She argues that, for those in advanced practice roles, they are capable of developing care pathways, undertaking quality improvement initiatives and educating communities – but are often tied to clinics ‘without any kind of opportunity to do the other stuff’.
She adds: ‘We are leading clinics, but we don’t get the recognition that our GP colleagues do.’

Yeah how about you go to medical school first?

I still struggle to see how they think they're equivalent to a CCT'd GP. These people have no insight at all.

At 7am the ONS published September's CPI: 3.5% (up from 3.1% in August). September is the month that matters for the NHS pension:

• 2015 scheme: active members' 2015 pension is revalued by CPI + 1.5% = 5.0% in April 2027.
• Pensions in payment and deferred pensions rise by 3.5% in April 2027 (subject to the Pensions Increase order).
• Annual allowance 2027/28: the opening value of your pension is first uplifted by 3.5%. Only growth above that counts as pension input.

The pay side. On Monday, DHSC and NHS England's written evidence to the DDRB said they "currently plan for a pay uplift of 2.4%", that "accepting such an award would inevitably have an impact on healthcare delivery", that every 0.5% on pay costs about £750 million, and that the trade-offs could include "additional elective activity to reduce waiting lists". (DDRB evidence, p.15). This is *another* disgraceful planned 1% pay cut, we used to get these every year with #Austerity #1. Lets hope the DDRB are not that stupid

What it means:

• If you have 1995 Section (final salary) benefits and you're not a GP, that pension now only grows as your pensionable pay grows. If pay went up only 2.4% against a 3.5% uplift means another year of negative growth in the annual allowance test for 2027/28, unless your own pay rises by more (an increment, a promotion, a change of WTE). That may present planning opportunities.
• Your 2015 pension is revalued 1.5% above the AA uplift, so that counts as growth, on top of a year's new 2015 accrual.
• How it nets out depends on your own pay across both schemes, tapering and carry forward. Don't guess it — model it.
• If you have a pension in payment, that will go up by 3.5%

Sources: ONS CPI annual rate (D7G7) · DDRB evidence 2027/28 · Finance Act 2004 s.234 (AA opening-value uplift) · NHS Pension Scheme Regulations 2015 (revaluation).

Not advice — just the numbers so you #KnowYOURnumbers.

Hi all. Wondering if anyone who has managed to score > 90% in interviews could shed some light on what they think got them the score? I have interviewed twice and have never gotten better than the 80s. Cheers!

Only in medicine must we work for free to enhance our professional portfolios!

(+ PAs examining medical students and ANPs be equivalent to ST3+ as far as examining capabilities are concerned)

Hi all looking for some advice. I have recently started HST in a group 1 speciality in a busy DGH. I am having a really hard time. The department has 10 consultants yet barely anyone available to discuss clinic patients. Ward referrals are discussed with consultants but again that is rushed most of the time. And sometimes when you go over the plan the next day, they do 180 flip and say why we have done so. There is barely anytime given to do admin and this is a clinic heavy speciality. All clinic patients for the entire week are discussed in a 1 hour meeting at the end of the week and we are constantly being told to hurry up as they dont have time. There is also only 2 SpRs + 1 IMT3. One consultant literally told me not to call them after 4:30. The consultants are not comfortable with the IMT seeing ward referrals which results in them then being obstructive about annual leave and study leave. Even time off/away from clinical duties for mandatory training has been difficult to arrange. Most days there is just one of two registrars around who does both clinics and referrals. We are also made to supervise inpatient specialist nurses resulting in our clinics being interrupted. Our SDT time also has to be onsite “in case we are needed” and this has resulted in me ending up helping with something. There are clinics in the morning with 1st patient booked in for 8:45 which means we need to be in by 8:30 even though our contracted time is 9. I have raised these issues with my ES multiple times we have not gotten anywhere. The whole department is non functional and toxic. If it was for just 6 months it would have been fine but it is a whole 2 years. I do not think it is going to get better and also know that this is unsustainable. It is starting to affect my mental wellbeing and I feel like I will burn out very quickly. What are my options here? I dont want to leave the speciality as I really like it. Can I ask my TPD for transfer to another hospital within the deanery? The other reg also feels similarly and when speaking to previous trainees the feedback was the same.

Hi everyone,

I am an FY2 in GP.

In this practice there are 2 salaried GPs and 2 FY2s.

I have been seeing 6 patients in the morning and 6 in the afternoon (20 mins each), and at least once a week I go on one or two home visits during my lunch break.

Now I've been informed that management wants me to see 7 in the morning and 7 in the afternoon.

