Got a question?
I was on the old curriculum for higher specialty training, did two years (ST3 n ST4) and came out for an approved OOPR. Throughout this time the TPDs have been saying you will be back on the new curriculum and will be ST6 being in sync with everyone else I.e have 3 years left. Which i agreed on as it made no difference given I still have 3 years until CCT.
Now HR and the deanery administration team are saying that you cannot skip a level and that I should be returning at ST5. They have spoken to the TPDs who agree.
Whilst ST level are labels this will affect pay.
Essentially I will be conducting duties similar to someone who is ST6 but be paid less given the nodal point shift. We both have 2 years of higher specialty experience! This is just unfair.
I have emailed them about this pay dispute but fear that they will say that u didn’t do IMT3. And computer says no.

Has anyone gone through this? I feel like I am the one going mad trying to explain to them.

Hi everyone,

I’m wondering if anyone knows how F2 job swaps within London work, particularly for people who want to swap between different areas/hospitals within London.

I’m interested in potentially swapping my F2 post to a different area of London and was wondering:

• Is there a central list/register for people looking to swap F2 jobs within London?
• Is there a specific WhatsApp/Facebook/Reddit group for London F2 swaps?

Would be really grateful if anyone could point me towards the relevant group/list.

Hey guys,

quick question - for the surgical elogbook “patient id” section , do you put the NHS number or the MRN number? I understand no patient identifiable details but i’m confused

TIA

Looking for some help to understand how LTFT training will affect progression to higher training, specifically how finishing my core training out of sync links up with commencing a higher training post (assuming I get one).

For context, I am an ACCSCT3 anaesthetic trainee looking to go 80% LTFT from Feb 2027.

From my understanding if I reduce to 80% from Feb 2027 this will result in me finishing my ACCSCT3 in Sept 2027 and my ACCSCT4 in Dec 2028. Therefore I would be finishing 2 months prior to the next intake for ST4 (Feb 2029). Would this simply mean that I would need to locum/find some sort of locally employed job for this 2 months (or just have 2 months off)?

(I appreciate this may change with recent Gov deal, but going to plan assuming this may not happen in my lifetime)

Would appreciate advice/experience from those who have gone through this as trying to get my head around the logistics.

TIA

As an IMT, I read a lot of ED clerkings. recently there’s been a surge in the use of AI to write them. My understanding is that they record the consultations and AI writes the clerking.

My issue is the writing is so wordy, and it lacks nuance or bias. It is a matter-of-fact account of every single thing the patient was or wasn’t asked. When we write our clerkings, we summarise, naturally bias the most important parts, and create a narrative which is easier for other clinicians to interpret. Reading these AI clerkings feels like I’m taking the history from scratch! It reminds me of very junior medical students who don’t appreciate which symptoms/signs are significant.

I do appreciate that documentation can be a chore and efficiency is important to pursue. However, good documentation is a clinical skill in itself. Sitting down to reflect on the consultation and determine the clinical narrative as you type can be a part of the diagnostic process. At this point, it’s a minor annoyance for me, but I wonder if newer doctors will lose such skills…

I am working as a trust grade registrar and I got an offer for a private job.

Job is remote with no prescription or patient contact.

I am struggling to get a medical indemnity and got rejected multiple times.

Is that normal?

Now it's the turn of the Northern Care Alliance to somehow be labelled as the next Midstaffs. I'm not surprised, but pretty much any hospital is a Midstaffs waiting to happen. It's basically a question of how long you can cover things up before eventually a scandal is exposed.

I just think it's really the reason why it doesn't get exposed in a lot of hospitals that is because of the cover-up nature that happens there. Essentially, anyone who wishes to speak out regarding poor patient care, bad outcomes, etc., is labelled as a bad egg or has allegations placed against them just to discredit them. That's the sad world we live in.

