The ROADS to Success - CMECcmec.info/wp-content/uploads/2011/07/Roads-To-Success1.pdf ·...
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The ROADS to Success
A practical approach to career management for medical students, junior doctors
(and their supervisors).
Caroline Elton & Joan Reid
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First published 2007 By the Postgraduate Deanery for Kent, Surrey and Sussex
Second edition published 2008 By the Postgraduate Deanery for Kent, Surrey and Sussex
Third edition published 2010 By the Postgraduate Deanery for Kent, Surrey and Sussex
Third edition formatted for online use 2012 By the Postgraduate Deanery for Kent, Surrey and Sussex
Acknowledgements This book has been produced by the careers specialists in the KSS (Kent, Surrey and Sussex) and London deaneries. It started life as a set of resources in A4 ring binders developed to support the foundation programme run by the South Thames Foundation School. The authors have received help from people in both organisations, plus a number of others, and would like to thank the following people: Karen Allman, Professor David Black, Dr Elizabeth Cottrell, Dr Graeme Dewhurst, Dr Cath Jenson, Dr Arun Kumar, Dr Andrew Long, Dr Melanie Newport, Professor Zoë Playdon, Dr Pam Shaw, Michael Strevens, Jason Yarrow, Maire Shelly, Jonathan Nodding, and Dr Melanie Jones, Dr Darshan Sudarshi, Dr Charles Twort, Dr Jan Welch and Dr Helen Wilson. Dr John Launer from London Deanery gave a particularly helpful critique of an earlier draft, and we are also extremely grateful to Professor Chris McManus for his input on the section on psychometric testing.
Our thanks also to Judy Horacek, and to Scribe Publications, for allowing us to reproduce a selection of cartoons from Make Cakes Not War.
Caroline Elton would like to acknowledge the late Professor Kath Green, who tragically died as the first edition of this book was going to print. Kath was a much valued mentor and someone with whom it was a privilege to work for many years. Caroline would also like to thank Howard Cooper and Rob Nathan.
Finally, both authors wish to acknowledge the support of their respective ‘Andrews’. Andrew Reid provided helpful technical advice at various points and Andrew Franklin offered publishing input, as well as introducing us to Judy Horacek’s cartoons. Both Andrews are probably relieved that the end of ROADS has been reached.
Caroline Elton and Joan Reid July 2010
The cartoons are the copyright of Judy Horacek, 2006, and are taken from Make Cakes Not War, published by Scribe Publications.
Copyright: Caroline Elton, Joan Reid and the Postgraduate Deanery for Kent, Surrey & Sussex.
Do not distribute this book without the permission of the copyright holders.
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3Contents
Page No.
I. Introduction: About the book ........................................................... 3
II. Stage 1 of Career Planning: Self-Assessment ........................................................... 9
III. Stage 2 of Career Planning: Career Exploration ..................................................... 33
IV. Stage 3 of Career Planning: Decision Making ......................................................... 45
V. Stage 4 of Career Planning: Plan Implementation ................................................. 59
VI. Guidelines for the Educational Supervisor ............................................................... 81
References ................................................................ 103
Appendices ............................................................... 104
Contents
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4
The Roads to Success
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5
INTRODUCTION:ABOUT THE BOOK
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6
The Roads to Success
I. INTRODUCTION About the book
ROADS to Success• Isapracticalcareer-planninghandbookforallpostgraduatedoctors
(althoughmedicalstudentscanuseitaswell).
Providesastructuredframeworktohelpallpostgraduatedoctorswiththeirpost-foundation careerplanning. (It isnot just aimedat traineeswhoarehavingdifficultymakinguptheirminds.)
• Includesexercisesthathavebeentailor-writtenforpostgraduatedoctorsandthathavebeentriedandtestedoveranumberofyears.
• Isbasedonarigorousreviewofboththegeneralcareer-planningliteratureandthespecificliteratureonmedicalspecialtychoice.
• Aimstohelptraineesmakerobustcareerdecisions,andtoknowhowbesttoimplementtheirplans.
• Alsocontainsguidanceforeducationalsupervisors,onhowbesttosupporttraineeswiththetaskofcareerplanning.
How this book is organisedThisbookusesastructuredfour-stageapproachtocareerplanning:
Stage 1: Self-AssessmentStage 2: Career ExplorationStage 3: Decision MakingStage 4: Plan Implementation
Therearenumerousreasonswhythisframeworkisused,butonevitalbenefitofthestructuredapproachisthatithelpsyouapproachthetaskofcareerplanninginasystematicway.Togiveyousomeexamples,worryingaboutyourapplicationformsorinterviews(Stage4activities)isawasteoftimeifyouarenotclearaboutStages1–3.Similarly,poordecisionmaking(Stage3)oftenrestsoninadequateself-assessmentorcareerexploration(i.e.Stages1and2).
Theimportanceofastructuredapproachwasillustratedbyalarge-scaleresearchstudyofwork-basedcareerdiscussions(Hirshetal,2001)whichfoundthatiftheprovidersandrecipientsofcareersupportsharedacommonframework,therecipientsfoundthediscussionsmoreuseful.
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7So,inthishandbook,whileChapters2–5arewrittenforpostgraduatedoctors,Chapter6isfortheeducationalsupervisor,enablingbothpartiestosharesuchaframework.
(Wewouldalsorecommendthatbothpartiesreadthewholebook.Forexample,Chapter6suggestsquestions,linkedtothefourstages,thateducationalsupervisorsmightwanttodiscusswiththeirtrainees.Inordertogetthemostoutofthesemeetings,traineesmightfinditextremelyhelpfultolookatthesesuggestionsinChapter6inadvance,asawayofpreparingfortheireducationalappraisal).
When this book should be readThetransitionfrommedicalschooltobeingaqualifieddoctorisprettydemanding,andlongertermcareerplanningmaynotseemanimmediatepriorityatthestartofyourF1year.WhilstitclearlymakessenseforyoutogetthroughinductionandtheearlyweeksofyourfirstF1jobbeforeyoustartfocussingoncareerplanning,wewouldsuggestthatyoushoulddipintothisbookandslowlyworkyourwaythroughthechaptersassoonasyoufeelsettledintoyourfirstF1job.Youmightalsowanttoreviewsomeoftheexercisesasyoumovebetweendifferentfoundationjobsbecauseyourviewsaboutyourself,andaboutdifferentspecialtiesmaychange.
Perhapsitalsoneedstobestressedthateventhoughthefoundationprogrammelaststwoyears,youwillbecompletingapplicationsforpost-foundationspecialtytrainingintheDecemberofyourF2year.Sothetimeperiodformakingspecialtydecisionsisactuallyquitetight.Whatthismeansisthat‘lastminute.com’hasnoplaceasacareerplanningstrategy.
Somespecialtytrainingpathwaysalsorequiretraineestoundertakeapost-foundation‘core’trainingblock,beforelaterembarkingonhigherspecialtytraining.Forexample,ifyouwanttotraininamedicalspecialtyyouwillfirstcompletetwoyearsofcoremedicaltraining,andthenapplyforaplaceonahigherspecialtytrainingprogramme.Withover25specialtiestochoosefrom,traineesoncoremedicaltrainingprogrammesstillhavesubstantialspecialtychoicedecisionstomake.Theexercisesinthisbookcanalsobeusedbypost-foundationtraineesonprogrammessuchascoremedicaltraining,aswellasbydoctorswhoarenotcurrentlyinatrainingpost,butwhowanttoapplyforspecialtytraininginfuture.
Introduction – About the book
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8
The Roads to Success
How to use this bookTheexercisesinthisbookcanbeusedindifferentways.Youcancompletethemonyourown,andthendiscussyouranswerswithcolleagues,partner,familyand,ofcourse,youreducationalsupervisor.Insometruststheexercisesarealsoincorporatedintostructuredjuniordoctorcareer-planningsessions.
Butwhetheryoucompletetheexercisesonyourown,oraspartofaworkshop,westronglyadviseyounottotakea‘pickandmix’approach.Althoughitistempting(particularlyifyouhavedecidedonyourpost-foundationoptions)toskipStages1–3andturnstraighttoStage4,thisisnotthemosteffectivewaytoplanyourcareer.Evenifyouknowwhatyouwanttodopost-foundation,theexerciseswithinStages1and2,andthethoroughnessofyourdecisionmaking(Stage3),willgiveyoutherawdatathatyouneedtodrawonforyourapplicationformandinterview.SkippingstraighttoStage4mayreduceyourchancesofbeingsuccessfulinimplementingyourpreferredcareeroption.
About the titleCentraltothebookistheROADSchecklist.Thisprovidesawayofanalysingyourcareerdecision,toseeifitisrobust.Specifically,whenyouhavemadeupyourmindaboutyourpost-foundationcareer,youshouldimaginethatsomebodyischallengingyouwiththefollowingquestions:
Realistic:Areyoubeingrealisticaboutyourselfandaboutthedemandsofthejob?
Opportunities:Haveyougivenseriousconsiderationtoalltheopportunitiesavailable?
Anchors:Haveyoubuiltinthethingsthatprovidesupportinyourlife?
Development:Doesyourdecisionadequatelydevelopyourpotential?
Stress:Haveyouminimisedthoseaspectsofworkthatyoufindparticularlystressful?
Andinadditiontoposingthesequestionstoyourself,wewouldalsoadvisethatyoudiscussyouranswerswithyoureducationalsupervisor,oranotherexperiencedclinician.
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9About the authorsWhatexperiencedowebringtothetaskofwritingthiscareerhandbook?
• Betweenthetwoofuswehavebeenprovidingcareersupporttoindividualsandgroupsforover30years,workingforcommercialcareerconsultanciesandinourprivatepractices.
• Bothofusarequalifiedcareersprofessionalsandqualifiedusersofpsychometrictests.
• CEcompletedherPh.D.intheDepartmentofAcademicPsychiatryatthethenMiddlesexHospitalandisacharteredpsychologist.Fortenyearssheworkedpart-timeasadeaneryeducationadviserandspenthundredsofhoursobservingconsultantsteachtheirjuniorsinclinicalsettings.Shehasalsoruntrainingworkshopsfortraineesand/orconsultantsoncareerissueswithinKSSaswellasfortheEastern,London,Oxford,andWestMidlandsdeaneries.SinceSeptember2008shehasbeentheHeadofCareersAdviceandPlanningatLondonDeanery.
• JRiscurrentlyworkingasHeadofCareersfortheSouthThamesFoundationSchoolsandiscourseleaderforthePostgraduateCertificateinManagingMedicalCareers.ShealsomanagesthemedicalcareerswebsiteonbehalfoftheDepartmentofHealth.Shehasprovidedcareercounsellingandcoachingtoawiderangeofprofessionalsatavarietyofstagesintheircareers.
Butneitherofusisclinicallyqualified,soinwritingthisbookwehaveworkedcloselywithseniorclinicians,andalsowithmedicalstudentsandjuniordoctors.Inthisway,wehopethatwehaveproducedapracticalhandbookthatwillassistmedicalstudentsandjuniordoctorswiththechallengingtaskofplanningtheircareers.
Introduction – About the book
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10
The Roads to Success
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11
STAGE 1 OF CAREER PLANNING:
SELF-ASSESSMENT
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12
The Roads to Success
II. STAGE 1 OF CAREER PLANNING: Self-AssessmentOverviewInthischapter,afterabriefintroduction,youwillbeintroducedtofourself-assessmentexercises.Theseexercisescover:
• Workvalues
• Achievements/skillsandinterests
• Stressesandstrains
• RoleModels
Therefollowsadescriptionofdifferentpsychometricinstruments.Ifyoudodecidethatthepsychometricapproachmighthelpyouwithyourcareerdecisionmaking,thendetailsofhowtogetyourselftestedareincludedinthischapter.
Finally,thechapterendswithtwodifferentapproachestosummarisingtheresultsoftheStage1self-assessmentactivities.
Introduction: a clinical analogyAlthoughtherearemanydifferentmodelsofpatientconsultation,insomeshapeorformtheywillallcovertakingapatienthistory,examiningthepatient,decidingwhetherfurthertestsarenecessary(andiftheyare,carryingthemout),formingadiagnosis,implementingatreatmentplan,andthenreviewingprogress.
Furthermore,thesetaskshavetobecarriedoutintherightorder:ifanunknownpatientwalkedthroughthedoorofyourconsultingroomyouwouldn’trecommendaspecifictreatmentifyouhadn’ttakenahistory,examinedhimorher,perhapscarriedoutsomefurtherinvestigations,andformulatedadiagnosis.
Modelsofclinicalconsultationcanserveasagoodparallelforacareer-planningframework:
Patient consultation Career planningTakingpatienthistory Self-assessmentExaminingthepatient ExplorationofparticularcareeroptionsFormulatingadiagnosis CareerdecisionmakingImplementingatreatmentplan Implementingacareerplan
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13Significantly,inbothclinicalconsultationandcareerplanning,thefirsttwostagesarelinked.Whatyouhaveelicitedduringthepatienthistoryinformsthefocusofyourclinicalexamination.Similarly,intermsofcareerplanning,whatyoufindoutinStage1(self-assessment)informsnotonlywhichdifferentcareeroptionsthatyouexploreingreaterdetail,butalsothespecificissuesthatyouresearchwithineachcareeroption.Forexample,ifyouhaverealisedthatyourcoreworkvaluesincludegreatcontinuityofpatientcareandopportunitiesworkinginaparticularlocationforteaching,partofyourresearchwouldbetofindoutwhether,inthecareeroptionsthatyouareexploring,youwouldtendtocareforpatientsoveralongtimespanandalsowhetherthejobmarketwassuchthatyouwouldprobablybeabletostayinaparticularpartofthecountry.
Inbothclinicalconsultationandcareerplanningtheremightbeacertainto-ingandfro-ingbetweenthestages.So,forexample,aclinicalsignthatisseenonexaminationmightmeanthatyougobackandaskfurtherquestionsaboutthepatient’scurrentorpastmedicalhistory;andwhileyouareplanningyourcareer,somethingthatyoufindoutwhenyouareresearchingaparticularcareeroptionmightleadyoutogobackandundertakesomemoreself-assessment.
Thisparallelbetweenclinicalconsultationandcareerplanningisusefulinthatithighlightstheimportanceofapproachingbothtasksinasystematicmanner,andbeingguidedbyanunderlyingstagedframework.However,wedowanttostressthatitisnotaperfectparallel.Inclinicalconsultationtheaim(althoughitisnotalwaysrealised)istoestablishadefinitivediagnosis–toprovideananswertothequestion:‘Whatisitthatiscausingthesesymptomsinthispatient?’Intermsofcareerplanning,thenotionofadefinitivediagnosiscanbeunhelpfulasitmightbetakentosuggestthateachindividualcouldonlybehappyinoneparticularspecialty.Thisiscountertothewiderresearchliterature(discussedlaterinthechapter),whichstronglysuggeststhatindividualscouldbesatisfiedinanumberofdifferentcareeroptions.
Afurtherproblemwiththeparallelisthatitmightunwittinglyseemtoimplythatthereissomethingwrongwiththeperson(theycan’tdecideontheircareer),andsotheyneedtreatment(findingoutaboutthemselvesanddifferentoptions),tomakethem‘better’.Instead,ascareersprofessionalswewouldarguethatnotonlyisitcompletely‘normal’forpeopletohavedifficultydecidingontheircareeroptions,butalsothefour-stagemodelthatwehaveusedinthisbookappliesequallytopeoplewhoarehavingdifficultydecidingandtothosewhohavealreadydecided,butwanttomaximisetheirchancesofsuccess.
Stage 1 – Self-Assessment
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14
The Roads to Success
Stage 1: self-assessmentAdequateclinicaldecisionmakingcannotoccurifthedoctorhastakenapoorhistory,performedanexaminationinadequatelyororderedthewrongclinicalinvestigations.Similarly,inourrespectivecareer-counsellingpracticesitisstrikinghowoftenitisthatclientswhoaredissatisfiedwiththeirpreviouscareerchoiceshadleaptintotheirchosenlinesofworkwithscantattentiontowhattheywerelookingforinajob(self-assessment)andonlycursoryresearchintowhetherthejobtheywereconsideringwouldmatchtheirparticularcareerneeds(careerexploration).
Startingwithself-assessment,thereisawholerangeofaspectsofyourselfthatyoucouldinvestigate,andforeachofthesetherearedifferentpossiblewaysofcarryingouttheself-assessment.Inthishandbookwefocusonfourkeyareas:workvalues,skills/interests,rolemodelsandthestresses/strainsofwork.Weregardtheseasthebareminimumintermsoftherangeofissuesthatyouneedtoconsiderwhenplanningyourcareer.
Personalityinstruments(suchastheMyers-BriggsTypeIndicator)orInterests/PersonalAttributesInventories(suchastheSelf-DirectedSearchortheSci59specialtychoiceinventory)arealsobeingusedtohelpmedicalstudentsandtraineedoctorswiththeircareerdecisionmaking.Sowealsoprovidesomeguidanceonwhenpsychometrictestingmightbeappropriateandhowbesttointerprettheresults.
Exercise 1: work values
Introduction to exercise 1RobNathan,aleadingoccupationalpsychologistandcareercounsellor,haswrittenanexcellentpracticalguideforcareercounsellors.Inhisbook(NathanandHill,2006),hehasthefollowingtosayaboutworkvalues:
‘Valuesinrelationtoworkrepresentthedegreetowhichapersonregardshisorherworkasworthwhile.This“worthwhileness”includestheamountofpower,autonomy,creativity,learning,altruism,security,statusandmoneywhicharesoughtinwork.’
Clearly‘worthwhileness’isanimportantcomponentofoccupationalsatisfaction,andthusitisvitaltobecomecleareronone’sunderlyingworkvalues.
Theexercisebelowisadaptedfromagenericsetofworkvalues(HobsonandScally,2000).Usingtheexperiencegainedfromrunningworkshopsfortraineesinfourdeaneries,weremovedworkvaluesthatparticipantsfeltwerenotrelevanttomedicine,andreplacedthemwithvaluesthattheparticipantsfeltweremissingfromthegenericlist.Inaddition,therehave
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15beenasmallnumberofresearchstudiesondoctors’workvalues,andwecheckedthelistthatwehadassembledagainstthisresearchliterature,toseethattherewasareasonablefit.
WehavealsoadaptedHobsonandScally’sgradingcriteria,inthelightofatrainee’scommentthatitisimportanttothinkaboutthoseworkvaluesthatyoudon’twanttobepresent.(And,infact,thisnotionthatoccupationaldecisionmakingalsoinvolvesthinkingaboutthingsthatyoudon’twantaccordswiththewiderresearchliterature.)
NOT IMPORTANT
QUITE IMPORTANT
IMPORTANT NOT PRESENT
(i.e. important that you
don’t have this at work)
VERY IMPORTANT
PLACE OF WORK Workinginaspecificpart
ofthecountry
MONEY Thepossibilityofearning
ahighersalary
VARIETY havingavarietyofdifferent
responsibilties
COMPETITIVE workinginaspecialtytowhich
entryishighlycompetitive
Stage 1 – Self-Assessment
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The Roads to Success
INDEPENDENCE Beingabletoworkonyourown
MANAGING YOUR OWN TIME
Havingsomeflexibilityinwhenyou
carryoutyourdifferentresponsibilities
FRIENDS Formingfriendshipswith
colleaguesatwork
PACE OF WORK Arapidpaceofwork
RESPECT Ahigh-statusjob
MANAGING OTHERS theopportunitytomanage
aclinicalservice
CREATIVITY Thinkingupnewideasand
waysofdoingthings
EXCITEMENT Workinginacontextwhere
youtakeclinicaldecisions
underpressure
CONTACT WITH PATIENTS Workinginthecontext
whereyouhavelotsof
contactwithpatients
TECHNIQUES Workinginaspecialtyinwhichyou
performparticularsurgicaland/or
diagnosticprocedures
COMMUNITY SETTING Workingina
community-basedspecialty
HOSPITAL-BASED Workingina
hospital-basedspecialty
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17
RECOGNITION Receivingappreciationfor
theworkyoudo
JOB SECURITY Knowingthatyourworkwill
alwaysbethereforyou
CONTROLLABLE LIFESTYLE Workinginaspecialtywhere
youcanachieveasatisfactory
work/lifebalance
PRECISION Workingattaskswhichinvoive
greatcareandprecision
CONTINUITY OF CARE Workinginaspecialtywhereyou
canprovidecontinuityofcare
foryourpatients
SUPERVISION Havingresponsibilityfor
supervisingothers
HELPING PEOPLE Arolewhichyouhelpindividuals,
groupsorsocietyinsomeway
LEARNING Arapidlychangingrolein
whichyouwillcontinuallybe
learningnewthings
BEING EXPERT Beingknownassomeonewith
specialknowledgeorskills
ORGANISATION Workinginawell-known
hospitalorservice
PROMOTION Workinwhichthereisagood
chanceofpromotion
CHALLENGE Being‘stretched’andgivennew
problemstoworkon
Stage 1 – Self-Assessment
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The Roads to Success
PREDICTABILITY Havingaworkroutinewhich
isfairlypredictable
RESEARCH Havingtheopportunityto
carryoutresearch
COMMUNITY Workinginaplacewhereyou
cangetinvolvedinthe
localcommunity
WORK WITH OTHERS Workinginateamalongsideothers
PHYSICAL CHALLENGE Workthatisphysicallydemanding
TEACHING Beingabletoteachothers
FLEXIBLE WORKING Aroleinwhichthereisthepossibility
ofworkingpart-time
TYPES OF PATIENTS Workingwithaparticular
patientgroup
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19Instructions for Exercise 11.Photocopy this exercise. Then,using thephotocopies, cutout the four
‘headings’cards:
•VeryImportant •NotImportant
•QuiteImportant •ImportantNotPresent
2.Againusingthephotocopiescutouttheindividualworkvaluescards
a Thensorttheworkvaluescardsunderthefourheadings(i.e.pileupthoseworkvaluesthatare‘VeryImportant’toyouunderthe‘VeryImportant’heading,etc.)
b Trytobealittleselective–so,forexample,don’thavemorethansevenoreightworkvaluescardsunderthe‘VeryImportant’heading.
c Ifthereareanyworkvaluesthatarenotonthelist,butyouknowhaveasignificantbearingonyourcareerdecision-making,thenaddtheminonseparatepiecesofpaper.(Youcanaddtheminunderanyofthefourheadings.)
d Ifyoucan,trytorank-orderyour‘VeryImportant’workvalues.
3.Writedownyour‘VeryImportant’workvalues.(And,ifyouhavemanagedtorankthem,writethemdowninrankorder.)
Lookatyourlistandconsiderthefollowingquestions:
a Isthereanythingthatsurprisesyou,oranythingthathasraisedyourawarenessaboutyourselffromthelist?Ifso,makeanoteofwhateveritisthathasstruckyou.
b Thinkabouthowyourworkvaluesmightchangeovertime.Arethereanyvalueswhicharenot‘VeryImportant’now–butmightbesoin5-10years’time?(‘Flexibleworking’maybeanobviousone,buttheremightwellbeothers.)Ifthisisthecase,thenmakesurethatyoutakeanoteofhowyouimagineyourworkvaluesmightchange.
c Arethereanyworkvalueswhichyouregardas‘VeryImportant’butareunlikelytofindanoutletinanyoftheoptionsyouare
1._____________________
2._____________________
3._____________________
4._____________________
5._____________________
6._____________________
7._____________________
8._____________________
Stage 1 – Self-Assessment
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considering?(Forexample,artisticvaluesareveryimportanttosomedoctors,buttheydon’tnecessarilyfindanoutletforthemintheirpaidroleinmedicine.)Ifthisisthecase,isthereanywaythatyoucouldfindanoutletforthesevaluesoutsidework?Andifyoudid,wouldthisbesatisfactoryforyou,ormightyoustillendupfeelingunfulfilled?
Exercise 2: achievements, skills and interests
Introduction to exercise 2Inthisexerciseweaskyoutoconsiderthreeachievements–twofromyourworkasajuniordoctor/medicalstudentandonefromoutsidework.
Typically,whenwegivetrainees/studentsthisparticularexerciseoncourses,somewillsaythattheydon’tactuallyhaveanyachievements.Butsucharesponseisbasedonacrucialmisunderstanding.Whenwesaythatwewouldlikeyoutoconsiderthreeachievements,wearenotsayingthattheyshouldbeofworld-shatteringimportanceorenormous,orrare(e.g.aleadpaperinamajormedicaljournal).Instead,whatweareaskingyoutoidentifyissomethingthatyouhavedonethatyoufeltproudabout,andideally,butnotessentially,somethingforwhichyoureceivedpositivefeedbackfromapatient,colleagueorsupervisor.
Itisalsoimportant,giventhatthisexerciseispartoftheself-assessmentstageofanoverallcareer-planningmodel,thatyouranswersaregenuine,ratherthanofthe‘MissWorld/I’dliketosavetheplanet’variety.Thepurposeoftheexerciseistothinkaboutthingsthatyouhavedonewell,andwhichhavegivenyouagenuinesenseofsatisfaction.Itisnotaboutimpressingothers–butratherstartingtothinkmoreclearlyaboutwhatmakesyoutick,sothatyoucanusethisknowledgeasthebasisforsubsequentcareerdecisionmaking.
Instructions for exercise 2D.Read through your e-portfolio and identify two things that you were
involvedwithatworkwhichgaveyougreatpersonalsatisfaction.Whenhaveyoufelttheglowofsatisfactionthatyoudidaparticulartaskwell?
Whenhaveyoureceivedpositivefeedback?
(Seeifsomethinginyoure-portfoliojogsyourmemoryaboutparticularachievements.Butifitdoesn’t,choosesomethingthatyouhaven’twrittenaboutinyourportfolio.Thevitalthingistochoosesomethingthatyoudidwellandyoufoundpersonallysatisfying.)
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21Ifyouareamedicalstudent,youmayhavealearningportfoliothatyoucoulduseforthisactivity.Ifyoudonothaveeitheramedicalstudentore-portfolio,thenjustchoosesomethingfromyourmemory.
Inadditiontothework-basedexampleyoushouldalsoidentifysomethingthatyouhavebeeninvolvedwith,outofwork,thatgaveyougreatsatisfaction.Possibleexamplesincludeachievementsinsports,music,drama,localcommunityaction,charities,religiousinstitutions,etc.Sometimes,though,the‘outofwork’achievementsarehome-based.Forexample,ifyouhavegotthroughmedicalschoolwhilesimultaneouslycaringforayoungchild,thenthatisaveryrealachievement–andyoucanuseittodemonstratethepossessionofawholerangeofpersonalskillssuchascommitment,organisation,timemanagement,etc.
B.Foreachachievement,identifyalltheskillsinvolved.Thesecouldbetechnicalskills,communicationskills,organisationalskills,conceptualskills,etc.Teaseoutalltheskillsthatyouusedtoaccomplisheachofthelistedachievements.Moreover,don’tjustlistthebroadtypeofskill(e.g.‘communication’skills),buttrytoanalyseyourachievementsatamoredetailedlevel.(Seetheexamplebelow.)
C.Foreachachievement,describehowyou(and,ifpossible,otherpeople)knewtheachievementwasasuccess.
Example
A.Achievement:
Successfullypresentingcaseatfirstmulti-disciplinarycaseconference.
B.Skillsinvolved:
Summarisingcomplexcasenotes.
Buildingeffectiverelationshipswiththeotherprofessionalspresentattheconference,noneofwhomIhadmetbefore.
Presentationskills–presentingmypointofviewtotheotherattendees.
Standingfirmwhenmyviewpointwaschallenged,butnotresortingtousingasimilarlyconfrontationalapproach.
HowdidI(orotherpeople)knowitwasasuccess?
Feedbackfromotherpeopleattendingthecaseconference.
Despiteinitialopposition,theapproachthatIsuggestedwasacceptedbytheteam.
Stage 1 – Self-Assessment
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D.Finally, lookat the listsofskillsyouhave identified.Putamarknext tothoseskills thatyouaremost interested inusingatwork.Youcanalsonotedowntheskillsthatyouhavenotdevelopedyet,butthatyouwanttodevelopinthefuture.
Repeattheexercisefortheothertwoachievements.
Exercise 3: stresses and strains
Introduction to exercise 3Nowswitchyourfocustoareasinandoutofworkthatyoufinddifficult.Allspecialtieswillcontaintasksthatyouenjoyless;however,goodcareerdecisionmakinginvolvesidentifyingwhatyoufindstressfulanddifficult,andthenchoosingacareerpathwaythatminimisestheseparticularstresses.
