The advice zone
You can use BMJ Careers' advice zone (www.bmjcareers.com/advicezone) to submit a career question or browse existing questions and answers on many different topics. A panel of more than 200 experienced advisers are ready to respond to your queries. Here is a selection of what has been published on the advice zone site so far
Isn't palliative medicine depressing when all your patients eventually die?
There are two ways to look at this. One is to say that if you consider the death of a patient to be a failure then palliative medicine will be depressing and you should choose another career. The other more positive perspective is shared by most palliative medicine doctors: sadly, patients are inevitably going to die, and good palliative care can turn bad deaths into good deaths. You would prefer it if people were not ill at all but, given that they are going to die, you can do them the biggest favour by making it as comfortable as possible. And you can achieve at least some success in this direction with most patients.
Idris Baker, specialist registrar in palliative medicine, Leicester, UK
I have had a serious health problem in the past. It meant that I needed some time away from work. I am well now, and this was a few years ago, but I keep being asked about it every time I fill in a health questionnaire. I am being discriminated against because of my past and am tempted not to write it down next time I apply for a job. Can I do this?
Discrimination is against the law, and there are steps that you can take if you feel that this has happened to you. The BMA has employment and industrial relations officers and careers advisers who can help you. However, it may not be discrimination that you are facing. By law, an employer has a legal duty to safeguard their employees' health at work and to take reasonably practicable measures to accommodate an employee's health and welfare needs at work. Practically, this means that there needs to be a way an employer can prove that they have looked after the welfare of their staff at work. The occupational health service is one way that employers help meet this need, and most job offers are provisional on medical clearance.
So if at an interview you have been found to meet the criteria for the job, it is up to the occupational health department to comment on your medical fitness. Your manager or interviewer cannot or should not coerce your medical details from you.
If you have had serious health problems, your occupational health department may just need to know more details, either by way of a phone call or a clinical consultation. If you have successfully been in employment since your illness, then it is unlikely that you will be medically unfit for a similar post. Even if you have an ongoing problem, again, you may be fit for work, and the occupational health department may even be able to provide you with more ongoing support.
Occupational health departments have a strict code of confidentiality and will not disclose medical information to your employers, manager, or consultant without your consent. Health questionnaires should ideally be returned directly to the occupational health department, where access to the information is restricted to the department's personnel.
Without knowing the exact details of your health problem, it is difficult to explore comment more specifically. However, I would always advise that you should not lie on a health questionnaire because you are signing a document declaring the authenticity of the information you have just disclosed. If some one does lie about their health and then runs into problems later on, there are likely to be issues raised about their integrity when the truth is disclosed.
If you do have any worries about filling in health questionnaires, telephone the relevant occupational health department (anonymously if you prefer) and have a chat with the occupational health doctor who should be happy to provide the information.
Sam Flynn, specialist registrar in occupational health, Exeter, UK
I am interested in working in the Middle East on a long term basis. Could someone please advise me on how to find jobs, and the working condition?
You probably have to start by asking yourself a few questions. Are you interested in a particular country? Do you have a specialty in mind? Do you want to work in a development setting, or are you more interested in working in an emergency setting or after a conflict? Examples of the latter would be the Palestinian territories occupied by Israel, or Iraq. Personal circumstances--for example, having a family--may determine the areas you can, or are prepared to, work in.
You also need to think about the organisation that you wish to work for. The voluntary sector--charities, missions, and other non-governmental agencies--form one group. Government and national health services are a second option--where there may be opportunities at national or local levels. There are also international agencies--donor agencies and United Nations institutions. Universities and other academic bodies form a further group. The appropriateness of each one will depend on your interests, skills, qualifications, and the sort of remuneration and working conditions that you expect. You will also need to check whether qualifications from your home country are recognised in the country in which you are interested in working.
Perhaps the best way to start is to identify international non-government agencies with a base in the country in which you live. Find out which of these have operations in the Middle East. An internet search will help you with this. Try and get hold of their literature and then see if you can get to meet one or two of the individuals involved in their activities. Sometimes agencies and institutions run workshops, open days, and presentations. Once you get to know a few individuals working in or with people in the country you are interested in, you can then start to seek information on specific opportunities and working conditions.
Nick Banatvala, Senior adviser, Department for International Development, UK
