Twenty-five upcoming and expanding opportunities for doctors

The NHS England workforce plan is published. It aims to increase staff numbers and improve retention. Looks like medical school places will double, and the possibility of shortened training and apprenticeship-based studying is being explored. The increase in undergraduate university places will mean an increase in the requirement for teaching staff in the short term, and an increase in postgraduate trainers in 5-10 years. Our daily clinical working practices are likely to change too, both as a result of workforce expansion, and due to any changes brought in to improve retention.

How can current doctors position their careers to benefit from this changing landscape? There are at least twenty-five upcoming and expanding opportunities. I’ve indicated whom each opportunity might apply to, but most opportunities would suit a wide range of doctors or even current medical students.

1: Early career doctors – develop your medical education credentials to be in a position to take on education roles

Doctors that are currently early in their careers could focus on developing as a medical educator. This means studying medical education e.g. with a master’s degree, taking a teaching fellow job, and doing projects that involve education. Finding an existing clinical educator as a mentor is often useful, as that person can keep you informed of any opportunities that come up, for example writing OSCE stations or examining.

2: Senior educators – more opportunities to mentor

Existing medical educators will also benefit from more early career doctors being interested in medical education. So there will be more opportunities to mentor and develop younger doctors, which itself will help senior doctors lead meaningful careers. The early career doctors are likely to want to help with the day-to-day aspects of education too, so it will be great to have extra help.

3: Develop yourself as a mentor – mentors get as much as mentees from the mentoring relationship

All of us are likely to be doing much more training, and having mentoring skills to support our training roles is super useful and desirable. You can read up about mentoring, or attend a course to develop yourself as one. Using coaching as a leadership style is an asset too.

4: Senior educators – new undergraduate University leadership opportunities

With more undergraduates, there will be a need for more academic and leadership roles too. So now is a good time to polish the CV, and spend some time thinking what you want from your career next. Have a look here for things to consider when looking at a change in your current career.

5: Senior educators – new undergraduate Trust leadership opportunities

Universities deliver the preclinical course, and set the curriculum and materials for the clinical course, but the vast bulk of clinical training is delivered at NHS Trust level. This means that someone at Trust level needs to have oversight of what is delivered, and its quality.

6: Existing senior doctors – new teaching opportunities

There are likely to be lots of opportunities to actually deliver the teaching to undergraduates, in addition to the expansion in leadership roles. If you haven’t delivered much teaching to date, but would be interested?in doing so, then now would be a good time to develop your medical education credentials.

7: Opportunities in Professionalism

When we think about teaching the focus is usually on delivery, or instructional design, or leadership. But more students means a greater need to ensure that they all develop their professionalism skills, and that any bad behaviours are addressed. So there will be an opportunity for more roles based in developing professionalism and addressing fitness to practice issues. For undergraduates these roles are usually University-based, but I suspect there will be an expansion in GMC staffing too.

8: Opportunities in Assessment

Assessment is another area that will likely see growth. Most clinicians will develop their teaching skills, yet being an expert in assessment requires very specific knowledge and skills that not many possess.

9: Be creative - new courses, new ways of learning

Student numbers will expand, but medicine is advancing all the time, as is technology. There will be opportunities for people to be creative, develop new ways of learning, and use technology to enhance the learning experience.

10: Existing doctors – opportunities in postgraduate clinical supervision

Existing doctors are likely to need to do more clinical and educational supervision once the new students graduate. These roles are rewarding, and come with protected and paid time. Taking them on requires specific training, so if you are interested in this area I suggest attending relevant training offered at Trust or Deanery level.

11: Existing doctors – could you be the Training Programme Director?

Postgraduate training need to be organised and quality assured, just like undergraduate training. More doctors means more need for senior doctors to run the training programmes. If you are looking at a TPD role in the future, spend some time thinking what you need to do to build evidence and credibility that will make you an attractive applicant in the future.

12: Running postgraduate clinical courses

The new doctors will all want to attend specific skills courses, like advanced life support and surgical skills and exam revision courses. If you enjoy teaching on courses, then look at requirements to become a trainer. You might even set up and run your own course. If you already run a course, then plan for an increase in demand.

13: Running postgraduate non-clinical courses

There is likely to be an increase in courses tailored at non-technical skills including communication and train-the-trainer courses. The new doctors will all be applying for jobs, so there will probably be an increase on the need for places on interview skills courses too.

14: Supervision of non-doctors

There is likely to be further expansion in non-doctors doing roles traditionally done by doctors. All these roles will need some form of supervision by doctors, so if you enjoy training, developing, and supervision non-doctors then this is likely to be a growth area.

