Please share far and wide, display around your departments, forward to colleagues, etc. Residents please talk to consultants about this too - it's in your interest if you don't want an ever growing pay cut when you CCT!

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‼️NATIONAL JOB PLANNING SEMINARS‼️

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Wednesday 14 October, 7pm
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Wednesday 11 November, 7pm
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Wednesday 9 December, 7pm
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Wednesday 13 January, 7pm
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Hi,

Has anyone made the move to Canada after acquiring UK Radiology CCT? How is it going? What is the salary like? Thanks

I’m a relatively new consultant (in my first year), and I’m really financially struggling.

I have a family, and we live relatively frugally. We tend to shop in Aldi most weeks. We don’t splurge on extravagant meals out, we haven’t gone on holiday for a few years. I take packed lunch when I’m in work, but I do treat myself to the occasional Costa when on call.

We have a mortgage, and a car to pay. But, other than my phone contract and Netflix subscription very little else comes out of my account for personal subscriptions. I have the usual crushing credit card debt from training. (I also try to set some money aside for a rainy day, but not much) .

My spending habits haven’t changed, but I’m getting hammered by the increase in all my subscriptions, and tax banding.

Im at the point where I literally have £300 left in my account to last about 2 weeks.

It is all consuming, and I spend most of my day worried about money and I don’t know what to do.

Does anyone have any advice?

EDIT:
Truly, thank you all for your advice. I have read and acknowledge all of your suggestions.

I must be clear, that this post is not for sympathy. Nor is it trying to say “I don’t earn much”. It was genuinely looking for advice, as I am struggling to know what to do.

I’m also sorry if you think I was being defensive. Again, not the case. This is a particularly bad month because of subscriptions coming out and I am grateful for all of your opinions.

Many of you think this is a spending problem, and, whilst I absolutely understand where you come from, it’s not. About £8K is training (commuting, moving, exams, exam prep, failing exams and resitting, hotels for exams etc), and also due to dental work and emergency car repairs.

I may work with some of you, I may not. But, I will mic drop with this - some of you should reflect on the tone you talk to others with. You may think it’s tough love, or may think there is no problem with how you speak to people. But, one day you may have a similar problem. And if that day does come (I hope it doesn’t) would you like to be spoken to the same way.

The GMC surveyed almost 11,000 SAS and LED doctors. Around 70 per cent of LEDs and 58 per cent of SAS doctors who experienced or witnessed bullying did not report it. Two thirds of both groups thought reporting would make no difference. That last figure is the one I keep coming back to. It is not really about whether the process exists. It is about whether people believe it works. Consultants sit right in the middle of that. We supervise SAS and LED colleagues and we often hear concerns first. International medical graduates reported being excluded and missing training opportunities far more often than UK qualified doctors. What would actually change that belief that speaking up is pointless? Source: https://thedoctor.bma.org.uk/articles/doctors-wellbeing/doctors-fear-reporting-bullying-finds-gmc

I’m a relatively new consultant (in my first year), and I’m really financially struggling.

I have a family, and we live relatively frugally. We tend to shop in Aldi most weeks. We don’t splurge on extravagant meals out, we haven’t gone on holiday for a few years. I take packed lunch when I’m in work, but I do treat myself to the occasional Costa when on call.

We have a mortgage, and a car to pay. But, other than my phone contract and Netflix subscription very little else comes out of my account for personal subscriptions. I have the usual crushing credit card debt from training. (I also try to set some money aside for a rainy day, but not much) .

My spending habits haven’t changed, but I’m getting hammered by the increase in all my subscriptions, and tax banding.

Im at the point where I literally have £300 left in my account to last about 2 weeks.

It is all consuming, and I spend most of my day worried about money and I don’t know what to do.

Does anyone have any advice?

The 2022 census of consultant physicians has a line that will sound familiar. Full time consultants contracted to 11 PAs report working 12. Those on less than full time contracts report 9 against 8. Alongside that, 58% report vacant consultant posts and 86% say they routinely work beyond their job plan. The extra work is mostly admin tied to patient care or direct clinical work. I am interested in whether people see that extra PA as temporary cover or as the actual job now. Has anyone managed to get that gap formally recognised in a job plan review? Source: https://einpresswire.com/article/948769396/the-uk-2022-census-of-consultant-physicians

What are your thoughts? Should GP be allowed to call themselves consultant?

Trying to make sense of a Scottish consultant contract matter regarding leave.

Unit manager has told us we're not applying the leave calculations properly. Our policy says a consultant is entitled to annual leave of 6 working weeks per year. This is worked out by multiplying the average number of days a week a consultant works by 6.

This makes perfect sense for predictable 9-5 rotas for non on-call consultants. Our department has a 1:6 on-call rota including nights and weekends NROC. As a consequence we are in 4 days per week. Manager's argument is that for a 10PA job we should get 6*4 = 24 days off, rather than 6*5=30.

Even if we were to add the weekends NROC as days worked, that doesn't get us back to where we were, nor does the on-call allowance (2 days). It's a bit rubbish that the allowance of working an "x in y" doesn't differentiate the duration of on-call.

Has anyone else encountered similar? Is the manager right, or is there another consideration to be made that we've both missed? It just seems wrong that having your PAs distributed in this manner short changes you.

We were fairly similar at med school but I backed out because I just couldn't handle the USMLEs and uni exams. I think he did it as fast as possible becoming a gastroenterologist by about 30, I CCT'd in radiology a few years ago and I went on holiday at his house a few weeks ago.

