Hello everyone, I am a doctor (IMG) in the UK, been working here for 4 years during which I completed my foundation training and I am signed off for my core surgical training.

My experience since FY2 has been in surgery, I do love it, love seeing patients, treating unwell ones, operating.

I have put so much time, money & effort, got all my numbers in theatres, did almost all surgical courses etc. I have always received compliments from my seniors/ colleagues for my proactive work.

The problem: While studying last year for the MRCS, I had some heavy family circumstances, which has been incredibly overwhelming, leading me to cancel my MRCS application, I have been feeling very burnt out and exhausted, leading me to question my specialty of choice.

Although I love surgery, I do not feel that I want the lifestyle that comes with it. Reality is, yes some people are doing it all and say it is possible and while I do agree, I think for this to be achievable, either family life or work will be compromised.

With good enthusiastic surgical training comes staying in the hospital overtime, going the extra mile (I am sure surgical trainees will understand what I mean).

All this has lead me to take the very difficult decision to change specialties. Due to my limited experience in other specialties and because I simply cannot see myself as a GP, and because the only simple training pathway I found is psychiatry (MSRA- based only) I have been preparing for this.

I fear I am jumping into something far from what I love, and something I do not know. But also I am 29 and the thought of getting trust grade jobs in random specialties and figuring it all out from the start fills my eyes with tears I do not think I can do it and spend months/ years at this stage to find a specialty.

Equally going ahead with surgery as my heart would please will burn any desires I have outside my career.

I am really struggling and despite being called “an amazing doctor” so often at work I feel severely unaccomplished and feel that I have wasted my time and just so burnt out and left struggling with years passing without being in a training program.

I really do not have anyone that I can share those thoughts with.

So any kind, wise advice is incredibly needed. Thank you

Hi,

I had my exam recently, just can't stop thinking about aome issues, In consultation I said that the patient has very subtle ulnar deviation and I am not sure of that. Would that be considered as inventing sign? And do you know how this would impact the score ? I can't stop thinking

I have a relative who is currently an F1 considering radiology as a career. They are debating between perusing radiology (they have a very strong portfolio in this area) in the UK or going overseas for better pay and working conditions. I am an IM resident in the US and am sure I could help him to find connections and match in IM here. His primary goal is financial so is open to either option. I have heard most radiology consultants seem to clear £200-300k a year with relative ease with private work whereas as a generalist in the states he’d make about the same (maybe even a bit less). I’m not sure if I’m advising him incorrectly to stay in the UK and do radiology as it seems very lucrative?

Done the whole F3 malarkey with a plan to save whilst being able to pursue other areas of my life and just enjoy life a bit more. As you can imagine, more fool me as this has royally bit me in the arse. I have currently 2 shifts booked over the next two months. Both from combination of the amount of locums looking for work, and the trust employing more trust grades or simply just not filling gaps.

I am being proactive within the field - applying for last minute cover, applying for every other local bank within a 3 hour one-way travel radius, even applying for the bank for when I'm home over Christmas. I'm refreshing NHS jobs as often as I can without obsessing over it, and also considering any new trust grades/clinical fellow openings. A recent post I applied for was just dissolved rather than filled!

So I'm contemplating finding other sources of income and looking for any bright ideas, because ultimately any money per hour is better than no money per hour.
There are many things I would want to do, but a lot these would involve paying for further qualifications or the qualifications are gained over 6-12 months, which kind of defeat the purpose (although the expense is a one off).

I'm contemplating using my birthday and Christmas gifts to help fund said quals. Is that sad as a qualified doctor? Maybe.. but, gratefully, I'm otherwise very fulfilled in my life and don't have a need for anything material.

I guess the issue being is that I'm really valuing my flexible time and my much improved mental state... I reeeeally don't want to sacrifice that, when the plan was to go back into full time after this locum year. I really feel I need this breather...

(as a side note - and whether it makes anyone in a similar boat feel any better - my manager has said in the 20 years she has done this job the past 18 months is the worst she's seen it..)

