The advice zone

Got a career or university related problem that needs answering? Can't find the right person to point you in the right direction? Log on to the Advice Zone at www.bmjcareers.com/advicezone to post a question or to see if one of our experts has already solved your problem

Is a career in anaesthetics stressful?

Many doctors are aware of anaesthetists' presence when things go wrong, in resuscitation scenarios and critical care. Is this the bulk of an anaesthetist's work and is it a high stress occupation? Anaesthesia is an interesting job and much of the workload is regular, predictable, and unexciting. However, when things go wrong the job is stressful and challenging. This is usually less than 5% of time spent in practice. Anaesthetists are experts in critical care and managing the most ill patients. A little drama and stress is makes the job interesting and helps stop complacency setting in.

Peter Maguire, consultant anaesthetist, Belfast

What are the career options in homoeopathy?

You can use homoeopathy within your conventional medical field as an extra option, or you can work purely in homoeopathy. It is easy as a general practitioner to integrate homeopathy into conventional work, since any homeopathic medicine can be prescribed on an FP10, and you are an independent practitioner. In hospitals, the available medicines are tightly controlled, so direct use of homoeopathy is not easy, but you can suggest it. I work in a hospice, where I am relatively autonomous, and I write up conventional drugs and homoeopathic medicines together on the drug sheets.

If you want to work purely in homoeopathy, then there are NHS and private options. There are five NHS homoeopathy units in the United Kingdom (in Liverpool, London, Glasgow, Bristol, and Tunbridge Wells), and a number of charitably funded clinics. Each NHS unit is led by a consultant and has some posts for senior house officers; all have clinical assistant sessions. At present, to become a consultant in homoeopathic medicine you have to hold a conventional certificate of completion of specialist training (CCST) and to work as a clinical assistant you will need to be a member of the Faculty of Homeopathy (MFHom). Within the private sector, Boots have recently employed a number of medical homoeopaths as they have expanded into complementary medicine. Otherwise, you can join an established private homoeopathic practice as a junior, or set up your own practice.

The Faculty of Homeopathy has produced a private practitioners' resource pack, obtainable free by email or for £5 by post from The Faculty of Homeopathy, 15 Clerkenwell Close, London EC1A 0RR.

Kathy Ryan, medical homoeopath, Liverpool

How do I change to a non-medical career?

The best place to start is with yourself. Start by thinking about what you want in your new career: what is important to you? What did you like about being in medicine, and what did you not like? Imagine being in your ideal job. Close your eyes and picture your day. Even if you are not clear yet what your occupation would be, get a sense of the sights, sounds, smells, and how you are feeling. So you are starting with the "where"--the environment of your new career. Next, think about what you might be doing in your new career--the "what." What skills do you need to do this? Have you got these already or do you need to take a course? When and where can you do this? Do you have transferable skills from medicine to use in the new career? Be clear about the reasons for leaving your present career: what do you want to gain from this move? What values are important to you in doing so? Would this new job be more about "who" you really are? Would it link into what you hope to achieve during your life, or do you have other reasons for wanting the change? Would your move to a new career link into your spiritual self and beliefs?

Once you have become clear about these things and have clarity about the why, how, when, what, and how of leaving medicine, you will probably know what to do and also be clear about how to proceed and where to go for further advice, if you still need it. Remember this: you know yourself better than anyone else... you already know the answer to your question. Now take action. Take a look at "Are you a square peg in a round hole." (http://bmj.com/cgi/content/full/325/7367/S109)

Susan Kersley, life coach, Cornwall

How should I go about starting a career in plastic surgery?

The earlier you decide on your choice of career, the easier it is to plan for the future. If you have inclinations towards plastic surgery at medical school then attachments to a plastic surgery unit in the United Kingdom, or an elective abroad, would be useful. Any prizes or intercalated degrees, especially in topics related to plastic surgery or surgery in general, would be advantageous. In practice, however, many undergraduate students do not have any exposure to plastic surgery and, therefore, it is difficult to commit at such an early stage. Once qualified and after completing house officer jobs, budding plastic surgeons must obtain a broad experience of many surgical specialties and secure a place on a surgical rotation, especially one that has a plastic surgery job. Trainees must obtain the surgical membership diploma from one of the surgical royal colleges and begin to improve their CV in preparation for applying for specialist registrar training schemes.

Abhilash Jain, consultant plastic surgeon, Cambridge

Whom do I contact about a job in Australia?

Finding out about available posts is best done through senior colleagues with contacts abroad. Apart from jobs in the overseas section of the BMJ Careers, posts are also advertised in the relevant specialty journals. The Medical Journal of Australia is available on the internet (www.mja.com.au), and its website contains links to useful addresses in Australia. It also has the journal's classified section. Unlike in Britain, most jobs are advertised in the general press such as the Australian, the Age, the Courier-Mail, the West Australian, and the Sydney Morning Herald. For instance, medical jobs in the Australian are advertised in the weekend edition. There is an online edition (www.theaustralian. news.com.au) although it does not carry the full range of jobs that were advertised in the print version.

Stephen Kisely, GP, Australia



studentBMJ 2004;12:1-44 February ISSN 0966-6494