sugardipped28
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After 8 years of specialist training, if a doctor is unable to gain a consultancy role straight away, lets say, the right specialism role doesnt come up in the doctors area and they dont want to relocate for the role, what are the options left for the doctor at this point? If they decide to stay where they are and"wait" for the right consultant role to become available, what would their job be in the meantime?
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ecolier
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(Original post by sugardipped28)
After 8 years of specialist training, if a doctor is unable to gain a consultancy role straight away, lets say, the right specialism role doesnt come up in the doctors area and they dont want to relocate for the role, what are the options left for the doctor at this point? If they decide to stay where they are and"wait" for the right consultant role to become available, what would their job be in the meantime?
They can "locum" and work as a non-training doctor. A lot of people take time out after FY2 to work as "FY3" or "FY4" etc. (Grades which don't officially exist, hence the quotation marks).

And it's not strictly 8 years specialist training either - it's 2 years foundation programme (FY1 and FY2) then depending on the specialty the length varies. GP training, for example takes 3 years after FY2; psychiatry is 6 years after FY2; most medical / surgical specialties take 7-8 years after FY2.

Also in the current climate, a lot of specialties have consultant posts available - depending on whether you are amenable to moving elsewhere in the country. My specialty for example - there are consultant vacancies all over the country, many hospitals are literally desperate for consultants.
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sugardipped28
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They can "locum" and work as a non-training doctor. A lot of people take time out after FY2 to work as "FY3" or "FY4" etc. (Grades which don't officially exist, hence the quotation marks).

And it's not strictly 8 years specialist training either - it's 2 years foundation programme (FY1 and FY2) then depending on the specialty the length varies. GP training, for example takes 3 years after FY2; psychiatry is 6 years after FY2; most medical / surgical specialties take 7-8 years after FY2.

Also in the current climate, a lot of specialties have consultant posts available - depending on whether you are amenable to moving elsewhere in the country. My specialty for example - there are consultant vacancies all over the country, many hospitals are literally desperate for consultants.
Thanks, thats really helpful. My question pertains specifically to paediatrics. If you complete your specialist training in paediatrics with a special interest in allergy for example, ive been told that consultant posts for this are hard to come by and so I wondered if at this point you can still work in your specialism whilst you "wait" for a consultant role, if you are not wanting to relocate. Someone mentioned you'd just become an SAS doctor but not sure this is accurate?
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ecolier
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(Original post by sugardipped28)
Thanks, thats really helpful. My question pertains specifically to paediatrics. If you complete your specialist training in paediatrics with a special interest in allergy for example, ive been told that consultant posts for this are hard to come by and so I wondered if at this point you can still work in your specialism whilst you "wait" for a locum role, if you are not wanting to relocate. Someone mentioned you'd just become an SAS doctor but not sure this is accurate?
Yes you can. Same for (some) medical specialties - depending on your CCT (certificate of completion of training) you may be able to work as a general medical consultant while waiting for your ideal consultant job.

If you train in paediatrics, you may have a CCT in general paediatrics so you can work as a consultant in that while waiting for your consultant job. However to do paediatric allergy medicine, just to enter that training pathway itself could be competitive.

Smile88egc is a paediatric doctor, she may be able to answer your Q better.
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sugardipped28
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Yes you can. Same for medical specialties - depending on your CCT (certificate of completion of training) you can work as a general medical consultant while waiting for your ideal consultant job.

If you train in paediatrics, you may have a CCT in general paediatrics so you can work as a consultant in that while waiting for your consultant job. However to do paediatric allergy medicine, just to enter that training pathway itself could be competitive.

Smile88egc is a paediatric doctor, she may be able to answer your Q better.
Thats great, thanks so much!
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Thanks, thats really helpful. My question pertains specifically to paediatrics. If you complete your specialist training in paediatrics with a special interest in allergy for example, ive been told that consultant posts for this are hard to come by and so I wondered if at this point you can still work in your specialism whilst you "wait" for a consultant role, if you are not wanting to relocate. Someone mentioned you'd just become an SAS doctor but not sure this is accurate?
If you're wanting a very specific post then you may have trouble I suppose yes.

