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Doctors at Work Podcast.

Episode #66

How to make career decisions. With Ellen Nelson-Rowe

Mat Daniel


When you start working as a doctor, a myriad of different options are on offer. Ellen is a foundation doctor, and in this episode she tells me that it can be useful to plan both short term and long term career steps. Even if you think you know what you want to do, it still pays to keep your mind open and build generic capabilities and achievements. It’s also important to consider how work fits into the rest of your life. And I love her view that leadership roles roles enable her to make a difference.

Dr Ellen Nelson-Rowe is a junior doctor on a specialised foundation programme for Medical Education based in East Midlands. Her career passions are surgery, medical education and leadership which her dream is to combine all in a portfolio career. She also has a keen interest in communications and continues to balance leadership roles alongside her foundation training. Some of the organisations she is currently involved with include The Healthcare Leadership Academy, Melanin Medics and SFO ENT UK. She is passionate about her faith and ensures to prioritise church and life around the demands of F1.


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Podcast Transcript

Mat: [00:00:00] Welcome to Doctors at work. My name is Mat Daniel, and this podcast is about doctor’s careers. Today, we’re talking about how to make career decisions, and I’m having a conversation with Ellen Nelson Rowe, who’s a foundation doctor. Now when you start working as a doctor, a myriad of different options are on offer. And Ellen tells me that it can be useful to plan both short term as well as long term career steps.

And even if you think that you know what you want to do, it pays to keep your mind open and build generic capabilities and achievements because you don’t know what the future will bring. It’s also important to consider how work fits into the rest of your life. And I love Ellen’s view that leadership roles enable her to make a difference. Welcome, Ellen. Tell me a little bit about yourself.

Ellen: Hello. I’m Ellen. I’m an f 1. I’m on the specialized foundation program for medical education. I have a keen interest in surgery as well as leadership and medical education[00:01:00] and outside of work Musical, I go to church and enjoy enjoying life.

Mat: So I invited you to talk today about career decision making. And you’re an f 1 doctor, so you’re early on in your career decision making. Tell me about how you’ve decided, what your next career steps are.

Ellen: So for me and this isn’t always the case for everyone, but I started that Before I left when in med school I made the opportunity to whittle down career options Through medical school, and I think I very quickly realized that it is surgery that I wanted to do. But I still left a slightly open book just to not narrow down my actions Completely because I think it’s important to be open, and you don’t know until you start working as a doctor what actually is suited to yourself.

I made sure to start building a portfolio from medical school, which I think actually helped me to what’s the word? Prioritize my next steps as well. And just doing a lot of research is really important and asking people what is it actually [00:02:00] like in the career that you’re doing? Because even as an f 1, your experience as a surgeon in f 1 are completely different to a registrar. New responsibilities do change.

And knowing, you may not enjoy it now, but, actually, as you get to those points, you probably will do. So making those points to do that. And just making sure you stay on top of all the application information. So even if kinda cool surgical training criteria is coming out, although you may not think it’s relevant to you now, but It’s quite important to read that so that you know what’s next and what should you be solely doing to prepare yourself for the next steps as well. Yeah, that’s some things there.

I’m interested

Mat: in that balance between finding something that you like, but at the same time, keeping your mind open because, because you don’t know what it’s gonna be like, as a doctor. How did you get that balance right?

Ellen: I think it’s a balance of what we were talking about beep previously is about portfolio and experience. I think there’s always a generic point of portfolio that you can build regardless of what you want to go into that’s gonna be useful. There’s [00:03:00] always Kind of quality improvement, leadership, teaching and then getting the experience in those whatever it seems to get you interested in to make sure you get that experience as well.

But also just being honest with yourself and just realistic. Actually, your priorities may change. Your interest may change as well and not put all your eggs into 1 basket just because then sometimes you might feel a bit lost and, actually, you put all of this kinda identity into 1 Kind of focused career, and, actually, you realize it’s actually not for you, and then you have nowhere to go after that. So you need to leave that sort of room for balance as well. And, your family priorities may change or your location priorities may change.

And, actually, what you’ve bought was what you wanted to do when you realize, the lifestyle that it has for you then being able to okay. Maybe not that. So for example I Definitely know I wanted to do surgery, but I was always kinda swaying between general surgery and ENT. But, actually, having done my first rotation in general surgery, I know I don’t want [00:04:00] to do general surgery. And that is more just looking at the lifestyle of The registrars and I was like, no.

I don’t want that lifestyle for myself the way the general surgery, the registrar, the rotors, how tired they are. So you have to allow that room for experience and observing as well. Mhmm. And

Mat: How important is the whole life because you talked about how work fits into the rest of your life. So can you tell me a bit more about that?