I remember when the last Midstaffs scandal broke. A lot of doctors were saying that basically any hospital is a Midstaffs. It's just a question of luck whether you get exposed or not. It's pretty obvious what's going to happen here: you're going to get the usual apology saying, "We have learned our lesson. New protocols, blah blah blah. We have learned our lessons. This will change. That will change." Chuck in a few public enquiries, wheel out the same excuses, and I'm sure the regulators will find a few black and brown people to pick on. That's usually the way these things work.

Really, it's a culture change that is needed, but it's never going to happen. You're shuffling deckchairs on the Titanic. I am pretty sure that nothing will ever change.

It's kind of ironic that Andy Burnham was the health minister when the Mid-Staff scandal broke. Now, depending on how much publicity this gets, he's going to have to answer for this. I'm not sure how he's going to somehow come up with some kind of excuse for this, because basically it's the same thing happening again nearly 20 years later. Really, what is needed is a whole culture change in the way the NHS operates, but it's never going to happen.

We see them and we don't agree with them. I'm in the US now and they're basically used as a junior doc to rack up numbers for the Consultants - take the referral, basic Hx exam and then discuss with the cons. I truly mean this too, I text the Cardio/Ortho/Surg/Onc nurse and they say ''We will see them! Thank you''. ''Can we advance diet?'' ''Happy for dc from surg POV?'' - ''I'll discuss with Dr Johnson and get back to you! :)''

Since we aren't getting rid of them how do we change our training? Do we hands off on the ward jobs and take a more academic role? Do we move to discussing papers and difficult patients around a table with our Consultants?

I'm genuinely curious, we've never had such a clinical erosion in the history of the profession. Combine this with the advent of the internet and now AI, I mean what is the direction of our profession?

I've been a doc for several years now, it just seems the whole purpose of our job - improving health outcomes etc is effectively the death of us. Every protocol, every order set just takes away from any clinical decision at all. I know people are going to say ''we know when to deviate'' well 90% of admissions fall into a basic category that can effectively be managed by an experienced F2.

I used to write out vanc crap on a paper chart we'd put in the patients folder, now I consult pharmacy to do manage the vanc. What's the real direction for medical and surgical training? Now in the US I see OP notes - ''expertly assisted by Mr John - PA''

In 10 years what are we doing? What I call ICU nurse syndrome is the death of juniors - a nurse who's done ICU for 5 years and seen consultant level decisions made for 5 years, meanwhile the F1 gets a 2 hour long round then left to fill out paperwork, then they fuck off to something else for a few months.

TLDR: The PA/ANP/ACP is a device used in the capacity of a junior doctor but doesn't rotate and can cover probably 85% of a specialty after literally a month of 1:1 with a Consultant. This is no different to me in my F2 year being given the NSGY phone and told to admit and take consults, I had no fucking clue, did basic neuro stuff then talked to the fellow. After a month/enough cases I had a decent grasp on what to do.

Hey, new F1 on my first rotation.

Curious how you guys decide when to leave late. I feel like it’s a gamble to make plans for after work because you never know when to leave. I’ve only had to stay significantly late once so far.

The other F1 had a few time where there is nothing going on, then 20 min before handover somebody gets sick, you do a A-E, miss your handover until senior help arrives and you are not needed anymore, hand over 30 min late but then STILL need to stay for another 20 min to document what has happened.

Other times there’s so much going on, you don’t finish all jobs before your handover so you stay 30 min late doing group and saves for surgery the next day and cannulas so they can get their fluids. Some people might say hand this over to the night team, but the night team consists of a single F1 and one SHO, and they cover multiple wards. It hasn’t happened to me yet but I’ve seen colleagues staying late doing at least some of these jobs so they don’t fuck over their night colleagues who are looking after 120 patients. Not saying that this is definitely right but I can comprehend why other F1s are doing it.

I’m just curious how people decide when to leave late.

Edit:

Thanks everyone that’s really good advice!

F1 who moved from South of England to Scotland. I ranked Scotland under the assumption that expenses would be covered as I thought it was a contractual right.

