0:01 choosing a medical specialty is so much
0:03 more than what do you find interesting
0:05 or what's your passion and it's
0:07 definitely a lot more nuanced than
0:10 taking a buzzfeed quiz or i think once i
0:12 even saw an instagram filter that said
0:13 that it will help you choose your
0:15 medical specialty [Music]
0:20 [Music]
0:22 hi everyone my name is catherine and i'm
0:24 a junior doctor and a gp trainee working
0:26 in london united kingdom four months ago
0:28 i made my first video which was a vlog
0:31 on a day in the life of a gp trainee and
0:33 to be honest i was super happy when it
0:35 hit a thousand views but the views kept
0:36 going up and up and i think at the
0:39 moment it's that 26 000 views which
0:40 absolutely boggles my mind thank you so
0:42 much to everyone who watched it and i'm
0:44 glad you found it useful today i thought
0:46 i'd sit down to make another video which
0:47 was actually inspired by one of the
0:49 comments from the vlog and this comic
0:52 comes from a user named ym and ym asks
0:54 can you do a video on reasons for going
0:56 into gp or how to make the most of
0:57 medical school in choosing your specialty
0:59 specialty
1:00 so great question wyan thank you for
1:02 your comment i thought about this
1:04 question for a while now and i've
1:05 decided to approach it in a slightly
1:07 different way so i'm not going to be
1:08 talking about why i chose general
1:10 practice in this video but rather i'm
1:12 going to speak through some frameworks
1:14 and tools which i found useful and
1:16 perhaps you can consider using in
1:18 choosing your own medical specialty the
1:19 reason for this is that choosing a
1:21 specialty has a huge impact on your
1:23 career which in turn makes up anything
1:26 between 20 60 of your meaningful adult
1:28 hours which in turn has a huge impact on
1:30 your day-to-day life for up to 30 years
1:32 i found it a lot more useful approaching
1:35 this problem from first principles and
1:37 self-reflection and self-inquiry rather
1:38 than listening to someone else speak
1:40 about their own specialty which
1:43 inevitably will have a roasted bias to
1:44 it or might end up in them trying to
1:46 convince you to go into their own
1:48 specialty but for a decision of the
1:49 scale you shouldn't be relying on
1:51 convincing i also found that i didn't
1:54 really get very good or impartial career
1:55 advice in medical school or even in
1:57 foundation training yes i would have a
1:59 passing conversation with a senior or
2:01 consultant but every time i felt like
2:03 the conversation always ended up in them
2:05 saying something like well obviously my
2:07 specialty is the best you should really
2:08 consider doing it oh what you want to be
2:11 a gp you're way too good for that or
2:12 once when i was considering going into
2:15 psychiatry a consultant even said what
2:16 you want to work with crazy people all
2:19 the time which needless to say is very
2:20 unhelpful extremely rude and
2:23 stigmatizing as with any big decision or
2:25 dilemma in life or even a medicine i
2:27 think it's really essential to approach
2:28 the problem with a framework this is in
2:30 order to provide some sense and clarity
2:32 in your decision making and also to
2:34 guide you in what further research you
2:36 need to do to fill in the gaps i don't
2:38 expect you to come to a decision on what
2:40 specialty to go into by the end of this
2:42 video this is a process that might take
2:44 weeks months even years
2:46 and it's not a static process either
2:49 it's a continual process of
2:51 research reviewing assessing and
2:54 re-evaluating so first off you have to
2:56 know what choices you have what medical
2:58 specialties are there a good place to
3:00 start is the hee or the higher education
3:02 england list of specialties which i will
3:04 link down below in the description box
3:05 and also i'll put a screenshot up up
3:07 here you might find that going through
3:09 this list you might actually come across
3:10 specialties that you've not heard about
3:12 and within this website they also put in
3:14 the person specifications for each one
3:16 of the specialties which essentially is
3:18 the eligibility criteria for each one
3:19 now i'm just going to start off with
3:21 seven questions to ask yourself and
3:23 these are sort of screening questions to
3:25 start you off on the brainstorming
3:27 journey so number one is where do you
3:29 want to work do you see yourself working
3:32 in a busy hospital ward in the community
3:34 on a busy shop floor in a e do you
3:36 prefer a mix of community and inpatient
