The next generation of specialists need time to become experts
Research from Sheffield has provided an important insight into what can make a difference. A 2024 journal article by Raju SA, Bowker-Howell FJ, Aziz I, et al. examined the impact of out-of-programme clinical fellowships in gastroenterology and hepatology and found that these fellowships offer doctors valuable opportunities to develop advanced clinical skills, undertake research and build confidence before taking up consultant posts.
The findings are striking. Clinical fellows reported high levels of satisfaction with their experience and unanimously felt the programme had enhanced their clinical confidence and prepared them for consultant practice. The opportunity to develop a subspecialty interest, improve endoscopy skills and gain research experience were among the most commonly cited benefits.
Perhaps most importantly, the study highlights something many doctors already know instinctively: expertise requires deliberate investment. Whether that is gaining additional experience in endoscopy, developing leadership skills, conducting research, or acquiring specialist knowledge in a particular field, these opportunities help produce consultants who feel ready to take on the challenges of modern healthcare.
The lesson extends far beyond gastroenterology. Across medicine, we need to think carefully about how we support doctors as they move through training and into senior roles. Workforce planning cannot simply focus on increasing the number of training posts. Expansion is important, but quantity alone is not enough. We must also create pathways that allow doctors to deepen their skills, explore specialist interests and build confidence as clinicians.
This is particularly important at a time when the NHS faces significant workforce pressures. If we want to retain talented doctors and encourage them to build long-term careers in the UK, they need to feel they are progressing, developing and being supported to become the best doctors they can be. The Sheffield fellowship model demonstrates that this investment benefits not only resident doctors but also patients, hospitals and the wider health system. Clinical fellows contribute to service delivery while developing their own expertise, and many subsequently remain within the NHS workforce as consultants.
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