Moving on from clinical practice

Abstract

Non-vocational degrees are broad enough for graduates to ponder on which way their careers might develop as they meander through undergraduate life. English, maths, and the humanities, to name a few, allow graduates breathing space to consider their options. Some would see this as a benefit: there is no burden of expectation; things remain flexible. And some would view this as a disadvantage with no clear career path or likelihood of employment in a definite sector. Medicine, on the other hand, leads graduates down a structured path into their chosen career, on the basis of a choice that was usually made—in most of Europe, Asia, and Australia—at around age 17. Medical graduates are signposted through the next steps of training to full qualification. Although there are choices to be made within medicine, the broad direction is set. Should medical graduates feel obliged to follow this set path? If medical school and the reality of practising as a doctor don’t match up to expectations, should medical students go off piste? What are the alternatives, and how feasible and realistic is it to look outside the clinical sphere? In the US, medical school is at postgraduate level, after completion of a general undergraduate degree—typically four years at each stage, taking the average age for starting medical school to 24.1 Is this a more sensible age to make a decision about a lifelong career? A cohort study by the BMA followed the career paths of 545 UK medical graduates from the class of 1995. One of the main findings was that “while three quarters of cohort doctors are currently satisfied with practising medicine, a fifth report a lukewarm desire to practise medicine and the remainder have little or no desire to practise medicine.”⇓2 Reason for leaving medicine as a career: …