3:38 do you see yourself working in theaters
3:40 or in a lab try and imagine the setting
3:42 that you feel you would enjoy working in
3:43 number two
3:45 who do you want to be working with are
3:46 you someone who would be okay working
3:48 independently or would you rather work
3:50 in a team and bounce off each other
3:51 question number three is a very
3:53 important question to ask yourself and
3:55 requires a bit of self-reflection and
3:58 the question is how do you work what are
4:00 your strengths so is it communication is
4:02 it data interpretation analytical
4:04 thinking are you someone who likes
4:06 juggling multiple patients and multiple
4:07 problems at the same time or are you
4:09 someone who likes to focus on one
4:11 patient and one task in front of you do
4:12 you enjoy a fast-paced pressured
4:14 environment where you have to make lots
4:16 of decisions quickly or do you prefer a
4:18 slower pace environment where you're
4:20 able to have some time to think about a
4:22 problem think about medical emergencies
4:24 do you enjoy them can you stay calm or
4:25 do they just stress you out no matter
4:27 how much experience you have do you
4:30 enjoy complexity uncertainty unpredictability
4:31 unpredictability
4:33 are you someone who wants to know what
4:34 you're going to be doing each working
4:36 day and think of the actual working
4:38 environment are you someone who wouldn't
4:39 mind working in a noisy environment or
4:41 do you prefer peace and quiet
4:43 are you a morning person would you be
4:45 able to wake up at 6am and go in to do a
4:47 surgical list or are you sort of more of
4:49 a night owl if you completely clash with
4:51 the culture of the specialty ask
4:53 yourself why and ask yourself if it's
4:54 possible for you to go through the
4:56 training if you don't really agree with
4:57 perhaps the core essence of the
5:00 specialty question number four what will
5:02 you do are you someone who enjoys
5:03 practical procedures are you someone who
5:06 enjoys working with research and data do
5:07 you like having every single
5:08 investigation possible on your
5:10 fingertips are you someone who enjoys
5:11 teaching and what opportunities are
5:13 there for that do you like working with
5:14 the bigger pictures of things like
5:16 healthcare policy and management how
5:18 would you compare being a specialist and
5:20 expert on a certain topic compared to
5:22 being a generalist and knowing a bit
5:23 about lots of different topics and
5:25 finally how much administrative work do
5:27 you want to do are you someone who would
5:29 be okay doing all of your own letters
5:31 and your referrals or would you prefer a
5:33 large team of juniors doing all your
5:35 discharge summaries and so on for you
5:37 and question number five who will be
5:39 your patients so think about if there's
5:40 a particular group of patients that you
5:43 enjoy working with in terms of age in
5:45 terms of disease variety in terms of
5:46 acute or chronic diseases do you want a
5:49 range in variety of pathology how much
5:50 patient contact do you want and what
5:52 sort of therapeutic relationship do you
5:53 want to build
5:55 is continuity of care and follow-up
5:58 important to you question number six
6:00 this is a question that i feel quite
6:01 strongly about because it's helped me
6:03 provide a lot of direction in my own
6:06 process how will you get there so how
6:08 long is the training path that you're
6:10 intending on taking will it involve a
6:12 lot of on-calls weekends and
6:13 out-of-hours commitments is it a
6:15 run-through program or is it a core
6:17 program followed by a re-application for
6:20 more specialist registrar training so do
6:21 as much research as possible on the
6:23 actual training program and speak to the
6:25 trainees are they happy do they have
6:27 much supervision or teaching time is
6:29 this time protected do they get much
6:31 feedback what exams will you have to
6:32 take would you prefer more of a
6:34 one-to-one apprenticeship style training
6:36 approach or do you mind sort of being
6:37 thrown into the deep end if you'd like
6:39 to train less than full-time is this
6:41 possible and how easy is it is there a
6:43 specific location you'd like to stay in
6:46 because of family friends caring needs
6:48 health needs would you be expected to
6:50 uproot and move around the country often
6:52 for different jobs are you okay with the
6:53 long commute if you wanted to stay in a
6:55 particular place and importantly what
6:57 does a job market look like at the end
6:58 of your training are there many