Maybe this is just more of a shout into the void... it's pretty dire

Recently started a new job in a new hospital in a different trust. All I have to say is what do nurses do exactly? During my nights whether I’m covering the assessment suite or the wards. The nurses cannot do bloods, or cannulas or catheters or NGs or anything. So I end up assessing the patient - putting a plan and then doing everything myself. And the worst part is they call you and demand. Like legit all they do is check obs every 4 hours or even longer but at the same time the HCA are the ones that do the obs most of the time, they also clean the patient up and check their glucose. During one of my weekend shifts there was a very unwell patient who had no access, and I was there trying to get access and failing and there was literally nobody else that could try. Disregarding the fact that the nurses were eating all day and doing basically nothing or minimal things but they kept on nagging and killing me about discharge summaries and going down to pharmacy to sign prescriptions even though they could literally see me trying to cannulate / bleed a patient who was so dry and turned out to be obstructed. In addition I was me trying to cannulate and bleed a patient who was an IVDU with a penetrating injury and the nurse walks in and asks him to swab his groin! She then says oh I’m sorry laughs and leaves. She comes back in to do his obs mid way while I’m still trying and when I ask her to hand me some bottles she doesn’t and then says sorry. I genuinely feel like I’m hating this place a lot and it’s so unsupported and exhausting. I just don’t know what to do, even if try and speak to someone I don’t think anything will change unfortunately.

My ES undermine me a lot. I actually don't know what to do. IMT trainee here, everything is good, training is good, hospital is ok, just cannot stand my ES. They never loses an opportunity to belittle me, that too in front of everyone. It's affecting my mental health now. What should I do?

https://www.theguardian.com/uk-news/2024/oct/31/ian-paterson-inquest-breast-surgeon-mastectomy-didnt-need-to-know

Ian Paterson carried out "mastectomies" intending on leaving breast tissue behind for "aesthetic reasons". As this increases recurrence risk substantially, he was risking his patients' lives for the most thoughtless and arrogant of reasons - the possibility that it might "look better" if more was left behind.

How could we respond to a colleague doing similarly aberrant things? He seems to have been arrogant and aggressive with colleagues in MDT, but everyone has met someone like that. Concerns were previously raised.

Wondering about core psychiatry training. My understanding is all posts are now decided from MSRA scores? I’m a GEM student in my final year with an interest in psychiatry and was wondering how to buff my CV to apply for it. Is there any point based on how they recruit?

Many thanks

What are your thoughts of the downsides of having a flatter hierarchy in medicine including with other healthcare professionals, stories experiences and accounts welcome…

I work for big tertiary trust and came across a 'consultant' the other day with the prefix Mr rather Dr (non-surgical). Curious as to their background (expecting them to also hold MRCS), I googled their name and they indeed appear on the department's 'list of consultants' on the trust's public website with a full associated biography. Interestingly they aren't actually a doctor yet are seemingly given all the credentials of a CCT.. Is this above board or I am in the wrong in thinking it's rather misleading?

If I am covering someone’s on call shift that falls on a bank holiday, would I be entitled to a day in lieu? TIA!

Hi,

I’m in the process of finalising my elective at the moment. And am planning to do half of it in ophthalmology as I am interested in in ophthalmology as a career

According to the st1 portfolio, an elective will count as 1 portfolio point.

Does the elective have to be in UK to count? I was planning on going to a third world country and working in a rural hospital.

Would appreciate if anyone could shed some light on what counts, many thanks!

Hi, as per the headline I was wondering when are we expecting to get the 6% 24/25 uplift (+ consolidated £1k) in Wales? Also if my incremental date is in September, will I get backpay backdated to April 24 or September 24? I hope that makes sense. Thanks a lot.

Are the applications open for August 2025 speciality application? I can’t see them on oriel. I thought they were supposed to be open now

As the title suggests really - how do you go about studying for post-graduate exams whilst working? Is it worth making an Anki deck and doing daily reviews? or skipping that stage and only focusing on question banks?

