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 Table of Contents  
Year : 2017  |  Volume : 2  |  Issue : 3  |  Page : 35-40

Career building starts in the mind

1 School of Medical Education, King's College London, London, UK
2 School of Medical Education, University of Birmingham, Birmingham, UK
3 Department of Plastic Surgery, Guy's and St Thomas' Hospital, London, UK

Date of Web Publication26-Jul-2017

Correspondence Address:
Mimi R Borrelli
School of Medical Education, King's College London, London
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijssr.ijssr_13_17

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There is enormous flexibility in the careers of medical professionals. Careers can be defining, motivating, and inspiring. Careers require continual and active engagement in their construction, and constantly evolve as new experiences and knowledge is gained. Career building starts with the development and identification of ideas, aims, and values, which alter attitudes, habits, and ultimately shape behaviors to achieve aspirations. This article discusses the ideas and strategic approaches to optimizing experiences and building a career within medicine.

Keywords: Building, career, mind-set

How to cite this article:
Borrelli MR, Farwana R, Agha R. Career building starts in the mind. IJS Short Rep 2017;2:35-40

How to cite this URL:
Borrelli MR, Farwana R, Agha R. Career building starts in the mind. IJS Short Rep [serial online] 2017 [cited 2019 Jan 18];2:35-40. Available from: http://www.ijsshortreports.com/text.asp?2017/2/3/35/211655

  Introduction Top

Watch your thoughts they become words. Watch your words they become actions. Watch your actions they become habit. Watch your habits they become character. Watch your character it becomes your destiny.

- Lau Tzu.

A career is “a person's course or progress through life; a course of professional life or employment, which affords opportunity for progress or advancement in the world.”[1] Careers are constructed when meaning and direction is imposed on vocational behavior to guide, regulate, and sustain vocational activities, express self-concepts, and substantiate goals.[2] Career building requires continual and active engagement, and it is our individual responsibility.[3] It starts with the development and identification of ideas, aims, and values. Thoughts then alter attitudes, habits, and ultimately shape behaviors to achieve aspirations. Medicine is a unique specialty where on completion of a medical degree there is an enormous amount of flexibility within which a career can be shaped. This article discusses the ideas and strategic approaches to optimizing experiences and building a career within medicine which starts with embracing different ways to think.

  Develop Your Vision Top

Work constitutes a substantial part of an individual's life. An average adult spends up to a third of their life in work.[4] As much as a quarter of the variation in adult life satisfaction can be accounted for by satisfaction with work.[5] Performing jobs in line with your career leads to increased productivity, job satisfaction, job success, and lowers both levels of stress[6] and incidence of mental health problems.[7] Job satisfaction tends to correlate with life satisfaction[8],[9] and individual performance.[10],[11] Employees who report they are satisfied are more cooperative, punctual, efficient, reliable, and stay longer than dissatisfied employees.[9]

Choose a job you love, and you will never have to work a day in your life.”

- Confucius.

In medicine, this has implications on patient's quality of care. Patients of physicians who reported being very satisfied with their work were more satisfied with their health-care visits and own health[12] and have greater adherence to medical treatment.[12],[13] It is, therefore, important to seek a career that will bring you satisfaction. The structure of medical training does not necessitate us to choose our career until even 4 years after graduating. Yet, it is beneficial and even encouraged to think about one's career early.

Considering career steps does not equate to committing to that field. Thoughts about careers are inherently dynamic; ambitions and priorities are refined as knowledge is gained from life experiences. However, a great consistency lies in core factors that shape career preferences. One of these factors is developing a vision. This will bring direction and focus such that experiences sought are in line with a given career and are therefore, additive. These add to the narrative which defines you and to which can be referred in future applications, personal statements, interviews, or conversations.

Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful.”

- Albert Schweitzer.

Creating a vision of your career starts with analyzing your abilities and skill set, including identifying your strengths and weaknesses, defining your life goals, values, and passions. Identification of the utmost important career factors enables achievement of both work and personal goals. Since medicine offers numerous specialties, there is a combination of factors to consider, as discussed below. Depending on each person's characteristics, certain specialties will appeal and complement different skill sets.

