‘So, what are you going to specialise in then?’

I’d bet this is a question most medical students and foundation doctors get asked on a regular basis. There’s so much information out there about moving into specialties, but far less about what else foundation doctors can do after FY2.

I’m now in my FY2 year, uncertain about what I want to do for the rest of my career. After chatting with colleagues, I realised most of them felt similarly and were planning to take a break for a year or so ‘out of training’ to make those choices and find something that fits.

There are many other reasons to take a break after your foundation years: improve portfolios, move abroad, save money, or simply take a break from the intensity of medical school and foundation years to just breathe! Personally, I’d gone straight from school into university, and from finals into the pandemic, so a break felt like a no-brainer.

After researching and talking to colleagues, these are some of the options that I’ve been considering for the two years that I’ll take out after FY2.

Junior clinical or educational fellow

A junior clinical or educational fellow is a similar role to a senior house officer (SHO) post, but with allocated time out of the rota to work on clinical audit projects (if a JCF), or educational projects. These posts usually last around six months and can be in several different specialties.

Pros

• Good portfolio opportunities. Junior fellow posts can offer more training opportunities than a locum post, with plenty of opportunities to get involved in projects or teaching. Many educational fellows fund courses or PG Certs to allow for further learning. Study budgets are also on offer.
• Deciding on a specialty. You may be able to get a fellow post in a speciality that you’re curious about; experiencing different specialities may help you decide what you want to do in the future.

Cons

• Pay and rota. Your pay won’t be hugely increased from your FY2 pay, and you’ll often be on an SHO rota, which means on calls!

I know that I excel as part of a supportive team with training opportunities, so this option feels like the right one for me to choose at the start of my career break.

Locum

A locum fills in rota gaps, either through an agency or the hospital staff bank.

Pros

• Pay and flexibility. Locum rates for SHOs are usually around £40 per hour (or less in London), which is a big increase on your hourly rate in a non-locum post. This gives you the option to save money or work fewer days. You can also decide which shifts you want to work; no nights or on-calls if you don’t fancy it!

Cons

• Less stability. Locum shifts can be cancelled last minute, or there can even be periods of less available shifts. You may also have to work and commute to several different hospitals.
• Not part of a team. Unless you’re a locum in the same department, you’ll often be in unfamiliar work environments with different colleagues, so you may end up feeling as if you’re working on your own a lot.
• Harder to develop portfolio. You’ll have to work to find your own training opportunities, as well as evidencing your clinical development on your portfolio.

Although locum work requires you to be proactive, it gives you the freedom and money to do other things that you’re interested in alongside other work, medical or not, and can be far more rewarding than expected.

Overseas work

Many medics choose to work abroad after FY2, which is still possible even in the pandemic. There are many options of where to go and what to do, but some of the most popular include going to Australia, Canada or New Zealand.

Pros

• Lifestyle. Every medic that I spoke to who has gone abroad emphasised the difference in work-life balance and pay when working overseas. With more free time and more money, you also get to explore new countries and cultures – and enjoy life!

Cons

• Organising. Moving abroad isn’t cheap, and you have to factor in visas, indemnity and registration to make sure that you’re working abroad safely.

I plan to work abroad (hopefully in New Zealand) towards the end of my career break and gain further experience in specialities that I may be swaying towards at that point.

It’s all about you

These are just a few of the options available to junior doctors, and something that can only be figured out as you go through your foundation years and weigh up what’s important to you. As medics, we’re often in a rush to get to the next rung on the ladder, but it’s important to remember that you have time to make these choices. Most specialties will not have issues with future doctors taking some time out, especially if that makes them feel more ready to start their careers later on.

My top tips would be to ask colleagues who are further along the path than you for their advice and experiences, and to remember that in the grand scheme of your career, a couple of years to figure out what you enjoy doing most is no time at all.