Seb Gray, Nick Schindler, Rachael Mitchell, Nancy Bostock, Nikhil Ganjoo, Ollie Bevington, James Dearden, Louise Budd, Tom Whitby & David James

This post is part of our Consultant Life seriesmore coming soon!

Nobody can prepare you for the last stint of paediatric training. Whether you’re one of the few who flew straight through the run-through programme or whether you took the scenic route, the insecurity of not knowing if or where you’ll get a job is a novel and not particularly nice experience. You are not alone in feeling this and with the evolving Stepping Up groups and mentorship programmes, hopefully support structures have improved. This piece focuses on the light at the end of the tunnel – CCT and that first consultant job. What do you need to do practically alongside some top tips from some of the RCPCH Trainee Committee alumni who are going through the process now or have been through it in the last few years.

Certificate of Completion of Training (CCT)

Once you have the golden outcome 6 from your ARCP, you are eligible to apply for CCT. Outcome 6 confirms that you are ‘fully cooked’ having completed a minimum of four years in a GMC training programme and kept your school board happy enough. Don’t worry – the four years is a GMC minimum requirement not specific to paediatrics and not another twist in the tail of the shape of training. Whilst there has definitely been a move away from the tick-box requirements of paediatric training, there are still numerous boxes to be ticked to ensure there are no unnecessary outcome 6 barriers. Embracing Kaizen and building it into your everyday practice from the earliest opportunity will save hours of retrospective learning entries (although we appreciate that if you’re reading this now, it may be too late for that!).

Once you’ve been given your ARCP outcome 6, you can create a new event from your home page/ dashboard on Kaizen – “Completion form (CCT and CESR-CP)” but you will need to have a couple of bits of information ready. These include:

  • A CCT-specific CV which needs to contain certain essential bits of information about everything from when you started paediatric training (example template below):

o   Title of post (including grade and specialty)

o   Exact dates on which the post started and finished (having a smartphone calendar is particularly useful for this)

o   Full time or less than full time (including how LTFT)

o   Duration (pro rata if LTFT)

o   Name of the hospital or centre with full address

o   Name(s) of supervisor(s)

o   Outline of duties undertaken (be brief, it doesn’t need excessive detail)

o   On-call ratio (e.g. 1:5; don’t worry about getting this exactly right – if you don’t know, nobody else will!)

  • Date you completed MRCPCH 

This then gets submitted to the RCPCH Completions team who double check everything before forwarding to the regional lead and Head of School for sign off. It then gets returned to the RCPCH admin team for one more check before going to the RCPCH Officer for Training for final sign off. This process takes approximately three weeks if there aren’t any anomalies. You will be contacted if any further details/ clarifications are required which might delay things a bit more and if applying during peak holiday periods there may also be a delay.

If you haven’t been advised to use a CCT-style CV throughout your training, it’s worth asking around recently appointed local consultants. Having a template with similar rotations not only saves time completing the same rotations but gives a clear guide of what’s expected. There are examples on the RCPCH official CCT guide website.

Applying for Consultant Jobs

The old school screening method of perusing the back pages of The BMJ doesn’t quite cut it these days and you’re likely to miss some excellent opportunities. Social media always seems to be brimming with innovative new roles but will also only show you options within your own echo chamber. The best way to make sure you don’t miss anything is to sign up to NHS Jobs. If you register what jobs you want to do and where, you’ll receive updates and you’ll never miss the chance for that dream job. 

Even if your dream job hasn’t yet made it onto NHS Jobs, you can start getting the ball rolling. The application forms don’t significantly vary and applications can be started and saved without submitting. We’d suggest finding a job similar to the one you’d like to do and start filling in the form. The clinical lead for the centre advertising the job will receive a notification email but this is anonymised and they should know that it’s not an application until the “submit application” button has been clicked. One way to ensure you upset prospective employers is to use a previous application without fully scrutinising the form so be careful not to mention how much you enjoyed working in Hospital X when applying to Hospital Y (particularly if local rivals!). 

You can save your application on NHS jobs and import sections of it (like your personal details and job history) into a new application. This major life hack doesn’t seem to last forever though, and some colleagues have been caught out and had to start from scratch, so remember to download a version of it, or keep your employment history copied in a word document. It could save you a lot of time in the future.

As mentioned already, nobody can prepare you for this final lap in the paediatric training marathon. Jobs that you seemed destined for may not materialise and others are clearly written with specific people in mind. It is however not over until the fat lady sings and the experience of applying and interviewing is invaluable even if you’re not successful the first time round.

The majority of us started in locum posts and it’s relatively rare to jump straight into a substantive consultant post. Whilst consultant movement is still rare for substantive posts, they are also not set in stone. Either way, having experience as a consultant certainly works in your favour when applying for posts. As you reach the end of training, you’ll experience an invisible pushing sensation towards applying for a consultant post. There are other options though. Numerous interesting fellowship posts are advertised frequently across the UK (and overseas during non-COVID periods). Just taking some time to yourself having been on the training conveyor belt for so long can be reinvigorating and invaluable to your long-term wellbeing.  

Ask your most honest colleagues and friends whether a role is suited to you or not. It’s amazing how many people will retrospectively comment that they didn’t think you were a fit for certain roles once you’d tried and failed to get them. Take a step back and really think about what’s important to you. Are you happy doing resident night shifts until you’re 50 if it means you have a 4-day working week? Can you cope with that obnoxious old consultant for the next few years until they retire? Are you so desperate to stay local that you’d consider adapting to any specialist interest? Would you be happy to be anywhere in the country as long as you get to only focus on your beloved <enter most loved organ here>?

Different people will prioritise things in different orders and what’s important to you should take priority. It is absolutely true that you will spend a similar amount of time with your work family as your actual family. It’s important that you like them and that they will have your back when life throws you ups and downs. 

It’s also just as important to have diversity within a workforce. A consultant cohort of like-minded people with similar demographics is suboptimal for reflecting the patients we look after. You need the devil’s advocates (and angel’s advocates) for balance and avoiding complacency.

Sub-specialists have already decided they want to work focussing on their chosen area and have likely accepted they may have to either move or be patient to get their substantive job. SPIN doctors may feel pigeon-holed if jobs come up with interests desirable in a different sub-specialty. However, completing a SPIN gives you translatable skills and post-CCT SPIN development is a definite option. By getting the SPIN signed off, you’re a proven completer-finisher and can emphasise that you’re willing to apply that approach to this new opportunity. Everyone will be doing a different job in 10 years to the one they’re currently doing and adaptability with enthusiasm is an attractive quality. There will be consultants in your department who have changed their specialist interest or gained a new one post-CCT. Ask them about it and don’t be afraid to ask the clinical director what areas would be of most use to the department. 

Watch this space for our next installment – preparing for Consultant interviews!

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