#medtwitter 2020 marks a decade of me being an NHS consultant, and has led to much reflection. There are things I wish I had been told before starting my post, and I have put a few of these together, some minor but some v important -
1/ Burnout is your biggest enemy - physical but more significantly emotional. When you first start, the tendency is to say yes to everything that is asked of you. Choose carefully, and only say yes to the things you really want to do, as you will end up doing them for a long time
2/ Embrace saying "I don't know" - it is not a sign of weakness, rather of being a good doctor and knowing your limits. Ask for help - refer for a second opinion, ask a colleague - you will learn something, and reduce the stress of uncertainty
3/ It is crucial to have interests outside the NHS. Music, literature, sport, an alternative focus. Otherwise it is all to easy to lose perspective during patches when the NHS is going badly
4/ If you have the opportunity to work in or build a multi-disciplinary team, take it. You will learn from a different approach, and it will keep you interested
5/ You are likely to be a consultant for almost ten times longer than you were an SpR. Don't envisage yourself doing the same job for those 30-40 years. Reinvention will keep you engaged - research, management, teaching - at different stages of your career
6/ Although it may not always feel like it, the managers are not the enemy. You must engage with them to achieve change in your clinical service, to the benefit of your patients and you
7/ Quietening outside noise will keep you sane. Even something as simple as not having your email inbox open in a busy clinic will make a difference
8/Complaints are inevitable. If you see enough people, you will get one. They are not necessarily indicative of a failing on your part. Read them, answer them, and ask if there is anything there that would suggest you change what you do and how you do it - not always the case!
9/ You learn more in your first year of being a consultant than in the preceding years of being an SpR. Enjoy it!
Many more, no doubt you have your own tips!
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