How I Created My Own Clinical Fellowship
Hi, I’m Amelia. I’m an F5 locum doctor and Clinical Lead at Messly. Since leaving training I have worked as a locum doctor in both community and District General hospitals, as a clinical fellow, and in private industry. In this article, I’ll explain how my clinical fellowship came to be, and the pros and cons of designing your own fellowship.
In my F4 Year, I did a clinical fellowship in CAMHS. It was a role I’d never anticipated or aspired to and yet it was one of the best experiences I have had in my professional career. In this article, I will explain how I got a role that was not advertised, how I negotiated my position, and why this fellowship was such a great experience for me. I’ll also give my top tips for creating your own fellowship role.
My path to this fellowship began a long time before my F4 Year started - back to when I was a foundation trainee. By the time I finished my foundation training programme I was severely burned out. I’d never been totally convinced that medicine was right for me, and had always known I was going to take an F3 Year without having any solid plans on what I wanted to do during that year besides travel. All I really wanted was a break. I needed a break.
During my foundation years, the only thing getting me through the days (and night shifts) was the F3 trip I had planned with my partner. We had decided to go to New Zealand and hike the north island from top to bottom. We'd started training for the trip in my limited time off work, and saving every penny from my foundation training to fund it as I had no intention of working while we were out there.
By the end of F2 I was more convinced than ever that I couldn’t continue medicine. I was physically unwell from the grueling shift work, mentally unwell from the absence of my hobbies and work-life balance, and stressed and overwhelmed by the recent onset of the pandemic. I also felt lost and disoriented by the abrupt changes that the pandemic put on my F3 travel plans and all hope for our epic adventure was shattered.
When my training contracted finished I found myself in the paradoxical position of being totally free in a global lockdown. The family visits, hobbies, and experiences I’d wanted to bring back into my life were no longer an option as Covid-19 continued to ravage the world.
I couldn’t face the idea of working full-time again and though I'd convinced myself that I would locum, I seemed to find every excuse to not accept any work. Instead, I embraced that sense of free-falling that came with having no income and no shifts booked to earn any income, instead living off the money I had saved for the travels I could no longer go on. I chose unemployment and emotional and psychological recovery from burnout, and I invested my time in the hobbies I’d put aside for so long. And for the first time in two years I started to feel happy on a day-to-day basis.
Around 6-8 months into my F3 Year, I started to panic that funds were running too low and I was de-skilling from not working for so long. Desperate for income, I tried to create opportunities for myself. I registered with a locum agency and took a few weeks of shifts at a far-from-home DGH to refill the coffers quickly. I also contacted my local DGH to get onto their staff bank, and I scoured the internet for local fellowship and non-medical jobs.
Though my locum agency was helpful and organised, the far-from-home DGH was so remote that the work felt unsafe. It was too anxiety invoking, and after so many months trying to recover from the stress of working, I didn’t want to sabotage my emotional recovery by accepting work that didn’t suit me, so I put this option aside as an ‘emergencies only’ stream of income.
The local staff bank was overwhelmingly disorganised and I spent months chasing their medical HR to get registered as a locum. In the end, it took so long to get replies and answers that I gave up. I was tired of fighting so hard for work I didn’t really want that badly.
Instead, I found an advert for a CAMHS SpR clinical fellow on NHS jobs. I knew I didn’t have enough experience to work at an SpR level but the advert provided the contact details for the CAMHS consultant who had listed the job.
My partner (who works in private industry) and I had recently had a conversation about how his female friends and colleagues often applied for jobs that they were overqualified for, while his male friends frequently applied for jobs they were underqualified for and the memory of this conversation was still fresh in my mind when I found the job advert.
I decided to throw caution to the wind and get in touch and ask whether the Consultant who had listed the job would consider an SHO instead of an SpR in the role. We ended up having a long phone call about my experience and my interests, at the end of which he encouraged me to apply for the job.
Though I’d never previously considered a career in CAMHS, I’d enjoyed psychiatry at University enough to arrange a medical elective at the Maudsley Institute of Psychiatry in London. I’d enjoyed working with kids during my GP rotation so even though I was ambivalent about continuing my career in medicine, there was something about this role that sparked my interest.