7:00 consultant posts available in the
7:02 location that you want to practice in
7:03 and tied to this think about how
7:06 competitive each training program is
7:08 again he published their competition
7:09 ratios every year on the website and
7:10 i'll link that down below and put a
7:12 screenshot here are you willing to wait
7:14 a year or even multiple years if you
7:16 don't manage to get into the training
7:18 path the first time though you'll hear a
7:19 lot of people say focus on the job that
7:21 you'll be doing as a consultant because
7:23 that's what you'll be spending 30 to 40
7:25 years doing which is completely true but
7:27 also are you willing to go through up to
7:29 10 year process in your late 20s and
7:30 early 30s
7:32 when a lot of other things may be going
7:34 on in your life having to constantly
7:36 juggle different commitments number
7:37 seven what else do you want to achieve
7:39 with your life and this could be other
7:42 hobbies side hustles family travel
7:44 overseas opportunities etc how much
7:46 autonomy and flexibility do you have
7:48 within the training program and as a
7:50 consultant to pursue these things and
7:51 another really important thing to
7:54 mention is well-being medicine is a
7:55 difficult and stressful job what do you
7:57 need around you to support you is it
7:58 friends and family in a particular
8:00 location is it a particular hobby that
8:02 you can only really pursue in certain
8:04 areas of the country are there
8:06 opportunities to work abroad look for
8:08 examples in the trainees and the seniors
8:10 ask yourself are they happy after
8:11 answering all those questions i've just
8:13 thrown at you you might have a clear
8:15 idea of what you want to do but i find
8:16 that the real interesting and juicy bit
8:19 is in doing some mental exercises so the
8:21 first exercise is a list of seven
8:23 questions and this is taken from a
8:25 document that was shared with me when i
8:26 reached out to the professional support
8:29 unit at hee and i would highly recommend
8:31 reaching out to the psu because i had a
8:32 really fruitful one-to-one careers
8:34 coaching slash counseling session with
8:36 someone and they shared with me this
8:37 document which is sort of a
8:39 brainstorming tapping into your
8:41 subconscious exercise and the questions
8:43 are i believe something is worth doing
8:46 if i'm someone who is good at i'm
8:48 passionate about i can spend hours i
8:50 want to interact with people who i work
8:53 best when i need an environment where so
8:54 here you can see that you're approaching
8:56 the careers decision making through
8:57 first principles so you're asking
8:59 yourself what do i want and then
9:02 hopefully finding a career direction or
9:04 specialty which fits in with that and i
9:05 think in the top of the sheet it
9:06 actually suggests that you should write
9:08 at least 30 statements so you can either
9:10 aim for a numerical number of statements
9:12 you want to write down or you can give
9:14 yourself 20 to 30 minutes to really deep
9:15 dive and reflect on
9:17 what it is that you want from your
9:19 career the second exercise is taken from
9:21 a website called wait but why which is a
9:24 blog written by a guy called tim urban
9:26 and he writes on a variety of different
9:28 topics ranging from how to name your
9:30 baby to why do procrastinators
9:32 procrastinate to a i think a six-part
9:34 series on elon musk but the article i'm
9:36 referring to is called how to pick a
9:39 career brackets that actually fits you
9:40 and it's quite a long read it's about a
9:43 25 to 30 minute read i think
9:45 but it has such a high return on
9:47 investment it actually changed the way
9:49 that i think about careers completely
9:50 i'm just going to sum up the points of
9:52 the article which i found the most
9:54 useful so this article refers to
9:55 choosing a career but i feel like it's
9:57 so applicable to choosing a specialty as
9:59 well so i'm just going to use these two
10:00 terms interchangeably
10:02 so he starts off the article talking
10:04 about how when we pick a career we have
10:07 to find the intersection between a want
10:09 pool and a reality pool and in order to
10:11 assess what we want in the want pool he
10:13 uses a framework called the yearning
10:15 octopus which is not actually an octopus
10:17 it's got five tentacles so it's a
10:19 pentapus i guess um but anyway it looks
10:21 like an octopus in some sense and on
10:23 each tentacle there is a different want
10:26 so there's social moral practical
10:28 lifestyle and personal and these
