. Great careers need to be successful, and they need to be satisfying. The two often go hand in hand, but not always. Choosing your career is the beginning. Many things go into a career choice, including an understanding of your values, strengths, weaknesses, and areas where you are willing to compromise. Remember that it is not just the broad area that you are choosing, you are also choosing other things like work environments, flexibility, and life balance. There is much more to careers than just choosing though – you need to get the job as well, successfully transition into the new role, and then deliver what is asked of you. Choosing career steps, again and again, is a career-long endeavour. It doesn’t stop once you decide what specialty you want to do, throughout the rest of your career there will be choices about type of work environment, additional roles, further career development, leadership, or life balance. And if you are thinking about changing careers have a look here.
Career destiny versus career multiplicity
There are two broad ways in how careers unfold. Whilst reality is never as binary as this, the concept is a useful one to help understand career management.
In the first, the ideal career destination is defined at the start, and plan put into place to deliver in. This approach is based on the assumption that each of us has only one career destiny, and career management is about discovering what that is and then following the path.
In the second approach, career management is seen as a learning journey where different options are tested, and the outcome examined to see what can be learnt. This approach is based on the notion that we each have multiple possible versions of ourselves in the future; there isn’t just one destiny, but instead a multiplicity of different possible careers.
The two approaches are fundamentally different in what underlies them, and in how career management occurs as a result. Different approaches suit different people. I would, however, say that I often see people who are searching for the one career destiny and assume that there is just the one. In the process they fail to see the myriad of other options, and instead of trying a series of low risk strategies as an experiment, they stagnate yearning for something that may not even exist.
As a doctor exploring careers, the world is your oyster. Remember to get to know yourself, as well as prospective careers. Explore the careers as just one aspect of your life as a whole, and not in isolation from the rest of who you are. Be the person who actively finds ways to flourish no matter what; career happiness depends much more of what you bring to the career, rather than on what the career brings to you.
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