Ellen: Yeah. So I think it’s everyone has different interest and different priorities with that as well. It’s just making sure that the job doesn’t define your life. I think, I’d like to think I’m a leader myself, and I do get involved in a lot of health care leadership outside of work. It’s very easy for that to become your identity.

And I think it’s where you put your identity is really important. For me, my identity is in Christ. I’m a Christian, so that’s my first priority. And then where does everything fit around that? So I always try to split that between personal mental, spiritual, and that sort of career based [00:05:00] is how I Look at things.

Church is 1 thing. My family is another thing. My friends is another thing. Just my general interest, I’m a massive Marble fan. I’m a bit of a geek when it comes to marble.

I like to go to the gym. I love my spin classes, but I also do enjoy going to work for the most part as well. And, actually, it’s no. On a Thursday evening, I’m either gonna be at church or maybe at a spin class. On a Tuesday, I’m gonna be at church or I’m gonna be at the gym.

Those are my blocked off time for me time, and then what I’m gonna do in my other evening. So it might be doing a meeting for 1 of the networks I’m doing, or it might be going to see my friends planning out Use that Google calendar to plan your time and look at, okay. So what can actually fit around my work shifts just to make sure that your life is really wholesome and fulfilled as well? Because If the only thing you’re doing is going to work, sleeping, eating, going to work, repeat, that’s okay. It’s not for everyone to keep themselves busy.

You don’t have to. But, also, there’s a danger that in that way, the job then becomes the center of your life, and I think it’s very important to make that distinction. [00:06:00]

Mat: I think the danger with that just working all the time is that it’s not something that’s sustainable in the long term. Might be able to do that for a number of months or possibly even a number of years. Mhmm.

But unless there’s some kind of balance and downtime and Replenishing and building your energy and fitness. It’s not sustainable. And, of course, there’s the very real risk that what happen what if something happens and you can’t? Mhmm. Let’s say you have a health problem or a family emergency, or maybe you don’t get into the career that you’ve chosen.

Yeah. And then all of a sudden, everything’s defined you around who you are, and then you didn’t get in or you can’t do that job anymore. And then your whole identity then falls apart. Exactly.

Ellen: And I think even more important is when you’re looking at stuff like annual leave as well as a foundation doctor, you only get 9 days of annual leave Coronation, which sounds like a lot, but it’s actually a lot more difficult than it sounds to get lots of blocks of a timer.

It was really difficult, [00:07:00] actually. So you can’t just rely on annual leave to be the only time that you wind down. You need to create those buckets of winding down time in your week your weeks. Otherwise, you will burn out, and I think it’s really important you have to start off, in a good routine. And every week will look different Just because of the nature of the job and what you’re experiencing, but if you can reclaim back some sort of routine.

So for me, Sunday is always church unless I’m working or Tuesdays, Tuesdays and Thursdays is always spin class. It had reclaiming your time back because the work Can flip your world upside down, particularly the night shift. That was probably the most overwhelming thing I had to do, my foundation training. And all of a sudden, I can’t go to gym because it’s 8 o’clock in the morning. I’ve just finished work.

And, yeah, you have to know find what you enjoy and prioritize those and fit your job around it.

Mat: So you’ve talked about leadership. So how did you get into leadership?

Ellen: So I think it started in medical, Actually, I think I got enrolled in a lot of health care societies. So I did the [00:08:00] surgical society.

I was, like, president of my African Caribbean Medical Association, and I soon realized that I had an act for leadership for policy. I realized that I’m not good at Sitting and not doing stuff myself. If I see a problem, I have to fix it. So I like to put myself in positions where I can create change. So I think university, I that’s when I really started to build a reputation for myself.

I had the opportunity to work with the university To write race quality action plans to build teaching programs, to I loved anatomy in med school, so got involved a lot of anatomy education in med school. And then I was thinking about it as I start near to graduating. I’m like, this I don’t want this to be the be all and end all that I did all the stuff in med Oh, then drop it off. And for some people, you do realize it’s not sustainable to keep up on top of all the societies who manage in med school. But for me, actually, I really do enjoy it, and I think having that So portfolio career lifestyle is what I would like to do in the future anyway.

So I had the opportunity to be a [00:09:00] scholar on the Healthcare Leadership Academy program, which if you don’t know, it’s like a 12 month leadership program for medical student all the way Consultants for any stage of the career, really not just have medicine, can be allied health as well. And you attend contact days, and you build a project over that time as well. And I did that I think in my fourth year. I really loved Yeah. And then I missed it because I took a step back just to focus on finals and just finishing uni.

And, actually, now I’ve now rejoined that Community is like a cohort director. I’m actually leading it, which is even great. I’ve got involved with the foundation training surgical society in My region I’m just part of melanomedics. I brought back my blogging, which I used to do in uni. Now I do that for melanomedics.

