Learning about clinical leadership: Our experience as Chief Registrars

Emily Bowen, Judy Martin and Marissa Minns are registrars in Geriatric Medicine. They were also in the first cohort of the Royal College of Physicians Chief Registrar programme.

“‘I don’t know where to start” a colleague confessed. “I’ve only been a consultant for 6 months, and now they want me to set up a new service…”’

It turns out that being a consultant is as much about leadership and management as it about the clinical work: leading a service or setting up a new one, writing a business case, managing colleagues and much more besides. Yet for the majority of us, the closest we come to leadership training as a registrar is a few days spent on a course.

The Royal College of Physicians Chief Registrar programme sets out to change that by equipping a new cohort of clinicians with the skills and experience they need take on roles in clinical leadership and management.

What on earth is a Chief Registrar?

The role originated from a recommendation in the 2013 Future Hospital Commission report. It identified the need to establish new, senior leadership roles with a focus on delivering high quality, safe care. To fulfil this brief the RCP turned to its medical registrars and started piloting the role of Chief Registrar.

The 2016/17 cohort consisted of 19 medical registrars (in a range of specialties) from across the UK and in 2017/18 this has doubled. We still spend 60% of our time manning the medical take, wards and outpatient departments but the other 40% is protected, allowing us to spend time on a whole range of projects from quality improvement and service redesign to junior doctor training and morale.

We all come together at the RCP for a training programme delivered in modules throughout the year but the rest of the job can be developed to suit your Trust.

What do we actually do?

We have had a wide range of experiences guided by the objectives and issues our individual trusts are facing.  Between us we have had the chance to work on developing ambulatory care services and acute hospital at home, improving induction for junior doctors, setting up junior doctor groups and forums and trying in various ways to help ease the winter pressures in our respective organisations.

We have also had the chance to learn what clinical and non-clinical leaders do, how the NHS works and all that is happening behind the scenes to keep the hospital running and improve patient experience.  We’ve developed a range of skills; how to lead a project, chair a meeting and prise money out of the finance department, but also how to manage our time and balance clinical and non-clinical work. We feel we’ve gained experiences that, whether or not we go into leadership roles in the future, will help us to be better doctors and ultimately provide an improved service for our patients.

How can I be a chief registrar?

If you have read this and would like more information or to apply to become a chief registrar then please email chiefregistrar@rcplondon.ac.uk.

Are you a senior (ST6 and ST7) specialist registrar in geriatric medicine, or a specialty doctor on CESR working towards a consultant post approaching your final registrar year? Register for the BGS Trainees’ Leadership and Management course, 14-15 October in Nottingham.

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