One of the purposes of vocational training is to develop good professional development habits and skills that will hopefully be sustained and honed throughout the rest of a doctor’s professional life. The great thing about completing vocational training and entering the ranks of seniority is not having to feel forced to study periodically and carry out formal examinations. However, it does not allow doctors to duck their continuing ethical responsibility to remain appropriately skilled and up to date. After all, shouldn’t doctors consider their career a continuous vocational training program?

I finished my own vocational training six months ago, and looking back, I feel that as well as gaining sustainable habits and skills, I learned which habits not to foster and which paths not to tred. So here are my tentative tips for ongoing professional development after vocational training:

1 – Become a member of an invisible college
The first invisible college was the precursor of The Royal Society of London is considered the first ever invisible college. Such colleges consist of informal groups of doctors, scientists, or academics who exchange information among themselves, and whose members acknowledge each other and accept new members based on their level of intervention and contribution within the group. A practical example of an invisible college is an email listserver joining colleagues of your specialty in your region, country, or even continent. I have learned much more from reading messages and articles posted on primary care listservers than from attending Pharma-sponsored conferences and continuous medical education (CME) activities. If you want to know lots about invisible colleges I recommend the book “The New Invisible College.”

2 – Read independent drug bulletins
I stopped seeing drug representatives a few months after beginning my vocational training program when I realised that I could spend my time more wisely by looking at independent publications about drugs and liaising with organisations that stand up against misleading health information, like Healthy Skepticism. Many drug representatives provide highly biased promotional information to doctors rather than relatively unbiased scientific information. There are lots of independent publications about drugs pretty much all around the world like Prescrire, but they’re surprisingly little known and overlooked.

3 – Nourish your networks
It is likely that during vocational training you had the chance to attend many national and international conferences, meet colleagues, and make new friends. It is during vocational training that solid professional contacts are made, but these contacts need to be maintained afterwards. After all, you will still continue to need reference letters, partners for international collaborative research projects, co-authors for academic papers, or simply to exchange professional remarks and information.

4 – Be an eternal apprentice
One leading senior Brazilian GP I know told me he tries to organise an informal one week educational visit once a year to a renowned colleague in some part of the world in order to learn about different ways of organising healthcare and practising clinical medicine. The knowledge, skills, and contacts acquired in this way are priceless. Moreover, it is also a great way to travel and get to see new parts of the world.

5 – Go back to school
If you haven’t had time so far, and you’re keen to continue studying after vocational training, it might be worth pursuing a Diploma, Masters, or PhD program, depending on your own level of funding, time, and ambition. An academic degree will make you stand out when applying for jobs and may provide a breath of fresh air and make you feel intellectually refreshed, as it is so easy for clinicians to stop feeling that clinical medicine remains intellectually fulfilling and challenging.

6 – Be sceptical, curious, restless, and persistent
At the end of the day, the most important thing is to maintain a permanent attitude of scepticism,  curiosity, and restlessness towards what we think and do in our daily work. Otherwise, it is difficult to continuously improve our clinical practice as we will be repeating the same mistakes over and over again. During a day at the health centre, I usually write down on a piece of paper doubts, clinical queries, or review topics  that come up during the consultation, and subsequently I try to do some targetted reading about these topics. Of course, persistence is also important, because as someone told me once, in the long term, persistence is a more important attribute than intelligence.

Tiago Villanueva is a GP based in Portugal and a former BMJ Clegg Scholar and editor, studentBMJ.  He is a member of Healthy Skepticism.