The alternatives are being more flexible with location, being more flexible with job specifics, or taking on a locum post (or doing short-term locums) in a different role whilst you wait. Or sometimes people do research fellowships, or find other roles. A little more flexibility can creep into the system once this senior, especially if you know the local department and they want to keep you around.

One thing that has surprised me recently is actually how flexible a lot of people are willing to be with the job they end up in. As life ticks by and you pick up commitments like a mortgage or kids, suddenly location and work-life balance becomes more important, and you may well be willing to apply to multiple specialities and let fate decide where you end up out of necessity.
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Paeds reg here.

Effectively, the more subspecialised you choose to become, the more likely you are to potentially need to move geographically for a consultant post, or accept a post that’s not exactly what you wanted. In paeds you can either have a special interest in an area whilst being a general paediatrician, or you can choose to fully subspecialise. However, everyone who trains in paeds also gets a general paediatrics CCT, irrespective of whether you also get a subspecialty.

In the event that you eg subspecialise in paediatric allergy and then find there are no tertiary centre jobs currently available, you can:
[1] Apply for a DGH “gen paeds with allergy interest” job, doing gen paeds acute work including service weeks, and then have allergy clinics. (NB this might be slightly harder for more niche sub specialties eg hepatology, IMD, palliative medicine...)
[2] Move to another geographical area
[3] Post-CCT fellowship
[4] locum consultant - there may be locum jobs available even if there aren’t any substantive
[5] Use your “period of grace” after CCT where you can work as a reg for a bit longer whilst waiting for boss jobs
[6] start to keep a look out from latter stages of training - possible to CCT early if you’ve done everything and the « right » job comes up earlier than you were expecting.
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sugardipped28
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Paeds reg here.

Effectively, the more subspecialised you choose to become, the more likely you are to potentially need to move geographically for a consultant post, or accept a post that’s not exactly what you wanted. In paeds you can either have a special interest in an area whilst being a general paediatrician, or you can choose to fully subspecialise. However, everyone who trains in paeds also gets a general paediatrics CCT, irrespective of whether you also get a subspecialty.

In the event that you eg subspecialise in paediatric allergy and then find there are no tertiary centre jobs currently available, you can:
[1] Apply for a DGH “gen paeds with allergy interest” job, doing gen paeds acute work including service weeks, and then have allergy clinics. (NB this might be slightly harder for more niche sub specialties eg hepatology, IMD, palliative medicine...)
[2] Move to another geographical area
[3] Post-CCT fellowship
[4] locum consultant - there may be locum jobs available even if there aren’t any substantive
[5] Use your “period of grace” after CCT where you can work as a reg for a bit longer whilst waiting for boss jobs
[6] start to keep a look out from latter stages of training - possible to CCT early if you’ve done everything and the « right » job comes up earlier than you were expecting.
Hi there

Thanks so much for the insight! If someone has already worked as a neonatal trainee within their 8 year training period, is this an area they could also consider once they reach CCT level? Do you have to choose/concentrate on one specialism within your 8 years training or can you have trained in a few different areas eg neonatal and then also allergy?

What is a DGH “gen paeds with allergy interest” job, could you elaborate a little?
Typically how long is a "period of grace" after CCT?

I suppose what im hoping to clarify is that if one were to choose not to relocate geographically and simply "wait" until their ideal consultant post comes up locally, (eg. Consultant paediatrician with an interest in allergy) whilst they "wait" will they be secure enough career wise to have plenty of options available to them until that ideal role comes up in their local area?
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(Original post by sugardipped28)
Hi there

Thanks so much for the insight! If someone has already worked as a neonatal trainee within their 8 year training period, is this an area they could also consider once they reach CCT level? Do you have to choose/concentrate on one specialism within your 8 years training or can you have trained in a few different areas eg neonatal and then also allergy?

What is a DGH “gen paeds with allergy interest” job, could you elaborate a little?
Typically how long is a "period of grace" after CCT?

