Recent issues of The Endocrinologist have outlined some helpful ways to negotiate specialty training, but haven’t yet tackled what to do when the final ARCP (Annual Review of Competence Progression) hurdle has been vaulted, and you stumble over the finishing line into that first consultant role. In the modern parlance, what follows are some ‘lifehacks’, or shortcuts, to ease that first year.

 

THE RIGHT TOOLS FOR THE JOB

The worst aspect of specialty training is the paperwork, with the spectre of unticked ePortfolio boxes an eternal haunting presence, only relieved by the hope that it will, one day, all be over. I’m afraid that this is a forlorn dream, as the reward for ePortfolio completion is to be made responsible for half a dozen more. Advice such as ‘Don’t do what I did’ will only take supervisees so far, so some formal training early on is a good idea.

As a bonus, you will also be signed up to your trust’s own particular appraisal programme. If used correctly, this has the potential to be one of those rare sequels that is better than the original. You may previously have regarded those colleagues who were capable of coherently answering the question ‘Where do you see yourself in 5 years?’ with justifiable suspicion. If used correctly and with the right support, the appraisal process can actually help you figure this out and plan to get there. There is no upside to the use of job-planning software, however; this will require the help of someone your trust has seconded from NASA.

 

MAKING IT PERSONAL

First impressions count in any new job, but even more so when you aren’t going to be moved on in 6 months. It is therefore vitally important to learn everyone’s names, as they could be your colleagues for the next 30 years.

Establish oneself as a benevolent presence by sending a few people home in the first week if they look as though they may have a cold. This is the equivalent of an old fashioned centre-half getting a ‘reducer’ in early in a football match to show they mean business. Publicly insisting that the registrar who was your fellow trainee a few months ago now address you as ‘Dr Smith’ is likely to make the wrong sort of first impression, even where that is your actual surname.

 

DON’T SUFFER IN SILENCE

Autonomy and responsibility are two sides of the same coin. Expect to come down with a virulent strain of ‘imposter syndrome’ early on, but don’t suffer alone. Your new consultant colleagues won’t think you’re a fraud if you ask them for advice. In a meeting, if there is something you don’t understand, but you think you should really know by now, you’re allowed to ask for clarification ‘for the students in the room’.

Learning how to properly manage a case for its own sake, and to look after a patient well, is a much more rewarding experience when it doesn’t have to be linked to a curriculum. Take advantage of your junior colleagues here, by expecting them to report to you on the latest guidelines for management of submassive pulmonary embolism, for instance, before you will sign their CPD request.

 

FOLLOW YOUR INCLINATIONS

The standard advice meted out to new consultants is to be careful not to say ‘yes’ to everything, lest you find yourself in committee meetings to decide on who should supply new light bulbs for the outpatients’ department. There is truth in this, but it’s just as important to seek out areas that you are really interested in, to start to carve out a niche.

If teaching is your passion, for instance, find out who is in charge of medical students on the firm, and if they’re ready to pass that baton on. If you have a flair for IT, and you’re convinced that the new electronic record system can’t really be as bad as everyone says, volunteer to help fix it. If you take on these types of role with one eye on a future clinical excellence award, rather than for their own satisfaction, you may find that they’re more of a burden than a pleasure.

 

MAINTAIN A BALANCE

Finally, a national conversation about physician burn-out is thankfully starting to take place in the UK. Establishing a healthy work–life balance right at the outset of a consultant career will serve you well in this regard. Not taking paperwork home with you is key, so proper planning of your SPA (supporting professional activity) time is vital.

Cultivating those hobbies and relationships that took a backseat during the itinerant life of a registrar will also make an important contribution, although after you’ve paid the General Medical Council for your full registration you might not quite have the funds to do so straightaway.

 

Dominic Cavlan

Barts Health NHS Trust, London