1. Medical Careers Career Support - Resources..? Andrew Long Associate Dean Head of School of Paediatrics London Deanery

2. Medical Careers Workshop outline Background Career challenges – personal experiences Resources – who? Resources – what? Potential Risks Significant benefits

3. Medical Careers Career Advice - MMC “…rigorous counselling and career advice should be available throughout training” “…underpinned by practical career advice and coaching, there should be opportunities to change direction later on” “…underpinned by practical career advice and coaching, there should be opportunities to change direction later on” “…they should match the choices of individuals with career advice, assessed potential and, importantly, the demands of the NHS for particular specialists and for GPs.” Modernising Medical Careers: The Next Steps, 2004

4. Medical Careers all four Departments of Health in the UK (plus CMOs) must be involved in any moves to change medical career structures DH should have a coherent model of medical workforce supply DH should urgently review its medical workforce advisory machinery content of higher specialty training and the numbers will be informed by dialogue between the Colleges, Deaneries, employers, and medical workforce advisory machinery career aspirations and choices should be informed by accurate data. Medical schools should play a greater role in careers advice Implementing the Tooke Report: Department of Health Update, November 2008

5. Medical Careers Postgraduate training – Inquiry recommendations * stems include for example Medicine, Surgery, Acute Common Stem and GP training. NB the term ‘specialty’ has no formal legal significance in these examples Medical student Medical School ‘Stand Alone’ Practitioner Consultant CCT Specialist Medical Degree Provisionally Registered doctor Postgraduate trainee F1 Full GMC registration Registered DoctorSpecialist Registrar 1 year Attends ‘Graduate’ school Guaranteed place for UKMG GP ~ 4 Core Specialty stems 3 years (fixed term) 4 - 6 month positions Integrated ‘Masters’ programmes available -Research -Education -Management -Global health Specialty assessments at selection centres PMETB CESR Optional higher credentialling/sub- specialty exams Competitive selection process with limits Specialist Registrar GP Specialist Registrar ‘Higher specialist Training’ Core Speciality Training ‘Staff Grade’

6. Medical Careers trainees must be involved in the decision-making and implementation of training innovations that affect their present and future careers support to assist the individual in day-to-day activities and decisions... should be carried out by someone with whom the individual works and who can be a positive role model for them. Mentoring could be undertaken by someone outside the specialty or even profession, the purpose being to provide an individual with career guidance and expertise. Time for Training Sir John Temple, 2010

7. Medical Careers Issue 6: Perceived deficiencies in careers information and advice 11. All of the appropriate organisations must work together to define good practice for the provision of careers information and advice. Such information must be easily accessible, simple to understand and contain transparent data on each specialty, including competition ratios and a potential applicant’s “likelihood of success”. Foundation for Excellence: An Evaluation of the Foundation Programme. Professor John Collins October 2010

8. Medical Careers “Although extensive careers information is available it would appear that the quality of careers advice may be lacking. Those in established medical practice often tend to support their own specialty area or, through the “hidden curriculum”, deter trainees from pursuing certain careers in medicine, such as general practice." Foundation for Excellence: An Evaluation of the Foundation Programme. Professor John Collins October 2010 “The optimal timing of careers decisions remains the subject of debate. Of those doctors who in their first year after graduation were definite about their specialty choice, 74% were in this specialty ten years later.”

9. Medical Careers ‘Informing Choices’

10. Medical Careers Personal experiences discuss with your neighbour – your most challenging experience in career guidance – what was the outcome – were expectations realistic – what resources would you/trainee have found most valuable other people information

11. Medical Careers Who is/might be involved? undergraduate – personal tutor, careers service, undergraduate Deanundergraduate – personal tutor, careers service, undergraduate Dean postgraduatepostgraduate – Educational Supervisor – College Tutor/Specialty Programme Director – Clinical Tutor (DoME) – Training Programme Director – Deanery Careers Adviser

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13. Stage 1 Self-help materials Workshops Stage 2 ES Guide ES e-learning Workshops

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15. Shared career planning framework an extensive survey of the components of effective career discussions in the workplace identified the importance of preparation (of both parties) and of having a simple shared framework to structure the discussion. Hirsh, W., Jackson, C. and Kidd, J. M., (2001). Straight talking: Effective Career Discussions at Work. Cambridge. National Institute for Careers Education and Counselling (NICEC).(Hirsh et al, 2001)

16. Medical Careers Four stage career planning framework

17. Medical Careers Psychometric Tools

18. Medical Careers www.mmc.nhs.uk

19. Medical Careers

20. www.mmc.nhs.uk ProgrammePostsAppsRatio Neurosurgery*171176.8 Clinical radiology17912517.0 Core Medical Training117124552.1 Obstetrics and Gynaecology*2491,2526.02 Histopathology*621653.0 Paediatrics*3401,3864.0 General practice*2,78348501.74 Competition Ratios Application ratios for ST1 in 2010 * Are competition ratios as 1 application made per applicant

21. www.mmc.nhs.uk ProgrammePostsAppsRatio Neurosurgery*1617510.9 Clinical radiology1775873.3 Core Medical Training120124752.1 Obstetrics and Gynaecology*2655972.3 Histopathology*601372.3 Paediatrics*4077531.9 General practice*325155411.7 Competition Ratios Application ratios for ST1 in 2011 * Are competition ratios as 1 application made per applicant Psychiatry 481 357 0.7

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23. www. medicalcareers.nhs.uk

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26. Stage 3 Training Faculty Postgraduate Certificate Stage 4 Interview Skills/cv workshops Individual careers support

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28. Potential Risks no guarantees relies on self-awareness, motivation, performance etc role of the ego! honesty can hurt! mis-direction current inflexibility time commitment

29. Medical Careers Significant benefits better workforce planning* contented workforce full rotas* scheduled migration no panic in Foundation training* fewer trainees in wrong specialty fewer trainees in difficulty *mythical

30. Medical Careers Any questions?