Abstract Aims Given the pressures for change in training, it is important that what is valuable for specialist registrars to learn in order to become good consultant clinical oncologists is identified to aid in curricular design. Materials and methods A qualitative, one-to-one, semi-structured interview study was undertaken with 12 clinical oncologists who had been appointed as consultants within the last 2 years. Results They described the ‘shock’ on realising that they had entered foreign territory. The three main themes that emerged were surviving, navigating and moving forward. Conclusions It was not enough to be a competent clinician. The newly appointed consultant could only carry out their clinical work adequately and develop as clinicians, researchers and educators if they could navigate the maze of emotions, relationships and management structures contained in the clinical and organisational contexts of their work.