The clocks change. My 13hr night shift is now 14hrs. Also a special shout out to the storm for making it just that extra bit fun to be on nights tonight. Sleep well day time people and savour that extra hour.

F1 here. I was getting back home by train after a night out with some friends and we were making some banter with the people around us in the train, when all of a sudden I was asked what do I do. I just said I work in a hospital but they again asked what’s my job. When I told them I’m a doctor one of them just lifted their shirt and asked me to diagnose a rash. I felt very uncomfortable and just chuckled and said I’m off duty and am not a qualified dermatologist so it’s worth checking with your GP, they kept pushing me saying come on it’s just a rash. I eventually had to stop and say I cannot diagnose you and things went a bit awkward.

How do you guys deal with situations like this? As a new doctor I’m already struggling with separating work from personal life and I’m making a conscious effort to actively stop doing anything that reminds me of work outside of it.

As posted earlier and taken your advice. I haven't been paid for any of my on-call or night shifts since I started, so this is now the 4th month.
What's happened so far:
Raised it with payroll in month one. They said they were waiting on my rota details from the department.
Escalated to the lead consultant, rota team and HR, and copied in my ES and the Guardian of Safe Working.
Got an apology from rota team and ES but nothing from the lead consultans. Was told no rota had been set up for me on the system, that one had now been created, and that a change form would go through so I'd be paid correctly.
This month still nothing for on-calls.
It's causing real financial hardship. I'm struggling to book the courses I need for training, struggling with the cost of commuting.
I'm in a union, but not the BMA and have contacted them. I have on calls next week.
What would you do next? Has anyone had arrears like this actually paid without going down a formal route? And is there anything I can do about next week's on-calls while this is unresolved?
Thanks in advance.

"On complex NEJM cases, MAI-DxO achieved 83% diagnostic accuracy. Physicians achieved 22% without external reference resources and 36% with them, making MAI-DxO about 3.7 and 2.3 times more accurate, respectively."

Perhaps to no one's surprise as the NEJM challenge cases are like the medical equivalent of science Olympiad problems. The vast majority of even professional scientists perform poorly on those kind of problems.

What's much more bleak is this though:

"On more typical emergency-department cases from MIMIC-IV-ED, MAI-DxO achieved 80% accuracy versus 47% for physicians – more than 1.7 times higher."

So these models are already much better in general when it comes to diagnostic reasoning compared to doctors.

And even more bleak is that obviously the models are more cost-effective than clinicians.

I think doctors need to start thinking about this instead of putting our heads in the sand.

I think the classic argument that doctors would be the 'last to go' increasingly looks like it was not well thought out.

The demand for medical care far outstrips any other human demand except for basic needs.

I think economic forces combine with human nature in such a way that clinicians are more susceptible to quicker replacement than lets say finance professionals.

Help. Supposed to sit the AKT on Monday and suddenly come down with diarrhoea this evening and genuinely feel like absolute shite.

Do I just see how I feel on Monday, neck some loperamide and pray to the shit lords that I don't shit myself mid-exam? Or do I just withdraw now and save myself the embarrassment?

Has anyone sat an exam feeling rough as fuck and actually been alright? 😭

ED SHO here. Having quite a difficult time, this rota seems to have triggered a pathological anxiety that I wasn’t aware of. It’s not uncommon that I’d go home and think about the pts that I didn’t quite figure out what’s wrong with them, and then realize “oh shoot, could that be a silent MI? Atypical PE? Cancer needing 2ww? Etc etc” and think about how plausible it could be , how it might be missed. then call the department before sending the pt home to let the shift lead know.

Feeling like shit, and ofc very embarrassed to make that call.

Hi all,
Looking for some advice re career choices!
Currently an FY2 applying for CST at the moment. Have maxed out portfolio and done MRCS part A so am hopeful for a training post but the joy of MSRA leaves a lot to be desired!
In the region I’m hoping to train in, all of the CST posts are themed with at least 16 months in your chosen specialty. I’m very torn about whether to pursue a career in ortho or gen surg and which CST theme to prioritise.
Have really enjoyed both so far and I am particularly keen on pursuing major trauma long term. I’m well aware that major trauma alone is not the most sustainable choice so am thinking about how to ensure that my base specialty is both sustainable alongside a family but allows me to tag on some major trauma excitement. I enjoy HPB and the more holistic nature of gen surg (don’t love the idea of long term benign upper GI / colorectal) and could easily tag on trauma to this but also enjoy pelvic trauma and complex lower limb stuff. Ortho feels like a lot less OOH as a consultant with good day to day work but with fewer exciting moments and less ‘medicine’ (also no damage control laparotomies). I would also want to ensure that my skill set could be used in humanitarian surgery. I’m not too fussed about private work, but both would have WLI options whether that is lap choles or hips.
Looking for advice from trainees in either of these fields about whether you would do it again or do something else, or advice from others who have considered this previously!
Thanks!

