Applying for a Consultant Physician Post

Stirling Pugh, PhD MSc Med Ed FRCP FHEA

Recent Regional Advisor (Training) RCP, recent Associate Post Graduate Dean, previous AAC panel member, previous Clinical Director

This page is aimed at Higher Specialty Trainees in their penultimate or final years. However, we expect that you have been thinking of your consultant post for sometime before this.

Ideally, before you chose your specialty you had some view of the sort of consultant you wanted to be, and the sort of hospital and department you wanted to end up in. Hopefully your abilities and performance during your training years is aligned with your aspirations.

Clearly, as you come to the end of your specialty training, you are fairly committed to your specialty. Fifteen to twenty years ago it was perhaps more possible to change in the final years to another specialty if you found that your abilities did not match your aspirations. Despite the intention of MMC allowing freedom of transfer to other specialties, in reality this is unlikely to be possible without a reasonable period of retraining. Therefore, if you have any doubts now is the time to speak.

Doubts, or not, arrange to meet with your Educational Supervisor to discuss your intended applications. Raise this at your Penultimate Year RITA/ARCP. Get feed back from the panel on whether they agree with your intentions.

Whether we like it or not some jobs in some areas will attract higher quality candidates than others. Consultant applications will be perhaps the most contested process that you will have faced in your career. It is important to be optimistic but realistic and prepare properly.

Teaching Hospital or District General Hospital? It is not a case that one is better than the other, but for your happiness and the harmony of the department you join, it is best to try and fit a round peg in a round hole. You may think this is stating the obvious, but I have had discussions with a senior trainee who suggested applying for a job in a major teaching hospital with an international reputation for research, when he had done no research, had no higher degree, had not given a presentation at a National meeting and never applied to a grant awarding body. There is nothing to stop you applying for such a job, but don’t be surprised, if you are in this position, that you don’t get shortlisted. However, if shortlisted, and appointed would you be happy in such a unit?

Step One: Which type of Job

If you have not already done so spend sometime looking through your CV, your previous choices will tell a lot about you. Think about which jobs you enjoyed and why.

Where in the country? You may have very good family and personal reasons for needing to be in a certain area. Otherwise, are you looking for city, urban or rural hospitals?

Large or small? There is a lot to be said for both. There are still a few small units or smaller specialities where you could be the only consultant in your specialty. This allows a greater degree of autonomy, but you need to be self-reliant and ‘a Jack of all Trades’ within your area. Larger hospitals and units may seem more protected for the new and nervous consultant, but may ultimately be constricting and stultifying. In the worse case very large units can split into tribes with open antagonism between groups of consultants.

But, be flexible and look to the future. Don’t close doors or say to yourself “I’m never going to apply for a job in …”

Step Two: Preparation

Start reading the job adverts

Get your CV ready; get it reviewed by a consultant you know that has done lots of interviewing and selections, (likely to be the most senior). Don’t be frightened to ask, most consultants are flattered to be asked, and helpful, not least because successful appointments from their department reflect well upon them.

Consider the three parts to your CV, evidence of ability to do the main specialty, evidence of a sub specialty interest, and evidence of additional skills (Medical Education, Management, Research, Risk Management, Medical Law etc.)

Start sending for Job Descriptions. Match yourself against the person specifications.

Step Three: The application

Be serious. Don’t be make trivial applications. If you want the job go for it, if you don’t leave it alone. Practice applications are not realistic.

Get the job description and person specification. These days you can review the hospital and department website. Discuss the post with your Education Supervisor. Discuss the town and area with your partner (I’m not joking!)

Make a list of things you still need to know and phone to discuss your application with the contact numbers on the job description.

Make a visit before applying. This is the big one. This is where you may work for the rest of your life. This is where you and your family will live, retire and possibly die. I can never understand how an applicant can expect to be taken seriously if they apply for a post without ever visiting the hospital and area.

The pre-application visit is your chance to interview them (discreetly) and your chance to walk away with no loss of face or inconvenience to anyone but yourself.

Submit your CV. Make sure it is adapted and honed to be appropriate for the post. If the Job Description asks for a sub specialty interest make sure your CV gives appropriate prominence to the evidence you have of your ability to supply that sub specialty.