Youmightthinkthatpeopledothisautomatically,andsomedo.However,wefrequentlyencounterclientswhohavemadechoicesbasedononefactor(e.g.optingforaspecialtythathas‘run-through’training),withoutadequatelyconsideringthewayinwhichthischoicewillinvolveotherfactorsthattheyfindstressful.
Instructions for exercise 3Whatwewouldlikeyoutodointhisexerciseistoidentifytwoexamples(onefromyourworkinglifeandonefromoutsidework)inwhichyoufeltthatyourstresslevelswerehigherthantheynormallyareforyou.
Again,itmayhelpyoutoreadthroughyourportfoliotojogyourmemory.Forthenon-workexample,flickthroughyourpersonaldiary,toseeifanyexamplescometomind.
Havingidentifiedthetwoexamples(onefromwork,andonefromoutsidework),thenanswerthefollowingquestions.(Gothroughthemseparatelyforeachexample).
1.Giveabriefdescriptionofthesituation,outliningthebackground,whatroleyouplayed,andwhatfeelingsitengenderedinyou.
2.Trytoidentifywhatitwasaboutthissituationthatmadeyoufeelthewaythatyoudid.Forexample,forthework-basedscenario,wasitthefeedbackfromothers,thepaceofwork,theresponseofthepatients,etc.
3.Whatcanyoulearnfromthisexampleintermsoffactorsthatyoumightwanttominimiseatwork?
Nowrepeattheexercise,thistimeanalysinganexamplefromoutsidework.(And,ofcourse,youcanrepeatthisexercise,givingmorethanoneworkandoneoutsideworkexample.)
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23Exercise 4: role modelsProbablythemostconsistentfindingintheliteratureonfactorseffectingspecialtychoiceistheinfluenceofrolemodels.Acrossalargerangeofdifferentspecialties,andinstudiesfromallovertheworld,doctorscitetheinfluenceofrolemodelsasoneofthefactorsthatinfluencedtheirchoiceofspecialty.
Sometimesthisinfluenceisdirect–traineesreportthattheyhavechosenaparticularspecialtybecausethatwasthespecialtyoftheirrolemodel.Atothertimes,itisnotthattheychoosethesamespecialtyastheirrolemodel–butratherthattheyrealisethattheywanttopracticeadifferentspecialtyinasimilarmannerastheirrolemodel.Itisalsoimportanttorealisethatthisinfluenceworksbothways;positiverolemodelsarerelatedtochoosingaparticularspecialtyorworkinginaparticularway,whilstnegativerolemodelsarecorrelatedwiththedecisionnottofollowaparticularcareerpath,ortopracticemedicineinaverydifferentmanner.
Theexercisebelowaimstohelpyouthinkaboutparticularrolemodels(bothpositiveandnegative)inordertoclarifysomeoftheaspectsofworkthataremostimportanttoyou.
Positive Role ModelsFirst,spendacoupleofmomentsidentifyingaparticulardoctorwhomyouconsidertobeapositiverolemodel.
Then,withreferencetothisparticulardoctortrytoanswerthefollowingquestions:
a Whatwasitaboutthisdoctorthatyouparticularlyadmired?(Forexample,wasitthedepthoftheirclinicalknowledge;theirmasteryofparticulartechniques;theirtemperament;theirenthusiasm;theirteamleadingskills;theirmannerwithpatients,etcetc).Youmightfindithelpfulifyouthinkaboutspecificexamplesofthisdoctoratworkinansweringthisquestion.Andyoudon’thavetolimityourselftooneortwopoints–theremightbeanumberofdifferentreasonswhyyouregardagivendoctorasapositiverolemodel.
b Useyouranswertoquestion(a)abovetoidentifyaspectsofworkthatareparticularlyimportanttoyouandyouneedtobepresentinordertofindworkfulfilling.
Stage 1 – Self-Assessment
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Negative Role ModelsNext,withoutnamingnames–spendacoupleofmomentsidentifyingaparticulardoctorwhomyouconsidertobeanegativerolemodel.
a Then,withreferencetothisdoctor(butstillwithoutnamingthem),thinkaboutwhatitwasabouttheirapproachtotheirwork,thatyoudisliked.
b Whatdoesyouanswertoquestion(a)abovetellyouaboutsomeofthefactorsthatareimportanttoyouatwork?
Psychometric instrumentsPsychometricinstrumentsaresometimesusedincareercounsellingtoassesspsychologicalattributesrelevanttooccupationalchoice,suchasoccupationalinterests,workvaluesandpersonality.
What does ‘instrument’ mean in this context?Asdoctors,theword‘instrument’conjuresupimagesofthespecialisedequipmentthatsurgeonsuseintheatre.Butapsychologistusesthewordsomewhatdifferently.Forapsychologistthereisadifferencebetweenapsychometrictestandapsychometricinventory,andthereforethegenericterm‘instrument’isusedtodescribesomethingthatappliestobothtestsandinventories.
Toexplainthisinabitmoredepth,forapsychologist,apsychometric‘test’referstomeasuresthatassessmaximumperformance.Theunderlyingassumptionoftheseisthatindividualswillattempttoperformatthetopoftheirform.So,forexample,apsychometricassessmentofverbalabilitywouldbeclassifiedasa‘test’,aspeoplewhofilleditinwouldprobablywanttodoaswellastheypossiblycould.Thiscanbecontrastedwithpsychometricmeasuresoftypicalresponse,whichareoftencalledinventories.Thesearebasedonself-report,withindividualsdescribingtheirlikesanddislikes,orhowtheytypicallybehave.
Themostcommoninstrumentsthatareusedwhencareercounsellingdoctorsaremeasuresofpersonality(suchastheMyers-BriggsTypeIndicator),ormeasuresofpersonalattributesandprofessionalpreferencessuchasSci59.Theseshouldthereforebecalledpsychometricinstrumentsorpsychometricinventories,nottests,astheydonotassessmaximumperformance.(SeeKidd,2006.)Butweappreciatethatusingtheterm‘instrument’inthiswayprobablysoundsstrangetomedicallyqualifiedreaders.
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25What makes them psychometric?Nextitisimportanttoconsiderwhatmakesasetofquestions‘psychometric’?
Afterall,thefourexercisesgivenearlierinthischapteralsoaimtoassessinterests,etcworkvalues,andprobablyalsorelatetoone’spersonality.
Withoutgoingintoexcessivedetail,themostimportantpointtomakeisthatwitha‘psychometric’instrument(asopposedtothesortofexercisesincludedearlieroninthischapter)dataareavailableonthemeasurementpropertiesoftheinstrument–inparticular,onitsreliabilityandvalidity.
Takingeachoftheseinturn,thereliabilityofaninstrumentreferstotheextenttowhichtheinstrumentproducesstableresults(assumingthattheunderlyingpsychologicalconstructthattheinstrumentistryingtomeasurehasn’tchanged).
Thevalidityoftheinstrumentreferstowhethertheinstrumentactuallymeasureswhatitpurportstobemeasuring,so,forexample,ameasureofoccupationalinterestsshouldactuallyassessthatconstructandnotsomeotherone.
Boththeseconceptsshouldbefamiliartoyoufromyourstudyofclinicaldiagnostictests,butinaclinicalcontexttheymaybegivendifferentterms.Forexample,insteadoftheterm‘reliability’youmighthaveseentheterms‘precision’or‘reproducibility’,andinsteadoftheterm‘validity’youmightbemorefamiliarwiththeconceptof‘accuracy’.
Butdespitetheconceptualoverlap,therearealsosomesubtledifferencesbetweenclinicaldiagnosticmeasurementsandthemeasurementofpsychologicalconstructs(i.e.psychometrics).Inaclinicalsituationaccuracycanbedefinedastherelationshipbetweentestresultsand‘goldstandard’results,wherethelatterreferstoanindependentdefinitivediagnosisofthepresenceorabsenceofdisease.Inatleastsomeclinicalsituations,the‘goldstandard’actuallyexists,whichinturnunderpinsthemeasurementofdiagnosticaccuracy.Thingsareneversowelldefinedwithpsychometrics,wherethe‘goldstandard’(ofintelligence,interests,values,etc.)isalwaysanothertheoreticalconstructratherthanhavingthemoreclear-cutstatusofaparticularclinicaldiagnosis.Andwethinkitimportanttobearthisdifferenceinmind,whenyouareconsideringtakingapsychometricinstrumenttohelpyouwithyourcareerdecisionmaking.
Stage 1 – Self-Assessment
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When might psychometric instruments be helpful?Let’sreturntotheanalogybetweenclinicalconsultationandcareerdecisionmakingmadeatthebeginningofthischapter.Whilemostinitialconsultationsarelikelytoincludetakingaclinicalhistoryandclinicalexamination,itisnotalwaysthecasethatfurtherclinicalinvestigationsarenecessary.
Asqualifiedtestuserswewouldsuggestthatasimilarsituationappliestotheuseofpsychometricinstrumentsinhelpingmedicalstudents/juniordoctorswiththeircareerdecisionmaking.Theself-assessmentexercisesandstrategiesforcareerexplorationincludedinthisbookwillprobablybesufficientformany(perhapseventhemajority)ofstudents/trainees,andtheywillbeabletomakecareerdecisionswithoutrecoursetopsychometricinstruments.
However,somestudentsortraineesgetabitstuck.Theystrugglewiththeself-assessmentexercises,orhavingcarriedouttheself-assessmentexercisesdon’tknowhowtotranslatetheresultsoftheexercisesintoideasaboutwhichspecialtiestoexplore.Forthesetrainees,personalityinventoriesormeasuresofoccupationalinterestcan,ifusedappropriately,behelpful.
Butitisreallyimportanttointroducesomewordsofcaution,andforyoutounderstandwhatpsychometricinstrumentscanandcannottellyou.
Introducinganotheranalogymighthelpmakethepositionclearer.
Asqualified(ornearlyqualified)clinicians,youmaywellhavebeenirritatedbyill-informedaccountsofmedicalissuesthatyouhavereadinthepopularpress,orhearddiscussedinsocialsituations.Youknowabouttheimportanceofanevidence-basedapproachwithrepresentativesamples,appropriateclinical-outcomemeasures,adequatetime-scalestomeasuretheeffects,etc.
Similarly,asexperiencedcareerspractitioners,weareoftenalarmed(and,ifwearehonest,sometimesinfuriated)bytheill-informedpronouncementsthataremadeabouttheroleofdifferentpsychometricinstrumentsinhelpingmedicalstudentsandtraineedoctorswithspecialtychoice.Weknowabouttheimportanceofexaminingthepsychometricpropertiesoftheinstrument(i.e.thereliabilityandvalidity),andcriticallyappraisingtheevidencethatthisparticularinstrumentmightbeanaccuratepredictoroffuturesatisfactionindifferentspecialties.
So.Whatistheevidence?
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27Personality inventoriesPersonalitymeasuresattempttocastlightonourindividualtemperaments–towhatextentweareforexamplecautious,adventurous,curious,gregarious,competitive,independentorsociable.Thesetypesofcharacteristicsmayhaveanimpactonthekindofworkthatwedowellandenjoyandalsoonthetypeofworktasksorenvironmentsthatwemightenjoyless,andfindmoredifficulttocarryout.
Intermsofevaluatingtheevidenceontherelationshipbetweenpersonalityandmedicalspecialtychoice,thepictureiscomplicatedbythefactthatdifferentmeasuresofpersonalityhavebeenusedwithdifferentgroups,thusmakingcomparisonsextremelydifficult.Furthermore,someofthestudieswerecarriedout20oreven30yearsagoandtheremayhavebeenconsiderableshiftsinthenatureofaparticularspecialtyduringthatperiod.AndasmostofthedatacomesfromtheUSAratherthantheUK,giventhattherearedifferencesintheorganisationofhealthcareinthetwocountries,itispossiblethatthewayinwhichaparticularspecialtyispractisedinthetwocountriesmayalsodiffersignificantly.Sothistoowouldcomplicatethepicture.
However,themostrecentreviewoftheliterature(seeBorgesandSavickas,2002)concludedthefollowing:
• Althoughthereisalooserelationbetweenafewpersonalityfactorsandparticularmedicalspecialties,thereismorevariationinpersonalitytraitswithinmedicalspecialtiesthanbetweenthem.
• Allpersonalitytypesappearinallspecialties.
• Morethanonemedicalspecialtyfitsthepersonalityofanyparticularmedicalstudent.
Butonthebasisofthis,theauthorsdonotinfactconcludethatpersonalitytestinghasnoplaceincareercounsellingmedicalstudentsortraineedoctors.Instead,theyrecommendthatpersonalityinstrumentsshouldbeusedasawayofincreasingself-knowledge,ratherthanasadiagnosticprocessthatwill‘match’aparticularpersonalitytoaparticularspecialty.Anarrowlydiagnosticapproachisnotsupportedbytheavailableevidence,andshouldbeavoidedatallcosts.
WhatthismeansinpracticeisthatifyoucompleteaquestionnairesuchastheMyers-BriggsTypeIndicator(MBTI),youcannotuseittoidentifythespecialtytowhichyouwouldbebestsuited.Butyoucanuseittofindoutabitmoreaboutyourself,andthenusethatincreasedself-knowledge(inadditiontotheself-knowledgegainedfromtheotheractivitiesoutlinedinthishandbook)tothinkcreativelyaboutspecialtiesthatmightsuityou.
Stage 1 – Self-Assessment
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Accessing the MBTINowadaysitispossibletoaccesstheMBTIonline,andaquickinternetsearchwillidentifyalistoforganisationsthatprovidethisservice.However,asthepotentialbenefitofthepsychometricapproachresidesinthequalityofthefeedbackdiscussion,wewouldnotrecommendyougoingdownthisroute.Instead,AppendixAgivesalistofprofessionalbodiesthataccreditcareercounsellors,andtheinformationinAppendixAabouttheBritishPsychologicalSocietyexplainshowyoucanidentifyasuitablyqualifiedindividualwhowouldadministertheMBTI,provideyouwithareport,anddiscusstheimplicationsofthereportwithyou.
Measures of occupational interestsHolland’sSelf-DirectedSearchisthemostwidelyusedmeasureofoccupationalinterest.AndtheconclusionreachedaboveabouttheuseofpersonalityinstrumentsappliestotheuseoftheSelf-DirectedSearch.(SeeBorgesetal,2004.)
Inthislaterpaper,Borgesetalmakethefollowingstatementintheirconclusion:
‘Earlyintheirtrainingmedicalstudentsshouldbedisabusedoftheideathatthereisoneperfectspecialtychoiceforeachperson. Insteadtheyshouldbehelpedtounderstandhowthey could use different specialties to construct satisfyingandsuccessfulcareers.’
GiventhattheMMCchangesmeanthattraineesnowneedtomakecareerdecisionsearlieronintheircareers,itmaybringadegreeofreassuranceforsometraineestorealisethatthereareprobablyanumberofdifferentspecialtiesthattheycouldenjoy.(Andforthecynicsamongyou,itisperhapsworthstressingthatthesefindingswerebasedonstudiesintheUSA,soitisnotapoliticalcoincidencethatsuchdatabecameavailablejustasthefoundationpilotswerebeingdevised!)
Sci59 (previously called Sci45)Finally,thereisourownhome-grownUKinventory,Sci59(GaleandGrant,2002).Thisinstrumentwasdevelopedtomeasurepersonalattributesandprofessionalpreferencesofdoctorsintrainingandbeyondandtomatchthesetothecharacteristicsneededtoprosperinthe59mostcommonspecialties,includinggeneralpractice.
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29Asarelativelyrecent‘kidontheblock’,Sci59wasnotincludedineitherofthetwostudieslistedabove.However,thebasicnotionthatallpsychometricinstrumentsshouldbeusedtosuggestcareerideasandincreaseself-understanding,ratherthanto‘diagnose’whatspecialtywillsuityou,isabasictenetofsoundcareer-counsellingpractice,andthusappliestoSci59.
Inaddition,ithastobestressedthattherearenopublishedpredictivevaliditydataonSci59(oronitsearlierversion,Sci45).WhatthismeansisthattherearenopublishedstudiesthathaveattemptedtocorrelateSci45scoreswithanymeasureofoccupationalsatisfactionofpeopleinpost.(And,infact,whiletheoriginallistofitemswasdrawnfrominterviewswithconsultantsandGPprincipals,indrawingupthefinallistofitemsSci45wasactuallycalibratedusingresponsesfromSHOswhohadnotyetembarkedontheirspecialtytraining.)
Asforthepracticalities,somemedicalschoolsanddeanerieshavemadeSci59available,whileothershavenot.SoifyouareinterestedintakingSci59youneedtocontactyourpersonaltutororFoundationProgrammemanager,toseeifitisonofferlocally.
ConclusionsWecannotstressstronglyenoughthatpsychometricinstrumentsthatareincludedaspartofacareer-planningprocessneedtoberegardedastoolsthatleadtogreaterself-awarenessratherthanassimplequick-fixsolutions.
Butpeoplelikecertainty.Andifyouareinthehighlystressfulpositionoftryingtochooseyournextcareermove,youmightbedesperatelyseekinganswers.Soyoudon’tnecessarilywanttohearthatpsychometricinstrumentsareindicativeratherthandiagnostic,andcan’tactuallyprovideyouwithdefinitivesolutions.
Giventhatyoumaywellbedesperateforananswer,feedbackshouldalwaysbegivenbypeoplewhounderstandwhatthetestcanandcannottellyou,andknowhowtousetheresultstoenhanceself-understanding.
Ultimately,whatyouwillgetoutofanyadditionalinstrumentsishighlydependentupontheskillsofthepersonwhoisgivingyoufeedback.Iftheychallengeyoutothinkaboutthewaysinwhichtheresultsoftheinstrumentaccord(ordon’taccord)withyourotherself-assessmentactivities,andiftheyarealltooawareofwhattheinstrumentscanandcannottellyou,thenitcanbeuseful.Ifnot,thenitisatbestuseless,and,atworst,misleading.
Stage 1 – Self-Assessment
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Summary of Stage 1
Introduction to summaryItisnowtimetoconstructasummaryofStage1.(RememberthattheprocessofcarryingoutthecareerexplorationtasksinStage2mightmakeyoureconsidersomeofyouranswerstotheseStage1exercises.ThereforeitisperfectlyacceptableforyoutoreturntoandrefinethisStage1summaryatalaterdate.)
ReadthroughyouranswerstotheStage1exercisesthatyouhavecompleted.Ifyouhavecompletedanypsychometricinstruments,thenreadthroughthereportsummaries,aswell,atthispoint.Thenrecordthekeypointsusingthesummaryheadingsgivenbelow.
1. The doctor-patient relationship(WritedownanypointsthathaveemergedfromtheStage1exercisesrelatingtothedoctor-patientrelationship.Thesemightincludesomeorallofthepointslistedbelow,butyoucanalsoaddyourownpersonalpoints.Thelistbelowisnotnecessarilyexhaustive.)
Doyouwanttoseepatientsinacommunityorhospitalsetting?
Doyouenjoybriefencounterswithpatients,orprovidingcontinuityofcareoverlongperiodsoftime?
Doyouwanttospendasignificantportionofyourworkingdayhavingcontactwithpatients?
Doyouwanttoworkwithacutelyillorchronicallyillpatients?
Whatabouttheemotionallandscape?(Forexample,doyoufinditrewardingtoworkwithpatientswhoareinadistressedordisturbedemotionalstate?)
Doyouhavepreferencesabouttheagesofyourpatients?Anddoyoupreferworkingwithindividualpatients,orpatientsandtheirfamilies?
Doyouwanttocontributedirectlytothetreatmentofpatients,orwouldyouenjoyworkingtosupportthediagnosticprocess(e.g.inareassuchasdiagnosticradiologyorpathology)?
Wouldyouenjoyhavingtoconsiderthewholeofthepatient’sbody(e.g.GP/paediatrician),orwouldyouenjoybecominganexpertonaspecificregionofthebody(e.g.ophthalmology)?
Doyouenjoyperformingtechnicaldiagnosticorinterventionalprocedures?
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312. Intellectual matters(SomeoftheseissuesmighthaveemergedintheearlierStage1exercises,butitispossiblethattheyhavenot.Iftheyhaven’t,itdoesn’tmatter–justfilloutthesummarynow.)
Whatareasofacademicworkhaveyoumostenjoyedstudyinginyourundergraduateandpostgraduatetraining?
Whatmedicaljournalsareyoumostdrawntoreading?
WithintheBMJ,whatsortsofarticlestendtoattractyourattention?
Whatsubjectshaveyouenjoyed(ormightyouinfutureenjoy)teachingtoothers?
Whatsubjectshaveyoucarriedoutanauditon(ormightyouplantocarryoutanauditoninthefuture)?
Whatsubjectshaveyouenjoyed(ormightyouenjoyinfuture)carryingoutresearchon?
3. StatusInthissectioninparticular(althoughitactuallyappliesthroughoutthewholeofthisStage1summary),itisimportanttoaskyourselfwhetheryouranswersrepresentyourownviews,orwhetheryouarebeingundulyinfluencedbypressurefromsignificantothers,suchasparentsorpartner.
Howimportantisittoyouthatyouworkinahighlycompetitivebranchofthemedicalprofession?
Howimportantisstatustoyou?
Doyouwanttoensurethatthereareopportunitiesforprivatepracticeinyourchosenspecialty?
Doyouwanttogointoabranchofmedicinewherethereisthepotentialforearningaveryhighsalary?
Isitimportanttoyouthatyouhaveopportunitiesforparticipatinginresearch?
Areopportunitiesfortravellingabroadwithyourworkimportanttoyou?
Stage 1 – Self-Assessment
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4. Quality of lifeWhatsortofwork–lifebalancedoyouwanttohavein5–10years’time?
Whatsortofweeklyschedulewouldyouliketohavein5–10years’time?
What,foryou,areyourcoreworkvalues,fromwhichyouderivemostsatisfaction?
Whatstressfulfactorsdoyouwanttominimiseatwork?
Isthelengthofpostgraduatetraininganissueforyou?
5. Relationships with colleaguesDoyouwanttobeabletospendquiteaportionofyourdayworkingonyourown?
Doyouwanttobeabletospendquiteaportionofyourdayworkinginteams?
Doyouenjoyworkinginmulti-disciplinaryteams?
Doyouwanttobeabletodevelopandmanageaclinicalservice?
Doyouwanttobeabletodoquitealotofteaching?
Doyouwanttobeabletocarryoutresearch?
An alternative way of summarising Stage 1
Instructions for alternative summarySomepeoplepreferdiagramsandpicturestowords.Ifyouwouldprefer,youcouldprovideamorevisuallybasedsummaryofStage1.
Takealargepieceofpaper(eitherA3orpaperfromaflipchart).
Copyouttheoutlineoftheshieldshownoverleaf.
Then,ineachofthefourquadrants,eitherwritebulletpointsofthekeyissuesor,ifyouaresoinclined,youcandevisesymbolstodepictthekeyissues.
Then,underneaththeshield,youcouldwriteabriefpunchymottothatencapsulateswhatitisthatisimportanttoyouinyourwork.
Theexampleonthefollowingpage,wasprovidedbyaconsultantingeneralgeriatricmedicine.
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Final commentsHopefullyyouhavefoundtheseexercisesuseful.Butifyouhaven’t,wewouldaskyoutobearwithus.
Whenyoucometoapplyforjobs,completingtheStage1exercisesinsufficientdetailwillhelpyouconstructclear,credibleanswersonyourwrittenapplicationforms,andalsohelpyoupreparehowtoanswerthesortsofquestionsthatwillbeposedatinterview.Thisisbecausethequalityofyourcareerdecisionmakingwillbethoroughlyscrutinisedintheapplicationprocess,andyouneedtodemonstratethatyouhavecarriedoutadequateself-assessment(Stage1),andthoroughcareerexploration(Stage2).
Afinalissuetoconsideriswhethercareerdecisionmakingisentirelyarationalprocess(asisimpliedbythe4-stagemodel).RecentoccupationalresearcherssuchasKrieshok(2009)arguethatintuitionalsohasavitalroletoplayincareerdecisionmaking;specificallyhesuggeststhatthroughoccupationalengagement(immersingoneselfinone’swork)combinedwithin-depthreflectiononthatengagement–thecontributionofintuitiveprocessesinoverallcareerdecisionmakingcanbeenhanced.Butthereagain,clinicianssuchasthesurgeonandwriterAtulGawandearguethatintuitionalsohasaroletoplayinclinicaldiagnosis–soperhapstheparallelbetweencareerandclinicaldecisionmakingreallyisausefulonetobearinmind.
Explainingtoeveryone
Work values
Contactwithpatients
ExcitementLearningTeaching
HelpingothersWorkwithothers
Hospital
Skills
Applying‘science’touncertainty
TranslatingsymptomsintomedicalmeaningDealingwithangryorupsetpeople
InterestsExplainingmyclinicalthinking/
reasoningtotraineesWorkingwithwhat’scausingproblemsforapatientwhen
otherscannotExplainingcomplexissues
topatients/carers
StressorsPracticalprocedures
Emergency/hyper-acute,e.g.A&Esituations
Managementdecisions
Stage 1 – Self-Assessment
Figure 1: Shield and motto from a consultant
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STAGE 2 OF CAREER PLANNING:
CAREER EXPLORATION
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The Roads to Success
III. STAGE 2 OF CAREER PLANNING: CAREER EXPLORATION
OverviewThischaptercoversStage2,careerexploration,indetail.Afterabriefexplanationofwhythisstageissoimportant,thestructureofpost-foundationtrainingisoutlined.Youwillthenbeintroducedtopreliminaryresearchtasksthatyoucancarryoutforanumberofdifferentcareeroptions,andmoredetailedresearchtasksthatyouwillcarryoutonasmallersubsetofoptions.Adviceisalsogivenonhowtonarrowdownyouroptions,sothatyouknowwhichoptionstoresearchingreaterdepth.Thechapterendswitha‘realitycheck’sothatyougivesufficientthoughttowhetherornotyourcareerchoicesarerealistic.
Why Stage 2 mattersTheexercisescoveredinStage1shouldhavegivenyouanopportunitytodevelopaclearerideaofwhatyouarelookingforinyourcareer.
InStage2youexploredifferentcareeroptions,inordertofindouttwothings:
Firstly,youneedtoresearchdifferentoptionsinordertoestablishwhichparticularcareerpathwaysaremostlikelytomatchyourownindividualskills,interests,values,personality,etc.Secondly,giventhefeedbackthatyouhavereceivedfrompeoplesuchasyoureducationalsupervisor,clinicalsupervisor,thetrustClinicalTutor/DirectorofMedicalEducationortheFoundationProgrammeTrainingDirector,youneedtoconsiderwhethertheoption(oroptions)thatyouareinterestedinseemtoberealisticcareerchoices.
AtthebeginningofStage2wewanttostressthatadequatecareerexplorationtakestime.Butitistimewellspent.(Bothofushaveworkedwithmanyclientswhoneverreallyexploredtheircareeroptionsproperly,andthen,overaperiodoftime,cametoregrettheirearlierchoices.)Inaddition,aswedescribedabove,spendingtimeexploringdifferentcareeroptionsisnotonlyimportantintermsofmakinggoodcareerdecisions,butwillalsohelpyoulateronattheapplicationformandinterviewstages.
WealsowanttoemphasisethatStage2isnotcarriedoutinavacuum–but,rather,Stage2followsonfromStage1.Thismeansthataswellasfindingoutthebasic‘facts’aboutaparticularcareerchoice(andbythiswemeanfactorssuchastypicaltrainingpathway,forspecialtytraining,person
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37specification,competitiveness,etc.),youwillalsoneedtoresearchthespecificquestionsthatyounowrealise(onthebasisofworkingthroughStage1)areimportanttoyou.
AneasywayofdoingthisistousethesummaryexercisethatyoucompletedattheendofStage1togeneratespecificissuesthatyouaregoingtoexploreinyourspecialtiesofinterest.
AcoupleofotherpointsstemfromthisideathatStages1and2arelinked:
Firstly,thecleareryouareaboutwhatisimportanttoyou(Stage1),themoretargetedandrelevantyourStage2researchislikelytobe.