Each specialty varies in terms of intellectual stimulation, academic focus, diversity, practicality, patient-centered care, or team-based work practice. A useful question is: “can you handle the bread-and-butter?” of the particular specialty[14] as this will constitute the majority of your time spent in that specific career. The patient population served by each specialty is another consideration as you will be interacting with this demographic for the majority of working life.

Colleagues and specialty stereotypes are also to be considered. Stereotypes reflect the interest of professionals and are self-perpetuating as doctors take on the qualities of their associated specialty.[15] Stereotypes can be used to assess personality fit. They may also attract or detract you toward or away from a specialty. Some have argued, however, that traditional stereotypes are inaccurate and outdated,[15] therefore this should not be the sole determining factor.

Specialties vary in terms of opportunities for mentorship, teaching, and progression within training pathways. The future of each specialty may be growing, shrinking, or becoming enhanced by technology. Expected income, job prestige, learning, travel, and global health opportunities are additional factors that differ between medical pathways.[16] Every specialty is stigmatized in some way and it is essential to consider the less attractive sides of each career. Work–life balance and other lifestyle factors are more favorable in some specialties than others. Working hours of jobs, however, are continually subject to change, and are therefore arguably less important in determining one career over another. Gender can play a role. Men and women can set different priorities; women tend to drive their ambition toward careers in which they feel they will succeed.

Defining a career is an ever-evolving process. Conversations with those actively working within specialisms of specific interest and understanding their own career choices and influences can help the development of personal choices and open the mind to considerations. Keeping an up-to-date log of reasons for and against certain careers, for example, in a word document, is a useful activity. It can be continually updated, reflected upon, and referred to in future interviews and applications. It is interesting for medical professionals to consider themselves as a brand with brand values. This involves consideration of the key attributes and skills that others might use to define them as people or brands, and what makes them stand-out, or what they want to be known for in terms of skills, attributes, and personal values. An interesting way of looking at this is to consider the two or three memorable words that would remain in another's mind that would define them after an interaction, be it a patient, colleague, or employee. Have integrity to your core values. It can be confusing as doctors in each specialty can easily criticize other specialties, while promoting their own. Students at medical school are quick to stigmatize certain fields, negatively influencing career choice.[17]

  Plan the Steps Top

Once a career goal is established, it is possible to work backward to outline the small achievable steps required to progress. Familiarization with specialty training pathways and job personal specifications will help identify time frames and hurdles. Understanding the skills that need to be developed will inform the courses, books, experience, and examinations that need to be accomplished in a logical time frame. Structured planning in this way, achieved well in advance, can enable identification of the optimal number of completed publications and international presentations that need to be achieved. Doing this early is beneficial as the activities are very time-consuming. Conversations with doctors, already established in their careers, can provide an invaluable source of data in all these decisions. A career vision can help to direct everyday decisions in prioritizing tasks and how to manage time, enhance efficiency, and avoid stress.

The ability to use career planning skills is one of Ball's[18] four career management competencies [Table 1]. Planning leads to efficiency, which is essential in a competitive work environment. Skills in planning and reflection contribute to job satisfaction and decrease stress.[19] Once goals are identified, they can be prioritized and scheduled in a timely manner. Identification of key milestones will facilitate measurement of progress along the way. It is very useful to monitor personal curriculum vitae (CV) on a monthly basis to ensure whether it reflects the progress desired, in addition to highlighting points of weaknesses to which to direct more attention.
Table 1: Ball's four overlapping career competences

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Ball[18] also discusses the importance of having the ability to engage in personal development, both in the planning stage and throughout the course of a career. This includes plans for personal investment including attending specific courses, examinations, and international exposure. These skills may be generic such as technical or communication skills or specialty specific. Within a medical career, commendable areas for personal investment include learning statistics, research methodology, financial, leadership management, and business skills. These can extrapolate across all specialties.

  Start the Journey Top

It is not in the stars to hold our destiny but in ourselves.”

- William Shakespeare.

