I am Cathryn Chadwick, I am the Vice President for Training and Assessment at the RCPCH and a General Paediatrician at Northampton General Hospital, where I have a neonatal interest. I have benefitted from flexibility in my career. It has enabled me to follow a varied path from general practice to paediatrics and latterly into medical education at the same time as being a parent and managing to keep a reasonably healthy work-life balance.Â
If flexibility had been missing from the equation, I honestly don’t think I could have managed while staying happy and healthy. We at RCPCPH are determined that our new training path will enable paediatricians to train and at the same time to develop their interests, give their out of work lives the care and attention they need and maintain life long, sustainable careers. Enhancing flexibility is a core principle in our Shape of Training plan, which has culminated in the new curriculum, Progress+.
Progressing at a rate that's right for you
From August 2023, training will be aligned to the RCPCH Progress+ curriculum. We are simplifying the programme from three levels to two levels. Trainees will spend up to four years in core training followed by three years in specialty training, either in general paediatrics, perhaps developing a special interest or in a sub-specialty.
Your progress can be personalised and capability based, not simply time based
After I qualified, I took some time to find my niche, I had several 6m posts, in emergency medicine, elderly care, obs and gynae and general practice. In modern parlance I had a Foundation Year 3, FY4 and stretching into a FY5 year! I learnt valuable transferable skills from all of these jobs, which meant that when I went into paediatrics, I was ready to progress more quickly to middle grade.
With Progress+, we recognise that doctors will enter training from a diversity of backgrounds, many with valuable and relevant capabilities under their belt already. This will allow trainees to progress at the rate that is right for them. With an educational supervisor staying with the same trainee for a whole level of training, progress can be personalised and capability based, not simply time based.
The seven year programme is indicative; some will take less time, some more. We anticipate that taking time out of programme will become more common as trainees want to develop individual interests or gain experience of sub-specialties. Making decisions about whether to follow a sub-specialty route can be difficult. Careers advice will be part of longitudinal supervision and for those who remain uncertain, we are creating flexibility to move between sub-specialty training paths.
Opportunites for less than full time training
I spent 10 years of my training working less than full time (LTFT). This made me pretty old when I finally became a consultant, but I enjoyed the journey and it probably kept me sane!
Training LTFT is very accepted in paediatrics, with over 50% of trainees choosing to work this way in many regions. Where possible, training programme directors are very receptive to LTFT for a wide variety of reasons, including ‘category 3’ where no specific reason is needed. Many trainees are choosing to work at 80% to improve their work life balance.
Don’t assume that less than full time training is the prerogative of female trainees! There are many male trainees also enjoying the flexibility of this way of working.
Varied routes into research
There are many routes into an academic or research based career. Some will come in as academic fellows at Specialty training level 1, or later in training, a path which gives more flexibility to mould clinical experience around research projects.
The majority of trainees are not on an academic track, but research capabilities are still an important part of the curriculum and can be acquired in the course of clinical training. Out Of Programme (OOP) experience has a place here, too. OOP can be taken to pursue research projects, to further a medical education interest or to take part in leadership and management projects.
We recognise that encouraging a full range of skills and experiences will make paediatricians fit for the future.Â
It's a lifelong career
Over the latter part of my career, I have taken on more educational roles and dropped some of my clinical work to take this on. As careers progress, interests change and work patterns need to be revisited.
The development of lifelong careers is very important to us and is an active College work stream. Our vision is to extend flexibility through the totality of a career, embedding flexibility from the start to the finish of what we regard as a hugely satisfying and rewarding career.
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Cathryn Chadwick is a general paediatrician based in Northampton