How can I support trainees with their career planning? 

Offering career support is a two way process - you (the trainer/supervisor) aren't there to tell your trainee what you think is the 'right' specialty for them and tell them 'what to do'. Similarly, the trainee isn't a passive recipient in the process, expecting to be 'told' which specialty to go into or to be spoon-fed. By having an appreciation of the career planning process and the tools, resources and tasks that can help, you can offer a structure that guides the trainee to work towards making realistic and informed decisions about their careers and taking decisive action.

Key terms used in careers support:  

Careers information
Offering specific information and checking doctors know where to find/access it, for example Health Careers website and Royal College websites.

Career advice
Offering time for the trainee to clarify or check out information which can help them to progress their career planning in some way. Advice should avoid being leading, biased, judgmental or at worst, incorrect. The goal with advice is for the trainee to clarify something for them self and decide on next steps.

Career guidance
Offering space and time for a trainee to explore their career situation in more depth, evaluating options and creating action plans to support their decision making and career progress.

Career counselling
Offering specialised careers support by an experienced careers practitioner who has undergone formal training in careers advice and guidance.

^{Definitions adapted from the work of Ali and Graham (1996), Kidd (2006) and Nathan and Hill (2008). See full references in the reading list below.}

Take a look at the 10 point checklist below to use as part of any career conversation you have with trainees at any level of their career progression.

A 10 point checklist

1. Use a structure to support any career conversation with the trainee to get the most out of the time you have available in your discussion. e.g. clarifying, exploring, summarising and action planning
2. Build an open, honest and constructive relationship with the trainee to facilitate self-understanding
3. Provide specific, objective and up to date information in a timely way, assisting in interpretation when appropriate
4. Take an interest in the individual and be committed to helping
5. Help the trainee to explore new perspectives they may not have considered
6. Offer constructive challenge but avoid being directive or judgemental; offer informed but unbiased opinions and feedback
7. Tailor your use of language to the trainee such that a shared vocabulary is used
8. Work together on forming strategies; review progress and adapt plans when needed; assist in goal setting and clarifying actions
9. Empower the trainee with confidence and skills to make realistic well-informed career decisions
10. Know your limitations and be aware of available sources of additional support

^{This 10 Point Checklist has been adapted from Association for graduate careers advisory services - agcas (2006). Careers Education Benchmark Statement. Sheffield: agcas and Kidd, JM; Hirsh W and Jackson C (2004). Straight Talking - the nature of effective career discussions at work. Journal of Career Development 20 231-45}

What can I expect from my trainee during any kind of career conversation?

In some ways, these are expected of any doctor as part of their educational development and therefore should be no different in terms of career development

Helpful trainee behaviours

• Proactive in seeking out help
• Well prepared for any meetings; brings along key documentation when required
• Willingness to be helped
• Aware of own strengths, skills and motivations
• Honesty with self and others
• Realistic
• Approaches issues with an open mind
• Considers a range of options
• Takes responsibility for own career learning
• Takes appropriate action

Trainee behaviours that may be more challenging to support

(The following list could also mean that the trainee is struggling in some way and needs additional support to enable greater self-reliance and insight).

• Just waits for help to come along
• Doesn't make an effort to find info or source people who can support
• Wants to be spoon fed and told what career path to follow
• Apathy - can't be bothered
• Pressure from peers/ family getting in the way
• Doesn't listen
• Tunnelled in thinking
• Rejects offers of support
• Blames others for situation
• Procrastinates, sticks head in the sand
• Struggles to identify issues 

Additional information to inform career discussions

The following additional information can help you in your conversations with trainees;