How do you manage to cover everything and retain it all whilst working full time?

Thanks in advance

Anyone know what the earliest exam date would be for paces 2025 first diet? The website says late January to end March which is a little vague. Just helpful for thinking about courses, not committing to other things at that time ect

Perhaps anyone who has sat paces before?

Thank you!

This was tweeted by the local BMA IRO. Both of the trust’s CMO and CEO have yet to reply the BMA LNC’s request to withdraw the imposed reduced locum rates.

We also know why they are doing this. They have increased the number of substantive staff ie. clinical fellows to fill in the gaps. Anyone would like to guess who’s taking up these shifts with pathetic rates?

SpR here in a surgical specialty. Our ward f1 is fairly sumernumerary so he comes to our theatre a fair amount of time to get theatre experience in the minor operations list. Problem with these lists is it’s usually a one man show - Nothing wrong with it and I’ve learnt my own ways of being efficient. F1 comes in a lot and when I ask them to do things (that will help with efficiency and give us more time to do teaching during the operation - not always easy when I have 7-8 cases booked for the day) eg ldoing discharge summary, they sort off huff/leave the room/ don’t completely do it/do it badly eg putting wrong details in discharge summary/ don’t know where anything is equipment wise and it ends up taking even longer than if I had just done it all myself.

Now nothing wrong with that, we all have to learn and I wouldn’t mind if they didn’t have the attitude problem that comes with it. What they tend to do is leave the room then come back at the end and ask if they can suture (this has happened 5 times now). At times I’ve let them and shown them how to do it and it takes painstakingly long (like 5 minutes for 1 suture) - again less of an issue if I have a scrub team/someone to do some of the paperwork but when it’s just me and a long list I just can’t afford this snail pace suturing for every case. If I tell them we’re tight on time and we don’t have time right now for some teaching they start saying oh I’ve been practising my suturing at home I’m quicker now in front of the patient and just creates a very awkward environment.

long story short I honestly don’t even want them in the theatre room with me. I hate to be that person that doesn’t give them teaching and I have really tried in the past but it slows everything down so much, they’re not willing to help me with anything else to get things running efficiently so we do have time to teach and just want to do the suturing and suturing alone.

How to deal with this (last week I was an inch close to just asking them to leave)

Has anyone got any influential stories of senior SpRs/fellows/consultants moving to the USA post CCT. Let’s assume you have to do USMLEs ect. Asking regarding surgery to be specific.

Need some inspiration, the NHS sucks and the training is a byproduct of service provision crumbs. Need a light at the end of this tunnel that makes it worth it.

Need some advice on a rota issue please. I'm a GP trainee currently working hospital placements. I've been given 3 rota lines to choose from for my next placement, but the coordinator has said if I select one rota line I'll 'owe' them 4 night shifts....

'If you chose Line 3 – you will OWE us 4 nights as the cut off point on the rolling rota ends on 4 nights, which means Line 3 has 4 less nights on the rota line.'

Surely this isn't right? I've never even paid attention to whether or not I'm working more night shifts by chance than my colleagues... surely this is just the way it is and it'll average out in the end? Anyone else had this? Can they actually give more four more random night shifts to work?

Can someone help and mention some good resources to prepare for the exam today pls ?

I am currently an f1 and am getting myself so worked up about ever being able to afford to live a decent lifestyle. I have a student loan debt of around £75,000, I don’t have parents who can afford to help me out with buying a house and there are no prospects of one day receiving any type of inheritance from any family members (just to give some context as at the moment I feel like I am surrounded by people with no student loan debt and inheritance money and are just able to buy a house and money is no stress for them)

My plan was to save money during my foundation years, due to relocation because of the UKFPO fuck up and some car payments I have thus far managed to save £1400 so far in F1 (after 3 paychecks) I am living in a shared house with other medics with fairly cheap rent

How realistic is it to save money during foundation and core training ?

