What career pathway will you choose?

Choosing a career pathway can be one of the greatest challenges facing a medical student or junior doctor. You’ll weigh up your strengths and weaknesses, your clinical and academic interests, and your personal or family needs. You’ll also grapple with the external factors like entry criteria, training requirements and the job market.

We’ve asked members of our Doctor in Training Advisory Council to share their insights about career choices and training pathways. We spoke with:

• Dr Malcolm Forbes – Advanced Trainee in Psychiatry, Victoria
• Dr Jack Marjot – Advanced Trainee in Emergency Medicine, NSW
• Dr James Kemper – HMO in Obstetrics & Gynaecology, Victoria

What attracted you to your chosen training pathway?

Malcolm:The work is extremely rewarding and there is a great opportunity to undertake important research in the field to improve the lives of individuals suffering with mental disorders. A day as a psychiatry registrar is always varied, but you have the opportunity to connect with patients at their most vulnerable.

Jack: I love that in ED you can stay truly generalised. You don’t get stuck in a rut or entrenched in a routine. Every time the phone goes off to announce an incoming ambulance it could be any pathology, any person, from any walk of life – and it’s going to be your responsibility over the next few hours to help keep that person alive. That’s a tangible and rewarding experience, and you share it with an incredibly diverse team of colleagues.

James: O&G is a fantastic speciality that straddles medicine and surgery. We get to care for women across their lifetime. Obstetrics allows us to share some of the happiest moments a family can have, and gynaecology allows us to conduct intricate and complex surgical procedures. I also love the unpredictability of the Birth Suite.

What challenges will junior doctors face in your pathway?

Malcolm:The emotional burden can be difficult at times, so it is important to have regular supervision and external support, such as a peer review group or mentor.

Jack:You get a unique amount of autonomy in ED as a junior doctor and, while the support is always there, you are largely free to start the work-up of the patient on you own. This can be a steep learning curve but will make you a much more confident doctor.

James:Applicants have three attempts to gain a spot with RANZCOG and are required to relocate during their training for a minimum six month period to a rural/regional community. Being a surgically based specialty, one of the biggest challenges is obtaining enough operative opportunities.

What advice would you give to a student or intern interested in your pathway?

Malcolm: While you can start psychiatry training straight out of internship, I recommend doing at least two years of prevocational work before you apply. This will help you develop the skills in general medicine to manage patients’ health better. Also, remember that inpatient psychiatry is very different to the work many psychiatrists end up doing. Don't let a rotation in a busy inpatient psychiatric unit - with limited opportunity for psychotherapeutic work - turn you off the specialty.

Jack: Get stuck in. Don’t be afraid to pick up complex cases or make your way into the resuscitation bays. As long as you bring help along if you feel out of your depth, exposing yourself to higher acuity patients will make you more familiar and comfortable with managing deteriorating patients.

James:Best advice - be keen! Talk to your local O&G department, get involved in research, try to get experience by obtaining rotations in O&G. You should also have a look at the RANZCOG application process, particularly the CV - there are components (e.g. research, leadership, altruism) that may take years to cultivate, so starting early will pay off.

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