Population mental health relies on retention of a skilled mental health workforce, including consultant psychiatrists. The purpose of this study was to explore UK psychiatrists’ experiences, expectations, and reflections about the transition from trainee to consultant. By exploring the transition experience, it was hoped that ideas could be generated which might inform ways of supporting psychiatrists during this period.

A qualitative approach was used to gather rich, detailed data about individuals’ experiences. The sample population was a large NHS mental health trust in the South West of the UK. Stratified purposeful sampling was used, allowing focus on three distinct groups of psychiatrists at different stages of transition. Four trainees, four Specialty Doctors and nine new consultant psychiatrists were interviewed 1-1 by the lead researcher. Qualitative data were analysed using thematic analysis.

Psychiatrists’ experiences of transition centred on three major themes: Facing the Real World, Learning from Others, and Being Myself. These themes were connected by central concepts of belonging and identity. New consultants must survive the challenges associated with transition, and establish professional identity as a consultant; an authentic sense of self-in-role. This relied on the psychiatrist's establishment of a sense of identity, industry and belonging within professional communities.

Transition is unique for each individual but there are common aspects, and study of seventeen individuals’ experiences enriched understanding of the transition period. Clinicians and managers must not underestimate the challenges faced at transition. This matters for the specialty; consultants form a small proportion of the workforce, but their functioning has a major impact. It would be detrimental to care provision if difficulties at consultant transition resulted in attrition of psychiatrists. The main recommendation is development of a trust-level transition programme to provide support to individuals, which could also be of value to the organisation and wider profession.