So you’ve decided on a specialty! Tips on how to prevent career uncertainty in the future and how to create longevity in your chosen area
Written by Dr Ashe Coxon – MBBS, FRACGP, DCH, MClinEd, GCCareerDvpt
Deciding on a specialty to train in is such an exciting milestone, and getting onto the training program is even more exciting. The adrenaline and rush of finally achieving what you have set out to do is exhilarating, and the pride you have can keep people very motivated and passionate about their chosen field. However, as exams loom, overtime becomes relentless and on call is very draining, the thrill of the job may begin to wear off and the reality of what training you have left prior to fellowship may seem very daunting.
Around exams and pre-fellowship is a common time for doctors to start questioning whether they made the right speciality choice. It is very easy for exhaustion to set in and cynicism towards your current chosen field with some people questioning if they want to change pathways. For some people changing specialties may be a good option but I would recommend discussing this with a trusted colleague, mentor, psychologist, career counsellor, GP or a trusted support person prior to making a significant decision.
Below are some things to consider if you did previously really enjoy your specialty but you’re now not enjoying it quite as much.
- Are you burnt out?
According to the 2013 Beyond Blue survey, burnout was high in doctors with 47.5% of doctors under the age of 30 who responded reported emotional exhaustion, 45.8% of doctors under 30 reported cynicism and 17.6% reported low professional efficacy (Reference 1). Awareness around burnout is increasing but often the individual themselves don’t recognize the symptoms. Below are some symptoms of burnout and if these symptoms are familiar, please discuss this with your GP, a supportive supervisor or work colleague, a friend, family members, psychologists or counsellors or all of the above. People understand and will help you.
- Symptoms of burnout are;
- Physical – constant exhaustion leading to somatic complaints; no improvement after rest and recovery; symptoms similar to those with depression such as poor sleep quality, lethargy, and a loss or increase in appetite
- Emotional – a negative outlook; detachment; loss of empathy, especially for patients and their situations; diminished motivation; sense of being defeated, trapped or helpless; inappropriate outbursts
- Behavioural – extreme negativity, callousness and cynicism; anger and cynicism towards patients, colleagues, hospital administration and family; substance abuse, such as an increased reliance on alcohol
- When did you last have a holiday?
Everyone needs holidays to enjoy work and doctors are not immune to this. It is very difficult to be on call, working overtime, studying after you finish work and trying to maintain a functional life. Having a holiday gives you a rest and allows you to look after yourself, recuperate and spend time with loved ones. If it has been too long, you need to talk to your administration/ manager/ supervisor/ boss about having a holiday.
- What is it exactly that you don’t like about your job?
As a career counsellor I speak to many people who want to discuss changing careers but haven’t reflected on what it is about their current career they don’t like. Often it ends up being administrative tasks, or short-lived unenjoyable aspects such as exams. Before deciding to change specialty pathways try to figure out the exact thing about your current job you don’t like – if its exams, then they will be finished soon. If it’s the roster, speak to someone about getting it changed. If it’s the department morale, perhaps consider working at a different hospital to see if morale is different before changing career paths. If its administrative tasks and paperwork, well, there is no career in medicine in which you can avoid that! If you’re not sure exactly what it is, then I suggest keeping a notepad on you and documenting every few hours what you enjoyed in the last few hours and what you didn’t – you may begin to see a pattern emerge.
- Imagine your life once you have completed you fellowship.
Look at the doctors who have ‘been there, done that’ and who have fellowed. What does their working day look like? Is this more manageable and enjoyable that what you imagined? Or not how you quite imagined. Talk to your seniors about their workload and what they do and don’t enjoy about their job as you may get some interesting insights. People are often very willing to pass on advice or adecdotes about their experience and getting their perspective may clarify some uncertainties you may have.
- Do you know your core values and are you satisfying them?
Have you ever considered what your core values are? If so, do you feel like you are satisfying them? If you have never considered what your values are then spend some time considering who you are, what you value in life and whether your current work situation is fitting in with your core values. Can you make some adjustments to make sure you do feel more content that you are satisfying your core value?
If you have never considered what your core values are (which is surprisingly common!), the article ‘Core Values and my medical career’ should assist you in becoming aware of these.
- Are you happy in your life outside of medicine?
Often when doctors get into medical school they focus on study and lose their extracurricular activities such as playing instruments, sports, spending time with friends and hobbies. It can be hard when tired and studying to have a hobby but having a life outside of medicine provides a distraction, happiness and something else to focus on and be good at. If you haven’t done a hobby in a while, pick one and start!
- Speak to someone about your concerns
If you really are unhappy in your chosen career, then speak to someone who you trust whether that is family, friends, a colleague, a current supervisor or someone you respect and trust. If you don’t feel comfortable talking to someone you know, or you’re wishing for an independent opinion then there are many people available for help – career counsellors, psychologists, your General Practitioner, or your employer may provide pastoral or career support.
At some stage in your long career as a doctor you will potentially question whether you have made the right choices along the way, and this can be a very overwhelming and scary thought. Having doubts about your career pathway can be significant warning signs but can also be fleeting thoughts and it is important to thoroughly consider the reasons behind these feelings. If you are unable to differentiate whether your concerns are fleeting or significant then speaking to a professional will likely assist you.
If you need to speak to someone urgently please reach out to;
Beyond Blue – 1300 224 636
Lifeline – 13 11 14
Doctors Health Advisory Service Queensland - 07 3833 4352
Doctors Health Advisory Service NSW - 02 9437 6552
Doctors Health Advisory Service ACT - 1300 374 377
Doctors Health Advisory Service SA & NT - 08 8366 0250
Doctors Health Advisory Service Tasmania - 1300 374 377
Doctors Health Advisory Service Victoria - 03 9280 8712
Doctors Health Advisory Service WA - 08 9321 3098
Doctors Health Advisory Service NZ - 0800 471 2654