Changes To Plan

Few careers go completely to plan. Change is a part of life and within a career lifecycle, there will be both external and personal factors that prompt a planned or unexpected transition.

Time Out of Programme

Both Foundation and Specialty training programmes have mechanisms to consider and accommodate, where possible, legitimate requests to take time out, train flexibly or change location. The Gold Guide outlines the eligibility criteria and procedures when considering any of the following changes within a specialty training programme. It is essential to discuss plans and requirements with Educational Supervisors and Programme Directors. Go to the Specialty Training website to find criteria and procedures for:

• Deferring the start of a specialty training programme
• Taking time out of programme (OOP), including career breaks
• Inter-Deanery Transfers

You can also view and download guidelines on Flexible (Less Than Full-Time) Training from this site.

Changing Specialty

It is a common misconception perception that it is difficult to change specialty but in reality many doctors do! It means reapplying in open competition to enter a new training pathway which may mean moving back, or sideways, to move forward. See the "Who can help me?" section. See also the BMJ article on Switching Specialty.

The trick is to explore and be sure of your specialty direction at the outset – see “ What are My Options?” Make good use of Taster opportunities during Foundation Year 2; exposure, however small, to an area of practice helps you to choose or eliminate it from your options. Core Training programmes provide a good clinical grounding with the option to review your pathway options in two or three years. If you are really unsure where to aim, then you could consider spending exploration and "testing the water" time in:

• Service-led Specialty Doctor posts
• FTSTA or LAT training posts
• Jobs abroad
• Other locum posts

Changing Career

If you are reconsidering your career direction, it is time for serious reflection and self evaluation and possibly some expert support. Do contact the Deanery careers Team for help in thinking through your decision. And remember there is no right or wrong way to pursue a career, which can include anything from:

• A career lifetime employed in a single pathway
• Sequential fixed term roles
• Self employment
• Flexible employment (working part time, then spending time in other non-work related activity)
• Portfolio (combining different types of work activity)
• Unpaid work/volunteering

Revisit the “What do I Want?” and "What are My Options?" pages for resources and links to help you with self and career assessment, and “Who Can Help Me” to find people or organisations who can support you. See also the BMJ Careers article on Leaving Medicine or visit the London Deanery resource for doctors considering alternative careers, Beyond Clinical Practice.