• Be proactive about discussing career plans with your trainee at each meeting you have with them - even if it appears to be covering old ground or revisiting topics already discussed, new career insights may emerge and trainees may identify additional actions and tasks they need to carry out to progress their next steps.
• Explore with your trainees what evidence and insights they have into their career direction and choices so far - have they spoken to people in the areas that interest them? Have they thought about strengths and weaknesses? What events have they been to? What documentation do they have which support or challenge their choices? Consider using the career audit tool (available from the Downloads Library) to prompt discussion with your trainees to review their progress so far and explore what they need to work on.
• Be prepared to offer constructive and helpful feedback and offer observations on what you hear/see/think/feel. Use a process of clarifying/exploring/summarising/action planning to keep any conversations focussed and on track. If new topics arise, consider booking separate time to discuss these.
• Offering career support is a two-way process - encourage trainees to take ownership over their careers; you aren't there to solve everything for them or give them all the answers, but you CAN often signpost and support the trainee by offering a largely confidential, trusting and constructive relationship. Make sure you follow up any actions you agree to on their behalf.
• Be prepared to offer constructive feedback based on your knowledge of the trainee, but take care not to lead the trainee wherever possible. Your job is to facilitate their thinking and understanding of themselves.
• Recognise your own limitations in terms of knowledge, skills and abilities. 
• Ensure that any actions are documented by the trainee in some way. Sometimes, it can be helpful to use an action planning template to make a record of items discussed, so that these can be reviewed and modified if needed at future meetings.

What other support is available for trainees?

Group support
You may choose to support your trainees through providing small group workshops to help them with particular aspects of career planning. This can be extremely valuable in terms of peer support and time efficiency on your part. There is a VLE module to support delivery of the F2 Specialty Applications workshop here: http://www.vle.eastmidlandsdeanery.nhs.uk/course/view.php?id=1061 

Psychometric assessment can offer a way of increasing self-awareness of preferences with a view to aiding career choice and progression. 

Sci-59 - The Specialty Choice Inventory
Sci59 is designed to match trainee's work based interests to the 59 specialties in its database. It is offered by the BMA if you are a member.  

Career Workshops to support trainees with their career planning.
Please see the Workshops page for more information.

Referrals to the Professional Support and Wellbeing service (PSW)
Professional Support and Wellbeing Service (PSW) | Health Education England The Professional Support and Wellbing service (PSW) provides short-term, solution-focused interventions for trainee doctors and dentists who are having difficulty progressing in training. Each trainee referred to the service has a dedicated PSW case manager who arranges support via specialist providers and then monitors their progress.
PSW Website: /page.php?id=899
PSW e-mail: psw.em@hee.nhs.uk

What other career support resources should I be aware of as a trainer/educational supervisor?

• The National Health Careers website - the site includes a variety of specialty information as well as a suite of career planning tools which trainees can freely use.
• Specialty training website - details the process around recruitment and selection into specialty training.
• Oriel - the website used for applying to Specialty Training has more detailed information on the application process and links to the lead recruitment organisations.
• Royal College websites - list of college addresses and web links.
• BMJ Careers - useful topical articles and key career topics.
• BMA Counselling Service - The BMA offers 24-hour counselling services to its members.
• Doctors Support Network - Provides peer support for doctors and medical students in the UK. Staffed by volunteer doctors.
• Home Office - Government site which provides information on eligibility to work in the UK.
• This website has sections for Foundation Trainees and Specialty Trainees with information around specialty choice, alternative careers, etc.
• Taster sessions for foundation doctors - Taster Days are available in the F1 and F2 year and are a great resource that can be used to access experience in specialties trainees may be considering as a future career.
• The Gold Guide - Reference Guide for Postgraduate Specialty Training in the UK.

Reading List

• Ali, L and Graham, B, (1996) The Counselling Approach to Careers Guidance. London: Routledge
• Kidd JM (2006) Understanding Career Counselling: theory, research and practice. London. Sage
• Nathan, R and Hill L. (2008). Career Counselling. London: Sage
• Hirsh W, Jackson C and Kidd J (2001) Straight Talking: effective career discussions at work. National Institute for Careers Education and Counselling (NICEC), Cambridge
• Jackson C, Hirsh W and Kidd J (2003) Informing Choices. The need for career advice in medical training. National Institute for Careers Education and Counselling (NICEC), Cambridge
• Association for graduate careers advisory service - agcas (2006). Careers Education Benchmark Statement. Sheffield: agcas

Further Resources
View the download library for key tools, further resources and support which can help your trainee.

Career Guidance Skills training module on the VLE

There is a Career Guidance Skills module on the East Midlands VLE - this goes into more detail about how to deliver effective career guidance to your trainees. See http://www.vle.eastmidlandsdeanery.nhs.uk/course/view.php?id=608 for further information.