Consultant (medicine)

In the United Kingdom, Ireland, and parts of the Commonwealth, consultant is the title of a senior hospital-based physician or surgeon who has completed all of their specialist training and been placed on the specialist register in their chosen specialty. These consultants have both clinical responsibilities as well as administrative responsibilities in managing Specialty, Associate Specialist, and Specialist (SAS) doctors and resident doctors. Following graduation from medical school, it takes approximately 8-10 years to become a consultant.

The primary objective of a consultant is to use expert knowledge and skill to diagnose and treat patients and ultimate clinical responsibility for their care. A physician must be on the Specialist Register before they may be employed as a substantive consultant in the National Health Service (NHS). This usually entails holding a Certificate of Completion of Training (CCT) in any of the recognised specialities, but academics with substantial publications and international reputation may be exempted from this requirement, in the expectation that they will practice at a tertiary level. "Locum consultant" appointments of limited duration may be given to those with clinical experience, with or without higher qualifications.

The term consultant may also be prefixed to other non-medical high specialist leadership roles in UK Healthcare settings such as Consultant Nurse, Consultant Dietician, Consultant Paramedic, and Consultant Pharmacist. These are roles undertaken by Non-Medical Practitioners in posts agreed by the Department of Health.

Definition

CCSC/BMA

The Central Consultants and Specialists Committee (CCSC), which is a Standing Committee of the BMA, agreed the following as a very broad description of the role of consultants:

"Primarily as the delivery of expert clinical care usually within a team, including the ability to recognise and manage the more complex end of the specialty spectrum (diagnosis, management decisions, difficult cases, including apparently simple cases which have a high incidence of complications in more inexperienced hands) but also involved in running departments, managerial decisions, teaching, training, researching, developing local services – generally being involved in the wider management and leadership of the organisations they work in, and the NHS generally."

This report from 2008 describes how most consultants work now and it describes what the 2003 contract was intended (by BMA negotiators at least) to remunerate and develop (a consultant-based service).