Transcript Slide 1
Introduction to the Career
Support Role
23rd February 2009
Aims
To understand the bigger picture of medical
careers
To share understanding of career lead role
and its place in the Wales Career strategy
To recognise what kind of career support is
needed along the pathway
To develop understanding and skills to
promote “good career help”
To identify next steps – and where we need
your help
Then…
Shift from a recognisable career
pathway to a less predictable
journey, requiring frequent
regeneration
…and now
Discuss:
Who you are, your career lead role
What you find most rewarding about your role in
the career development of Foundation
doctors/specialty trainees
What do you find most worrying or challenging?
The context we work in
Reality of medical careers means:
More UK medical graduates
No patronage / bias in selection
NHS will train the workforce it requires
Unpredictable applicant tactics
Feminisation of workforce
Work-life balance more important for all
Medical Unemployment
Historically poor retention in Wales
UK careers developments
Tooke , Darzi
Career pathways changing
Recruitment processes evolving
Improving access to LTFT training
UK careers group formalised
Workforce Planning
MEE – exploring future change
UKFPO
Careers workstream established
UK scoping exercise
Careers questions in PMETB survey
Feedback from medical students forum
New Curriculum and reference Guide
Careers skills in curriculum Guidance on
tasters in F1 and F2
Workforce Planning
More Academic posts
in early years
Experience assists
decision making
Careers in research
and/or medical
education promoted
More entering
academic medicine
Wales Career Strategy
Approved May 2008
Twice yearly Steering group meetings
Membership: Swansea & Cardiff UG Careers
and Curriculum leads, BMA representatives,
Workforce Planning, Med. Ed. And E-learning,
PGOs
Identifies actions needed and implementation
projects
Career Lead role defined & embedded in the
Strategy
Emerging themes – July 2008
1. Provision of careers information;
undergraduate and postgraduate
2. Integrating career support with learning
3. Methods of support: fairs, events, services
4. Systemic issues e.g. workforce planning,
geography
Early tasks
Promoting specialties through careers
fairs/events (BMJ, MCID,URDD)
Improving links between Undergraduate
and Foundation competencies (MCAN,
UKFPO)
Embedding careers education (F1/2,
SpR, Educational Supervisors, elearning)
Improving access to information (hard
and online resources, web development)
Foundation – embedded modules
F1 start – Career Planning (298)
F1 end – Making Decisions (c70)
F2 start – Specialty Applications
(300+)
Current issues
...discuss
Early thoughts – student mindsets
Challenges for medical students
76% increase 1996-2006
Two thirds now female
Careers advice at school – medicine a “safe bet”
for an A* student (from F2 workshop – Morriston)
Choices start to fluctuate early (60% by Semester 3
- Manchester)
Reduction in Foundation programme headroom
FtP – not enough just to get the exams, must
demonstrate employability (ASME June 08)
Cardiff medical student soundbites:
“I think we don’t know enough about the system to be energised to
learn about it”
“The future is blur as to what happens after F2…there’s so may
different routes to get to a particular specialty but what happens in
the interim, nobody really knows”
“There’s a lot of things changing at the moment, a lot, and more than
half of us don’t know what the hells going on”
“I’ve heard so much about FP1/2/ST…but I can honestly say if
someone said what is the form, how do you fill it in, when is the due
day…I feels like no-ones actually sat us down as a year group and
have been like, you’ve got to apply for jobs”
“I do admit that I’ve just kind of bumbled along…perhaps it would be
useful for future years to put some early thought in”
Into Foundation and beyond…
At its simplest…
The reality?
Wales F1 soundbites – confidence crisis
“I don’t think we get long enough to decide and that’s the
thing that’s bothering me now”
“All of our consultants know that we’re not going to be as
good as they are…as they’ll all probably have double the
experience that we have”
“The problem with the selection process…is how you look
on a piece of paper”
Challenges for Foundation doctors
MMC needs early decisions
Still changing; challenge for local helpers
First experience of competitive selection
48 hour rule for decisions
May not get first choice – no guarantees
Some get no offers
Future ratio of CCT holders to trainees
Future of consultant role/posts
Foundation doctors:
Largely undecided at the outset about future
choice
Feel rushed into specialty applications
Perceive the system as inflexible
Perception of “failure” – poor coping
strategies/Plan B
Feel information from their educational
supervisors is uncertain or inconsistent
Are influencing our medical students!
Myths about specialty choice
You only get one chance a year to apply for
specialty training
Working in a fixed term specialty post will count
against me in the future
Once in a specialty it is well nigh impossible to
change
Applications to change specialty will be
unfavourably viewed
If I apply to more than one Deanery/specialty the
others will find out
If a consultant expresses a view on a career
route it is the absolute truth
Messages we need to get out there
The choice is yours
There is plenty of opportunity in Wales and
it’s a sellers market in some specialties
There are options where you can explore
choices further if you need more time
There is some flexibility within the system
but aim to do the groundwork early
Things change all the time!
Challenges for ST/CT and above
Health / disability
Life events and changing WLB needs
Training / career not progressing
Wrong speciality choice
Academic interests
Desire for overseas experience
Wrong location
Wrong career??!!
