So you Want to be a Brain Surgeon? A Medical Careers Guide
Authors: Jane C Symonds
Journal: Journal of the Royal Society of Medicine (2001)

The feisty title should not mislead—this is by no means niche marketing but a panorama of medical career opportunities which could do much to avert professional disillusionment in future. Humour leavens an accessible and intensely informative review of every possible medical career option available in the UK. The training pathways, necessary qualifications and nature of work are outlined comprehensively; relevant statistics are quoted for each specialty, including numbers of posts and proportion of women currently employed. In the tradition of the best consumer guidebooks, symbols are awarded—here to summarize fundamental issues which will concern all likely recruits. Frowning faces represent stress levels on a scale of one to five, and a disconcertingly large number of specialties, including general practice and obstetrics and gynaecology, score highly. A five-dagger score represents seriously competitive careers such as cardiothoracic surgery: few specialties, notably care of the elderly, earn only one. No doubt some practitioners could challenge these rather subjective assessments but they illustrate vividly some highly relevant considerations.

The text is replete with useful information (including salary prospects and contact addresses), and much of the commentary resembles the personal advice of wise and thoughtful mentors. No myth remains unchallenged—paediatricians are not ‘big kids swinging stethoscopes and wearing Disney ties’. Aspiring paediatricians may be cheered by reading that the best aspects of their chosen specialty are its variety, the ‘high cure rate in most areas’ and the availability of flexible training. But they are warned of emotional stress (four frowning faces).

The format is consistent for each specialty, making comparison easy. Perhaps you are looking for an interesting low-stress career which is not overtly competitive? Consider nuclear medicine, but note that there are only 40 posts in the UK. Radiology, where 24% of posts are held by women, is also claimed to be a low-stress specialty, but readers may not entirely believe the author when he claims that the worst thing to happen could be ‘getting barium—or worse—on your suede shoes and dealing with colleagues who know everything’. What about family planning (now known as community gynaecology)? With only 66 posts, 60 of them held by women, this is a rapidly expanding and much needed specialty; surprisingly, both competitiveness and stress score highly. However, many people might find this work more appealing than obstetrics and gynaecology, where the worst aspects of the specialty are said to be nightwork, heavy routine workload and fierce competition for posts. A highly competitive doctor looking for a really fascinating job might actually want to be a brain surgeon. Most people will know that the difference between God and a neurosurgeon is that God does not think he is a neurosurgeon—although the author suggests that many neurosurgeons would ‘see that as one of God's failings’.

The editors are right in commenting that ‘there would be less regret and disillusion in medicine if doctors had chosen the right career in the first place’. The range of medical career opportunities is probably greater than many graduates appreciate. Medical students and recently qualified doctors are entitled to top-quality career advice, and this book is just that. A canny consumer's guide to the profession, it should be widely read and consulted by all who are still uncommitted in their medical careers and by those who advise them.