To CESR and beyond

1. To CESR and beyond by Dr Chris Ubawuchi MRCPsych Consultant Psychiatrist Lancashire Care NHS Foundation Trust

2. PMETB Survey 2008 • How careers of successful applicants develop after certification. • How quickly successful applicants were employed. • Type of certificate and likelihood of employment. • Whether the various certificates were considered to be sufficient for employment at consultant/GP level? • Clarity of recommendation on top-up training or submission of additional evidence .

3. Applications by route with decisions issued during survey period.

4. Trends 1. • Majority followed expected career pathways. • Significant proportion of associate specialists (58%) remained in their roles. • CESR applicants went into a broader range of roles vs SRCCT applicants. • Majority (65%) of doctors in staff grade posts at the time of CESR application took up roles other than consultant (locum consultant, associate specialist, trust doctor) or remained in staff grade posts after certification.

5. Trends 2 • 44% of locum consultants at the time of CESR application remained as locum consultants post certification vs 27% of SRCCT. • A small proportion of trainees with SRCCT and CESR certification remained trainees (14 and 12% respectively).

6. Trends3 • 78% of UK -based after certification and working as consultants and GPs took less than 6/12 to secure post. • CESR respondents appeared more likely to take longer than 6 months to take up a post at the substantive level. • 39% had not taken up a substantive consultant or GP post. • Type of certificate seemed to have no impact on the likelihood of applicants taking up substantive posts.

7. Trends 4 • 98% of substantive consultant/GP post certification felt qualified and had sufficient experience to take up such posts. • The two main reasons were in relation to management and feeling that more training/experience was needed.

8. Planning post-CESR • Information gathering and setting goals. • Identifying new learning needs and creating development plans. • Self evaluation(strengths and weaknesses). • Improving weaknesses and enhancing strengths. • Developing leadership and management skills. • Planning and taking responsibility for personal, educational and career development.

9. Planning process Pertinent questions • What do I wish to achieve over the next few years? • What training or resources would this require? • Would this need a change in my current job? • Strengths? • Weaknesses? why ? resources, further training, personality, systemic. remedies? • What guidance or help do I need? Who? How? • Clinical/training/organisational.

10. Applying for consultant posts • Consultant CV preparation. • Consultant interview preparation. • Career development courses. • Consultant interviews. • Securing a substantive post. • The dilemma of choosing.

11. The new consultant • Huge sense of achievement. • Feeling more empowered/ more independence. • More autonomy. • Competent to lead team, caring for patients without direct supervision. • Pressure and anxiety. • Surviving a period of uncertainty – up to the job? • Living up to your own, colleagues’ and employer’s expectations.

12. Developing core skills for new consultants • Becoming a consultant is just a step on the career journey • Key challenges facing a consultant (multi-faceted) • Key transitions • Understanding Trust priorities: drivers and impacts. • Trust vs clinical responsibilities • New role, new priorities - unique elements of the consultant role

13. Self management • Achieving balance between clinical and non-clinical priorities (PDP/Job planning/appraisal) • Time management/greater delegation. • Work -life balance. • Support mechanisms - balancing self-reliance with support from a mentor. • Trust and probity. • Responsibility for self development.

14. Managing others • Effective leadership. • Developing a unique team. • Setting clear direction • Environmental manipulation. • Delegation. • Conflict resolution.

15. Service governance • Balancing responsibilities. • Audits. • Clinical risk management. • Complaints, SUIs and individual liability • Avoiding complaint escalation. • Directorate and Medical Staff Committees. • Service redesign / modernising services. • Understanding NHS organisational structure.

16. Training, leadership and supervision for junior doctors • Model for juniors. • Development as clinical/educational supervisor. • Preparing your trainee for ARCP. • Balancing clinical & educational priorities • Mentoring. • Doctors in difficulty. • Addressing development as a teacher in PDP. • Pastoral care.

17. Working with commissioners/stakeholders • Working with stakeholders. • Business planning. • Prioritizing. • Supporting medical managers. • Delivering effective service. • Negotiation and Assertiveness.

18. Aspiring for excellence 1 • Commitment to patient care and wellbeing. • Setting high standards. • Providing patient focused care. • Professional leadership. • Commitment to the values and goals of the NHS. • Annual job planning. • Observing Private Practice Code of Conduct. • Commitment to achieving agreed service objectives

19. Aspiring for excellence 2 • Active participation in clinical governance. • Evidence based practice. • Contributing to knowledge base through research. • Excellence in teaching and training. • Contributing to policy making and planning.

20. Prevent burnout. • Welcome change as a opportunity not as a threat. • PDP and Job planning. • Maintain good relationships at work. • Control demands (unreasonable/unrealistic). • Have outside interests – get a life! • Physical fitness, healthy lifestyle, family/friends • Talk to others. Seek help if necessary. • Prevention is better than cure.

21. That’s all, folks !