In or out of programme: Being an out of programme (training) chief registrar

In the second part of the chief registrar: In or out blog series, Dr Raunak Singh describes his experience of taking on the chief registrar role out of programme.

  • Read part one for an in-programme perspective. 

I opted to undertake the chief registrar post as ‘out of programme for training’ (OOPT), and also opted out of on-calls. My main motivations for this were that my stage of training, ST5, felt like a natural point at which to think about developing non-clinical skills. I also wanted the breathing space to explore projects that I am passionate about. I am extremely grateful for the flexibility and autonomy afforded by going OOPT, without which I don’t think I would have been able to pursue 'blue-sky' projects such as improving junior doctor morale.

Having the thinking space and time for creativity has made it easier to keep progressing projects. It has also allowed me to explore and nurture areas of personal and professional development.  As doctors-in-training, we are used to rigid tenets of working life: the day shift, the on-calls, postgraduate exams, work-based assessments and meeting our appraisals. Being an OOPT chief registrar has encouraged me to develop separate skills needed for a sustainable working life - for example self-motivation, reflective development, autonomy, time management - which are good preparation for what actually being a consultant will be like. 

I also wanted the breathing space to explore projects that I am passionate about.

Dr Raunak Singh, chief registrar 2017/18

Are there any drawbacks to being OOPT rather than in-programme? Although there is less onus on clinical training, there is enough clinical time (up to 60%) to keep engaged with the ‘shop floor'. One welcome consequence of this was that during my clinical days, I really valued that time rather than worrying about my curriculum. I also felt better job satisfaction having the clear balance between clinical and non-clinical time. Again, this balance is more reflective of life as a consultant. Although my CCT will be extended, personally I have felt that this extra time is justified to help prepare me for the challenges of being a consultant.

As training is competency-based, I have still been able to address some aspects of my curriculum, and hence will hopefully have some time counted towards training (although by no means is this a deal-breaker). From a trust perspective, my training programme directors, supervisors and directorate leaders had to factor in my OOPT post when planning service provision, but they have been wholly supportive, and clearly foresaw the benefits of the chief registrar scheme. 

Personally, I have no regrets about choosing OOPT, and it entirely comes down to personal preference. Flexibility, autonomy, and room for creativity are the main benefits, with the minor expense of lengthening CCT being outweighed by these benefits of the chief registrar journey. 

Dr Raunak Singh is a Royal College of Physicians (RCP) chief registrar at University Hospitals of Leicester NHS Trust. 

In part one of our Chief registrar: In or out blog series, Dr Fasihul Khan describes his experiences as an in-programme chief registrar.