Secondly,alotofthemorepersonalisedinformationthatyouneedtofindoutaboutisnotavailableinthevariousmedicalcareerhandbooksoronthewebsitesofthedifferentRoyalCollegesanddeaneries.Instead,inordertofindoutwhatitis‘reallyreally’liketoworkinaparticularspecialty,youwillneedtotalktopeoplewhoarecurrentlyworkinginthatparticularfield.Withoutthissortofresearch(called‘informationalinterviewing’inthecareer-counsellingworld),itisdifficulttoascertainwhetherthecareerisgoingtomatchyourcoreworkvalues,skills,interests,etc.
Post-foundation trainingPost-foundation,ifyouwishtopursuetrainingwithinaparticularspecialty(includingGeneralPractice)youwillneedtoapplyforaspecialtytrainingpost.AllspecialtytrainingprogrammesleadeventuallytoaCertificateofCompletionofTraining(CCT),assumingsatisfactoryprogressandachievementoftherequiredcompetences.ACCTenablesyoutoapplytotheSpecialistorGeneralPractitionerregisterheldbytheGeneralMedicalCouncil.
Therearetwobroadtypesoftrainingprogrammesinspecialtytraining–‘run-through’trainingand‘uncoupled’trainingprogrammes.A‘run-through’programmeisonethatoffersthetraineestructuredtrainingthatwilltakethemthrough(assumingsatisfactoryprogress)tothepointwheretheycanbeawardedaCCT.
An‘uncoupled’trainingprogrammeisonewhichofferstwoyearsofcoretraining(threeinsomespecialties,e.g.psychiatry)followedbyopencompetitiontoenterhigherspecialtytrainingprogrammesleadingtoCCT.SecuringacoretrainingpostinanuncoupledspecialtydoesnotguaranteeyourprogressionthroughtoCCT.Youwillhavetogothroughanotherroundofcompetitionforpostsattheendofyourcoretraining.Entryforpostsatthisjunctionbetweencoretrainingandhigherspecialtytrainingwillbeopentoalleligibleapplicants(includingthoseworking
Stage 2 – Career Exploration
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The Roads to Success
innon-trainingposts).Thismeansthattheremaybesomeopportunitiesinfutureyearstoentertrainingatahigherlevel,forthosepeoplewhowerenotpreviouslysuccessfulinsecuringacoretrainingpost.But,again,inhighlycompetitivespecialties,itislikelytobeextremelydifficultforanapplicanttosecureatrainingpostatST3/4,iftheyhavenotpreviouslybeeninacoretrainingprogramme;theywillneedtodemonstratetherequisitecompetences.
Thefollowingdiagramisanoverviewofthecareerstructureforfoundationandspecialtytraining:
Figure 2
F1
Run-through postsST1, 2, 3, 4, 5, 6, 7 (8)
CT1, 2, (3)
ST3-ST7 (8)
F2
FoundationTrainingCorespecialty
trainingHigherspecialty
training
CompetitionforST1/CT1post(allspecialties)
Competitionforhigherspecialty
training(uncoupled)
Certificateforcompletionoftraining(CCT)
The flowchart below outlines the career structure for foundation and specialty training. This is an overview only. There may be other points of entry which aren’t shown here, depending on which vacancies are available at different stages of training
Specialtiesofferingrun-throughtrainingmayalsooffersomefixed-termspecialtyappointments(FTSTAs).Thiswillmeanthattheremaybesomeopportunitiesfordoctorstodeveloptheirtrainingexperiencesothattheymightbesuccessfulatalaterdateinsecuringaspecialtytrainingpost.ButithastoberecognisedthatinmanyspecialtiestherewillbehighlevelsofcompetitionandtakinganFTSTAinahighlycompetitivespecialtywon’tinanywayguaranteelatersuccessinobtainingatrainingpostatST2orST3.
Under-graduatemedicaltraining
(DiagramadaptedfromimagebyDavidRice,KSSDeanery,2008)
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39The application processApplicationstospecialtytrainingprogrammesareeitherthroughaRoyalCollegewebsiteortheleaddeanerywebsitedependingonthespecialty.GPrecruitmentismanagedthroughthenationalGPrecruitmentoffice(http://www.gprecruitment.org.uk/)andAcademicClinicalFellowshipsthroughtheNationalInstituteforHealthResearch(http://www.nihrtcc.nhs.uk/intetacatrain/).TheModernisingMedicalCareerswebsite(www.mmc.nhs.uk)containsthemostuptodatepictureontheoverallprocessandtimetableforspecialtytrainingrecruitment.
Therearealsoopportunitiesfordoctorswhoeitherdonotsucceedinsecuringatrainingpostorwhodecidethattheywanttogainmoreexperiencebeforechoosingaparticularspecialty.Furtherinformationisavailableonthemedicalcareerswebsite(http://www.medicalcareers.nhs.uk/postgraduate_doctors/specialty_doctors.aspx).JobopportunitiesareoftenadvertisedinNHSjobsandBMJcareers.
Entryforpostsatthisjunctionbetweencoretrainingandhigherspecialtytrainingwillbeopentoalleligibleapplicants(includingthoseworkinginnon-trainingpostsorotherwisenotoncoretrainingprogrammes).Thismeansthattheremaybesomeopportunitiesinfutureyearstoentertrainingatahigherlevel,forthosepeoplewhowerenotpreviouslysuccessfulinsecuringacoretrainingpost.Butagain,inhighlycompetitivespecialties,itislikelytobeextremelydifficultforanapplicanttosecureatrainingpostatST3/4,iftheyhavenotpreviouslybeeninacoretrainingprogramme.
Thedescriptionoftherecruitmentandselectionprocessiscorrectatthetimeofgoingtopress(July,2010),butitisimportantthattraineesrefertotheMMCandnationalmedicalcareerswebsitetokeepabreastofanymorerecentchanges.
Stage 2 – Career Exploration
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And in future years?Itisnotpossibletoprovidedetailsoftherecruitmentandselectionprocessesthatwillbeusedbyparticularspecialtiesastheyarecontinuingtoevolve.Howeveritispossibletomakesomegeneralcommentsthatshouldstandthetestoftime.
1. Keep on top of the system
Post-foundationtrainingcontinuestodevelopandchangeandtheonlywayyoucanensurethatyouarenotdisadvantagedbyfailingtofindoutaboutcriticalinformationistocarryoutregularchecksonsixdifferenttypesofwebsite:
a TheModernisingMedicalCareerswebsite(www.mmc.nhs.uk)whichproduceskeydocuments,outliningandupdatingdetailsofpost-foundationtraining,e.g.applicanthandbookandpersonspecificationsforeachspecialty
b TheMedicalCareerswebsite(www.medicalcareers.nhs.uk)whichcontainsinformationaboutspecialtiesandarangeofcareerplanningtoolsandresources
c Deanerywebsites,ofanyDeaneriestowhichyoumightapply
d RoyalCollegewebsite,ofanyspecialtiestowhichyoumightapply
e GPrecruitmentwebsiteforopportunitiesinGPspecialtyprogrammes
f NIHRwebsiteforopportunitiesinacademicmedicine,e.g.AcademicClinicalFellowships
2. Begin early
Don’tleaveyourcareerexplorationtothelastminute.Thishasneverbeenawisestrategybut inthecurrentsystemofflux it isparticularlyunwise.Instead,fromthetimeyoustart inyourfirstfoundationpostyoushouldberegularlycarryingouttheself-assessmenttasksdescribedinthepreviouschapter,andthecareerexplorationtasksdescribedinthischapter.
3. If you are uncertain – ask for help
Asajuniordoctoryouwillhaveaneducationalsupervisor,aswellasaccesstootherseniorclinicianswithadditionaleducationalresponsibilitiessuchastheDirectorofMedicalEducationorCollegeTutor. Ifyouareunsureabouttheimplicationofwhatyoureadonthesedifferentwebsites(orinthemedicalpress),thenaskforclarificationfromoneofthesepeople.Itisknownthatthesystemisparticularlyconfusingatthemoment,anditisbettertoseekclarificationearlyon,ratherthanwaituntilthepointwheneverybodyisfillingintheirapplicationforms.
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41Preliminary research tasksThesortsofissuesthatyoumightwanttobeginbyresearching(andinfactyoumaycarryoutthismorebasicdesk-boundresearchforanumberofdifferentoptions)includethefollowing:
Entrycriteriatothespecialty:thisisclearlylaidoutinthepersonspecificationswhichareavailableontheMMCwebsite.YoucanthenreviewyourStage1assessmentsagainstthepersonspecification,toseeifthereisaclosefit,orifthereareanyskillsorexperiencesthatyoumightneedtoacquire.
Ifyouarenotcurrentlyonafoundationprogramme,youneedtocheckthatyouareapplyingforentrytothecorrectlevel.YoureducationalsupervisororClinicalTutorshouldbeabletoadviseyouonthis.Alternativelyyoucancontactthecareersspecialistsatyourdeanery.Ifyouhaveaveryunusualquery,youcanalsoemailtheMMChelpdesk:[email protected]
Theapplicant’sguidetoSpecialtyTraining(availableontheMMCwebsite)containsdetailedadviceforoverseasapplicants,anditisimportantthatalloverseasapplicantsreadthisinformationcarefullybeforesubmittinganapplication.AndifyouhaveanyqueriesthecareersspecialistsatyourdeaneryortheMMChelpdesk(seeabove)shouldbeabletohelp.OverseasapplicantsshouldchecktheMMCwebsiteregularly,sotheykeepuptodatewithanychangestothelaw.
The C word (Competition)Inthepastitwasverydifficulttogetinformationabouttherelativecompetitivenessofdifferentspecialties.Oneofthedeaneries(theWestMidlands)pioneeredtheproductionofdataonthecomparativecompetitivenessofdifferentspecialties,butthesewerelocalratherthannationalfigures.Nationaldatafromthepreviousroundofrecruitmentarenowavailable(typicallyontheMMCwebsite)anditisimportantthatyoufamiliariseyourselfwiththisinformation.Informationaboutworkforceplanningdataisavailableonthenationalmedicalcareerswebsite(www.medicalcareers.nhs.uk).
Youalsoneedtodiscussthepossibleimplicationsofthecompetitivenessofyourspecialtychoiceswithyoureducationalsupervisor.
Stage 2 – Career Exploration
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Beyond preliminary researchSomeofyoumayknowimmediatelywhichoptionsyouwanttoexplorefurther.Ifthisappliestoyouthenskiptothenextsection.Butothersofyoumaybefarlesssure.
Ifyoufallintothislattercategory(i.e.youdon’tknowwhichoptionstoexploreindepth),thenthefollowingsuggestionsmighthelp:
1.Completearelevantpsychometricinstrumentinordertogeneratelistsofspecialtiesthatmightsuityou.(Remember,though,thatinthepreviouschapteritwasarguedinsomedetailthatresultsfrompsychometricinstrumentsshouldneverberegardedasnarrowlydiagnostic.)
2.DiscussyourStage1summarywithyoureducationalsupervisor,clinicalsupervisor,theClinicalTutor/DirectorofMedicalEducationortheFoundationProgrammeTrainingDirector,toseeiftheycanhelpyouwithideasofcareerstowhichyoumightbesuited.
3.ReadthroughoneonthespecialisedmedicalcareerhandbookbooksmentionedinAppendixBandreviewthespecialtyinformationprovidedonthemedicalcareerswebsite(www.medicalcareers.nhs.uk).Fromthese,chooseanumberofcareeroptionsthatseem,oninitialreading,tobeinteresting.
4.SearchthroughtheBMJCareerswebsitewhichcontainnumerousarticlesoncareersindifferentspecialties.
5.CheckthewebsiteofdifferentDeaneriestoseewhatinformationtheyprovideaboutthedifferentspecialtiesintheirregion.
Isn’t there another way of identifying suitable careers?Perhapsyouaresurprisedthatthereisn’tamore‘scientific’methodthanthesuggestionslistedabove.Butbasedonourprofessionaltraining,andalsoonourexperienceofhelpingpeoplemakegoodcareerdecisions,weknowthatthisprocessisasmuchanartasitisascience.Socalled‘scientific’approaches(particularlytheuseofpsychometricinstruments)canbeusefulingeneratingideas,buttheydon’tholdalltheanswers.Andoftentheanswersstarttoemergethroughfollowingupthesuggestionsofcolleaguesandsupervisorswithwhomyouhaveworked,coupledwithafairsmatteringofbackgroundreading.
Andfinally–ifyouhavedonealloftheabove–andnothinggrabsyourattention,perhapsyouneedtoaskyourselfwhetheryouactuallywanttoremaininmedicine.Ifthisisthecase,westronglyrecommendthatyou
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43eitheraskforareferraltothespecialistcareersadviser(ifyourdeaneryhasone),oryouseekoutsomeprivatecareercounsellingwithanappropriatelyqualifiedcareerscounsellor.
(SeeAppendixAforalistoforganisationsthataccreditcareersprofessionals.)
How to research options in further depthHavingdecidedwhichoptionsyouwishtoexplorefurther,youthenneedtoworkoutwhatitisyouwishtofindout,andhowyouwillgoaboutdoingso.
Often,thebestwaytofindoutmoreaboutaparticularcareeroptionistotryitout,asoneofyourfoundationprogrammeplacements.Butifthisisnotpossible(eitherbecausethespecialtyyouareinterestedindoesn’tofferfoundationplacements,orbecauseyouweren’tsuccessfulingettingtheplacementyouwanted),thenseeifyoucanarrangea‘taster’weekideallyearlyinyourfoundationyeartwo.AgoodplacetostartwouldbetodiscussthiswithyoureducationalsupervisorandFoundationProgrammeTrainingDirector.
Informational interviewingLookatthesummaryyouconstructedattheendofStage1.Foreachofthefivedifferentsections,writedownalistofspecificquestionsthatyouaregoingtoaskofthepersonwhois(orpeoplewhoare)currentlyworkingintheoptionsthatyouareinterestedin.
Youthenneedtoidentifyatleastoneperson(andpreferablymorethanone)workinginthatspecialty,inordertoputthesequestionstothem.Askyoureducationalsupervisorforsuggestionsastowhomyoucanask.Inaddition,youcanapproachcollegetutors.Itishelpfulifyouareabletotalktopeopleatdifferentlevelsofseniority,soaskamongyourfriendstoseeiftheyknowSpRsorconsultantsworkinginyourfieldofinterest.
Finally,setyourselfasuitabletimescaleinwhichtheseinterviewswillbecarriedoutandarrangetodiscussyourfindingswithyoureducationalsupervisor,orotherexperiencedclinician.
Stage 2 – Career Exploration
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Person, phone or email?Ideallyyoushouldtalktopeoplefacetoface.(AndsomeDeaneriesorganisecareersfairswhereyoucantalktopeopleinallsortsofdifferentspecialties,andtheBMJCareersFairsarealsousefulwaysoftalkingtopeopleinparticularspecialties.)
ClearlyifyouaredoingafoundationplacementinalargeteachinghospitalyouwillhaveeasieraccesstoabroaderrangeofspecialtiesthanifyouareinaspecialisedpsychiatrichospitalorasmallerDistrictGeneralHospital.Ifyoucan’tmanageaface-to-faceinterview,thenseeifyoucanarrangetotalktosomebodyonthephone.
Andifallelsefails–emailpeople,andaskifyoucansendthemalistofquestions.
Butwhateveryourmodeofcommunication,youneedtoapproachthetaskofinformationalinterviewingasanimportantresearchproject.Youarenothavinganaimless‘chat’;instead,youaretryingtogetanswerstosomeofthequestionsthathaveemergedfromtheStage1self-assessment.
(BeawarethatsomeoftheresponsestoquestionswillbequitesubjectiveThereforeitisusefultospeaktomorethanoneperson.Findoutwhattheintervieweeenjoysabouttheirwork.Notonlyisthisinterestinginformationtoelicit,butiftheygiveyouaverycynicalresponse,thenyouknowthatyoumightbegettingasomewhatjadedopinion.Andwhileitisclearlyimportanttogetabalancedratherthananoverlyglossyviewofthespecialty,youdowanttoavoidbeingturnedoffaspecialtybecauseyouhavetalkedtoaburnt-outclinician.)
Finally,it’sworthwhilegoingbacktothelibraryandspendingabitoftimewithyournoseinthejournals.Choosethemajorjournalsinyourspecialtyofinterest(ifyouareunsureaboutwhichjournalstheseare,askthelibrarian)andspendsometimehavingagoodreadthroughsomerecentissues.
Ofcourse,asyouhaven’tbegunspecialisttrainingintheseareas,manyofthearticleswillbetoospecialised.But,ingeneral,askyourselfwhetheryouaregrippedbysomeofthearticles,orwhethertheyleaveyousomewhatcold.
Inadditiontotherelevantjournals,youcanalsoaskthelibrariantodirectyoutosomeofthecoretextsinthefieldsthatyouareexploring.Andagain,poseyourselfthesamequestion.AmIreallyinterestedinreadingmoreaboutpsychiatry(cardiology,pathology,etc.)?Becauseifyouare,thatisagoodsign.Butifyouarenot(assumingthatyouhavechosenatextbookatapproximatelytherightlevel),thenyouneedtoaskyourselfwhetheryouaremakingagoodcareerdecision.
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45Reality check: is your career decision realistic?Thisisprobablythetrickiestissueofall.
Duringcoursesforconsultantsweoftengetaskedaboutthebestwaysofapproachingtraineeswhohave‘aninsightby-pass’.Andtheconsultantsthenstarttogivedetaileddescriptionsoftraineeswithseveredyspraxiawhowanttotraininmicro-surgery.
But,ontheotherhand,wealsooftenhearfromconsultantswhohadbeenadvisedatanearlierstageoftheircareerthat‘theywouldnevermakeit’asaradiologist,gastro-enterologist,etc.Andtheretheyare,15yearsintotheircareersasconsultantradiologistsorgastro-enterologists.Iftheyhadlistenedtothe‘advice’thathadbeengiventothemearlieron,theywouldhaveperhapsdeniedthemselvesthechanceofsucceedinginthecareerthattheyhadsettheirheartson.
Asatrainee,youhavetoaskyoureducationalsupervisorwhethertheythinkthatyourcareerplansarerealistic.(Andifyoureducationalsupervisorknowslittleaboutthespecialtyyouareconsidering,then,havingcompletedsomeofthecareerexplorationtasks,youshouldbeabletofilltheminwithdetailsofthepersonspecification,trainingpathway,competitionratiosetc.)
Clearlyiftheyfeelthatyourplansarerealistic,thenthereisn’taparticularproblem.(Althoughinthecurrentclimateoffluxyoushouldrealisethatthissupportfromyoureducationalsupervisordoesn’tguaranteethatyourplanswillbesuccessful.)
Butifyoureducationalsupervisorthinksthatyouarenotbeingrealistic,thenyouareinastickierposition,andyoushouldalwaystrytogetasmuchinformationaspossibleastothespecificnatureoftheirconcerns.
Ifyouthinkthattherehasbeenabreakdownofcommunicationwithyoureducationalsupervisorandthatyouhavebeenunfairlyjudged,thenyoucanasktodiscussyourplanswithanotherconsultant,orwiththeFoundationProgrammeTrainingDirector.(Inthefinalchapter,wewillrecommendtoallclinicianswhomaybetakingpartinthesesortsof‘secondopinion’meetingsthattheyalwayshaveacopyofallthepreviousassessmentsandalsoabriefreportfromtheeducationalsupervisor.)But,byallmeans,askifyoucanhavea‘secondopinion’fromanotherclinician.
Perhapsyoufeelthatyourdifficultiesinacertainplacementwereduetothingsgoingoninyourpersonallife,andyouareconfidentthatyoucouldhaveperformedbetterifcircumstanceshadbeendifferent.Ifatallpossible,discussthiswithyoureducationalsupervisororFoundationProgrammeTrainingDirector.
Stage 2 – Career Exploration
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But,ifyoufeelunabletodoso,thenthiswillbesomethingthatyoutakeaccountof,butisnotsharedwithyoursupervisingconsultants.
Ultimatelythedecisionastowhattoputdownonyourapplicationformisyourown.Andifyoudecidethatyoureducationalsupervisorisbeingunfairorundulypessimistic,thenyoucanofcourseactagainsttheiradvice.Butwewouldurgeyou,attheveryleast,torespondtoanycommentsthatyougetaboutnotbeingrealistic–bysayingtoyourself:‘HowdoIknowthatitisrealisticgiventhefeedbackthatIhavereceived?’Andyoushouldalsoaskyourself:‘HowamIgoingtobeabletoconvincetheshort-listingpanelandinterviewingpanelthatIamasuitablecandidate?’Toavoidchallengingyourselfwiththesetwoquestionsistoadopttheostrichapproach.And,asyet,therearen’ttoomanyostrichesinseniormedicalpositions.
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STAGE 3 OF CAREER PLANNING:
DECISION MAKING
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IV. STAGE 3 OF CAREER PLANNING: Decision Making
OverviewThischapterguidesyouthroughthedecisionmakingprocess.
Therearethreeexercisesinthischapter.Thefirst(‘ConstructingaLifeline’)providesyouwithanopportunitytoreviewsignificantdecisionsthatyouhavemadeinthepast.Thesecond(‘TheDecisionTemplate’)offersastructuredapproachforcomparingthedifferentoptionsthatyouarecurrentlyconsidering.
Butwhatevermethodyouuse,bytheendofStage3youwillneedtohavereachedadecisionaboutwhichoption(oroptions)youwillbeapplyingfornext.
ThethirdexerciseinvolvesyouusingtheROADSacronymtochecktherobustnessofyourcareerdecision,andthechapterendswithbriefadviceforthoseofyouwhoarefindingitdifficulttomakeupyourmind.
Exercise 1: constructing a Lifeline
Instructions for exercise 1Thinkabouthowyouhavemadeimportantdecisionsinthepast:forexample,career-relateddecisionsaboutA-levelsubjects,applyingformedicalschool,electivechoices,etc.,orpersonaldecisionsthatareunrelatedtowork,suchastakingagapyearbetweenschoolanduniversity,startingorendingasignificantpersonalrelationship,etc.
Then,followtheinstructionsbelow.(AndseeFig.2foranexample.)
1.Takeasheetofpaper(ideallyA3orflipchartpaper.ButA4willworkifitisallthatisavailable).Turnitroundsothatitis‘landscape’ratherthan‘portrait’.
2.Drawahorizontallineacrossthemiddleofthepaper.Notedownyourageattheright-handendoftheline.Then,putina‘plus’(+)abovethehorizontalline(tosignifytimesthatyoulookbackonwithpleasure)anda‘minus’(-)belowtheline(tosignifythosetimeswhenthingswerenotgoingwell).
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493.Beforeyougoanyfurther,thinkverycarefullyaboutthecoursethelinewilltake.Wherearethehighpointsandthelowpoints?Whichpartsoftheline(ifany)arerelativelystable?
4.Nowmarkinthesignificantlifeevents.Includeexperienceswhichinfluencedyou,achievements,andbothgoodandbadeventsthathaveoccurredinyourlifetodate.Allowyourselfsufficientspace,asincludingoneeventmaytriggeramemoryofanother.
5.Connectupthepointsthatyouhavemarked.
6.IdentifyacoupleofdecisionsthatyouhavemarkedonyourLifelinewhichyoufeel(inretrospect)haveworkedoutwell.Whatmadethemgooddecisions?Howdidyougoaboutmakingtheseparticulardecisions?
7.Now,identifyacoupleofdecisionsonyourLifelinethatyoufeel(inretrospect)didn’tworkoutsowell.*Whatmadethempoorerdecisions?Howdidyouapproachthesedecisionsthatdidn’tworkoutsowell?
8.Amuch-favouredadageofpsychologistsisthatthebestpredictoroffuturebehaviourispastbehaviour.Bearingthisinmind,canyouusethisanalysisofpastdecisionstothrowanylightonhowyoushouldapproachthecareerchoicesthatyouarecurrentlyfacing?(Onewayofdoingthisistolookatyouranswerstoquestions6and7inordertoidentifythebestwayforyoutoapproachyourcurrentdecision,aswellasapproachesyoushouldavoid.Forexample,doyouseemtobesomebodywhomakesgooddecisionswhenyourelyonyour‘gut’feelings,orareyousomebodywhohasmadeyourbestdecisionswhenyouadoptamorestructuredapproach?)
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* When we have used the Lifeline exercise in workshops (with both consultants and trainees), we have often heard the comment that there is no such thing as an entirely ‘bad’ decision, as good elements can emerge even from decisions that didn’t turn out at all smoothly. We would both entirely agree with this, and have examples from our own personal career histories that illustrate the point. Moreover, in our professional practice we often hear clients describe career decisions that they regret taking, but which they do realise also allowed them to develop certain useful skills. However, in terms of the Lifeline exercise, we do think that it is possible to identify decisions that you have taken that, in retrospect, you feel were not the best ones. These are decisions where, even though you can see that some good things have emerged from them, you have a sense that a different decision at that point in your life would probably have been a better option. It is these sorts or decisions that we would like you to identify in question 7.
Stage 3 – Decision Making
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9.HasanythingelsestruckyoufromcompletingthisLifelineexercise?(Andincaseyoudon’tunderstandthisquestion,itmighthelpifwegiveyouanexampleofthesortofinsightthatcanemerge.Oneofusonceranatwo-daycareer-planningworkshopforahousingassociationthatwasmakingalargenumberofstaffredundant.Thestaffattendingtheworkshopwere,forentirelyunderstandablereasons,angry,de-motivatedandanxiousaboutthefuture.Oneparticularmemberofstaffwasverywithdrawnduringthefirstdayoftheworkshop,andwasreluctanttocontributetothediscussions,orcompleteanyoftheactivities.FollowingtheLifelineexercise,therewasanoticeableshiftinhisattitude.Whenthefacilitatorremarkedonthis,andenquiredwhathadhappened,thememberofstaffrepliedthathehadfeltoverwhelmedbytheforthcomingredundancy,andhadconvincedhimselfthathewouldn’tgetanewjob.Butwhenhereviewedhislifelineasawholeherealisedthatthecurrentdilemmawasjustoneofaseriesofobstaclesthathehadfacedinhislifeand,ashehadovercomethepreviousones,henowfeltmoreconfidentthathewouldn’tbedefeatedbytheforthcomingredundancy.Thisisjustoneexample.ButitgivesaflavourofthesortofinsightsthatsometimesemergefromtheLifelineexercise.)
Figure 3 Lifeline Example from a consultant
+
__ _
_
+
+ +
Diagnosed withchildhood RA(RheumatoidArthritis)
Accepted forCambridge
Good
decis
ion
Marry, LifetimeFriendSupport
Work innegativeunrealisticexpectation ofspecialty-wrongarea, wrong specialty
Appointed asgeriatric trainee.Good decision!
Appointed as consultant
DeaneryPost!
Post too busyReduced supportPressure toorganise research
Correctcareerchoice!
0 7 26 27 29 34 48 50
Age
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51Exercise 2: a more structured approach to decision making
Instructions for Exercise 2IftheresultsfromtheLifelineexercisesuggestthatyouwouldbenefitfromamorestructuredapproach,thenyoumightfindtheexercisebelowhelpful.
1.WithreferencetotheStage1Summary,andusingthefiveheadings(Doctor-PatientRelationship,IntellectualMatters,Status,QualityofLifeandRelationshipswithColleagues),writedownyouranswerstothequestionslistedinFig3.Then,alongthetop,writedowntheparticularcareeroptionsthatyouarecurrentlyconsidering.(Ideally,thisshouldnotbemorethanfour,asotherwisethedecisionmakingbecomesratherunwieldy.)
2.WithreferencetoyourStage2research,notedownwhetheragivenfactor(e.g.seeingpatientsinacommunitysetting;continuityofpatientcare,etc.)ispresentorabsentinthedifferentspecialtiesyouareconsidering.
3.Countingthenumberof‘ticks’ineachcareeroptionmaywellbemisleading,becausethedifferentfactorsarenotnecessarilyofequalimportance.Instead,wewouldsuggestthatinitiallyyou‘eyeball’thechart,andseewhatconclusionsyoureach.Havingdonethat,wewouldrecommendthatyoudiscussthechartwithsignificantpeopleinyourlife(partner,family,closefriends),andalsowithyoureducationalsupervisor,oranotherclinicianwhoknowsyourclinicalwork.Inthisway,thebestcareerdecisionshouldbecomeclearertoyou.Inthisexercisewehaven’tincludedtheprecisedetailsofhowmanyoptionsyouhavetochoosefromatanyparticularstage(i.e.thedetailsofapplicationforfoundationyear1orpost-foundationtraining).Wecannotgazeintoacrystalballandpredicttheprecisedetailsoftheapplicationprocessintofoundationyear1,orintopost-foundationtrainingthatwillbeinplacenextyear,letalonetheyearafter.Thuswetookthedecisiontodescribeagenericapproachtodecisionmakingwhichcanbeappliedtoanysituation.