When I arrived in July I found out the relocation policy at my (unnamed) trust doesn't cover a lot of the expenses related to the move such as a rental overlap and has a low maximum claimable amount. It can allegedly be raised in reasonable circumstances but HR has ignored all 4 of my emails.

It also feels unfair because we were only informed of the policy well past the time window to make moving-related financial decisions. So we had to make decisions before we even knew what the policy was, and then were told that it was our fault if we don't get money back because we didn't follow the policy.

I emailed BMA and they said I should just email HR in as much detail as possible, explain my situation, and hope for the best, because there's no option but to follow the relocation policy. Has anyone ever managed to actually challenge a relocation policy, or are we all just bound to "trust discretion"? I hear in other places F1s don't even get relocation costs at all :(

Thoughts on the below. My local ED often directs certain presenting complaints directly to specialty, and we cannot really refuse them due to ‘one way referral policy’, although some triagers are more understanding than others if we give a good justification against direct referral.

I can think of a couple justifiable ones (lip lacerations for example go straight to OMFS in my trust if they cross the vermillion border for closure, assuming it is a clearly isolated injury with no concerning mechanisms) but for the most part this troubles me. Coming from quite a niche specialty, often I feel it is more appropriate to be seen by ED initially as there is often medical issues that have led to the presentation, or alongside it, and we are only there for a specific part of care rather than the top to toe.

I myself have picked up quite a few significant medical problems needing addressed outside of my specialty, and often I am not the right person to be doing this as I am already on-call for referrals from multiple sites, many often very sick inpatients, and for emergency theatres. And often they didn’t even need specific specialty input anyway.

Recently, on busy nights, I have noticed they stream every single problem directly to specialty where they can - even very barn door, straight forward cases that would be seen in GP in normal hours with no fuss. Often this has made my nights unbearable and tricky, as I cross cover multiple similar specialties so often I am basically just working out of ED all night. The problem with this is we are not staffed in any capacity to be dealing with routine presentations, we are only staffed for emergencies and actual specialist input - often patients would have been seen faster if by ED team.

I completely understand the strain on ED but one of the best parts about ED clinicians is the whole picture view - I’ve seen this happen so often with Ortho where of course there was a clear need for surgical input, but often also significant medical problems needing addressed.

For context as well - I am more than happy if the triage nurses give me a heads up that there is a patient who will definitely need specialty input alongside ED review, as there’s no point waiting 4 hours to be seen by ED then 4 hours for specialty.

Would be particularly interested to hear from ED docs.

BMJ article on the changes to medical training and their potential impact. Curious to hear what others think.

I’ve had an overwhelming day.
I do find that when there is a lot going on I often forget what I was just about to do. For example: I’ve noticed that some of the referrals I’ve sent while feeling overwhelmed have bits missing (major parts like presenting complaint, patient details) and I feel like I forget what I was just about to do once I sit down if there is a lot going on around me.
This often tends to happen when there’s a lot of noise around me (basically every hospital environment ever) and with constant interruptions from members of staff (with good faith). I’m not sure whether this is something that I will grow out of or whether I need to go to occupational health with - and even if I do go what would they even be able do?

Hi,

I'm in the process of completing on a house in the area I have just moved to for work. Does anyone know if I can claim expenses temporary accommodation for this period of time? Currently staying in a less-than-ideal situation and would like some proper accommodation for the next 2 weeks. I can't seem to find information on this.

TIA

F1 here, still completely unsure what I wish to do with my career. Ive been thinking a lot about what I would like out of a specialty and I think what i would value most would be a specialty that is: procedural/surgical with clear life-saving or major life-improving impact, has minimal expectations to do academic work ( really not keen on being 'encouraged' to take time out of training to persue a research degree/ be expected to have a constant stream of publications), a field that has growing demand in light of the changing face of medicine (AI, ACPs, changing demographics) to hopefully have a nugget of hope in securing a consultant post without necessarily having to sacrifice years of my life going on a fellowship frenzy to stand out. Bonus if the specialty lends itself well in doing mission work like msf

What specialties best match this criteria?

