How to choose a medical specialty

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اشترك في: الخميس إبريل 04, 2013 10:28 pm

How to choose a medical specialty

مشاركةبواسطة دكتور كمال سيد » الجمعة نوفمبر 15, 2013 7:33 am

How to choose a medical specialty


RCP specialty recruitment
office

How to choose a specialty
Version 1.0

Published 4 October 2013



When do I decide?

One of the hardest decisions in your career begins at foundation level, which is when you have to start
thinking about which specialty to pursue.

Anecdotally, about half of all foundation doctors have a good idea of what this is from very early on; the
other half are very much influenced by their experience. Some doctors will not be entirely sure even
when they are years into consultancy.

Your specialty preference can also change over time with experience and age; there are over 60
specialties and over 30 subspecialties to consider after foundation training!

If you know which specialties you prefer, you may be able to opt for particular foundation or core
programmes which assist your career decision. Other trainees are more influenced by ‘geography’, ie
they want to stay in a particular region, and will consider a range of specialties in order to fulfil that aim.

What factors help me decide?

When choosing a specialty it is important to take into consideration who you are: your personality, likes
and dislikes, abilities, passions, interests, ambitions, aptitudes, cognitive processes, limitations and task-
management skills.

What makes you unique? You need to consider the specialty’s requirements, conditions of success,
advantages and disadvantages, financial and personal compensations, prospects, and opportunities for
further career and educational development.

You should be realistic about the relative strength of your application; some specialties are very
oversubscribed.

All specialties require completion of an application form. Domains are marked at the shortlisting stage,
and if you don’t get many marks at this stage, you may not get an interview, no matter how good a
clinician you are.

Most doctors cannot gauge the relative strength of their application, but if you look at the national
application form, you should be able to work out whether you can gain marks in any or all of the
domains.

Additional degrees, postgraduate exams, presentations, publications and teaching or audit experience,
can provide the basis for enough marks at the shortlisting stage to get an interview for a very popular
specialty.

You should investigate the competition ratios, but bear in mind that these data are historical, and do not
necessarily reflect future competition – indeed the mere act of making this information available can
change applicant behaviour!

If you have decided on a career as a physician, the first step is relatively simple, because there are only
two main training routes. You should apply for either core medical training or acute care common stem
(acute medicine) training.

Entry is at core training level 1 (CT1), and the training lasts for two to three years. Both routes open up
the access to over 30 medical specialties which commence training at specialty training 3 (ST3). This ST3
training lasts four to five years, and can sometimes lead to subspecialty training (for example, as a
gastroenterologist, you could specialise further in hepatology).

RCP specialty recruitment office – How to choose a specialty © Royal College of Physicians 2013 2
Visit http://www.rcplondon.ac.uk/medical-careers to find out more about the different physician
specialties.

You may not know that there are a handful of ST3 specialties which accept trainees from other core
training programmes. For example, palliative medicine can take trainees from GP, and dermatology
from paediatric core training.

There are opportunities for trainees from surgery, anaesthetics, paediatrics, GP, psychiatry etc. to enter
some ST3 specialties. Additionally, some non-physician training programmes, such as intensive care
medicine, are available to physician trainees.

What are your aspirations?

You need to decide where you want to be in five or 10 years’ time, professionally and personally. Do you
want to have time with your children, family and friends or time to travel?

Where do you place your ideas of contentment or fulfilment; is this through an ultimate career success
or peak, or achieving a work–life balance?

Many factors can alter your aspirations at any stage of your career. Personal factors include your
relationships (sense of belongingness, connectedness with friends, family, colleagues, patients and the
community), your sense of self (purpose, passion and identity).

But there are also organisational/governmental factors (such as new laws coming into effect that may
change how certain work is done, thereby make it less or more appealing) and economic issues
(security, financial and career progression).

People change and so do their jobs; you need to adapt to your environment and discover new ways of
dealing with everyday pressures. Because of this continuous shift, you need to review your goals and
aspirations frequently.

Get experience

During clinical placements at student and foundation levels, you will experience a number of specialties,
and the real-life medical situations you will experience can influence your view of the field.

These placements are vital in providing a taste of life in a certain specialty; you should make the most of
these invaluable learning tools and try to get as many of these experiences as you can.

As a student, you can consider volunteering or undertaking elective work at a hospital to gain more
experience (and a point of difference on your CV).

As a foundation or core doctor you can arrange ‘taster’ sessions a specialty which is not already part of
your rotation.

Do ensure that your decision is objective, and not solely based on how much you like the consultant
and their team; really think how you felt about that specialty in itself.

RCP specialty recruitment office – How to choose a specialty © Royal College of Physicians 2013 3

Your personality

Something to take into consideration is your personality. Although this should not be the only factor,
you need to have an understanding of yourself and how you behave in situations.

How you process and communicate information, focus attention, in what environments you like to
work, and how you solve problems, are all crucial when weighing up what specialty would suit you.

Are you a hands-on practical person, or do you like to think about detail and solve complex problems?
Can you deal with uncertainty and complex/busy situations, or do you prefer a more ordered approach
with time to think?

Many of the medical specialties require a mixture of attributes because of the varied and variable
nature of work as a physician. Many deaneries/LETBs and foundation schools provide personality and
learning styles testing through their careers department, as well as detailed specialty descriptions.

