UCL CAREERS SERVICE
Your Career Management Skills:
Now, during the Foundation Programme and Beyond
Elaine Denniss
Careers Consultant
UCL Careers Service
What we will look at
• Introduce four part career management cycle
• Encourage reflection on your existing preferences and
priorities
• Look at ways to maximise your FP from a specialty
choice perspective
Four part Careers Management Cycle
• Self Awareness – What’s important to me?
• Option Generation – What’s available to me?
• Decision Making – How do I choose?
• Implementation – How do I make it happen?
Making the parallel
Clinical Decision Making
• Taking patient history
Career Decision Making
• Self understanding
• Examination/investigation
• Exploring options
• Differential diagnosis
• Making a career decision
• Treatment plan
• Implementing actions
Self Awareness
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Know yourself!
Essential to recognise a good ‘career fit’
‘What is important to be there in work
What is important to be missing in work
Think about yourself
• What do you know about yourself already?
• How can you find out more?
Building the picture
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Values / Priorities
Strengths
Skills
Stressors
Personality
Self report, feedback from others
Your Priorities and Values
• Working in a well known hospital
• Community based
• Hospital based
• Opportunity to carry out research
• Continuity of care
• Geographical location
• Work/life balance, regular hours
• Variety
• Clinical autonomy
• Working with technology
• Acute settings
And ....?
Different Roles of a Doctor
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Investigator
Counsellor
Researcher
Organiser
Decision maker
Leader
Entrepreneur
Technician
Strategist
Social Worker
ANY SUGGESTIONS?
Career Priorities
- Having an expertise
- Continuity of care
- Controllable hours
Roles
- Counsellor
- Motivator
- Researcher
Strengths/Energisers
- Relationship building
- Linking information
- Seeing the bigger picture
Personality
- Sensitive
- Idealistic
- Reflective
- Creative
Interests
Allergies/Stressors
- Human behaviour
- Making decisions under
- Mind/body interaction pressure
- Policy/current affairs - Cutting into flesh
- Solitary working
Option Generation
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How many specialities do you know?
Which ones appeal to you and why?
Which ones do not attract you and why?
Which ones are you just clueless about?
Which specialty?
+ves
• Able to decide how much time to
spend with patient
• Able to apply cutting edge
technology to patients
• Flexible working hours
• Supportive team working
-ves
•Need to let go of the patient –
don’t have total control of
patient
•Frustration when colleagues do
not agree with findings
Which specialty?
+ves
• Looking after the patient
as a person rather than
just a medical problem
• More simplistic and holistic
approach to patient care
• Dealing with patients and
their families
• Opportunities to
subspecialise
-ves
•Seeing patients slowly
deteriorating and dying on a
regular basis
•Do not always have easy
access to most
investigations
Which speciality?
+ves
• Whole patient medicine. Not just involved
in treating the illness but treating a
particular person
• Dealing with psychological effects on
patient
• Continuity of care - in contact with your
patient for many years
• Not a routine job – no two patients will
respond to treats in the same way
• Fast moving area of medicine
• Multidisciplinary treatment of patient –
always in contact with colleagues in a wide
range of specialties
• Growing speciality
-ves
•Draining –
emotional support
Option Exploration
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Challenges – What makes the job exciting or stimulating?
Demands
– What does it take to be successful?
Rewards
– What do people enjoy or get out of the job?
Prospects
– What are the chances for future development?
Limitations – What restrictions will this job place on you?
Conditions – What kind of working conditions are typical?
Downsides – What are the toughest bits of the job?
Personalities – What are the people like?
Alternatives – What other options have similar characteristics?
How can you find out more?
• On line resources eg medicalcareers.nhs.uk,
LETBs, BMJ Careers
• Engage with Royal Colleges
• Voluntary work
• Work shadowing
• Using your network (information interviewing)
Information Interviewing
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What would you like to know?
Which aspects of the job are you unsure about?
The ideal vs reality, pros and cons
The direction of the specialty
Length of training
Frame your questions in the right way
• Why do you like being a
Paediatrician?
= A potentially limited
question which is linked to
THEIR self
awareness/bias/needs
• How much autonomy do
you get in your work as a
Paediatrician?
= A focused question which
is linked to YOUR self
awareness/bias/needs
Decision Making
Ask yourself
• Do I have enough information?
• Have I tested my assumptions (image vs reality!)
• Have I played devil’s advocate with my choice?
