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MORALE is low and burnout across medical specialties is high. In part, this is fuelled by the constant worry about job security for junior doctors.
Some doctors who complete their training struggle to find regular work in the public sector for reasons too complex to detail in this short article. As discussed in MJA InSight last week, many junior doctors might not be able to even get a training place.
However, the lack of job security for junior doctors is likely to be part of normal cyclical workforce patterns, which indicates we shouldn’t be too worried. However, that offers little consolation to new practitioners who can’t find work now.
Doctors looking for work and those feeling uncertain about their job security often fear that if they deviate from the “normal” training conveyer belt they will be further disadvantaged and passed over in the competitive workplace.
I would like to challenge that notion.
Medicine as a profession is always changing. New evidence is regularly discovered that informs and changes the way we all practice. These changes are vigorously and appropriately debated.
There is no reason to think that significant changes in our workforce should be met with any less critical debate. In that debate, one thing that all practising doctors can be sure of is that workforce changes, like changes in practice, are inevitable.
And that change is hard.
No other professional graduates have job certainty and few other professions ever have the job security that we have enjoyed. Yet medicine also requires a level of personal sacrifice that is quite different to most other professions. So it’s understandable that this change to a less certain job future is a bitter pill for us to collectively swallow.
But it doesn’t have to be.
Amid change there is opportunity. Junior doctors now have more opportunities than their predecessors to shape the way they balance their life with work. And this is the real elephant in the room.
There is more to life than medicine.
Having just spent the better part of 15 years learning how not to have a life, but at least being assured of employment, that can be hard to remember and even harder to believe. Studying and specialising in medicine teaches us to sacrifice other parts of our life rather than nurture them.
So when we reach the end of the study and training road to find our future job prospects are not as certain as we expected, it can be very daunting. But this is where the opportunity lies.
For doctors still in training there is opportunity to gain experiences out of the ordinary through locum work, travel or volunteering abroad, or practise in an entirely new setting like the military, or accept an overseas fellowship, or even work as a doctor in Antarctica.
I’m willing to bet that doctors with this broader experience will be more marketable in a competitive job market than those with a generic ticket who are the same as the next applicant.
And for those of us recently qualified? This is our opportunity too.
This might be our only chance to really think about how we want to work — or perhaps how we don’t want to work. Is it time to do part-time clinical work so we can learn other skills we always wanted but never thought there would be time to achieve? Or time to be home for dinner and our children’s bath time? Or time to build a successful private practice?
Whatever we choose to do with our time, we have a choice to use it as an opportunity or waste it wishing things were how they used to be.
Before we know it there might be too many jobs again and we’ll wish we’d taken the chance when we had it.
Dr Simon Hendel is a Melbourne based anaesthetist.
Thankyou Dr Hendel for writing an article about junior doctor training.
I must agree with the above comments though, alternative options are limited and our industry has a slow uptake of embracing diversification, particularly in juniors.
As a risk taker and optimist by nature, I chose to travel, work, and have a baby during junior training which has all but erased my ability to re enter the “conveyer belt” and meet the ever increasing training prerequisites. Although I’m now happy to look outside medicine for a new career, it is an imbalanced investment of time and resources.
It is a foolhardy exercise to advise junior doctors to take alternate paths in the current climate if they have their heart set on a speciality career. Doors close on anyone who jumps on and off the “conveyer belt” prior to gaining a place or is looking for flexible training. There are simply not enough availability of training positions.
It is nice to see another article that addresses the training crisis. However, this article misses the mark and shows a lack of insight into the challenges facing junior doctors vying for career progression.
A flood of graduates means that most colleges have increased their prerequisite requirements for training. Often these are tied to recency requirements meaning they must be completed within a certain time of application. In turn, this means that ‘valuable’ rotations such as ICU (wanted by Physician/Surgical/ED/GP applicants alike) often have a queue, with residents forced into a game of cat and mouse with hospital HR departments. Taking a non-linear career path removes you from this system and it is very hard to return. Intern places have expanded, but resident jobs have not so hospitals often can’t find enough positions for their own, let alone unknown outsiders.
Working through the article’s suggested alternative pathways:
Locum – these jobs don’t exist anymore at a junior level. Why would they when there is a massive oversupply of residents?
Travel/Volunteer – problematic as it gets you ‘out of the loop’ with hospitals and at the back of the pack when it comes to preferred rotations.
Overseas fellowship – how do you do that when there are no training positions in the first place?
Antartica? As a PGY2….
The fact that Dr Hendel is recently qualified shows just how quickly the challenges facing junior doctors have changed and how disconnected most doctors are, even if they feel they have just lived it themselves.