Common Career Roadblocks for Doctors during ‘Career Season’: A guide for career practitioners who work with doctors

Career season’ in the medical world is commonly from April to August, which means a lot of career planning, refreshing of CVs, interview preparation, many nervous doctors and a lot of career indecision!

The medical training system can be complicated, very complex, very competitive, and many doctors feel immense pressure to choose a pathway.  In fact, many doctors themselves are unaware that there are over 80 specialty areas they can train and work in.

It is not uncommon to speak with a medical student, or even a junior doctor who themselves have little awareness of the barriers to complete specialty training and were unaware of the additional requirements and years of training that they need to complete after their medical degree.

Career counselors, practitioners or coaches who are not aware of how the medical training system works can be forgiven for not understanding why ‘wanting to do that specialty = job,’ and why May – July can be a difficult period for many doctors, and I will begin to try to explain!

Internship

Once medical students successfully graduate from medical school they are issued with their medical degree, but to gain full registration to practice as a doctor, they must satisfactorily complete an internship at an accredited hospital to gain General Registration from the Australian Health Practitioner Regulation Agency (AHPRA).

Roadblock #1 – The medical student who is putting in their internship preferences might find that their hospital and location of choice is a very in demand option, requiring the individual to move locations to find a role as an intern.  In addition to this, certain hospitals may provide the opportunity to experience clinical areas of interest and others may not (For instance, certain hospitals may not provide an obstetric service and therefor the doctor will not be exposed to obstetrics during their work which can lead to career indecision because ‘How do I decide if I want to be an obstetrician or not if I haven't had a chance to work in the area’?)

Medical Training

Once general registration has been satisfied the doctor can then work as a resident in the hospital system, essentially meaning that they rotate through different areas every 10 weeks and can sample a variety of rotations (Commonly 5 per year). For example, a second year our resident may do a term in the Emergency Department, Pediatrics, Cardiology, General Surgery and Palliative Care. A doctor can continue to be a resident for as long as they wish to, however by their 3-4 year after graduation the majority of doctors would be considering what specialty that they wish to train in and would be attempting to get accepted onto a training program.

To become a specialist in an area (E.g Cardiologist, General practitioner, Sexual health physician public heath physician) doctors need to be accepted onto a training program and work under supervision for 3 – 6 years. Once a doctor has successfully completed the training program (Which commonly had minimum of 3 exams often requiring an addition 6 – 12 months of preparation for) they can then practice independently in their field they have trained in.

Seems easy doesn’t it? Just pick what you want to train in and go for it!

Unfortunately many, many doctors experience many roadblocks throughout this process that career development practitioners working with doctors should be aware of.

Roadblock #2 – Getting accepted onto a training program can be incredibly challenging, time consuming, expensive, difficult and there is no guarantee that a doctor will be successful. For instance, some training programs will only allow the doctor 3 attempts to be accepted and each attempt is commonly done yearly, and it is also not uncommon to not be accepted onto the training program for a few years. This means the doctor applying to their preferred training program may not be accepted for a few years, there are often multiple pre-requisites for training programs (Certain courses or qualifications which can become expensive) and over this time a doctor may start to question whether it is still the desired pathway for them.

Roadblock #3 - If after all of the applications and years of trying to get onto a program they are not successful in being accepted onto their training program of choice then they are left trying to decide whether to pursue another training program, which will inevitably have their own pre-requisites that the doctor then need to do again. For instance, someone may have been attempting to be accepted onto the orthopedics training program to become an orthopedic surgeon and if they are unsuccessful they would have spent 3-4 years doing purely orthopedic related research programs, courses and training to make their CV competitive for the training program, and now they need to reconsider what other career to pursue, and how to show to the new career pathway their commitment to their new pathway.

Fortunately this is not the common pathway as most doctors will eventually get accepted onto their pathway of choice, but certainly for a few they will either not be accepted, or change their career intentions throughout this process and feel they need to ‘start again’. This is where they usually engage a career development practitioner who can be instrumental in assisting the transition.

Career Indecision

The majority of clients that I see are those who just can’t decide on what they wish to pursue as a career. As you can see, the length of training and commitment to training is lengthy, time consuming and expensive, so many doctors really want to be sure before they pursue a training program. The Medical Board of Australia recognizes over 80 specialties that a doctor can specialize in, and with only the ability to sample 5 rotations per year, it can leave doctors a) Unaware of the options they have available and b) Confused and conflicted that there may be ‘something out there’ that they haven’t sampled. 

To assist them through their decision the career practitioners at Medical Career Planning use a variety of practical exercises, reflective exercises and frameworks to assist in allowing the client to be aware of their own interests, skills, values and personality preferences.

As a career development practitioner one of my main goals is to build awareness of all of the careers that a doctor can train in, so I always make the doctor aware of all of the specialties they can train in and ask the client to consider the skills, interests and attributes that all of the specialties require and if they can see themselves pursuing them.

Why is ‘Career season’ stressful?

Job applications for resident positions and training programs are commonly open June – August meaning that big decisions need to be made around what hospital they will try and train in, what training program might they apply for, does the hospital they get allocated to have the rotations that will be necessary to assist them onto a training program, and what areas should they try and work in if they don’t know what they want to do yet with their career!

Career Longevity

As you can see, the lengthy process of application to training programs, successfully completing programs, exams (many people fail multiple exams in the process) and fellowship can take some doctors 10 – 20 years after their medical qualification.

Career satisfaction is hopefully still present, but for some they no longer enjoy the career that they have dedicated their professional years to, and then seek career counseling on what to do now. This can be a disheartening and difficult position the doctor may find themselves in and they will require a lot of support and career counseling to assist with finding contentment in their job, or transition to new roles.  A career development practitioner can play a HUGE role in these scenarios and can really make a difference in the career satisfaction for these doctors.

A Career Development Practitioner’s Role

So how can a career development practitioner, coach or counselor assist doctors in this decision-making process?

Reflective based exercises on identifying areas of interest, skills, values and future life goals can be very useful, as well as advising the doctor to be aware of all of their options.

Picking a medical specialty is very similar to choosing a vocation but the medical system has some intricacies that many are not aware of. Hopefully, the above will assist you in continuing to support, counsel and coach doctors towards their eventual career of choice.

The Medical Board of Australia has a comprehensive list of specialties https://www.medicalboard.gov.au/registration/types/specialist-registration/medical-specialties-and-specialty-fields.aspx and we at Medical Career Planning has a course outlining all specialties that a doctor can train in, skills required, general information about the field and brief descriptions around training and pre-requisites, so if you need help or a guide, feel free to check https://www.medicalcareerplanning.com.au/courses. Alternatively, you can message us directly.