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Another Way Down Under

How I stumbled into clinical education as part of my gap year

Written by Dr. Luke Farmery · Thursday 29th October 2015

Introduction

There seems to be an enormous pressure for foundation trainees to apply directly to core medical/specialty training. The presumption is that trainees will simply hop off one conveyor belt straight on to the next. But this is not the only option! Trainees are becoming increasingly aware that the end of Foundation Training signals the prime time to take a gap year or Foundation Year 3 (FY3). Since I am in the middle of my own FY3, I can certainly recommend it. However, I have written this blog not only to recommend, but also to provide you with the pointers I have accumulated along the way and how my decisions about the future have changed as a result of my adventure.   

A FY3 could be anything you wanted it to be. It could simply be another year’s work at the level of a Senior House Officer (SHO) as a Trust Grade (non trainee, hospital employee) to broaden your experience before making applications. Perhaps you manage to land a Trust Grade job in the speciality in which you hope to apply, adding some meat to your C.V. Perhaps you have no idea what you want to do next and need more time to think. Or perhaps you want to travel and work abroad for some time. Lots of people fall into the latter category and from my anecdotal evidence alone, the destination most trainees set their hearts on seems to be either Australia or New Zealand. 

Asides from the lack of language barrier, the reason Australia and New Zealand are so popular is because U.K graduates are able to work over there without any conversion examinations. This sets them apart from the U.S. However, there are still a few hoops to jump through before a U.K trainee is permitted to work in the clinical setting. First you will need a job offer, then a certificate of good standing from the GMC, then you will need to apply for a sponsored visa (your employer will need to sponsor you, and will only do so if you work enough hours in the week with them). Part of the visa application will include submitting a private medical report of your own health (which you will need to pay for). This all takes time (and did I mention money!) and if you are determined on working clinically, I encourage you to get the ball rolling early in your FY2 year. 

Medical Education

But clinical work is just one option available to you as a medical graduate. For those of you that are so inclined, I present the option of medical education. Ever since I first saw the anatomy demonstrators at my own medical school I have really wanted to give medical education (MedEd) a whirl. I'm not sure if it was the context of anatomy (a subject I enjoy anyway) or the teaching that attracted me, but as soon as I was on my way to completing my foundation training I was already looking up ways I could get involved with MedEd as an FY3. 

I decided I wanted to take up an anatomy demonstrator post in Australia and got to applying, but there were many barriers. The first and foremost for me was explaining to family and friends that I intended to go away. I found this step so difficult in fact, that I regrettably skipped it until I got an offer of employment. I would recommend involving loved ones at an early stage… Subsequently, I also discovered that the teaching post I was applying to would be too many hours for me to realistically fit in clinical work, but also not enough to make a ‘sponsored visa application’. The post was not ‘combined’ (i.e. the traditional model of employment for an anatomy demonstrator is to work part time in the hospital and part time in the university). I am sure these posts exist, but my post ended up being a purely an educational one. 

Due to these strict visa requirements, it ended up that I did not undertake any clinical work at all for three months whilst I worked a full semester as an 'assistant lecturer'. I was initially disappointed that I was not going to be a 'doctor' in Australia, but there were several unforeseen advantages that I would like to share with you: 

1. I was able to work on a Working-Holiday Visa. This is a 12 month visa that enables you to work with one employer for 6 months. It costs a fraction of a sponsored visa and mine came through the day after applying for it (VERY QUICK).

2. I was able to split my time away into 'Holiday' and 'Work', as I had no clinical rota. I mean, if you are travelling half way around the world it seems silly not to see the sights whilst you are there! 

3. No private medical. The working holiday visa does not require you to have an expensive private medical examination or chest x-ray. 

4. Exposure to academic faculty, and the potential to embark on research work or just generally improve your own knowledge (because guess what, you will have some free time!) 

However, there are also disadvantages to this 'all-out educator' approach: 

1. No clinical experience, apart from the clinical applications of what you are teaching 

2. Most posts I saw are part-time (but remember I did not look far), but pay well enough for a sensible lifestyle. 

3. Working Holiday Visa only allows you to work 6 months with one employer, so you will be unable to fit two semesters into one trip, unless your university will sponsor you full-time. 

Outcome:

So in the end I completed a post as an anatomy demonstrator in Australia for one semester. I received clinical job offers during my time researching and preparing for the trip, but turned them down in preference of the offer to work as a demonstrator and I am glad I did so!  I thoroughly enjoyed both the teaching aspects and the time to go over my own anatomy knowledge before embarking on further exams. I also had the time (and money) to enjoy the sights. The shorter duration (6 months with one employer, where I had originally intended to work for 12) meant my family were less reluctant to see me go (if such factors are important to you, as they are to me). 

Future:

I secured a Trust Grade position in Accident & Emergency before leaving for Australia and will be continuing my FY3 as an SHO. I aim to build my A&E experience in preparation for the Acute Common Care Stem. However, due to my enjoyment of my Australian experiences and my love of anatomy, I am also considering alternative applications to Radiology or Pathology and have even started researching the viability of undertaking a Masters in Clinical Education too. The time out has really given me time to think about what I would like to do next as well as giving me an experience I will never forget. 

Final Tips:

For those considering clinical work abroad, I would recommend setting up a LinkedIn account as a junior doctor. All of my offers came through connections I had made using the site. However, make sure you complete and update your profile as you would a C.V. I recently had my LinkedIn profile brought up in a job interview, and I was very thankful for having kept it in a professional manner.  

Sign off: 

Thanks for reading. If you have any similar experiences, or alternative advice, please feel free to comment. 

LARF 

@LFarmery

Disclaimer: All information here is as I understood it at the time from my own research and from the things I was told by the people I sought advice from. You may (and I expect will, with the changing political climate) find things different. If you do so, feel free to discuss below. 

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