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I am a second year medical student, and I now want to pursue engineering. Is it possible for me to do it at the same time and after this do I have many options in the field?

Thanks this is an interesting question and opposite from the direction that I moved (from physics to medicine). There is an increasing interest in combining the fields of engineering and medicine, especially within orthopaedics, radiology, and prosthetics. I do not know of any training programme that allows you to combine these as an undergraduate in the United Kingdom, however.

Various masters courses for biomedical engineering exist, but these would be after completing your medical degree. One is at Keele and another at University College London (Medical Physics and Bioengineering - MSc in Biomedical Engineering and Medical Imaging)

Continue your medical degree because as far as funding for further research is concerned you have a stronger case with medical training. Orthopaedics is probably the best specialty to consider. There are courses listed in the United States (www.latech.edu/tech/engr/bme/underpro.htm) but you would not be able to practise as a doctor on completion. In the meantime you could also try to arrange an elective at McGill University in Canada (www.medicine.mcgill.ca/undmededuca/english/cal/biomed.html) or a special study module to see if you really do like the subject.

Brian John Angus, clinical tutor, honorary consultant, University of Oxford

What training schemes are available in research and academic medicine?

Training in research initially can be provided by perhaps an entry level fellowship from the Wellcome Trust - these are designed to help an individual get going. If things look promising after a year they can be converted into a three year commitment as a clinical research training fellow (www.wellcome.ac.uk). Alternatively, many medical research charities actively support newcomers to research and offer entry level fellowships for individuals with applications to train with established investigators (see the Association of Medical Research Charities at www.amrc.org.uk). Advice is often available also on the websites of the royal colleges relevant to your chosen specialty, and many royal colleges run competitions for fellowships, sometimes providing quite short term initiation funding for clinically qualified candidates.

Howard Clark, specialist registrar in paediatrics, MRC John Radcliffe Hospital, Oxford

I want to work in Italy as a doctor; I've heard this is notoriously difficult. I lived there for a year and therefore speak Italian. I am in psychiatry training but could and would be equally happy doing general practice. Any suggestions?

I am surprised that you say it is difficult to find work in Italy. As far as I am aware salaries are much less than in this country although the quality of life is arguably much better. Assuming that you are a citizen of a European Union country there is freedom of employment within other European Union countries. A primary UK medical degree is accepted in Italy. A specialist medical qualification is also accepted in Italy, but you will need to obtain a certificate of equivalent experience from the relevant specialist college in Italy.

Research resources include the international department of the BMA (tel 020 7383 6491/6231), www.medicstravel.co.uk/CountryHospitals/Europe/Italy - an excellent website for hospital details, and the Italian Health Department may be able to give you some pointers. Also worth networking in your specialty in this country with the professors who will know their equivalents in Italy and may be able to put in a good word for you there.

You should (must) have full UK General Medical Council registration for any post in the European Union. Ensure that you have full documented proof of all qualifications and experience. You will need to apply to individual hospitals or country health departments. Carefully research the available indemnity insurance. In summary, the requirements for working in any EU country are the same as those for working in the United Kingdom.

James Sherifi, consultant, Euromedica Executive Search in Healthcare

I accepted a job offer six weeks ago for my first senior house officer position. I am due to start this job in seven weeks. I attended an interview for another senior house officer job in a different specialty and have been offered it. I really want to do this second job. Is it possible to decline the job I originally accepted?

There are two levels to think about here. The first is purely contractual - if you have accepted an offer of a post verbally only, then this probably does not constitute a contract between two parties. Even if it did, senior house officers have to give only one month's notice of termination of contract. So you would be within your strict legal rights under contract and employment law so to do.

On the other hand there is the professionalism about such a move. I am afraid that accepting posts and then declining them at a later point, almost last minute, is becoming more commonplace. Some trusts and indeed consultants take this very badly indeed and view it as unprofessional and untrustworthy. It all depends on whether you think you might wish to have a job in that trust in the future. You might want to talk it through with your educational supervisor in your current post and get some personal advice.

If your appointment was some time ago, even at this stage, presumably, there were appointable candidates below you. The trust could ring around to try and find somebody who still wants the job. If they had to readvertise that would be a complete headache, and you would have a permanent black mark against your name. I have just spent eight hours last week scoring 150 candidates for a short list for foundation programme posts, and that was only half of the applicants.

I would ring up medical staffing and tell them that you are now, after some thought, declining their offer (you do not have to give reasons) and follow this up with a short but polite letter.

Trevor Pickersgill, consultant neurologist, University Hospital of Wales

As an overseas doctor, how do I demonstrate my competence in English?

You must demonstrate competence in English through obtaining a satisfactory score in the International English Language Testing System (IELTS). The IELTS test consists of four sections: reading, writing, listening and speaking. Candidates must achieve minimum scores for each section, as well as a minimum overall score.

Jo Constable, BMA International department,


studentBMJ 2005;13:177-220 May ISSN 0966-6494

       

           

	CAREERS The advize zone       (May 2005)
	Fiona Martin (May 06, 2005)       clinical medical student, University of Nottingham mzyxfmm@nottingham.ac.uk
	Editor - Trevor Pickersgill1 highlights a common problem at all levels of the medical profession when job hunting. I'm beginning to think that many consultants are not actually living in the real world (gasp) and have this image of juniors applying for their advertised post as if it were the only job out there. Several of my friends have bemoaned this exact issue whereby consultants and trust managers seem to think that people should apply for only one post, wait by the phone to see if they've got it and then accept immediately. Presumably if unsuccessful, as is quite likely to be the case with most popular specialties, the would-be applicant is required to spend months going to consecutive job interviews in only their ideal areas. If they happen to be applying for jobs along with several hundred other hopefuls, that could take a very long time indeed. Dr. Pickersgill quite rightly points out that the practice of accepting jobs and then abandoning them is becoming commonplace. When applicants are being forced to give quick answers and accept posts immediately without consideration for their circumstances it's not really surprising. The alternative is to run the system as it is in just about every other job market where candidates apply for several posts and instead of being forced to accept the first one they get offered, they're allowed some time to get the results of the other interviews before deciding. Any employer who doesn't take into account the personal and professional circumstances of their applicants and future employees is destined for a long series of personal snubs and disappointments. Pickersgill T. The Advice Zone. StudentBMJ 2005;13:177-220 (May)

	CAREERS The advize zone       (May 2005)
	Simon James Carter (May 08, 2005)       4th Year Medical Student,University of Dundee s.j.carter@dundee.ac.uk
	Re. Engineering for 2nd year medical student: There is the option of doing an Intercalated degree in the middle of your medical training. I went all the way to London for a year last year and did UCL's Intercalated B.Sc. in Medical Physics and Bioengineering, which was well taught and great fun; I thoroughly recommend it to anyone interested in the subject! http://www.medphys.ucl.ac.uk/teaching/undergrad/f37m.htm Courses are taken mainly with final year Physics or Engineering students, with an extra maths course to get us medics up to speed! I think King's may do a course too; check out www.traumaroom.com for lists of intercalated courses.