Careers. At least we should try.

LOOKING BACK over the years it is fairly obvious that there has been little or no career guidance in medicine. Apart from the odd chat with a senior often not much senior to the young graduate himself nothing was readily available to the newly qualified doctor about future prospects in the great variety of medical fields prospects, that is, of training needs facilities or vacancies. Yet little was heard of any frustrations probably because the ratio of jobs to doctors was higher and few doctors needed to remain in unsatisfying employment. There were many gifted young doctors with brilliant student careers behind them who felt they had a chance of being appointed to the staff of their own teaching hospital and who hung on in other subsidiary posts such as anatomy or pharmacology in the hope that they would be better prepared for the next senior staff vacancy. However, these vacancies occurred only rarely with the death or retirement of senior staff often occurring in alarmingly rapid succession to be followed by an exceptionally long latent period and these men mostly made their marks and found niches in other teaching hospitals or in the larger provincial non-teaching hospitals. It was mainly the highly qualified and well experienced surgeons, physicians and gynaecologists who fell into this category; they had chosen their paths in a most single minded way early on in their careers and were not to be budged from their decision and dedication. Enquiry into other specialties often showed however that it was a chance vacancy at a particular moment which had introduced the young doctor to his final specialty a locum HS in ophthalmology, or otolaryngology, or a junior temporary demonstratorship in pathology had provided an opportunity for an insight into a specialty not achieved during student days. Similarly, a chance locum in an attractive general practice was the determining factor for the young doctor's choice both of career and location. Maybe there was a degree of inertia, in the past, for, having started in such posts it was easier to stay in them and go up the promotion ladder, especially if the prospects looked attractive rather than seek new fields of experience.