Helping doctors handle
specialty change
Barbara Wallis
UKFPO 9 September 2010
What is the most frequent thing those seeking
to change specialty tend to say?
‘You must think I’m mad!’
‘I’m disappointed I didn’t make
it in my first choice specialty’
Those changing specialty may be:
• Making a voluntary change
• Having to change: - training availability
- lack of aptitude
For those considering change this is a potentially
fraught time......
• embarassment
• anger
• uncertainty about which direction
• fear about chosen new direction
• disappointment and loss of self-esteem
Why look at this topic now?
•
Changing direction was not uncommon pre-MMC
•
There will always be a proportion of doctors who decide
– or need – to change direction, whatever the system
•
However MMC has made doctors choose their specialty
much earlier – less time to experience different options.
•
2007 MTAS effect
Oxford Deanery
And some specific developments:
•
‘Graduate expectations need to be carefully managed as it is
likely that the availability of training places in certain
specialities will be different from those available previously’ –
Workforce Review Team, Assessment of Workforce Priorities 2009/10
•
Increase in the predicted % of medical graduates needed in
primary care – not all may have considered GP. A fast-track
way of switching into GP may be politically expedient
•
More doctors may seek help to change direction/shift the focus
of their work.
On a piece of flipchart paper, in table groups,consider:
Why, in your experience, do doctors
think of changing specialty?
What have you found has helped
trainees switch?
How could we help them better?
Some quotes from successful switchers
• ‘This isn’t about what you should or could do – it’s about what
you want to do and that may evolve slowly.’ - Dr Giles P Croft,
surgeon turned cycle journalist and cycle magazine doctor
• ‘Your new career must be “you” - a 5* rule… ’ Dr Steve
Rousseau, GP turned microbiologist
• ‘If it’s in your heart, explore it until you know otherwise.’ Dr
Paula Hunt, trainee surgeon turned GP
Oxford Deanery
What worked for them?
• ‘Switch on your radar. Start networking.’ Giles P Croft
• ‘What was important to me was.... the wholehearted support of senior
trainees in the specialties I was leaving, who were generally disenchanted
with life....support from my then girlfriend (now my wife).....the positive
reaction of friends.......’ Dr Dan Faller, orthopaedic surgical trainee turned
GP.
Dealing with the feelings of transition:
•
‘Getting off the conveyor belt is uncomfortable. Keep yourself uncomfortable.
Anxiety is normal.’ Giles P Croft
•
‘Lots of things will jump out of the bushes at you…Colleagues and relatives will
not all be encouraging all of the time. Periodic attacks of cold feet …are
inevitable.’ Dr Steve Rousseau
•
‘I had to put blinkers on to focus on my surgical training, but once I’d taken my
blinkers off, I couldn’t put them back on again…..I decided not to be the victim
who didn’t/couldn’t pursue my original choice of surgery, but to be the best
GP I could, and appreciate the best aspects of the job.’ Dr Paula Hunt
Key words and phrases for our work with
trainees changing direction.....
what you want may evolve slowly
Networking
wholehearted support
disenchanted
uncomfortable
Not the victim
Some personal observations:
• ‘Successful switchers’ are by definition resilient as they have succeeded!
Some may need to dig deep for their resilience
• Encouraging creativity and appetite for opportunities may be key
• Self-awareness is fundamental but this can bring up other, difficult stuff
• Those without a good support network may find the process especially
hard – in particular those with family pressures to be a doctor.
Sources:
• How to change course in a medical career, Dr Steve Rousseau for Wessex
Deanery website 2010
• Ten principles of career change, Giles P Croft, BMJ Careers Fair 2008/2010
• Interview with Dr Paula Hunt, June 2010
• Case study quoted in Switching specialty, BMJ Careers, May 2009
• Email exchange with Dr Dan Faller, June 2010
Copyright: Barbara Wallis 2010