• Are there any factors that I’m giving too much/too
little weight to?
Implementation
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Anticipate
Prepare
Practice
Stand out!
Situational Judgement Test –
Five Professional Attributes
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Commitment to Professionalism
Coping with Pressure
Effective Communication
Patient Focus
Working Effectively as Part of a Team
Resources
BMJ - Tackling Situational Judgement Tests
http://careers.bmj.com/careers/advice/view-article.html?id=2365
Emedica
http://www.emedica.co.uk/bmjsjt.htm
GP Recruitment – Problem Solving Questions
http://www.gprecruitment.org.uk/downloads/Example%20questions%20St
age%202%20assessment%202011.pdf
Foundation Programme (UKFPO)
http://www.foundationprogramme.nhs.uk/pages/home/how-to-apply/SJTFAQs (including information on scoring)
Maximise your Foundation Programme
• Use your rotations as a chance to network with a range of
fellow clinicians, at all stages of training
• Explore taster courses and work shadowing opportunities
if possible
• Keep in touch with relevant Royal Colleges
• Many Deaneries offer careers support workshops for
F1/F2s
• Complete clinical audit(s) (including re-audit, presentation)
ideally resulting in service change
• Seek out opportunities to make presentations (local,
regional, national, international)
• Seek out opportunities for teaching
• Publications
‘Commitment to specialty’
• Relevant clinical work experience, e.g. rotations
• Additional work experience – electives, voluntary work
• Illustration of interests and preferences – SSCs,
supplementary reading, research
• Any involvement in relevant research – journal clubs,
poster presentations, IBSc research, previous degrees,
papers
• Additional achievements - Prizes/Awards/exams
• Royal College involvement - events/conferences,
presentations/networking events
• Extra-curricular activities – clubs and societies
How can you stand out?
Recruiter wish list
Besides good clinical skills, recruiters want trainees
who will...
– Learn quickly...not need repetition
– Take responsibility...not need direction
– Decide reliably...not need correction
– Show initiative...not need spoon-feeding
– Push themselves...not need motivation
– Stay...not change their minds
What they want you to demonstrate...
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Commitment to specialty
Comprehensive preparation
Communication skills and other competencies
Clear and reliable clinical thinking
Professionalism
What you might face
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Application/portfolio-based interviews
Competency-based interviews
Scenario-based interviews
Mock patient consultation / Simulation stations
Situational judgement tests
Presentations
Personal qualities
– Managing others &
teamwork
– Communication skills
– Vigilance & situational
awareness
– Organisation &
planning
– Working under
pressure
– Empathy & sensitivity
– Decision making
– Problem solving &
conceptual thinking
Working with personal qualities
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Understand and unpack skills
Observe others in action
Ask for examples/anecdotes
Review and reflect on your own experiences
Compile examples
Fill gaps by gaining relevant experience
Record learning
Your Portfolio – What does it say about you
as a doctor?
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Systematic
Organised
Logical thinker
Good decision maker
Reflective
Proactive
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Researcher
Teacher
Scientist
Clinician
Mentor
Leader
Commitment to speciality
Wider NHS issues
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Clinical governance
Evidence-based medicine
NHS reforms / Francis report
GP commissioning
Public health
Integration of social and health care to meet
demands of an ageing population
www.medicalcareers.nhs.uk
Finally, considering leaving medicine?
• Talk to a range of people, both within and beyond
medicine about your feelings and plans
• What is it you are ‘trying to get away from’?
• What is it you are ‘trying to reach’?
• How are your peers managing in relation to these factors?
Is this a ‘passing phase’ or a long term feeling?
• How long have you been feeling like this – honestly?
• What were the ‘triggers’ that made you feel like this?
