careers advice for a confused doc please!

Apologies as i know this topic is sort’ve covered in numerous places but i was just looking for some advice really.

I’m currently a foundation doctor working in the UK looking for some specialty advice.

About me:
Things I enjoy:

•

Clerking patients and presenting them to a senior to come up with a plan

•

The satisfaction and buzz when practical procedures (no matter how simple) go well and get a good result

•

Good relationships and rapport with colleagues

•

Academia and reading interesting literature / hearing from people truly interested in their field

Things I don’t enjoy as much:

•

Long ward rounds where little changes day to day for chronic patients

•

Learning about drugs and prescribing

•

Numbers

•

Hierarchical jobs and placements

•

Feeling hurried or hassled into making decisions or plans without time to properly reflect

•

Unclear presentations with multiple co-morbidities contributing to vague presenting complaints

I enjoyed learning about surgery and did an intercalated degree relating to it but am not sure if the technical, repetitive side of it would suit me and whether or not i might get bored becoming a consultant and doing the same repertoire of procedures again and again. Is this the reality in the long run?
I enjoy learning about medicine but my experience so far (mostly elderly care) has involved long ward rounds and lots of tinkering with medications/checking blood results/awaiting social care which I haven’t really enjoyed.

My problem is that I’ve enjoyed aspects of just about every specialty I’ve come across and am incredibly fickle!

I was just wondering if someone who’d never met me on here might be able to contribute a cold, objective opinion or two – would be much appreciated.

P.S. for those who give it any credence my Myers-Briggs is ISFP, or thereabouts!

Reply 1

Revenged

15

try getting a list of all the CT1 training posts and remember you will have to pick a theme (e.g. medicine) not a career (e.g. orthogeratrician) at this stage.

once you have the basic list start by crossing off things you will never do, then cross off things you do not think you will do.

when you have narrowed down to a few areas then
- find out from core trainees about the honest truth about it
- if it is a genuinely a good choice (surgery is not a good choice for jobs future, for example)
- organising taster weeks etc.

from my experience most people that genuinely are not sure by the start of fy2, many many are in this boat including myself!
- gap year medicine around the world / locum training post / agency locum
- people worry about not getting a job so they play 'safe' options, (e.g. gpvts , core medicine)
- people apply for lots of jobs because they want to stay in an area and they hope they will like it

many people in the latter realise they make mistakes, which is one problem with the current system as you have to pick so early.
there are however some good moves. many jobs (e.g. radiology , histolopathology , psychiatry, A&E) seems to have many who have picked second career options. going to gp training from other fields is probably the most common.

(edited 9 years ago)

Reply 2

alicexelizabeth

4

If you are not sure then perhaps taking some time out to discover more about surgery or other specialties you might like would be a good idea.

Also look at broad-based training. I think it is still in the pilot stages, but may give more choice later on.

Reply 3

Smile88egc

15

I advise all the F1/F2s coming through my speciality to take a year out before ploiughing on with their career. Training programmes are not always very flexible, and after foundation programme is a great time to take a long term locum/staff grade post. No pressure with training or assessments, and time to find out more about the specialities you've not yet been exposed to/ work in places you haven't been to. Always wish I had done it myself!

To me it sounds like you would enjoy a more acute specialty with high turnover, probable secondary care if you're after team working, but steer clear of A&E if you don't like working in a hurry!

Reply 4

junior.doctor

18

I would definitely second taking a year out - or more. My year out of training after FY2 became 3 years, and I loved every minute of it, and don't regret it for a moment. The 5.2 certificate you get at the end of FY2 is 'valid' for 3 years, so you can have a total of 3 years out after FY2 without having to prove your FY2 competencies with alternative certificates etc. Just make sure that you don't become 'over-qualified' in your chosen specialty - most specialties have limits of 18 months post-FY2 experience in order to be eligible to apply for ST1.

Reply 5

northerndoc

OP

Thanks for the replies. I am thinking of a year I locum jobs plus audit followed by travelling after f2 at the moment. One specialty that I find interesting in terms of bridging the gap between medicine and surgery is cardiology. Anyone with any experience have any thoughts?

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Reply 6

nexttime

22

Paeds? Ticks a lot of your boxes - clerking patients, wick turnover of patients, relatively well supported, generally nice people - but clearly is a fairly polarising specialty for other reasons!

Reply 7

Sarky

18

I nearly said O&G but you do need to make quick decisions sometimes. Hard to find a perfect fit though.

In my year group, I think 12/16 of us had either taken a year out post F2 or had come from other specialties.

Reply 8

digitalis

17

Original post by northerndoc

Apologies as i know this topic is sort’ve covered in numerous places but i was just looking for some advice really.

I’m currently a foundation doctor working in the UK looking for some specialty advice.

About me:
Things I enjoy:

•

Clerking patients and presenting them to a senior to come up with a plan

•

The satisfaction and buzz when practical procedures (no matter how simple) go well and get a good result

•

Good relationships and rapport with colleagues

•

Academia and reading interesting literature / hearing from people truly interested in their field

Things I don’t enjoy as much:

•

Long ward rounds where little changes day to day for chronic patients

•

Learning about drugs and prescribing

•

Numbers

•

Hierarchical jobs and placements

•

Feeling hurried or hassled into making decisions or plans without time to properly reflect

•

Unclear presentations with multiple co-morbidities contributing to vague presenting complaints

I enjoyed learning about surgery and did an intercalated degree relating to it but am not sure if the technical, repetitive side of it would suit me and whether or not i might get bored becoming a consultant and doing the same repertoire of procedures again and again. Is this the reality in the long run?
I enjoy learning about medicine but my experience so far (mostly elderly care) has involved long ward rounds and lots of tinkering with medications/checking blood results/awaiting social care which I haven’t really enjoyed.

