Gavin Tucker | Contributing Writer
A career in medicine is tough. Determining the usefulness of an arbitrary scale of career difficulty is also tough, but the significant personal and emotional demands of a career in medicine can be balanced by the extremely rewarding nature of the work you will do.
Roughly speaking, there are three main career pathways following medical school, hospital doctors, general practitioners, and “everything else”. Each of these paths occupy their own extremely important role in delivering a multidisciplinary and holistic approach to treating patients. Although they appear very different, there are huge opportunities for switching between these paths as you progress through your career.
At medical school, time flies; you only have two years of lectures before being dropped in the deep end of being attached to a consultant’s team, meeting patients and standing in on surgeries. Those looking to apply to Carribean medical schools may want to check out the Trinity School of Medicine’s guide on such accredited schools. I’m in third year, and it feels like I’ve finished university. The last three years are very much hospital-based and none of the lectures are on Trinity campus. Despite the exile, a practical-heavy course confers you with some significant advantages; the skills of performing physical exams and taking a patient’s history will be used every day of your career, the core basics of clinical medicine your consultants learned as students will largely be the same ones you learn (although the use of leeches and exorcisms have declined somewhat in recent years). All modules in medical school are compulsory, so you don’t need to make decisions about specialising just yet.
At medical school, time flies; you only have two years of lectures before being dropped in the deep end of being attached to a consultant’s team, meeting patients and standing in on surgeries.
On graduation, although you may have the smugness of signing your name with “Dr.”. In the Real World this means nothing until you’ve completed your internship. Internship is a year of rotating through different specialties, working as part of a team with nurses and experienced doctors. You are required to spend at least three months in general medicine and three months in general surgery. The remaining six months are divided up as you wish into broad specialties you think you may be interested in pursuing a career in. Completing your internship allows you to register as a doctor with the Irish Medical Council. Internship is also the first year where you will earn a salary.
Towards the end of your internship, you have to start thinking of the area you would like to specialise in – AKA: the growing-up stage of medicine. If you would like to work in primary care as a GP, you can enter one of the fourteen GP training schemes around the country any time after your internship year. A GP training scheme takes four years to complete, two years in hospital posts and the remainder spent in supervised general practice. Throughout this time, you will sit exams for membership of the Irish College of General Practitioners, after which you are a fully qualified GP and can begin work in a practice.
If you are interested in the route of hospital medicine, the path is longer and more complicated. After internship, you will begin two years of Basic Specialist Training (BST) as a Senior House Officer (SHO), you will still be under the everyday supervision of a senior doctor but your responsibilities and competencies become greater as time goes on. This period is of the most demanding points in the medical career path, you will be expected to present papers, do research, perform audits into clinical practice and sit exams for membership of the Royal College of Physicians, all while providing high standards of care for patients. A lot of miscellaneous and tedious jobs get left to the SHOs, this is the time when you will be responsible for patients on night shifts and some weekends whilst your senior doctors are away. With recent protests and reforms ongoing, the demands on SHOs and other non-consultant doctors may have changed by the time you graduate.
You may have the smugness of signing your name with “Dr.” at graduation, but in the Real World this means nothing until you’ve completed your internship.
After BST, the next rung on the ladder is Higher Specialist Training (HST), entry to HST is very competitive and some doctors have to wait for a year or two before gaining the requirements to enter HST. The RCPI runs a one-year scheme called the Registrar Training Program which is designed for doctors who want to enter HST and allows you to spend a year gaining experience as a registrar in your own chosen specialty.
You’ve made it to HST! As a Specialty Registrar, you are tossed around much less at this final stage, your posts will typically be anywhere from six to twelve months long at a time. This stage of your career will be a lot more fluid than what has come before, HST typically takes four to six years to complete and allows significant opportunities for developing interest in subspecialties, research or clinical work in other countries. If you’re considering a career as a clinical academic or a researcher, this will be the time to do your PhD, although this can technically be done at any stage after graduation. On completion of HST, you can enter the Specialist Division of the Medical Council’s Register, making you eligible to apply for a consultancy post. These aren’t quite as common as we would like, and many doctors will spend years viciously CV-padding at a level worthy of a Student’s Union hack with as many publications, audits and work in a wide variety of situations to make their application for a consultancy post stand out.
Although the majority of your class will become GPs or hospital doctors, remember that a medical degree provides a range of transferable skills which open up a huge variety of healthcare-related careers for you; academia, research, epidemiology, healthcare management and administration, education, physiotherapy, occupational therapy or becoming a medical officer in the Royal Navy as one of my lecturers did. The one piece of advice I’ve been given consistently from my seniors is to never allow yourself to feel boxed into pursuing a particular career or specialty, always be open to new fields, ideas and opportunities whenever they pop up during your career.
For more information, see www.rcpi.ie and www.icgp.ie.
