1. Developing Careers Support for Undergraduate Medical Students
A Case Study from University of Liverpool
Christine Waddelove
Senior Careers Adviser
School of Medical Education

2. A Day in the Life?

3. Why the need to develop careers support?
Changes in postgraduate medicine training e.g. Modernising Medical Careers agenda (2005)
Research shows dissatisfaction of junior doctors with lack of careers advice*
Increased Diversity and flexibility of students entering medicine e.g. ‘feminisation’
Changes in society – growth in number of speciality areas
Retention
International doctors – restrictions?
*Jackson C, Ball JE, Hirsh W, Kidd JM. Informing choices: the need for career advice in medical training  . London: BMA Health Policy and Economic Research Unit, 2003.

4. Application Process pre- and post- MMC
Before
PRHO - SHO (lost tribe)
Specialist Registrar
Applications all year round
Multiple applications required
Potential for perceived favouritism/nepotism
Now
F1 and F2
Specialty Trainee
National timeline
UK-wide online application system
National scoring guidance
Fair and open competitive process

5. Specialty Training post MMC www.mmc.nhs.uk

6. Helped by government reports....
2005 Career Management: an approach for medical schools, deaneries, royal colleges and trusts, put together by the (MMC) working group for career management states:
‘ an effective career management system must span the totality of undergraduate and postgraduate medical training, including recruitment of students into medical school.’
2007 Recommendation 17 in the Tooke report emphasised the need for medical schools to play a greater role in providing careers information and advice:
‘Career aspirations and choices should be informed by accurate data. Medical schools should play a greater role in careers advice.’
2008 This recommendation has subsequently been fully accepted by the Secretary of State for Health:
‘I am pleased that Sir John has acknowledged the role that medical schools have to play in providing careers advice. I look forward to hearing more about their plans in this area shortly.’
2009 Tomorrow’s Doctors
‘Schools must have a carers guidance strategy. Generic resources should include an outline of career paths in medicine and the postgraduate specialties, as well as guidance on application forms and process. Specific guidance should be provided for personalised career planning.’

7. So why specifically careers support at undergraduate level?
Doctors will have to choose which speciality to enter 16 months after graduation during early part Foundation year 2
Decisions made in medical school can help or hinder choices
Useful to develop career management skills early because doctors will need these skills during their career

8. Some of their choices Extra curricular activities
Positions of responsibility
Work experience / voluntary work
Student societies
Elective
Special Study Modules (SSCs in some institutions)
Intercalate
Publish Articles
Undertake audits
Teaching
Prizes/Awards

9. In the next 3 minutes in groups of 2/3 write down as many medical specialties as you can

10. Medical Specialties Anaesthesia Chemical Pathology Clinical Radiology
General Practice
Histopathology
Medical Microbiology
Medical Virology
Medicine (sub specialties)
Acute medicine
Allergy
Audiological medicine
Cardiology
Clinical genetics
Clinical neurophysiology
Clinical oncology
Clinical pharmacology & therapeutics
Dermatology
Endocrinology & diabetes
Gastroenterology
General internal medicine/acute medicine
Genito-urinary medicine
Geriatric medicine
Haematology
Immunology
Infectious diseases
Metabolic medicine
Medical oncology
Medical ophthalmology
Neurology
Nuclear medicine
Occupational medicine
Paediatric cardiology
Palliative medicine
Pharmaceutical medicine
Rehabilitation medicine
Renal medicine
Respiratory medicine
Rheumatology
Sports & exercise medicine
Stroke Medicine
Tropical medicine
Emergency Medicine
Neurosurgery
Obstetrics and gynaecology
Ophthalmology
Paediatrics
Psychiatry – general
Public Health
Surgery (sub specialties)
Cardiothoracic surgery
General surgery
Oral and maxillo f acial surgery
Orthopaedic
Otolaryngology (ENT)
Paediatric surgery
Plastic surgery
Trauma and orthopaedic surgery
Urology

11. Some Issues

12. UK Medical School Intake www.foundation.nhs.uk

13. 2009 ST1 Level Posts & Applications of (source) www
2009 ST1 Level Posts & Applications of (source)

14. Issues
Need to work on expectations of prospective medical graduates and medical graduates
In % of the available specialty posts were in GP and yet only 13% of foundation doctors applied for GP.
Core surgery represented 8% of the available posts with 20% of foundation doctors applying for them (see figure 2).
By % of specialty posts will be in GP
Geography – some areas short doctors others massively oversubscribed

15. Development Strategies
Involved ‘taster days’ with 6th formers
Developed relevant careers information –leaflets and website
Career readiness tools e.g. Sci59
Used technology – VLE / guidance/ voice-over presentations
Developed career management skills workshops within curriculum - Customising ‘Destinations
Fairs- “balloon” debate, Year3 and Year5 trust fairs
Training the trainers - consultants
Work conjunction with post graduate deanery
Research

16. Example of recent SSM titles – 3rd year
‘’Undergraduate and postgraduate experiences as factors affecting speciality choice’’.
“A critical evaluation of the careers management advice suggested for junior doctors since the implementation of the modernising medical careers agenda”.
“General Practice as a career over the last two decades”.
“What factors determine junior doctors and medical students decision to pursue a career in primary care specialties and how has this changed over the recent decade?”

17. History and examination
Stage approach to Career Planning– Elton, C. and Reid, J. (2007) The roads to success. A practical approach to career planning for medical students, foundation trainees (and their supervisors), London: Postgraduate Deanery for Kent, Surrey, and Sussex)
History and examination
Self Awareness
or Assessment
Investigations
exploration
Career
Diagnosis
making
Decision
Implementation
Treatment
Plan 17

18. What have medical students said:
“Awareness that MBChB degree is only the start of the process of being a doctor, it will be followed by at least 5 and maybe up to 12 years of study - I am sure I was told this but I certainly didn’t think about it!”
“The sheer number of specialties available and that I wasn’t just training as a ‘general doctor’.”
“It’s a long slog – consider having a gap year before you come to university as once you are on the ‘training route’ it can be hard to decide when you should take time off and you need it!”
“Unlike other undergraduates who may leave the university after 3 years you will be in the same place for 5 years and then most students will undertake their foundation 2 years in that region – so think carefully about where you want to be.”

19. Contd..
“Make the most of your first few years at med school and take the opportunity to mix with students from different departments, it gets much harder after 3 rd year because of time and a lot of the other students have gone, it’s all to easy just to mix with medics.”
“You are not going to cure everyone – very few specialties cure – maybe orthopaedics – be realistic otherwise you will become disillusioned.”
“Beware of the shock when you go on the wards for the first time – at times you are bound to question whether this is the career for you.”

20. Key Learning Points Medical students are typically “Generation Y”
Delivery of career management and employability must optimise interest and need
Students are most motivated when content and topic align with real-life career needs
Only interested when right thing at right time

21. Useful Resources Resource to help you plan your career in medicine
Lots of information on specialties, competitiveness etc
Lots of Information on the Foundation programme
Information on medical specialties etc.
Useful Book- The Medical Student Career Handbook edited by Elizabeth Cottrell