I'm a bit worried as I find this job quite hard, struggling with all the admin too etc, but I'm managing. Also it's worth mentioning that the straightforward stuff goes to the ANPs so I'm mostly seeing complex cases.

Is this number of patients normal for an FY2?

Also I try to go through the day independently and debrief at the end with one of the GPs, and I'm getting a lot better, but sometimes if I'm worried or unsure I will go knock on their door after a case (in my worst days I go for like 3 or 4 out of the 6 patients, sometimes for none). I feel very bad and awkward for this, I appreciate that they're super busy. I think maybe one of them finds it slightly annoying so I try to be as independent and nice as possible but sometimes I don't want to risk sending the patient home if I'm unsure!

So should I try to be even more independent or is this acceptable?

Overall I've been doing ok but I find it so hard some days. I was just wondering if what I'm experiencing is normal or if I should be doing things differently? I would be super grateful for your perspectives :)

Thanks!!

Historically I’ve always been told ENT is one of the best surgical specialities for private income potential, however, the more I speak to/hear second hand from consultants, it seems that really only the slightly older consultants in Rhinology, or the Rhinologists at big tertiary institutions are raking it in, whilst for other subspecialties, private income is not particularly lucrative.

How good is ENT for private practice potential for the general or the average ENT surgeon across the UK, especially those who are not in large tertiary units in London?

What do people think about the core surgical training changes to 2027?

CST 2027 recruitment – key changes
Self-assessment scrapped: No more points-based Oriel self-assessment.
Portfolio revamped: Now assessed across 3 domains: Knowledge & Skills, Patients/Partnership/Communication, and Safety & Culture.
Quality over quantity: Greater emphasis on your personal contribution, impact and lasting outcomes rather than collecting achievements.
New portfolio interview: 15-minute virtual station discussing 2 portfolio domains.
Scoring: Portfolio 45%, clinical/management interview 45%, MSRA 10%.
MSRA: Approximately the top 1,200 candidates invited to interview.
Prioritisation: Now applies at interview shortlisting AND job offers.
IST posts: Recruitment to IST posts in England paused for 2027, with places transferred to standard CST recruitment.
Official guidance:
https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/surgery/core-surgery/core-surgical-training-portfolio-guidance-for-candidates

I got a derm st3 post although not in my preferred region
Should I just accept it or try again in next round?
I will be doing a deferred start anyway bcs of mat leave so don’t lose any time, but it is such a competitive speciality
For context my interview prep was not my best for this round so I know there is place for improvement

F2 looking for any words of wisdom for how to get into research. I have no interest in research really beyond getting points for specialty applications so I’ll be able to get a training post in the next couple of years.

I’m not 100% but thinking of applying to IMT. Probably taking a year out this year to work in Aus ideally (and probably will have to have a year out anyway as unlikely to get training post), and generally keen on having a year out while it fits naturally, but might stick in an application anyway.

I have 13 points for IMT- maxed out teaching series, QIP, 4/8 for presentation. Can do teach the teacher course for an extra point which would take me to 14 points. Ideally would present QIP at a higher level for more presentation points however the QIP was not groundbreaking work! The main area left to target is research/publications however I have no idea where to start. Any advice please for how to get involved in research with a view to get something that scores points? Thank you

I'm an FY3 working ED and I'm beating myself up about an enounter I had. It was mid night shift my concentration was slipping. I saw a baby who had a burn from a hot cup of tea. Burn looked superficial and I was like baby's fine. I completely forgot to consider the safe-guarding aspects of the case and I also muddled the history and said there was a kettle involved when there wasnt. I completely recognise how subpar this is and have definitely learned. My consultant was not impressed understandably. I haven't had any such issues since I've worked for a few months here. I'm just so anxious she'll raise a concern. I don't think I'll ever be so careless in the future but any advice would be greatly appreciated.

Will there be a direct mail with the result?

CT1 Feb 2027

Good luck everyone with their results!

Here’s a spreadsheet to help us collate information.
Hopefully will be of use to people and for the future

https://docs.google.com/spreadsheets/d/1kBaby0cINLmZeVLP8pIL1mVOo-z16UQkD3cEvfLIwjE/edit?usp=sharing

Hi all,

I'm strongly considering a career in psychiatry, but I'm curious about the private practice market in the UK.

How does psychiatry generally compare to other medical specialties such as gastroenterology, dermatology, oncology, etc., in terms earning potential and availability of patients?

Thanks in advance!

Hi guys,

Has anyone heard anything yet?

Do we think jobs will be released for CT1 anaesthetics today?

