The truth of the matter is that training to become a medical consultant takes many years. Starting from medical school, it typically requires at least 15 years in the best-case scenario (Fig 1), though this is rarely the case. Between life events, identifying your specialist interest, and building a portfolio for your chosen specialty, the process can take significantly longer. For IMGs relocating to different countries, this timeline is often extended further by the need to revalidate your training based on your level when moving. Therefore, it’s crucial to understand your options when designing your career path, as this can significantly save you time. In this article, I introduce the concept of pursuing a parallel rather than a serial career pathway.
Figure 1: UK serial run-through training pathway (best case scenario)
What is serialising?
Serialising, or following a serial career pathway, is the traditionally understood model of career progression. This typically involves focusing on one area at a time, such as clinical practice or academic work, completing one before moving on to the next. In an ideal scenario, this pathway offers the advantage of focused attention on each aspect, allowing you to explore and decide your preferences for the future. However, a major downside with this pathway, is the time required to invest in one area while letting go of the other. In clinical practice, especially surgery, one risks de-skilling. In the UK, the shortest time to complete training on this pathway is approximately 15 years if on a run-through, where one knows what they want to specialize in and doesn’t need to build out their portfolio Fig 1. But realistically, it often takes closer to 20 years in total Fig 2.
Figure 2: UK serial career pathway with academic portfolio
What is parallelising?
Parallelising, or following a parallel career pathway, is less commonly known but highly effective. It involves managing multiple aspects of your career simultaneously—not by multitasking but by task-shifting. Imagine having several tabs open in a browser, each representing a different aspect of your career. This approach can be particularly advantageous for those pressed for time, such as IMGs who are trying to achieve CCT while building their portfolio within the shortest possible time.
Parallelising offers flexibility, allowing you to experiment and learn before fully committing to any single path, like a full-time MD. It’s akin to the design thinking process often used in business and software industries, where you test ideas and commit only if they prove worthwhile. You can simultaneously engage in academics or management roles while continuing your clinical practice. One significant advantage is the reduced total training time (approximately 17 years) Fig 3. Additionally, since you continue practising clinically, especially for surgeons, you won’t lose your hands-on skills.
However, the main challenge is balancing and shifting between different commitments without compromising productivity.
Figure 3: UK parallel career pathway
Conclusion:
Both serial and parallel training pathways offer distinct advantages and challenges. When designing your career plan, it’s important to consider both options based on your personal goals, circumstances, and resources. Additionally, a hybrid approach—combining aspects of both serial and parallel pathways—can provide a flexible and efficient route, allowing you to benefit from the strengths of each. By thoughtfully planning your career pathway, you can achieve your professional goals in the most effective and timely manner possible.