Stage 3 – Decision Making
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Figure 3: Exercise 2 – Questions to consider for each option1.Doctor-patientrelationship Options
(pleasetick)
1 2 3
Doyouwanttoseepatientsincommunityorhospitalsetting?
Do you enjoy brief encounters with patients,or providing continuity of care over long periodsoftime?
Do you want to spend most of your working dayhavingcontactwithpatients?
Do youwant toworkwith acutely ill or chronicallyillpatients?
Whatabouttheemotionallandscape?(Forexample,doyoufinditrewardingworkingwithpatientswhoareinadistressedordisturbedemotionalstate?).
Do you have preferences about the ages of yourpatients?Anddoyoupreferworkingwithindividualpatients,orpatientsandtheirfamilies?
Doyouwanttocontributedirectlytothetreatmentofpatients,orwouldyouenjoyworkingtosupportthediagnostic process (e.g. in areas such as diagnosticradiologyorpathology)?
Wouldyouenjoyhavingtoconsiderthewholeofthepatient’sbody,(e.g.asaGP/paediatrician),orwouldyouenjoybecominganexpertonaspecificregionofthebody(e.g.ophthalmology)?
Do you enjoy performing technical diagnostic orinterventionalprocedures?
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532.Intellectualmatters Options(pleasetick)
1 2 3
Whatareasofacademicworkhaveyoumostenjoyedstudying in your undergraduate and postgraduatetraining?
What medical journals are you most drawntoreading?
Within the BMJ, what sorts of articles tend toattractyourattention?
What subjects have you enjoyed (or might you infutureenjoy)teachingtoothers?
What subjects have you enjoyed (or might youenjoyinfuture)carryingoutresearchon?
What subjects have you carried out an auditon (or might you plan to carry out an audit oninthefuture)?
3.Status Options(pleasetick)
1 2 3
Howimportantisittoyouthatyouworkinahighlycompetitivebranchofthemedicalprofession?
Howimportantisstatustoyou?
Doyouwant toensure that thereareopportunitiesforprivatepracticeinyourchosenspecialty?
Doyouwanttogointoabranchofmedicinewherethereisthepotentialforearningaveryhighsalary?
Isitimportanttoyouthatyouhaveopportunitiesforparticipatinginresearch?
Are opportunities for travelling abroad with yourworkimportanttoyou?
Stage 3 – Decision Making
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4.Qualityoflife Options(pleasetick)
1 2 3
Whatsortofwork-lifebalancedoyouwanttohavein5-10years’time?
Whatsortofweeklyschedulewould liketohave in5-10years’time?
What,foryou,areyourcoreworkvalues,fromwhichyouderivemostsatisfaction?
What stressful factors do you want to minimise atwork?
Is the length of post-graduate training an issueforyou?
5.Relationshipswithcolleagues Options(pleasetick)
1 2 3
Doyouwanttobeabletospendquiteaportionofyourdayworkingonyourown?
Doyouwanttobeabletospendquiteaportionofyourdayworkinginteams?
Doyouenjoyworkinginmulti-disciplinaryteams?
Do youwant to be able to develop andmanage aclinicalservice?
Doyouwanttobeabletodoquitealotofteaching?
Doyouwanttobeabletocarryoutresearch?
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55Crunch Time: Making the DecisionFromExercise2youshouldhavegotsomesenseofwhathashelpedyoutomakegooddecisionsinthepast(andperhapstoo,offactorsthathavecontributedtoyoumakinglesssuccessfulchoices).ItisworthbearinginmindKrieshok’sfindings(mentionedinChapter2),thatintuitioncanalsobeimportantincareerdecisionmaking.ButitisalsonecessarytobeclearaboutwhatKrieshokissayingwhenhedescribesintuitivedecisionmakingprocesses.Hecertainlyisn’ttalkingaboutcrystalballornavel-gazing.Insteadhearguesthatthewaytohelppeoplemakegoodcareerdecisionsistoencouragethemtogetstuckindifferentcareer-relatedactivitiesandthenstepbackandreflectontheexperience.Atthispoint(andnotbefore)–astrong‘gutfeeling’thataparticularoptionisright(orforthatmatterwrong),maywellbeofvalue.
Exercise 3: how robust is your career decision?ThefinaltaskthatwewouldencourageyoutocarryoutistointerrogateyourcareerdecisionusingtheROADSchecklist.Initiallywewouldsuggestthatyoushoulddothisonyourown.Butthenyoushouldtalkthroughyourconclusionswiththesamepeoplelistedabove.(And,ofcourse,theresultsofallthreeexercisesdetailedinthischaptercouldbediscussedwiththerelevantpeopleononeoccasion,oronseparateoccasions,dependinguponyourownparticularcircumstances.)
Good career decisions: ROADS
Realistic–areyoubeingrealisticaboutyourselfANDthedemandsofthejob?
Opportunities–haveyougivenseriousconsiderationtoalltheopportunitiesavailable?
Anchors–haveyoubuiltinthethingsthatprovidesupportinyourlife?
Development–doyourchoicesfullydevelopyourpotential?
Stress–haveyouconsideredthoseaspectsofworkthatcreateparticularstressesforyou?
Stage 3 – Decision Making
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If you can’t make up your mindThereareanumberofpossiblereasonswhyyoumightstrugglewithadecision.(Andinfact,thesereasonsarenotmutuallyexclusive.)
1.Youarestillunclearaboutyourskills,interests,achievements,values,etc.
2.Yourcareerresearchtodatehasn’tenabledyoutobecomemoreclearabouttheextentofthe‘match’betweentheworkfactorsthataremostimportanttoyouandthedifferentcareeroptionsthatyouarecurrentlyconsidering.
3.You’vegonethroughStages1and2thoroughlybutyoustillcan’tmakeupyourmind(perhapsbecauseyouaresomeonewhoalwaysstruggleswithdecisions).
4.Youareuncertainwhetheryouwishtoremaininmedicineatall.
If1and/or2applytoyou,andyouhaven’treallydevotedmuchtimetoworkingthroughthestructuredexercisesoutlinedinthishandbook,thenitmightbeusefulforyoutogobackanddoso.Butif3applies(i.e.youhavecompletedtheexercisestothebestofyourability,anddiscussedthemwithyoureducationalsupervisor,butyoustillcannotdecide)wewouldadviseyoutoaskforareferraltothedeanerycareersteam.
Andif4applies,thenwewouldstronglyrecommendthatyouseekprofessionalhelpfromanexperiencedandappropriatelyqualifiedcareersprofessional(seeAppendixA).Bothofushaveexperienceofworkingwithindividualswhofallintothiscategory,andasaresultweknowthatthedecisiontoleavemedicineisamajorone,andthattheindividualsconcernedhaveenormouslyappreciatedtheinputfrompeoplewhohaveaprofessionalgroundingincareerplanning.
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57Some final thoughtsAnumberofclinicalcolleagueshavegivenustheirinsightsintothedecisionstheymadeontheirspecialtychoice–seeTable2below.
Table 2: specialty choice – some reflections from some consultants and a GP
“ I have made a sequence of specialty decisions throughout my career and I realise that where I am now could have been reached by several different routes. My decision to go into anaesthesia was because it combined an in-depth knowledge of physiology with practical skills and I loved the specialty. The challenge of intensive care took the knowledge and skills combination to a new level for me with the additional elements of teams working together in a critical situation and communicating with patients and their families. Then, when an opportunity to develop my interest in medical education came along, I jumped at it. Certainly, my career plans have changed with my circumstances, the system and the opportunities available.”
“ I enjoy new challenges; being open to changes and flexible enough to take advantage of them is important to me… Nothing stands still; my career has been a fantastic journey – and it still is!”
“ My career owes more to serendipity rather than planning, and I am grateful that medicine has supplied me with so many diverse opportunities… Advice? Think about what you like doing and how to engineer change. If you consider that something could be done better, make constructive suggestions and ask for support to improve it. Be aware, though, that you will probably end up running it and more…”
“ I have been a consultant anaesthetist for just over 20 years. During that time my clinical work has changed and evolved giving me the opportunity to develop and improve services for patients, and participate in training new entrants to my speciality. My non-clinical work has enabled me to be involved in postgraduate medical education and NHS management, as well as contribute to national organisations and specialist societies.
Stage 3 – Decision Making
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Many of the roles I have undertaken have come about because I have volunteered and got involved in areas not traditionally associated with my clinical role in a District Hospital in Wales. I have found that if you feel strongly about a subject, are enthusiastic and demonstrate a willingness to work hard and implement change, all sorts of things are possible. My career is always developing and has plenty of challenges – six years ago I was the President of the Medical Women’s Federation and Flexible Training advisor to the Royal College of Anaesthetists. Today I am an Associate Dean for Careers and Less than full-time training in Wales and a Special advisor – Careers to the UK Foundation Programme Office. I even went back to formal study and obtained a PG certificate at the age of 53. Who knows what tomorrow may bring, Finally, my supportive partner and children have certainly helped along the way.”
“ I am a geriatrician. Like most of us, I think I made my decision quite late as I realised that I liked general medicine and didn’t really want to specialise. I was also very aware of a work-life balance. I think I would have been happy in most specialties – most of us enjoy having specialist knowledge and being able to make a difference.”
“ When I commenced my PRHO year, I had been quite determined to become a surgeon. During my stint in surgery, this interest strangely ebbed and disappeared, perhaps out of a realisation that I did not possess the appropriate mindset. I then considered paediatrics, which I had enjoyed as a medical student, but had concerns with pursuing, having had little personal experience of dealing with children. Two weeks as a PRHO in paediatrics proved sufficient to rekindle this interest and any anxieties were dissipated by paediatric trainees, who advised me to trust natural paternal instincts! Twenty-six years on, I have no regrets whatsoever.”
“ You may want to use my quote as an example of how not to do it. I applied for chest medicine in the early 1980s for two reasons. Firstly, I and my contemporaries were assured that there would be lots of jobs in chest medicine in the late 1980s, when all the chest physicians appointed shortly after World War II to sanatoria posts would be retiring, and, secondly, I thought that my father, who died in my first year at medical school, was a chest physician and I wanted to follow in his footsteps. The sanatoria were closed down in the mid-1980s, and so jobs were extremely scarce in the late 1980s, and it turned out that my father was a cardiologist!”
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59“ I made my specialty choice largely on the basis of work-life balance. I wanted a career that in the future would be flexible enough to fit around having children and possibly moving around the country (depending on my husband’s work). This sounds quite old-fashioned and unambitious, but having subsequently gone on to be involved in running the GP Flexible Career Scheme, I know it is something a large proportion of female (and some male) doctors aspire to once the reality of having children hits home. It is very hard when choosing a career path in your mid-20s to think ahead to having a family, but I would encourage anyone who wants to do so (and has a partner with a career) to talk to as many doctors as they can who have attempted to combine career and family. I suspect many wish they could work part-time, but have been unable to do so in hospital specialties. As a GP you maintain ultimate responsibility for the care of the whole patient and the role has endless variety and stimulation. It is sometimes possible to negotiate a contract for “school hours only” for a few years, which is invaluable if you have small children and a partner who works long hours.”
“ There are also many opportunities for outside interests; I have been able to develop a career as a GP educationalist while my children are still young, doing much of my work in the evenings when they are in bed and fitting the rest around school runs, sports days and all the rest of family life. It was definitely the right choice for me.”
Stage 3 – Decision Making
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STAGE 4 OF CAREER PLANNING:
PLAN IMPLEMENTATION
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V. STAGE 4 OF CAREER PLANNING: Plan Implementation
OverviewThischaptercoversthenitty-grittyofputtingyourplanintoaction.Itbeginswithadescriptionoftheapplicationprocess,andthenincludesdetailedadviceonhowtofillinapplicationforms.Inaddition,CVguidelinesareincludedinAppendixC.Thechapterthenmovesontoexplainingpreparationyoucandoinadvanceoftheinterview,andalsocoversadviceonperformingwellontheday.
SomespecialtiesalsorequireapplicantstomakeapresentationaspartoftheinterviewprocessandwehaveincludedsomebasicguidelinesongivinganinterviewpresentationinAppendixD.
Thischapterendsbyreferringtosomecontemporaryresearchoncareerplanningwhichhighlightstheroleofluckandchance.Inendingthechapterinthiswaywearenotsuggestingthatyoucanrelyonstrikingitlucky–butatthesametime,theresearchdoesflagupthealmostinevitableinfluenceofchancefactorsinlifelongcareerplanning.
Application formsInrecentyearstherehasbeenanenormousshiftintheapplicationprocess.Notsomanyyearsagoapplicantsfilledinastandardhospitalapplicationform(whichwasoftenthesameforadministrative,clericalandallhealthcarestaff),andtheyalsoincludedaCV.Intheoldsystemverylittleweightwasattachedtothebriefpersonalstatement’onthestandardapplicationform,andeverythingwentontheCV.
Buttimeshavechanged,andstructuredapplicationformshavelargelyreplacedCVs.Oneofthedifficultiesinthischangeisthatsomeconsultantshaven’tquiteregisteredthisit.Thismeansthattheymightnotalwaysprovidethemostusefuladvice.Itislikelythatapplicationformswillcontinuetoevolveandshort-listingwillprobablystilltakeplaceonthebasisofsomesortofstructuredform.Sothinkingabouthowbesttoapproachtheseformsisstillanecessarytask.
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63Initial preparationAlthoughinthecurrentsystemyoudon’thavetocompletetheapplicationinonesitting,itstillhelpsifyouarethoroughlypreparedforwhentheapplicationprocessgoeslive.
Oneusefulwayofmakingthetaskoffillingintheseformseasieristoprepareanup-to-dateCVinadvance(seeAppendixC).Thismeansthatallthebackgrounddata(datesofexams,ofelectives,ofdifferentposts,etc.),iswellorganisedinadvance,andinoneplace.
Intermsofhelpingyouanswerthemorediscursivequestionsontheforms,theanswerstotheexercisesthatyouhavecompletedinthishandbookshouldprovidegoodrawdata.Inaddition,juniordoctorswillalsoneedtorefertotheirlearningportfolios,whilesomemedicalstudentswillhavesimilarcollectionsofreflectivewritingthattheyhadtofillinfortheirundergraduatecourse.Thebetterorganisedyouarewiththesethreedocuments(i.e.yourCV,youranswerstotheROADSexercisesandyourlearningportfolio),theeasieryouwillfindthetaskoffillingintheapplicationform.
Overview of the application processAsdescribedinchapter3,specialtyrecruitmentiseithernationallyordeaneryleddependingonthespecialty.Whatthismeansisthatyouhavetofamiliariseyourselfwiththedeanery,RoyalCollegeandMMCwebsites,inordertobeontopoftheprocessusedinthespecialtiestowhichyouintendtoapply.Ifyoulookatthesewebsitesyouwillfindoutwherethepostsareadvertised.Inaddition,youwillalsofindoutaboutthetimelineforapplications.Thesedatesareimmutableandyouwanttobeawareoftheminadvance,sothatfillingoutyourapplicationformsdoesn’tbecomeahorrendouslast-minuterush.Thisisparticularlyimportantifyouintendtosubmitanumberofdifferentapplications.
Adetailedapplicant’sguidetospecialtyrecruitment,toassistapplicantswiththeprocess,isavailableontheMMCwebsite.YouwillneedtomakesureyouhavereadthroughthisguideandthoughtaboutitsimplicationsassoonasitismadeavailableontheMMCwebsite.
Stage 4 – Plan Implementation
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Figure 4: Overview of the application process for foundation and specialty training programmes
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65Some golden rulesManyofthepointslistedbelowwillseemobvious.Butoneofushashadexperiencescoringapplicationsforfoundationprogrammes(andtheotherhasconsiderableexperienceofmedicalrecruitmentandselection,particularlyatconsultantlevel)–andbothofusknowthatanumberofapplicantsdisregardsomeofthesebasicpoints.
1. Preparation, preparation, preparationMakesurethatyouunderstandthepracticalitiesoftheapplicationprocess.
Thisinvolvesreadingthroughthewholeformextremelycarefully.Whenisthedeadline?Lookingatallthequestions,howlongmightittakeyoutodevisereallygoodanswers?Willyouneedtofindadditionalinformationthatyoudon’tyethavetohand?
Youshouldn’tstartansweringanyquestionuntilyouhavestudiedthewholeform,becauseanexamplethatyougiveforonequestionmightbeonethatyoufindyouwanttore-useforasubsequentquestion.
2. Understand what the recruiters are looking forFamiliariseyourselfwiththepersonspecificationforthetrainingpostasshort-listingwilltakeplacewithreferencetothisspecification.(Afterall,youmightbakethebestchocolatechipcookiesontheplanet,butiftherecruitersaren’tlookingforchocolatechipcookiebakersitprobablywon’tdoyouanygoodtosayso.)Youalwayshavetoconstructyouranswerstothequestionswiththepersonspecificationinmind.(Butthisdoesn’tmeanasimplereiterationofthepersonspecificationonyourapplicationform.Thatapproachbecomesextremelytiresomeforthereader.)
3. Check, check, and then check againMistakes(inspellingorgrammar)willmakeitharderforyoutogetyourpointsacrossandcanleadtothelossofmarks.Youmightfeelthatthisisunfairasyouareapplyingtoworkasadoctor,notanEnglishteacher.Butwewouldcounter-arguethatthedifferencebetween0.25and0.025mgforaparticularmedicationcouldbeamatteroflifeanddeath.Attentiontodetailmatters,andbeingsloppyonyourformwon’thelpyougetyourmessageacross.
4. A note about plagiarismTherehavebeenanumberofcasesrecentlywhereapplicantshavebeenreferredtotheGMCforplagiarism.Sobearinmindtheguidancegivenin‘GoodMedicalPractice’that:‘Youmustbehonestandtrustworthywhenwritingreports,andwhencompletingorsigningforms,reports
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andotherdocuments.’Italsogoesontosaythat:‘Youmustalwaysbehonestaboutyourexperience,qualificationsandpositions,particularlywhenapplyingforposts.’
Completedapplicationformswillbecheckedforplagiarismandtheanswersontheformmustbeyourownratherthancopiedfromtheworksofothers.Usingacommercialservicetoprovideanswersforyourformswouldnotberegardedascompatiblewiththerequirementthatyouwritetheanswersyourself.Andifthecommercialservicesendupwithanumberofapplicantswritingverysimilaranswers,thenthisisthesortofsituationthatmightbedetectedbytheanti-plagiarismsoftware.
Theissueofhowmuchhelpfriends/supervisorscanresponsiblygiveyouisafargreyerarea.ButinChapter6(thechapterforeducationalsupervisors)weadviseconsultantstogiveyougeneralfeedbackratherthanmentioningspecificwordingthatyoushouldincludeontheforms.
How to approach the short-answer questionsTherewillbeanumberofquestionsontheformthatrelatetothepersonspecification.Youcould,forexample,beaskedaboutyourexperienceofteam-working,leadership,time-management,makingdifficultdecisions,oryourlongertermcareerplans.
Typically,thespacetoanswerthesequestionsislimitedtoaspecificwordcount.
Someconsultantsmayberelativelyunfamiliarwiththesesortsofquestions,andmaystrugglewithgivingyouthebestadvice.(Certainly,theadvicethatyoucandashoffanyoldanswer,becausethesequestionsaren’tthatimportant,isnotadvicethatyoushouldfollow.)
1.Asawayofpreparingtowriteyouranswer,youmightwanttousetheSTARstructure.Bythiswemeanyoucouldbreakdownyourexampleinto:Situation/Task Provideaconciseoverviewoftheexampleyouareconsideringusing,ensuringthatitisrelevanttothequestion. Actions Whatexactlydidyoudo?Whatwasyourroleandcontribution?Whatskillsdidyouuse?(Thispartwillprobablyformthebulkofyouranswer.) Results/Reflection Whatwastheoutcome?Whathaveyoulearntfromit?
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67TheSTARacronymisaveryusefulwayofanalysingtheexamplesthatyouintendusingintheshort-answerquestions.However,dependingupontheactualwordingofthequestion,youmightnotactuallyincludeallthedifferentparts,oryoumaywanttoemphasiseonepartmorethananother.SointheactualansweryouwillhavetotailortheSTARcomponentstothespecificsofthequestion.ButSTARisanexcellentstartingpoint.
2.Asmentionedabove,gathertogetheralltherelevantpersonaldatathatyoumightneedtoreferto,inoneplace,beforeyoustartansweringthesequestions.Andbythiswemeanyouranswerstotheexercisesinthisbook,yourCV,yourlearningportfolio,informationonanyauditsyouhavedoneand,forjuniordoctors,theassessmentsthatyouhavecarriedout.
3.Beforeyoustartwritinganything,readthroughtheGMC’sguide‘GoodMedicalPractice’(whichcanbeobtainedfromtheGMCwebsite).Thiswillremindyouofthequalitiesandvaluesthatthereaderwillbelookingforinyouranswers.Scoringoftheapplicationformmayrelatetotheelementsofgoodpracticeoutlinedinthisdocument.
4.Readthequestionextremelycarefully.Youneedtomakesurethatyouanswerallpartsofthequestion,aseachpartwillbeallocatedseparatemarks.Ifthequestionhasanumberofparts,structureyouranswerinalogicalwaysothatitmatchesthedifferentpartsofthequestion.Inthiswayyouwillmakeiteasierfortheshort-listertorecognisethatyouhavefullyansweredalltheparts.Inaddition,youranswersalwaysneedtoberelevanttothequestionthathasbeenasked.(Whenwearerunningseminarsonapplicationformsweoftensaythatyoushouldimaginethateachwordyouwriteisfightingforinclusioninyouranswer.Ifitdoesn’t‘addvalue’,itshouldn’tbethere.)
5.Whenthequestionasksforexamplesofachievements,orinitiative,orleadership,itisnotrequiringyoutohaveextraordinaryexamples.Inotherwords,theshort-listersarenotexpectingyoutohavewrittentheleadarticleinNature,orhaveclimbedtothetopofEverest.Instead,theyarelookingforanswersinwhichyoureflectintelligently,andwithinsight,onthesortsofexperiencesthatyouwouldbeexpectedtohave,atyourparticularleveloftraining.
6.Youwillfinditeasiertowritegoodanswersaboutgenericskills(e.g.time-management,communicationskills,teamworking)ifyouhavehadsomebackgroundtrainingintheseissues.Ifsessionsonthesetopicsareofferedaspartofthegenerictrainingprogramme,wewouldstronglyadviseyoutoattendthem.Thiswillgiveyouabasictheoretical
Stage 4 – Plan Implementation
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underpinningthatyoucanusetostructureyouranswer.Ifthesesessionshaven’tbeenoffered(orifyoumissedthem),thendoabitofbackgroundreadingbeforefillingouttheform.
7.Whenyouareconstructingyouranswerstrytothinkaboutwhatanobserverwouldnoticeiftheyhadbeenwatchingyou.Forexample,ifyouwereaskedtoexplainhowyoucommunicatedwithanagitatedpatient,agoodanswermightdescribehowyouremainedcalm,andrespondedtothespecificconcernsthepatientraised.Ifthepatienthaddemandedtoseetheconsultant,youwouldalsoexplaincarefullytothepatientthattheconsultantwasnotonsite,butyouwouldbedoingawardroundthefollowingmorningandtakepersonalresponsibilityforaskinghim/hertospeaktothepatientwhens/hewasontheward.Ananswerlikethisdemonstratestothereaderthatyoudoinfactknowwhatconstituteseffectivecommunicationwithanagitatedpatient.Incontrast,ananswerwhichsaidsomethinglike‘ImadesurethatthewayIrespondedtothepatientdiminishedtheirlevelofagitation’doesn’tconveytothereaderthatyouwouldhavethefirstcluehowtodothisinpractice.
8.Youwillprobablyneedtoedityourfirstattemptatwritingtheseanswers.Wesuggestthisbecauseoftenthefirstdraftmissespointsout,orincludesirrelevantdetail,butitisdifficulttospotthisatthetime.Instead,ifyouwritethefirstdraft,andthenleaveit(foratleastafewhours),whenyoucomebacktoit,itisfareasiertoseewhatchangesneedtobemade.
9.Whatyouneedtoavoidissomethingthatreadslikeareiterationofthepersonspecification.Incontrast,whatyouwanttoaimforissomethingthatengagestheinterestofthereader.Withthebestapplicationformsnotonlyisitclearthatthecandidatehasthenecessaryabilitiesandskills,butthereaderalsobuildsupaninitialsenseofwhatthecandidateislikeasaperson.It’saveryhardbalancetostrikebecauseyoudon’twanttosoundtooconfidentorover-familiar.Butyoualsodon’twantyouranswerstobearidortosoundasiftheyhavecomeoutofatextbook.
Inourexperiencethebestwayoffindingthemiddleroadandwritinganswersthatengagetheinterestofthereader(andare,ofcourse,alsohighlyrelevanttothequestion)istowriteaboutexamplesthatmattertoyou.Withtheseexamples,itiseasiertoconveyyourinterestandinvolvement,andinturnthishelpstoengagethereader.Butyoualsoneedtoallowsufficienttimeforfillingintheapplicationform.Ifyouhavereadthequestioncarefully,chosenyourmostappropriateexamples,andthenfine-tunedyouranswersthroughsufficientediting,youaremaximisingyourchancesofsuccess.
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69So how long is long enough?Therearenohardandfastrulesonhowlongittakestofillinyourapplicationform.Butinourexperienceitusuallytakeslongerthanyouwouldthink.
Wewouldcertainlyadviseyounottoleavetheformstothelastcoupleofdaysbeforethedeadline.Instead,lookatthemassoonasthesystemgoeslive,andapproachfillingthemininthesystematicwaythatwehavedescribedabove.Itmightalsobehelpfultoaskmoreseniorcolleagueswhohavealreadycompletedtheseformshowlongittook.
Portfolios and CVsDuringbothfoundationandspecialtytrainingyouwilluseaportfolio/e-portfoliotosupportyourlearning,collecttogetherinformationaboutyourassessmentsandotherachievements.YourportfoliocanhelpsupportyouwithcareerplanningandyourPersonalDevelopmentPlancanbeusedtohelpyouconsiderwhatyouneedtodotoprogressyourcareer.
Keepingyouportfoliouptodateisessentialasitisusedasevidencetosupportsign-offasyouprogressthroughyourtrainingprogramme(FoundationandSpecialty)andcanbeusedtohelpsupportyourapplicationsforspecialtytraining.Itisoftenreviewedduringtheselection/interviewprocessintospecialtytraining.Doensureyourportfolioiscomprehensiveandcontainsyourreflectionsonyourtrainingtodate.ItshouldalsoincludeaCVwhichisausefulwayoforganisingdataaboutyoureducationalcareerhistorytodateandwehaveincludedsomeadviceonwritingCVsinAppendixC.
Long listing and short listingOncetheapplicationdeadlinehasbeenreachedthenextstageintheselectionprocessislonglisting.Theapplicationswhichhavebeenreceivedarecheckedagainsttheessentialeligibilitycriteriainthepersonspecificationforthespecialtyandlevelappliedfor.Thenextstageisshortlisting.ForGPrecruitmentthisinvolvesMachineMarkedTests(MMT)inClinicalProblemSolving(CPD)andSituationalJudgement(SJT)anddetailedexplanationsofthesedifferenttests,togetherwithsamplequestions,areavailableontheGPnationalrecruitmentwebsite(www.gprecruitment.org.uk).Forotherspecialtiesshortlistingiscarriedoutbyconsultantsinthatspecialty.SomespecialtiesarereviewingtheirselectionmethodologyanditlikelythatMMTswillbedevelopedandformanincreasingpartoftheselectionprocessinthefuture.
Stage 4 – Plan Implementation
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Interviews
IntroductionItisusefultobeginbythinkingaboutthepurposeofinterviews.
Aformalansweristhatthepurposeoftheinterviewistoassesseachcandidateagainstthepersonspecification,andthusidentifywhichcandidate(orcandidates)isbestsuitedtothepositiononoffer.Butitisalsoimportanttorealisethatyou(astheapplicant)andthepanelmembersallsharemembershipofthehumanrace.Aninterviewshouldnotfeellikeamechanisedprocessofqualitycontrolbut,instead,aprofessionalconversationinwhichyoubuilduprapportwiththepanel.