And, actually, I’ve just found time to do the stuff that I’ve really enjoyed in uni, but, obviously, just cussing it down to what is sustainable as well. And it’s just great because I’ve been able to just continue what I enjoy. [00:10:00] And, also, because I’m on the specialized leadership program for medical education, I’ve got more time to do that as well with the teaching and get involved in opportunities and finding programs and teaching to do as well. So If you’re I think for the people who are more inclined in a med school, I think it’s very easy to continue it in foundation training. I think it’s important not To take up too much because you need just need to give yourself time to adjust to the job as well.

But it’s very doable and I really enjoy it. And then Just going back very quickly to what we’re talking about career planning wise. So I decided to revise for an exam very quickly into f 1, And I soon realized that it’s very hard to do all those things whilst you’re revising. So it’s just knowing what your priorities are, but it’s very doable. And I think if that’s something that you’re interested in doing.

I think it’s the best time to start exploring that is now so then you know what your priorities are as you progress in a career. I hope

Mat: you’re enjoying the show. Please click subscribe so you’ll be notified [00:11:00] when new episodes become available. This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to 1 person who you think might benefit from listening.

Thank you. Now on with the show. A really good tip that I heard about Balancing how much you do today and tomorrow is that you don’t have to do everything at the same time. So that Exactly. If you’re doing an exam for the next 6 months, the focus is exam.

But then for the next 6 months after that, the focus can be leadership. And the 6 months after that, the focus can be, family and health or whatever. So so we’ve got a limited amount of time, and we can’t, at the same time, do everything. But you can do everything sequentially. Yeah.

Ellen: Yeah. Exactly. And I think also with that is just knowing and it sounds very hard to say, but knowing that you are replaceable, I think often People have this mindset about them. If they’re not there, that stuff can’t go on. No.

The world will [00:12:00] go on. It’s completely okay to take a step back, and I think There’s a lesson point about working and collaborating with other people. And, actually, there are sometimes where people need to take a step back and people will take a step forward To help you do that and, actually, you don’t have to go on this journey alone. Being part of collaborative groups kinda gives you the opportunity and space to do that as well. You know, what I

Mat: really liked is you said that that you got into leadership because you were looking at problems and you wanted to be You wanted to be in a position where you can fix them, and that Mhmm.

That’s a really that for me is interesting because I think as doctors, I think we love to moan. Yeah. By your experience has been my experiences. We love to moan. And, that’s okay, isn’t it?

Sort of, we debrief and we face challenging and you discuss it. You know, Not nothing wrong with that. I think that what I think is a profession, what I don’t think we’re very good at, because we’re not very good in doing something about it. Yeah. Now we we sit around and moan, and we don’t realize quite how much power We have

Ellen: Yeah.

I think I Even as a foundation doctor as [00:13:00] well, I think there’s so much you can get involved with just even little things. Although I made an intentional effort actually not to go for representative positions just because I did that all through medical school. I don’t want to make it Always a part of what I always do. You can be representatives and be part of junior doctor forums to make chain. But even little things.

For example, I got involved in a departmental audit, and, actually, the audit tool performer was really bad. So I went up to the quality improvement department, and I sat down with the person who created the forms. I’m really sorry, but what you created is not very good. And I Provided feedback, and then they integrated that into the new tool that they made which is a lot more usable. Actually, I think we can translate feedback into Creating change even at little stages, and I think, we always talk about the that sort of that effect, that little changes can create a big impact.

And I think you can do it from your foundation training and also making most of the people who can advocate for you as well to make those changes if you feel uncomfortable. So I Soon [00:14:00] realized there was a lot of inefficiencies in the department, and I escalated it with my supervisors and seniors to Make change happen of why stuff isn’t gonna happen. Particularly when it comes to, etcetera, reporting or staying late, you have to advocate for yourself because sometimes people will advocate for you otherwise.

Mat: And there’s a mindset there, which is about changing the things that you can change. And imagine what the world would be like if every 1 of us change the things that are in our power.

Exactly. And you change what’s in your power. I change what’s in my power. Everybody changes what’s in their power.

It would be a totally different system, wouldn’t it? Mhmm. Yeah. Yeah. So for somebody listening who isn’t in leadership at the moment, and they think, that sounds really interesting.

How what advice what tips would you give to get somebody started?

Ellen: I think it’s reaching out to people. So I think we’re not very good as I would say that very generally, but it’s actually networking with others. I’m a massive advocate for LinkedIn. I’ve been using LinkedIn for about 3 years [00:15:00] now.

And, actually, the opportunities I found from LinkedIn from just opportunities To finding a mentor through LinkedIn, that really helped me build my career. Actually, a mentor is probably really important. I think we don’t talk about that enough. I think we often rely on the Supervisor model, which has its place when it comes to training and staying type of priorities, but actually a mentor that lifestyle other side of the career stuff is really important. And actually finding someone who’s in a position that you’re interested in and actually asking if they could sit down with you for Just 15 minutes just to give you some pointers of where to go next because, otherwise, it can be quite hard to know how to get in.

