Career Focus

Career focus

BMJ 1996; 313 doi: (Published 30 November 1996) Cite this as: BMJ 1996;313:S2-7069
  1. Caroline Anderson,, lecturer
  1. Department of General Practice, Nottingham NG7 2UH

    How to organise a careers forum Casing career options over wine and cheese is a well worn medical tradition. Caroline Anderson, a lecturer in the department of general practice in Nottingham develops the concept

    Calls for a national policy to establish career guidance facilities from medical school through to retirement have been backed by the BMA, which has recently produced the comprehensive and challenging Guidelines for provision of careers services.(1)

    This article describes a unique format for a career forum, which we introduced initially for general practice, but which is now being extended to other medical and surgical specialities. The forum enables students and junior doctors to get relevant information and discuss their own personal needs and circumstances.

    Current facilities

    A national survey in 1992 revealed an unmet need for career guidance and pastoral care among medical students.(2) Only half the schools could identify an individual responsible for career guidance, and only five replies were received from career tutors. The most commonly mentioned form of career guidance (68% of respondents) was the BMA careers fair, which consists of a series of stands representing different specialities. The follow up survey (3) showed that there is now more interest in the subject of career guidance and greater concern with providing advice tailored to individual students' needs.

    One major incentive for change is the curricular change recommended in Tomorrow's Doctors by the education committee of the General Medical Council, which states that personal and professional development is a major issue. Pre-registration house jobs are now considered an extension of medical school training. A further incentive is the teaching quality assessment(4)-the university equivalent of OFSTED school inspections-that will take place over the next three years in all universities and medical schools. One of the sections assessed is ‘student support and guidance.'

    A career forum

    The aims of the forum are to encourage final year medical students to think about career planning in general terms, give practical information on training for general practice or other specialties, to highlight the flexibility which a training in general practice can provide, and to allow students to raise questions and concerns in an informal setting.

    Box 1: Careers forum sample timetable

    • 1830 Introduction

    • 1835 Devising your personal career plan

    • 1845 Why become a GP?

    • 1855 How to become a GP

    • –requirements for training

    • –VTS or self constructed scheme

    • –applying for a post

    • 1910 What you can do as a GP

    Case scenarios to illustrate the flexibility and possibilities following GP training

    • 1920 How the BMA can help

    • 1925 Handouts and signing up for small groups

    • 1930 Cheese and wine. Meet the course organisers (stands)

    • 2000 Small discussion groups facilitated by GP registrars

    • 2100 Informal debrief for qualified participants and guests

    • 2130 End

    Rationale: Information giving, 50 mins. Series of ten minute slots by different presenters who each cover two or three important points. Handouts with essential information are provided.

    Food and meet the course organisers, 40 mins. Food is a great incentive for medical students. Local course organisers have stands with their information booklets.

    Small groups, 60 mins. Personalised career discussion. GP registrar facilitates group of 6-8 students with GP principal as a resource.

    Qualified participants write a paragraph about their job, interests, and other commitments in advance so students can sign up for an appropriate group.

    Debrief, 30 mins. For qualified participants and guests to collect feedback sheet, share ideas and thank the participants.

    The programme has distinct sections as described in Box 1. Information giving is followed by food and VTS stands, and this is followed by small group personalised discussions.

    Senior medical students are easily accessible and used to attending the medical school for evening guest lectures. A similar forum is appropriate for qualified junior doctors but an off site venue such as a restaurant may be more congenial. As doctors move on contacting them becomes more problematic.

    Box 2: Planning a career forum

    9 months before:

    • Identify the target group and a sponsor.

    • Identify planning group members.

    • Decide date and book venue. Avoid exams, electives and junior house officer interviews.

    4 months before:

    • Identify people and resources required.

    • Invite appropriate medical contributors ie, (8 registrars, 8 GPs including local presenters and course organisers)

    • Finalise programme.

    • Create list of students or junior doctors.

    2 months before:

    • Send medical participants details of evening and their role, send out guest invitations.

