Developing in the Career Support Role

30th March 2011

Deanery Careers: areas of activity 2010/2011

• Education

• Support and Guidance

• Promoting Wales

• Workforce

• National Links

• Careers strategy

Education 2010 - 2011

• Training the trainers – workshops, e learning (130 Educational Supervisors F2F)

• School Career Leads and FPD (21)• Foundation workshops (279 F1/344 F2)• GP Trainees (15)• Preparing for consultant selection (91)• MedWales (200 6th formers)• Medical student lectures• Mentoring (50)

2% 5%

23%

11%

12%2%

4%

2%

9%

2%

11%

2%

2% 9%

2%

2%

MedWales

Medical Students attending F1

F1 - Planning your Medical Career

F1 - Making Career Decisions

F2 - Applying for Specialty Training

F2 - Future career tactics

F2 - Interview Practice

GPST

SpR - Preparing for Consultant Selection

PGCM - Supporting Doctors w ith Careers

Ed. Supervisor - Supporting Doctors w ith Careers

Ed. Supervisors - Active Appraiser

Postgrad MSc - Supporting Doctors w ithCareers/Mentoring

Mentoring

Introduction to Career Support

Developing career support skills

Careers Education Events

F2 destinations 2010

• 245 F2 respondents• 173 (70%) appointed to specialty• 128 of these (75%) in Wales and 43 (25%) to

England• 96% got first choice specialty• 20 going overseas (Not as many as we think)• 29 taking career break• 13 leaving the profession, not known where they

go

Consultant Selection – learning gaps

• CV quality (too long, too many lists, poor clinical/non-clinical balance)

• Lack of awareness of what consultants actually do

• Wales-only view• Poor grasp of bigger picture (policy, key

players, changes)• Have trained in the good times, will need to

lead through the tough times• Need better preparation for transition

Caseload

2009 – 2010• 39 referrals• Top 3 sources:

Self, Performance, Ed. Supervisor

• Top 3 reasons

Progress, change, leaving

2010 – 2011• 53 referrals• Top 3 sources:

Self, Performance, Ed. Supervisor

• Top 3 reasons

Progress, change, leaving

Resignations

• A knee jerk response to external factors or carefully considered decision

• Poor awareness of other options – OOPC, LTFT, carers leave

• Need for career change or social support?

! Let us know if you or anyone you know is considering resignation

Returners to medicine

• Supporting Doctors• Out of medicine for 5 – 10 years• Many find a way after meeting us• Started supernumerary posts• Building case for a funded scheme• Let us know if you know of anyone

considering returning to Medicine

Brand Wales

• A Big Issue• Common misconceptions about Wales• More joined up promotion of Careers in Wales i.e. BMA “We’ll keep a Welcome” campaign/Facebook New Brand image – “The Smart Choice”

BUT

Experience of training is a key factor in recruitment/retention

How the new look was intended to look…

We weren’t too far off!

New Resources• New look for DVD and on-line videos: now clips

for WCAT, EM and SAS • New brand feeding into printed resources and

ST:

http://specialty.walesdeanery.org • Campaign page

www.walesthesmartchoice.co.uk • Specialty Leaflets• F1 & F2 E-Learning modules• Interactive Career Map

http://careers.walesdeanery.org

Events last yearFoundation Jobs FairBMJ London and West Midlands (October

2010/11)Medsin Conference November 2010

(Swansea)Local events (Morriston, Princess of

Wales)MedWales 2010 and 2011and…

Medical Careers Information Day

• Much larger event in 2010 with 36 stands.

• Highest attendance from sixth formers

• Students from as far as Dundee!

• Information giving day for students and to encourage early planning

• So where are the F1s and F2s?

StatisticsWho came?

When did they decide to come?

Why?

For your diaries…• Our Medical Careers Information Day

• Consultants and trainees across all specialties

• All Nations Centre, Cardiff

• Saturday 15 October 2011

• 10.00 am – 3.30 pm

• Students, Junior doctors, Trainees

• Please promote – posters/guides

• Help resource stand and workshop speakers

National Careers Activity

• NEAF: Associate Deans with lead for careers• MCAN: Represented on Committee of

ACGAS UG Medical Careers Advisers• An emerging professional group: PG

Certificate/Diploma in Managing Medical Careers

• Presence at ASME, AoME, UKFPO events (workshops, posters, presentations)

3544 LTFT trainees -Nov 2010

LTFT by Deanery

LTFT Conference/Research• LTFT Conference on the 1st March, well

attended by Trainees and positively received• Presentations from BMA, Trainee Rep and