Ofcourse,buildingupsuchrapportiseasiersaidthandone.Andnearlyeverybodyisnervousbeforeaninterview–particularlywhenthereisalotatstake.Butitisusefultorememberthatyouwanttoconveyasenseofwhoyouareasapersonduringtheinterview.Afterall,thepanelwillbeaskingthemselvesifyouarethesortofpersonwhomtheywouldwanttohaveasatrainee.
Ifyouareverynervous,itisfinetosaytothepanelthatyoufindinterviewsquitestressful.Similarly,ifyouareaskedanextremelydifficultquestionyoucanbeginyouranswerbysayingsomethinglike‘That’satoughone.ButI’llgiveitago.’Inthese–andotherways–youcanconveysomethingofyourpersonalitytothepanel.
Weoftenremindourclientsthatinterviewsforjobsarenotlikepoliceinterrogations.Bythiswemeanthatwhereas,ifthepolicewereinterviewingyoutofindoutifyouhadcommittedacrime,youwouldbeunwisetocommentthataquestionwasveryhard,orthatyouneededabitoftimetoprepareananswer,suchstrategiesareentirelyappropriateinajobinterview.Because,inthelattersituation,respondinginthiswaybothgivesasenseofyourownpersonalityandalsoshowsthatyouhandlepressurewell.
Preparing for an interviewMostinterviewswillbestructuredandtime-limited.Therewillalmostcertainlybemorethanonepersonpresent.Ifthereisapanel,onememberwillbeappointedasChair,andisthepersonwhoislikelytowelcomeyou,introducetheotherpanelmembers,andoutlinethestructureoftheinterview.Ifthemantraforestateagentsis‘location,location,location’,asimilarrefrainforcareercounsellorswouldbe‘preparation,preparation,preparation’.(Andthisapplies,ofcourse,asdiscussedabove,totheapplicationformstageaswellastointerviews.)
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71Thereasonwhythisissoimportantisthatmanyquestionscanbroadlybepredictedinadvance.Soifyoudevoteadequatetimetopre-interviewpreparation,youshouldbeabletoimprovethequalityofyourperformanceontheday.(Ofcourse,youmightstillbeaskedsomequestionsthatyouhaven’tconsideredbefore.Butifastructuredinterviewprocessisused,atleastyoucanreassureyourselfthatallthecandidateswillhavebeenaskedthisparticularquestion.)
So how should you prepare?Forstartersitishelpfultorealisethatquestionswhichareaskedatinterviewsareusuallydividedintothreebroadareas:
1.Questionsaboutyou.
2.Questionsaboutthejob/specialty.
3.Questionsaboutthewidercontextofhealthcare.
Eachofthesethreecategorieswillbeconsideredinturn.
1. Questions about youThelistbelowgivesexamplesofthesortsofquestionsaboutyourselfthatyoumightbeasked.
1.Describesomeofyourkeyqualities/characteristics.
2.Tellmewhatyouhavegainedfromyourtrainingtodate?
3.Whatareyourkeystrengths?
4.Whatdoyouthinkisyourgreatestachievementtodate?
5.Tellmeaboutyourapproachtoworkinginateam.
6.Describeasituationatworkwhich,inretrospect,youthinkyoucouldhavehandledbetter.Whatdidyoulearnfromthesituation?
7.Whatsortofdecisionsdoyoufinditdifficulttomake?
8.Whatdoyouseeyourselfdoinginfiveyears’time?
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General guidance on these questionsItisalwaysfarbettertorefertospecificexamplesthantotalkingeneralities.So,forexample,ifyouareaskedaboutyourstrengths,mentionperhapstwotofourpoints,butlinkeachofthemtoaspecificexample(whichcanbefromworkorfromoutofwork).Ifyoujusttalkingeneralities(I’mcompassionate,organised,thorough,etc.),alittlevoicepipesupintheheadofthelistenersaying,‘Well,youwouldsaythat,wouldn’tyou?’Butifyousupplytheexamples,theanswerasawholehasmuchmorecredibility.
(Andasanaside:that’swhyworkingthroughtheexercisesinthisbookisimportant,becausetheysupplyyouwiththesortsofexamplesthatyouwillneedtodrawoninyourapplicationformsandatinterview.)
Notonlyshouldyouhavethoughtoutexamplesofallyourpositivepoints,butyoushouldalsohaveplannedwhatexamplesyouwillgiveifyouareaskedaboutyourmistakesorareasofweakness.
Thekeythingtoconsiderwhenyouareaskedaboutmistakesorareasofweaknessistochooseanappropriateexample.BearinginmindtheelementsoftheGMC’s‘TheNewDoctor’youcannotrefertoanyexamplethatwouldcausethepaneltohavedoubtsaboutyoursuitabilityasadoctor.But,equally,youdon’twanttorefertoanythingtootrivial,ortobetoocleverbysneakinginapositiveundertheguiseofanegative.Forexample,ifyouareaskedaboutyourweaknesses,respondingbysayingthatyouworktoohardmightbeoff-puttingforthepanel.Everybodyhasareasofpersonalweakness,andtheyshouldbeabletodiscussthem,withinsight,ataninterview.
Wewouldsuggestthatthebeststrategyistochooseamiddle-of-the-roadsortofexample,andthen–whetheryouareaskedforthispartornot–tellthepanelhowyouremediedthesituation.So,forexample,youcouldsaysomethingsuchasinitiallyyoufoundithardtoswitchofffromwork,anditwasaffectingyoursleep.Butyourealisedthatyouhadtobeabletorechargeyourbatteriesattheendoftheday,soyoustartedgoingforarun,playingthepiano,readinganovel,orwhatever,andthathelpedyoutoswitchofffromworkandgetagoodnight’ssleep.(Thisisonlyoneexample–therearehundredsthatyoucoulduse.Butitillustratesthepointthatyouneedtopicktheeverydaysortsofexamplesthatwillhaveactuallyhappenedtoyouaspartofyourmedicalschool/foundationtraining,andthendescribetothepanelwhatyoudidtoremedythesituation.)
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732. Questions about the job/specialtyQuestionsinthiscategorymightincludethefollowing:
1.Whydoyouwantthisjob?
2.Whyhaveyouappliedtothisparticulartrainingprogramme?
3.TalkusthroughyourCV.
4.Whatskillswillyoubringtothisspecialty?
5.Describeyourviewsonwhetherlessthanfull-timetrainingispossible?
6.Whatdoyouthinkittakestoexcelinthisparticularspecialty?
7.What’sthemostusefulcoursethatyouhaveattendedinthelast12months?
8.Tellusaboutaresearchpaperthatyouhavereadrecentlythathashadanimpactonyourclinicalpractice.
ForquestionsofthistypeyouwillbedrawingonyouranswerstotheStage1andStage2exercises,includinganypsychometricinstrumentsthatyouhavecompleted.Ifyouhavegivensufficientthoughttoboththesestagesyoushouldbeabletogivecoherentanswerstothesesortsofquestions.Thisisbecause,essentially,mostofthesequestionsareassessingthematchbetweenyourpersonalqualitiesandthedemandsofthejob.
Beforeyougoforaninterviewyoushouldbefamiliarwiththepersonspecification,andanyotherbasicinformationontrainingissuedbytherelevantRoyalCollege.Inaddition,youshouldalsotrytogetsomesense(eitherthroughCollegeliteratureorthroughtalkingtopeopleinpost)oflikelydevelopmentsinthatspecialty,because,withtheintroductionofnewtechnologies,somespecialtiescanexpectsignificantchangesinthefuture.(Awell-knownexampleiscardio-thoracicsurgery,wheretheriseininvasivecardiology–performedbymedicallytrainedcardiologists,notsurgeons–hasmeantthatmoreproceduresarebeingdonethroughcatheters,withearlierinterventioninacutemyocardialinfarction,andthereforelessopen-chestsurgeryisrequired.)Socheckforlikelyfuturedevelopmentsinyourspecialtyofinterest.
Asforgoodwaysofansweringquestionsaboutthespecialty,youneedtodistinguishbetweenquestionsofdifferentsorts.Forexample,ifyouareaskedwhyyouwanttotraininaparticularspecialty,youshouldn’thavetopauseforalongtimebeforeyouanswer.Infact,youshouldexpecttobeaskedwhyyouareapplyingforthepost,andagood,well-thought-outanswershouldbeonthetipofyourtongue.
Stage 4 – Plan Implementation
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However,youmightalsobeaskedtodiscusssomemorecomplexscenariosrelatedtoyourspecialty–orindeedtothepracticeofmedicineingeneral.Inthissituation,youwillnotbeexpectedtohaveananswerimmediatelyanditisperfectlyacceptabletopausebeforeyourespond.(Moredetailedguidanceonansweringquestionsofthissortwillbegivenbelow.)
Questions about the wider context of healthcareTypicalquestionsinthisthirdcategoryincludethefollowing:
1.WhatdoyouthinkabouttherecommendationsoftheTookeInquiryintoMMC,andtheDepartmentofHealth’sresponsetotheserecommendations?
2.Describehowyouthinkappraisalwillhelpimprovethequalityofcarethatdoctorsdelivertotheirpatients?
3.WhatdoyouthinkarethemainchallengesfacingtheNHS?(ThesecouldincludePaymentbyResults,MMC,NHSDirect,FoundationTrusts,etc.)
4.Shouldpatientsbeinvolvedindecisionmakingabouttheircare?
5.HowmighttheEuropeanWorkingTimeDirectiveaffectyou?
6.Whatisaudit,andhowdoesitdifferfromresearch?
7.Canyoutellmeaboutanauditprojectthathasinfluencedyourpractice?
InansweringthesequestionsyouarenotexpectedtobeanexpertonhealthpolicyorhaveanMBAinhealthcaremanagement.However,youareexpectedtohaveabasicunderstandingofthewiderhealthcarecontextinwhichyouwouldbetraining.
Asabasicminimumyoushouldlookatthefollowingwebsites:
1.TheDepartmentofHealth.
2.TherelevantRoyalCollege.
3.TheDeanery/FoundationSchooltowhichyouareapplying.
4.TheMMCwebsite
Inaddition,youmightalsowanttolookthroughtheon-linearchivesofBMJCareers(tofindrecentarticlesaboutyourspecialty),HealthServiceJournal(togetshortarticlesonhealthservicetopics)andperhapseventheKing’sFund(whichhasgoodcoverageofrelevantNHSpolicyissuessuchastheestablishmentoffoundationtrusts).
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75Ifyouareverykeenonmanagementissues,andseeyourselfassomebodywhomightwanttomanageaclinicalserviceinfuture,seeifyoucangettotalktosomebodyinyourTrust(orPCT)whohasaseniormanagementposition.Theywillbeabletogiveyouafeelforhowinitiativeswhichyoureadabout(e.g.PaymentbyResults)arebeingimplementedinpractice.
Questions that you can’t easily anticipateYoumightfindthatyouaregivenparticularclinicalscenariosandaskedtocommentonthem.Or,alternatively,youmightbeaskedaboutyourviewsontrickyethicaldilemmas.
Asmentionedabove,don’trushintoansweringquestionsofthissort,andtakeamomentortwotogatheryourthoughts.Asregardstheclinicalscenarios,thepanelwillbeinterestedinboththecontentofyouranswerandalsowhetheryoudemonstrateasystematic,well-thought-outapproachtotheproblem.Ifthereisonefactthatyouareunsureabout,thenacknowledgethistothepanel,buttryyourbesttoprovidealogical,well-reasonedanswerthatdemonstratesanabilitytodistinguishbetweenessentialandnon-essentialclinicaltasks.
Incontrasttotheclinicalscenario,ifyouareposedacomplexethicaldilemma,youdon’tnecessarilyneedtogivethepanelahard-and-fastanswerastoexactlywhatyouwoulddo.Instead,youcansaythatthatisaverytrickysituation,andonethatyouwouldhopethatyouwouldneverfindyourselfin.Ineffect,youdescribethefactorsthatyouwouldtakeintoconsiderationwhenapproachingthesituation,ratherthannecessarilycomingupwithsomethingcutanddried.
(If,though,thepanelsaysthatyouaresittingonthefence,andtheyneedyoutobemoreexplicitinwhatyouwoulddo,thenofcourseyouwouldhavetocomedownononesideofthefenceortheother.)
Structuring your answerInthesectionaboveonapplicationforms,itwassuggestedthatyoucouldusetheSTARapproachasinitialpreparationforyourapplicationformanswers.
Torecap:theSTARapproachsuggeststhatyoushoulddothefollowing:
1.Brieflydescribethesituationortask.
2.Brieflydescribeyourownactions/activities–i.e.whatyoudid.
3.Brieflydescribetheresults(and/oryourreflections).
4.TheMMCwebsite.
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Itcanbeusefulinterviewpreparationifyoureadthroughyourportfolio,andtheanswerstotheStage1and2exercises,inordertoanalysebothpositiveandnegativeexamples,usingtheSTARstructure.However,wewouldnotsuggestthatyounecessarilysticktotheSTARstructureinhowyouwordyouranswerininterview–orthatyounecessarilygiveequalweighttothedifferentcomponents.
Youcertainlydon’twanttogivetheimpressionthatyouareparrottingpre-preparedanswers,asthisisunlikelytobuildarapportwiththepanel.
Instead,bythinkingthroughclearexamples(ofbothpositiveandnegativeaspectsofyourwork)priortotheinterview,youcangivemoresuccinctandfocusedanswers.
General advice on interview technique1.Ifyouarebeinginterviewedbyapanelyouneedtomakesurethatyou
buildarapportwithallthepanelmembers.Althoughyoushouldfocusyoureyecontactonthepersonwhohasaskedyouthequestion,youmightalsowanttomakeeyecontactfromtimetotimewiththeotherpanelmembers.
2.Ifyoudon’tunderstandaquestion,theninthefirstplaceyoucanaskforittoberepeatedorclarified.Ifyoustilldon’tunderstandaftertherepetition/clarification,itisprobablybesttoindicatethisinyouranswer.Forexample,youcouldsaysomethinglike:‘Iamnotsureifthisiswhatyouarelookingforintheanswer,butIthinkthatthekeypointsherearex,yandz.’Ifthereisanypossibilitythatyouhaven’tproperlyunderstoodthequestion,itisbettertoalludetothisinyouranswer.Givingacompletelyoff-the-wallanswer,withoutindicatingtothepanelthatyouknowyoumaybewayoff-track,ispotentiallyfarmoredamagingtoyourchances.
3.Itistobehopedthatthepanelwon’tbegivingyoushort,closedquestions(exceptwheretheyneedtocheckoutparticularfactualdetails,suchaswhenyouwouldbeabletostartinpost).Butiftheydo,resistthetemptationtogiveone-wordanswers,andexpandontheansweralittle,regardlessofthequestion.
4.Ifyoudon’tknowtheanswertoafactualquestion,don’trambleoninthehopeofdivineinspirationarrivingmid-answer.Inourexperience,ittendsnottobeforthcoming!Instead,itisbesttoadmitthatyoudon’tknowtheanswer,smile,andexplainthatyouhaveforgottenit,orthatitissomethingyouhaven’texperiencedyet.Ifyoucan,offerananswertoamoregenericsituationrelatedtothequestion,butthatdoesn’trequireyoutorememberaparticularfactualdetail.(Forexample,ifyouareaskedaboutthemanagementofaparticularconditioninan
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77elderlypatient,andyouhaveforgottenthedetails,orneverknewthem,wewouldsuggestthatyouadmittoyourignorance,andthensaysomethingaboutgeneralapproachestocareoftheelderly.)
5.Longramblinganswersarebestavoided.Assoonasyourealiseyouhavestartedtoramble,pause,gatheryourthoughts,provideabriefsummary,andthenfinishoffyouranswer.
6.Lookthroughthesuggestedinterviewquestionslistedaboveandpractisegivingsuccinctanswers.Wewouldsuggestthatyousaytheseanswersoutloud,ratherthanrunningthroughthepointsinyourhead.Ifyougetintothehabitofvocalizingyouranswertothemirror,itcanbelessanxiety-provokingtohearyourselfspeakingintheactualinterview.Inaddition,youcanalsopractisenotrushingthroughyouranswers,butusingaslightlyslower,clearer,rateofspeech.
7.Thinkaboutyourbodylanguage(notonlyeyecontact,butalsohowyouaresitting,whetheryouappearsufficiently,butnotoverlyrelaxed,etc.).Ifappropriate,alightnessoftouchcangodownwell–butobviouslythisdependsuponthesituation.So,forexample,ifyouarepresentedwithascenarioinvolvingaverydistressingsituation,wewouldnotadviseyoutotreatitinalight-heartedmanner.Butifyouareaskedaboutyourweakness,youcan(afterfirstdemonstratinginsightthroughanappropriatediscussionofaparticularweakness)addacommentlike:‘Ialsohaveaweaknessforchocolate’,orManchesterUnited,orwhatever.Butyouhavetouseyourprofessionaljudgementastowhethersuchcommentswouldbeappropriateornot(justasyouuseyourjudgementwithpatientsastowhether,ataparticularmoment,alight-heartedcommentwouldeasethesituation,orcausegreatoffence).
When it’s your turn to ask questionsAttheendoftheinterviewyoumaybeaskedifyouhaveanyquestions.(Ifyourinterviewisonly10–15minutes,thismightnothappen.)
Iftheydoaskyouforyourquestions,avoidputtingaquestionforthesakeofit.Interviewsaretiringforthepanel,aswellasforthecandidates,andinterviewersdon’tappreciatebeingaskedpointlessquestions.
Ifyoureallyhaven’tgotasensiblequestion,saysomethinglike:‘AllthequestionsthatIhadplannedtoaskhavebeencoveredinyourexplanationofthepost.‘Thismeansthatyoudon’tendtheinterviewbyrespondingwithacurt‘No’.
However,itisagoodideatohaveacoupleofsuitablequestionsupyoursleeve.Possibilitiesincludethefollowing:
Stage 4 – Plan Implementation
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1.Whatimpactdoyouthinkthechangestomedicalcareerpathwayswillhaveonthetraininginthisdeanery?
2.Arethereanyopportunities,atalaterdate,forsub-specialtytraininginx,y,orz?(Butmakesurethattheanswertothisquestionisnotcoveredinanyreadilyavailableinformationaboutthetrainingprogramme.)
3.Whathavethetraineeswhohavejustfinishedtraininginxspecialtyinthishospitalgoneontodo?
PresentationsPriortotheMMCreforms,interviewsforentryintoaspecialisttrainingprogramme,orforconsultantposts,typicallyinvolvedyougivingapresentation.Atpresentyouwouldprobablynotbeexpectedtogiveapresentationduringaninterviewforentryontoafoundationprogramme.However,youmaybeaskedtogiveapresentationduringaninterviewforabasicspecialtytrainingprogramme.Andstartingin2008,somespecialtiesrequiredtheapplicanttodevisethepresentationonthedayoftheinterview–i.e.theydidnotsupplythetitleofthepresentationinadvance.WehaveincludedguidelinesforpreparingapresentationtobegivenaspartofaninterviewinAppendixD.
Selection centresOneoftherecommendationsoftheTookeInquiryintoMMCwasfortheneedtodevelopmorerobustselectionsystems.
Anumberofspecialtiesarenowusing‘selectioncentres’aspartoftherecruitmentandselectionprocess.Thisapproachisbasedontheideathatyouendupwithmorerobustselectiondecisionsifyoupresentapplicantswithtasksthatreflecttheactualactivitiesthattheywouldhavetocarryoutinthejobtowhichtheyareapplying.Soforexample,theselectioncentrethatisusedinGeneralPracticeincludes3exercises:anencounterwithasimulatedpatient;agroupexerciseandawrittenexercise(www.gprecruitment.org.uk).Theseactivitiesareobservedandassessedbytrainedassessors.
Ifthespecialtytowhichyouareapplyingisusingaselectioncentreapproach,youwillbeprovidedwithinformationabouttheselectioncentreaspartoftheinformationavailableforapplicants.Thereisoftenlittlespecificpreparationthatyoucandofortheselectioncentresabovemakingyourselffamiliarwiththepersonspecificationofthepostforwhichyouareapplying.However,youmayfindithelpfultolookataDVDproducedbytheAssociationofGraduateCareersAdvisoryServicesentitled‘SelectionCentresforSpecialtyTraining’.AsktheCentreManagerinyour
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79postgraduateeducationcentre,orthecareersspecialistsatyourdeaneryforfurtherinformation.
Final commentsInwritingthischapter,wefeelasifwehaveleftyouonsomethingofacliffhanger.Wehavegivendetailedguidanceondecisionmakingandplanimplementation–andafterthatyoucan’tprogressyourplansanyfurtheruntilyouhaveheardtheresultsoftheselectionprocess.
Ifyouaresuccessful,wehopethatthestructuredadvicegiveninthishandbookhashelpedyoutomakearobustcareerdecision,andthatyouarelookingforwardtogettinggoingwiththenextstageofyourcareer.
Ifyouareunsuccessful,youmightbeinaverydifferentstateofmind.Inourexperience(bothpersonal,andalsofromourclientwork),weknowhowdemoralisedandhurtpeoplecanfeelwhentheyhaveputahugeamountofworkintoanapplicationprocesswhichultimatelyendsupinrejection.It’softenaverydepressingpositiontobein.
But,intime,youwillhavetopickyourselfup,dustyourselfdown,andworkoutyournextsteps.
Thefirstthingtodoistotrytogetasmuchinformationaspossibleaboutyourunsuccessfulapplication,becausethemoreinformationyouhave,thebetterpositionyouareintoreviewyournextstep.
Afterthis,wewouldadviseyoutogothroughabriefreviewofthecareer-planningframework,toseeifyouwanttochangeyourchoicesornot.Ifyoudecidenotto,youwillthenneedtoconcentrateonStage4,toseehowyoucanincreaseyourchancesofasubsequentapplicationbeingsuccessful.
Wewouldalsoliketoaddtwofurtherobservations.
Thefirstisthatamythhasbeencirculatinginmedicalrecruitmentthatforeachdoctorthereisreallyonlyonecareeroptionthatwouldsuitthem.Inpart,wethinkthatthisisaby-productoftheolddayswhen,atinterviewsforhigherspecialisttraining,youhadtodemonstrateyourundyingdevotiontothatspecialty,andnoother.
Butthismythdoesn’thavepsychologicalvalidity.Instead,aswedescribedinChapter2,thepsychologicalliteraturesuggeststhateachdoctorcouldbewellsuitedtoanumberofdifferentspecialties(althoughtherewoulddefinitelybeothersthatwouldnotsuitthemwell).Sowewouldencourageyoutobeflexibleinyourthinking–inparticularaboutthe‘O’intheROADSacronym,i.e.‘opportunities’.Gobackandseeifthereareotheroptionsthatyouhadn’tconsideredpreviouslytowhichyoumightalsobesuited.
Stage 4 – Plan Implementation
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Thesecondobservationrelatestothefirst,andisthatevenwithinspecialtiesthereisenormousvariationintheday-to-daydetailsofwhatpeopleactuallydo.Forexample,aGPinasingle-handedruralpracticeandaGPinalargemulti-partnerhealthcentrepracticewillhavesomedutiesincommon,butotheraspectsoftheirdailyworkwilldifferenormously.
Whatthismeansisthatevenwhenyouhavesuccessfullynavigatedyourselfthroughthemazeofspecialtytraining,thedemandsofcareerdecisionmakingarenotover.Quitethecontraryinfact,asyouwillhavetomakeimportantcareerdecisionsthroughoutyourprofessionallife,uptoandincludingthetimeyoudecidetoretire.(Examplesincludewhetheryouwanttodosub-specialtytraining,becomeaGPwithaSpecialInterest,developingteachingormanagementresponsibilities,flexibleorpart-timeworking,etc.)
JohnKrumboltz,aneminentpsychologistatStandfordUniversityhasarguedthatchangeisaninevitablefeatureofcontemporarycareers–andtherealchallengeofcareerplanningislearninghowtoidentifyaroutethroughanunpredictablecareerlandscape.WhilstKrumboltz’sresearchisbasedontheAmericanemploymentsituation,andcoversthejobmarketasawholeratherthanjustmedicalcareers–medicalstudentsanddoctorsintheUKcanprobablyidentifywithhisconclusionthatcareerpathwayscontainanelementofunpredictability.
Krumboltzhasevencoinedatermforhispreferredapproach‘plannedhappenstance’whichhedefinesashelpingpeople‘togenerate,recogniseandincorporatechanceeventsintocareerdevelopment’.(Mitchell,LevinandKrumboltz,1999).
It’sbeyondthescopeofROADStolookindetailathowtomakethebestofchanceeventsinordertomaximisecareersuccess–butwewillletKrumboltzhavethelastwordinthischapterbecausewhathesaysseemsparticularlyrelevanttothechallengescurrentlyfacingdoctorsintheUK:
‘Someluckliesinnotgettingwhatyouthoughtyouwantedbutgettingwhatyouhave,which,onceyouhavegotit,youmaybesmartenoughtoseeiswhatyouwouldhavewantedhadyouknown’.(KrumboltzandLevin,2007).
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GUIDELINES FOR THE EDUCATIONAL
SUPERVISOR
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VI. GUIDELINES FOR THE EDUCATIONAL SUPERVISOR
OverviewThischapterbeginswithabriefdescriptionofthekeyplayersinpostgraduatecareersupportattrustlevel(namelyClinicalTutor/DirectorofMedicalEducation,theFoundationProgrammeTrainingDirectorand,insomedeaneries,theFacultyCareersLead).Itthenmovesontodescribingboththebroaderandcareersupportresponsibilitiesoftheeducationalsupervisor,andlooksindetailatthespecificconcernsthatconsultantsoftenexpressaboutthecareersupportaspectsoftheireducationalsupervisoryrole.Specificguidelinesaregivenaboutsupportingtraineeswhosecareerplansyoubelievetobeunrealisticaswellassupportingtraineeswhoarecontemplatingleavingmedicine.
Thechapterthenprovidesguidanceonhowtoapproacha1:1career-planningdiscussionwithyourtrainee,andgivesexamplesofthesortsofissuesyoumightdiscussineachofthefourcareer-planningstages.Althoughtheemphasisofthechapterisontheprovisionof1:1support,thechapterendswithguidanceonrunninggroupcareer-planningworkshops.DetailedsuggestedteachingplansfortheseworkshopsareincludedinAppendicesEandF.(Furtherelectronicresourcescanbefoundonthemedicalcareerswebsitewww.medicalcareers.nhs.uk).
Key players in the delivery of career supportItcanbehelpfultothinkabouttiersofcareersupport.
Thefirsttierofsupportwilltypicallybeprovidedbyeducationalsupervisorsastheyaremostlikelytobeabletotakeamoreinformedandconstructiveroleaboutaparticulartrainee’sstrengthsandweaknesses.ThesecondtierofsupportistypicallyprovidedbythetrustDirectorsofPostgraduateMedicalEducation(DMEs),whichisthenewtermfortrustClinicalTutors.SittingalongsidetheDMEs,theFoundationProgrammeTrainingDirectorsand,ifyourdeaneryhasthem,theFacultyCareersLeadscanalsobecalledupontoprovidesecond-tiersupport.
Thethirdtierofsupportisthatprovidedbythedeanery-basedcareersteam.
Typicalreferralstothisteamincludeatraineewhoisstrugglingtomakedecisions,someonewhoishangingontoplanswhichallconcernedfeelaredesperatelyunrealistic,oratraineewhoisseriouslyconsideringleavingmedicine.
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85Inaddition,seniorclinicianswithintheFoundationSchoolsometimescalluponthedeanerycareersteamwhenaparticulartraineeiscausingconcernandseemstobefindingithardtosettleintotheirroleasajuniordoctor.
Ideally,everybodywhoprovidescareersupportshouldbeappropriatelytrainedforthelevelofsupportthattheyprovide.Withinmanydeaneries,basictraininghasbeenprovidedforeducationalsupervisorsonhowbesttosupporttraineeswiththeircareerplanning.Somedeaneries(e.g.N.WesternandLondon)havealsoproducede-learningresourcesforcliniciansonthistopic.Forthesecondtier,theNationalAssociationofClinicalTutors(NACT)providesrelevanttraining.Asforthethirdtier,thesearepeoplelikeuswhoarequalifiedcareersprofessionals,sothetaskthereiscontinuingprofessionaldevelopmentratherthanbasicskillstraining.OrganisationssuchasAGCAS(AssociationofGraduateCareersAdvisoryServices)provideprofessionaltrainingthatishighlyrelevanttostaffofferingthird-tiersupportandtherearealsoanumberofprofessionalnetworksforMedicalCareersAdvisors.
