Flexibility is the key word

I have followed with interest the debate on the changing role of the consultant psychiatrist, and the difficulties in recruitment and retention. Over the past 6 months, there have been editorials, opinion articles, correspondence and a recent study by Mears et al (Psychiatric Bulletin, April 2004, 28, 13-131) about different aspects of this debate. The Royal College, the British Medical Association and the General Medical Council are all debating how to reflect these pressures by changing consultant roles. I agree with Professor Appleby that flexibility is the key word (Psychiatric Bulletin, April 2004, 28, 113).

As a specialist registrar, I have watched consultants and trusts struggle to provide safe, effective services within constrained budgets. Compared with a training post, a substantive post brings with it not just increased clinical work and responsibility, but also extra roles in management and teaching. On top of this, individuals have to fit in a healthy work-life balance.

During training, I decided that sectorised jobs involved too many competing demands. I opted to work only with in-patients as a part-time consultant. Unfortunately, many trusts that I approached for jobs struggled to accommodate this style of working.

I have been able to take advantage of an opportunity offered by National Health Service professionals. I started in February on the New Consultant Entry Scheme, which offers a 6 month trial with support, mentoring and extra continuing professional development time. There have been teething problems but the chance to try out newer ways of working on a trial basis seemed less risky than committing to a substantive job only to walk away.