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7 December 2016
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The opportunity cost game – signing up to become a clinical fellow

So this was a risk.

Opportunity cost is always the name of the game, and it can be hard to assess prospectively. Accepting a place on the National Medical Director’s Clinical Fellow Scheme in February 2016 felt like a leap into the unknown, an exciting opportunity to do something different and massively expand my knowledge and horizons, but a daunting choice nonetheless. My employment history reads ‘bad waitress’ and (hopefully slightly better) ‘doctor’. Not much there then to predict my abilities in an environment vastly different to any I have worked in before.

Three months in, and whilst my colleagues would be better placed to speak for my performance, I can speak for my enjoyment and my experience; they are overwhelmingly positive. I’m working at the Health Foundation, an independent charity committed to bringing about better health and healthcare for people in the UK. Spending my days surrounded by some of the brightest minds in improvement, health policy, health economics, and data analytics is a joy. In an organisation with a diverse remit, I am involved in a variety of projects of different scope and breadth. I have the freedom to innovate and the support to put ideas into practice. Front line healthcare it certainly isn’t, but it does feel like being in a different epicentre, one with a wider lens and a longer term focus.

My day job is but one part of the fellowship experience. As one of 31 clinical fellows in the class of 2016/17, I am part of a community of people with diverse backgrounds and clinical interests, united in a desire to learn more about the wider healthcare system, and to contribute meaningfully to it. I’m working with two GP fellows to create a network for early career GPs with an interest in leadership (we’ve had incredible senior support to do this), and another fellow and I have taken on responsibility for the shortlisting process of the National Medical Director’s Clinical Fellow Scheme 2017/18. The access we have to leaders across healthcare, and the opportunities to learn from them are astounding and unique.

All this is not without its existential crises, for me at least. I miss my clinical colleagues and the sense of constant productivity that a day in GP-land yields. Most of all, I miss seeing patients. Many of those needs are selfish, not altruistic; they are what I get from being a doctor, not what patients get from me. And yes, I worry that I will de-skill. To acknowledge that though is also to say that I think this is worth it. At heart, I remain a doctor, I care about patients just as I have always done, and in these challenging times I care more deeply than ever about social justice, the centrality of health in that, and the need to equip myself, as a doctor, with the tools, experience and understanding to fight more effectively for the principles I believe in.

Three months into this, and I have no regrets about my decision to take the fellowship. It is more opportunity than cost. I don’t think I’m naïve in hoping that, come September 2017, I’ll have some management and improvement skills to add to my waitressing ones, and those new skills are ones I believe will make me a more effective GP too, more able to create, support and enable change around me. If you’re reading this then chances are you’re thinking about applying to join the class of 2017. I’d encourage you to make the leap.

Interested in applying to the National Medical Director's Clinical Fellow Scheme 2017/18 cohort? Find out more and submit your application by 16 January 2017.

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