Visit again. Prepare for the visits by making sure you see all appropriate people. Try to see all the consultants in the unit, see the Clinical Director, the Medical Director, and the Surgical Clinical Director if your specialty has close dealings with surgeons. Don’t forget the managers. Try to visit the CEO, some allow visits (good sign), some don’t (in my opinion a bad sign – but remember CEOs are temporary compared to your future consultant colleagues.) Again, I don’t know of anyone who considers an applicant to be serious who only visits on the morning of the interview. Frankly, I wouldn’t shortlist them, but in employment law, if you apply and meet the person specification you will be interviewed if there is capacity to do so. As Clinical Director and Regional Advisor I have interviewed such applicants generally the interviews were a waste of time for both parties and did not result in appointment.

Step Four: The Interview

Prepare and practice.

The Consultant interview is still an old style interview panel, although it may be preceded by a presentation. It may be the first such interview you have faced (CMT and HST interviews may have been by multi-station interviews)

We hope to be running interview preparation and practice training days at Severn Postgraduate Medical Education starting in Autumn 2010.

Presentations are now quite common. Prepare this well in advance and practice presenting it in front of different groups. Make sure it addresses the question, runs to time and offers solutions with which you agree (don’t just tell them what you think they want to hear). Use the knowledge you gained about the Unit and Trust at the visits. Make sure you have evidence for your conclusions and any recommendations.

Prepare. Generally there are similar representatives on each appointment panel.

There is usually a Lay Chairperson who will greet you and introduce you to the other panel members. They will not usually ask a question, but sometimes may ask what attracted you to the area (they may be a current or previous councillor or Mayor). Rarely will they ask a political question.

There will be a representative from the consultants of your speciality. They often ask about your training, experience and intentions in your speciality.

There may be another physician representing the rest of the consultant body. They may ask about your experience of Take medicine, general medicine etc. They may be tasked to ask about audit, clinical governance etc.

There will be a representative of the Medical Managers, usually more than one. There is usually the Clinical Director of the Directorate you will be in and the Medical Director of the Trust. The Clinical Director will often ask about recent, possibly contentious changes in medical management. For example, European Working Time Directive and its effect on hospital ward cover, or Hospital at Night etc. The Medical Director may ask a broader area such as Clinical Governance, Re- validation or the Future of Secondary care in your speciality.

There will be senior Non-medical Managers, usually the CEO or their representative. They may ask similar questions to the MD or about Targets, Cancer waits, Referral to Treatment Time, the 4-Hour waits in A&E etc.

There will be a College representative, who will often ask you about medical education.

There may be a University representative who may ask about research or teaching of undergraduates.

Tips – try to be clear, definite and concise in your answers. Try not to waffle. If you have prepared and practiced most of the question areas should have been covered. Don’t try to be all things to all men. If you are by inclination over conciliatory, try the ‘Good thing, Bad Thing? Why?’ approach.

For example, “Some people say revalidation is going to cause a lot of stress and won’t stop the next Harold Shipman, what do you think?” You answer by stating your position “I think revalidation may be a positive thing for the medical profession (i.e. Good Thing). (Why?) It gives us the opportunity to properly assess ourselves and insist on the support we need to be good doctors and improve patient care.”

Pitfalls You may detect that one panel member is using you to score points off another panel member. The Chairman or other panellists should prevent this, but sometimes it happens. In such cases be open, honest and truthful about your own thoughts and beliefs. Don’t try to keep both sides happy if you do, they may both mark you down. If you present your views honestly with reasons, one of them will support you, the other will at least acknowledge you have thought about the subject, the rest of the panel will hopefully appreciate your integrity.

Practice. Make a list of likely interview questions, you can find quite a few on the Internet. Get your friends and family to grill you. Especially if this is your first interview make sure you get a mock interview as practice.

Be prepared to accept the job at the interview if offered it unless you get seriously upset by the attitude of the panellists, in such rare cases ask to speak to the Chairman during the discussions and explain that you are withdrawing your application. Write later to the CEO to explain why. If you think this is a serious possibility best to withdraw before the interview.

If you are appointed, you are likely to be pressed for an early start date. Have your response and reasons ready.

If you are not appointed, one of the panellists (often the College representative) will give you feedback. This may be helpful, or may not, but listen just in case. The College rep will be doing their best to help, they may not necessarily agree with the panel, but of course can’t tell you that. If the rejection was a shock, ask one of your referees if they can find out more.

On the subject of referees, you should have one from your current post, a senior Consultant/Professor if possible, and a referee who can support your sub-speciality if you have one.

Don’t brood about rejections, they didn’t deserve you.

Useful Links

These links and downloads may help your preparations. This leads to an area where you can download information specific to your specialty.

Royal College of Physicians