Defining ‘you’Thepreviousfivechapterswerewrittenforthejuniordoctorormedicalstudent.Incontrast,thischapteriswrittenwiththeeducationalsupervisorinmind.(Ineffectthe‘you’thatwehaveinmindwhenwritingthishandbookhasswitched.ThroughoutChapters1–5,the‘you’hasrepresentedtherecipientofcareersupport,whileinthischapterthe‘you’becomestheeducationalsupervisor.)
Shared frameworkWewanttoreturnbrieflytothefirstchapter,wherereferencewasmadetoastudybyHirshetal(2001).Inthisstudyitwasfoundthatinworkplacecareerdiscussions,ifbothparticipantshadacommonframeworktherecipientsfoundthecareerdiscussionsmoreproductive.Bearingthisfindinginmind,itshouldbeclearthatyou(theeducationalsupervisor)shouldreadthroughand‘digest’thecontentsofthefirstfivechapters.(And,infact,youmightalsowanttotryoutsomeoftheexercisesyourself,asthatwayyouwillbeinabetterpositiontodiscussthemwithyourtrainees.)
Guidelines for the Educational Supervisor
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The role of the educational supervisorTheguidetospecialtytraining(the‘GoldGuide’)publishedin2008andavailableontheMMCwebsite,outlinestherolesofeducationalandclinicalsupervisor.Itisclearfromthisguidethatthesamepersonmayprovideclinicalandeducationalsupervision,althoughitisalsoacceptableiftherolesaresplit,aslongasthereisappropriateliaisonbetweenthetwosupervisors.
Digressingforabriefmoment,itisnecessarytorefertosomeeducationaltheory,inordertoclarifythedifferencesinroles.
Ifyoulookatastandardtextbookonthetheoryofassessment(e.g.FreemanandLewis,1998),youwillfindexplanationsaboutthedifferencebetweenformativeandsummativeassessment.
Formativeassessmentaimstoprovidefeedbacktothetrainee,sothattheyareinapositiontobeabletoimprovetheirwork.Ittendstobeprovidedduringaperiodoftraining,ratherthansimplyattheend.Formativeassessmentattemptstouncoverboththestrengthsandweaknessesinatrainee’swork.
Incontrast,summativeassessmentcountstowardsorconstitutesafinalassessmentorqualification.Itinvolvesmakingaprofessionaljudgementabouttheadequacy(orotherwise)ofdifferentaspectsofthetrainee’swork.
Applyingthesetermstothecontextoffoundationtraining,withintheoperationalframework,botheducationalandclinicalsupervisorshavetobetrainedtocarryoutcompetenceassessmentsofjuniordoctors(i.e.summativeassessment).Inaddition,educationalsupervisorshavetoprovideeducationalappraisals(i.e.formativeassessments),toenablethetraineetoreflectontheirlearning,andthenjointlyagreeonappropriateeducationalgoals.
Itisalsothetaskoftheeducationalsupervisortohaveregulardiscussionswiththeirjuniordoctorsabouttheircareerplans,andreferthemtosecond-(oreventhird-)tiersupportifnecessary.
Educational supervisor as provider of career supportHavingruntrainingworkshopsforconsultantsinanumberofdeaneries,weknowthatconsultantsoftenexpressconcernaboutthefollowingissues:
1.Theirlevelofexpertiseacrossthewholespanofmedicalcareers.
2.Cantheyprovidehigh-qualityadvice?
3.Thetraineewithunrealisticcareerplans.
4.Thetraineewhoisconsideringleavingmedicine.
Eachofthesewillbeconsideredinturn.
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87You’re not an expert across the whole range of medical careersOncourseswhenconsultantssaythattheyareworriedaboutgivingcareersadvicebecausetheydon’thavesufficientinformationaboutallthedifferentoptionsavailable,weoftendrawparallelswithourowncareer-counsellingpractices.Currentlyinourownprivatepracticesweareworkingwithindividualsinpublishing,medicine,thewinetrade,healthpolicyresearch,journalism,financialservices,veterinarymedicine,telecommunicationsandproductionengineering.Andwhileweknowquitealotaboutsomeofthesefields,wemightknowrelativelylittleaboutotheroccupationsonthelist.
Butourroleisnottobean‘expert’ineachandeverypossibleoccupation(therearetoomanyofthemtoachievethis).Instead,weneedtoknowwhereourclientscanfindmoreinformation–printedandweb-based(e.g.www.medicalcareers.nhs.uk),andalsoknowhowtheycangainaccesstopeoplewhodohaveexpertiseinthefieldofinterest.
UsingthesuggestionsoutlinedinChapter3,youshouldbeinabetterpositiontodirecttraineestoappropriateresources,sothattheycanbegintoaccesstheinformationthattheyneedinordertodecidewhetherthatparticularoptionmightsuitthem.Bearinmind,too,thatifthetraineehasworkedtheirwaythroughtheStage1exercises,theyshouldbeinabetterpositiontoknowthesortofinformationthattheywanttofindoutaboutwhentheybegintoexploreparticularoptions.
Concerns about the quality of careers adviceWhatabouttheconcernthatyoumightinadvertentlygiveatraineepoorcareersadvice?Weunderstandthatthisisadefiniteareaofconcernandwealsoknowthatyou–theeducationalsupervisors–areinfront-linepositions,intermsofreceivinganxiousandoverwroughtrequestsforhelpfromyourjuniordoctors.Inreality,makingdecisionsishardenoughatthebestoftimes,andinthecurrentclimateoffrequentchangesinpost-graduatemedicaltraining,itcanbecomeevenharder.
Infact,currentlyitisextremelychallengingtogive‘advice’astherearesomanyunknownsinthenewsystem.However,wewouldsuggestthatadvicegivingisnotyourkeyrole–evenifthesituationwasmuchmorestable.Instead,yourroleistoprovidea‘routemap’forthetraineethroughtheroughterrainofcareerdecisionmaking,butitisuptothetraineetopickthefinaldestination.Ortophraseitratherdifferently,yourroleistoaskchallenging,insightfulquestions–butnottoprovidetheanswers.
Guidelines for the Educational Supervisor
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Oncourseswhenweintroducethisideaofprovidinga‘routemap’,butnotthefinaldestination,wearefrequentlychallengedbyconsultants,whotellusthatitisunrealistic.However,havinghadmanyheateddiscussionswithconsultants,overanumberofyears,wefeelthatmuchofthedisagreementcomesfromanunderstandableconfusionbetweentwodifferentaspectsoftheeducationalsupervisoryrole,namelythatofassessor(ifyouarecarryingoutasummative,competenceassessment)andcareersadviser(whenyouhaveaformativedevelopmentaldiscussionaboutthetrainee’scareerplans).
Imaginethefollowingscenario.Inyourroleasclinicalsupervisoryouhavegradedaparticulartraineeas‘borderlineforF1completion’onsomeoftheassessmenttools.Inparticular,theirperformanceseemshighlyvariableonsomeDOPS(DirectObservationofProceduralSkills)assessments.
Butyouarealsoaneducationalsupervisortothistrainee,andduringtheireducationalappraisaltheytellyouthattheywanttoapplyforbasicspecialisttraininginsurgery,withalong-termgoaloftraininginaparticularlycompetitivesurgicalspecialty.Whatshouldyoudo?
First,ifyouarebotheducationalandclinicalsupervisortoaparticulartrainee,whenyouaresittingdowntohaveanappraisalmeeting,youneedtothinkaboutwhathatyouarewearing.Intermsofyourroleasasummativeassessor,youcannot(andmustnot)alteryourprofessionaljudgementthatyourtraineehasbeen‘borderline’onthesecompetencies,justbecausetheyhavesettheirheartonacareerinsurgery.Butintermsofyourroleasacareersadviser,ratherthanagonisingwhetheryoushouldadvisethetraineetoreconsidertheircareerchoices,youshouldfocusonaskingthefollowingsortsofchallengingquestions.
Whatdoesthetraineeseeastheirkeystrengths?
Howdoesthisself-assessmentoftheirkeystrengthsfitinwithsomeoftheassessmentevidenceintheirlearningportfolio?
Inwhichareashavetheybeenassessedasbeinglessstrong?Areanyoftheseareasimportantintermsofdemonstratingsuitabilityforsurgicaltraining?
Isthereamatchbetweentheirareasofpersonalweaknessandareaswhicharecriticallyimportantintermsofsuitabilityforsurgicaltraining?
HavetheyresearchedthelikelycompetitivenessforBasicSurgicalTraining?
WhataretheirthoughtsonthefactthatcompetitionforentryintoBasicSurgicalTrainingisgoingtobeverytough,buttheyhavenotscoredhighlyontherelevantkeycompetencies?
HavetheythoughtthroughtherobustnessoftheirdecisionusingtheROADScriteria?
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89Andwecouldgoonandon…
Typicallyconsultantsthenchallengeusandsaywhynot‘callaspadeaspade’,andjusttellthemthattheyarenotsuitedforfurthertraininginsurgery?Wewouldarguethatthechallengingquestionsapproachoutlinedaboveismorerobust,forthefollowingreasons.
1.Thedirectiveapproach(i.e.‘IfIwereyou,I’dditchsurgery’)absolvesthetraineefromtakingresponsibilityfortheirowndecisionmaking.
2.Posingchallengingquestionsratherthanprovidinganswersmakesitmorelikelythatthediscussionwillbeopenedup,andthetraineewillstarttothinkcriticallyabouttheirposition.
3.Ifyougodownthe‘IfIwereyou’route,itistemptingforyourownpetlikesanddislikestoinfluencetheadviceyougive.Thismeansthatyoumightbemorelikelytoencouragethetraineetoreconsiderspecialtiesofinteresttoyou,andtoavoidthoseyouparticularlydislikedatmedicalschool.Butofcourse,the‘IfIwereyou’routehasabasicflaw:thetraineeisnotyou.
4.Youropinioncouldpossiblybewrong.(Forexample,perhapssomethingisgoingoninthetrainee’sprivatelifethatmeansthattheyhavebeensleepingpoorly,andinturngettingpoorassessmentresults.Butthetraineeknowsthatatmedicalschooltheyreceivedhighlyfavourablefeedbackontheirpotentialforsurgicaltraining.)
Wewanttoreiteratethatinsuggestingyouavoidthe‘IfIwereyou’advice-givingapproach,wearenotadvocatingthatyouavoidchallengingthetrainee’scareerdecisionmaking.Butwearesuggestingthatyouencouragethetraineetoreflectontherobustnessoftheircareerplansbyposingchallengingquestions,ratherthanpointingouttheanswers.Andifyougodownthisroute,anyconcernaboutprovidingpooradviceshouldbemuchlessacute.
Infact,whatyoushouldbeconcernedaboutisposingquestionsthatareinsufficientlychallenging.
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The trainee with unrealistic career plansThelengthyexamplediscussedaboveisobviouslyalsorelevanttotheissueofthe‘unrealistic’trainee.Butitmightalsobehelpfultomentionacoupleofotherpoints.
First,ifyouarefacedwithatraineewhopersistsinwantingtopursueacareerplanthatyoufeeliscompletelyunrealistic,wewouldsuggestthatyouaskthetraineetogoanddiscusstheirplanswithanothercolleaguewhoisinthatparticularspecialty,orwithsomebody(eitheraclinicianoracareersadviser)whohashadadditionaltrainingincareersupport.Youshouldthendoabriefsummaryoutliningyourownconcernsabouttherobustnessoftheircareerplansandgiveittothepersonwhowillbeprovidingthisadditionalsupport.
Secondly,oncourses,weoftenendupdiscussingthedifferencebetweenbehavingresponsibly‘to’butnotbeingresponsible‘for’thetrainee.Asoutlinedabove,wewouldsuggestthatpartofbeingresponsible‘to’thetraineeinvolvestheprovisionofclear,constructivefeedbackabouthowtheyareperformingintheircurrentrole;encouragingthetraineetocarryoutstages1–3ofthecareer-planningprocessandchallengingtherobustnessofproposedcareerplansusingtheROADScriteria.Allofthesearewaysinwhichyouarebehavingresponsibly‘to’thetrainee.
Butyouarenotresponsible‘for’thetrainee.
Ifyourtraineewantstoignoreclearfeedbackthatyouhavegiventhemabouttheirbelow-averageperformanceinthecurrentjob,orignorethefactsonhowcompetitiveitistosucceedintheirchosenpathway,orignorethefactthattheycan’treallygiveaclearandcoherentreasonastowhytheyfeelthattheyaresuitedtothespecialty,then,ultimately,thatisthetrainee’sdecision.
Thisdistinctionmighthelpyoufeellessanxiousifatraineeinsistsonfollowingwhatyoufeelisanill-advisedcareerpathway.Becauseifyouhavebehavedresponsibly‘to’thetrainee,thatisallthatisrequiredofyou,anditisnotalwayspossibletostopsomepeoplefrommakingpoorcareerdecisions.
The trainee who is contemplating leaving medicineTraineesmayconsiderleavingmedicineforavarietyofreasons.Forsome,thenotionthattheymightnotbesuitedtotheprofessionhadalreadystartedduringtheirundergraduatetraining,whileforothersitisthedemandsofbeingajuniordoctor,ratherthanamedicalstudent,thatmakethemwanttoreconsidertheirplans.Andyetothersmightbeinfluencedbyfeelingunsupportedinaparticularplacement.
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91Inaddition,whilesometraineeswhoareconsideringleavingtheprofessionexperiencedifficultieswiththeirtraining,andareperhapsregardedbytheireducationalsupervisorsaspossiblynotbeinguptothejob,othersmaybehighlyregardedbytheirsupervisors.
Workingthroughthestructuredapproachtocareerplanningoutlinedinthishandbook,shouldhelpthetraineestarttobecomeclearerabouttheircareerplans.Andifitseemsthatalackofsupportinacurrentplacementiscontributingtotheirdissatisfactionwiththeprofession,youwouldneedtoliaisewiththeFoundationProgrammeTrainingDirectorinyourtrust(orspecialtytrainingdirector,ifitisapost-foundationtrainee).
However,asbothofusareprovidingindividualcareercounsellingtotraineeswhoareconsideringleavingmedicine,weknowfromexperiencethatmanyofthesetraineesgreatlyvaluespecialisedcareersupport.Wewouldthereforesuggestthatifatraineecomestoyousayingthattheymightwanttoleavetheprofessionyoubeginbyusingtheapproachoutlinedbelowinthischapter,toseeifitisatemporaryissuethatcanberesolvedrelativelysimply,oranissuerelatingtospecificdifficultiesinaparticularplacement.Butif,afterfurtherdiscussion,itseemsthattheyareseriouslyconsideringleavingmedicine,wewouldsuggestthattheyaccesstheadditionalthird-tiercareersupportorinvestinsomeprivatecareercounselling.
Currently,giventheflurryofactivityaroundmedicalcareercounselling,anumberoforganisationsarebeingsetuptoofferservices.Justaswithothersortsofcounsellingorpsychotherapy,wewouldstronglyrecommendthatyourtraineechecksthatthepractitionerisadequatelyaccreditedbyasuitableprofessionalorganisation.AlistofappropriateprofessionalbodiesisincludedinAppendixA.
Wewouldalsoliketoaddonefurtherobservation.Inourexperience,consultantsoftenfeelasenseofpersonalfailurewhenatrainee(particularlyagoodone)admitsthattheyareconsideringleavingtheprofession.Wewouldcertainlywantyou,inyourroleaseducationalsupervisor,tobehaveresponsibly‘to’yourtrainee,inallthewaysdetailedabove.Thusiftheycometoyousayingthattheyareunhappyandmightwanttoleavemedicine,wewouldwantyoutoprovideasupportive,structuredresponse,inordertoseeifitisatemporaryproblemthatcouldberemediedinsomeway.
Butif,afteryouprovidethissortofresponse,thetraineestillpersistsinwantingtoleavemedicine,thenyouarenotresponsible‘for’thisdecision,anditdoesnotrepresentapersonalfailingonyourpart.
Whatweoftenpointoutwhenthisissueisraisedintrainingworkshopsisthatifselectionintomedicalschoolwasacompletelyfoolproofbusiness,andifpeopledidnotchangeduringtheirfiveorsixyearsofundergraduatetraining,youwouldberighttofeelthatthetraineehad,insomecrucial
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way,beenletdownbythesystem.Butofcourseselectionintomedicalschoolisnotcompletelyfoolproof,andpeoplechangeduringtheirundergraduatetraining.Soforbothofthesereasonssometraineesmaycorrectlyconcludethattheydon’twanttostayinmedicine.
Yourresponsibilityistoensurethattheyhavethoughtthroughthedecisionadequately,andwhereappropriatereceivedspecialisedcareersupport.Butyoushouldn’tautomaticallyregardtheexitingtraineeasapersonalfailure.
How to approach a 1:1 career-planning session with your trainee Oneoftheresponsibilitiesoftheeducationalsupervisoristohaveregularfeedbackmeetingswithyourtrainee.Thismeansthatyoushoulddevotesometimetodiscussingyourtrainee’scareerplansateacheducationalappraisalmeeting.However,dependinguponhoweachparticulartraineeisfurtheringtheircareerplans,youmightwanttoconcentrateoncareerissuesduringonesessionorevenarrangeaseparatetimewhenyouspecificallyfocusontheircareerplans.
Atallcosts,whatyouwanttoavoidisthetraineefailingtoengagewiththenecessityofidentifyingtheirnextcareermove–andthengoingintopanicmodeatthebeginningofthesecondfoundationyear,whenrecruitmentforspecialtytraininglooms.
Use the four-stage approachItwasarguedabovethatyourcentralrole,intermsofsupportingcareerplanning,istoprovideyourtraineewitha‘routemap’throughthecareer-planningstages.SoinyourfirstsessionwithyourF1traineewewouldsuggestthatyouchecktheirunderstandingoftheoverallfour-stagecareer-planningframework,andthenconcentrateonStages1and2.
Wecannotemphasiseenoughthatgoodcareerdecisionmakingrestsonthefoundationsofadequateself-assessmentandcareerexploration.Itisthereforeimperativethatyouencourageyourtraineestospendadequatetimeonthesefirsttwostages.
Insubsequentsections,waysofsupportingyourtraineethrougheachofthefourcareerplanningstagesaredescribed.
Askyourtraineestobringtheirlearningportfoliosand(iftheyhaveone)theircareer-planningfoldertoalloftheirmeetings.Thiswillhelpthemtoreviewtheirwork,andalsohelpthemdevelopasystematicapproachtotheircareerplanning.
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93Wewouldalsoliketoemphasisetheimportanceoflisteningcarefullytoyourtraineeinthese1:1meetings.(Andafavouriteadagethatweoftenuseontrainingcoursesisgiventhatwehavebeenequippedwithtwoearsandonemouth,weshouldusetheminthoseproportions.)Onehelpfulwayofmonitoringwhetheryouarelisteningwithenoughcareistotrytomonitorwhoisdoingmostofthetalking.Theremightbetimesina1:1educationalappraisalmeetingwhenyou(theconsultant)shoulddomostofthetalking.Butingeneral,incareer-planningsessions,youshouldbeaskingthequestions,andcontributingyourfeedback,whilethetraineeshouldbedoingmostofthetalking.
Intermsofhelpingthetraineereflectontheirdevelopingcareerplans,inthesectionsbelowweoutlinethesortsofquestionsthatyoushouldbeposingtoyourtrainees.Butitisimportanttoremembertheparallelwithclinicalconsultationsdescribedatthebeginningofchapter2:justasitispointlessworryingaboutthedetailsofatreatmentregimenuntilyouhavetakenaclinicalhistory,examinedthepatient,andatleastformedapreliminarydiagnosis,sotoodoyouhavetoensurethattheearlierstagesofcareerplanningareinplacebeforeyoustartdolingoutadviceonhowtosucceedattheapplicationprocess.
Yourtraineemightalsofindithelpfulifyouagreeonspecificcareer-planningtasksthattheywillcarryoutbetweenthe1:1meetings,togetherwithappropriatetimescalesfortheircompletion.
Weaving in your feedbackInyourroleofguidingyourtraineethroughastructuredframeworkofcareerplanning,youalsohaveavitalroleintermsofprovidingthemwithfeedbackontheirperformancetodate.
Usingthelearningportfolio(andanyotherrelevantdata),youneedtoweaveinyourownunderstandingofhowtheyhavebeenprogressing.Ifthisunderstandingaccordswiththeirself-assessmentordevelopingcareerplans,thenyouneedtosayso.Equally,whenthereisadiscrepancybetweenwhattheyaresayingaboutthemselvesandyourownopinion–thenyouneed(asdescribedabove)tohighlightthesediscrepancies,inordertodiscussthemasfullyaspossible.
Whileweareadvocatingthatyoushouldencourageyourtraineetoengageinrigorousself-assessment,wearenotadvocatingthatthisshouldtakeplaceinavacuum.Instead,itisyourtasktouseyourunderstandingofthistrainee’sperformancetoconfirm,ortoposeconstructivechallengesto,whatthetraineeissayingabouttheircareerplans.
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Asummaryofthekeypointsfora1:1meetingwithyourtraineeisincludedinTable3.
Table 3: Summary of key points for a 1:1 meeting•Spendsometimediscussingyourtrainee’scareerplansateacheducationalappraisalmeetingandifnecessaryarrangeanextrameetingdevotedtocareerplanning.
•Encourageyourtraineenottoleavecareerplanningtothelastminute.
•Inyourfirstsession,reviewtheoverallfour-stagecareer-planningmodel.
•Askyourtraineetobringtheirlearningportfolioandiftheyhaveone,theircareer-planningfoldertoall1:1meetings.
•Listeningiskey.Remember!Wehavetwoearsandonemouth–tobeusedinthatproportion.
•HelpyourtraineetolaythegroundworkbyspendingsufficienttimeonStages1and2.
•Attheendofeachmeeting,askyourtraineetospecifywhichcareer-planningtaskstheywillcarryout,andwithinwhichspecifiedtimescale.
•Ensureyouprovidethemwithclear,constructivefeedbackontheirperformancetodate.
•Encouragethemtousethelearningportfolio(andanyotherrelevantdata)toenhancetheirunderstandingofhowtheyhavebeenprogressing.
•Ifyouareconcernedthatthetraineeisbeingunrealistic,focusonchallengingquestionsratherthandirectiveadvice.
•Ifnecessarysuggestthattheytalkthroughtheircareerplanswithacolleague.Beforethismeeting,provideyourcolleaguewithabriefreportthatoutlinesyourconcerns.
Helping your trainee with their self-assessments (Stage 1)Yourtaskhereistoencouragethetraineetoconductathoroughself-assessmentoftheirworkvalues,skillsetc.aswellaspossiblycompletingapsychometrictestofinterestsorpersonality.Youalsowanttohelpthetraineetoreflectontheresultsoftheseself-assessments,sothattheyareabletoidentifytheimplicationsoftheseexercisesfortheirfuturecareerchoices.
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95Wewouldnot,however,recommendthatthetraineecompletestheseexercisesduringthe1:1meeting.Instead,wewouldsuggestthatthetraineeshouldcompletetheexercisesintheirowntime(orinacareer-planningworkshop),andthattheyshouldbringthecompletedexercisestothe1:1sessionforfurtherdiscussion.
Inthetablebelow(seeTable4),wegivesuggestionsforthesortsofquestionsthatyoucouldhelpfullyposetoyourtraineeabouttheStage1exercises.(Theseareonlysuggestedquestions,socalled‘Startersfor10’.WearenotadvocatingthatyouploughthroughthequestionsinTable3likeasemi-structuredpsychiatricinterview,but,rather,thatyouusethequestionsbelowtogetafeelforhowyoucanhelpyourtraineebecomeclearerabouttheircorevalues,interests,skills,etc.)
Table 4: Good questions to pose to your trainee about the Stage 1 exercises
Work values1.Whatdoyouseeasyourcoreworkvalues?
2.Whatarethepossibleimplicationsofanyofyourcoreworkvaluesforthecareerdecisionsthatyouarecurrentlyfacing?
3.Thinkingbacktoatimewhenyouparticularlyenjoyedyourwork,whatlinkscanyouseebetweenthereasonsforthisenjoymentandyourcoreworkvalues?
4.Whatabouttheopposite,i.e.whatlinkscanyouseebetweenatimewhenyouwereparticularlyunhappyatworkandyourcoreworkvalues?
5.Howmightyourcoreworkvalueschangeovertime,andhowmightyouadjustyourcareerplansinorderthatthereisanappropriatematchfortheseanticipatedchangesinworkvalues?
Achievements/skills/interests1.Usingtheresultsfromtheexercisewhereyouexaminedspecific
achievements,whatkeyskillsdidyouidentify?Ofthese,whichareyouparticularlyinterestedinusingatwork?
2.Arethereanykeyskillsthatyouaren’tusingatworkthatyouwouldliketobeabletouse,inordertofindworkmoresatisfying?
3.Whatkeyskillsdidyouidentifyinyournon-workexample?Arethereanytherethatyouwouldbeinterestedinusinginaworkcontext?
4.Whatfactorscontributetoyoufeelingstressedatwork?
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Psychometric instruments1.(Before.)Whatareyouhopingtogainfromtakingthisparticular
instrument?
2.(After.)Whatareyourthoughtsabouttheresults?Towhatextentdotheresultsaccordwithwhatyoualreadyknowaboutyourself?Canyougivespecificexamples?Andtowhatextentdotheresultsconflictwithwhatyoualreadyknowaboutyourself?(Andagain,canyougivespecificexamples?)
Role ModelsThinkingaboutadoctorwhomyouregardasapositiverolemodel,canyouidentifyaspectsofworkthatareparticularlyimportanttoyou.
Summary of Stage 11.Ifyouwereaskedtogiveasummaryoftheself-assessmentexercises
thatyoucarriedoutaspartofStage1,whatwouldyousay?
2.Canyoudescribeexamplesfromyourcareertodatethatillustrateyourindividualpatternofvalues,skills,interests,rolemodels,etc.thatyouhaveincludedinyoursummary?
3.Ifyoudonotfeelatallclearaboutyourkeyvalues,skills,interests,etc.,whatareyougoingtodoinordertoenhanceyourabilitytocompletetheStage1exercisesinsufficientdetail?
Helping your trainee explore different career options (Stage 2)Thekeytaskforyouinthisstageistoencourageyourtraineetoconductasystematicexplorationofdifferentcareeroptionsthatinterestthem.Furthermore,ashasbeenarguedthroughout,thiscareerexplorationdoesnotinvolveresearchingeachoptioninastandardisedway,but,instead,youneedtoencourageyourtraineetoconstructapersonalisedlistofqueries(derivedfromtheStage1self-assessments)andthenapplythispersonalisedlisttothespecificcareersthattheyareexploringfurther.
Allthepointsdiscussedinthesectionsabove(e.g.goodlisteningcombinedwithaskingchallengingquestions)alsoapplytohowyoushouldsupportyourtraineethroughtheirStage2activities.
GoodquestionstoposetoyourtraineeinthisstageofthecareerplanningframeworkareincludedinTable5(overleaf).
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97Table 5: Good questions to pose to your trainee about the Stage 2 exercises1.Haveyouidentifiedtwotofouroptionsthatyouwanttoexplore
further?Ifyes,thengotoquestion3,ifno,thengotoquestion2.
2.Whatspecifictasksareyougoingtocarryoutinordertobeabletoidentifyasuitableshortlistofpossibleoptions?(ThismightincludegoingbacktoredotheStage1exercisesinmoredetail,arrangingtocompleteapsychometricinstrumentsuchasSci59ortheMyers-BriggsTypeIndicator.Oritmightinvolvegettingsomeadditional1:1supportsuchasarrangingasessionwiththeFacultyCareersLeadortheSeniorCareersAdviserinyourdeanery.)
3.(Iftheeducationalsupervisorhasconcernsaboutanyofthechoicesbeingexplored.)OnthebasisofwhatIhaveseenofyourwork/yourassessments,itseemsasif(nametherelevantcompetence)issomethingthatyoustrugglewith.Yetthiswouldbeseemtobeakeyaspectoftrainingin(namethespecialty).Howdoyoureconcilethesetwofacts?
4.Havingidentifiedtwotofouroptionsthatyouwanttoexplorefurther,haveyouconstructedalistofspecificquestions(linkedtotheStage1self-assessmentactivities)thatyouaregoingtoexplore?Havingdonethis,foreachquestion,haveyouworkedoutwhatyouaregoingtoread/whomyouaregoingtoask?Whattimescalehaveyousetyourself?
