Any fellow doctors for career advice help please

[indecisivedoctor]

Hi,

I have name changed for this so as to not out myself.

I'm an SHO in a busy DGH with young children. Plodding through my core medical training LTFT ( mid year 2 but no exams yet). Want to work in palliative medicine and am pretty sure that being a consultant is not the be all and end all to me so would be happy to be a specialty doctor in the hospice setting. I love being a doctor but my family come first and I want to be around especially whilst my children are young.

My plan was to finish CMT, get my exams and try to get a post.

Out of the blue a post has arisen at my local hospice- somewhere I would love to work for professional and practical reasons. It's a part time post and if I was successful it would mean leaving CMT before completion. I am led to believe this means you can't ever reapply for CMT in the same deanery which would make it hard to get back onto the training ladder.

I don't know much about the non training grade career ladder. Part of me thinks I should play it safe and stay in CMT but part of me would hate to miss the opportunity of what would on paper be my dream job ( local, preferred hospice, working for a consultant I know, like and respect, part time... )

There is of course no guarantee I would get the job and that could make the decision for me but I would be really grateful for anyones experience or advice.

I'm a consultant in a different specialty

I work LTFT, my DC are young primary age and I plan to continue this until they are at secondary.
I may not be best placed to advise as I always knew that I wanted to be a consultant and never considered specialty Dr posts but didn't want your post to go unanswered.

It is rough on you and your family working in a demanding job with on calls, rotating every 6 months and doing exams and I can see why you would want to step off.

On the other hand you do need to be sure that you won't regret it later as it is really hard to get back depending on specialty and area. It might be an irreversible decision. I suppose there's always article 14 but in some specialties it's more of a theoretical than a real option and in reality not regarded as equivalent to CCT.

When I was towards the end of training I really wanted to be in charge, manage patients and the service my own way rather than always being answerable to someone else and you never get that with a staff grade position.

Also there is such a variation in these roles from ones where there is little chance of progression or further training and you get stuck doing an SHO level job forever to ones where you can develop in the role and carve your own niche. It depends on your colleagues basically.

Might also depend what your DH does. Mine is not a medic and tbh we are glad of my job security, good salary and pension in this climate. However if you DH is a medic then there is less pressure on you to be the main earner and it's hard to have 2 medical careers in the family.

Only you can really decide what is best in your specific situation but I guess I'd encourage you to be sure that you think of the future rather than just now. Your kids aren't small forever. The shifts, rotations and exams are not forever.

I also think that keeping options open by getting CMT signed off would be a good thing. Was trying to work out how long you have left, 1 year, more? Med SHO jobs are gruelling for sure, but you have already put in a lot of time and energy.
I baled for work life balance reasons after MRCP but am very glad to have that experience under my belt.
Also worth considering that current training review will effectively create a pool of sub consultants doing "staff grade" jobs , which may mean without CST or whatever they're planning to call it, you will struggle to find a role. I know palliative care is different from other specialties because of the non NHS employment, but I would still be cautious.
Other things to consider: you don't say how old your DC are, but if not yet at school, you need to bear in mind that it all gets much harder once they are (child care, school activities etc etc). ( so going back to training might be harder at that point)
Is your DP (making assumptions here) likely to need to move areas for jobs any time soonish ? If so, more qualifications will make it easier for you to find a new job in a new place.
Can some outside the box thinking help? Would temporarily going full time get you through CMT and out in time to take up a deferred start at the hospice? Or into appropriate specialty training sooner ?
Clearly only you and your partner can decide in the end what is best for your family and there are always many compromises to be made along the way.

" I am led to believe this means you can't ever reapply for CMT in the same deanery which would make it hard to get back onto the training ladder."

Can you check this is the case? My DH (also an SHO) was led to believe that if you didn't take up a ST post once offered you couldn't reapply to that Deanery - that wasn't true.

Can you look into out of programme opportunities? They tend to only be willing to go up to 2 years out of programme but it might give you a bit of a break if that would work for you.

Otherwise, if taking the hospice job really would mean jacking in the CMT & not being able to resume from the same point, I would aim to get the CMT finished… gives you so many more options...

I would finish CMT first, and then look at non training palliative care posts, and the training scheme. CMT will keep your options open and give you something concrete if you decide to aim for Consultant, move areas, change interests, trusts reduce the number of non training doctors, etc.

When your children are older you will have many years of work ahead and may want more responsibility than a staff grade role can provide.

Is there anything you can do to make CMT more pleasant? Does CMT allow out of programme experience? If you are hating your current job, how long until you are rotating?

Medics are generally a cautious bunch career wise though, I think most replies will be to finish CMT first.

Just a thought.... a friend has put her training 'on hold' whilst doing a different medical job, and she will return in a few years. Probably CMT won't be that flexible (friend's speciality is in need of more trainees), but it is worth investigating.

I am a GP trainee btw.

It's so hard right now but you have to try and imagine what you might want from your life in 5/10/20 years time and whether getting to that point it worth the sacrifices you might have to make now.

I'm a reg in a different hospital specialty and am LTFT, which has put my CCT date back from 2016 to 2020. I've always been a bit unsure if I want to continue to consultant level, as there's plenty of opportunities for staff grade in my specialty and I'm not sure I can stomach another 6 years of moving round, fighting over which places I can commute to, trying to battle for job shares etc. but when I think about what I want from my career I think I need to continue for now. It's much easier to get training/courses/exams etc as a trainee which if you do step out, give you a lot more flexibility. The other factor, as someone mentioned above, is that having worked in my area for 6 years I have built up ideas about my surgical/management/clinical style and can't imagine having to work to someone else's decisions for the rest of my career.

If I were you I'd probably carry on to the end of CMT, get my exams and then reassess, unless you're very sure this is the job you'll want for the rest of your days anyway, no matter how many more years and qualifications you do.