Changing career direction


If you're not sure if your career is heading the right way what are the main things you need to consider? Dr Caroline Elton provides some guidance.

I'm an ST2 in histopathology and I think I have made the wrong career choice. Previously I completed core medicine and I have got my MRCP exams. But I found life on the wards really stressful, to say nothing of the on-calls, so I moved into a role away from front line patient care. The problem is I am really missing patient contact and even though I find the work reasonably interesting, my heart really isn't in it. What should I do?

There are a number of important factors to consider when facing a decision like this. First, is there something going on in your current rotation that has nothing to do with the choice of specialty – for example, difficulties with colleagues or your supervising consultant - which is having a detrimental effect on your enjoyment of your work? Difficult colleagues can zap your motivation, but if your dilemma is more about a specific colleague or the atmosphere in a team, than about the specialty itself, you might find you enjoy your current specialty more in your next rotation.

Second, are there things going on in your life outside of work that might be contributing to how you are feeling about your job? This might be impacting on your mood, and colouring your attitude to your work, with the net result that you aren't enjoying your job very much.

If neither of these seems to apply, you could try a thorough career self-assessment. In the same way that you approach a clinical decision by taking a patient history, when faced with a career decision you need to review your own career history. That will help you identify your abilities, skills, interests and core values, as well as highlighting aspects of work you find particularly stressful.

Finally, you may want to explore the career 'tipping point'. Simply put, this means identifying the smallest career shift that produces the greatest psychological gain. For you, the smallest shift could be to work out if there are any options within histopathology that you might enjoy more.

If you are still not sure, your next task might be to explore the 20-plus ST3 medical specialties which are open to you because you have already successfully completed core medical training.

You may be able to find some that would suit your preferences better, for example, among the less acute, out-patient based options (given your previous experience with ward based work). CT1/ST1 specialties may be worth a look, too.

Only after you have discounted all these options would you start looking at jobs such as medical writer or medical statistician i.e. jobs that draw on some, but not all, aspects of your clinical training.

The process of stepping back slowly and incrementally from your current job until you identify the 'tipping point' offers a systematic way of approaching a career shift.

Given that you have already identified that a key missing ingredient in your current job is patient contact, I suspect that one of the different ST3 medical specialties will work well for you in future.

Dr Caroline Elton is an occupational psychologist and former head of the Careers Unit at London Deanery. In February 2014 she set up CPD: Career Planning for Doctors/Dentists

This article originally appeared in the printed edition of wardround April 2014 entitled "Time to change direction?".

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