5.Haveyouidentifieda‘backupplan’incaseyouarenotsuccessfulinachievingyourfirst-choiceoption?Ifnot,doyouthinkthatthismightbeausefulstrategy?Howmightyougoaboutchoosingyour‘backupplan’?
Helping your trainee make a good career decision (Stage 3)Yourkeytaskhereistohelpyourtraineemakeafinaldecisionastowhattheyaregoingtoapplyforontheirapplicationform.YoushouldalsohelptheminterrogatetherobustnessofthisdecisionusingtheROADScriteria.
Goodquestionstoposetoyourtraineeinthisstageofthecareer-planningframeworkareincludedinTable6.
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Table 6: Good questions to pose to your trainee about Stage 31.LookingbackattheLifelineexercise,canyouidentifyagoodcareer
decisionthatyouhavemadeinthepast?Withreferencetothisexample,howdidyouarriveatthisdecision?
2.Whatcanyoulearnfromthispreviousdecisionintermsofhowbesttoapproachyourcurrentdecision?
3.Howwouldyouexplainyourcareerdecisionintermsofthematchbetweenwhatyounowunderstandaboutyourself(Stage1)andwhatyouhavefoundoutaboutthecareeroptionsthatyouwishtopursue(Stage2)?
4.HaveyoureviewedyourdecisionusingtheROADSchecklist?Realistic –areyoubeingrealisticaboutyourselfANDthedemandsofthejob? Opportunities –haveyougivenseriousconsiderationtoalltheopportunitiesavailable? Anchors –haveyoubuiltinthethingsthatprovidesupportinyourlife? Development –doyourchoicesfullydevelopyourpotential? Stress –haveyouconsideredthoseaspectsofworkthatposeparticularstressesforyou?
5.Haveyouidentifiedbothaplan,anda‘backupplan’?(If,astheeducationalsupervisor,youthinkthattheplanand/orthe‘backup’failtomeetoneormoreoftheROADScriteria,thenyouneedtoraisethisissuewithyourtrainee.Ifyourtraineedoesn’twanttotakethequestionsthatyouarechallengingthemwithonboard,thenyoucansuggestthattheygoanddiscusstheircareerplanswiththeFacultyCareersLeadortheDeaneryCareersAdviser.)
Helping your trainee with implementing their plans (Stage 4)Atthisstageyouneedtodiscusstheapplicationformswithyourtrainee,andalsoensurethattheyaredoingadequateinterviewpreparation.
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99Application formsTheissueofhowfaritispermissibletohelpyourtraineeswiththeirapplicationformsisavexedone.Ifyouaregoingtobeinvolvedinshort-listingorinterviewing,thenitisprobablyadvisableifyousuggestthatyourtraineehasamoredetailedconversationabouttheirapplicationformorabouttheinterviewwithanothercolleague.
Wewouldsuggestthatyouencouragethetraineestoreadthroughthedetailedadvicegivenintherelevantsectionsofthishandbook.Inaddition(aslongasyouarenotactuallyinvolvedintheshort-listingorinterviewprocess),youcanreadthroughdraftsoftheiranswersandmakegeneralcomments.Forexample,itispermissibletomakegeneralcommentssuchas:‘Idon’tthinkthatyouhaveadequatelyansweredthesecondpartofthequestion’or‘Idon’tthinkthatyouranswerclearlydemonstratesthatyouhaveallthenecessaryskills.’Youshould,however,avoidsuggestingspecificwordingthattheyshouldincludeintheform.
Thesortsofquestionsthatyoucouldposetoyourtraineeatthisstageofthecareer-planningprocessareincludedinTable7.
Table 7: Good questions to pose to your trainee about application forms1.HaveyoucarefullyreadthroughChapter3inthishandbook?
2.Areyouclearthatyouaregoingtomeettheapplicationdeadlines?
3.Haveyoucheckedthatyouranswerstallywiththespecificcriteriaasoutlinedinthepersonspecification?(But,equally,haveyoumadesurethatyouranswersdonotinvolvesimplyrepeatingthewordingofthepersonspecificationonyouractualapplicationform?)
4.Haveyoucheckedandre-checkedyourspellingandgrammar?
InterviewsUsingthesampleinterviewquestionsincludedinChapter3,youcanconductmockinterviewswithyourtrainees.Youcaneitherdothisona1:1basis,orcanincorporateinterviewtrainingintoagroupcareer-planningworkshop(seebelow).But,again,wewouldsuggestthatyoudon’trunamockinterviewforatrainee(orgroupoftrainees)ifyouareactuallyontheinterviewingpanel.
Intermsofdiscussinginterviewpreparationduringa1:1sessionwithyourtrainee,thesortsofquestionsthatyoumightwanttoaskareincludedinTable8.
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Table 8: Good questions to pose to your trainee about interviews1.Haveyouthoughtaboutthequestionsthatyouarehighlylikelytobe
asked,andplannedsomestronganswers?(Youcanthendiscussthese.)
2.Haveyoupreparedasmallnumberofexamples(takenfromyoure-portfolio)thatclearlydemonstrateyourkeyskillsandabilities?Haveyoualsopreparedsomesuitableexamplesincaseyouareaskedaboutareasinwhichyouareweaker,oraboutmistakesthatyouhavemadeinthepast?(And,again,youcandiscussthese.)
3.Whatspecificconcernsdoyouhaveabouttheinterviewprocess?Howareyouintendingtoaddresstheseconcerns?Whoelsecouldhelpyou?
Group career-planning workshopsInsomeregionscareer-planningworkshopshavebeenincorporatedintothegenerictaughtfoundationprogramme.
Thisisastrategythatwewouldadvocate;notonlyisitanefficientuseoftime,butalsothetraineescanlearnmuch,andgainencouragementandsupportfromeachother.
Thepersonrunningtheworkshopdoesn’tneedtobea‘careersexpert’,asallthenecessarybasicmaterialshavebeenworkedoutforyou,andaredetailedbelow.Instead,theroleofthepersonrunningtheworkshopistoactasafacilitator.
Manyofthebasicguidelinesdescribedaboveabouthowbesttoapproachthetaskof1:1careersmeetingsalsoapplytothetaskofgroupfacilitation.Forexample,aswitha1:1meeting,inagroupsessionitisalsoimportantto:
1.Outlinetheoverallfour-stagecareerplanningframework.
2.Listencarefullytothepointsthatthetraineesaremaking.
3.Posechallengingquestions.
Butthereareafewpointsthatapplyspecificallytothegroupsituation.Specifically,wewouldhighlightthefollowing:
Avoidthediscussionofhighlypersonalissues(suchaswhetherinfuturetheymightwanttohaveafamily)infrontofthegroup.Thiscanbediscussedbysettingataskforthewholegroup,gettingthegrouptodiscussitinsmallergroups,andthenreconveningwhenyouaskforgeneralcomments.Traineesaremuchmorelikelytospeakopenlytosmallgroupsoftheirpeersthaninlargergroups,inwhichtheconsultantispresent.
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101Ifyouareaskingthemtoreflectonnegativeissues(whattheyfindstressful,mistakes,etc.),getthemtodiscussthisinpairs,orperhapstowritedowntheirthoughtsontheirown.Youshouldn’taskthetraineestodiscusswhatcouldbequitepainfulissuesinasmall-orlarge-groupcontext.Forthesetasksusepairedwork,oraskthemtoworkindividually.
Providetimeattheendofthesessionfortraineestocomeandspeaktoyouinprivate.Iftheissuetheyraiseturnsouttobequiteacomplexone,youmightneedtoarrangeanadditionaltime,orsuggestareferraltoanothersource.But,inourexperience,attheendofsessionstraineesoftencomeandraiseissuesinprivatethattheydidnotfeelcomfortableraisinginfrontofthewholegroup.Oneadvantageofagroupcontextisthattheycanlearnfromeachother.Soifatraineeasksyouachallengingquestion,ifappropriateposeitbacktothegroupforcomments,beforeyouwadeinwithyourownanswer.Oftenthegroupwillcomeupwithexcellentanswers,andthetraineesfindthesupportandadviceoftheirpeersparticularlyhelpful.
Final commentsHavingrunalargenumberoftrainingworkshopsforconsultants,weknowthatsomeeducationalsupervisorsfeeldistinctlyuneasyabouttheircareersupportresponsibilities.
Itisourhopethatthestructuredfour-stagemodeloutlinedinthischapterwillprovideyouwithapracticalframeworkforapproachingthetask.Thefollowingfigureprovidesanoverviewoftheactivitieswhichneedtobecovered.
Guidelines for the Educational Supervisor
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Figure 6: Foundation programme – overview of activities
Foundationyear1:RunearlyinF1 Foundationyear2:RunearlyinF2
Careerplanningstage
Traineedoctors Foundationprogrammeteam
Traineedoctors Foundationprogrammeteam
Stage1–self-assessment
Interests
Values
Skillsandachievements
Stressesandstrains
Psychometrictests(optional)
Reflectivepractice(e-portfolio)
Personaldevelopmentplans
Careersummarysheets
Rolemodelexercise
Runworkshop1forF1doctorstointroducethecareer-planningframeworkandcoverStages1and2ingreaterdetail–seeAppendixE
Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees
EducationalsupervisortoensurePersonalDevelopmentPlans/CareerSummarysheetscomplete
ReviewStage1and2assessmentsinordertoprepareforStage3
ReflectivePratice(e-portfolio)
Personaldevelopmentplans
Careersummarysheets
Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees
EducationalsupervisorstoensurePersonaldevelopment
Stage2–careerexploration
F1TraineetosetSMARTplanafterworkshop
Initialsearchtoidentifypossiblecareeroptions
Morefocussedsearch,includinginterviewingpeopleinthespecialitiesofinterest
Attendevents,includingcareersfairs
Arrangetasters
Runworkshop1asabove
Educationalsupervisorstoreviewin1:1meetingswithtrainees
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
Introducespecialtytrainingpersonspecifications
ThetraineeconsiderstheircareeroptionsinlightofanychangesintheirStage1/2activities
ThetraineetofullyconsiderplanB
Arrangetasters
Educationalsupervisorstoreviewin1:1meetingswithtrainees
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
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103Stage3–decisionmaking
EmphasisegooddecisionmakingcomesfromcarryingoutStage1and2
WhenreadythetraineemovestoStage3
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
IntroducetheimportanceofplanB.TraineetoreflectonStage2–careerexploration
Highlighttimescalesforspecialtyrecruitment
Thetraineeconsiderstheircareeroptions
Decision-makingexerciseROADS
Carryoutfurtherinterviewingpeopleinthespecialtiesofinterest
ThetraineetofullyconsiderplanB
Runworkshop2forF2doctorstoincludeabriefreviewofthecareer-planningframeworkandtocoverStages3and4–seeAppendixF
Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
Stage4–planimplement-ation
F2TraineetosetSMARTplanafterworkshop
Reflectivepractice(e-portfolio):
Personaldevelopmentplans
Careersummarysheets
IntroducelinkageofStages1,2and3onqualityapplicationsandinterviewperformance
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
Applicationforms
Interviews
Roleofportfolioonselectionprocess
PeninsulaDeanery/AGCASDVD–selectioncentresforSpecialtyTraining
Runworkshop2asabove
Educationalsupervisorstoreviewcareerplanningin1:1meetingswithtrainees.
EducationalsupervisortoensurePersonaldevelopmentplans/careersummarysheetscomplete
Reflectivepractice(e-portfolio):
Personaldevelopmentplans
Careersummarysheets
Guidelines for the Educational Supervisor
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Chapter2beganwithaclinicalanalogy,namelycomparingthefour-stagecareer-planningframeworktoamodelofclinicalconsultation,andwewouldliketoreturnbrieflytothisparallel,inthefinalsectionofthehandbook.
Asexperiencedclinicians,yourapproachtoaclinicalconsultationwillbynowbesecondnaturetoyou,asitissomethingthatyoudowithoutthinking,dayin,dayout.Butthesameisn’ttrueforyourmedicalstudents(andwasn’ttrueforyouwhenyouwereamedicalstudent).Thisthereforeremindsusthatlearningacomplexnewskilltakesbothtimeandpractice.
Puttingtheframeworkoutlinedinthishandbookintopracticewilltakeabitoftimetogetusedto,astherearebothinformationtoassimilateandskillstodevelop.Andyouwillalsoneedtopractiseit.Butyouarestartingfromagoodvantagepointgiventhatyoualreadyhaveahighlydevelopedsetofcommunicationskillsthatyouuseinyourpatientconsultations(andalsointeachingandmanagementtasks).
Oftenattheendofworkshopsconsultantsexpressreliefthatataskthattheyhadpreviouslyfeltwasbeyondtheirexpertise(namelytheprovisionofcareersupport)turnedouttobemuchmorestraightforwardthantheyhadinitiallyenvisaged.
Wehopethatbyusingthishandbook,youwillreachasimilarconclusion.
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105ReferencesBorges,N.J.andSavickas,M.L.(2002).‘Personalityandmedicalspecialtychoice:aliteraturereviewandintegration’,Journal of Career Assessment,10,no.3,pp.362–80
Borges,N.J.,Savickas,M.L.andJones,B.J.(2004).‘Holland’stheoryappliedtomedicalspecialtychoice’,Journal of Career Assessment,12,no.2,pp.188–206
Freeman,R.andLewis,R.(1998).Planning and Implementing Assessment. London:KoganPage
Gale,R.andGrant,J.(2002).‘Sci45:thedevelopmentofaspecialtychoiceinventory’,Medical Education,36(7),pp.659–66
Hirsh,W.,Jackson,C.andKidd,J.M.(2001).Straight Talking: Effective Career Discussions at Work.Cambridge:NationalInstituteforCareersEducationandCounselling(NICEC)
Kidd,J.M.(2006).Understanding Career Counselling:Theory,ResearchandPractice.London:Sage
Krieshok,ThomasS.;Black,MichaelD.;McKay,RobynA.Careerdecisionmaking:Thelimitsofrationalityandtheabundanceofnon-consciousprocesses.Journal of Vocational Behavior(0001-8791)Dec,2009.Vol.75,Iss.3;pp.275–290
KrumboltzandLevin2007.Luck Is No Accident Making the Most of Happenstance in Your Life and CareerbyKrumboltz,John;Levin,Al(2004)
Mitchell,KE;Levin,AS;Krumboltz,JD.Plannedhappenstance:constructingunexpectedcareeropportunitiesJournalofCounseling and Development(0748-9633)Spring1999.Vol.77,Iss.2;pp.115–24
Nathan,R.andHill,L.(2006).Career Counselling.2ndedn.London:Sage
TookeJ.Aspiring to excellence: final report on the independent inquiry into Modernising Medical Careers.London:MMCInquiry,2008.www.mmcinquiry.org.uk
Bibliography
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Appendix A
Career Counsellors: List of Professional BodiesWithinthecareer-counsellingprofessionthewordsinformation,adviceandguidancehavespecificmeanings:
Information–thisistheprovisionofinformationonlearningandworkwhichcanbeprovidedthroughawiderangeofmedialikewebsites,leaflets,etc.andfacetoface.Withinthemedicaleducationcontextinformationaboutspecialtytrainingopportunities,competitionratios,etc.aregoodexamples.
Advice–thisiswheresomeonemightwishtodiscusstheinformationtheyhavegatheredwithsomeonetodeveloptheirunderstandingofitandfindoutifthereareothersourcesofinformationwhichwouldbeusefultothem.Thepersongivingtheadvicemightproposetheyneedmorein-depthsupportandthisiswhereguidancecomesin.
Guidance–theprovisionofin-depthsupporttoanindividual,oftenfacetofaceorbytelephone.Increasingly,electronicmediaarebeingusedtoprovideguidanceandit’salsooftenprovidedinagroupsetting.
Pleasenotethatcareercounsellorsarealsooftencalledcareeradvisers,careerguidanceprofessionals,careerconsultantsandcareerpractitioners.Increasingly,peoplearealsoofferingcareercoaching.
Institute of Career Guidance:http://www.icg-uk.org/
TheICGaccreditscareerguidanceprofessionalandhasasectiononitswebsitetohelpyoufindacareeradviser.
AGCAS:http://www.agcas.org.uk/
TheAssociationofGraduateCareersAdvisoryServicesistheprofessionalassociationofcareerprofessionalsinHigherEducation.UniversityCareersServicesareusuallymembersofAGCASandyourmedicalschoolmayhaveaccesstotheservicesoftheuniversitycareersservice.
Prospects:http://www.prospects.ac.uk/cms/ShowPage/Home_page/p!eLaXi
ThisistheUK’sofficialwebsiteforgraduatesanditissupportedbyAGCAS.Youcanemailacareersconsultantandalsofindacareercoachifyouwanttoworkwithsomeoneonanindividualbasis.Theseservicesareincludedinthecareersadvicesectionofthewebsite.
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107NAEGA:http://www.naega.org.uk/
TheNationalAssociationforEducationalGuidanceforAdultsisapractitionerorganisationrunbymembersformembers.Thewebsitehaslinkstoguidanceprovidersinits‘lookingforguidance’section.
British Psychological Society:http://www.bps.org.uk/
TheBPSistherepresentativebodyforpsychologyandpsychologistsintheUK.
Youcanusetheirmainsitetofindacharteredpsychologist.
TheBPSalsoaccreditspractitionersintheuseofpsychometricinstrumentsandhasaseparatewebsiteforthePsychologicalTestingCentre:
http://www.psychtesting.org.uk/.Thedirectoriessectioncontainsdetailsofqualifiedtesters,andwithinthedirectoriessectionyouneedtosearchforaLevelBinstrument(aspersonalityinstrumentssuchastheMBTIarecategorisedasLevelB).
Coaching
Coachingisanincreasinglypopulartoolwhichcanbeusedtohelpsupportpersonaldevelopment.Itcanalsobeofferedaslifecoaching,careercoaching,personaldevelopmentcoaching,etc.TheEuropeanCoachingInstitutedefinescoachingasa‘simpleyeteffectiveformofpersonaldevelopmentwhereclientandcoachcreateanalliancethatpromotesandsustainstheclient’spersonalgrowthandcompetence’.
Atthemomenttherearenoofficialregulatorystandardsforcoachingandnogovernedtrainingstandardswhichneedtobeattainedbeforeindividualscanbecomeacoach.Therearethoughtwointernationallyself-appointedaccreditationbodiesthataimtoself-regulatetheindustryandwithintheUKCIPD(CharteredInstituteofPersonnelandDevelopment)provideadvicetoHRprofessionalsoncoachingandmentoring.
Herearesomewebsitesifyouwouldliketofindoutmore:
CIPD:http://www.cipd.co.uk/subjects/lrnanddev/coachmntor/
International Coach Federation:http://www.coachfederation.org/icf/
European Mentoring and Coaching Council:http://www.emccouncil.org/
Appendix A
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Appendix B
Further Resources for Career PlanningGeneral career planning
Hopson,B.andScally,M.(2000).BuildYourOwnRainbow:WorkbookforCareerandLifeManagement.London:KoganPage
(Thiscanalsobeusedasaself-helpguidebytraineeswhowantmorehelpwithStage1.)
Schein,E.H.(1990).CareerAnchors:DiscoveringYourRealValues:Instrument.USA:Jossey-Bass.Pfiefer
Medical career guides
SouthWestPeninsularandAGCASDVD–Selectioncentresforspecialitytraining.http://www.agcas.org.uk/agcas_resources/37-selection-centres-for-speciality-training
Chambers,R.,Mohanna,K.andField,S.(2000).OpportunitiesandOptionsinMedicalCareers.Oxford:RadcliffeMedicalPress
Cottrell,E.,Rebora,C.andWilliams,M.(2006).TheMedicalStudentCareerHandbook.Oxford:RadcliffePublishing
EcclesS.andSanders,S.(2008).SoYouWanttobeaBrainSurgeon?Amedicalcareersguide.Oxford:OxfordUniversityPress
Hastie,A.andStephensonA.(2008).ChoosingGeneralPractice.Oxford:BlackwellPublishing
Hill,E.(2008)Soyouwanttobeamedicalmum?Oxford:OxfordUniversityPress
Kersley,S.(2005).PrescriptionforChange.Oxford:RadcliffeKersley,S.(2006).ABCofChangeforDoctors.Oxford:Radcliffe
Lepnurm,R.,Danielson,D.andDobson,R.(2006).‘Cornerstonesofcareersatisfactioninmedicine’,CanadianJournalofPsychiatry,51,no.8,pp.512–22
MacDonald,R.andHadridge,P.(2003).MyBeautifulCareer.London:BMJPublishingGroup
RoyalCollegeofPhysiciansofLondon(2002).CareersInformationHandbookforTrainees.London:RoyalCollegeofPhysicians
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109Careers guidance counselling guides
Ali,L.andGraham,B.(1996).TheCounsellingApproachtoCareersGuidance.London:TaylorandFrancis(Routledge)
Cochran,L.(1997).CareerCounselling:aNarrativeApproach.London:Sage
Kapes,J.T.,Mastie,M.M.andWhitfield,E.A.(eds.)(1994).ACounsellor’sGuidetoCareerAssessmentInstruments.3rdedn.NationalCareerDevelopmentAssociation
Reid,H.andBimrose,J.(eds.)ConstructingtheFuture:TransformingCareerGuidance.InstituteofCareerGuidance
Watts,A.G.,Law,W.,Killeen,J.,Kidd,J.M.andHawthorn,R.(1996).RethinkingCareersEducationandGuidance.London:Routledge
Yost,E.B.andCorbishley,M.A.(1987).CareerCounselling:aPsychologicalApproach.USA:Jossey-Bass.Pfiefer
Coaching guides
Covey,S.(2004).7HabitsofHighlyEffectivePeople.London:SimonandSchuster
Gallwey,W.T.(2001).TheInnerGameofWork.London:RandomHouse
Landsberg,M.(2003).TheTaoofCoaching.London:ProfileBooks
Whitmore,J.(2002).CoachingforPerformance:GrowingPeople,PerformanceandPurpose.NationalBookNetwork
Royal College websites
Thesesitescontainawiderangeofinformationincludingpersonspecifications,informationabouteducationandtraining,flexibletraining,etc.
• AcademyofMedicalRoyalColleges:http://www.aomrc.org.uk/
• CollegeofEmergencyMedicine:http://www.collemergencymed.ac.uk/CEM/default.asp
• RoyalCollegeofAnaesthetists:http://www.rcoa.ac.uk/
• FacultyofDentalSurgery:http://www.rcseng.ac.uk/fds
• RoyalCollegeofGeneralPractitioners:http://www.rcgp.org.uk/
• RoyalCollegeofObstetriciansandGynaecology:http://www.rcog.org.uk/
• FacultyofOccupationalMedicine:http://www.facoccmed.ac.uk/
• RoyalCollegeofOphthalmologists:http://www.rcophth.ac.uk/
• RoyalCollegeofPaediatricsandChildHealth:http://www.rcpch.ac.uk/
Appendix B
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• RoyalCollegeofPathologists:http://www.rcpath.org/
• FacultyofPharmaceuticalMedicine:http://www.fpm.org.uk/
• RoyalCollegeofPhysiciansofEdinburgh:http://www.rcpe.ac.uk/
• RoyalCollegeofPhysiciansofLondon:http://www.rcplondon.ac.uk/
• RoyalCollegeofPhysiciansandSurgeonsofGlasgow:http://www.rcpsg.ac.uk/Pages/default.aspx
• RoyalCollegeofPhysiciansofIreland:http://www.rcpi.ie/pages/home.aspx
• RoyalCollegeofPsychiatrists:http://www.rcpsych.ac.uk/
• FacultyofPublicHealth:http://www.fphm.org.uk/
• RoyalCollegeofRadiologists:http://www.rcr.ac.uk/
• RoyalCollegeofSurgeonsofEdinburgh:http://www.rcsed.ac.uk/site/0/default.aspx
• RoyalCollegeofSurgeonsofEngland:http://www.rcseng.ac.uk/
• RoyalCollegeofSurgeonsinIreland:http://www.rcsi.ie/
Medical careers websites
• NHSMedicalCareers:http://www.medicalcareers.nhs.uk
• NHScareers:http://www.nhscareers.nhs.uk/
• BMJcareers:http://careers.bmj.com/careers/hospital-medical-healthcare-doctors-jobs.html
• Doctors.net:http://www.doctors.net.uk/
• UKFoundationProgramme:http://www.foundationprogramme.nhs.uk/pages/home
Websites which advertise medical jobs and training opportunities
• NationalrecruitmentofficeforGPtraining:
• http://www.gprecruitment.org.uk/
• NationalInstituteforHealthresearchadvertisejobsinacademicmedicine:http://www.nihr.ac.uk/Pages/default.aspx
• NHSjobs:http://www.jobs.nhs.uk/
• BMJcareers:http://careers.bmj.com/careers/hospital-medical-healthcare-doctors-jobs.html
• HealthServiceJournal:http://www.hsj.co.uk/
• TheLancet:http://careers.thelancet.com/home/index.cfm?site_id=8802
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111Essential websites
• COPMeDistheConferenceonPostgraduateMedicalDeansintheUK:http://www.copmed.org.uk/
• DepartmentofHealth:http://www.dh.gov.uk/en/index.htm–canbeusedtoobtainacopyofthe‘GoldGuide’whichregulatesspecialtytraining
• GMC:http://www.dh.gov.uk/en/index.htm–forcopiesof‘GoodMedicalPractice’and‘TheNewDoctor’aswellinformationontheregulationofpostgraduatemedicaleducation.
• BMA:http://www.bma.org.uk/–andensureyouhaveacopyoftheBMAJuniorDoctorsHandbook.
• EqualityandHumanRightsCommission:http://www.equalityhumanrights.com/advice-and-guidance/–theDisabilityDiscriminationAct(1995)introducedanumberofimportantprovisionsforemployees:theguaranteedinterviewschemeandrequiringemployerstomakereasonableadjustmentsforpeoplewithdisabilities.TheEqualityandHumanRightsCommission’swebsitecontainsusefulinformationandadvice.
• BritishDyslexiaAssociation:http://www.bdadyslexia.org.uk/–isacharitywhichprovidesarangeofservicestoemployersandemployees.
Psychometric tests
Sci45/59.SpecialtyChoiceInventory.
AvailablefromtheOpenUniversityCentreforEducationinMedicine
Tel.01908653776
AvailableforBMAmembersfromtheBMAwebsite.Somedeanerieshavealsopurchasedlicencesforthisinstrument.AsktheCentreManageratyourtrustEducationCentre,orthedeanerycareersstaff.
Appendix B
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Appendix C
Guidelines for CV WritingIntroduction
Thereisconsiderablevariabilityinrecommendedlayoutsandwewouldsuggestthatyoudiscussthismatterwithyoureducationalsupervisorandyourcolleagues.Butwhateverlayoutyouchoose,youneedtomakesurethattheCVmatchesthepersonspecificationoftheposttowhichyouareapplying.
Todootherwisecangivetheimpressionthatyouaren’treallythatkeenonbeingofferedthepost.
Theissueofincludinginformationthatidentifiesyourageisalsotricky.Fromalegalpointofview,youdonotneedtoincludesuchinformation,sonotonlyyourdateofbirthbutalsothedatesatwhichyouachieveddifferentqualificationscanbeomitted.However,althoughrecruiterscannotmarkyoudownforomittingthisinformation,theymightfinditsurprising,asmanypeoplewouldexpecttoputthedatesatwhichtheypassedparticularexamsontheirCV.Again,wewouldsuggestthatyougetlocaladvicefromyoureducationalsupervisor.
Theheadingsbelowgiveonepossiblestructure,anditiscertainlyausefulstartingpointforconstructingyourfinalCV.
Personal details
Yourname,address,telephonenumber,andemailaddress–theseshouldbeatthetopofpageoneofyourCVandcouldbeshowninaheaderonsubsequentpages.
Career plan
Onesentencesummarisingyourcareeraims,andhowthejobonofferwillhelpyouachievethem.
Personal information
IncludeyourGMCnumberandtypeofregistration.Youdonotneedtoincludeyourdateofbirth,nationality,maritalstatusorsex.
Professionalqualifications(fromthecurrenttime,backtomedicalschool,i.e.includemostrecentfirst).
