I was recently invited to give my thoughts on the transition to becoming a consultant but didn't actually get to give the talk

Inspired by @two_medics' and @MedCrisis' timely podcast discussion, I thought I'd share it with #medtwitter

Becoming a consultant: a meme-oir 🧵
Preface: this is just my thoughts and opinions and some things I wish I'd known. There are far better threads on how to be a consultant, and an excellent course for new consultants run by @drannamaino and @RCOphth
Congratulations. You've made it to the end and you're not a trainee any more
It's been a long road getting you ready for your time in the spotlight
So take a moment to relax and celebrate your win
So now you've levelled up and you're in the driving seat. Finally a chance to do things properly, the way you’ve not been able to do before. All those frustrated moments, where you could see what needed fixing but didn’t have the power – now is your moment to shine
You finally get to glimpse behind the curtain and you now understand why you were always met with weary resignation when suggesting ways to improve things. It doesn't mean you don't bother but you now need to learn how to pick your battles
Everything is both familiar and completely different. Even if you’ve returned to a hospital you’ve trained in, everything just feels slightly different. It can be easy to feel overwhelmed, especially if (like me) you think you’re now just supposed to get on with it
It can feel like suddenly everyone is coming to you to sort things out and somehow every issue becomes your responsibility to fix
Biggest thing I wish I’d appreciated more is that its still ok to ask for help. Just because you’re a consultant, you’re not expected to know everything. There will always be consultants more senior who can give advice about patients, work issues, job plans, life in general
Remember your junior colleagues can also be a source of knowledge as they may have seen/done things you haven’t. Some people are too proud to ask juniors for their opinions but we all have our own viewpoints/experience to offer
Seriously, ask for help. You'll be surprised at some of the unexpected sources of help you'll encounter
Remember no one is indispensable. The NHS is an inertia-laden machine and if you remove one part the rest will keep on going. Doesn't mean you’re not important, but it means you needn't sacrifice yourself. Prioritise your mental and physical health and don’t overburden yourself
Be strict with yourself about work/life boundaries. This is important for your juniors too – if you email/message them about work in non-work time, it sends the message this is normal and perpetuates it. Lead by example and make it easier for others to prioritise themselves too
Despite the extra responsibility, you will have free time. No exams to prepare for, no portfolio to complete. People often suggest filling this time with business cases, research etc. Great if that floats your boat, but now you finally have some spare time why seek out more work?
Certainly in the first couple of years, just focus on getting yourself settled. It can seem like you’ve got the hang of things quite early on, but speaking from experience it doesn’t take much to throw you off balance
So what to do with that time. Hobbies! Remember those? Those things you did to help you get into med school/foundation/specialty training. Now you’ve actually got time to invest in these so make the most of
it. Spend time with family. Read that pile of dusty (non-medical) books
One of the best bits about being a consultant is the opportunity to get to know your patients. I've lost track the number of times a bad day has been turned around by seeing the friendly face of a patient who I’ve met several times
over the years
Of course there's always a downside - I found it lonelier than I was expecting. I hadn't fully appreciated how the little moments of chatting in clinic helped pass the day. Lunches is a more solitary affair – other cons are busy with their work and the cons-junior divide kicks in
On the plus side, you're now going to be in one place for a while so you'll get the chance to become a full member of the crew
So, in summary...
And my four top tips would be:

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