Over the last few weeks I’ve had conversations with several of our middle graders about their career path. They’ve spoken candidly about uncertainty and doubt in their choices. There’s a sense of feeling rushed into career decisions. There’s also the perception that once you’re on that path you can’t change.
Our junior doctors are feeling trapped.
I’ve talked before about how training has changed even in the time I’ve been qualified. However even by the end of my PRHO year I felt that I should have a vague idea of what to do. The options put to me were not that great. I was not a ‘high flyer’ so a medical or surgical rotation was unlikely. I also wasn’t academically minded so research was out too. My choices were go to Australia or get on a GP rotation.
Back in the mid 90s general practice was thought of as the career choice of women wanting to be part time and/or have families. Nor was it a speciality that many got excited about. Now before I alienate all my GP friends and colleagues that was not how I viewed it but it was how many saw it back then.
I wanted to become a GP as I was attracted to the diversity of work it had to offer. I was however a little hesitant about going straight into being a GP registrar with only a year of medical experience. I worked in rural Northumberland doing a 1 in 4 on call and Saturday morning emergency surgery. We weren’t part of a co-operative so all the out of hours were managed solely by the practice.
It was one of the hardest jobs I’ve ever done. There was no learning curve per se – it was a straight up line. It was however where I learnt about perspectives, the patient/doctor/carer agenda and safety netting. It’s also where I learnt I did not want to be a GP. I didn’t think it was the right fit for me.
However bearing in mind what I said earlier I felt I had little option but to continue doing jobs that might get me to the end of GP training. At the back of my mind I also wondered if it could help get me on a medical rotation. So I went freelance. I resigned from the rotation, moved to Glasgow and started doing a variety of jobs.
I look back on this time with great fondness. I like to call them the ‘faffing about years’. In that time I did jobs in several different hospitals in Geriatrics, A&E and General Medicine.
I toyed with Cardiology as a speciality but research put me off. It wasn’t until some 4 years later I thought about Geriatrics. I think bringing that degree of life experience and professional maturity really helped. I’d never considered Geriatrics before. I brought with me a wealth of understanding that stretched from primary care to the ED and into the rest of secondary care.
So as I listened to people talk at a recent education meeting how ‘broad based training’ is simply wasting time and lacks focus I became a bit depressed. I found myself back in 1996 and our Dundee Medics review. It opened with the now infamous monologue from Trainspotting. It was given a medics spin though:
‘I chose not to choose life. I chose something else. I chose medicine’
Choose your future indeed but perhaps that ought to include time to faff. Try out different specialties, see what one fits. Choose life.