I was ecstatic when I got my substantive NHS Consultant job.

If you've ever spent years dreaming of something, you'll appreciate just how stressful the thought of failing is.

But I'm surprised about what's made the biggest difference since I got the job...

I thought it would be staying in one place.

As a trainee I'd worked in over 30 different jobs.

That feeling of having to prove yourself over and over again is....urghhh.

The thing is…

I thought staying in the same place would be the best thing about having a substantive post.

No moving around, no rearranging childcare, no unexpected commutes.

And, I'm not gonna lie Reader, that part is pretty awesome.

I've actually got to know the people in my hospital. I love them. And I can even remember the route to work without my satnav.*

But I've realised location isn't the best thing about finally getting a consultant job.

Not if you want to develop as a clinician and build a sustainable career.

Why?

Because moving around the country (or the world) is only part of the stress of being a trainee.

What you get from having a consultant job goes well beyond that. It's about your family, your life, your future.

It's about helping your family take control of your own lives.

And I don’t mean that you'll actually be able to leave the house exactly when you want to.

I can't promise that.

I mean freedom to plan.

Plan your leave. Plan your holidays. Plan your. wedding (I know, right?)

That’s why getting that substantive job means so much.

To build a relationship with your team, have colleagues that have your back, and be able to plan your life outside of work too.

So sure, location might help with route planning.

But having control and stability is the best part.

In medicine, the clinicians who are happiest enjoy both their work and their non-work lives.

But wanting to get your dream job and getting that phone call to say you've got it are two separate battles.

And unfortunately it’s only getting harder to achieve.

Competition has never been more fierce for substantive posts.

Every post has multiple applicants…

More and more people are prepping properly now as they realise how important securing that dream job is.

So the chance of getting a specific post shrinks by the year.

Trust me:

It’s a whole different world out there in 2025 compared to 2020. It’s why people who found it easy in previous interviews are now struggling. The nature of substantive interviews has changed.

What’s more, we’ve barely scratched the surface of the new types of questions and scenarios being asked in interviews.

Different worlds require different approaches.

So tomorrow, I’ll explain the major hurdles you face - and what you might do to adapt.

Talk then,

Tessa

​

P.S. Watch out for my emails over the next 2 days to hear more.

*that part may not be entirely true due to my poor spatial awareness