Doctors of many talents

Junior doctors are pushing to create pathways to more diverse careers

Many of medicine’s most celebrated practitioners have been doctors whose work has shone beyond the consulting rooms, wards and theatres of the clinical sphere — from John Snow and the epidemiology of his Broad Street Pump intervention, to Anton Chekhov and The cherry orchard. More recently and closer to home, we have Dr Pat McGorry and his research in and advocacy for mental health, and Dr Norman Swan and his medical journalism.

Theirs are often called “portfolio careers”, a term coined by management guru Charles Handy in the 1980s. It describes the working life of people who don’t follow a single career path but who, like Swan, McGorry, Snow and Chekhov, are able combine two or more different areas simultaneously. It may be medicine and art, business, media or engineering but, in practice, it is more often a combination of medicine and research, teaching or health administration.

And in an increasingly competitive Australian medical workplace for junior doctors, a second or third string to the professional bow is now an important career advantage. Training administrators say this is contributing to a growing interest in participation in research and teaching during the prevocational and specialist training periods.

But how can doctors incorporate the additional commitments required to develop a career in parallel with their medical training?

Dr Harris Eyre is busy developing his portfolio career with a mix of clinical medicine, administration, public health, education and research, based in Townsville, Queensland, where he is resident medical officer and in the first year of his PhD through the University of Adelaide. He cites Dr McGorry as a particular inspiration in how to balance clinical and non-clinical career paths.

Like Dr McGorry, Dr Eyre and other doctors-in-training are keen to have health-related experience outside clinical medicine. They’re all just a little bit nerdy that way, he says.

“We’re just a little bit inquisitive and want to see what else is out there. We know that there’s a whole other world related to health — the social issues that are outside clinical medicine. So we know it’s a good thing to get involved and we want to help engineer the system in Australia to make it possible for other people.”

He says there is a big hunger out there in junior doctors and medical students for the opportunity to incorporate additional pathways during their training in order to be involved in other aspects of the health system. Clinical academic training pathways in particular are needed, he says.

Dr Eyre points out the current difficulty in pursuing such a pathway. “I do my research, my PhD, on top of my clinical work and it’s very hard to get time off from the hospital.

“My research now is done in the morning before I go to work and after work when I get home. That has big impacts on my relationship with my partner, and sport and socialising.”

Earlier this year Dr Eyre and his colleagues were involved in setting out the Australian Medical Association’s position statement, which points out that the current academic-clinical workforce is ageing and that raises questions about career progression, job security and remuneration.

Among other recommendations, the position statement suggests that the opportunity to take part in research should become part of every medical student’s education and that mentors could play a vital role in fostering early career medical researchers.

Dr Eyre suggests that for those interested in a clinical-academic career, one rotation of the internship year could be devoted to research. The concept is similar to the United Kingdom’s successful Academic Foundation Programme, where medical graduates have the opportunity to begin working towards a combined clinical and research, teaching or leadership career from their internship year. In 2013, 501 places were offered in the UK program and there is strong demand for it to be expanded.

At a time when clinical training places are at a critical shortage across Australia, if interested graduates are able to spend part of their internship in a laboratory, it may help free some more placements.

And tentative moves by a number of colleges to provide more part-time specialist and general practice training places could make space for Dr Eyre and his colleagues to cultivate emerging portfolio careers without significantly eating into precious family and social life.

Given the track record of doctors past and present who have embraced such multifaceted careers, with greater recognition and encouragement, the benefits for the individuals involved, the broader health system and society in general could well be significant.