What is it about a specialty that you are drawn to?

Key preferences to consider while choosing a specialty:

• Patient contact levels – will you have time to develop patient relationships, or would you prefer
to see many patients in a day? What kind of patients do you want to treat, ie do demographics
play a role in your decision?

• Training schedule and time taken to reach consultant level – how long do you want to train for,
how many hours are required and once you are a consultant what hours are you required to
work?

• How competitive is the specialty selection process? Do you have the knowledge and skill base to
get selected? (See http://specialtytraining.hee.nhs.uk/ for details of specialty entry)

• Career progression – how far can you go in each specialty, how far do you want to career-climb?

• Stress management – how do you cope with haste/stress? Would you prefer time to think things
over? Could you work in the high-pressure environment of acute medicine?

• Do you like to work by yourself or in a team?

• Do you like research? Data and analysis?

• Do you like problem solving, or straightforward care practices – structured work?

• Do you like to teach others, speak to groups?

How does it all add up?

A strengths, weaknesses, opportunities and threats (SWOT) analysis is useful for discovering your
tendencies and what you think about particular specialties – how do the positives and negatives really
add up? Do some have more weight than others in your decision making?

This may assist you in deciding which specialties you would like to apply for, ranking your favourites and
absolute last resorts.

RCP specialty recruitment office – How to choose a specialty © Royal College of Physicians 2013 4
Example ‘SWOT’ analysis - acute medicine doctor

Strengths

• Get to deal with lots of patients, interesting and challenging cases.

• I would get to work with many inspiring doctors.

• I like dealing with high-pressure situations and thinking on my feet.

• I enjoy seeing that I have made a difference; with acute medicine this is clear within a short
period of time. I know a lot of theory about acute medicine and procedures.

• I know that acute medicine doctors spend quite a lot of time leading and teaching the team, and
I enjoy these aspects of work.

Weaknesses

• I am not good at working shifts as I get tired easily.

• Sometimes I get stressed when constantly under high pressure, I perform better when there are
up and down periods with time to rest.

• Acute Medicine doctors are always under pressure to increase the speed to which patients are
discharged or transferred; I prefer to spend quality time with patients so I know that I have
looked after them as best I could.

• I don’t like dealing with drunk and disorderly patients and they are often the ones we are
expected to treat.

Opportunities

• I know a few acute medicine doctors in my home town so it may be easier to get work
experience. There are always lots of jobs opening up as there are many doctors in the specialty.
Threats

• Will I be able to work under constant pressure for my whole consultant career? Is the future of
acute medicine going to change so much that I won’t want to do it?

Down the wrong path? Or unsure which path to set out on?

If you find yourself in the position where you doubt whether you are in the right specialty, there are still
opportunities for change.

Quite a few specialties recognise that trainees who move from one training path to another bring with
them useful skills – for example undertaking core medical training before moving into radiology or
general practice, or undertaking general practice before entering physician training.

However, the more changes you make, the longer your overall training pathway becomes, and your
decision-making capabilities may be questioned by selectors.

You could consider a fixed-term post, either in the UK or abroad, to gain experience in particular
specialties; this will help you validate your decision about the specialty you want to pursue next. This is
also relevant if you having trouble choosing your first specialty.

RCP specialty recruitment office – How to choose a specialty © Royal College of Physicians 2013 5
Quite a few foundation doctors step off the career ladder before entering specialty training, in order to
experience different specialties and different healthcare systems, and the experience gained is usually
very useful.

Good luck!

Liz Berkin

Clinical lead for specialty recruitment, RCP London

Resources:

http://archive.student.bmj.com/issues/0 ... ls/433.php

http://www.rcplondon.ac.uk/medical-careers

http://careers.bmj.com/careers/advice/v ... d=20000585

http://www.support4doctors.org/detail.p ... oose-your-
specialty?category_id=13

http://careers.bmj.com/careers/advice/v ... d=20001603

http://www.cardiff.ac.uk/pgmde/careersa ... index.html

http://www.medicalcareers.nhs.uk/career ... sment.aspx

http://www.medicalcareers.nhs.uk/career_planning.aspx

http://www.londondeanery.ac.uk/var/care ... ooklet.pdf

http://www.londondeanery.ac.uk/videos/2 ... areers.swf

http://www.londondeanery.ac.uk/videos/r ... anning.swf

RCP specialty recruitment office – How to choose a specialty © Royal College of Physicians 2013 6
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اشترك في: الخميس إبريل 04, 2013 10:28 pm

Re: How to choose a medical specialty

مشاركةبواسطة دكتور كمال سيد » الثلاثاء إبريل 12, 2016 8:34 am

Choosing a Specialty

Remember when you were doing uni applications, and had to deal with the same handful of questions from people you bumped into…
https://meducation.net/resources/39947- ... -Specialty
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اشترك في: الخميس ديسمبر 28, 2017 11:24 am

Re: How to choose a medical specialty

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اشترك في: الجمعة ديسمبر 29, 2017 6:56 am

Re: How to choose a medical specialty

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اشترك في: الثلاثاء مايو 29, 2018 7:26 am

Re: How to choose a medical specialty

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