At what point will I be able to buy a house?

Should I look to buy a house?

What is the best thing to do financially for student loan repayments?

Is it sensible to aim for consultancy as soon as possible?

At what point does it just become not worth the sacrifice of the having a family and having time to spend the little money that you earn I have already given up all hopes of being able to move back to the London area as I just don’t think I’ll ever be in a position to afford it

Just anyone that can give me some hope here would be great

Finished Core Anaesthetics Training in August 2024, have failed to get a desired London ST4 job twice now (most recently for Feb 25). This has left me feeling really dejected and hopeless about the prospect of replying for august 2025.

Currently doing a clinical fellow post on ICU which I’m enjoying and getting good clinical exposure/leadership opportunities in clinical setting.

Have got > 37 portfolio points for next round of applications but still feel I could blow it all on interview. I’m also told by consultants I work with that I’m sound clinically and have demonstrated a level of working beyond a CT3 in the real world.

Having taken an F3 and F4 before core anaesthetics, I fear that time is ticking on and I’m going to end up either never becoming a consultant or becoming a consultant in my 40s…

Overall am looking for some reassurance that it’s possible to get that anaesthetics ST4 job and any advice on how to perform well in interview!

Scottish resident doctor.

Thinking about requesting to drop down to 80%.

Currently on a 1.4 banding from working an ostensibly 9-5 job with one in 6 weekends.

The weekends are about to change to 1 in 7 anyway.

Could any one advise what I could expect in terms of

1. banding
2. take home pay
3. how the rota might be worked out?

Many thanks!

Hello :)

I am not a medical person, but a good friend of mine is a doctor and is approaching a crossroads - that I need help to help her navigate.

She's always wanted to be and trained to be a doctor. Been doctoring a lot. Emergency medicine for quite a while then peads, and specialising in utero surgery, etc. She's moved, had a baby and wants to be full time GP. Took I think her 2nd MRCGP and is convinced of a fail. There is no unconvincing her, and she said she just doesn't know if she has it in her for another go.

So, medical folk, if she fails this, what's the next option? I've tried to google, google was no use....

Thank you!

I’m working in ED and rota’d to be working Christmas Day as part of my normal working pattern, but I requested annual leave and it has just been approved (hooray!).

However, I’ve been told that I won’t get the TOIL I would have got for working a bank holiday if I take this off as annual leave. This feels wrong to me, as I’m essentially using 2 days of leave (1 A/L day and losing 1 TOIL day) just to get 1 day off.

This is the first department that has let me book annual leave on a bank holiday rather than having to swap the shift, so I’ve not come across this situation before.

Has anyone else ever had this happen?

Since it's Halloween and my housing estate has gone full American with its Halloween celebrations, I thought I would share the joy by encouraging any legitimate "autoshitogenic" medical/hospital stories.

For what it's worth, in IMT, I had to cover wards overnight on different sides of a repurposed TB hospital. It felt really eerie in the dark walking alone and I always thought either a zombie or an axe murderer was lying in wait around each corner.

My girlfriend is considering upping and leaving the UK because, to put it in her words, the NHS is in a dire state.

As far as I understand, it's extremely difficult to get into training after your foundation year.

Even if you get in and complete the 3 years of training, it's still extremely hard to get into secure the next training programme. If you don't manage to get in, you'll have to apply for a registrar job, which only offer 6 month or 1 year contracts depending on the hospital, and then the cycle continues. On top of that, you could be let go at any point in time.

The lack of job security, the uncertainty of location and the stress of the many applications/ processes that she'll have to go through seems to weighing on her, to the point that she's seriously considering leaving the UK.

I don't want her to go, but I don't know what to say as things really do sound bad here.

What's other people's experience with this and if you've been in a similar situation, how have things worked out for you abroad vs in the UK?

[Edit - the planned destination is most likely Singapore, so any insight from anyone who's worked over there or know any colleagues out that way would be much appreciated.]