15: More complexity in patient care?

Related to point above, if non-doctors are doing some routine roles done by doctors in the past, then what does this leave for doctors? There is an opportunity here for us to shape how a multi-professional workforce divides the work. Doctors of the future are likely to spend more time on complex tasks. This can be good and bad, and now would be an appropriate time to consider how you as an individual want to work as part of a multi-professional team.

16: Opportunities to shape multi-professional working

Most of us will have an opinion, but someone will have to come up with ways of implementing the new ways of working. If you are a conceptual thinker there is an opportunity to develop how teams of the future work. Likewise, there will be opportunities to implement new ways of working in what will likely be quite transformative for the NHS.

17: Researching new ways of working

If you are interested in research, new ways of working will ideally be backed by solid evidence of effectiveness. Research can find out what best practice is, and can evaluate what is put into place. I hope that multi-professional working will be set up and evaluated in a scientifically rigorous way, and there is then an opportunity for multi-professional researchers to expand their work in this area.

18: Will all doctors be equal? An opportunity for traditionally-trained doctors?

I wonder whether doctors that have been through a four year university programme or an apprenticeship will be performing, or viewed as performing, at same level as current doctors are? Controversial, I know. It will be great to have an expanded workforce skilled in generic capabilities, but will they have the breadth of knowledge and experience to be a good GP, or the depth of expertise to be a super-specialist consultant? If someone has been through an apprenticeship non-academic programme, how will they do at fellowship exams? Or will exams change? There is likely to be opportunities for current doctors, and those on traditional academic courses, to differentiate themselves from others that have not had such thorough training. The differences won’t be there in low complexity generic work, but they might be there when it comes to breadth, depth, and risk management both in primary and secondary care.

19: More opportunities for high value private work?

If access to NHS care improves, then private practice is likely to reduce. On the other hand, if the NHS offers care delivered by non-doctors as standard, will there be people that would be happy to pay to see a doctor? I hope that we don’t end up with a complete two-tier system where those that can afford it get to see the doctor, but those that cannot are seen by a non-doctor. I hope that we figure out a way to provide great care as a multi-professional team, yet also wonder whether there will always be some patients prepared to pay to see a doctor rather than a non-doctor.

20: Better life balance

I hope that a focus on retention will make it easier to work less than full time, take career breaks, and have portfolio careers. All of these will lead to better life balance for doctors.

21: More meaningful careers

More students means more opportunities for those interested in developing others, whereas more staff and focus on retention means that doctors will have the headspace to focus on thriving in a meaningful career rather than just surviving from one day to the next. Knowing your values will help you determine what kind of person you want to be, and this helps create a rich and meaningful career.

22: Opportunities for doctors to support other doctors’ wellbeing

I’m unclear exactly what the retention strategy will be, and expect that there will be an enhanced focus on wellbeing. Whilst most of us would recoil at the thought of more resilience training, I do think there is a role for wellbeing support and resilience when done as part of an overall package that includes working conditions, staffing, and pay. The best people to understand what a doctor is going through is another doctor, so I suspect there will be more opportunities for doctors who specialise in supporting other doctors’ wellbeing.

23: Opportunities for doctors to help other doctors’ career development

Like the wellbeing offer, I hope that retention efforts will include a focus on doctors’ career development. How can we best support doctors from abroad, those in under-represented or minority groups? How do we support new GPs or consultants, or those that are peri-retirement? Again, one doctor is best placed to understand another, so I expect there will be more opportunities for doctors to support each other’s careers.

24: Clinical leadership opportunities

Better retention will need better cultures and better leadership. I think at present, many of us are put off taking on leadership roles, because they are often a poisoned chalice, or because we don’t see people like ourselves in the leadership roles. If the culture genuinely shifts towards compassionate, distributed, and inclusive leadership, the I suspect there will be many more of us interested in taking on leadership roles and developing high-performing teams.

25: Be a culture influencer

I hope that genuine change is coming with a focus on the kind of culture that doctors want to stay in. This means that those of us that have been trying to change cultures might finally be heard. And there will be opportunity to hold politicians and NHS executives to account, whether directly or through social media. The workforce plan then provides an opportunity for doctors on social media to influence the way culture develops. I hope we can do this in a developmental, rather than a critical way.

Whether we want it or not, change is coming. I hope it delivers better patient care and better careers for healthcare professionals. It also presents multiple new and expanding opportunities for doctors, some of which are presented here. Let me know what I missed! It’s wise to be ready for these upcoming opportunities. What will guide your career decisions? What learning and experience do you need to acquire to position yourself so you can take advantages of opportunities when they come?

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