scope:

Introduction

Graduate students starting their MBA at Harvard Business School are told from the outset that getting the prestigious qualifi cation is just the start. It is not a fi nal destination but merely a transition that prepares them for the rest of their career. Along with lectures on corporate fi nance, global markets and emerging economies, there is a specifi c module dedicated to developing a vision for their own future and devoting all their energy towards achieving that goal.

Medical students have an equally intensive undergraduate study. They are taught human anatomy, molecular biology and statistics. They spend time on the wards learning how to deal with a number of different systemic diseases but somewhere along the way they miss out on the teaching that is fundamental to a student of business.

How should a fi nal-year student choose what career to pursue and what do they need to do to get into that career? What sort of questions are asked on an application form, and what type of answers are the shortlisting panel looking for? How should you prepare yourself for an interview? If you are offered a place that would not be your fi rst choice should you accept it immediately and then work towards the greater goal or should you risk being without a job in the short term rather than doing something that takes you away from your ideal career?

Attaining your own career goals in medicine in the UK was, until relatively recently, very much a lottery. Jobs were advertised in a few select journals and candidates could apply for as many or as few as they wanted. They could be announced at any time of year and deaneries across the country placed advertisements at different times. It was easy to miss a dream job simply because you hadn't read the current issue of BMJ Careers. Candidates were chosen for interview based on a curriculum vitae, which could range from one side of paper to a ream of pages stapled at the top and placed in a binder. Those who used yellow parchment paper may have stood out from those who printed theirs off on plain white paper.

Shortlisting for a job interview was sometimes about who you knew, rather than how much you knew. Career advancement in many fi elds often meant socialising with your boss and colleagues outside of working hours. In some respects things have perhaps changed very little but in others there have been dramatic differences over time.

It was unlikely that candidates for junior training jobs had any research experience or had carried out an audit. It was even less likely that they could answer a question about fi tness to practice or the current changes within the National Health Service. An interview question about their experience as a vascular surgeon may have been answered well but a query about the seven pillars of clinical governance might have been met with a blank look.

The advent of Modernising Medical Careers has changed all of this. Jobs are now advertised at specifi c time points throughout the year and almost all applications are made online. It is not good enough to have merely helped with an audit or written a poster. The candidates who are selected for interview will have initiated an audit and then claimed that it had far-reaching conclusions. Rather than being an author on a poster they may have helped produce it and then presented the results to a regional specialist meeting.

The world of min-CEX, DOPs and 360-degree appraisals may have improved the process of review and competency but it does have a number of downsides. Perhaps chief amongst these is the difficulty of standing out from the crowd. If all applicants have an up-to-date training portfolio then how do you show a shortlisting committee that you are better than your peers? If all candidates have participated in an audit then how do you convince the interview panel that yours was one of the better ones?

The answer is to follow the example of the MBA student. You need to have a long-term strategy and then devote your resources towards achieving that aim. The effort that you put in towards your career goals at the outset will have far-reaching benefi ts and short-term pain does indeed often lead to advantages in the long term. No matter whether you wish to be a part-time salaried GP in a remote village in the Cotswolds or an academic neurosurgeon in a London teaching hospital, it still pays to have a strategy. You need to understand the exact questions on an application form and know what the panel is looking for to achieve maximum marks. You need to practice your interview answers until you know what to say even before they have fi nished asking you the question. When offered to initiate an audit or a piece of research by a senior colleague you need to know when to accept and devote an entire weekend to making a deadline and when to simply say no and walk away.

Many of these questions can only be answered with experience. You need to spend time working as a doctor and speak to senior colleagues who have faced these challenges before. You will get confl icting advice about how to pursue your career and at the end of the day it is important that you make your own decisions based on what you understand and what is important to you. We hope, however, that this book will help point you in the right direction.

In the words of Harvard's MBA programme, "It's time to fi nd your future".