How to Enjoy a Medical Career in the NHS by pursuing Secondary or Portfolio Careers

1. How to Enjoy a Medical Career in the NHS by pursuing Secondary or Portfolio Careers a Personal Perspective by Dr U Ahmed Consultant Physician

2. Introduction • Career Options in Medicine • Choosing a Career in Medicine • Secondary or Parallel Careers • Portfolio Careers • Professionals’ Perspective • Personal Perspective • Conclusion

3. Career Options in Medicine • Accident & Emergency • Anaesthesia & Intensive Care • Anatomy & Physiology • Biochemistry • Cardiology • Dermatology • Ear, Nose & Throat

4. Career Options in Medicine cont. • Endocrinology & Diabetes • Gastroenterology • General Medicine • General Surgery • Genetics • Geriatric Medicine • Haematology & Oncology

5. Career Options in Medicine - 3 • Microbiology & Virology • Neurology & Neurosurgery • Obstetrics & Gynaecology • Ophthalmology & Optometry • Orthopaedics • Pathology • Pharmacology & Therapeutics

6. Career Options in Medicine - 4 • Psychiatry & Psychology • Public Health • Radiology & Radiography • Respiratory Medicine • Rheumatology • Sports Medicine • Urology & Nephrology

7. Career Options in Medicine - 5 • General Practice • Others • Event / Expedition / Rescue Medicine • Audiological Medicine • Obstetric / Maternal Medicine • Occupational Health • Many More !

8. Critical Care Medicine Advantages • basic sciences application • rapid results • gain expertise in Rx critically ill • MDT working / leader • growing specialty • greater interaction with other specialties

9. Critical Care Medicine - 2 Disadvantages • long hours • emotionally & physically challenging • unpredictable work patterns • limited opportunity for private practice • often the focus of colleagues’ frustrations !

10. Audiological Medicine Advantages • diversity of skills needed • application of scientific developments • plenty of patients • secondary career opportunity : Medico-Legal & occupational health • plenty of sleep : nil emergency, no on-call

11. Audiological Medicine - 2 Disadvantages • less glamorous • limited geographical flexibility • less popular amongst medical colleagues • no overtime payments as a trainee

12. Geriatric Medicine Advantages • challenging : multiple problems • fun : usually great fun to work with • rewarding : grateful patients & relatives • opportunity for professional development : sub-specialties expanding • team-working

13. Geriatric Medicine - 2 Disadvantages • increasing work load • frustration : problems in discharge • mortality : often high • less glamorous • shifting boundary e.g. community geriatrics • less opportunity for private practice

14. Histopathology Advantages • interesting and challenging work • joy in making a difficult diagnosis • scope to develop special interest and expertise • sociable hours • good opportunities : flexibility, teaching, research, private practice, secondary career

15. Histopathology - 2 Disadvantages • limited clinical contact with patients • exposure to cases of unnatural death • relatively sedentary occupation • demanding in terms of decision making • bad press recently • unglamorous

16. Clinical Genetics Role of the Clinical Geneticist • Organisation of regional genetics centres • Training for clinical genetics • Advantages • Disadvantages

17. Clinical Genetics - 2 Role of the clinical geneticist • diagnosis of genetic disorders : all ages • investigation & assessment of genetic risk • genetic counselling and surveillance • liaison with genetic labs • education & training • research

18. Organisation of regional genetics centres • generally based in large cities • Consultant led service • team-based : doctors, nurses, scientists • referrals from primary care & Consultants

19. Training for clinical genetics • MRCP, MRCPCH or equivalent • previous experience in genetic (BSc/MSc) • four year Calman training programme • research and publications (MD/PhD) encouraged • clinical training in both adult & paediatric genetics useful

20. Advantages • wide variety of issues covered • opportunities for sub-specialsation e.g. cancer genetics • outpatient specialty : no emergencies • broad understanding of whole of medicine • team working • research / publications

21. Disadvantages • unpopular • less glamorous • communicating bad news • limited choice geographically • research degree crucial  to career progress • sedate specialty : little or no drama • small specialty : may be expanding

22. Forensic Psychotherapy • SpR Training • 5-year training schemes : 2 years’ psychotherapy, 2 years’ forensic,1 year joint • work involves acquiring forensic & psychotherapeutic knowledge base • specific skills : individual & group work, risk assessment, team work, supervisory, self-reflection

23. Forensic Psychotherapy - 2 Consultant Forensic Psychotherapy role : • assessing and treating patients • advising colleagues • supervising junior doctors & others • supporting staff in forensic settings • court assessments of psychopathology, risk, and capacity for Rx

24. Forensic Psychotherapy - 3 Advantages • alleviation of suffering • challenging • fascinating Disadvantages • can be frightening • less glamorous / demanding

25. General Practice Advantages : • challenging • good long term prospects • commitment to community • egalitarian • gratifying / flexible working • opportunities for secondary careers

