It is not easy to make the transition from
trainee to consultant. Although trainees find they are well
prepared for clinical work, the greater volume of work and new
leadership / management responsibilities are often challenging
(Houghton et al, 2002). New consultants are expected
to chair meetings, provide support and leadership to teams, deal
with difficult colleagues, interview new staff, provide training
and supervision, as well as preparing business plans and developing
Trainees are advised to obtain practical
leadership and management experience and attend theoretical courses
(Houghton et al, 2002). Invaluable experience can be
gained by undertaking a locum or ‘acting’ consultant post,
especially a locum post where you hope to obtain a substantive
Applying for a consultant post
Your first consultant job should be a job that
you really want to have, with colleagues that you like, where you
will enjoy working. It may be worth imagining what this ideal job
would be like (Houghton, 2003) and then looking for a job to match
your specification. Let senior colleagues know of your interests,
in case a job is likely to become vacant soon.
Factors to consider when applying for a
consultant post include:
Location is important, especially if you have
personal / family commitments. Moving home or commuting long
distances are additional stresses to consider. Isolation from
family and friends when your work is far away from your home can
add stress during the transition to being a consultant.
Consider the catchment area carefully, taking
heed of the level of social deprivation and the type of work. It is
advisable to look for less obvious duties and responsibilities, for
example care of asylum seekers, prisoners or the close proximity to
a port. All of these could affect the intensity and type of work
that you might be expected to do.
Check to see whether you have the relevant
experience. Clues about the intensity of work are often in the
person specification such as ‘must be able to work well under
extreme pressure’. Are you excited about the job? Only apply if you
really want the job.
Colleagues and department
It is worthwhile checking the
history of the post including reasons for the vacancy. For a new
post, consider the possibility that the post may contain parts of
the service that other consultants do not want. Ask yourself such
- How well does the service
- Who will be your manager?
- Will you enjoy working with the
- Do you like and respect your prospective
consultant colleagues and are they likely to be supportive towards
It is advisable to read the information about
a post carefully. Before you go to the interview, arrange to meet
prospective colleagues and senior management and visit the
services. Even if you have worked there previously, the visit is
likely to be time well spent.
Employment contract and Job Plan
When appointed, you will have to work
according to a Job Plan. There will be fixed sessions for clinical
duties, administration, continuing professional development (CPD)
and possibly research. Information should be provided on the
expected case-load, catchment area, on-call duties, study leave
arrangements, the employment contract and salary. Administrative
support should be provided such as secretarial assistance, your own
office, a computer and access to the email system. Further
information regarding Job Planning can be obtained from the RCPsych
College Report CR174: Safe patients and high-quality services: a
guide to job descriptions and job plans for consultant
Before applying for the post, it is advisable
to discuss the employment contract and job plan with senior
colleagues and to obtain advice from a professional adviser, for
example from the British Medical Association. If you have concerns,
you should aim to address these before interview, although there
may be opportunities following accepting a post in principle.
Explore the financial situation of the organisation. Is the service
in debt, due for significant reorganisation or expecting cuts in
services or staff?
Managing the transition
The administrative workload is much greater
for a consultant, with swathes of emails, government and local
documents to read and committee meetings to attend. Not only will
you have to see the patients but also you will probably have to
organise clinics, manage waiting lists, keep the service on track,
supervise trainees and build working relationships with a wide
range of staff, many of whom, if not all, will be new to you.
Attending local management meetings will
orientate you to service developments and local politics. You may
have to bid for resources, write business plans and be involved in
making decisions about cuts in services.
Good organisational skills are needed to avoid
being overwhelmed by multiple demands on your time. It is crucial
to attend to fixed commitments so you will have to prioritise,
delegate and manage your tasks. Key success factors include
effective time management and the ability to plan ahead. Be
prepared to say ‘no’ to taking on extra demands, especially at the
beginning. If you are being swamped with work, review the pattern
of your work and seek advice from your mentor.
Apart from being pleasant and calm, an ideal
secretary (or personal assistant) will have good organisational
skills, type accurately and be able to take minutes. They may know
how the organisation functions and can identify decision-makers. If
you are willing to listen to their advice, they will tactfully
guide you through the transition. You can help by giving clear
instructions if a task needs to be completed by a deadline so they
can prioritise their own work.
It is not unusual to worry and to wonder
whether you will be able to cope. New consultants often feel
isolated and may not know where to turn for advice and help. Before
you begin your new job, it is a good idea to identify someone to
whom you can turn for advice. This person could be a previous
trainer or a newly identified mentor.
It is important to maintain integrity and
probity. Some new consultants have problems managing the increased
power that comes with their new role. Remember you are being
observed in your interactions with others. Unless you have worked
in the organisation before, most people will know who you are well
before you know them. Avoid making inappropriate comments and bear
in mind that colleagues may be related to one another. Address
issues promptly rather than leaving them as you will not be moving
on in the next few months as you did when training.
The Royal College of Psychiatrists recommends
that all new consultants have access to a designated senior
colleague – a mentor, who can provide advice, support and
information, which is especially important in the early days of a
new job. Many organisations can provide a new consultant with a
list of colleagues who have volunteered to be mentors. It is not
compulsory to have a mentor, but having someone you can trust to
talk to and who can offer sensible advice can help to reduce stress
and uncertainty at this difficult time of taking up a new job. A
mentor’s support can also help to broaden your skills effectively
StartΨell is a Consultant led initiative for
Psychiatrists in their first five years as a Consultant or Locum
StartΨell focusses on 6 elements to support
Psychiatrists in their first consultant role with the intention to
establish good habits for their careers:
- Using support
Further details can be obtained from the
Tips for looking after
- Be aware of your personal safety in your new
environment. Learn about local policies and procedures, attend
promptly to occupational health requirements and take part in
induction courses and essential training.
- Discover how your performance will be
measured, whether it will be for example by the number of
admissions, length of stay of patients or the number of ward rounds
- Maintain confidentiality and keep good
records. It takes only a few minutes to dictate or make a file note
of telephone contacts, interviews and meetings. Ensure appropriate
entries are made in the clinical record each time that you see a
- Obtain professional insurance by becoming a
member of a medical defence organisation. Ensure that your name is
on the Specialist Register of the General Medical Council and that
you are registered to implement relevant mental health
- In the first few months, arrange to join a
peer group, create your personal development plan and start
collecting the evidence of attendance at CPD events, which you will
need for your annual appraisal. Book study leave in advance and
arrange cover for absences.
Family, friends and interests will help to
keep a balance in your life. Plan your holidays well in advance so
work commitments and on-call duties do not have to be rearranged at
short notice. If you do have the misfortune to fall ill, seek help
and allow yourself time to recover.
- Hougton A., Peters, T. & Boulton, J.
(2002) What do new consultants have to say? BMJ Career
Focus, 325, S145a.
- Houghton, A. (2003) Getting that all
important job. BMJ Career
Focus, 326, S143.
This information guide is intended for a trainee psychiatrist
who will become a consultant. The information can be used as a
guide only and is not a substitute for professional advice. If you
need further advice and support, please contact the Psychiatrists’
© Royal College of Psychiatrists 2017
If you require advice and support about a particular issue then please contact the
Psychiatrists' Support Service at the Royal College of Psychiatrists on 0207 245
0412 or email
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