I suppose what im hoping to clarify is that if one were to choose not to relocate geographically and simply "wait" until their ideal consultant post comes up locally, (eg. Consultant paediatrician with an interest in allergy) whilst they "wait" will they be secure enough career wise to have plenty of options available to them until that ideal role comes up in their local area?
https://lasepgmdesupport.hee.nhs.uk/...riod-of-grace-

https://lasepgmdesupport.hee.nhs.uk/...riod-of-grace-
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junior.doctor
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(Original post by sugardipped28)
Hi there

Thanks so much for the insight! If someone has already worked as a neonatal trainee within their 8 year training period, is this an area they could also consider once they reach CCT level? Do you have to choose/concentrate on one specialism within your 8 years training or can you have trained in a few different areas eg neonatal and then also allergy?

What is a DGH “gen paeds with allergy interest” job, could you elaborate a little?
Typically how long is a "period of grace" after CCT?

I suppose what im hoping to clarify is that if one were to choose not to relocate geographically and simply "wait" until their ideal consultant post comes up locally, (eg. Consultant paediatrician with an interest in allergy) whilst they "wait" will they be secure enough career wise to have plenty of options available to them until that ideal role comes up in their local area?
We all have to do neonatal jobs within paeds training. There are set minimum amounts - but many people end up doing more than that. There are dedicated neonatal jobs, then there are jobs where you cover both paeds and neonates (usually in DGHs where there is a level 1 or 2 unit), and there are jobs eg where you do community within daytime hours and cover neonates on-calls OOH. In addition to the 'standard helping' of neonates jobs, you can again do additional neonates as a trainee, especially later in training, in order to develop an interest - either as a special interest, or as neonatal 'grid' (full subspecialty).

There are a couple of ways that you can end up working in neonates as a consultant - either in a tertiary NICU - where you will realistically have needed to do subspecialty training. The other way, is that many general paeds consultants work in a DGH where there is also a level 1 or 2 NNU. Generally, in the day, there will be certain consultants with more of a neonates interest who will cover the NNU - but all consultants will be required to cover the NNU out of hours. And of course an extreme preterm baby / very sick baby can always unexpectedly deliver anywhere that there is maternity provision, even if that ends up being a maternity with a linked level 1 neonatal unit rather than a NICU. It's perfectly possible to develop a neonates interest and work in one of these centres with a level 1/2 alongside a paeds unit.

In discussion with your training programme director, it's generally possible to shape your jobs, especially the later ones, to reflect your interests. There are certain compulsory components, but they are fewer once later in training. I specifically requested a paeds ED job earlier in my training. Remember that if you go all-out subspecialty, eg taking your example of allergy, most of your later training will be dedicated to that. So it would be hard to develop a second substantial interest pre-CCT unless it was something that was obviously heavily linked. Everyone gets a gen paeds CCT, so anyone with a subspecialty training can still work in a DGH in a more general job. But remember that in order to have done your subspecialty, you'll have done less general paeds training in later stages. You can do post-CCT fellowships to develop other interests.

DGH jobs with interests vs tertiary.... Let's take respiratory as an example, as I've done that on both sides. Tertiary centre - everything that you do is respiratory. Your inpatients are only complex respiratory patients (even the more general wheeze / uncomplicated asthma stay under the general paeds team). We covered the long term trache-vented ward, and lots of our patients were on PICU. You don't see any gen paeds inpatients. Other specialty / general teams call you for help / reviews. People from all over the region in DGHs call for advice. Children get transferred in for complex care that can't be done in their DGH, eg bronchoscopy, chest drain under GA for empyema. Our team undertook bronchoscopy, detailed lung function testing, sleep study lab. We coordinated the regional cystic fibrosis service, often in shared care with local DGHs but overseen by us. Dedicated respiratory radiology MDTs , other MDTs. Lots of hyper-specialist clinics - baby CF, complex asthma, long term ventilation... Conversely, DGH - a lot of your work will be general paediatrics. You'll do general service weeks as a consultant, covering all inpatients. You'll get to advise on more complicated respiratory inpatients, but depending on the type of unit and what it can manage, many more complicated children needing ongoing care, may need referring to a tertiary centre.Clinics will be a combination - general clinics, and also some respiratory clinics. Some of those will be subspecialty, eg CF MDT clinics. And you'll be able to use your skills of things like interpreting sleep studies.