Common themes we encounter
Early Foundation – is this right for me?
Flawed decisions when originally applying for
specialty
MTAS effect feeding into ST3+ thinking
Later change of pathway (or even career)
Academic posts stimulating thoughts of change
Worklife balance, changing circumstances and
priorities
“I’m finding it just harder than I thought”
Core trainees – future options
Sudden or planned resignation
NICEC Research findings
Around half of all work-based career
discussions are not part of a formal process
Many are spontaneous and unplanned
But the best conversations are structured and
involve preparation and reflection. A common
framework is a predictor of effectiveness
NICEC/CIPD Research findings
ROADS safety check:
To what extent:
Is your goal Realistic?
Have you considered all Opportunities?
Have you built in the Anchors that will provide
personal support in the background to your
career?
Will your choice Develop your potential?
Can you work with or minimise the Stress factors
in your career choice?
Four stages to encourage:
Self assessment (taking a history)
Exploring career values, motivators, preferences,
personal strengths, limitations
Career exploration (investigations)
Establishing options, alternatives and plan B’s,
information gathering, networking, reality checking
Decision making (diagnosis)
Evaluating options, mapping skills and attributes against
actual roles, considering preferred work environments,
clarifying personal factors
Plan implementation (treatment plan)
Applicant research, CV update and applications,
preparing for assessments
This model is featured in:
Deanery Careers website
www.cardiff.ac.uk/pgmde/careersandrecruitment
National Careers website
[email protected]
Other Deanery Careers Services
Foundation Year 1 resources (they have
the book)
F1/F2 curriculum based careers sessions
Step 1 - Work Values
Work Values – 4 dimensions
Sort pieces of paper under the headings
Try to rank the “very important”
Any surprises?
Any which might be very important in 10 years
time?
Will you find outlet for all the v important in your
current career choices?
Self-assessment
Psychometric tools: e.g.MBTI – can be
remotely administered but only by
qualified practitioner. Feedback
essential.
More general open access selfassessment tools e.g.
www.windmillsonline.co.uk,
www.teamtechnology.co.uk
SCI59
On line self assessment tool
Improves self awareness if questions considered
Gives 10 specialities most likely to enjoy
Gives 10 specialities which will be a challenge
Take it with a pinch of salt – hazard
warning!!!
Free to BMA members via their website
http://www.bma.org.uk/careers/careers_service/
Careersguidance.jsp
Sources of Careers Information
1.
2.
3.
4.
5.
6.
7.
8.
9.
Peers
Professional network contacts
University – tutors, careers services
Web based – MMC, Deaneries, Royal Colleges,
BMJ, social network sites
Local NHS – Ed. Supvrs, College tutors, PGO,
HR
Deaneries
Libraries (see PG Centre)
Careers fairs
Independent sources
Web based information
www.medicalcareers.nhs.uk
A one stop shop single site for use by
students, trainees and supporters
New Deanery Careers pages now live!
www.cardiff/ac/uk/pgmde/careersandrecruitment
www.medicalcareers.nhs.uk
Information for Postgraduate Doctors
Specialty Pages
External sources of information
www.mmc.nhs.uk : person specifications
and specialty recruitment info
www.bma.org.uk : guidance on
recruitment rounds and current procedures
www.nhscareers.nhs.uk : for outlines of
specialities, pay
careerfocus.bmj.com/ : details of UK and
other job vacancies, career advice, FAQ
On-line Resources
www.doctorstrainingwales.tv
1100 – 1500 viewers a month since
December 2008
Lots of non-UK visitors
Promotional information cards for
trainees/applicants
New chapters being added
Decisions, decisions…
Influences on career decisions
Time - earlier decisions are now required!
Generation (Boomers, X and Y)
Choice left to individual – (UK norm)
Prior exposure to a speciality helps inform
choice
Peer influence (what others think)
Role models
Positive and negative experiences (“horn
and halo”)
Life style and work life balance
Doctors need to take an evidence-based
approach!
Typical decision dilemmas
Which round am I aiming for?
What are my main specialty options and
preferences?
What about any dual career issues?
Core vs run-through programme implications
What evidence do I have ?
Where should I apply?
What is my 1st, 2nd, 3rd choice?
What is my Plan B?
Should I go abroad?
Information – for specialty choices
Skills and competencies required
Experience needed
Pathways and progression
Competition ratios
Number and type of posts
Local and UK variation
Qualifications and training needed
Must be up to date information!
Wales competition ratios 2009
Specialty
Grade
Vacancies
Applications
Ratio
Anaesthetics /
ACCS
CT1
32
126
4
Cardiology
ST3
2
50
25
Clinical Radiology
ST1
7
224
32
CMT and ACCS
CT1
80
292
3.5
Core Psychiatry
CT1
27
129
5
Core Surgical
CT1
74
225
3
Em Med + ACCS
CT1
4
89
22
Ophthalmology
ST1
4
11
3
Ophthalmology
ST3
5
55
11
ENT
ST3
2
37
18
T+O
ST3
3
175
58
General Practice*
ST1
136
246
1.8
Paediatrics*
ST1
12
55
4.5
O+G*
ST1
5
45
9
Speciality Competition Ratios
Powerful set of
information
Many interpretations
No UK agreed format
May distort
application process
year on year
Guidance on
interpretation
Useful models
Egan – 3 stages (now, next, how?)