• There IS life beyond medicine – what suits you depends
on the appeal/lack of appeal of parts of medicine
• Talk to careers professionals within medical school, UCL
Careers Service, Foundation Schools, Deaneries, BMA
• Don’t worry – you’re not the first and you won’t be the last
Medical Careers Post Foundation
UCL CAREERS SERVICE
PG LETB
Medical School
MBBS
student
Foundation
School
Foundation
Trainee
Specialty
Trainee
[Postgraduate Medical Training]
UCL CAREERS SERVICE
Basic Medical Career Structure
MBBS Degree
Less than FT training,
time out, LAT, LAS
non-training careers
Foundation Programme (2 years)
Academic Foundation Programme (2 years)
GMC registration after F1
Specialty training – uncoupled, run-through
Core specialty training
Higher specialty training
GP Training
Academic Fellowship Programme
CCT
Senior medical posts
Other
Options:
Academic
Medicine
Medical
Education
Work
Abroad
Research
Core Specialty Training
• Core Medical Training (2 years)
• Core Surgical Training (2 years)
• Broad Based Training (2 years then enter CT2 or ST2 ) –
only 52 places offered 2013 through 7 LETBs
• Psychiatry (CT1 – CT3)
Themed Core Specialties
(Acute Care Common Stem – ACCS)
• Acute Medicine (CT1 – 2 + CT2 CMT)
• Anaesthesia (CT 1 – 2 + CT2 Anaes)
• Emergency Medicine (CT1 – CT2 + CT3 EM)
• Intensive Care Medicine (currently through ‘parent’
ACCS pathways)
Run Through Specialities
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Chemical pathology
Clinical radiology
General Practice
Histopathology
Medical microbiology/virology – microbiology
Medical microbiology/virology – virology
Neurosurgery
Obstetrics & Gynaecology
Paediatrics
Public Health
Time Out of Training
The trend for F2s wanting a year out continues
In 2013 a third of junior doctors took time away from formal
UK training
http://careers.bmj.com/careers/advice/viewarticle.html?id=20015702
http://www.theadventuremedic.com/features/taking-time-outfrom
Out of Programme Experience (OOPE)
Examples:
The NHS Medical Director’s Clinical Fellow Scheme
Darzi Fellowships in Clinical Leadership
Specialty recruitment – the process
Most specialties
Register
Application
(November)
(December)
Interview/
assessment
Offer/
clearing
(December/
January)
(by beginning
March)
GP recruitment and Broad Based Training
Register
(November)
Test
(January)
Assessment
centre
(February)
Offer
(by beginning
March)
Specialty recruitment
• Each specialty run by a Royal College, LETB or
National Organisation (Units of Application)
• Slightly different logistics for each pathway
• Most applications open late Nov, but some are
earlier (ACF & GP)
• Details from the Oriel website
!! TIP: Start familiarising yourself in your F1 year
(or before)!
Academic Clinical Fellowship
• Targeted at doctors in the early years of specialty training
(ST1 onwards).
• Provides a clinical and academic training environment to
help the trainee in post prepare a competitive application
for a training fellowship for a higher degree (e.g. from
NIHR, Wellcome Trust, Medical Research Council) or, if
applicable a postdoctoral fellowship.
• NIHR ACF posts are profiled for a maximum of three
years, or up to four years for GP posts.
Common topics on application forms
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Academic qualifications
Awards and prizes
Achievements
Presentations
Publications
Teaching
Audit
Commitment to specialty
Maximum points CMT(max 64)
1. Additional undergraduate degrees and qualifications -10 pts
Degree obtained during medical course or prior to starting medicine – 1st class honours
2. Postgraduate degrees and qualifications – 10 pts
PhD or DPhil
3. Additional Achievements – 10 pts
National prize related to medicine
4. Presentations – 6 pts
Have made an oral presentation or shown more than one poster at a national or international
meeting
5. Publications – 8 pts
Am first author or joint first author in more than one PubMed-cited research publication (or in
press)
6. Teaching Experience – 10 pts
Have designed and organised a regional medical teaching programme consisting of at least two
sessions and I have undergone formal training in teaching methods lasting between 5 and 20
days
7. Clinical Audit- 10 pts
Have designed and led an audit or quality improvement proejct leading to a documented change in
Source: CMT shortlisting criteria
practice and I have presented it at a meeting
Maximum points (free text)
• Achievements outside medicine: ‘One or more
truly outstanding achievements, on a scale
beyond the capability of most people, utilising
many relevant skills and qualities’
• Commitment to specialty: ‘Clear
understanding both of self based on good
evidence, and of what the specialty involves
based on extensive exploration. Clear
Source: RCPsych shortlisting criteria
reasoning’
What can you boost?
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Academic qualifications
Awards and prizes
Achievements
Presentations
Publications
Teaching
Audit
Commitment to specialty
Can do very
little about by F2 year
Might do
something
about
Specialty Training - Resources
www.oriel.nhs.uk
www.specialtytraining.hee.nhs.uk
www.gprecruitment.hee.nhs.uk/
www.nihrtcc.nhs.uk
(for academic clinical fellowships)