I interviewed for the SpR position despite feeling it was unlikely that it would amount to anything. The Consultant I’d spoken to was sufficiently impressed with my interview to appeal to the Trust to create an additional SHO post and hire both myself and a psychiatry SpR. Because the position now had funding before it had a formal job plan, I was able to negotiate the role and to an extent, write my own job plan.
I wanted more consistency and continuity in my work, as well as sufficient time for sleep, exercise, and hobbies outside of work. I wanted flexible working and the opportunity to learn, teach, read, study, and research. I was scared to enter a full-time contract after the stresses of F1 and F2, but the ability to write my job plan helped me feel empowered, respected, and in control of my career for the first time.
Foundation training had taught me enough about myself to know that I’d struggle to be happy while working irregular shifts, on-call rotas, nights, and weekends. So when medical HR initially said I’d be joining the on-call rota, I pushed back and said that I wouldn’t be able to accept the job if it required out-of-hours work. They conceded and removed the on call component with no deduction to pay.
When I started my F4 Year and my 12 month clinical fellowship in CAMHS, I also unknowingly started the slow transition back to confident, happy doctor. There were many things about that role that did not go to plan but the greatest gift it gave me was that it helped me fall in love with my chosen career for the first time ever.
I was fortunate in that role that I'd found a team who supported me. The consultant advocated for me and the SpR supported me both as a friend and a colleague, ensuring I was always growing and progressing my skills, as well as looking out for my day-to-day wellbeing. I'd never felt so cared for in an NHS job before and the combination of an outstanding team and my decision to advocate for myself when designing the role resulted in an outstanding 12 months.
I started foundation training not totally convinced medicine was for me and I ended foundation training completely convinced that there was no medical job that I could do that would allow me to be happy while working. My self-designed CAMHS fellowship was the first medical position I’d ever had that I’d truly loved, and I was sad to leave at the end of my year. Instead of constantly feeling that I was losing myself to medicine, I finally found that there was something in myself I’d be losing if I chose to leave medicine permanently.
After my fellowship ended, I started locuming again while working part-time with Messly. The change in my confidence and attitude was profound compared to when I was locuming pre-fellowship. Prior to starting my fellowship I’d found it near impossible to find locum work close to home, and felt forced to look out of county. However, after my fellowship and my profound change in attitude towards being a doctor, I managed to find locum work closer to home with much more ease. Suddenly opportunities started flooding in and I was able to find an even better balance between work and play than I had as a foundation trainee or even in the fellowship role.
Having spoken to many other clinical fellows, it has become clear to me that junior doctors are not aware that they can create or negotiate fellowship roles. If you can find an advocate and fill a niche in a department, many Trusts will be open to you creating your own opportunities. Therefore, I have outlined my top 3 tips for creating a fellowship from scratch that works for you.
💡 Tips for creating your own fellowship role
✅ Be open minded - I was open to any specialty when looking for roles and didn’t limit myself to one department.
✅ Speak to people - If I hadn’t reached out the the Consultant on the job listing for further advice on a role I wasn’t really qualified for, I’d never have got the job. In order to create this role, I needed a senior doctor to argue my case and help obtain funding for the role so having them on board was essential to my success in obtaining the role.
✅ Advocate for yourself - From experience, I knew what I would and wouldn’t be able to manage from a rota and I stuck to my guns after being offered the job. I also requested the things I wanted like a study budget, flexible working, weekly supervision, research, and teaching. If you don’t ask, you won’t get!
If you want to hear more about Amelia’s experience in creating her fellowship or have any questions about this article, please get in touch with us at firstname.lastname@example.org
This article is part of a wider series of resources and guides that are designed to support you as a locum doctor, covering areas such as getting your first job, managing your finances, understanding your rights, and many more. Visit our Locum Doctor Hub for everything you need to know about locuming today.
Additionally, if you're considering an F3 year, you might also find it useful to look through the selection of resources we've put together in our F3 Resource Hub.
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