Soifyouhavecompletedadditionalprofessionalqualifications(e.g.MRCPPart1),thisshouldgofirst.Thenlistyourmedicalschoolqualifications.Foreachqualificationlist:
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113–Titleofqualification,classofdegree(ifrelevant),awardingbodyand,ifyouchooseto,thedate.
–Inaddition,bullet-pointprizes/distinctionsatmedicalschool.Youmayalsoincludeabulletpointonyourelectiveyear,aspartofthedescriptionofyourundergraduatetraining.
Education
Detailsofyourschoolqualificationswithnameofschoolandgradesandagain,ifyouchooseto,thedate.(Again,mostrecentfirst.)
Professional expertise
Includejobtitle,locationsanddates.Forcurrentandpreviousposts,beyondlistingjobtitle,employingtrustanddates,youcanalsoincludeacoupleofbulletpointshighlightingthekeyfeaturesofeachjobthatdemonstrateyoursuitabilityforthepostonoffer.Ifyouareamoreexperiencedapplicantwhohashadanumberofpreviousmedicaljobs,thenyoudon’twanttogivetoomuchdetailonjobsthatyoudidaconsiderabletimeago,oronjobsinwhichyoubasicallygainedthesameexperience.Thekeypointhereisthatyoudon’tneedtogivethesameamountofinformationoneachandeveryjobthatyouincludeinyourCV;matchingtothepersonspecificationistheimportanttask.
Practical skills
Bullet-pointspecificproceduresyouarefamiliarwithandwhererelevantindicatehowmanyyouhaveperformed.Forexample,‘performedmorethan20chestaspirations’.
Additional courses
ListALSorotherrelevantcourse.
Research
Listyourpublications,casereportsandconferencepresentations(butbewaryofwriting‘inpreparation’asthiscanirritateconsultants,whoknowthatsuchclaimsoftendon’tamounttomuch).
Teaching and audit
Includeacoupleofexamples,andmakesureyoubrieflymentiontheoutcomeofanyaudit.
Other relevant skills
Forexample,youcanmentionforeignlanguagesthatyouspeak,andparticularITskills.
Appendix C
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Interests
Bullet-pointacoupleofyourintereststhatyoucantalkaboutatinterviewandthataddvaluetoyourapplication.
References
Giveatleasttworeferences.Oneoftherefereesshouldbeyourcurrentormostrecenteducationalsupervisor.Includeaccuratecontactdetailsforthoserefereesandremembertoletyourrefereeknowthatyouhavegiventheirdetailsasarefereeasthisavoidsunnecessarydelays.
IfyouwantmoredetailedguidanceonCVwriting,thefollowingtwobooksareuseful:
AdamPoole.HowtoGetaJobinMedicine.ElsevierHealthSciences.2005
SamMcErin.WritingaWinningCV:EffectiveProfessionalDevelopment.Edukom.2004
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115Appendix D
Guidelines for Giving a Presentation at a Job InterviewForsomespecialtiesyoumaybeaskedtogiveapresentationaspartoftheselectionprocess.Usuallythesubjectisgiventoyouinadvancetogetherwiththemaximumtimeyouhavetodeliveritontheday.
Whenthetopicisgiventoyouinadvance
1. PreparationStartyourpreparationbyresearchingandgatheringyourthoughtsonthesubjectmatterofthepresentationandwhatyoucouldcover.Askcolleagues,friendsandothersfortheirviewsonwhatshouldbeincluded.Dobeawarethatitmightbeappropriatetobringinhigherlevelcontextualinformation,e.g.anewpolicyontreatmentforthatparticularspecialty.Onceyouhaveanideaofwhatyouthinkyouwillcover,organiseyourmaterialandstartthinkingaboutthebestwaytopresentit.
2. PowerPointMostpeopleusepackageslikePowerPointandthatisfine.Dokeepyourslidessimple,withacleanlayoutandeffectivecolourscheme.Busyslideswithlotsofdetailareoftendifficulttoreadandflyingbulletpointsandflashyeffectscanbeveryirritatingtointerviewers.Alsoensureyouarefamiliarwiththecontentasthiswillhelpyoudeliveramorefluentpresentation.Keepthelayoutofyourslidescleanandsimple.Diagramscanbeeffectiveandhelpyoutomakeyourpoint.Theyshouldbedrawninsuchawaythatitisclearhowtheyshouldberead.Keepthenumberofbulletpointsontheslidestonomorethanfiveorsixandeachbulletshouldactasapromptforyoutoexplainthepointfurther.
3. Backup Technologydoessometimesletyoudownsodotakealongpapercopiesofthematerialwhichyoucandistributeandrefertoifthetechnologyfails.Thisshowsgoodplanning,andthatyoudon’tfalltopieceswhenthegoinggetstough.
4. Beginnings Thepresentationislikelytobeearlyintheinterviewprocesssomakesureyouintroduceyourselfandthesubjectmattertothepanelbeforeyoustart.Takeadeepbreathandtrytoenjoythepresentation.
Appendix D
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5. PositioningDuringthepresentationbeawareofwhereyouarestandingandmakesureyoudon’tobstructthepanel’sviewofyourslides.Youwillalsoneedtomaintaineyecontactwiththepanel.Thefocusofyourpresentationisthepanel–solookatthemandnotthecomputerortheslidesonthewall.Ifyouneedpromptsforyourpresentation,prepareasetofnoteswhichyoukeeptohandandcanreferto.Inaddition,fluencycomesfrombeingveryfamiliarwiththecontentsofthepresentation.Avoidatallcoststurningyourbackontheinterviewersandreadingthepointsfromtheslides,anddon’tpaceupanddown!Itcanmaketheinterviewingpanelnervous.
6. Timing Youwillbeaskedtokeepyourpresentationwithinaparticulartimeframe.Makesureyoucansticktothis,assomepanelsmightstopyouwhenyoucometotime,evenifyouhaven’tfinishedwhatyouwantedtosay.
7. PracticeItisessentialtopractiseyourpresentationoutloudtoyourself,andthenideallytoanaudience.Seeifyoucanfindasmallwillingaudienceoffriendsandfamilytohelpyou.Thiswillalsohelpyoucheckthatitiswithinthetimelimits.Goingthroughitinyourheadtakesalotlesstimethanspeakingitoutloudandwillgiveyouafalseimpressionofhowlongitwilltakeyouontheday.Also,dothinkaboutthewayyourvoicetoneandpacemightbeaffectedbynervesontheday.Youmayspeakfasterorslowersodobearthatinmindwhenyouarecheckingyourtiming.Takingadeepbreathbeforeyoustarthelpsgetoxygentoyourbrain.Ifatanytimeduringthepresentationyoufeelyouarerunningoutofbreathorgettingcarriedaway,finishyournextpoint,pause,takeadeepbreathandstartagain.
8. Questions Onceyouhavecompletedyourpresentationtheinterviewersarelikelytoaskyousomequestionsaboutit.Dothinkinadvancewhattheymightaskandpreparesomesuitableanswers.Thereisalwaysapossibilitythatoneoftheinterviewerswillaskyousomethingwhichisinanunfamiliararea.Youcan’tprepareforthis.Takeamomentortwotocomposeyourself,smileandthentrytogivethebestanswerpossible.
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117When the topic is given to you on the dayInthissituation,youobviouslycannotprepareyourpresentationinadvance.
Theonlyconstructivepreparationthatyoucandoistotalkwithfriendsandcolleaguestothinkthroughpossibletopicsthatyoumightbegiven.Arethereanyparticularlyhotcontroversiesinyourspecialtyofinterest?Ifthereare,youmightwanttothinkthroughabriefsummaryofyourviewsontheissue.(Andyoushoulddothisanywayasawayofpreparingforthequestionsthatyoumightbeaskedatinterview.)
Butbeyondthinkingaboutpossibletopics,theotherpreparationyoucanusefullydoistoworkouthowmany‘bulletpoints’youcandiscussintheallocatedtime.(Typicallyyouwillknowhowlongthepresentationispriortotheinterview,evenifyoudon’tknowtheprecisetopic.)Soyoumightwanttohaveadummyrunwithatopicthatyoumakeupyourself–justtoseehowmuchcontentyoucancomfortablycoverinthegiventimespan.
Ifthetopicisgiventoyouonthedayyouwillbeprovidedwithacetatesandpensratherthanbeingexpectedtodoan‘on-the-spot’PowerPointpresentation.Makesurethatyourwritingisclear,thatyouspellwordscorrectly,andthatyoudon’ttrytostufftoomuchcontentontoeachacetate.
Itisalsoimportantthatyoudon’tsetyourselfimpossiblestandards.Iftheygiveyouthetopiconthedaytheyareassessinghowquicklyyoucanconstructawellorderedcoverageofthetopic–theyarenotexpectingyoutoknoweverylastfact,orhavebeautifullyhand-illustratedacetates.Sotrytokeepcalm,spendmostofthepreparationtimeonorderingyourargument,andthenintheactualpresentationjustincludeafewacetateswithasmallnumberofbulletpointsoneachacetate.
Beyondthispoints4,5and7listedabovealsoapply.(Intermsof7.‘practice’,youclearlycan’tpractisetheactualpresentation,butyoucanpractisegivingapresentationwithatopicofyourownchoiceinordertogetusedtothesoundofyourvoice,speakingatanappropriatepaceandre-startingifyougoblankduringthetimethatyouarespeaking.)Asmentionedabove,thispracticecanalsohelpyouworkouthowmuchcontentyoucancomfortablycoverintheallocatedtime.
Appendix D
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Appendix E
Workshop 1 – Introduction to career-planning seminar for F1 traineesIntroduction
ThisworkshophasbeendesignedtointroducecareerplanningtofoundationprogrammetraineesandshouldbeheldearlyonintheirF1year.Alltraineesshouldbeencouragedtoattendandwillneedtobringalongthisresourcebook.Forthisworkshopyoushouldideallyallocateatleasttwohourstoensurethematerialiscoveredadequately.Thetimingsgivenbelowareforaworkshoplastingtwoandahalfhours.
• Purposeofthesessionandintroduction:15minutes
• Briefoverviewofthefourstages:10minutes;
• Stage1self-assessment:60minutes;
• Shortbreak:15minutes;
• Stage2careerexploration:30minutes;
• Plenary:20minutes.
Thetimingscanbeamendedtocoverthematerialinatwo-orthree-hoursessionbyeitherreducingthebreakandplenarysessionforatwo-hoursessionorincreasingthetimespentonStages1and2forathree-hoursession.
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119Workshop Plan Time Activity Teachingnotes Resources
15mins Explainthepurposeofthesessionandabriefintroduction
Stage1self-assessment
Explainthefourstages:
1.Self-assessment:workvaluesandskillsandinterests.
2.Careerexploration:researchintodifferentcareerpathways.
3.Decisionmaking.
4.Planimplementation.
Introductorycomments:a.Thefour-stageframeworkisonethat
appliestocareerdecisionmakingatanystageofone’scareer–itisnotrestrictedtothecurrentcareerdecisionsthatthefoundationtraineesarefacing.
b.Thisintroductorysessionwon’tprovidethetraineeswithalltheanswers,i.e.theywon’tbe‘sorted’bytheendofthesession.Instead,thesessionaimstoprovidetraineeswithasenseofthequestionsthattheyneedtoaskthemselvesoverthecomingweeks/months,pluswaysoffindinganswerstothesequestions–sothatbytheJan/FeboftheirF2yeartheyaremorelikelytomakeasoundcareerdecision.
c.ThesessionwillconcentrateonStages1and2,butwillalsotouchontheothertwostagesinmoredetailinsubsequentsessions.
d.Thisintroductorysessionisstillusefultothosetraineeswhoalreadyfeedthattheyhavemadetheirmindupabouttheirpost-foundationcareer.Why?Firstofall,itisusefultocheckiftheircareerdecisionmakingisrobust.Secondly,Stage4(planimplementation)dependsonthepreviousstages.Ifthedecisionrestsonafirmfoundationofself-assessment(Stage1),careerexploration(Stage2),andhowthesematchtogether(Stage3),thetraineewillbebetterequippedtowriteaconvincingapplicationformandprovidegoodanswersatinterview.
RuntwoStage1exercises:workvaluesandskills/achievements
Traineestohaveaccesstothisbookandbringtheirownfoundationportfolios.
ChapterII
Appendix E
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30mins Stage1self-assessment
Exercise1:workvalues
Explainthatworkvalueshavebeenfoundtobeanimportantpredictorofoccupationalsatisfaction.Thenexplainhowtodothecardsort.
Aftethetraineeshavesortedthecards(ontheirown),encouragethemtopairupandtalkthroughthequestions.
Reconveneasagroup,andaskthetraineesforanycomments.
Youmightalsoaskthemtothinkabouttimesatworkwhenthryhavebeenparticularlysatisfied(or,forthatmatter,particularlydissatisfied),andtoseeifthereisalinkbetweenhowtheywerefeelingabouttheirworkatthispointsandtheirworkvalues.(theexerciseonstressesandstrainshasnotbeenincludedintheseminarguidelinesbecauseitisprobablybettertodoamoredetailedassessmentofdifficultiesatworkina1:1ratherthanagroupsetting.)
ChapterII.Copytheworkvaluescardsandhavescissorsandenvelopes.
20mins Stage1self-assessment
Exercise2:skills/achievements
SeeChapter2forinstructions.
Howmanyexamples?Workinginpairs,thetraineesshouldanalyseoneworkexampleandonenon-workexample.
ChapterII.Traineesfoundationportfolio
10mins Stage1self-assessment
PuttingtheStage1exercisestogether
Oncethetraineeshaveworkedthroughthevaluesandskills/achievementsexercises,encouragethemtodrawoutaheraldicshield,dividedintofoursections.
Worksvalues/interests
Skills/stressors
Askthetraineestoputafewbulletpointsineachofthefourquadrants.Refertoexampleinthebook.Theycanwriteapersonalmottointheylike.
(Andiftheywantmoreself-assessmentexercises,directthem,forstarters,totheHopsonandScallybookincludedintheresourceslistinAppendixB.
ChapterII.
15mins 15-minutebreak
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12130minsintotal,includingtheexercise
Stage2careerexploration
IntroductiontoStage2
Thenextstageistoexploredifferentcareeroptionstofindouttwothings:
1.Whichparticularcareerpathwaysaremostlikelytomatchthetrainees’skills,interest,valuesetc.
2.Givenfeedbackfromtheeducationalsupervisorand/orDirectorofMedicalEducation,thetraineeneedstoconsiderwhethertheoptions(s)theyareinterestedinseemtoberealisticcareerchoices.
Otherpointstoshow
• Adequatecareerexplorationtakestime
• Stage2isnotcarriedoutinavacuum–rather,Stage2followsonfromStage1.
• SothetraineecanusethesummaryexercisefromStage1togeneratealistofspecificissuestobeexploredintheirspecialtiesofinterest.
• Theclearerthetraineeisaboutwhatisimportanttothem(Stage1),themoretargetedandrelevanttheStage2researchcanbe.
• Traineeswillhavetoaugmenttheirreadingaboutdifferentoptionswithtalkingtopeople–atvariouslevelsofseniority–whoarecurrentlyworkinginthisspecialty.Withoutthis,itwillbedifficulttoascertainwhetherthecareerisgoingtomatchtheircoreworkvalues,skills,interestsetc.
• Theremaybesometo-ingandfro-ingbetweenStages1and2.So,forexample,somethingthatatraineefindsoutaspartoftheirStage2researchmightcausethemtore-thinksomeaspectoftheirinitialself-assessment.
ChapterIII
Appendix E
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Stage2careerexploration
Exercise3:whatresourcesareoutthere?
1.TheresourceslistattheendofChapterIIIcontainsalistofusefulbooksandwebsites.
2.TheMMCwebsitecanbeusedtoaccessalldeanerywebsites.TheCOPMeDsitehaslinkstoallRoyalCollegewebsites.Checktheseforrelevantjournalsandeventswhichgivetheopportunitytofindoutmoreaboutthespecialty.
3.Checkthenoticeboardinthepostgraduatecentreforotherusefulinformationanddetailsoflocalevents.
Activity:identifythreecareerresearchtaskswhichfollowonfromtheStage1self-assessmentsthatthetraineeisgoingtoundertake.Thetraineeshouldwritethesedown,committoadatefortheircompletionanddiscussthetaskswithacolleague.
ChapterIII
20mins Plenary Recapthepurposeofthissessionhasbeentooutlineaframework(andthusprovidequestionsratherthananswers).
Remindthemthattherewillbefurthersessions,aspartofthegenericprogramme,whichwilllookatStages3and4(andwillalsolookatpost-F2trainingroutesinmoredetail).
Encouragethemtospendsufficienttimeontheircareerplanning,ratherthanleavingitalltothelastminute.
Dealwithanyotherquestions.
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123Appendix F
Workshop 2 – Introduction to career-planning seminar for F2 traineesIntroduction
ThesecondworkshopisforF2traineesandshouldberunearlyintheirF2yearasitcoversapplicationformsandinterviews.ThesessionshouldlastthreehourstoensurethematerialiscoveredadequatelyTheworkshopshouldberunbyaclinicianwithexperienceofhelpingtraineeswiththeircareerdecisionmakingandwhohasbeeninvolvedinrecruitmentandselectiontoposts.Anoutlinesessionplanisasfollows:
• Purposeofthesessionandintroduction:5minutes
• Briefreviewofthefourstages:10minutes.
• Stage3decisionmaking:30minutes
• Stage4applicationforms:45minutes
• Break:15minutes(thiscanbetimedtosuitlocalarrangements)
• Stage4interviews:50minutes
• Plenaryandquestions:25minutes
Appendix F
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Workshop planTime Activity Teachingnotes Resources
15mins Purposeofthesessionandbriefoverviewofthefourstages.
Explainthefourstages:
1.Self-assessment.
2.Careerexploration.
3.Decisionmaking.
4.Planimplementation.
Introductorycomments:
a.Thefour-stageframeworkisonethatappliestocareerdecisionmakingatanystageofone’scareer–itisnotrestrictedtothecurrentcareerdecisionsthatthefoundationtraineesarefacing.
b.ThissessionbuildsontheintroductorysessiontheymayhavehadintheirF1yearandspecificallyfocusesonStages3and4ofthecareer-planningframework.Itwon’tprovidethetraineeswithalltheanswers,i.e.theywon’tbe‘sorted’bytheendofthesession.Instead,thesessionaimstooutlinethepreparatorytasksthattraineesneedtocarryoutpriortofillingintheirapplicationformsandbeforeaselectioninterview.
c.ThesessionwillconcentrateonStages3and4,andwillonlytouchontheothertwostagestosetthecontext.
d.Stage4(planimplementation)dependsonthepreviousstages.Ifthedecisionrestsonafirmfoundationofselfassessment(Stage1),careerexploration(Stage2),andhowthesematchtogether(Stage3),thetraineewillbebetterequippedtowriteaconvincingapplicationformandprovidegoodanswersatinterview.
Traineestohaveaccesstothisbook.
Stage3decisionmaking
IntroductiontoStage3andanexercise.
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1255mins Stage3decisionmaking
IntroductiontoStage3
Peoplemakedecisionsindifferentways.Somemulloveradecisionforawhileandthen,onthebasisofagutfeeling,becomeconfidentthatonepathwayistherightoneforthem.Othersliketobemoreconcreteintheprocessanddrawupcostbenefittables.Eitherapproachisvalid.
Somepointsthatyoumightwanttoraiseincludethefollowing.
•Askthemtoreflectonpastcareerdecisionsinordertoidentifywhathelpedthemreachadecision.Isthisapproachvalidfortheircurrentcareerdecision?
•Iftheyareconsideringpost-foundationtraininginaspecialtywhichisverycompetitive,itmightbeadvisableforthemtohavea‘backup’planforalesscompetitivespecialty.
•Advisethemtodiscusstheirplanwithacolleague,andalsowiththeireducationalsupervisorortheFacultyCareersLead.Then,introducethemtotheideaoftheROADScriteria.
ROADS–asystematicwayofreviewingcareerdecisions
Realistic–areyoubeingrealisticaboutyourselfANDaboutthedemandsofthejob?
Opportunities–haveyougivenseriousconsiderationtoalltheopportunitiesavailable?
Anchors–haveyoubuiltinthethingsthatprovidesupportinyourlife?
Development–doyourchoicesfullydevelopyourpotential?
Stress–haveyouconsideredthoseaspectsofworkthatposeparticularstressesforyou?
Ifyouhavetime,takeacareerdecisionyouhavemadeinthepastandreviewitwiththegroupusingtheROADScriteria.(itisbettertousethefaciliatorsexamplethantoaskforexamplesfrompreviouscareerdecisionsfromthetrainees,assometimesthiscanleadtoquiteapersonalissuebeingunwittinglyopenedupinfrontofthegroup.)
Appendix F
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15mins Stage3decisionmaking
Lifelineexercise
ThisexercisecanbeusedwithbothindividualsandgroupsandisincludedinChapter3.
Exercise1:Lifelineexercise
AsktraineestocompletetheLifeline,thenaskthemtosplitintopairsforthediscussion.
Askthetraineestogettogetherinpairsanddiscussthefollowingquestions:
1.Whichchangesrepresentedgoodcareerdecisions?
2.UsetheROADScriteriatodescribethewaysinwhichtheyweregoodcareerdecisions.
3.Werethereanydecisionsthat,inretrospect,werenotsogood?Ifso,usetheROADScriteriatodescribethewaysinwhichthedecisionturnedoutnottobesofavourable.
4.LookingattheirLifelinesofar,cantheyseeapatternintermsofwhathelpedandwhathinderedanydecisionsthattheyhavemadeinthepast?
Ifthetraineehasmadeadecisionabouttheirpost-F2training,thentheycananalysethedecisionusingtheROADScriteria.
ChapterIV.
Blankpaper.
10mins Stage3decisionmaking
Stage3plenary
Askthetraineesiftheyhaveanycomments.Youmightalsowanttoaskthetraineeswhattheyhadlearntaboutthemselves,intermsofhowtheyapproachthetaskofmakingdecisions.
5mins Stage4planimplementation
IntroductiontoStage4
byStage4(whichtraineesneedtoreachwellinadvanceofthetimethattheywillhavetofillouttheirapplicationforms)traineesshouldknowwhatpostorspecialtytrainingprogrammetheywishtoapplyfor.
Thepurposeofthisstageistowriteexcellentapplicationformsandprepareforinterviews.Sometraineeswillalreadyknowwhattheyareapplyingforbutothersmaybeundecided.Eitherway,theycanusetheworkshoptopracticetheirtechniques.
ChapterV
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127Applicationforms
Thetimingsforthissessionare:
10minutes:provideanoverviewoftheapplicationprocess
20minutes:askthetraineeseachtodraftananswertoonequestiontakingfromthequestionbank,andthencritiquetheiranswerinpairs.
10minutes:sharehintsandtips.
ChapterV
10mins Applicationforms–overview
Overviewoftheapplicationprocess
Chapter5containsaflowchartwhichyoucanusetowalkthroughtheprocess.DoencouragetraineestoassembleaCV,sotheyhavealltheinformationinoneplace,andstresstheimportanceofaskingtheirrefereesinadvance.
Bringoutthekeypointsfromtheinformationoninitialpreparationandgoldenrules:
Asawayofpreparingtowriteanswersforapplicationforms,traineesmightwanttousetheSTARstructure.Bythiswemeanthetraineecouldbreakdowntheirexampleinto:
Situation/Task
Provideaconciseoverviewoftheexampleyouareconsideringusing,ensuringthatitisrelevanttothequestion.
Actions
Whatexactlydidyoudo?Whatwereyourroleandcontribution?Whatskillsdidyouuse?(Thispartwillprobablyformthebulkofyouranswer).
Results/Reflection
Whatwastheoutcome?Whathaveyoulearntaboutit?
ChapterV
20mins Applicationforms–exercise
Exercise2:applicationforms
Askthegrouptosplitintopairsandtoconsideronequestionfromthequestionbankdetailedbelow.Youwillalsowishtoaddyourownsuggestionsaswell.
Traineesshouldpreparetheiranswerindividuallyandthenworkinginpairscritiquewhattheyhavewritten.IntheircritquetheymightwanttorefertotheSTARacronym.
ChapterV
Appendix F
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Exercise2:questionbank
1.Givearecentexampleofaclinicalsituationinwhichyoufeelteamworkingcouldhavebeenimproved.
2.Describeyourexperienceofclinicalauditindicatingclearlyyourownlevelofinvolvementandtheclinicalrelevanceoftheaudit.
3.Describeadifficultclinicalsituationyoutackledwell.
4.WhatdoyouconsiderthemostchallengingaspectsofapplyingtheGMC‘GoodMedicalPractice’toyourowncareer?
5.Describeyourexperienceofclinicalgovernanceandindicateclearlyyourownlevelofinvolvement?
6.Describeyourexperienceofworkinginmulti-disciplinaryteams,includingyourobservationsontheeffectivenessofteamwork.Youmaygiveexamplesfrombothinsideandoutsidemedicine.
7.Describehowyoudeploytime-managementskillsinordertooptimiseyourprofessionaldevelopment.
Youmayprefertodevelopyourownquestions.
10mins Applicationforms–groupdiscussion
Bringthegroupbacktogetherandaskthemtosharetheirthoughtsaboutthequestionstheychosetoanswer.Trytoensureeachpaircontributestheirideastothediscussion.
InthissessionrefertoChapters5and6,todrawouttherelevantpoints.
ChapterV
15-minutebreak
Interviews Thepurposeofthissessionistogiveyouanopportunitytodiscussaselectionofthequestionsfoundationtraineesmightbeaskedatinterviews.
Thetimingsforthesessionareasfollows:
5minutes:outlineoftheexercise
25minutes:fortheexerciseinpairs
20minutes:reassembleasagrouptosharebestpractice.
ChapterV
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1295mins Interviews–exerciseoutline
Somekeypointsaboutinterviews:
Mostinterviewswillbestructuredandtime-limited.Therewillalmostcertainlybemorethanonepersonpresent.Ifthereisapanel,onememberwillbeappointedasChair,anditisthepersonwhoislikelytowelcomethetrainee,introducetheotherpanelmembers,andoutlinethestructureoftheinterview.
Preparationisall-importantasmanyquestionscanbroadlybepredictedinadvance.Soiftraineesdevoteadequatetimetopre-interviewpreparation,theyshouldbeabletoimprovethequalityoftheirperformanceontheday.(Ofcourse,traineesmightstillbeaskedsomequestionsthattheyhaven’tconsideredbefore.Butifastructuredinterviewprocessisused,thenatleasttraineescanbereassuredthatallthecandidateswillbeposedthisparticularquestion.)
Sohowshouldtraineesprepare?
Forstartersitishelpfultorealisethatquestionswhixhareaskedatinterviewsareusualllydividedinthreebroadareas:
1.Questionsaboutyou.
2.Questionsaboutthejob/specialty.
3.Questionsaboutthewidercontextofhealthcare.
Itisfarbetterfortraineestorefertospecificexamplesthantotalkingeneralities.Thenextexerciseaimstogivethemachancetopracticestructuringspecificexamples.
25mins Interviewsexercise
Exercise3
AsthegrouptosplitintopairsandtoconsideratleastonequestionfromeachofthethreecategoriesinChapter5usingtheSTARtechniquetheyusedfortheapplicationformsexercise.
Checkwhichquestionsarebeingcoveredsothatyoucanensureareasonablerangehasbeenchosenratherthanjustthefirsttwoineachsection.Thereisaselectionofquestionstochoosefromandyoumightwishtoaddsomeofyourownaswell.
ChapterV
Appendix F
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The Roads to Success
20mins Interviews–groupdiscussion
Bringthegroupbacktogetherandaskthemtosharetheirthoughtsaboutthequestionstheychosetoanswer.Trytoensureeachpaircontributestheirideastothediscussion.
Inthissessionaimtodrawoutsomeoverallgeneralpointsanddiscussinterviewtechnique.
ChapterV
15mins Finalplenary Recapthatthepurposeofthissessionhasbeentoprovideareviewofthefour-stageprocess,andthenlookindetailatStage3(decisionmaking)andStage4(planimplementation).
Encouragethemtospendsufficienttimeontheircareerplanning,ratherthanleavingitalltothelastminute.
Encouragethemtoidentifyonecareer-planningtaskthattheywillcommittocompletingandthathascomeoutoftoday’sworkshop.Getthemtowritethisdown,withasuitabletimescale,andthenbrieflytodiscussitinpairs.
Dealwithanyotherquestions.
Notes
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University of London
PostgraduateDeaneryforKent,Surrey&Sussex