View of a junior doctor.
Capacity
We are taught in Medical School that we should respect patients' autonomy. If there is no impairment of or disturbance of a person's mind or brain, and if the patient is able to understand, retain, weigh, and communicate the decision being made, a patient has mental capacity. No matter what decision they make, rational or irrational, we should respect it.
If I assessed myself at the age of 17 when I applied to Medical School, did I have the capacity to decide for a career in medicine?
Looking back, I certainly did not understand what a career in medicine really means. It is one of the few vocational degrees that channel university students directly into a lifelong career. A double-edged sword. On one hand, the job security is second to none, even in an age where newspapers claim robots and AI will take over the world. However, for us from the inside, it often feels like we are on a conveyor belt, with a fixed journey of 5 years to become a GP or 8-10 years to become a hospital consultant.
Now that I have practiced medicine for a year, I have a better idea of what a career in medicine entails. With flashing images of bankers living a lavishing life, do I still want a career in medicine? How do I know? What will this flood of new information and technology bring to medicine in the near future? How do I prepare myself? There is no right or wrong answer.
Having spent the last 3 years navigating myself, I have condensed it into 3 steps. I hope some might be helpful to you.
1. Set your target. Where do I want to be?
This is extremely difficult and could change many times before you really hit it on the nail. After having studied hundreds of millionaires, Napoleon Hill recommended in his book (Think and Grow Rich) to lock yourself in a quiet room, inspect deeply, and define clearly exactly what you want in life [1]. It should be so clear that you can paint an image in your head and imagine yourself living it. Of course, this would change from time to time. For me, it took 5 iterations over 2 years. At the age of 25, I have set a satisfactory image for my end goal.
You might think, what is the point of all this? You are on a set path to becoming a GP/ consultant. You will get a training number, find a partner, get a house and get on. Yes, this is the path medical school has set us to go on. However, life has limitless opportunities. Have you ever asked yourself the very critical question of "why do I have to be a doctor?”. I am sure every one of us has. This is precisely the point of this exercise.
You will finally open up, and explore all the other opportunities that are out there, working in consultancy, working in finance, become an entrepreneur, working in Pharma, the list goes on. Then, distill this into what you fundamentally look to achieve in this life. It is terrifying to open this Pandora box, in a way, because you do not know what you will find out. But I can guarantee you, once you have reached the conclusion, to know what is really important for you, many decisions will be a breeze.
It is extremely difficult to have this conversation with yourself, but you will be the sole benefactor of this exercise. This is the first step, to be viscerally truthful to yourself, and define what do you really want?
2. Learn about yourself. Where am I?
Knowing where you want to be is a great start, you have drawn your finish line. Now work backwards. Before making a move, you need to know where you currently are. Say you want to improve healthcare on the population level, but you just graduated from Medical School. You have a long way to go. It is an abstract goal, and there are many solutions that one may explore. Realistically, find something that is practical and appealing to you as an individual. Start with exploring the opportunities that are readily accessible. A well-paved path, on the other hand, such as becoming a GP, will be more straightforward. But again, a holistic understanding of where you are today will help map out the knowledge and skills you need to get to the finish line.
Many would recommend identifying your core values. A set of moral beliefs that you firmly believe in and define your approach in life. This method is proposed by Stephen Covey, the author of "7 habits of highly successful people" and Ray Dalio, the CEO of Bridgewater Associates, the largest hedge fund firm in the world [2][3].
Your set of values acts as a compass amongst the chaos in life.
3. Capacity-building and be open-minded about change. How do I get there?
This is going to be the most difficult challenge. Rarely someone can prescribe a set of instructions to simply follow. If luckily, you know you want a specific career, often job description with a list of required evidence is a starting point. Almost all the ST training programmes have this. Although even so, it might not be a straightforward path. Let alone if your choice is an unconventional one. A lot of the time, it is up to ourselves to try, fail and learn along the way.
After all, as long as we get to where we want, the process matters only to us.
To enjoy the process, we need the golden triangle of autonomy, purpose, and mastery. The first two elements have been addressed in the above sections. To reach mastery requires specific knowledge and skills. What are the skills that you need to achieve your goal? And how do you start to acquire them? Often skills such as leadership, communication, and mentorship are highly sought.
Match it with your current stage of training, the environment, your resources, and your shortcomings. Then, explore the courses and projects where you can acquire these. It can be within, or outside of Medicine.
I found the careers research called the 80,000 hours, conducted by the University of Oxford helpful [4]. Some sections more useful than the others. In particular, the chapter on career capital helped my navigation. You might be the same, where you need to build up flexible skills to prepare for the uncertainty lies ahead. Eurekadoc has also held webinars on Career Design and will be releasing a fantastic course on this topic in February 2019 [5]. Watch this space.
These are steps that I have found to be useful. It requires a significant amount of work to figure it out for yourself. It is very worthwhile and gave me some incredible insight about myself and the world.
Start researching. Talk to people. And give it a go!
References:
[1] Hill, N. Think and Grow Rich (2014). San Diego. Dauphin Publications Inc.
[2] Covey, S. 7 Habits of highly effective people (1989). London. Simon & Shuster.
[3] Dalio, R. Principles (2017). New York. Simon & Schuster.
[4] 80,000 Hours. Universit of Oxford Future of Humanity Institute. Link: https://80000hours.org/career-guide/career-planning/
[5] Career design workshop for doctors. Eurekadoc. Link: https://www.eurekadoc.com/career-design-workshop
Coming up:
About healthcare: bringing value. View of a junior doctor.