One of the enduring legacies of the RCP Future Hospital Programme is the chief registrar scheme, about to begin its fourth year. Dr Aarij Shahid Siddiqui, RCP chief registrar 2017–18, joined the UK-wide national scheme in 2017 as a senior trainee specialising in gastroenterology at Cardiff and Vale University Health board.
During my time as chief registrar, I was able to attend medical directorate and board-level meetings and encouraged to engage with senior executives on a variety of projects. For example, as a group of junior doctors, we formalised a pathway for raising concerns and we improved the Hospital at Night system. I started a weekly medical unit round, held a trainee engagement event, a quality improvement skills workshop and worked to establish a junior doctors’ forum in my hospital.
It’s a fantastic learning opportunity. A chief registrar is a leader; a trainee advocate. Their role is to stand up for junior doctors and provide a link between trainees, consultants and the health board. The RCP chief registrar scheme provides protected time for senior trainees to practice leadership and quality improvement while remaining in clinical practice. They are also supported by a bespoke 10-month development programme designed and delivered by the RCP in London.
Chief registrars:
- provide a vital bridge between senior clinical leaders, managers and the wider trainee workforce
- address local challenges and priorities
- collaborate across teams and traditional boundaries to deliver better outcomes for patients.
The RCP development programme has helped me learn more about myself: my leadership style, my strengths – and how I engage with others. For trainees, I think the role is an excellent opportunity to learn about how a hospital works and the barriers to bringing about change. It also gives you a feeling of empowerment and helps you to see that you can change the things which are most important to us as doctors.
Chief registrar challenges have increased my resolve to take up future leadership roles and encourage juniors to do the same. Most importantly, as chief registrar I was able to improve trainees’ awareness and ability to report unsafe staffing levels.
The RCP in Wales is campaigning for more investment in national programmes such as the chief registrar scheme and flexible portfolio training. Our recent report, Doing things differently: Supporting junior doctors in Wales, flagged up a whole raft of junior doctor concerns – but crucially, outlined a number of case studies and recommendations aimed at improving staff health and wellbeing and the trainee work-life balance. It’s worth a read.
I am now one of four Wales-based graduates of the RCP chief registrar programme, with a fifth recently appointed in Swansea Bay who will take up post later this year. Dr Sabreen Akhtar, one of my colleagues, and a graduate of the 2016–2017 programme, agrees that it is an exciting opportunity.
Originally, my role was intended to focus on quality improvement at the health board, but it grew and changed with the needs of trainees to become more of an advocate role … In a leadership role, it is important to be visible, approachable and on-call … Protected training time is vital, and health boards need to understand that trainees must be allowed to learn.
Unfortunately, Wales has struggled to recruit chief registrars in the past. We’re not sure why; it may have something to do with the sheer number of rota gaps in our hospitals, and the constant firefighting that most of us are doing every day. When your priority is delivering excellent patient care, it can be difficult to think about taking some time to think about wider systemic problems.
But that’s exactly why more of us should be getting involved in schemes like this one. I believe that every hospital in Wales can benefit from appointing a chief registrar with protected time to help solve local issues. We may be doctors-in-training at the moment, but it won’t be long before we are the consultants and senior medical leaders of the future.