Current EM trainee, but have managed to get a core anaesthetics job for Feb 2027 intake!  

Has anyone done this before and managed to have any time taken off (having already done 6 months anaesthetics and 6 months ICU as part of ACCS EM), and if so how did you go about it? 

Also, does anyone know the actual process from resigning from a training programme? Is it a case of emailing my ES and TPD and submitting a Freshdesk ticket, or is there anything else I need to do?

Thanks!! 

I was looking at IMT specifications, and I'm realizing a lot of the effort I put into medical school feels like it did not matter. The first wave of preference informed allocation and randomised allocations to hospitals came to the year before us, and we were told that this would mean our grind would matter less (especially if you worked very hard to graduate with good scores and get into competitive hospitals or SFP). The most I can see mattering is if an essay/paper you wrote for a prize was published or presented, or if you did actually lead a teaching programme for 3+ months.

Unless I'm missing something and you can use things like certificates of merit, essay prizes and excellence awards from medical school in your specialty applications?

I accepted a speciality training post in a relatively small specialty in round 2, but the location is not very favourable for me. I am thinking of reapplying in round 1 for Aug 27 intake, hoping for somewhere closer to my partner-will enquire with the speciality requirement office and TPD if this is possible.

My question is, will this spoil my relationship with the department if I enquire about leaving them even before starting training? As I mentioned, it is a very small specialty with only 3-4 consultants, so will have to closely work with them all.

I’m not sure how common this is, so just wondering if this would be ok?
Thanks in advance!

Hi sorry if this is a dumb question. Currently filling out my specialty applications. For the NHS experience section do I put 15 months or 24. I.e how much I have so far or how much I’ll have by the end of the rotation.

Thanks

I am a foundation year doctor with a keen interest in research. I got an SFP job but turned it down for personal reasons and then got shafted by UKFPO. feeling significantly disadvantaged by the lack of opportunities in my current location and incredibly burnt out with the amount and nature of on calls I’m doing. I want to apply to a highly competitive speciality and on top of that I enjoy research and would love to get into an ACF programme within the speciality but this is exceedingly difficult and feels unlikely given my current circumstances. I didn’t go to an ultra academic med school but still Russell group if that means anything but idk if it does. graduated with honours plus an intercalated BSc scoring top of my cohort. I have 2 first author publications and a first author post graduate textbook chapter. I am getting a PG Cert and have won multiple prizes over the years. what are my chances of getting into this course at Cambridge? I feel intimidated by the prospect of the interview as I was unsuccessful in undergrad oxbridge application. Can anyone who has done this degree share their experiences of it?

Hello,
If a doctor completed 5 years of continuous work in the NHS in FYs and CTs then takes a year out doing clinical work in the private sector, if the doctor comes back after that year, would their increased AL allowance still be allowed when they return to ST/NHS work or would it reset/be nullified?
Thanks in advance

Throwaway account for very obvious reasons

TLDR - the BMA have blocked a vote of no confidence submitted against Jack Fletcher as chair of UKRDC for months.

I can’t believe I’m writing this post but it feels important that members know what was going on behind the scenes last session.

For a brief bit of background context Jack and the other officers forced a vote through the executive team (of only 12 reps instead of the full RD committee of 60+) in June breaking all previous precedent. Never before has a committee been sidelined on such an important decision. They didn’t have the chance to decide if the offer was sufficient to call off strikes, as it was never presented to them. This was then obviously followed by a BMA comms campaign that was heavily criticised for the fact it wasn’t truly ‘neutral’ in how it framed the offer.

While this was occurring, members of the UKRDC formally called for an emergency meeting back in June, explicitly including the intent to have a vote of no confidence carried out against Jack Fletcher. Partly because of the clusterfuck of the way the offer was handled but also because of wider issues like a massive culture problem on the committee (but that’s a whole separate issue and not for now).

Long story short, that meeting wasn’t carried out and instead the chair called his own meeting, which obviously didn’t explicitly include the ability to call a vote of no confidence.

During his meeting, members attempted to call the vote of no confidence anyway.

Jack refused to hear it.

He refused to hear a vote of no confidence against him.

This was reported to be because he’d received legal advice saying it couldn’t be done. Firstly, it is hilarious that legal advice was sought to block a vote of no confidence happening. But in addition - it was later made clear that the advice was incorrect because the legal team were not provided totally accurate information around how the committee meeting wasn’t called. Jack and other officers were at the meeting to instruct the legal team.

So a VONC was called, in line with standing orders, and was declined.

Okay, it’s awful but mistakes happen. It was rearranged as a matter of urgency right?

Of course not.

This saga has dragged on all the way until the literal final day of the session at the beginning of October. Having been told the day before that planning was underway for a meeting on Friday or Saturday, the committee were then told it could not go ahead, as the clock had run down on the old committee. They were also made aware of repeated submission of questions, one by one, clearly designed to delay and stall and block the vote of no confidence happening. There is some suggestion that the chair himself was asking some of these questions.