LTFT Advisor• Research project – mapping destination of

LTFTs over the past ten years.• Data collection, focus groups and an online

survey

• Results of online survey – 95% of trainees remained in Wales after completing training

UK Round-up

Collins Report

GMC surveys

UKFPO update

Collins report

Collins - careers-related issue (1)

All of the appropriate organisations must work together to define good practice for the provision of careers information and advice. Such information must be easily accessible, simple to understand and contain transparent data on each specialty, including competition ratios and a potential applicant’s “likelihood of success”

Collins - careers-related issue (2)

Deaneries/Foundation Schools should make a greater effort to meet one of the important purposes of the Programme – to ensure that trainees experience many different specialties – by maximising and simplifying access to Tasters and by implementing organised “swap shops” for trainees to exchange rotations by 2013. Foundation Schools should disclose through their local Deanery website the degree of flexibility allowed by their programme in a standardised format.

GMC Trainee Survey 2010

• Career management skills and planning: 55% foundation trainees said they had been able to develop their career management skills and career plans and that the opportunity was useful

• Information to assist career planning: 40% (48% F2 and 34% F1) knew where to look to get sufficient information

• 25% said they had received information but that there was not enough high quality information in place

UKFPO Annual Report

• Relatively low numbers undertaking GP placements in F1 or F2 in some foundation schools (range 30-95%) compared to the 50% requirement for GPs in specialty

• There are also issues around opportunities to experience hard-to-recruit specialties in foundation

Tasters for Foundation doctors

• Standardised guidance for effective tasters on the UKFPO website and also in the Foundation Programme Reference Guide.

• Rough Guide to the Foundation Programme (2010 edition) contained comprehensive guidance on tasters.

• Do you provide tasters in your specialty / location?

UK Careers Issues• Work ongoing to agree presentation of 2011

competition ratios• UK MCWG future ?• UKFPO Careers workstream to March 2011• NEAF and MCAN meetings ongoing• MSC developing information for school

leavers contemplating a medical career• Future setting of deaneries in England?

Workforce – many sources

• NLIAH report – overview and speciality reports

• CFWI report – reducing numbers in some specialities

• Collins report on Foundation programme – Autumn 2010

• BMA Cohort Study – 4th report• UKFPO warns of shortfall of F1 posts for

2011 – September 2010 • Junior doctors desert the NHS – Times, Sept

2010

Vacancies leading to CCT - 2010Career Options 2010 - Posts leading to CCT

53

11

7 75.5

4 4 41.5 1.5 1 1 0.5 0.3 0.1

56

11

6

3 35

3 2

7

1 1 1 1

44

19

4 4

9 8

42 2 1 1 1 1

0

10

20

30

40

50

60

Speciality

% o

f en

try level p

osts

England

Scotland

Wales

Activity 1

Delivering a Career Planning Workshop

Plan 20 minutes delivery:

• Group 1 Slides 1 – 14 (first 3 objectives)• Group 2 Slides 15 – 16 (objective 4)• Group 3 Slides 17 – 25 (objective 5)• 60 minutes total• Learners must engage and participate, ask questions• 15 minutes feedback

Career Theory - Update

Theories of career decision making

• Person-Environment Fit Theories e.g. work of Holland

• Developmental Career Theory e.g. Super• Psychodynamic Theories• Structural Theories e.g. Roberts• Law’s Community Interaction Theory• Narrative approach to careers e.g. Cochran

Counselling theories

Person Centered Approaches (Derived from the work of Carl Rogers) –congruence, unconditional positive regard and empathic understanding

‘Person-centered career counselling is a relationship between a counsellor and a client, arising from the client’s concerns, which creates a psychological climate in which the client can evolve a personal identity, decide the vocational goal that is fulfilment of that identity, determine a planned route to that goal, and implement that plan. The person-centered career counselor relates with genuineness, unconditional positive regard and empathy; the locus of control for decisions remains with the client out of the counselor’s trust in the self-actualizing tendency of the individual. The focus in person-centered career counselling is that of attitudes and beliefs that foster the natural actualizing process rather than on techniques and goals.