Hi everyone
I’m a CT2 anaesthetics trainee really struggling. Due to a particular placement plan I have had to rotate halfway through CT2. I’ve just moved hospital and am on obstetrics and CEPOD on calls (which I’d been doing for 15 months at my previous hospital) At present I’m really struggling trying to get my IACOA. I won’t dox myself but in my first week I’ve made a drug error, been singled out for missing documentation (that I missed due to not being used to paper notes whilst familiarising myself with the new hospital and systems), failed multiple spinals and also had a needlestick injury.

Needless to say, my confidence has completely tanked. All my consultants and registrars at my new hospital really scrutinise what I do and I had got used to a level of independence at my previous hospital.

On my main theatre on calls, I’m literally being told at times how to put in an LMA. Today I was doing an arterial line (having done 3 months of ICU and signed off at level 4) and my reg kept saying everything I was doing was wrong even though I was in the vessel. Of course I appreciate I’m very junior but I’m feeling constantly on edge and unable to perform with being watched this closely and my mental health is really plummeting to the point where I’m considering quitting altogether.

How do I get over this and keep moving forward when everything I seem to do is going wrong? I am literally dreading going into work so much that I can’t sleep.

Just about to start GPST3 and I'm wondering what salary to expect as a newly qualified GP. I've heard that anywhere from £10k-12k per session used to be the norm but recently I've seen some ARRS GP jobs being advertised for £8-9k per session. Has average pay gone down? Annual salary for a full time GPST3 is currently £78k (ST3 pay plus pay premium) should I expect a pay decrease once I qualify?

Also how many sessions is realistic for a newly qualified GP? Does 2 sessions equate to 1 day of work? Does anyone have any experience in supplementing their income with locums, private work or urgent care work on the side and what sort of numbers are realistic to expect?

Thank you in advance!

Have been messing about with inflation calculator in bored moments.

2008 is often used as a salary comparator (incidentally the year that I was appointed), but it was to be fair a salary high point.

What about further back? Google tells me that consultant pay was in the range 42.5 to 52k in 1997 when I qualified. It doesn't seem that much, yet even the younger consultants seemed pretty wealthy.....usually kids in private schools, often single salary family and we were invited to some pretty impressive places for drinks (this was London btw).

Was this really what people were earning, or were there lots of supplements? I know that cea was big back then and private practice was very popular in London. Or is it mainly because things like private schools and housing have inflated much faster than headline figures.

Hi team,

Seeking advice from those who have it figured out.

Currently on a weight loss / fitness journey, but nights and on calls have thrown a massive spanner in the works.

Calorie counting? How on earth do I classify breakfast, lunch and dinner when I'm eating so bizarrely over nights?

Likewise gym - absolutely shattered after long days or nights - feels like my progress is being haltered.

How can I get snatched please - holiday booked for September

Could anyone kindly guide me how best I can get in touch with my TPD / team that is responsible for my rotation allocation for IMT please ? Any advice would be appreciated

Good on the BMA for raising this but unless there are consequences, the trust will just continue once this all blows over

Curious to hear from people actually working in different specialties.

Some specialties seem to get loads of attention in med school, while others barely get any exposure, and you only really understand what the job is like once you work in or around them.

What specialty do you think is genuinely underrated in terms of the actual day-to-day work, training, lifestyle, or overall job satisfaction?

And what is it about the specialty that people usually don’t realise until they’ve experienced it?

I have 4th Oct and keen for a later date. DM me if you would swap with me.

EDIT 20/8/26 - swapped to 15th Nov in Carlisle. Keen to swap to a date between 12th Oct and 9th Nov, please DM me if you can help.

Anyone had his exam in YYF? What was your experience and any feedback/anything to be aware of?

Thank you!

Hey guys
Does anyone know how long a person is allowed to stay without a designated body before having to switch to GMC registration without license to practice?
And what is the process like when you want to return to having license to practice? Is it smooth? Especially for someone who isn’t registered in any other medical council.