I think the difficulty in staying in a general DGH job for too long whilst deliberately waiting for a tertiary subspecialty interest job locally, is that your skill set is slowly going to change reflecting the amount of generalist work that you'll do, and keeping yourself up to date and competitive may be challenging after more than a couple of years. But there would definitely be plenty of other options for someone with a subspecialty, which would mean that you wouldn't have to move, even if that meant that the job you took wasn't your ideal job / interest. I imagine that allergy is a bit different, in the sense that it is possible to build and grow a decent service within a DGH, and that with the right people and team, there might not be a huge difference between allergy-specific work in a tertiary centre and a DGH. The difference, would be the amount of general work you'd also be expected to do in addition to your allergy work, and therefore what proportion of your job plan would be dedicated allergy.

In all reality - paeds subspecialty is a small world. You'll have done your training within wherever there are tertiary centres in your locality. It will be no secret within those departments, who is going to be retiring shortly / if the department are planning to expand. It will therefore be pretty clear if there are going to be any jobs coming up in the coming year or two. You'll therefore most likely know if it's worth waiting or not.

In my Deanery, period of grace is 6 calendar months (irrespective of whether full time or LTFT).
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sugardipped28
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We all have to do neonatal jobs within paeds training. There are set minimum amounts - but many people end up doing more than that. There are dedicated neonatal jobs, then there are jobs where you cover both paeds and neonates (usually in DGHs where there is a level 1 or 2 unit), and there are jobs eg where you do community within daytime hours and cover neonates on-calls OOH. In addition to the 'standard helping' of neonates jobs, you can again do additional neonates as a trainee, especially later in training, in order to develop an interest - either as a special interest, or as neonatal 'grid' (full subspecialty).

There are a couple of ways that you can end up working in neonates as a consultant - either in a tertiary NICU - where you will realistically have needed to do subspecialty training. The other way, is that many general paeds consultants work in a DGH where there is also a level 1 or 2 NNU. Generally, in the day, there will be certain consultants with more of a neonates interest who will cover the NNU - but all consultants will be required to cover the NNU out of hours. And of course an extreme preterm baby / very sick baby can always unexpectedly deliver anywhere that there is maternity provision, even if that ends up being a maternity with a linked level 1 neonatal unit rather than a NICU. It's perfectly possible to develop a neonates interest and work in one of these centres with a level 1/2 alongside a paeds unit.

In discussion with your training programme director, it's generally possible to shape your jobs, especially the later ones, to reflect your interests. There are certain compulsory components, but they are fewer once later in training. I specifically requested a paeds ED job earlier in my training. Remember that if you go all-out subspecialty, eg taking your example of allergy, most of your later training will be dedicated to that. So it would be hard to develop a second substantial interest pre-CCT unless it was something that was obviously heavily linked. Everyone gets a gen paeds CCT, so anyone with a subspecialty training can still work in a DGH in a more general job. But remember that in order to have done your subspecialty, you'll have done less general paeds training in later stages. You can do post-CCT fellowships to develop other interests.

DGH jobs with interests vs tertiary.... Let's take respiratory as an example, as I've done that on both sides. Tertiary centre - everything that you do is respiratory. Your inpatients are only complex respiratory patients (even the more general wheeze / uncomplicated asthma stay under the general paeds team). We covered the long term trache-vented ward, and lots of our patients were on PICU. You don't see any gen paeds inpatients. Other specialty / general teams call you for help / reviews. People from all over the region in DGHs call for advice. Children get transferred in for complex care that can't be done in their DGH, eg bronchoscopy, chest drain under GA for empyema. Our team undertook bronchoscopy, detailed lung function testing, sleep study lab. We coordinated the regional cystic fibrosis service, often in shared care with local DGHs but overseen by us. Dedicated respiratory radiology MDTs , other MDTs. Lots of hyper-specialist clinics - baby CF, complex asthma, long term ventilation... Conversely, DGH - a lot of your work will be general paediatrics. You'll do general service weeks as a consultant, covering all inpatients. You'll get to advise on more complicated respiratory inpatients, but depending on the type of unit and what it can manage, many more complicated children needing ongoing care, may need referring to a tertiary centre.Clinics will be a combination - general clinics, and also some respiratory clinics. Some of those will be subspecialty, eg CF MDT clinics. And you'll be able to use your skills of things like interpreting sleep studies.

