Reviews PERSONAL VIEW

What's wrong with having more than one consultant grade?

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7440.651 (Published 11 March 2004) Cite this as: BMJ 2004;328:651
  1. Richard Hayward, consultant neurosurgeon
  1. Great Ormond Street Hospital for Children, London

    At the age of thirty something, budding specialist registrars can expect to become a consultant—a post they may occupy for the next 30 years. But once they have reached this dizzy height what challenges remain to them in terms of career progression? The answer, of course, is none. Consultant-hood is a plateau. There is no higher grade. My own experience, after my appointment as consultant, was one of anticlimax. What was I to do next? Of course my new responsibilities were a challenge: I wanted to establish myself, in my own eyes and among my peers. I ploughed on, but I confess now to having felt not a little depressed. I'd worked so hard to get my new position, and now there was this sudden gap in my life. How was I to fill it?

    My experience, after appointment as consultant, was an anticlimax

    There were various possibilities. I could lie back and do as little work as possible while I concentrated on non-medical life—on my …

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