Portfolio careers for medical graduates: implications for postgraduate training and workforce planning

Abstract

Portfolio careers in medicine can be defined as significant involvement in one or more portfolios of activity beyond a practitioner’s primary clinical role, either concurrently or in sequence. Portfolio occupations may include medical education, research, administration, legal medicine, the arts, engineering, business and consulting, leadership, politics and entrepreneurship. Despite significant interest among junior doctors, portfolios are poorly integrated with prevocational and speciality training programs in Australia. The present paper seeks to explore this issue. More formal systems for portfolio careers in Australia have the potential to increase job satisfaction, flexibility and retention, as well as diversify trainee skill sets. Although there are numerous benefits from involvement in portfolio careers, there are also risks to the trainee, employing health service and workforce modelling. Formalising pathways to portfolio careers relies on assessing stakeholder interest, enhancing flexibility in training programs, developing support programs, mentorship and coaching schemes and improving support structures in health services. What is known about the topic? Portfolio careers are well understood as a career structure in general business. However, in medicine little is known about the concept of portfolio careers, their drivers, benefits and risks. There are significant issues faced by the Australian junior medical workforce such as a need for diversified skill-sets (e.g. increased involvement in research, public health and leadership), low job satisfaction for junior doctors and an increasing emphasis of work-life balance and mental well-being. What does this paper add? This paper critically analyses the concept of portfolio careers in the postgraduate setting by critiquing literature on the international and national experiences in this field. This paper outlines potential benefits of portfolio careers requiring further research, such as a diversification in the workforce and improved job satisfaction. Risks include reducing the health service provision capacity of junior doctors and drawing doctors away from a medical career. What are the implications for practitioners? This paper has substantial educational and workforce implications for medical students, junior doctors and medical managers. For medical students and junior doctors this paper frames the possibilities in a medical career, as well as benefits and risks of aiming for a portfolio career in medicine. For medical managers, this paper suggests strategies for further research, enhancing workforce job satisfaction and potential pitfalls of increasing opportunities for medical portfolio careers.