Career options in medicine

Medicine can be an exceptionally rewarding career, but one of its many hurdles is deciding which specialisation to choose. Fortunately, we’re here to help.
Elliot DE
Medical Doctor, Law Graduate & current PhD Student
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Completing medical school in Australia will now earn you the MD qualification – you used to graduate with the old Bachelor of Medicine / Bachelor of Surgery (which I have!), but these have been largely phased out with the MD. There are no differences in the career options between the two, and the purpose of this blog is just to demonstrate a brief idea of some different career options for medical doctors in the Australian context. This is obviously not an exclusive overview of all of the specialist options for medical graduates, but just a brief insight into a few of them – especially those that aren’t usually considered – just to demonstrate to you the really broad range of career options for the MD graduates! It also has to be said that every single medical speciality is becoming more and more difficult to get into, as there is greater competition for places, and an increasing number of graduates vying for a limited number of positions. Thus, most MD graduates may only get into a training program for a speciality 4-5 year after graduate from an MD, and will have to work as general, junior hospital doctors until then – desperately trying to get experience, contacts, and research publications to help their specialty applications! Just a brief note too: MD graduates can obviously move into careers that are non-medical (I have!), such as business consultancy, health policy, government and so forth, but these career options will not be the focus here. Without any more hesitation, I have selected a number of medical specialties that doctors can move in to, once they complete the MD.

Surgery

Surgery (and to be as simple as possible, ‘surgery’ here will refer to general surgery… though many of the comments are true for all the sub-specialties) is one of the most competitive specialties to get into, and one of the hardest to stay in. Surgeons work incredibly long hours, with seemingly little reward in the majority of their early career and tend to the surgical management of patients. In medical school, you will typically not have a lot (or no) surgery-specific education or training, though it is highly important that all medical students do. As a result, many student-run organisations called ‘surgical societies’ have begun to run events and activities to deliver these educational needs to students outside of a packed curriculum. Indeed, I was partly responsible in creating the ‘Surgical Interest Association’ (Surgia – www.surgia.org), which runs primarily out of Griffith University.

Medical administration

Rather than being responsible for filing and paperwork for a doctor, a medical administrator would be more likely in a position to fire said doctor! Basically, a medical administrator is an individual with a medical degree who works in health departments, hospitals, or medical boards as somewhat of a manager. For example, a medical administrator could work as a Director of Services or CEO at a hospital, or as the Principal Medical Officer in the State health department. They are typically there to make decisions regarding patient movement, service efficiency, and hospital/healthcare policy. Most of their work would centre on their interaction with administration staff, clinical heads of practice areas, and also with other individuals in upper hospital/health management.

Medical researcher

A medical researcher is very similar, if not practically the exact same, as a scientific researcher – the only real, tangible difference is arguably the fact that the medical researcher has medical qualifications. Typically, medical research will be more focused on clinical applications of scientific investigations and may be also more attuned to public health or policy needs. There are a few benefits in obtaining medical qualifications whilst performing research, which mainly relate to the ability to obtain funding and secure research proposals. However, a career of being a predominantly medical researcher, or engaging in the practice significantly, can be very challenging and stressful – not only is there uncertainty and apprehension in research generally due to the high level of planning and meticulous methodology required, but also the severe lack of funding to research in the country means there is a huge amount of pressure to obtain money from a very small pool.

Medical education

Medical education is obviously an exceptionally important part of the medical field, as medical educators are directly responsible for educating the next generation of doctors. Medical educators are usually located at medical schools and are primarily responsible for coordinating and delivering medical education. Unfortunately, across many medical schools there are complaints as to the quality and fairness/transparency of teaching and assessment methods, which do tend to depart quite significantly from standards observed in other courses. Thus, it is exceptionally important to encourage young students to consider being a part of medical education reform from an early stage – either as being involved as a medical educator in the future, or engaging to enhance the quality of teaching and assessment whilst in medical school.

Anaesthetist

Anaesthesia is not simply ‘putting the patient to sleep’. The anaesthetist in the operating room environment is responsible for monitoring all aspects of the patients care, and basically keeps the patient alive during surgery. Anaesthetics have also moved strongly into fields such as pain management, and are experts in keeping airways patent. The anaesthetist may seem like they have a fairly ‘slow’ job in the operating theatre; however, although they may effortlessly control all aspects of the patients’ bodily functions, they have to be on-hand immediately if something goes wrong. They are the masters of critical care, and will be called on immediately if an emergency situation arises.

Radiology

Radiology is the art of interpretation and reporting of imaging and other image-based investigative modalities, at its very basic form. Radiologists will typically receive requests from other doctors for MRIs/CTs/X-Rays and so on, and they will be required to organise this (usually through radiographers), and the radiologist will carefully analyse the pictures and create a detailed report. Evidently, radiologists need to have a very high expertise across whole-body anatomy, intricate knowledge in the various complexities that arise across every imaging modality, and be able to use professional language at an extremely advanced level.

Orthopaedic surgery

Orthopaedic surgery concerns operations that involve the bone and muscle – you may see these surgeons conducting hip replacements, carpal tunnel releases, fracture repairs, or even working with neurosurgeons in correcting spinal injuries. Orthopaedic surgeons are lovingly referred to as ‘orthopods’, and are often ridiculed as a bit of a Neanderthal bunch, mostly because of their propensity to use instruments in surgery that resemble hammers and clubs. Indeed, the surgeries conducted by orthopaedic surgeons are commonly (though not always) quite messy affairs; bones are generally ripped from their places, metallic plates are smashed into place, and muscles are exposed.

Paediatric surgery

As one would no doubt predict, paediatric surgeons have to have exceptionally precise surgical technique and control. Paediatric surgeons will operate exclusively on children (paediatric patients), and these surgeries may be anywhere in the body – they are not so restricted as anatomically-specific surgical specialties (i.e. neurosurgery, cardiothoracics). However, for more specialised areas, they will often be joined by general surgeons in that particular field, or paediatric surgeons with that specific sub-specialty interest will be in attendance. Paediatric surgery is technically challenging and highly stressful – having a child’s life in your hands can be extremely nerve-wracking, especially with the added pressure and expectation from the patient’s family, who would meet the death of their young son, daughter, niece, or nephew with despair.

Rehabilitation doctor

The specialty focuses on the management of functional loss, activity limitation or participation restriction that arises out of illness and injury. Rehabilitation Medicine is the diagnosis, assessment and management of an individual with a disability due to illness or injury, and the specialist physician’s work with people with a disability to help them achieve an optimal level of performance and improve their quality of life. Entry into rehabilitation medicine is quite similar to that seen in most other medical physician specialties, and the training program lasts for approximately 4 years once an individual is accepted.

Psychiatry

The specialty focuses on the diagnosis and treatment of mental health disease and conditions. In a time of widespread mental health issues, which are severely undertreated and resulting in an alarming rate of suicide, psychiatrists have a vital job in the community. The psychiatry Fellowship Program takes a minimum of 60 months full-time equivalent to complete. During the training period, trainees work as registrars in hospitals and clinics, where they are supervised by experienced psychiatrists. Psychiatry registrars (trainees) are able to have quite a lot of flexibility in their employment, and there are part-time and full-time work options.

Elliot DE is a current PhD Candidate, Medical Doctor & Law Graduate. He is also a Humanities Tutor at GradReady Preparation Courses.