(Bozarth J.D and Fisher, Rl (1990). Person-centered career counseling. In W.B. Walsh and S.H. Ospiow (Eds). Handbook of Vocational Psychology. Mahway, NJ: Erlbaum

Emerging Career Theories

• Narrative Theories• emphasise the process of re-interpreting

the past in order to develop and maintain a coherent story, rather than just the existence of memory of a consistent past

• emphasises ‘emplotment’ - the process of viewing the self as the main character in a meaningful and productive narrative

Emerging Careers Theories

• Career Learning and Storyboarding• SeSiFU – sensing, sifting, focusing and

understanding • storyboarding aimed at enabling clients to

find out ‘What’s going on?’ and to work out ‘What can I do about it?’. It focuses on reflecting on a turning point in a person’s life and gives clients the opportunity to explore their own capacity for flexibility

Emerging Career Theories

• Happenstance (chance)• Counsellors need to teach clients to engage in exploratory

activities to increase the probability that the clients will discover unexpected career opportunities. Unplanned events can become opportunities for learning.

• The ultimate goal of career counselling is creating satisfying lives, not just making a decision

• Practitioners should get clients to engage in exploratory action

• Open-mindedness should be celebrated, not discouraged

• Benefits should be maximised from unplanned events

Emerging Career Theories

• Systems theory framework (STF) social contextual systems – the principal social influences within which

individuals interact and/or receive input from e.g. family, community, media, education etc.

environmental/contextual systems – things like geographical location, political decisions, historical trends, labour market etc.

• Chaos theory draws attention to the complexity, changeability and connectedness of

the components of career development – complexity, change, chance

• Cultural capital increased focus in widening participation into medicine and medical

school

Skills session

• 1:1 Discussion exercise

• Review of Core skills

• Case studies

1:1 Discussion Exercise

• Working in pairs• Topic -Where you grew up• 3 minutes to ask questions and take notes• Swap

• 3 minutes to talk about where you grew up• Swap

Core skills

Ali and Graham (1996) provide a clear account of the essential skills that are used in career counselling (and in fact, in any counselling relationship). According to this model, certain skills are more basic than others – although all levels of skills are essential for an effective counselling relationship.

The Skills Pyramid

Interpretative Skills

Understanding Skills

More Influence

Strengthen Empathy

Active Listening

Skills

Ali, L. and Graham, B. (1996) The counselling approach to career guidance. London: Routledge, an imprint of Taylor and Francis Books Limited

More about the Skills Pyramid

• Interpretative skills – challenging, immediacy, self-disclosure and providing information

• Understanding skills – restating, paraphrasing, summarising and asking open questions

• Active listening skills - this term means listening to: the content of what is being said, how it is said, the possible meaning behind the words, the feelings expressed and the nature of any silences. It is used through the whole session

Four stage model

Clarifying Exploring

Action Planning Evaluating

Ali, L. and Graham, B. (1996) The counselling approach to career guidance. London: Routledge, an imprint of Taylor and Francis Books Limited

Clarifying

Tasks• Setting the scene• Developing empathy• Hearing the clients story• Making an initial

assessment

Skills• Developing and

conveying empathy• Active listening• Paraphrasing• Summarising

Exploring

Tasks• Building the contract• Exploring the issues

within the contract• Encouraging the

client to explore other options

• Re-examining the contract

Skills• Active listening• Skilful questioning• Paraphrasing• Summarising

Evaluating

Tasks• Challenging

inconsistencies• Enabling the client to

weigh up the pros and cons for each option

• Prioritising options with the client

• Re-examining the contract

Skills• Active listening• Questioning• Challenging• Providing information• Self-disclosure• Being specific

Action planning

Tasks• Helping the client

identify what needs to be done

• Encouraging the client to formulate an appropriate plan of action

• Introducing the concept of referral if necessary

• Reviewing the contract• Ending the interview

Skills• Developing and

conveying empathy• Active listening• Paraphrasing• Summarising

Case studies

• In groups of 4

• Read case study allocated

• Using 4 stage model how would you approach working with this trainee?

Summary and next steps

Help for the Helpers • “Supporting Doctors with their Careers” and

“Being an Effective Mentor”• 2 hour sessions for Educators• 2 CPD points from RCP• Opportunity for interaction, reflection, discussion• We can run – or so can you!• Also on-line module based on London Deanery

materials, on PLATO (which you previewed)• Aligns with PMETB domains for Educational

Supervisors

And finally…• Our resourcing is changing a little

• Wider range of workshops

• Caseload increasing

• More Wales PR and promotion

• Admin and financial resources stretched

• So…

We really do need your help with…

• Specialty information for leaflets

• Delivering F1 workshops

• Medical Careers fair on 15th October 2011 and BMJ (Foundation, specialties)

• Promoting, organising and co-delivering training for Educational Supervisors

The role of the career lead…

…say “no” to Sat-Nav!

Thank you!