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RCP specialty recruitment

officeHow to choose a specialtyVersion 1.0Published 4 October 2013 2 RCP specialty recruitment office How to choose a specialty Royal College of Physicians 2013


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When do I decide?One of the hardest decisions in your career begins at foundation level, which is when you have to startthinking about which specialty to pursue.Anecdotally, about half of all foundation doctors have a good idea of what this is from very early on; theother 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 60specialties 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 coreprogrammes which assist your career decision. Other trainees are more influenced by geography, iethey 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, likesand dislikes, abilities, passions, interests, ambitions, aptitudes, cognitive processes, limitations and task-management skills.What makes you unique? You need to consider the specialtys requirements, conditions of success,

advantages and disadvantages, financial and personal compensations, prospects, and opportunities forfurther career and educational development.You should be realistic about the relative strength of your application; some specialties are veryoversubscribed.All specialties require completion of an application form. Domains are marked at the shortlisting stage,and if you dont get many marks at this stage, you may not get an interview, no matter how good aclinician you are.Most doctors cannot gauge the relative strength of their application, but if you look at the nationalapplication form, you should be able to work out whether you can gain marks in any or all of thedomains.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 popularspecialty.You should investigate the competition ratios, but bear in mind that these data are historical, and do notnecessarily reflect future competition indeed the mere act of making this information available canchange applicant behaviour!If you have decided on a career as a physician, the first step is relatively simple, because there are onlytwo 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 upthe access to over 30 medical specialties which commence training at specialty training 3 (ST3). This ST3training lasts four to five years, and can sometimes lead to subspecialty training (for example, as agastroenterologist, you could specialise further in hepatology). 3 RCP specialty recruitment office How to

choose a specialty Royal College of Physicians 2013 to find out more about the different physicianspecialties. 4 RCP specialty recruitment office How to choose a specialty Royal College of Physicians 2013


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Your personalitySomething 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 towork, 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 approachwith time to think?Many of the medical specialties require a mixture of attributes because of the varied and variable natureof work as a physician. Many deaneries/LETBs and foundation schools provide personality and learningstyles 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 seemany patients in a day? What kind of patients do you want to treat, ie do demographics play a role inyour decision?

Training schedule and time ta ken to reach consultant level how long do you want to train for, howmany 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 bas e to getselected? (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 pr actices 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 yourtendencies and what you think about particular specialties how do the positives and negatives reallyadd 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 andabsolute last resorts. 5 RCP specialty recruitment office How to choose a specialty Royal College ofPhysicians 2013


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Example SWOT analysis - acute medicine doctorStrengths 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 oftime. 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 Ienjoy 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 upand down periods with time to rest.

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

I dont like dealing with drunk and disorderly patients and they are often the ones we are expected totreat.

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 acutemedicine going to change so much that I wont 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 stillopportunities for change.Quite a few specialties recognise that trainees who move from one training path to another bring withthem useful skills for example undertaking core medical training before moving into radiology orgeneral practice, or undertaking general practice before entering physician training.However, the more changes you make, the longer your overall training pathway becomes, and yourdecision-making capabilities may be questioned by selectors.

You could consider a fixed-term post, either in the UK or abroad, to gain experience in particularspecialties; this will help you validate your decision about the specialty you want to pursue next. This isalso relevant if you having trouble choosing your first specialty. 6 RCP specialty recruitment office How tochoose a specialty Royal College of Physicians 2013


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Quite a few foundation doctors step off the career ladder before entering specialty training, in order toexperience different specialties and different healthcare systems, and the experience gained is usuallyvery useful.Good luck!Liz BerkinClinical lead for specialty recruitment, RCP London

Resources:http://archive.student.bmj.com/issues/08/12/editorials/433.phphttp://www.rcplondon.ac.uk/medical-careershttp://careers.bmj.com/careers/advice/view-article.html?id=20000585http://www.support4doctors.org/detail.php/3/careers-advice-ways-to-choose-your-specialty?category_id=13http://careers.bmj.com/careers/advice/view-article.html?id=20001603http://www.cardiff.ac.uk/pgmde/careersandrecruitment/careerplanning/options/index.htmlhttp://www.medicalcareers.nhs.uk/career_planning/self_assessment.aspxhttp://www.medicalcareers.nhs.uk/career_planning.aspxhttp://www.londondeanery.ac.uk/var/careers-unit/files/careers_booklet.pdfhttp://www.londondeanery.ac.uk/videos/21st-century-careers.swfhttp://www.londondeanery.ac.uk/videos/role-models-in-career-planning.swf

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