Schein – Career anchors
More of/less of analysis
Kitbags – what to take, what to leave
Force fields – push and pull
Decision timeline
5- and 10-year plans
Supporting applications
Cardiff Uni Careers support for Year 5 FP
applications
Downloadable handouts on Applications,
CVs and Interviews
F2 workshop on Applying for Specialty
Training – F2F and online
Practice interview sessions at PGCs
Generic Curriculum module on applying
for consultant posts
Selection for Specialty DVD
To help prepare for specialty
recruitment
PGCs have a copy
F2 doctors 2008/9 have a copy
Now streamed on PLATO as an online
learning resource
So what makes a good career
helper?
Who helped you?
Think a career conversation with someone
which had a memorable effect on your career?
What did they do that helped?
How did their behaviour reinforce the positive
impact they had on your thinking?
How did this conversation make you feel?
Career help can include:
Information giving and signposting
Advice about specific options
Guidance about broader direction
Coaching
Counselling
Mentoring
Outplacement support
Some of these require specialist training and
experience – but some skills are transferable
What it isn’t
Telling someone what is or isn’t good for them
Telling them how awful the system is and best of
luck with it, mate
The “If I were you” approach (you’re not!)
A gatekeeper role (I can make or break your
prospects…)
Selective – everyone needs help at some stage
Knowing all the answers – you just need to ask
the right questions
Components of a good career
conversation
Where you are at now
How you are doing
Values and drivers
Potential and aspirations
Options (local and wider)
Processes and politics
Pros and cons of choices
Next steps
Effective and ineffective behaviours
Showing real interest in
the person, and insight
Being positive and
enthusiastic
Offering constructive
challenge and advice
Using facilitative
interpersonal skills
Giving information
Giving honest feedback
on skills and potential
Sharing networks
Managing the session
Appearing uninterested or
failing to show empathy
with their situation
Misunderstanding the
issue by failing to listen or
check with the individual
Jumping in with a career
suggestion without
preparing the ground first
“Toeing the party line”
rather than being frank
and open
Airing your own
career/system baggage
Promising to do
something and then
failing to follow it up.
Encourage doctors to help you by:
Being proactive about seeking help from you
and others
Thinking about themselves, their options and
how they match
Being willing to share and disclose career
thoughts and concerns
Being open minded and open to feedback
Prompting discussions well before a job move
and being flexible on timings and tactics
Being willing to face reality and to adapt the plan
if necessary
Taking ownership and following up actions
Help for the Helpers
“Supporting Doctors with their Careers”
2 hour session for Educational Supervisors
Carries 2 CPD points from RCP
Opportunity for interaction, reflection, discussion
We can run – or so can you!
On-line module based on London Deanery
materials
Coming soon – “Being an Effective Mentor”
Aligns with PMETB domains for Educational
Supervisors
Role Models
Inspirational role models can influence careers
decisions
Observed behaviours will be noted and shared by
students and trainees
We are all role models
Trainers can discuss working lives with students and
PG trainees, as well as teach clinical material.
Improves forward thinking on what a role will involve
in the future
Foundation trainees are role models for students
On role models in Wales:
“ I think you get more influenced if you see someone you’re impressed
by”
“You might think that it is really interesting but if you’ve got a consultant
who…just shouts at you all the time or takes an instant dislike to
you…then you just don’t like it”
“I had a horrible consultant, just completely humiliated you and you get
completely put off, you’re scared of the subject and you don’t want
to do it… whereas I had a placement where I absolutely loved it, it
was brilliant and I had a really encouraging consultant and that is
kind of what I want to do”
“I liked everything that goes into [this specialty} but sitting there with
this consultant, I just sat there for the entire time going ‘I do not want
to be like you. You are the antichrist of doctors’ ”
The joys of a medical career!
You get to work with talented people
You get to meet and understand all kinds of
people (patients, teams)
The work is interesting, varied, never dull
Specialties are evolving and changing
Lots of opportunity to specialise and diversify
It is pretty recession-proof
It’s a journey, not a race, a forced choice or a
competition
It’s unique – no right or wrong career, just your
career
And finally…
Future Career Lead agenda
Specialty information in Wales for BMJ
Careers 2010
Developing on-line resources
Evaluating and co-delivering F1/2
workshops
Medical careers fair on 16th October 2010
Promoting, organising and co-delivering
training for Education Supervisors
Promoting mentor training and CAMEO
Development options
Follow up day, annual events
Involvement in Career Strategy Group
meetings
UK and Deanery website sections resources for career helpers
Mentor training/CAMEO
Coaching Skills
Online PDE module
PG Certificate in Managing Medical
Careers
The role of the career lead…
…say “no” to career Sat-Nav!