26. General Practice - 2 Disadvantages : • same old problems • front line work • unsociable hours • risk of verbal and physical abuse • lack of career structure • increasing work load

27. Non-standard grade posts - 2 Advantages : • opportunity for specialisation • secondary career opportunity • job variety • can be rewarding • Consultant post, occasionally

28. Non-standard grades posts Disadvantages • poor prospects • not challenging : risk of de-skilling • very frustrating • lack of autonomy • lack of opportunities • low status

29. Choosing A Career in Medicine • Medical Career Decision Making Process • External / Impersonal Influence • Internal / Personal Influence • Other / Fortuitous Influence

30. External / Impersonal Influence • Selection criteria to medical school • Qualification exams • Jobs Design / Career structure • Appointments / Conditions • Career Progression criteria • Continued Professional Development • Retirement

31. Internal / Personal Influence • Idea • Define decision • Gather Information • Test virtual model • Make choice • Implement • Experience & Review BMJ 2000;320:S2

32. Difficulties in Medical Careers - 1 • Wrong specialty • Wrong place • Overwork & burnout • Boredom & loss of delight in work • Developing incapacity • Environmental change • Interpersonal strife

33. Difficulties in Medical Careers - 2 • Trouble at home • Stress • Ill-health • Getting exams • Getting jobs • Uncertainty • Other

34. Secondary or Parallel Careers • Advantages • Disadvantages • Secondary career options • Recipe for Success

35. Secondary or Parallel Careers - 2 Advantages - 1 • increased job satisfaction : more variety • more challenges & intellectual stimulation • development of new skills & competencies • meeting new people • more experience / and distribution of it • reducing stress through tasks, variety etc.

36. Secondary or Parallel Careers - 3 Advantages - 2 • preventing burnout • recognition - discretionary points or distinction award • increased remuneration • personal fulfilment / development • increased opportunities elsewhere !

37. Secondary or Parallel Careers - 4 Disadvantages • very demanding • personal & family inconvenience • reduced opportunity for local responsibility • impression of excessive absence from base • resentment by some colleagues

38. Secondary or Parallel Careers - 5 Examples of Secondary Careers • professional • membership (Chair) of committees • chairman of MSC • Medico-Legal work • work for national bodies : BMA, GMC etc. • medical journalism, authorship

39. Secondary or Parallel Careers - 6 Examples of Secondary Careers - 2 • speciality • specialty work for directorate, trust, HA • regional work : adviser, chair of training • national duties • work for a specialty society e.g. ARC, CRC • work for a disease/patient group : SA, PDS

40. Secondary or Parallel Careers - 7 Examples of Secondary Careers - 3 Education • undergraduate teaching • postgraduate teaching, organising courses • college / specialty / PG tutor • director of education / PG dean • Managerial : Clinical / Medical Director / CEO

41. Secondary or Parallel Careers - 8 Recipe for Success • Plan ahead : acquire necessary skills, MA • Agree a workable time table • Work hard at all responsibilities • Be efficient : innovate, IT etc. • Pay back any lost sessions • Maintain good relations with colleagues

42. Secondary or Parallel Careers - 9 Recipe for Success - 2 • keep support staff separate • communicate effectively : staff should all know your TT • deal with criticisms / professional jealousy • use : PC, e-mail, business cards, records • seek a mentor / mentor others !

43. Portfolio Careers Portfolio Career Opportunities • Clinical Practice: PP, MO to other orgs, locs • Education:T&T, examiner, deanery,courses • Academic: research, editing, author, chair • Quality Assurance: audit, TQM, complaints • Management: HoD, CD, MD, CEO, Chair • Medicine & Law: Medico-Legal, forensic, EW

44. Portfolio Careers - 2 Portfolio Career Opportunities - 2 • Leadership / Politics : BMA, GMC, RCP, RSM • The Media : writing, publishing,TV / Radio • Overseas : medical travel, voluntary service • Business : pharmaceuticals, consultancy etc. • Mens sana : informatics, curator, ethics, libr • Others : HM Forces, CS ,charities, TA, etc.

45. Professionals’ Perspective • CG : author, lecturer, charity,M-L,politician • W-CL : cons, lect, soli, M-L, author • RP : cons, lec, media doc • SH : SpR, entrepreneur, rescue/event/exp med • Others : ons+ceo,gynae+sculptor,surg+entre • Still others : cc cons+airline ceo, cons+biote

46. Personal Perspective • Consultant Physician • Management Consultant • Medico-Legal Consultant • Bioethics Consultant • Lecturer • Charity Worker : professional & personal • Entrepreneurship / Politics

47. Personal Perspective - 2 • Plan well ahead • Acquire necessary qualification(s) / skills • Pursue your interests • Prepare to work hard & sacrifice • Do not be put off by obstacles • Review & reassess constantly • Keep on top of your primary career !

48. Conclusion • Only Change is Constant • One Career in a Lifetime - WHY ? ? • Explore your ‘OTHER’ Potentials • Work Hard • PRAY HARDER ! • Thank You