I think the difficulty in staying in a general DGH job for too long whilst deliberately waiting for a tertiary subspecialty interest job locally, is that your skill set is slowly going to change reflecting the amount of generalist work that you'll do, and keeping yourself up to date and competitive may be challenging after more than a couple of years. But there would definitely be plenty of other options for someone with a subspecialty, which would mean that you wouldn't have to move, even if that meant that the job you took wasn't your ideal job / interest. I imagine that allergy is a bit different, in the sense that it is possible to build and grow a decent service within a DGH, and that with the right people and team, there might not be a huge difference between allergy-specific work in a tertiary centre and a DGH. The difference, would be the amount of general work you'd also be expected to do in addition to your allergy work, and therefore what proportion of your job plan would be dedicated allergy.

In all reality - paeds subspecialty is a small world. You'll have done your training within wherever there are tertiary centres in your locality. It will be no secret within those departments, who is going to be retiring shortly / if the department are planning to expand. It will therefore be pretty clear if there are going to be any jobs coming up in the coming year or two. You'll therefore most likely know if it's worth waiting or not.

In my Deanery, period of grace is 6 calendar months (irrespective of whether full time or LTFT).
Thanks so much! Final questions -

- If a paediatrician wants to go specialise in allergy at a consultancy level, how many years training would they have had to devote working specifically in an allergy department prior to this? Im assuming you cant just train in general paediatrics, or a completely different area like neonatal medicine, and then at the last minute before your CCT you decide you're going to specialise in allergy at a consultant level? What is the flexibility like?

- What is the typical weekend shift frequency for a paediatrician in their last stages of training before CCT, if they work 4 days per week for example instead of full time. I read that its 1 in 2, but ideally 1 in 3, is this accurate?

- What are the exact hours for a twilight shift? Or do they vary?

Thanks :-)
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Thanks so much! Final questions -

- If a paediatrician wants to go specialise in allergy at a consultancy level, how many years training would they have had to devote working specifically in an allergy department prior to this? Im assuming you cant just train in general paediatrics, or a completely different area like neonatal medicine, and then at the last minute before your CCT you decide you're going to specialise in allergy at a consultant level? What is the flexibility like?

- What is the typical weekend shift frequency for a paediatrician in their last stages of training before CCT, if they work 4 days per week for example instead of full time. I read that its 1 in 2, but ideally 1 in 3, is this accurate?

- What are the exact hours for a twilight shift? Or do they vary?

Thanks :-)
Twilights are hugely variable. Generally start mid-late afternoon, I’ve done some that finish at 21.30, others that finish at 02.00, and everything in between...

Weekend frequency - again very variable and partly specialty - specific. Generally neonates are more frequent. Babies do not respect nights / weekends in terms of being born / getting sick. Therefore need more similar staffing numbers for all shifts. Paeds ED also understandably higher frequency. There is no difference between ST4 and ST8 when it comes to oncall frequency - once you’re a reg, you’re a reg, and the reg rota is the same for everyone and doesn’t decrease for more senior regs. I currently do 3 weekends in 8 on a neonatal rota. My experience on reg rota has generally been somewhere around 1:3 weekends for full time people. If you work less than full time, you work at a % of full time. Eg 80% hours - you work 80% of all shift types on the full time rota (nights, long days, weekends...)

Any subspecialty training takes 2-3 years. You have to apply (competitively) for ‘grid’ at national level - there are a limited number of spaces for subspecialty training each year, and many folk are unsuccessful at getting a place. You may also find that your subspecialty place is at the other end of the country in another Deanery.... If successful, the subspecialty training happens over the last 2-3 years of your training, so you still finish at ST8 like everyone else. You can’t make last minute decisions at CCT for things like full subspecialty training, but you can still develop a special interest in an area at a later stage - post-CCT fellowship, or developing the interest once you’re a consultant.
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We all have to do neonatal jobs within paeds training. There are set minimum amounts - but many people end up doing more than that. There are dedicated neonatal jobs, then there are jobs where you cover both paeds and neonates (usually in DGHs where there is a level 1 or 2 unit), and there are jobs eg where you do community within daytime hours and cover neonates on-calls OOH. In addition to the 'standard helping' of neonates jobs, you can again do additional neonates as a trainee, especially later in training, in order to develop an interest - either as a special interest, or as neonatal 'grid' (full subspecialty).

