First 100 days as a Consultant

Becoming a consultant can often be a significant step up in role and responsibility. We are often well prepared to deal with the clinical demands of being a consultant but less frequently full prepared for the non-clinical tasks that come with the role. This guide may serve as an overview of some of the commonly encountered issues and accompanying solutions to help a new consultant quickly ease into their role.

General thoughts

  • Remember this is a new role and settling in can take time. Try and avoid taking on extra roles until you do feel more settled.
  • Take the time to book annual leave in advance – this means you get leave when you want it and have something to look forward to!
  • Use your study leave. Most trust provide 14 days of study leave per year and most consultants do not use it up. Mandatory training can count as study leave – consider doing this on a study day rather than in your free time!
  • Take the time to agree a job plan with your secretary so that you can both agree how they can best support you in your role. 
  • Keep in touch with colleagues and take the time to support each other - we have all been new to a job at some point. Some institutions may even have an informal peer support network for new consultants – use all of the support you can get!
  • Working ‘al desco’ is not a good lunch time habit. Even spending 15 minutes in the canteen or break room with colleagues is often a good way to mentally refresh and prepare for the afternoon.
  • Don’t feel that you have to now, as a consultant, be able to independently manage every problem within your specialty. Even the most capable and experience consultants need to seek advice from colleagues at times. 

Admin

  • Responsibility for filling results and acting according is now ultimately your responsibility. Keeping on top of the results list can is an important way of minimising clinical risk and guaranteeing patient care. It is worth encouraging the ward teams under your supervision to keep up with the filing of results for inpatients.
  • Admin always takes longer than you think. Ensure you make the most of the time available to stay on top of it. For some people this might mean filing routine results (which often does not require much though) first thing in the morning at work or for a set period during lunch time
  • Checking relevant results whilst authorizing letters can often save some time in the long run
  • A task list can often keep you on track!
  • There is often useful information about upcoming changes or challenges your organisation sends via email, so try to ensure you keep up to date with your emails. That said; some days the email traffic can be simply overwhelming. Consider setting up an inbox file for circulars to keep for reading later.
  • Try and attend departmental and governance meetings. The issues raised are often pertinent to your work – even tangentially. Additionally, such meetings are usually enhanced by wider engagement within the consultant body and other colleagues may feel less burdened knowing there is good attendance.

Supervising doctors

  • Ensure you are aware of any trainees you provide education or clinical supervision too. You may wish to email them to ask that they make an appointment to meet you. 
  • Ensure you are familiar with your trainees’ curriculum and curriculum platform – horus etc.
  • Consider how you could engage with training and educating junior doctors in the course of your clinical work. Offering Workplace based Assessment or WBPA to junior doctors whilst on the ward round can be a good way to engage and educate them and can take some of the pressure away from the trainee. 

Complaints, incidents and legal interactions

  • Complaints can be distressing but are relatively common. Often the issue (or issues) may be entirely out of your control, and you may even feel you have done a good job. Commonly the complainant is only seeking further clarification. Colleague support and a dispassionate approach can often help with process. 
  • Witness statements for a coroner’s inquest (or procurator fiscal) are also surprisingly common. As with complaints, a witness request is rarely a sign of personal clinical failing. An inquest can be held for several reasons including concerns raised by relatives or to rule on an occupational disease as the cause of death. The role of the coroner’s inquest is not to apportion blame but to establish the identity of the deceased and the location, time and cause of death. Although there is probably local guidance on how to write a report it is definitely worth speaking to a colleague and reading a previous statement they will have prepared.
  • Inquest summons. Occasionally you may be summoned to an inquest as a witness to provide your statement and assist the coroner (or procurator fiscal) in their investigation. This is a statutory obligation. Your trust will have a liaison team to help and guide you through the process, and you should meet with the trust solicitors to help you prepare. It would also be wise to contact your personal indemnity society to provide independent advice and guidance as there is always the risk of a conflict of interest between yourself and the trust. Once again you will have seasoned colleagues to talk to for support and guidance.