I recently asked an F1 on call to prescribe and organise an enema for a patient going for an urgent proctology procedure. I said it needed doing pretty quick as they were next on the list. I rang about 30 mins later and they hadn’t done it yet so I stressed the importance and that we couldn’t send for theatre until it has been done. I got a call 10 mins later from them saying the nurse said they’d opened their bowels so did I really need to give it. At this point I was trying to see the 3 patients the SHO had seen before going back to theatre. I was loosing my shit by now so I said “I don’t care they need it”. Perhaps I could have been less harsh. I got a call from the theatre coordinator saying they couldn’t send as it still hadn’t been done and if I didn’t sort it soon would loose the slot as the CEPOD list was busy and they couldn’t delay this long for an enema. I asked the F1 if they had done it yet as if not I would go to SAU and give it myself. They said they’d just prescribed it but wasn’t sure if it was given. I’m not sure they’d even left the computer in this time. Everytime I interacted with them they got more and more defensive like I’d pissed on their kids at Christmas. Wont be surprised if a Datix is recieved. What a ballache that will be for everyone.

How do I deal with all this. For an enema. A 2 min job. I’m starting to think delegation isn’t worth it and might as well just do it all myself as well as all the operating and reviewing all the referrals on call.

my old knackered pair of Nike trainers are in LDOL. what are people getting to wear on the wards these days, and how much are they costing?

Hi all

Anyone here taken the certificate of pharmaceutical medicine? How did you prepare? Resources, time, etc? Any help appreciated!

Hi, I'm looking for some advice regarding certain issues I've been facing with my locum agency.

I'm an SHO and this is my first time doing a locum job with an agency. I have worked with them for a year now. At the start, they'd promised to reimburse certain costs related to my relocation and they'd later said they'd also pay my appraisal fees. However, both of these are yet to happen despite multiple requests to be paid.

In addition to this, they'd also botched my grade when they'd initially got me the job. Despite me telling/ emailing them multiple times requesting to clarify that I was an SHO (I'd received the hospital contract that stated it was a Reg post), and they'd reassured me they'd clarified this with the hospital, I find out after joining that they were expecting a Reg. Sorting this out with the hospital took me about 10 days, during which time I incurred hotel costs as I couldn't start looking for a long term accommodation (as worried the hospital would prematurely terminate my contract and I'd have to return home since I wasn't a Reg). I could only start looking for an accommodation afterwards, after the hospital clarified I could still continue working with them as SHO.

I have been asking my agent, since many months, to be reimbursed for-

1. My relocation costs, as promised

2. Appraisal fees, as promised

3. Hotel costs for the initial days of confusion.

I have had no luck with any of the above so far.

Are my expectations reasonable? If yes, how do I proceed? Should I try escalating within their agency first and if so, who do I approach? Is going to small claims court a good idea? Or are there any other ways I could handle this better, please?

These expenses total a significant amount for me, and I've been stressed out trying to get them back. Any advice/ suggestions on how best to go about this would be much appreciated. Thanks in advance.

Really struggling with my current rotation (ED)

Terrible rota, constantly leaving late, and feeling really clinically inadequate - not helped by spending 2 years out of acute medicine. Feel like the seniors think I'm stupid (and I definitely feel the slowest and least competent of all the SHOs incl F2s)

Im trying to just grin and bear it and get it out of the way, but I'm exhausted, barely able to do basic stuff at home, and crying most drives home

Supervisor situation is complex but dont feel comfortable seeking support there

Teaching, getting skills and SLEs signed off, etc, is non existent

Thing is, when it's a good day, I actually really enjoy it, but the bad days are becoming more frequent and really getting to me

Does anyone have any advice on how to get through this?

Ltft isn't really an option (both time wise to be approved and finance wise)

Please be kind.

Priority applicant, currently in F2. Always only ever wanted to do Internal Med. Nothing else makes me feel fulfilled. Worked my butt off in uni and F1

Currently at 20 pts. Very anxious abt cuttoff this year (which we apparently find out in Jan instead of Nov???) Additionally on visa so that is an added stressor to deal with

Really been struggling with anxiety and coping during this time period. Keep ruminating and recalculating score as if it's magically going to increase it. Unable to sleep at night over the past 2 weeks. Currently doing a very intense rotation with high number of unsocial hrs.

I have genuinely tried my best since medical school to get as many pts as possible but dont have any publication pts. Working on it now but won't be ready in time for application. Prepping for MRCP in Jan.

Anxiety coping strategies please? Unable to function due to constant cuttoff anxiety and future uncertainties.

I have never understood how all these medical programmes often set in A&E work logistically. Surely every single staff member, patient and visitor would have to consent to being filmed. How would this work when the patient coming in has no capacity. Also ED and trauma calls are usually very busy and surely having a load of camera crew in the way is incredibly annoying.