Junior Doctors Lifestyle

Is having a ‘Plan B’ a bad idea?

Do you have a career Plan B, just in case things don’t work out? I’ve been thinking a lot of about the concept of a ‘Plan B’ in the context of careers, relationships, and just life in general. It’s certainly very topical at the moment, with changes to surgical training in Australia. In the past, you had unlimited attempts at applying for a surgical training program. The Australian Orthopaedic Association was the first to introduce a maximum limit of 3 attempts, with the other surgical specialties following suit. There are some candidates who will never get onto a surgical training program due to performance and other issues, but may never realise it because no one has the heart to tell them, or because they don’t know how to take the hint. In general, doctors are uncomfortable with giving negative feedback. I’ve experienced working with doctors who were told by their supervisors that they may wish to consider a non-clinical specialty (i.e. they are terrible with patients!) but kept pursuing a clinical career. The 3-attempt rule weeds those people out.

However, there are plenty of brilliant doctors who get onto training programs after more than three goes. It doesn’t necessarily mean that they are inferior to those who get accepted on their first go. We all know that selection processes are imperfect and not always based on merit. I worked with a registrar who was colour-blind and had a terrible tremor who was accepted into a surgical training program because he looked good on paper and knew who to impress. As hard as you might work to build a strong CV, obtain good references, and perform well in interviews, there are always elements at play that are outside of your control. With the maximum limit in place for most (if not all) surgical specialties from 2020, there is increasing pressure to have a plan B ‘just in case’ you use up your three tries.

… or maybe your Plan B isn’t even medical.

I’ve never liked the idea of a Plan B. It feels defeatist. I’ve always believed in willing things to happen, visualising success. By thinking of a Plan B, it tampers with that image… but thinking is not enough. A true plan B must already be in place, ready to take over, if and when Plan A comes crashing down. For example, if specialty B is your back-up, you need to prepare your application for specialty B by having experience, referees, and activities related to that specialty. With so many graduating doctors due to the medical student ‘tsunami’ of the last decade, the work environment is extremely competitive. Being good is not enough. I’ve met medical students who are already stressed about publications in their chosen field. It’s hard enough publishing papers in specialty A, you now need to be thinking about research in specialty B (and maybe even, C, D, and E) too.

What this creates is a dilution of your efforts. Plan Bs need investment, and that time, attention, and energy is taken away from pursuing your Plan A. Going to conferences, networking, and expressing interest all take time. Plan B is hard work. It’s a difficult dilemma and I won’t pretend that I know the answers. I do think that having a back plan or two can potentially sabotage your dream career. I believe in working your balls off and putting absolutely everything into your top choice, reflected in the ‘mamba mentality’ of the late LA Lakers star Kobe Bryant. When you don’t worry about a Plan B, you can exert all your energy and focus into what you really want. Having this winning mindset is something that is encouraged by many performance psychologists.

Putting all your eggs in one basket has a risk, of course. I’ve always been an optimist. I don’t like to think about failing. I like to deal with failure if and when it happens, but don’t let it invade my thoughts when I’m chasing a particular dream. By focussing on my plan A, I give it my undivided attention, and it allows me to be present. The criticism with this approach is that there is nothing in place if and when you fail, and it can make rebuilding a longer process. I’ve always told my students that if there are X number of spots for your dream job, you might as well get one of them. Why shouldn’t it be you? Go for it.

I feel the same way about relationships. How many of you have joked with a good friend, saying “Let’s get married if we’re both still single by <insert arbitrary age here>“? How many women have a male friend who will be their baby daddy / sperm donor if they haven’t found a partner by age 35 (and wants a child before the risk of Down syndrome starts going up)? I think most of us have thought about relationship back ups. The scary truth is, a lot of people do have back up partners, or “back burner” relationships, which sometimes translate to real life problems such as infidelity.

The underlying psychology is this: some people are afraid to be alone. Just in case the current relationship doesn’t work out, there is someone ready and waiting. Whether you call it ‘cushioning’, ‘benching’, or whatever the trendy dating lexicon is today, having someone as a back up can be harmful. At the very least, it’s selfish, and can be a cruel thing to do if the back up person has feelings for you.

In order to keep the back burner relationship viable, you have to maintain contact. With social media and mobile phones, this is increasingly easy to do. Whether it’s a sexy snapchat, a flirty text message, or a heart-eyes emoji on their latest selfie, people are easily accessible to keep communication channels open. This is at the very least emotional cheating, and stops you from being fully present in your main relationship. If you are keeping a back up person on stand-by, how can you be truly emotionally invested in a relationship? This causes people to sabotage their chances of developing a genuine and meaningful connection.

Another issue with having a back up partner is that it’s easy to turn to them when there are problems in the current relationship. Instead of addressing the issues and working on a relationship, it’s easy to seek support, comfort, or romantic attention from the back up without having to commit to the others aspects of being in a relationship. As such, the back up partner is seen through rose coloured glasses. The idea of that person is idealistic, and very rarely reflects what it would actually be like to be with that person.

So, I’m not a fan of the Plan B. Whether it’s a job, a partner, or anything else in life, I like to be present and mindful.

What’s your take on the Plan B? Is it sensible and realistic, or are you affecting your chances at giving your all to something?

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