Achievement requires hard work, investment of considerable time and dedication. Gladwell[20] proposed that hard work may be more important than innate talent in his popularization of the 10,000-h rule, based on Ericsson's psychological work in expertise.[21] There are always necessary but laborious tasks to negotiate in the pursuit of careers. Motivation, drive, and commitment are required to see these to completion. Keeping a career vision in mind can enable the successful execution of tasks and the necessary time, hard work, and sacrifice required. A continued commitment to the future will help motivate individuals through the hard times. Each task needs to be considered individually in terms of its own risk and reward profile. Ideally, less enjoyable tasks should be completed at the beginning of the day which has the advantage of freeing up the day and mind for more enjoyable activities. Alternatively, these less enjoyable tasks can be completed at a time where individuals' productivity peaks to enhance efficiency. Enjoyable tasks can be sandwiched in-between the less enjoyable tasks, borrowing from the “sandwich approach” used in giving critical feedback.[22] The ability to see the importance of all tasks, enjoyable or less enjoyable, may enhance motivation. The practice of self-discipline and structured time planning across both work and personal lives is essential to mental and physical health, which in turn will enhance a positive career.

  Be Open to Change Top

While goals can be set and time planned, environments can change and opportunities are unpredictable. It is impossible to predict where a given opportunity can lead. Remaining both focused on an ultimate vision but remaining adaptable and flexible will help maximize situations. Success in careers is argued to be enhanced by the ability to proactively seek out and utilize all available career opportunities.[19] This is supported by Ball[18] who discusses the “ability to optimize a given career situation.”

For a strong medical career, it is critical to pursue opportunities for entrepreneurship inside and outside the profession. This can involve pursuing research, sitting on committees, managerial roles, or organizing teaching. Imagination is the only limit to the opportunities available.[23] Creativity, as outlined by Henri Poincaré, is the “ability to unite preexisting elements in new combinations that are useful.”[24] Certain experiences gained and characters met in the course of a career can be incredibly influential in driving success or otherwise. Nurture plays a big role in career choice, for example, medical schools that focus on family practice have a large number of medical students going into family practice.[25]

  Maximize Opportunities Top

Not only should experiences be sought out but also each experience should be maximized. Every conversation, be it an interview or an informal discussion, is a source of information. Every task is an opportunity to improve and expand skill sets and further career success. Regardless of the size of the task, it must be completed with such integrity and at the highest standards to reflect reliability and work ethic. This will encourage further projects with peers and feed a positive cycle of research, inevitably advancing CV building.

On completion of each task, it is important to consider relevant publication or presentation opportunities based on achievement and results. An audit can be completed with a systematic review or may stimulate a re-audit. Subsequent opportunities for publication or presentations may follow that can offer golden opportunities for networking. Student selective components in medical school can often lead to these opportunities and should be maximized. Every placement or rotation offers the opportunity to develop generic skills which are transferable and essential to all professional and social lives and careers. Personal maximal engagement to each placement will be critical to development of skills which are based on numbers, communication, problem-solving, team working, information technology, and behavior and learning.

  Social Skills Top

We all need people who will give us feedback. That's how we will improve.”

- Bill Gates.

Social interaction is core to all aspects of life. Strong social skills with colleagues and patients alike are essential to form positive work environments. It allows for effective teamwork, self-development, and social fulfillment. Constructive feedback is crucial for self-development and should be actively sought from all levels and all opportunities. Honest discussions with others can help enhance understanding and perspectives which otherwise might never be achieved. It is important, however, that in these discussions individuals are mindful as to how their own behaviors and language are perceived by others. The Kip Academy in America, founded by Lou Gehrig, applies the protocol “SSLANT” (smile, sit up, listen, ask questions, nod when being spoken to, track with your eyes) to any social interaction which can be applied to the business environment.[20] An overzealous requirement for feedback might come across as arrogance or aggravating, and keeping an element of self-deprecation, courtesy and consideration for others will always deliver results. Sincere offerings of help should be seen for what it is and how it can further career and success as opposed to from whom it has been offered.

Never be the smartest person in the room.”

- Michael Dell.

People will forget what you said. People will forget what you did. But people will never forget how you made them feel.”

- Maya Angelou.

Networking is an often undervalued activity that needs to be started early on in life and constantly conducted throughout a career and beyond. Networking has facilitated the development of ideas and transfer of knowledge across geographical boundaries and generations worldwide. It has been greatly enhanced in the recent years through the Internet and the evolvement of social media, including platforms such as Twitter and LinkedIn, which can be harnessed to maintain and extend networking continually and globally.