There are a couple of ways that you can end up working in neonates as a consultant - either in a tertiary NICU - where you will realistically have needed to do subspecialty training. The other way, is that many general paeds consultants work in a DGH where there is also a level 1 or 2 NNU. Generally, in the day, there will be certain consultants with more of a neonates interest who will cover the NNU - but all consultants will be required to cover the NNU out of hours. And of course an extreme preterm baby / very sick baby can always unexpectedly deliver anywhere that there is maternity provision, even if that ends up being a maternity with a linked level 1 neonatal unit rather than a NICU. It's perfectly possible to develop a neonates interest and work in one of these centres with a level 1/2 alongside a paeds unit.

In discussion with your training programme director, it's generally possible to shape your jobs, especially the later ones, to reflect your interests. There are certain compulsory components, but they are fewer once later in training. I specifically requested a paeds ED job earlier in my training. Remember that if you go all-out subspecialty, eg taking your example of allergy, most of your later training will be dedicated to that. So it would be hard to develop a second substantial interest pre-CCT unless it was something that was obviously heavily linked. Everyone gets a gen paeds CCT, so anyone with a subspecialty training can still work in a DGH in a more general job. But remember that in order to have done your subspecialty, you'll have done less general paeds training in later stages. You can do post-CCT fellowships to develop other interests.

DGH jobs with interests vs tertiary.... Let's take respiratory as an example, as I've done that on both sides. Tertiary centre - everything that you do is respiratory. Your inpatients are only complex respiratory patients (even the more general wheeze / uncomplicated asthma stay under the general paeds team). We covered the long term trache-vented ward, and lots of our patients were on PICU. You don't see any gen paeds inpatients. Other specialty / general teams call you for help / reviews. People from all over the region in DGHs call for advice. Children get transferred in for complex care that can't be done in their DGH, eg bronchoscopy, chest drain under GA for empyema. Our team undertook bronchoscopy, detailed lung function testing, sleep study lab. We coordinated the regional cystic fibrosis service, often in shared care with local DGHs but overseen by us. Dedicated respiratory radiology MDTs , other MDTs. Lots of hyper-specialist clinics - baby CF, complex asthma, long term ventilation... Conversely, DGH - a lot of your work will be general paediatrics. You'll do general service weeks as a consultant, covering all inpatients. You'll get to advise on more complicated respiratory inpatients, but depending on the type of unit and what it can manage, many more complicated children needing ongoing care, may need referring to a tertiary centre.Clinics will be a combination - general clinics, and also some respiratory clinics. Some of those will be subspecialty, eg CF MDT clinics. And you'll be able to use your skills of things like interpreting sleep studies.

I think the difficulty in staying in a general DGH job for too long whilst deliberately waiting for a tertiary subspecialty interest job locally, is that your skill set is slowly going to change reflecting the amount of generalist work that you'll do, and keeping yourself up to date and competitive may be challenging after more than a couple of years. But there would definitely be plenty of other options for someone with a subspecialty, which would mean that you wouldn't have to move, even if that meant that the job you took wasn't your ideal job / interest. I imagine that allergy is a bit different, in the sense that it is possible to build and grow a decent service within a DGH, and that with the right people and team, there might not be a huge difference between allergy-specific work in a tertiary centre and a DGH. The difference, would be the amount of general work you'd also be expected to do in addition to your allergy work, and therefore what proportion of your job plan would be dedicated allergy.

In all reality - paeds subspecialty is a small world. You'll have done your training within wherever there are tertiary centres in your locality. It will be no secret within those departments, who is going to be retiring shortly / if the department are planning to expand. It will therefore be pretty clear if there are going to be any jobs coming up in the coming year or two. You'll therefore most likely know if it's worth waiting or not.

