Career Story: ICM and Acute Medicine LTFT

I am full time on a 1 in 10 on call rota for ICM (2.5PA/week). I provide five weeks of day time critical care a year and in between work one to two days of clinical acute medicine a week. My educational supervision time is delivered for AIM and I supervise three ACCS trainees currently — SPA time of 1.5 PA plus 0.5 PA for ES work. I am a FAMUS and FICE mentor and have recently added two hours (0.5PA) a week to my job plan to mentor and teach ultrasound within the acute medicine department to enable our trust to fulfil this key new component of the AIM curriculum. 

Don’t despair if you are a senior registrar and feel clueless about this stuff. Consultant job plans seemed a bit of a mystery right up until you find yourself negotiating them! As a dual trainee outside of anaesthetics, you first need to explore the priorities of both departments in any potential trusts that you wish to work, and how your job or elements of the job plan will be funded. You may be applying to job adverts which may or may not be tailored to suit you or as a dual trainee, it may need to be bespoke for you (mine was). 

With many medicine business units moving towards seven-day working, acute medicine may ask you to contribute to out of hours work, as will the intensive care department. The feeling of not wanting to disappoint either team will become very familiar to you and is, unfortunately, the biggest negative of dual working. However, with more non-anaesthetic dual trainees gaining CCT than ever before, I am sure flexibility in the way you can split out of hours will follow if that is required. 

I chose my trust because I knew there would be scope to be flexible within my job plan, allowing me to start less than full time and not mandate pre-determined numbers of weeks in critical care ( 2 in 10 often required on a 1 in 10 rota). At 8.5PA, this would have left little time for acute medicine. I feel at present my job plan works well for me, but it may not be the one you want, so I hope this has helped any dual trainee to start to think about what would work for you and your chosen hospital, as you start your search for the right job, in the right place, with the right teams for you.