Firstly, lets start with an apology. I’ve haven’t posted for a month as I’ve been struggling health wise and not really been able to get to a laptop to be able to write. Although annoying, it has given me plenty of time to think about what I might want to write next, so hopefully you’ll forgive me.
Now, onto the present. I’ve been in post for 20 years this month, and have also just spent some time recording a couple of webinars that covered bits about the journey to consultant. It felt timely, therefore, to put something out there talking about my experience of the consultant journey. Word of warning, though, this is only my experience, and everyone’s journey is different. I hope my sharing this it will help others, both in validating the aspiration but also in supporting expectation setting by talking about what it was really like to go through. Frankly, I want to be clear that it is never as linear as it appears from the outside and that that is perfectly OK.
So, let’s start at the very beginning. On my first day in post (all the way back in 2004) I was told that I was on an 11 year programme from trainee to consultant, and boy did I drink that cool aid and believe that would be the truth, after all these people were my bosses, supervisors and mentors. Sadly, it transpired that although they were being inspiring they were also far from being completely honest in terms of disclosing how straight forward, or not, the programme and progression actually were. I am now a Consultant Healthcare Scientist, although it took me 16 years rather than 11. Now I’ve reached the promise land I want to be clear that it was no where near the linear journey that I was sold on recruitment and there was a lot of struggle at every single stage. That being said however, now I’ve crossed the line, I wouldn’t have had it any other way. It was dealing with those barriers and obstacles that made me really decide who I was and what I wanted. It was also where most of the learning was truly at. So I wanted to write a blog post that doesn’t sell the ideal but discusses the realities of what some of those barriers looked like and to make those facing them a) feel less isolated and b) know they can be overcome.
You have to be doing the job to get the job
This one took me a long time to fully comprehend, as it can feel counter intuitive, but you have to already be doing most of the role in order to be able to get the role permanently. It is easy, in moments of frustration, to turn around and say ‘that’s not what I’m paid to do’ or ‘if they want me to do that job they need to pay me for it’. There are definitely times when you need to dig your heels in about workload and boundaries, but this generally needs to be the nuclear option. For the most part, you need to be prepared to roll your sleeves up and jump in to get the experience so that you are well placed to advocate for a post to be created, if that’s your aspiration, or to enable you to apply elsewhere with confidence. For me, I learnt huge amounts when I provided maternity cover for a year as a trainee. It built trust and showed willing to my clinical lead as well as providing me with experiences I would not have had in any other circumstance, enabled me to springboard into my next post, and meant my clinical lead wanted me stay enough they found money at the end of my training. Maintaining an openness to opportunities and an awareness of the fact that stepping up, although not always recognised financially or otherwise, does come with benefits on all sides and is an important part of playing the long game.
There is no single way to get from A to B
When I started, I thought the journey would be straight forward. I’d finish training, I’d get my 4th year funded, I’d get a Clinical Scientist post. Then I would work towards FRCPath and a PhD, hopefully moving into a Principle Clinical Scientist post. Once I’d achieved my tick boxes, my loyalty and hard work would be rewarded and a Consultant post would be forth coming. That’s just not the way work places and budgets work however. On this one patience is THE virtue, and the sooner you can acknowledge that A doesn’t immediately lead to B, the better for your mental well being. That said, the training pathway now available for Healthcare Scientists does make, at least the early stages, more straight forward.
Counter intuitively I’m going to say that, looking back, not having access to the straight forward route has been the most beneficial thing that could have happened to me. I would never have ended up with a clinical academic career if I hadn’t needed to acquire further salary funding and a PhD. I would never have ended up in Infection Prevention and Control if my training programme had been funded for the full four years. So many of the things I value the most only came about because I had to find ways around barriers and due to glorious happenstance. Despite being challenging in the moment, I’m grateful for every detour taken.
