Developing Careers Support for Undergraduate Medical StudentsA Case Study from University of Liverpool

Christine Waddelove

Senior Careers Adviser

School of Medical Education

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A Day in the Life?

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.

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

Specialty Training post MMC www.mmc.nhs.uk

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.’

 

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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

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

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

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

Some Issues

UK Medical School Intake www.foundation.nhs.uk

2009 ST1 Level Posts & Applications of (source) www.foundationprogramme.nhs.uk

Issues• Need to work on expectations of prospective

medical graduates and medical graduates • In 2009 40% 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 2012 60% of specialty posts will be in GP• Geography – some areas short doctors others

massively oversubscribed

Development Strategies• Involved ‘taster days’ with 6th

formers• Developed relevant careers

information –leaflets and website

• Career readiness tools e.g. Sci59

• Used technology – VLE /email 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

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?”

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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)

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.”

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.”

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

Useful Resources• Resource to help you plan your career in medicinehttp://www.medicalcareers.nhs.uk/Pages/default.aspx• Lots of information on specialties, competitiveness etchttp://www.mmc.nhs.uk/• Lots of Information on the Foundation programmehttp://www.foundationprogramme.nhs.uk/pages/home• Information on medical specialties etc.http://www.nhscareers.nhs.uk/medical_training.shtml

Useful Book- The Medical Student Career Handbook edited by Elizabeth Cottrell