Stepping Up - transition from trainee to new consultant

RCPCH_Step up Line RGB-01.jpg

The Stepping Up pilot programme combines a regional network of doctors with a range of learning resources to support the transition of senior trainees “Stepping up” into new consultant roles. The transition period encompasses the 5 year period post-START ST7 to the end of year 3 consultant (ST7-C3+) primarily.


There is demand for greater support during the difficult transition phase from senior trainee to new consultant, as highlighted in RCPCH CCT & CESR cohort surveys.  While trainees are supported throughout the training programme to develop skills to work independently as consultants, the reality of working as a senior trainee is challenging, given pressures on service for both trainees and trained paediatricians and reduction in SPA time and study leave funding for consultants.  Working independently as a consultant is also vastly different to working as a supported ST8 trainee. 

A College-facilitated regional network for senior trainees (post-START ST7s and upwards) and new consultants (up to 3 years into consultancy) can help prepare senior trainees for the challenging transition and also support new consultants working in an increasingly challenging working environment, improving morale and encouraging entrants to paediatrics longer term.

RCPCH is responding to this call with a pilot running September 2017 - Aug 2018 to test the impact, sustainability and effectiveness of the regional networks for this group of paediatricians. The network aims to support these doctors with this challenging 5 year transition period “Stepping Up” from senior trainee to being a new consultant.

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

The pilot regions and Champions

Wessex and East of England have been selected as the pilot regions.

These regions have been selected as they provide both geographical variation and diversity, as well as selecting areas that have different challenges with recruiting and retaining paediatricians in training and during consultancy.

Each region has a Champion whose responsibility it is to set up and coordinate Stepping Up meetings and activities in the region.

The Stepping Up Champion role

The Stepping Up Champion:

  • engages with all ST7 and 8 paediatric trainees and new consultants who are up to 3 years post CCT/CESR/CESR in their region via email/ebulletin
  • facilitates (set up, publicise and support) a minimum of 3 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

The application deadline to apply to be a pilot Champion closed on 6 November 2017 at 9am. However the role description is still available

The regional network meeting structure

It is entirely up to the regional pilot Champion and those in their regional network to 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.

Feedback from the senior trainees and new consultants at Annual Conference 2017 highlighted a range of topics for that new consultants are concerned about which could be usefully discussed at regional meetings e.g.:

  • Managing internal Trust politics and handling non-medical staff and managers
  • Learning 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 fro 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

Meetings can be tied into ones already set up by Heads of School for level 3 trainees to make it easier to manage.


Each pilot region will be given a total budget for the year of £450 to be used for e.g. speaker honoraria or provision of refreshments if no speaker is required.  Travel & 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, relevant groups in each pilot region are 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 to support the transition from ST7-new consultant




Additional education, training and resources