Due diligence
Compare jobs by substance, not hospital prestige
The job title, Trust name or promise of research time is a weak proxy for day-to-day training value. Compare the actual rota and support with your next career decision.
Clinical mix and grade
What cases and referrals will you see, how much independent decision-making is expected, what procedures are realistic, and does the work match the next role you want?
Rota and senior cover
Get the draft rota: nights, weekends, sites, cross-cover, rest, escalation, resident registrar and consultant availability. A daytime taster cannot answer every out-of-hours question.
Supervision and development
Who is the named supervisor, what are the induction and feedback arrangements, what teaching is protected, can you access study leave, and how is appraisal supported?
Terms and life outside work
Check written pay basis and enhancements, permanent or justified fixed-term status, leave, commuting between sites, LTFT arrangements where available and actual start-date flexibility.
Fictional comparison
Two attractive titles can mean different jobs
Imagine you want to consolidate general surgery before deciding whether to apply for training. These invented posts illustrate a decision process, not recommended rota patterns or a scoring system. Put the actual documents side by side and mark unknowns rather than filling them with optimism.
Post A: district general hospital surgical fellow
The written pack describes ward and emergency duties at junior level, nights on the surgical rota, a named educational supervisor and a scheduled monthly development session. The rota coordinator supplies an example cycle. A current fellow says theatre attendance varies because ward cover is difficult. The main strength is visible general service work and support; the unresolved issue is how often development sessions survive staffing gaps.
Post B: tertiary unit specialty fellow
The advert names a specialist research interest and mentions theatre opportunities. The draft rota has frequent ward cover, with no separate research session identified. A consultant verbally offers help with a project, but no project scope, supervisor time or access arrangements are documented. This may still be a useful post, but you cannot yet treat protected research or regular operating as established features.
Reason through the trade-off
If broad junior surgical work and predictable support are your priorities, A may be the better fit after clarifying development cover. If you already have that experience and need a particular specialist project, B deserves further questions. A tertiary name does not answer those questions. Neither choice is settled by adding arbitrary points: an unsafe mismatch in expected autonomy cannot be cancelled out by an attractive research title.
Resolve the unknowns
Ask the person who can verify the answer
Keep a short decision record: issue, answer, who gave it, date, document and outstanding action. A written aspiration is still an aspiration; a current fellow's account helps test delivery but does not amend your contract.
Rota and out-of-hours support
Ask the rota coordinator for sites, cross-cover, nights, weekends and an example cycle. Ask the clinical lead who is physically present and who is available remotely on each shift. Ask a current fellow how escalation works when the usual senior is occupied. Record any mismatch and get it resolved before relying on the arrangement.
Teaching, theatre and research
Ask the proposed supervisor which sessions are timetabled, who covers clinical work, how cancellations are handled and when feedback occurs. Ask the research lead whether a proposed project has a feasible question, approvals, access and supervision. Ask a current fellow what they actually attended in a recent rota cycle. 'Opportunities available' is a useful starting question, not confirmation of a protected session.
Terms and promises
Medical staffing or HR should confirm the contract, grade, pay basis, sites, leave, notice and start conditions. Ask for an important verbal promise to be reflected in the appropriate written offer, rota or development arrangement. If it remains unconfirmed, decide whether you would still accept without it. Obtain individual contract advice when the wording or consequences are unclear.
From understanding to practice
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