In part one of our interview, Sonia Hutton-Taylor, founder of Medical Forum, talks through some of the ways in which she helps doctors through a period of transition.
Q: If a young doctor were trying to decide whether or not to continue in medicine, what kind of questions might you ask them to help them make an informed decision?
A: There are literally dozens of questions we need to ask if people are thinking of such a radical change.
For example, why did they choose to do medicine in the first place – was this primarily due to school or family pressure, for instance?
The same applies if someone has been doing badly in exams. It is important to ask why rather than merely accept they are failing say, because they have not done enough work. We need to ask why. Is it exam/study technique, or is it motivation? Do they really want the job at the end of it? We need to analyse in a bit more depth.
Even with someone who has been doing well in exams, if they say they haven’t got a job we need to probe further. For decades, doctors have experienced short periods of unemployment.
The best approach for each individual will vary with their circumstances. For instance, if they have a family, with children and a mortgage, and are the main breadwinner, the options to consider might need to be quite different when compared with someone who has fewer commitments. That is why all the questions need to be asked and put on the table.
Q: If a consultant were trying to decide whether or not to continue in medicine, would you ask them any different questions?
A: I would ask them exactly the same questions, although possibly in a different order. The principles of career guidance are the same, whatever the age. We need information, possibly information people haven’t been asked for before. As for younger doctors, this would include asking “why did you do medicine?”
As one gets older there tend to be more responsibilities, such as a family and a mortgage. The financial implications are therefore likely to be more significant and any transition may need to be carefully planned.
Q: Why might doctors be thinking of a change of career?
I suspect every doctor has doubts about medicine at some stage in their career. It might be because medicine is a very demanding career, with a lot of hurdles to jump through. It might be that people who go into medicine set themselves such high standards. It might be that many of the people who go into medicine tend to be self-deprecating, which in itself breeds a sense of self-doubt.
Q: On the Medical Forum website you refer to 16 Career Factors. What sort of factors are they, and why do you see them as being important?
A: The factors include things like motivation, energy, health, ambition levels, desire for further study/learning and so on – factors that could play in important part in a career plan.
For some people flexibility could rank high very high, in which case most surgical specialities might not suit, although anaesthetics might well do. For others a socially worthwhile or community-based role might rank quite low in which case general practice, community paediatrics and the like would probably not be a good choice.
When advising doctors I often find that they have looked at just one or two career factors. It is absolutely vital to look at all the factors.
That’s probably why I have seen quite a number of fundamentally wrong career decisions where, if they had looked at all the career factors five years ago, they would never have made that decision.
You can work through the different career factors in a structured way with Medical Forum but anything that helps you do this is likely to be worthwhile – for instance talking them through with a supportive/neutral friend, spouse or colleague.
Q: Can you give an example of a young doctor you’ve helped, what their career problem was and what difference your help made?
A: There are so many different cases. I believe it is wrong to choose just one because it might make your readers think we could not help them. Here are a few very general examples:
Someone who is unhappy in medicine who genuinely needs and wants to change career direction, who we can help to think through the options.
Someone who is unhappy in their current job, where analysis identifies skills needed, possibly non-clinical skills, which, when acquired, make them much happier.
Someone who keeps failing exams, who we can help to understand why (are they not planning enough? Are there study skill problems? Are they not sufficiently motivated? Is this not the field for them) to either help them pass or realize they need to re-evaluate their career direction.
Someone who repeatedly fails at interview – either through lack of planning, targeting the wrong jobs or not being able to sell themselves – whom we can help work out the reasons for the problem to help improve their prospects of success.
Someone wanting to change direction within medicine, say from general practice to public health, without being clear about the key skills they would bring to their new field and how these are relevant.
Every doctor and their situation is different. For instance, we also help doctors who have performance problems, health problems, are looking to retire early or to get back into medicine after GMC suspension.
Q: What career related tools and resources are available through Medical Forum, and where would someone best start?
A: Our website is a good place to start. There are a number of different levels of support people can access, from free guest entry to paid-for services. Some Trusts and hospitals have signed up for our Career Guidance Essentials Toolkit, in which case every doctor working for them will have access to the career tools, with the password available from your supervisor or clinical tutor. These include tools for people wanting to provide as well as receive better career guidance, i.e. for trainers and trainees.
Q: How does this compare with careers advice available from the deaneries?
A: Three deaneries have subscribed to the Medical Forum toolkit and use this as part of their repertoire of careers advice resources.
My own view is that there is considerable value in a smorgasbord approach to careers advice, operating at several levels including advice from the people you’re training with, from the hospital and from the Deanery.
I also think there is a very big difference between career advice and career support – the latter comprising career counselling, career information, career advice, career guidance, career management skills and career envisioning.
At the moment it seems as if the people who get the most careers advice may be those who are are experiencing some difficulty or underperforming. I’d like to see careers support start as early as possible, from medical school onwards, and not just assuming a careers fair will provide what’s needed. Things are changing though and some medical schools are onto this. Careers advice doesn’t always need to be from a fellow doctor, but it needs to be from someone familiar with the intricacies of the medical career structure, how rigid this can sometimes be, but also where hidden flexibilities lie.
Sonia Hutton-Taylor is the founder of Medical Forum