10:30 tentacles often don't get along with
10:32 each other complicating this even
10:33 further is that within each tentacle
10:35 there may be differing wants and fears
10:37 which are in direct conflict with each
10:39 other so an example of this that i can
10:41 think of medicine is that one would
10:43 think that going into medicine would
10:45 fulfill the moral tentacle if your whole
10:47 life was dedicated to work and
10:49 alleviating suffering of others to the
10:50 detriment of the well-being of your
10:53 loved ones then your moral tentacle
10:55 would be quite unhappy and it's not as
10:57 simple as looking at the urine octopus
10:59 saying you know i want these tentacles
11:00 and i don't want these ones it's an
11:02 exercise where you have to really ask
11:04 yourself why do i want this and i must
11:07 caveat this by saying that being able to
11:09 be completely selfish does assume a
11:10 level of privilege so it assumes that
11:12 you don't have any disabilities for
11:14 example or any dependents or you don't
11:15 have to care for anyone so on the
11:17 article he gives an example of someone
11:19 who fantasizes of making 1.2 million
11:21 dollars a year and on the surface each
11:23 one of the five tentacles has a desire
11:25 for wealth for one reason or another but
11:27 on unpacking this this person realizes
11:29 that it's actually a sense of security
11:31 that they're after but this is not basic
11:33 security which the practical tentacle
11:35 would like but rather a certain level of
11:37 fanciness that is given by a rich
11:39 lifestyle so it's actually the lifestyle
11:41 and social tentacle that wants this or
11:42 perhaps the impulse is driven by the
11:44 emotional well-being section of the
11:45 lifestyle tentacle to alleviate
11:47 compulsive financial stress that this
11:49 person was grown up to forever feel and
11:51 as we go through this exercise of the
11:53 yearning octopus there will emerge a
11:55 hierarchy of yearnings which is almost
11:58 as important as the yearnings themselves
12:00 so he uses this illustration of five
12:02 different categories five different
12:04 categories are the non-negotiable bowl
12:06 the top shelf the middle shelf the
12:08 bottom shelf and then the trash can
12:10 shelf placement is as much about deep
12:12 prioritizing as it is about prioritizing
12:14 as you're choosing which parts of you
12:15 are the most important to make you happy
12:17 you're also choosing which parts of you
12:18 you intentionally want to leave
12:20 inevitably through going through this exercise
12:21 exercise
12:23 not all yearnings are going to be happy
12:24 there's going to be clashes there's
12:26 going to be arguments and some fears
12:28 will come up he then mentions this
12:30 concept called the interrogation room
12:32 which is essentially a mental exercise
12:33 to figure out whether each of these
12:35 yearnings are authentically you
12:37 so obviously as we go through life we're
12:39 going to hear different bits of advice
12:41 and be influenced by different people
12:43 but there's a difference between being
12:44 given a piece of advice
12:46 thinking about it yourself and deciding
12:48 to embrace it and take it on
12:50 versus having other people masquerading
12:52 as you and making your own decisions
12:54 this could be your seven-year-old self
12:56 your parents your friends your
12:58 colleagues what society thinks so using
13:00 these frameworks and applying it to
13:02 choosing a specialty within medicine
13:03 look at your responses at the initial
13:05 seven screening questions the first
13:07 mental exercise and your yearning
13:09 octopus put your wants in a hierarchy
13:11 and as you do this ask yourself are
13:13 these once actually truly authentically
13:15 mine then use this framework to find
13:17 your ideal specialty every single
13:19 specialty has its pros and cons and the
13:21 aim here is to try and find a balance of
13:23 the compromises that you're willing to
13:24 make going through these mental
13:25 exercises they're not easy it's a
13:28 massive process of trying to get to know
13:30 yourself and there might be a
13:32 differentiation between your actual
13:33 self-knowledge and your perceived
13:35 self-knowledge in this wonderful graph
13:37 that he puts up in the article and i
13:38 want to bring up another concept here
13:40 which is along the way going through
13:41 this process you might encounter what
13:43 are called cognitive biases and there's
13:45 a whole list of these but some that i
13:47 want to pick out are firstly
13:49 confirmation bias and this is when you
