The following was kindly written for SURG by Mr Alan Turner, Retired Consultant Urologist and Medical Director, Peterborough Hospitals NHS Trust.
Consultant Appointments
A strategy to get your desired Consultant Appointment:
When I was looking for a Consultant Post my then chief advised me:
?Choose the hospital more carefully possibly than your partner sadly it is easier to separate from a partner and establish another relationship than it is to leave a hospital post and get another one?.
?Be very careful about an appointment to a hospital where you have been at the end of your SpR training. It is very flattering to be asked to join the Consultant staff but you may always be the SpR in the eyes of your consultant colleagues with all that that entails?.
After many years of observing consultants and their progress I am sure these comments still hold true.
Choosing the Hospital:
Remember as a Consultant you should be very important for them. They will depend on your ability to earn their income and reputation. You should therefore be courted to join the hospital.
Look at the information that you are sent with the application. Does it make you feel ?I want to work there?. If it does not make you think that and the description is rather dull then that might reflect the attitude of the hospital. In this day and age hospitals should be selling themselves they do it to primary care so they should do it for prospective consultants.
Find out what you can about the Hospital eg grapevine at SURG meetings, look at the Healthcare Commission website there should be reports on hospitals (CHAI reviews are published) as will be the Star Ratings. We may not agree with the concept of Star Ratings but it does give you a guide as to the state of a hospital. Beware a failing hospital.
Visit it at a weekend and wander in see what it feels like see how you are greeted if you ask for the say Postgraduate Centre. It is surprising how much you gain from first impressions were they really welcoming and helpful if so it is a good sign of a happy staff and if not good would you really want to work there.
Look around the geographical area with your partner, look at what facilities are available recreation (work-life balance) schools (boring) connections to other parts of the country/cities (get out easily to meetings and friends) houses and their cost (can we afford a decent life here).
Remember if you or your partner do not like things then do not apply, you might get the job. Be realistic though life is about compromise.
The Post:
You should receive an Application pack which should contain the following:
- Job Description which should include a model timetable
- Person Specification
- Information on the Trust
- Staffing and Relevant Services
- Teaching commitments
- Terms and Conditions of Service
If any are missing ask for them. They might refer you to the Department of Health website for the Terms and Conditions which is acceptable.
All Consultant Posts should be suitable for those wishing to work less than Full-Time. If not then the Trust should clarify why not.
It should also outline how the post being advertised fits in with the department and thus any sub-speciality interest that may be needed. If not ASK - the hospital may just be on a fishing trip to see who applies but this may lead to all kinds of problems.
Preparatory Work:
Visit the Hospital officially. You should try and meet the following:
- Possible Consultant Colleagues in the same speciality
- Possible Consultant Colleagues in an allied speciality eg anaesthesia, radiology, nephrology, gastroenterology etc to see what they feel about the new appointment
- Possible colleagues in the support services eg physiotherapy
- Medical Director ? they may give you a slightly different view from potential colleagues
- Chief Executive - they should give you the same view as the Medical Director if not what is the relationship in management and where is the Trust heading
Questions to Ask:
What is expected of the new appointment?:
- Is it a replacement? - thus all that is expected is to maintain the status quo - could be boring if you are not allowed to develop
- Is it to increase the capacity of the department? ? the department is busy good reputation etc and they want another pair of hands to complement everyone else
- Is it to increase the capability of the department? ? your chance to develop your sub- speciality interest
- Is it to increase the portfolio of the Trust? ? this is to develop a completely new speciality doubtful in this day when specialities are contracting that this will be the situation
These questions will give you a flavour of what will be expected of you in the post.
No matter what, you need to establish that the Trust has thought about the implications of the appointment especially around costs for:
Equipment - especially if you are replacing a retiring consultant ? they will not necessarily be using modern techniques eg minimally invasive kit. I doubt whether they will have thought about this.
Support Departments ? any special investigative procedures that are now needed for you to provide a modern service which the hospital may not have.
Support Staff ? if they are increasing the numbers are the support staff available eg junior medical staff, theatre sessions, anaesthetists, physiotherapists to mention but a few.
Medications ? not so much possibly for surgeons but there may be new non-operative treatments that require a substantial investment in drugs.
It is important to ASK about the above as if the Trust has not thought these matters through then you could spend the first few years of your consultant life fighting for what you consider the bare essentials of a modern service. ? not good.
They may seem very receptive to new ideas but if you get the impression that there will be little support in the broadest sense for new ideas then be careful.
Application Form:
Everyone has the CCST so you have to ensure that your application gets selected. Make it interesting, try and tailor it to what the hospital wants eg if they want a hand surgeon make sure that your training in hand surgery is well presented and stands out. If in your spare time you do something different eg sailing across the oceans again make sure it stands out. All this looks as if you are the correct person for the post and also you are someone who has that little bit extra to offer.
Interview Panel:
There is a local majority and a medical majority.
Interview:
Congratulations you have been selected for the interview. As you have not done one for a few years ask your chief if he would mind giving you a mock interview to see if you have any bad habits which might make the panel not want you and to give you some feedback as to how you come over. You have one chance to impress the panel do not waste it!
You may be asked to give a presentation to staff. You will be informed of this in advance and how long the presentation should be. Find out the audience to whom you will be presenting to and tailor it to that audience. Keep it clear and succinct.
There will always be the ?standard interview? at which all the panel members will have the chance to ask questions. Before the interview starts the questions that will be asked and by whom are agreed so that all candidates are asked the same questions.
A few tips in general:
- Short answers ? do not meander
- Try and look as if you want the post
- Keep panel interested
- Try and engage all panel members
- Watch their body language ? if one is yawning or looking away then you have lost it!
