WA News Guest Opinion / Editorial Specialist or Generalist
Specialist or Generalist
Written by Dr Tim Fiori
Wednesday, 28 June 2017

Specialist or Generalist? Surely it’s not a binary choice? More and more junior doctors are using medical degrees as ‘passports’ into new and exciting ventures…

When I started life as a medical student a senior consultant told us all that we would ‘struggle to specialise’. The logic being that his generation was going to both live longer and work longer before hanging up their stethoscopes.

So, according to him, we'd all have trouble getting into our ‘dream specialties’ due to a scarcity of positions plus being forced to compete with a deluge of new medical students. I recall brushing off the comment by asking a recurring question, ‘so what kind of doctor do I want to be?’.

Stumbling through our degrees and internships, we largely remained protected against the market forces of health care. Some of us were on scholarships and all of us, we thought, could rest assured that we’d be employed once we graduated. But when we made the transition to hospital residents a degree of panic began to set in.

It became increasingly clear that we would have to compete for a limited number of positions and doing so could require a lot of ‘on-call’ hours and registrar positions with no real light at the end of the tunnel.

This is not a new problem, nor is it unique to the medical profession. The difference being, arguably, in the structure of our career progression and our expectation of doing just that – progressing!

Many of us entered medicine aspiring to join the ranks of a niche specialty. Subsequently, just as many of us are now looking at the practicality of achieving such a goal. Postgraduate degrees, research publications and overseas experience are just some of the increasing requirements before being considered for specialist training.

Many of us are now facing a dilemma – Specialist or Generalist?

But I think it can be viewed a little differently. Surely it’s not a binary choice? More and more junior doctors are using medical degrees as ‘passports’ into new and exciting ventures, whether that’s entrepreneurial projects such as personalised medicine and developing medical devices or pursuing roles in advocacy and public health.

A medical degree is a rare privilege, and has the added bonus of allowing us to fund a project or a vision while work flexibly as a locum. We are so lucky to be able to take creative risks in exploring our passions!

I think we finish our degrees far more prepared to make such choices than we realise. I’ve followed just such a trajectory by commercialising my research interests in neurotechnology while still working as an RMO. It’s been a steep learning curve but it’s given me the chance to develop a wider set of experiences useful in both clinical and non-clinical settings. A deviation into the unknown can be an exciting thing and open up all sorts of career opportunities.

So, ‘Specialist’ or ‘Generalist’? We live in exciting times and I think we’ve got a lot more choices than that!

By Dr Tim Fiori