Stepping up - transition from trainee to new consultant paediatrician

How do we support the transition of of senior trainees stepping up into new consultant roles? Our Stepping Up pilot programme supports the five year period from RCPCHStart (Specialty Trainee 7+) to the end of year three consultancy. It does this through a regional network of doctors and a range of learning resources.
Last modified
18 February 2019


As highlighted in our CCT and CESR cohort studies, there is demand for more support in the difficult transition phase from senior trainee to new consultant.

Trainees are supported throughout the training programme to develop skills to work independently as consultants. However, the reality of working as a senior trainee is challenging - particularly given pressures on service for both trainees and trained paediatricians and reduction in SPA (supporting professional activity) time and study leave funding for consultants.

Working independently as a consultant is also vastly different to working as a supported ST8 trainee.

A regional network for senior trainees (post-RCPCHStart ST7s and up) and new consultants (up to three years into consultancy) can help prepare senior trainees for the transition. It can also support new consultants working in an increasingly challenging working environment, improving morale and encouraging entrants to paediatrics longer term.

We are responding to this call with a pilot from September 2017 to August 2019 to test the impact, sustainability and effectiveness of the regional networks for this group of paediatricians.

Relevant resources for this audience are also available via the links below.

Pilot regions and champions

Wessex and East of England have been pilot sites since October 2017. As of September 2018 and to August 2019, we have expanded to new pilot sites in Wales, East Midlands, West Midlands and Yorkshire and Humber.

These regions have been selected as they provide both geographical variation and diversity. They also have different challenges with recruiting and retaining paediatricians in training and during consultancy.

Each regional Champion sets up and coordinates Stepping Up meetings and activities in the region.

Current champions

Pilot meetings planned

  • East of England – next meeting will be 17 May 2019, Watford and then in Sept 2019 in Norwich. For more details about the next meetings and to sign up to the mailing list, contact - also see download section for meetings flyer.
  • East Midlands - next meeting 15 March 2019 at the Rainbow Children's Hospice in Loughborough. For more details and to sign up to the mailing list, contact 
  • Wales - last meeting was 29 January 2019 at Princess of Wales Hospital, Bridgend. For details about the next meetings and to sign up to the mailing list, contact
  • Wessex – the last meeting was 4 October 2018 09.30-17.15 at Southern House, Otterbourne. For details about the next meetings in Spring and Summer 2019 and to sign up to the network mailing list, contact 
  • Yorkshire and Humber - Spring 2019 meeting being planning. Contact

About the Stepping Up champion role

The Stepping Up champion:

  • engages with all ST7 and 8 paediatric trainees and new consultants who are up to three years post CCT/CESR/CESR in their region via email/ebulletin
  • facilitates (set up, publicise and support) a minimum of three network meetings within the pilot year for this group, focusing on meeting topics suggested by this group of doctors
  • ensures the needs of both clinical and academic paediatricians are catered for in meetings
  • sources external speakers for meetings as required
  • liaises with local Head of School, Training Programme Directors and Regional Leads to ensure promotion of and support for network meetings
  • liaises with RCPCH Mentoring Champions to encourage development of local mentoring pairs and facilitate informal buddying
  • keeps the national pilot Stepping Up lead and RCPCH staff informed of progress
  • helps evaluate the pilot in their region in liaison with the Stepping Up lead/RCPCH team.

Regional network meeting structure

The regional pilot champion and those in their regional network decide what happens during a meeting. Meetings could be set up to have a keynote speaker, followed by Q&A and group discussions, or they could be set up to allow time for informal buddying or formal mentoring discussions to take place.

To make it easier to manage, meetings can be tied into ones already set up by Heads of School for level three trainees.

Senior trainees and new consultants at RCPCH Conference 2017 fed back on topics they are concerned about. These could be discussed at regional meetings. They include:

  • managing internal NHS Trust politics and handling non-medical staff and managers
  • how to entrust senior registrars with clinical decisions
  • how to handle patient queries from juniors over the phone, when on call but not resident
  • transition from shift to non-shift working
  • management of child deaths
  • management of child protection issues
  • handling of complaints
  • local appraisal and revalidation processes including for those in academic roles
  • management of rotas
  • management of handovers
  • Management of biannual trainee changeover
  • how to choose the right consultant job
  • where to seek careers guidance including for those in academic roles
  • how to negotiate pay
  • contract and job planning issues
  • roles to take on/avoid as a new consultant
  • looking after self and building/maintaining resilience.


Each pilot region has access to a total budget for the academic year of £450. This can be used for speaker honoraria/thank you gifts or provision of refreshments if no speaker is required.

Travel and subsistence costs for trainees/new consultants cannot be covered by this budget. Room hire should be negotiated free of charge by using local Trust or HEE/Deanery rooms.

Pilot evaluation

To evaluate the impact of the pilot, each pilot region will be asked to complete/submit the following to feed into a consolidated pilot report.

  • Target group in region survey at start of pilot to evaluate confidence levels on a number of issues that target group currently face, and what they want from meetings.
  • Target group in region survey at end of pilot to evaluate change in confidence levels, overall usefulness of local network and recommendations for future activity.
  • Pilot regional champions quantitative and qualitative feedback around logistics, attendance numbers at each regional meeting, support from Regional Leads, Heads of Schools, etc., funding uses and recommendations for future activity.
  • Qualitative feedback from target group attendees at each regional meeting to demonstrate usefulness of meeting.

Professional development resources

The aims below to support the transition from ST7-new consultant.

Disclaimer: Inclusion of non-RCPCH courses, elearning and other educational resources on this webpage do not imply RCPCH endorsement or CPD approval. Learners should ensure the resources they subscribe to meet their educational needs.


eLearning and webinars