When it comes down to it, the person responsible for your progression is you
This one may feel harsh to hear, but no one is as invested in your career as you are. I’ve had a fair few people over years who’ve come to me and said that they deserve to be given X or Y. No matter how true this may be, this isn’t how it works in reality. If you want something to happen, you have to be the driving force to make it so. You are the star of your own movie.
I think a good example, for me, of this was my training programme. I was really fortunate that no one would block anything I wanted to do. The flip side of that coin was that no one sorted anything out on my behalf. It was my responsibility. I could go to any clinic, shadow anyone I wanted to shadow, but I had to reach out to find the contacts and arrange it. I had to have a vision of where I wanted to be and put together the pieces to enable me to get there. This is, in turn, enormously freeing and terrifying. It taught me early to be the master of my own destiny, and this is an important lesson for anyone on this pathway, irrespective of how supportive your surroundings at some point you will have to make it on your own.
You will hear a lot of no
One of the reasons to learn early to be your own driving force is that you will hear a lot of no as you under take this journey, whether that be linked to funding, exams, or posts. If you haven’t set your own direction then it can be hard to keep driving, as you may not be sure what you keep pushing for. As the old adage says, if you don’t have faith in yourself, no one else is likely to.
A lot of the no you hear will not be personal, a lot of it will be nothing to do with you or your skills. That doesn’t stop it from being hard to hear or from it feeling personal when it is not. A key skill that isn’t much talked about is learning how to respond to these challenges. You need to move to a place where you are able to process and move on without carrying that rejection with you. To learn from the moment and then let it go, so you always emerge a stronger, better person for the experience.
You have to know what matters
Something that can really help when facing the barriers and challenges along the way is being really clear what matters and why you are pursuing the choices you’ve made. Why does this route align with your own personal values and beliefs? If you understand your ‘why’ then you can weather the delays. It makes it so much easier to get back up when you’ve taken a knock.
The other side of this, which we don’t talk about anywhere near as much, is the importance of knowing what doesn’t matter. You can’t fight a battle on all fronts, and there will be positions you get into when you discover that you are fighting for something out of habit or without thinking about it. This is a waste of energy that you could be focusing on something that actually matters to you. Developing the self reflection to know when this is the case and using it to remove yourself from the arena is one of the most freeing and valuable skills you can invest in. I learnt this late, and I really wish I’d realised it earlier.
It is not an even playing field
I started this journey as pretty naive. I think I genuinely thought everyone would have a similar set of challenges and barriers to overcome. This just isn’t true. I know people who’ve become Consultants over a weekend with no external advert or interview. I know of trainees who’ve gone from point A directly to point B because their faces fit and everything aligned for them, not many but some. The challenging reality is that sometimes the playing field just isn’t even. Some disciplines are more set up for straight forward progression than others. Some disciplines have a bigger medical leadership who may not understand the role of Healthcare Scientists. In all honesty, being a woman in science is also not always straightforward. The gender issues are not always as obvious, but they are definitely still there, and that’s before we even start talking about other diversity issues.
When confronted with moments where this imbalance becomes apparent, we always have 2 choices, you can quit, or you can continue to fight. One of my core values has always been about parity of access, and one of the reasons I became a Lead Healthcare Scientist was to be in a position where I had the capacity to influence in this area. So when you come across inequality on your journey, whether it’s something you face or become aware of as an ally, I would always encourage you to be the change you want to see and to remember these moments when you are in a position to make life different for those that follow you.
Know that it’s OK to change your mind
So far, I’ve talked a lot about making Consultant, but I think it’s important to talk about the fact that it’s OK to also not want to end up as one. Life is about far more than work, and even in work we all find different sources of joy. The job role as a Consultant is not the same as a qualified Clinical Scientist. You won’t get lab time. There’s an expectation that it’s not a 9 – 5 role, and you will sacrifice a lot to get there, both financially and in your home life. It’s not the right choice for everyone, irrespective of your capability to do the role if you chose. I just wanted to take a moment out to write something that is supportive of starting along this route and then deciding it isn’t for you, for all kinds of different reasons.
