![\"Picture1\"](\"https:\/\/blogs.bmj.com\/adc\/files\/2016\/04\/Picture1.jpg\")
You’ve made it. You have new shoes. You cut your hair and filed your nails.<\/p>\nYou’ve made it. You have new shoes. You cut your hair and filed your nails.<\/p>\n
What else do you need to do to get through your first few months as a new Consultant?<\/p>\n
Well, nobody can tell you precisely how to survive your first few months as a consultant.\u00a0 However, Ian, Vin and Helen\u00a0do have a (quite a few) thoughts that you may find helpful.<\/p>\n
<\/p>\n
<\/p>\n
Even with contracted training you\u2019ll have spent at least seven years working towards a fairly single minded goal:\u00a0 becoming a consultant.\u00a0 When you get there, you\u2019re likely to find that it\u2019s pretty different from what you may have expected.\u00a0 For us, it was the second most difficult career transition we\u2019ve had to make \u2013 the first being the transition from being a medical student to being a doctor.\u00a0 There\u2019s a sense in which we all imagine that the appointment at consultant grade comes with the intellectual equivalent of the keys to the executive washroom \u2013 some sort of certainty and confidence, ability to deal with all problems as they arise, and the full package which you may have thought that the more senior consultants have.\u00a0 It doesn\u2019t.\u00a0 The ability to be a consultant takes time.\u00a0 Take time to cultivate it.\u00a0 In fact, clinical situations that you would have hitherto managed with your eyes closed may send you scuttling back to the textbooks in search of added confidence, so prepare yourself for professional doubts and uncertainty.<\/p>\n
<\/p>\n
The culture shock comes in a variety of forms.\u00a0 It may be the previously aloof elderly consultant greeting you warmly and insisting from this moment on that he or she is addressed by their given name; your peer group now spans decades rather than years.\u00a0 It may be the fact that when you see a child in clinic the buck stops with you \u2013 or at least it feels that way.\u00a0 It may even be the realisation that after a decade of moves every six months, now you\u2019re going to spend the next two or three decades in pretty much same place.\u00a0 Don\u2019t underestimate the degree of disorientation that this can induce; be ready to reflect on it, sort out how you feel about it, talk about it, or whatever else works for you.<\/p>\n
\u00a0<\/strong><\/p>\n All trusts will require that you attend a formal trust induction.\u00a0 The usefulness of this will depend on your trust.\u00a0 It will, however, be mandatory and will, if properly organised be very helpful in avoiding the need to attend, for example, a fire lecture for the next year.<\/p>\n <\/p>\n What we mean here is to give yourself the opportunity to meet the people you\u2019re going to be working with, and work out how systems function in your organisation.\u00a0 You should negotiate that you spend your first week on this \u2013 and if you think that this is excessive, it\u2019s worth noting that many successful organisations spend weeks on induction, and that senior NHS managers \u2013 who will move more than you are ever likely to now that you have a senior post \u2013 will usually spend their first two weeks working out who is who in the organisation.<\/p>\n <\/p>\n People to meet during induction should include:<\/p>\n <\/p>\n The questions you ask in induction can range from the very simple \u2013 where do I find the toilets \u2013 to the potentially very nebulous \u2013 how do I begin to fit in with the strategy of this organisation.\u00a0 Note that induction of this sort is as important \u2013 perhaps even more important \u2013 if you are just changing role from junior to senior or locum to substantive in the same trust.<\/p>\n <\/p>\n You might turn up on your first day and discover at least one or more of the following (all true examples from friends or colleagues):<\/p>\n It\u2019s easy to find this very frustrating, and we would agree that it hardly gives the impression that you are valued.\u00a0 Nonetheless, however easy it is to take it personally, don\u2019t.\u00a0 It\u2019s not intended; it\u2019s just an occasional consequence of working in an environment as busy and complex as healthcare.\u00a0 Just keep on asking the right questions of the right person \u2013 your directorate general manager would be a good person to start with.<\/p>\n <\/p>\n There are very many sorts of mentor.\u00a0\u00a0 We can\u2019t tell you how to choose a mentor \u2013 you need to do this yourself, based on what your needs are, and how you like to discuss things.\u00a0 If, for example, your preference is for a discussion over a pint, then you wouldn\u2019t chose someone you know to be teetotal.\u00a0 You don\u2019t have to meet with them that often, but some advice from time to time can be very helpful. \u00a0It\u2019s worth thinking of having two or more mentors:<\/p>\n Ideally this will be someone who knows a bit about the hospital; somebody who has been in post for five years or more.\u00a0 They don\u2019t need to know your department \u2013 in fact, it can be an advantage if they\u2019re unfamiliar with it.<\/p>\n Rarely you might find that you are provided with a mentor.\u00a0 This is fine; you may well get a lot from them, and get along well with them.\u00a0 However, you ought also to find somebody who you actually want to be your mentor too.<\/p>\n In addition, many people value the support they get from having another recently appointed consultant to meet up with regularly, either within their trust or from further afield.\u00a0 An informal comparing of notes can be very helpful.<\/p>\n <\/p>\n Some senior consultants counsel their newer colleagues to \u201cSay no to everything in your first year\u201d.\u00a0 There\u2019s some sense in this, but it goes a little too far.\u00a0 It is true that it is flattering to be invited to sit on senior committees, to be someone who people go to for their opinion and enthusiasm, and it is easy to regard the relative paucity of appointments in your diary in the first few months as an invitation to fill the time with each and every request.\u00a0 Hence, \u201cJust say no\u201d can be quite protective against overload by the end of your first year.\u00a0 However, if you\u2019ve got through this first year and have done nothing but the very basic level of activity, then are you really fulfilling your potential?\u00a0 Isn\u2019t this just as bad \u2013 if less tiring \u2013 than just saying \u201cyes\u201d to everything?\u00a0 Our opinion would be that it\u2019s better to have a clear sense of what your values are, and what you want to do, and then to try to agree to the things that fit with this \u2013 and reject the things that don\u2019t.<\/p>\n \u00a0<\/strong><\/p>\n Few of us are fortunate enough to have careers free of patient complaints, and we all have thoughts about what this might feel like when it eventually happens.\u00a0 There are two main things to consider about your first complaint when you receive it:<\/p>\n <\/p>\n Yearly appraisal is a mandatory part of your career as a consultant.\u00a0 Most people in industry regard the idea undergoing appraisal just once a year as woefully inadequate, and waiting a whole year before having your first appraisal is probably too long.\u00a0\u00a0 You\u2019ve got a big advantage \u2013 you\u2019re used to appraisal and know, roughly, what to expect from it since it formed a major part of your training.\u00a0 It\u2019s not unreasonable to plan to have an appraisal four months into your new post.\u00a0 It will serve as a useful point to sit down and discuss how you\u2019re doing and any troubles you\u2019re having.\u00a0 It will also help get you used to the paperwork.\u00a0 Note, also, that appraisal will feed into revalidation \u2013 which will be the process by which you will retain your right to practice, so you need to be on top of it.<\/p>\n \u00a0<\/strong><\/p>\n Further reading<\/strong><\/p>\n Now no-one can hope to\u00a0be able to give advice about many of the issues we\u2019ve faced in the years since we became consultants.\u00a0 However, we found the following books useful \u2013 especially if you read lightly, dip in and out, and discard the parts you don\u2019t like or don\u2019t find helpful:<\/p>\n <\/p>\n\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n