Finding programs, such as the health leadership academy. There’s also leadership programs such as the Edward Jenner online modules that you can do as well to really Aggress your understanding of leadership but also just being brave enough to ask if you can shadow someone and just email. Even if the trust executive you want to do, can I shadow you for a meeting and finding those opportunities? And often, even in the postgraduate department, they’re always [00:16:00] Giving opportunities to help out with programs, whether that’s for sparring medics or kinda teaching. Just do little things that get you in the positions to meet people and then and progress from there.

So for example because I’m doing the financial program in medical education although a lot of this, A lot of my the bulk of my work starts in f 2. I’ve started to make the contacts I need from f 1. So whether that is just getting involved with being a simulated patient now, That’s enabled me to meet the assessments team, which then helps me for my next job. So put yourself in strategic positions to meet people for your next steps as well. Mhmm.

Mat: How did you decide to do the academic foundation program?

Ellen: Again, I know some repetitive. I was from med school I really just I love teaching. I really love demonstrating what I’ve learned to breaking it down for other people. And medical education is not just teaching.

I think there’s A big push in medical education now with professional identity. We’re looking at technology enhanced learning and the way the world Going with AI and virtual reality, I find it really fascinating of [00:17:00] what how much we can do to enhance the learning of other people. So I decided not to integrate in medical school because I reached a point where I’m like, oh, I’m really just ready to just to graduate now. And I thought this would be a really good opportunity because they fully funded a PG cert, which is great to get a Qualification and also just to get protected time to do what I love and enable me to continue the other things that I’ve spoken about before as well. And, yeah, it’s been a great it’s very competitive.

I’m getting even more competitive, but I’m very grateful that I’m had the opportunity to get on the program. What

Mat: does the program involve?

Ellen: So it looks different in different trust, but for me you get a so most foundation doctors get 6 forms per rotation. I get 5, and then 1 of these rotations is 4 months of pure medical education. And you Split your time to clinical and academic.

So it’s meant to be 1 day a week clinical and 4 days academic. I don’t know that my trust, we just do a block of 3 [00:18:00] weeks of Clinical A and E, and then it’s just pure medical education, simulation follow-up training, getting involved in academic projects. You enroll into PUTG cert for the whole The year which they fully fund as well, and they expect you to get involved with teaching opportunities throughout your 2 years of training. So that’s point of education for research. It’s a similar thing.

You get a dedicated block or you might have a dedicated 1 day a week, which is quite similar to what the Later on, the academic clinical fellowships offer. And they also help you with grant writing and those sort of research Opportunity is to present your work as well, and it’s really great if you do want to go that truly academic route as a stepping stone Into that as well to know what it’s like balancing your time, clinical and academic. Because I know for myself that for my future, I’d like to be clinical, Would like to have maybe have a role in med school, maybe do some leadership as well. So it really gives you that insight into what’s it like balancing your time as well.

Mat: Mhmm.

And maybe if I bring us to a close then when it comes to career decision making, what tips and advice would [00:19:00] you give to others trying to make career decisions?

Ellen: I think having 1 2 year like, there’s a tip actually called t 5 10, which is 2 year, 5 year, 10 year plan. And it may seem a bit extreme to think about where you want to be in 10 years’ time. Actually, it really just helps have an End goal and work backward to see how you can get there and know what are the pathways to get to that. You really need to do your research to know To know where to go next, I think you can’t just wake up and decide, okay.

I want to do surgery, and then have no idea what you need to do. It’s really important to sit down with The people who are ahead of you in your career and can give you pointers in terms of the exams or the portfolio that you need to do to help you plan your time And build yourself to be strategically ready to apply for these positions. So I would say number 1 is speak to people slash speak to, Like a mentor to help you get started on your journey. Secondly, I would say think about what your Priorities are because for some people, they just want [00:20:00] to do Medicine or just want to do surgery or just want to stay where they are very happy locum until f 8, f 9 if they want to. But just think about Where the impact of training has on your lifestyle as well.

And I think it’s great that we’re seeing less of all time becoming such a popular option now, which is giving creating a lot more flexibility with Training. So knowing your priorities with that does help your career planning as well. And I think thirdly, you stay in staying ahead of the game. Know the end point. You have to you can’t make decisions Very suddenly, you have to be prepared almost a year in advance and know when the deadlines are, know what the goal posts are, know what the criteria are so that you’ve got a year Ahead of you to be ready for your next steps.

And I think that just helped people. So it’s all about being organized. If I have to summarize it in 1 word, it’s Organization.

Mat: Wonderful. Thank you very much, Ellen.

Ellen: No problem.[00:21:00]

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