13:50 only pay attention to pieces of
13:52 information that confirm preconceived
13:53 beliefs that you already have about a
13:55 certain specialty secondly is authority
13:57 bias which is when you put increased
13:59 weight in an option because someone that
14:01 you like or someone that you respect
14:03 told you to go for it the third one is
14:04 framing bias which is when you're
14:06 influenced by how the specialty was
14:08 presented to you rather than actual
14:10 content of the presentation and finally
14:11 the bias which i find most interesting
14:14 is the escalation of commitment bias
14:16 which is when one remains committed to
14:17 previous behaviors especially if they
14:19 were performed publicly even though they
14:21 don't have desirable outcomes in other
14:23 words it's sort of saying i have got too
14:25 much to lose because i've put so much
14:27 effort and time into this decision or
14:29 process already and even though i feel
14:31 like it's not going the right way i'm
14:33 just going to continue going on and i
14:34 feel like this fear is related to
14:36 thinking that our careers are tunnels
14:38 which adds to the fear of making the
14:40 wrong decision or changing root i think
14:42 that this is especially pertinent within
14:44 medicine especially in uk
14:46 where medicine is an undergraduate
14:48 degree so we decide when we're sort of
14:50 16 17 years old and some people even
14:51 younger that we're going to go to
14:54 medical school when we don't really have
14:56 an idea or even have a capability to
14:58 think about what else do we want in life
15:00 and therefore we're definitely in danger
15:02 of being increasingly disillusioned and
15:04 increasingly unhappy with the decision
15:06 that our 16 year old self made for us
15:08 this is especially paralyzing for
15:11 perfectionistic types which medicine
15:13 inevitably attracts but actually what's
15:15 mentioned at the end of the weight but
15:17 why article is that today's career
15:19 landscape is not a series of tunnels but
15:21 rather it's a long series of science
15:23 experiments our career decisions they're
15:25 rarely fixed we should be constantly
15:27 auditing and evaluating what is it that
15:29 we want and staying true to ourselves
15:31 the best justice that you can do for
15:33 yourself is to provide yourself with the
15:35 right preparation resources and
15:37 information necessary to make the right
15:39 decision at that particular time in your
15:41 life and once we move from point a to
15:43 point b and we re-evaluate and think
15:45 actually i don't like the direction i'm
15:47 heading that's completely fine and at
15:49 risk of sounding pretentious but i love
15:50 this quote so much it's by a danish
15:52 philosopher called soren kyoku guard i'm
15:54 not sure if i'm pronouncing that right
15:56 and the quote is life can only be
15:57 understood backwards but it must be
15:59 lived forwards so after this video which
16:01 is a lot longer than i intended it to be
16:04 my voice is a bit sort of dry now um
16:06 going back to ym's comment how do i make
16:07 the most out of medical school in
16:08 choosing a specialty essentially have
16:10 these frameworks in your mind as you go
16:12 through each placement use medical
16:14 school as a time to evaluate and assess
16:15 what you want from your life in your
16:17 career give yourself the best chance
16:19 possible expose yourself in as many
16:21 opportunities as you can volunteer to go
16:22 into different settings different
16:24 clinics because after medical school
16:25 it's actually quite difficult to have
16:27 such a wide variety of different
16:29 specialties that you're exposed to so
16:31 that wraps up the video thank you so
16:32 much for everyone who stuck it out to
16:34 the end as you can probably tell this is
16:36 a topic that i've thought a lot about
16:37 and i really hope that you'll take away
16:39 these frameworks and tools to your own
16:41 careers whether you're with a medicine
16:43 or you're not within medicine to give
16:45 you some clarity for this very important
16:47 decision that you'll be making so i do
16:49 plan on making more videos in the future
16:51 but there will not be any sort of
16:53 regularity to it i must say because i'm
16:55 on quite a busy on call rota at the
16:58 moment and i prefer to focus on the
16:59 quality of the videos rather than the
17:01 quantity so if you've got any feedback
17:03 on this video or any other videos you
17:05 feel you want me to do in the future
17:07 then please comment down below and i
17:08 read all the comments so thanks for
