Skills Toolkit: Making the most of training

Making the most of your time while training: the advice I listened to

Katie Wallace is an ST6 in clinical oncology. She describes herself as a fairly ordinary trainee. She feels that she’s not very good at exams and had her fi rst child as an SHO. Her perspective transformed by a fellowship with the Future Leaders Programme in Yorkshire, which inspired her to become a North Representative to the Faculty of Medical Leadership and Management trainee steering group, Chair of Junior Members Forum at the BMA and various other local roles.

Medical training can feel like a mountain to climb… then towards the end the time rushes by faster than you want. Before you find yourself facing interviews and jobs after completion of training, there are ways you can prepare yourself and make the most of the opportunities that are unique to training roles. People love to give advice; you cannot follow all of it but in this article, I share the advice I have received and want to pass on.

1. Any job becomes routine, find something with flashes of brilliance

As a student I had a placement with an anaesthetist who described how the bulk of any role will become routine whatever you do and so you need to find a job where there is a skill, role or opportunity that inspires and motivates you. He explained how, for our orthopaedic colleague, it was second hip revisions which he would only occasionally do but the challenge inspired him. Medical careers are not easily embarked on or maintained. This advice recognises the need to understand our motivation to be able to nurture and maintain it. All jobs have good days and bad days, but we will be better doctors if we can find a role where the good days maintain us through the bad ones.

2. Apply for opportunities

Go for it. We always imagine the competition is greater and therefore people do not put themselves forwards for awards and opportunities. I have found myself over recent years repeating this to many colleagues because it is good advice. Colleagues think their quality improvement project (QIP) or audit must be ground breaking to be considered for a conference but I’ve never known a poster abstract to be rejected. The effort does not have to be huge but the benefits for your CV can be great so what is holding you back?

3. Think about what you want to do beyond the clinical

A GP partner or consultant is rarely purely a clinician. Whilst our medical training would imply we spend all our time diagnosing cases in a multiple choice question format, the job plan of senior colleagues varies hugely. Once you become a consultant you will need to negotiate your job plan and have a clear understanding of what you want to do and what skills you have to offer. This places you in a better position to take on roles you enjoy. A senior registrar told me at the start of my speciality training that all consultants have an area of interest; research, teaching or leadership. Your training is the ideal time to gain experience and explore what interests you. Once you have found the area that inspires you there are opportunities to demonstrate that enthusiasm through post graduate degrees and local roles. The danger of not exploring this is that as a new consultant you find yourself with a job plan with time dedicated to something you do not like.

4. Do something every year

As an ST3, at the start of speciality training, a senior colleague asked to join my project. When I discussed it with my supervising consultant, they advised me to say no because the colleague was trying to bolster their CV at the end of their training using my work. Nowadays as a more senior trainee, I have a more relaxed attitude because we are all trying to boost our CV’s and the service demands, exams, and courses make publications and extra-curricular activities hard to achieve. We are all familiar with the search for a quick and easy QIP to satisfy training requirements. However, the consultant had a point in that you cannot do everything at the last minute. The interview panel can see the dates and distribution of your work and experience. They suggest doing something every year. It is easier than it sounds if you consider completing and presenting a QIP one year and then the following year presenting the work as a poster at a conference. Be flexible and make the most of the work you have done - every audit or QIP is a potential presentation or publication.

5. Make sure you have your cake before you ice it

I struggle with this one. This exact phrase was said to a friend. To me I was told to gain my clinical competency to give me legitimacy before pursuing my areas of interest (leadership and retirement in case you wondered). It feels hard when phrased as needing to prove that you have the cake or legitimacy, but it is sensible and that’s why it is being said to different people in different ways. Membership exams are hard. I have failed more than most but once they are done you are free to pursue your interests and have a rounded life. There is a balance and revision is more productive when you are fulfilled and happy but sometimes titles and qualifications open doors to opportunities that you would not have otherwise so it is worth investing the time and energy.

6. Do not be afraid of the scenic route

Medical careers can feel like conveyor belts since Modernising Medical Careers was introduced; national recruitment and runthrough training schemes give the impression that you are making a commitment for life and there is no going back or stepping off. It is not true. You can change speciality, you can retrain, you can even use your skills in different areas. GP’s are perhaps the most forward thinking of these with a vast array of portfolio careers demonstrating that the options are limitless. But there are many ways to gain experience, broaden your options and explore the potential of your career, for example with fellowships with the Faculty of Medical Leadership and Management (FMLM), Harkness and so many other options. I did a leadership fellowship with Yorkshire and Humber Health Education England (HEE) (the future leaders programme); it transformed my career and I would recommend the experience to anyone. While there are arguments for becoming a consultant sooner, I have not met anyone who regretted a year of stepping sideways, yet.

7. Do not let your preconceptions hold you back

A few years back the Medical Women’s Federation, Royal Colleges, British Medical Association and FMLM were among the many medical organisations that I did not understand or think there was a role for people like me to get involved in. I was wrong. There are opportunities for anyone but they are not necessarily well-advertised. Talk to people, listen, look and be curious and there will be ways you can get involved. The success of medical organisations that represent our colleagues depends on our participation. There is a role for everyone you just need to find it and go for it to get involved.

Key points:

Find work you enjoy; it’s where we spend most of our waking hours. Seize opportunities to explore your interests and shape your role around those interests. Pass your exams but be kind to yourself and don’t be afraid to take more time or step sideways.