As an educational supervisor you should familiarise themselves with the four stages. See the career planning pages. Research has shown that career discussions are more useful if the people providing and receiving career support share a common framework. Further information on this can be found in Hirsh, W., Jackson, C. and Kidd, J. M, (2001) Straight Talking: Effective Career Discussions at Work Cambridge: National Institute for Careers Education and Counselling.

You might also want to try out some of the exercises yourself, so that you will be in a better position to discuss them with your trainees.

Wherever you are in your student’s or trainee’s career path, you should ensure that career plans are discussed as part of every review meeting that you have. This will help them to develop their preferences and make it easier when the time comes for tough decisions.  

Asking your student or trainee to bring along materials such as their foundation learning portfolio or print-outs from their NHS Medical Career exercises to each review meeting will help you to have a more in-depth discussion about their career plans.

Although it is tempting for students and trainees to skip the earlier career planning stages – particularly if they feel that they have decided on their post-foundation options – you should discourage them from doing so. Even if they are convinced that they know what they want to do post-foundation, completing the exercises and reading the information contained in Stages 1, 2 and 3 will help them to ask the right questions of themselves and give them the raw data they will need for writing job applications and responding to interview questions. Skipping stages could reduce their chances of successfully implementing their post-foundation choices.

During a review meeting, the person who should be doing most of the talking is your student or trainee. If you find that it is you, you need to consider the reasons behind this. Is there something worrying the trainee that you haven’t explored adequately? Does the trainee feel comfortable with you? Asking open questions, allowing slightly longer pauses after you ask a question and asking follow-up questions to prompt a fuller answer may help.

It is important that you provide clear constructive feedback on all aspects of a student or trainees performance to date. This means spending sufficient time discussing what has been going well, what seem to be their key strengths, and the possible career implications of these. Then if necessary, you may need to discuss areas of their performance that have not been going so well (see section 7 below).

In any one meeting, there needs to be an overall balance in the feedback provided. It may be appropriate for a student or trainee to leave a review meeting with the realisation that they probably need to revise their career plans. But you don’t want them to leave a review meeting feeling utterly demoralised and that they have no future at all in any branch of medicine. The way to avoid the latter could be to ensure that you have a balanced discussion, spending sufficient time on their strengths as well as areas where their performance might be causing concern.

Provide a route map rather than a final destination. Educational supervisors are frequently concerned that they might inadvertently give a student or trainee poor careers advice. This concern is particularly acute at the moment, given the uncertainties surrounding applying for post-foundation jobs.

However, it might help you to know that advice giving is not, in fact, your key role. Instead, you should use the four-stage structure to provide a ‘route map’ through the rough terrain of career decision making. You’ll need to be clear that it is always up to the student/trainee to pick their final career destination.

Another way of putting this is to say that your role may involve posing challenging, insightful questions – but it doesn’t involve providing the answers. This idea is explored in greater detail in this sample scenario.

At the end of each session, ask your student or trainee to specify which career planning tasks they will be doing next, and also agree on an appropriate time-scale. This will help keep the trainee on track and minimise the chances that they find themselves completely ill-prepared to make a decision when they come to the point of applying for their post-foundation training.