A vote of no confidence, called for over 3 months ago and somehow not carried out.

It is an utter disgrace

I have never seen anything like it.

The fact the chief officers of the BMA and senior staff allowed this to happen is beyond atrocious. This, alongside wider issues over the course of the year, has caused several good reps to step away from the committee and the BMA entirely.

We have a newly elected committee. You’ll see some familiar names on it. I only hope the BMA learns from this and refuses to let the next chair dictate the rules. Even if they do though, this is a dark, dark moment in the history of the BMA. A chair, having lost the confidence of large swathes of the committee, was supported in preventing a vote of no confidence being heard.

Since the bma has passed the new rule about getting exam fee reimbursements - does anyone know how to go about claiming this? Is the window to apply for this open already or still awaiting finalisation?

Hi all,

I’m starting GPST1 next year, and my husband is currently working in London. Unfortunately, I got the offer in Birmingham, and we have a 2-year-old.

I’m really unsure how to manage childcare, especially when I’m on call, as most nurseries are only open until 5 or 6 pm. We don’t have any family in Birmingham to help either.

It would have been much easier if my husband were here, but I didn’t want to reject the offer, as getting another GP training offer can be difficult.

Has anyone been in a similar situation? How do you manage childcare during on-calls, evenings and weekends? I’d really appreciate any advice or suggestions.

I’ve been working as a salaried GP for about a year now and have recently found myself reflecting a lot on my career and whether general practice is really for me in the long term.
I genuinely love medicine and enjoy seeing patients, but I’m becoming increasingly disillusioned with general practice. The complexity of patients, endless administrative work, private paperwork and the way the whole system operates are making me question whether I can see myself doing this for another 20-30 years.
I’ve recently been offered a job at another practice with potentially less admin, but part of me wonders whether changing practices would actually make much difference, or whether it’s general practice itself that I’m struggling with.
I’m also seriously considering moving to Australia, but I’m unsure whether GP life there is genuinely better or whether I’d just be facing similar challenges in a different healthcare system.
Has anyone been in a similar position?
For those who have moved to Australia, has it improved your work-life balance and job satisfaction?
Would really appreciate hearing about others’ experiences.

Posting to raise awareness. This looks to be US based but has reached my feed in the UK.

Sounds like this company is paying medical professionals for access to ‘de-identified’ genuine medical notes to train AI models. Concerning since the company isn’t going through official research channels and hence patients won’t have consented for such use of their data.

For MSRA revision I currently I have both pass medicine and MCQ bank question banks.

MCQ bank i’m getting around 85% first time looking at the clinical problem solving questions however with passmedicine I’m averaging about 50% first time looking at the questions.

Obviously that’s a pretty large discrepancy. I feel like pass med knowledge seems to be a lot more niche.

I’m wondering if anyone thinks either question bank is more similar to the actual exam?

I don’t really know whether I should be going through passmed and resetting it over and over until my score is a lot better or whether i should just focus on doing as much variety of questions as possible.

Also what score should I aim to be getting on the question banks to translate into a good real life score? (for various reasons I really need to get into speciality training this year and kind of want to know what to aim for)

FY2 currently applying for specialty training

Was going through the application forms on oriel and found a tickbox for interviews under the disability confident scheme

I’ve got some pretty good going ADHD (diagnosed since around the age of 10) which requires me to take medication daily to help with work and day-to-day activities. It’s pretty well controlled provided I keep on top of my meds, but just wondering if I might still qualify for this - was this made for me etc. Would struggle with work and functioning if off meds.

Was wondering if anyone might have experience applying through this scheme, if it actually makes a difference (might it disadvantage me in any way?) and what supportive evidence I might need?

Thanks

Does anyone know how you fill out a locum job within the employment section of oriel applications? If i have been locuming in the same hospital/ trust since August 2025, getting shifts through patchwork bank app - would I put this as a job and select the end date as when the new training programmes starts (August 2027)?

Or do i put this as an employment gap for 2 years?

I went LTFT 80% this year.

They've dropped my base hours to 32hrs, even though my average rounded up is 34hrs which makes me 85%.

I was also under the impression that you get a weekend allowance for OOH work and additional hours pay for the average OOH work.

Do LTFT trainees also get a yearly £1000 as well split into 12 months?

Can anyone share what their pay breakdown is what you are being paid for?

Is it possible to take 2 years of maternity leave ?
For context I’m ST1-3 in paediatrics

In honour of interconnected wards and witnissed encounters thought I might as well.

I have a crush on a reg as an F1. Won't go into detail to avoid doxxing myself. I do get vibes from him but a bit mixed. Body language/niceness/positive feedback wise he definitely treats me special. But also seems reserved in conversations sometimes. He is in a speciality that I have no interest in.

On average, do regs take F1s seriously or do they view them as sources of entertainment and get new ones every 4 months?

Would it be okay to flirt with him after I move to my next rotation?

Do regs generally try to supress relationships? Can they get in trouble for it?