- Watch your own body language
Questions:
The questioning usually follows a set pattern and in the following order:
- College Representative
- University Representative
- Hospital Consultants (usually 2)
- Medical Director
- Chief Executive
- Lay Chair
College Representative:
There to see if you are appointable you should be as you have CCST so they could ask about your specific training for the post for which you are applying. Your chance to tell the panel you are just what they are looking for as your training in what they want is more than adequate and in addition you have done other related things eg know how to give chemotherapy for cancer and have been involved in trials.
University Representative:
Only present if there is a major teaching commitment so you will be asked about teaching and your experience and ways in which you know you are a good teacher eg feedback from students, pass rates at exams etc Tell the panel all this before they ask you and it has to be dragged out!
Hospital Consultants:
They usually want to know what you have done and why you want to join their department.
This is your chance to tell them why they should select you how your training fits into their department to strengthen it and make it a department to be proud of. Be positive it is surprising how few people can sell themselves.
The Rest:
This is where the question can be difficult to forecast but in general the Medical Director will want to know how you interact and the Chief Exec will want to be convinced that you want to come to his hospital and that it is not just the next in line. The lay chair will want to know a bit about you outside medicine. So these following questions could be asked:
?What are your strengths and weaknesses?? Any management course or book can explain what this is about and what answers are expected. Do NOT say I have none when it comes to weaknesses. Do not say another is not wanting to do your paperwork ? might be true but not the best thing to say.
?How do you deal with a difficult colleague?? Not an uncommon problem try to think how you dealt with a junior who was a problem and tell them how you dealt with it good practical stuff.
?How do you deal with a failing colleague?? Obviously trying to prevent cover ups You must deal with it positively by involving more senior people you are too inexperienced in these matters If they cover it up then go higher and higher in the organisation. Remember if you know about something and do nothing you are in just as much trouble if an enquiry takes place.
?Why this Hospital?? You must think of good reasons eg joining a good department and tell them how you know it is a good one, a hospital with a good reputation say how you know. What they need to know is that you have positively looked at the hospital and said ?Yes? this is where I would want to be. Makes the CEO etc feel good about their hospital.
?How do you relax?? Its amazing what I have heard reading medical texts is not the best answer how does that relax you. Watching television - what Coronation Street!! Try and be a bit more specific. If you play a sport for example tell them who you play for or how often There are numerous ways in which to relax so be specific about whatever you do.
?Where do you think your Speciality will be in 5 Years?? There have been so many changes in the last few years have you got any forward vision as to how things may change and how you are going to adapt.
?How would you get to know the GPs?? Under the new payments system you will have to be able to sell yourself to the GPs preferably you do this by presentations, audit meetings would suggest ?by dinner parties? is not the correct answer.
?What would you want from the Hospital?? Your chance to tell them what you would need to build up the department and for you to develop they should not want someone who thinks great I have my Consultant Post so that is it until I retire. Try and think what you would like to do to develop yourself.
?Are you a Team Player?? More and more we work in teams so the answer should be ?Yes? but give examples as to how you know eg feedback from your boss at appraisal.
?What Audits have you been involved with and did they change practice?? Tell them what you have done.
?What is your most favourite paper you have written and why?? Again tell them what you have done.
?If I was to phone your Junior Staff and say what are you really like what would they say?? Try and get in a bit about team player, approachable etc remember your references may say different.
?Why this area of the country?? Apart from the hospital and how great it is you can say that you have looked around the area and like what you see. Try and give examples of good points even if it is good connections with major centres or good schools etc.
If there is a recent article that affect the NHS then try and get a feel for its implications to you eg Bristol Enquiry, Shipman Enquiry. It may also be worth visiting the Departmnet of Health website to see what is hot on the agenda www.doh.gov.uk
There may be numerous others but these are those that come up often. Do NOT try and crack jokes they can go horribly wrong. There seemed to be a vogue a little while ago to start your answer by saying ?That was a good question? the panel knows it was a good question that is why we are asking it We do NOT wish to be complimented on our question just answer it!!!
End of Interview:
You will be asked if you have any questions. You may want to clarify some points a bout funding of the post etc or you can say ?No Thank You I have had the chance to talk to everyone I wanted to.? No one will be offended.
You will be asked if you were offered the post would you accept. Could I suggest you answer in the affirmative saying no thanks is not a good move wasting everyone?s time. Remember if you do not want the post do not come for the interview. The panel do talk to others in the speciality and such an answer soon gets around.
Successful Candidate:
Congratulations you have been called back and told you will be offered the job. Do NOT sign any contract most hospitals will not ask you to do this but some will. It should be a standard contract but go away and read it to make sure.
Post Interview Negotiations:
The job should lay down the number of PAs and there is nothing that you can do to increase these you may be able to negotiate them down if you wish to go less than full-time. What you could ask for is a pay increase above the minimum but I doubt if you will be successful unless you are in a shortage speciality.
References:
Remember there is a duty for your referees to tell the truth no longer can they give a good reference to ?get rid of you?. Ask them what they are going to say about you it may come as a shock and if there is a problem then you need to try and correct it. I have seen references which say that a person is less that adequate for many reasons Not much of a chance of getting a consultant post with that reference. Ask your referees for an idea of what they are going to say about you The RITA assessments should give you an idea.
More details on the Appointments Process visit:
- www.doh.gov.uk
- The National Health Service (Appointment of Consultants) Regulations ? Good Practice Guidance January 2005
- Maintaining High Professional Standards in the Modern NHS February 2005
- Terms and Conditions of Service for NHS Consultants - 2003
- Consultant Contract Implementation Team ? Modernisation Agency
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