In my Deanery, period of grace is 6 calendar months (irrespective of whether full time or LTFT).
This is very informative. I was thinking about doing a neonate trust grade post after f2, with a view of possibly going into anaesthetics.
What is your view on this?
Neonatal medicine is very specialised, do you think it would be helpful for me and if so, how would you recommend I make the most from the job?
Or would you recommend I should avoid the job?
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This is very informative. I was thinking about doing a neonate trust grade post after f2, with a view of possibly going into anaesthetics.
What is your view on this?
Neonatal medicine is very specialised, do you think it would be helpful for me and if so, how would you recommend I make the most from the job?
Or would you recommend I should avoid the job?
Neonates would be an odd choice for anaesthetics, it's not like anything we do jn adult anaes/ICM. I also don't know if anywhere would hire trust grade docs with no neonatal experience? So I wouldn't necessarily think it would be the best option if you wanted to do anaesthetics
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Neonates would be an odd choice for anaesthetics, it's not like anything we do jn adult anaes/ICM. I also don't know if anywhere would hire trust grade docs with no neonatal experience? So I wouldn't necessarily think it would be the best option if you wanted to do anaesthetics
That's true. I have a 6 month post in ICU and I was looking for another 6 month post in a different specialty. Neonates was one of the few offered currently at the trust. what would you advise I should do?
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smooth

The (tertiary) NNU I last worked in, had a couple of SHO level fellow jobs. Most people who did them, did have a little bit of previous paeds or NNU experience - but in honesty, most of our new ST1 trainees are brand new to neonates. So are registrars we’re very used to perpetually having SHOs with zero previous experience.

I would echo Helenia comment - my initial reaction was that neonates would not be relevant for anaesthetics, but you’ve had that conformed by an anaesthetist now - as an NNU reg I have never involved anaesthetics, even if I’m struggling - I intubate / do lines myself. And with the greatest respect, most anaesthetists I’ve known, have zero experience of tiny humans and tiny airways, so would not want to get involved. Generally even in paeds if we have an emergency in a baby requiring intubation, the anaesthetist and I discuss who is best placed to do it and it’s often me rather than them, depending on their paeds experience (although I need their expertise in best drugs to use depending on why we’re intubating). It’s different techniques - in the same way I would not have the experience to comfortably intubate an older child or adult. So any skills you were to learn in neonates would not really be readily transferable. Except maybe cannulating - once you can cannulate a 500g baby, you can cannulate anything 😂

The reality of an SHO job in neonates, is that the vast majority of it is NOT intensive care. You’ll spend large amounts of your time on postnatal wards doing baby checks, reviewing jaundiced babies and babies on antibiotics, sorting out the midwives’ many and varied baby dramas. On NNU you’ll spend lots of time in SCBU nurseries with the fairly well feeding and growing babies. Doing lots of paperwork and routine tasks. You’ll go to deliveries to do newborn resuscitation - a useful experience but again no relevance to anaesthetics (I’ve known one or two obstetric anaesthetists wander over and look vaguely interested when it’s clear that things are going badly wrong on the baby resus side, but that’s rare, and they don’t generally get involved as there’ll be a neonatal reg and NICU nurse present by then, and they have their own patient to look after anyway).

In terms of the short periods of time within your rota that you’ll spend doing time in the intensive care rooms - there will probably be some opportunity to learn procedures. Intubation, umbilical lines, CVLs. But realistically before you get near being able to do these, you’ll need to master the basics first including basic cannulation of term and preterm babies, and watch a few procedures being done. You’ll also probably be in competition with the specialty trainees who need to get these skills practised and signed off. And as I said - even if you do get a chance to learn, umbi lines have zero relevance to anaesthetics, and intubation is very different in neonates.

Have you ever done paeds before? And what level neonates would the job be? (Level 2 unit, level3?) Why do you want to do the job? If it’s for general curiosity/ interest, fine. If it’s for relevance to anaesthetics - don’t bother. If you have absolutely zero previous paeds experience, this is likely to be a job with an incredibly steep learning curve that you’ll find very hard. But not impossible.
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Helenia
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#17
(Original post by smooth)
That's true. I have a 6 month post in ICU and I was looking for another 6 month post in a different specialty. Neonates was one of the few offered currently at the trust. what would you advise I should do?
Check the anaesthetics person spec but I think you get points for most acute specialties. Ones that I would suggest but you should double check are A&E, gen med/surg (if not done a decent amount in foundation), general paeds - would be more relevant and usrful than neonates.
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