My problem is that I’ve enjoyed aspects of just about every specialty I’ve come across and am incredibly fickle!

I was just wondering if someone who’d never met me on here might be able to contribute a cold, objective opinion or two – would be much appreciated.

P.S. for those who give it any credence my Myers-Briggs is ISFP, or thereabouts!

Anaesthesia.

Reply 9

northerndoc

OP

Thanks for the replies. I think time out after F2 to think would be a good idea. I'm sure I'll find something I enjoy. Out of interest, were taster weeks any use?

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Reply 10

Helenia

20

Original post by northerndoc

Thanks for the replies. I think time out after F2 to think would be a good idea. I'm sure I'll find something I enjoy. Out of interest, were taster weeks any use?

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I found mine useful both in confirming my desire to do anaesthetics (which I'd only had two weeks of at med school, and in which I couldn't intubate because I had a broken left arm) and in scoring points for the job application. So yeah, if you have the opportunity, do one!

Reply 11

InArduisFouette

21

Original post by digitalis

Anaesthesia.

assumingthe OP can reconscile the time pressured stuff , as they will have ot take their share of on call as Anaesthetics 'SHO' and Anaesthetics 'reg'

I like anaesthetists as a group of people , as once you've overcome the initial shock at the anesthetic sense of humour ( all those volatiles ... )

Reply 12

northerndoc

OP

Thanks again for the replies on this. Having applied some thought to it I'm going to look into gastro - seems like a great mix of medicine and surgery. Anyone got any thoughts, had any experience?

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Reply 13

Helenia

20

Original post by northerndoc

Thanks again for the replies on this. Having applied some thought to it I'm going to look into gastro - seems like a great mix of medicine and surgery. Anyone got any thoughts, had any experience?

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You do realise that most gastro jobs will require you to also do med reg on-calls, right?

Reply 14

visesh

17

Original post by digitalis

Anaesthesia.

They don't want to 'learn about drugs' or enjoy numbers - pretty tough to pass the ol FRCA with that view n'est pas? :tongue:

Surgery might just fit in there to be honest, but there are times you need to make quick decisions and be a little hurried.

Reply 15

northerndoc

OP

Med reg on calls surely can't be the worst thing in the world? I know a couple of ST3s who don't seem to be finding them too awful? Unless I'm being a little deluded. As for not liking prescribing, numbers and quick maths I think you're right - anaesthetics might scare the hell out of me! Gastro strikes me as one of the most surgical specialties and ENT one of the most medical surgical specialties so I'm keen to learn more about both of those. I guess the primary decision still comes down to physician vs surgeon though

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Reply 16

northerndoc

OP

Gastro as one of the most surgical medical specialties I meant to write

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Reply 17

Sarky

18

Original post by northerndoc

Med reg on calls surely can't be the worst thing in the world? I know a couple of ST3s who don't seem to be finding them too awful? Unless I'm being a little deluded. As for not liking prescribing, numbers and quick maths I think you're right - anaesthetics might scare the hell out of me! Gastro strikes me as one of the most surgical specialties and ENT one of the most medical surgical specialties so I'm keen to learn more about both of those. I guess the primary decision still comes down to physician vs surgeon though

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I'd almost rather be an orthopaedic reg than the medical registrar. And I bloody hate orthopaedics. Just as well as most of my ortho friends also hate O&G. Med reg is one of the hardest jobs in the hospital I think.

Reply 18

nexttime

22

Original post by northerndoc

Med reg on calls surely can't be the worst thing in the world? I know a couple of ST3s who don't seem to be finding them too awful? Unless I'm being a little deluded. As for not liking prescribing, numbers and quick maths I think you're right - anaesthetics might scare the hell out of me! Gastro strikes me as one of the most surgical specialties and ENT one of the most medical surgical specialties so I'm keen to learn more about both of those. I guess the primary decision still comes down to physician vs surgeon though

The med reg on call is widely regarded as the toughest job in the hospital. You're in charge of a large number of acute patients as well as having a bleep that will not stop going off. To state that its always the worst would obviously be untrue, but it definitely does have quite a reputation behind it!

Reply 19

The Only Rivo

2

How often does a neprho/gastro/endo registrar have to do med reg on-calls? Do they have to continue to do them until CCT or is it only the first 3 years (ST3-ST5)?

Also, my understanding is that most cardio regs nowadays only have to do med reg on-calls in ST3 (or maybe also ST4 but certainly not ST5) and only during the rotations in the DGHs of their deanery. During their rotations in the tertiary cardiac centre they don't have to be med reg since they do CCU on-call instead (which you aren't allowed to do in ST3 as it's perceived you need some experience before taking this responsibility). I know this is the case here in Glasgow. Is it similar elsewhere? and if so, is it because most cardio trainees drop out of GIM pretty early on in order to focus on on sub-specialization (e.g. intervention, EP...etc)?

careers advice for a confused doc please!

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