Attending conferences provides exposure to parallel careers which might include publishing, research, and parallel businesses linked to a given specialty. In the medium-to-long-term goals, this could provide exposure to the possibility of sitting on boards as nonexecutive directors and/or providing expertise in the medicolegal profession. Conferences are not only a great opportunity to increase knowledge on subject matters of interest but also a chance to network with potential future colleagues and employers and leading professionals who would not otherwise be in a social position to meet. Having positive interactions with seniors can help hone in communication skills with seniors which might only otherwise be encountered in interviews, and in turn enhance credibility. Specialty conferences may even provide the opportunity to meet people who may potentially be on interview boards or offer their invaluable mentorship.

A mentor is someone who will allow you to see the hope inside yourself.”

- Oprah Winfrey.

A mentor is an experienced and trusted advisor who can vastly enhance career progression. They can be a source of knowledge and wisdom that is otherwise inaccessible. Mentors can provide invaluable information on lessons learned, hurdles, internal politics, and opportunities. Often seen as sources of inspiration, mentors are also safe havens for discussing potential problems faced. Mentors can benefit themselves in the process of mentoring others, and mentees can themselves be mentors to others, facilitating the fluidity of learning across academic generations. Mentors can provide academic support on work-related projects and research endeavors, but can provide key contacts through their own networks. Most importantly, they help realize self-worth and highlight the potential in each mentee.

  Enjoy the Journey Top

Focus on the journey, not the destination. Joy is found not in finishing an activity but in doing it.”

- James Anderson.

A career is not only focused on reaching the final destination but also on actively enjoying reaching the milestones along the way. This is particularly important in medicine where training programs are exceptionally long, in comparison to other careers. Setbacks are of course expected, but the way in which they are managed constructively allows for increased learning and a stronger journey ahead.

Many of life's failures are people who did not realize how close they were to success when they gave up.”

- Thomas A. Edison.

Learning how to deal with failure is a skill and requires an element of self-belief, confidence, self-esteem, and the ability to continually persevere. Most successful people, and almost all entrepreneurs, have encountered numerous failures in their careers but have used them to their advantage. When the rewards are sufficiently enticing, odds of poorer outcomes may be acceptable. Setbacks can be seen in a positive light. In medicine, this may be encountered when a paper receives rejections from many journals. Using a negative experience, such as this, can feed learning. For example, by writing better papers or conducting higher quality research. Failure is an inevitable part of being successful.

  Work–life Balance Top

The final of Ball's[18] four competencies of career management is the ability to balance work and nonwork. There has been growing interest in the importance of work–life balance particularly in careers such as medicine which involve late nights, long hours, and high-stress situations. There is a high incidence of mental health problems and alcoholism in the world of medicine, much of which could be avoided, through better management of a work–life balance. There is increasing evidence that maintaining a good work–life balance can avoid stress and burnout. Elements to factor in for achieving a good work–life balance include making room for family life and friends, good health through exercise, a balanced diet, enough sleep, and pursuit of outside hobbies. A well-rounded individual is often seen favorably by potential future employees as it indicate a healthy body and mind as well as resilience, determination, and someone whom others would enjoy spending time with in the workplace. There is strong evidence that good work–life balance enhances happiness.

  Conclusion Top

Career building is a slow developmental process that requires personal responsibility. It is important to be open, enhancing uncertainties, opportunistic, and creative to work on a step-by-step career strategy to reach the final career goal. An occupation provides a mechanism of social integration; it offers individuals a strategy for participating in and sustaining themselves in the society.[2] Work fulfills basic human needs including financial provisions and intrinsic needs for passion that is ideally incorporated into work life.[26] The “Three As of Medicine” defined as “able,” “affable,” and “available” are identified as important by Murray[27] for building both successful medical practice and a medical career. Ability is essential and is enhanced through hard work, practice, and dedication. Showing ability and having integrity through even the most minor tasks can lead to better opportunities and more responsibilities. Being affable, amicable, and easy to approach can invite more opportunities. Availability can open many doors and help deal with adversity. The right mind-set, personal belief of self-worth, integrity, and hard work are all fundamental to building a successful career. It can be immensely fulfilling to unlock your potential and realizing your career ambitions.[23]

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Conflicts of interest

There are no conflicts of interest.

  References Top

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  In this article
Develop Your Vision
Plan the Steps
Start the Journey
Be Open to Change
Maximize Opportu...
Social Skills
Enjoy the Journey
Work–life ...
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