Navigating my medical career path

Dr Patricia Nelson, consultant old age psychiatry, Greater Manchester Mental Health NHS Foundation Trust.

Although I was born in Germany, I spent most of my early life in the UK. In my late teens I was offered a scholarship to study medicine in the Soviet Union (now Russia). I returned back to the UK as an overseas medical graduate fluent in Russian.

After completing various clinical attachments and passing the Professional and Linguistic Assessments Board (PLAB) exams, I began working as a locum senior house officer (SHO) while waiting to go on the SHO training programme.

During this time, I became a mother of two. Sadly, following various family circumstances and the death of my husband, I found myself a single young mother of two children aged 10 and four. At this point I needed a job that offered stability without overwhelming demands and my post as a staff grade in a memory service suited me perfectly.

Rekindling ambition

In 2009, my consultant recommended me for associate specialist post and by 2012, I felt a renewed drive to challenge myself and progress in my career.

"My journey was filled with challenges, detours and moments of doubt – but also resilience, growth and triumph."

I began exploring new opportunities, starting with formally adding medical student teaching to my job plan. I also joined the membership training programme, balancing it alongside my part-time job.

By 2014, I was offered the opportunity to complete a secondment doing research for two-days-a-week for two years. I expanded my experience further by incorporating psychotherapy and liaison and emergency psychiatric assessments in care homes on my special interest days.

During an appraisal meeting I discussed my aspiration to start my Certificate of Eligibility for Specialist Registration (CESR) journey. I was encouraged to consider an inpatient post to diversify my experience. I was hesitant to leave my long-term job but  began to look for inpatient jobs in Manchester.

I couldn’t take up another associate specialist role in a new organisation because the grade is closed to new entrants, so I was facing a significant pay cut for this move. However, I made the leap to relocate to Manchester and started an inpatient specialty grade role in old age psychiatry. It was a bold, intentional move, driven by specific, measurable, achievable, relevant, and time-bound (SMART) planning. Could I aspire to become a consultant?

Stepping into leadership

In the new role I worked autonomously, supporting a newly qualified consultant and teaching medical students. I became the specialty and specialist (SAS) representative and worked alongside the SAS tutor. My next milestones were to complete the section 12 approval course, go on the ST on call rota for out of hours and then complete the ‘train the trainer’ course to become a clinical supervisor for foundation year doctors.

In early 2019, my consultant supported my application for approved clinician (AC) status which meant that I could work as acting consultant for one year. I covered my consultant’s maternity leave and following this I was offered the position of a specialist or as an acting consultant in the community.

This was an easy decision: I had come this far! I went for the community consultant post.

Navigating the pandemic

This new role came at the height of the pandemic. I was repeatedly asked to help out and provide supervision to locum consultant colleagues without AC status.

This was proving very challenging, I was juggling two days at the hospital and three days a week in the community. The workload became unsustainable, so I made the sensible decision to return to the hospital to cover the vacant consultant position to reduce stress all round.

I had aimed to complete my CESR* application in 2021, but because I hadn’t completed the membership exams I enrolled in an MSc in clinical psychiatry (2021-23). Once I had completed this my portfolio would be ready.

In 2022, I became SAS lead and after a few delays submitting to the portfolio pathway, in February 2025 I was welcomed onto the medical register.

If I can do it, anyone can! My journey was filled with challenges, detours and moments of doubt – but also resilience, growth and triumph. To anyone navigating their own path in medicine: keep going. Your story is still unfolding.

*The CESR (Certificate of Eligibility for Specialist Registration) pathway was renamed the Portfolio Pathway in November 2023.