Training in the NHS as a Doctor in a specialist area (a Registrar) has a few well-trodden pathways: full time training, less than full time (with a ‘reason’), academia, and then a parallel route called the CESR pathway. The idea is to come out of your period of training with the competencies specific for your specialty and do that in the prescribed time. In some specialities you get to be ‘dual accredited’ – say, general medicine and rheumatology.
The tightrope of training to be a good Doctor, and also growing your other interests, is a difficult one to balance. It was recently made a lot easier for new trainees by the recent decision by Health Education England to support and allow more flexible training, in part due to the rise of ‘portfolio careers’, and the need to retain the clinicians currently haemorrhaging out of the system.
The Topol Digital Health Fellowship is a lesson in how this ‘new way’ can work and support those wanting to have less-traditional training pathways and show different skills that are not necessarily on normal training outcomes.
Because of this support I have recently been calling myself an ‘Informatician and Dermatologist’. This change in identity and re-affirmation of my dual skills and interests has truly increased my happiness within my Dermatology job and I feel confident in understanding where my career, interests and values are aligned. There is now also a Flexible Portfolio Training scheme supported by the Royal College of Physicians (RCP). These trainees get 20% of their time to develop side expertise in four pathways: clinical informatics, education, quality improvement and research.
We have 2 FPTs in clinical informatics in the North East and we hope to grow this number. We have already been able to support their novel career pathways with the new Faculty of Digital Health in Newcastle and a Faculty of Clinical Informatics-approved CPD programme. I am also helping to mentor them and provide peer support for what is a small but perfectly formed group.
The struggle is real when you go against the prevailing thinking or system. You question whether your view is right and have to fight for your interests to be taken seriously, and on a par with other more accepted pathways. My pathway was considered initially as being less of a Doctor. Support from the groups which are out there in Informatics (the expanding Informatics In The Pub [IITP] Network, your Trust CCIOs, the Faculty of Clinical Informatics Early Careers Group etc) will help you know that you are not less of an Anything.
After a number of years, I think I know more who I am.
My name is Matthew, and I am a Doctor-Plus.