This site is intended for health professionals only

Careers information and guidance for nurses and GPs

Ruth Chambers
MD FRCGP
GP and Professor of Primary Care Development
School of Health
Staffordshire University
Stoke-on-Trent
Education Lead
NHS Alliance
National Convenor
Accredited Professional Development
RCGP
E:r.chambers@staffs.ac.uk

NHS professionals frequently ask about alternative career options and the qualifications they might need if they were to switch specialties. New models of health service provision dictate the need for further training and development to extend the skills base of established staff. Yet information about these opportunities is not easily available. 
A qualitative survey of GPs undertaken in 1996 in the West Midlands region demonstrated the absence of impartial careers counselling and easily available careers information for medical students or doctors considering a career in primary care, and for doctors already working in primary care.(1)
The need for more doctors and nurses in primary care across the UK is well recognised. Vacancies arise as trained staff leave the NHS or follow the national trend to part-time working. Each new NHS reorganisation and innovation provides opportunities for health professionals to adopt management responsibilities that take them away from clinical posts. The expertise of clinical managers may be lost in NHS reorganisations where there are no obvious alternative career pathways and support for career development is inadequate or misguided. The morale of NHS staff is said to be at an all-time low, leading to early retirements or part-time clinical working. 
The NHS Plan describes the staff numbers needed for an NHS workforce that is able to provide the quality of healthcare and service provision anticipated in the near future, and to achieve the National Service Frameworks and national strategies.(2) It is not obvious where the additional workforce will come from. Nurses and doctors are being recruited from overseas, but such initiatives have been heavily criticised as a "nursing brain drain effect for third world countries",(3) or wasteful of resources, as fewer GPs have been recruited than planned, and they require intensive and costly induction.
 
Doctors
The increasing proportion of female GPs has created a need for a larger number of GPs, as women are more likely to work part-time while their children are young.
 
Nurses
A shortage of children's nurses means that some accident and emergency departments cannot meet basic minimum standards.(4) One-third of all health visitors are thought to be due to retire in the next five years.(5) The challenge is for the NHS to create a working environment that encourages nurses to stay in practice.(6)
Providing impartial and comprehensive careers information, and empowering others to provide careers guidance and counselling, could contribute significantly to getting trained health professionals back to the NHS.
 
Who can provide careers information?
Careers information gives you the facts about the qualifications and experience needed for alternative career pathways and the opportunities that there are for career progression. The need to develop a coordinated approach to promoting recruitment and retention initiatives for NHS professionals has been recognised by the workforce development confederations. 
The national NHS careers initiative in England provides much of the basic information about entry criteria and details of training for all type of careers in the health field. There are some good books that describe the wide variety of jobs and opportunities available to health professionals (see Resources). 
You can get information about:

  • Qualifications required and opportunities in other similar posts or alternative specialties.
  • Educational opportunities - bursaries, grants, new and established degree courses.
  • Nonhealth careers (maybe being a GP or nurse isn't so bad when you ­consider the other options!).

Who can provide guidance and ­counselling?
Careers guidance is more personal, providing advice within the context of the opportunities available. It is useful for those who have not made a career decision or are unaware of the best way of achieving their career goals. Someone providing careers guidance should know how and be able to provide advice within the context of the opportunities that are available to the individual. 
Career counselling is an umbrella term for the process of enabling somebody to evaluate his or her current career and identify what steps are needed to change. Someone who is providing careers counselling should facilitate individual health professionals in evaluating their own situation and identify what steps are needed in order to change. They should understand the meaning of and arrange personality profile testing, if that is appropriate. They should know how to identify a person's strengths and weaknesses in relation to work options and careers information. They should also be able to provide career counselling in an impartial and nonjudgmental manner.
Careers guidance or counselling can help you to:

  • Think carefully about taking time out from your current career.
  • Re-evaluate your career choice and why you are considering change.
  • Reassess whether you want to work full- or part-time or retire early.
  • Match your strengths to a career specialty or way of working that suits you - taking on more ­responsibility, extending your skills (such as becoming a GP specialist or nurse practitioner).

The NHS needs to invest in training health professionals with an aptitude for careers guidance and counselling, or employ nonclinical careers advisers. Such specialist help is urgently needed - the current situation, where unhappy GPs and nurses underperform at work or retire early, should not be allowed to continue.

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References

  1. Chambers R. Need for career ­counselling for general practice in the West Midlands region. Stoke-on-Trent: Staffordshire University; 1997.
  2. Department of Health. The NHS Plan. London: Stationery Office; 2000.
  3. Buchan G. The way we were. Nursing Standard 2001;15(47):20-1.
  4. News item. Nursing Standard 2001;15(47):4.
  5. Scott G. Scottish nursing ­recruitment. Nursing Standard 2001;15(41):9.
  6. Parish C. Drop in vacancies is just a start. Nursing Standard 2001;15(44):6.

Resources
NHS Careers
T:0845 6060 655
W:www.nhs.uk/careers
Medical Forum
T:0700 079 0173
W:http://medicalforum.com
Chambers R, Mohanna K, Field S. Opportunities and options in medical careers. Oxford: Radcliffe Medical Press; 2000
Ward C, Eccles S, editors. So you want to be a brain surgeon? 2nd ed. London: Oxford University Press; 2001