    1 month before:

    • Send out the student invitations with reply box next to pigeon holes.

    • Arrange posters, announcements in lectures and prepare handouts.

    1 week before:

    • Confirm numbers for caterers and finalise the small groups.

    • Confirm with porters about entry, exit and parking.

    • Consider practice session for presenters

    After the event:

    • Collate feedback, write summary and circulate to medical participants and guests.

    • Planning team meeting to evaluate career forum and make suggestions for future events. Conceive next event.

    Organisers and resources need to be planned carefully over a gestation period similar to a pregnancy (see Box 2). Our planning team consists of an administrator, a part time lecturer from the department of general practice, a vocational training scheme course organiser and a final year medical student. However faculty boards of the royal colleges could approach their local medical school to put on a similar event for senior students or junior doctors.

    Publicity is of crucial importance. The final year student on the planning team announces the forum in lectures and encourages replies to the personalised invitations. All replies are entered in a prize draw for a bottle of wine. This strategy has achieved an attendance rate of up to 40% of a year group attending on a voluntary basis on a week day evening.

    Speakers have included local health authority managers and medical advisers, the postgraduate dean, and the university medical student counsellor.

    After the talks the students sign up for one of the 6-8 small discussion groups, tailored to different interests. Students choose a group likely to suit their needs, and also choose the topics for discussion.

    Each discussion group is led by a GP registrar with a GP principal as a resource. Before the meeting, participating doctors provide a brief description of their experience their family status (eg marital status, number of children, job of spouse), and their special interests. The list of names and addresses is provided to allow future contacts.

    General practitioners in training are deliberately chosen to chair and facilitate the small groups because the students relate well to their near peers. The GPs and registrars chosen represent a wide diversity of experience and interests, and include a female doctor in each group.

    Topics for discussion could include the versatility of GP training, training in a restricted area, coordinating careers with a medical partner, time out for travelling, working abroad, part time training and working, interpretation of BMJ advertisements, manpower, and where to get further advice.

    The forum has been well received by the student participants and others, has been well attended, and has been effective in its aim of improving careers guidance.

    Backing it up

    Incorporating a GP careers forum into the curriculum is only one aspect of the totality of career development. It is unrealistic to expect medical students to have decided which speciality they wish to enter by qualification. However, the skills necessary to plan one's career in a coherent manner can be learned like any other skill.

    Parkhouse comments: “Guiding people about how to get a particular job or succeed in a given speciality is fundamentally different from counselling them about their strengths and weaknesses (and) how to come to terms with their professional lives.” (5) This complex mixture also needs to encompass medical interests combined with a realistic consideration of personal circumstances. These factors are very individual and differ with time. In particular the increasing proportion of female doctors, who now number more than half of those qualifying in medicine, requires a more flexible approach to career development.

    The RCGP research work has enabled us to pool experiences, innovations and suggestions from around the country and suggests that facilities for career guidance should be improved.(1-3) There should be a coordinator for career guidance who is known to the medical students, readily available and regularly updated careers advice in libraries with information technology, a pastoral tutor available to discuss general issues and direct students towards appropriate speciality advice where necessary, and a specialist adviser should be identified as the first point of contact in each speciality.

    These facilities should be integrated with those for doctors so that career planning can be initiated at medical school.

    In Nottingham, the careers forum idea is being developed for senior students who can attend surgical, medical, psychiatric, and flexible training meetings once a term. Sessions on curriculum vitae preparation and interview technique are provided. Just before qualification, the ‘preparation for house jobs’ course will have a full day seminar on career issues. A handbook with the time tabled career activities which also explains the other career resources such as library facilities, and provides a contact list of specialist advisers for the use of students and mentors.

    Providing flexibility and a supportive environment should be the aim, which should help future generations of doctors to deal with the inevitable pressures of medicine more effectively and positively. This would enable recruitment and retention issues to be addressed in a constructive manner.


    Details, including sample letters and handouts, are available in the booklet “How to organise a careers forum for general practice,” from the Department of General Practice at Nottingham, priced £5.


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