Sometimes, I think people feel pressured to continue as ‘I’ve started so I must finish’. I love where I’ve ended up, and it was always my passion. If that wasn’t the case, then I would always support ending up where your passion does lie. That could be in the lab, in education, in quality or leadership. We are so lucky to have so many different options. I’m also aware that I talk about ending up working where your passion lies, and that is also not right for everyone. For many people, that passion doesn’t lie at work at all but with other aspects of their lives, and work is just what enables those things to happen. In my clunky way, I suppose what I’m trying to say is you do you boo and don’t let the pressure of expectation or external influences lead you down a pathway that isn’t right for you.
Bring yourself to every interaction
This all brings me onto something that also took me a long time to embrace. You can’t spend a career spanning decades pretending to be somebody else. For about my first 5 years in post, I didn’t really talk about the things that interested me. I didn’t talk about being a gamer and a geek because I was just really concerned about any judgement and how that might impact my career progression. It took me a while to accept that putting on a front is both really tiring and limits the amount of genuine relationship building you can do.
That said, I acknowledge that it can also be really hard to turn up as your whole self. I know there are some leaders out there who say we don’t owe our full selves to work, but I don’t think I know how to do it any other way. If I want those I lead to share something of themselves so we can build true connections, then I don’t think I can do differently. I’m not saying that everyone has to share every aspect of their lives, but I think I have to lead by example. For me, this means embracing the fact that I am not perfect and that I will have bad days as well as good, and make it OK to talk about those things. For me, that opens up dialogue on coping strategies and deeper dialogue versus pretending that everything is perfect. Everyone brings something different and we should honour that difference by embracing it rather than hiding who we are.
Sometimes, it’s just a case of continuing to show up
I’ve talked a bunch about some of the reasons that making Consultant may involve surmounting or finding a way around barriers. I think one of the things we talk less about is the fact that the thing that often makes the most different is continuous effort. At its heart it’s about continuing to show up, on good days and on bad. It’s about demonstrating commitment and being in it for the long haul.
Now, when I say continuous, no one expects every day to be the same, but there is a consistency linked to intention. If you are clear where your ambition lies and stick to it, it is easier for those around you to also factor that into their thinking. If you are changing the goal and ambition regularly, then can be harder for those trying to support you. It’s not that you can’t change your mind, but you should try not to scatter gun your approach. Making Consultant, to me, like getting a PhD, mostly seems to be about a tenacity of purpose that means you keep showing up, combined with the patience to know it will happen eventually.
Always remember why you started the journey
I think many of you will know that patience is not my greatest asset and so I found the journey so frustrating at times, as I had such a clear vision that was not always shared by others. For this reason, you really need to know that the pursuit of this is right for you, right for you when start, but also stays right for you along the way. It’s that clarity of purpose that can re-centre you when things are tough or when you are facing those no’s. Without it you could easily falter and it may be that it really isn’t the right option for you.
The other reason to have that clarity of purpose is that it is not like reaching the destination transports you to a land of rainbows and bunnies. Consultant roles have their own challenges, and in many ways just having the title doesn’t really change anything. The job is still the job. Therefore, if you aren’t sure along the way, you may just be signing up for more of something that may not be what you want it to be. The flip side of that coin is that if you are sure, and know what you are working for, you are likely to end up in the job you’ve dreamed of and aspired towards for over a decade, and that feels pretty damned good.
The people make the journey worthwhile
I just wanted to finish with something that has struck me more and more as I moved along the stages to becoming a Consultant. Although all the professional stages feel significant, it’s the people I’ve met along the way that I am most grateful for. It’s these people who will stick with you long after the nerves and stresses of an exam are just a distant memory. They will be the ones that guide and pick you up when you hear the no and face the obstacles. They are the ones that, when they celebrate with you, make the celebrations really worthy of the name. So don’t be so focused on putting one foot in front of the other that you forget to look up and find time to develop the relationships that will last a life time.
All opinions in this blog are my own
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