The great leap forward from trainee to consultant ends with one well-grounded foot. Clinical training to current standards provides the novitiate with a firm base as far as taking clinical responsibility. Responsibilty for maintaining or developing service and the profession is another matter, and in this respect too many newly-appointed consultants find themselves with their other foot in a quagmire, at risk of being bogged down in administration. One foot that has received solid grounding is not enough to hit the ground running. Actually, the stumble goes unnoticed as often as not. Dead-end committee posts are hived off on to the new appointee and no-one remarks on his silence at table or the failure to grasp the politics of administration. Some, of course, take to the mud with squeals of glee, throwing their weight around without moving from the spot. Some colleagues get spattered. Some sink. No progress ensues. There may then evolve a distaste for administration, a spurning of bureaucracy, truancy from the Division (can there be worse?) and rotting relationships with hospital administrators. Does it matter? Surely people find out soon enough how the system works; if you can run a group you can chair a committee; individuals make better decisions than committees and nobody listens in any case.
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