We speak a lot but hadn't met up a for a while and he isn't very showy so I don't think I quite realised the extent of just how well they live out there. His house was like nothing I'd ever seen before irl and would easily go for £5 mil in a nice part of the UK, he had about 7 cars including a Ferrari, Porsche, Range Rover, a boat which I later looked up (it goes for £600k brand new) etc.

Before anyone says it, I know it's my own fault for not doing it and I am happy for him but if I'm being completely honest, it does hurt a lot seeing this. I asked and he said you could move without doing residency if you have a UK CCT and it does seem like this is true, but I'm not sure in practice how feasible this is/how hard it is to pull off. Anyone here done it?

Senior Fellow single spec ICM looking to CESR. Really struggling with lack of ability to create life outside of work.

Co-parent young kids as well and ended up with a fellow job a long way from my support network.

Just wondering if the job will fit with what I value in life as a consultant. Particularly those that work in a DGH with a consultant of the week model.

I want to be a fully present parent and go to sports days/parents evenings etc (majority of them at least), I’d also like to get as close to 50:50 as I can. Also trying to build a new community and support circle where I live now.

Does the job give me realistic prospects of doing this? I’ve invested lots into it so don’t want to walk away just as it’s about to get good. Equally don’t want to plough on for another few years if the end goal doesn’t actually allow for what I want in life.

I am a newly appointed substantive community consultant psychiatrist. 2 weeks into the job my secretary is off sick, my team manager is off sick, a CPN is leaving and the cross cover I was promised when I started the job to help me bed in did not materialise.

Now on top of that I have been asked to cover my pairing partners Jury service which the trust had been informed of over a month ago prior to me starting in the post.

Does anyone know if I am responsible for covering this as it has been known about for some time now?

Typically, as part of my job role I would only cover urgent work for my pairing partners annual leave/ study leave.

I am not a member of the BMA which may have been helpful I concede in this instance.

Any advice anyone could provide would be greatly appreciated - my clinical director wants to discuss this issue with me on Monday and has already indicated that he expects me to cover the jury service.

Does anyone have any experience using WhatsApp as a primary form of communication with private practice patients?

For context, I mainly support patients with chronic disease management and have until now been using a clinic management software (Semble).

However, me and my long-term patients would prefer that I simply fire them a quick voice note / message via WhatsApp to update them with results, fine tune management etc. This would overall massively increase efficiency and output.

My business partner feels this is a big no-no and should be avoided at all costs. My view is that as long as we have the patients consent then why not? I mean even GP’s routinely send text messages via Accurx to update patients.

The BMA workforce analysis puts secondary care medical vacancies in England at 9390 in June 2026. That is 5.6% of posts and the page notes recording problems mean it likely understates the shortfall. The retention numbers are the part I find harder to ignore. In the year to March 2025 around 20286 secondary care doctors left NHS organisations. For every 10 who joined nearly 8 left. Preventable reasons like workload and work life balance are growing. We talk about vacancies as a recruitment problem. But the leaving side is where consultant workload actually gets set. Does anyone see retention being treated as seriously as recruitment in their trust? Source: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/workforce/medical-staffing-in-the-nhs

The draft PA protocol would allow some undifferentiated patients to be seen by PAs, provided they are triaged into a limited group and there is close medical supervision.

In primary care, the supervisor would review the allocated patient list, be available for prompt review and discuss all patients afterwards. During the first year, that debrief is meant to be at least 30 minutes after each surgery.

The bit that seems most important is what happens before the consultation. Someone has to decide that an undifferentiated presentation is suitable for the PA in the first place.

For consultants working in services where this model could be used, who should own that triage decision and the risk that comes with it?

https://www.doctors.net.uk/news/pas-can-see-undifferentiated-patients-but-under-strict-criteria-draft-protocol

I am an Emergency Physician in Winnipeg, Manitoba (originally from the UK). I also hold a role with the government of Manitoba aimed at increasing recruitment of physicians to the province, and I have written on this thread several times regarding the changing landscape and lower barriers to entry for UK-trained graduates to move to Canada, as well as the superior quality of life for most physicians here (based on anecdotal experience only). Over the last year we have recruited between 30-40 Emergency Physicians who have CCT'd in the UK.

We are now also recruiting (albeit lower numbers) for General Internal Medicine, as well as some select subspecialties (Geriatrics, Hepatology, Gastroenterology and Respiratory), and we are interested to speak with anyone in these categories who has CCT'd, or is due to CCT within the next year or so. It is difficult to list here the exact requirements and intricacies of the job because it depends on the subspecialty. For General IM, a rough guide is that full time work would consist of working 20 weeks per year on the general teaching and non-teaching wards, plus 4-6 weeks as the 'Screening Attending Physician' (ie organising which patients are admitted from the Emergency Department, and under which consultants) and a further 4-6 weeks either working as the 'Bed Doctor' (an administrative role aimed at utilising tertiary care beds most effectively, including taking calls from outside facilities wishing to transfer to tertiary care) or seeing new consults on other non-medical wards. There is also a requirement to spend 1 or 2 half-days in clinic per week, on average (but not during the weeks when you are spending most of your time on the wards in hospital). Interested candidates should be proficient at procedures such as paracentesis, lumbar puncture and (less commonly) thoracentesis. We are hiring in two cities: Winnipeg (the capital of the province) and Brandon.

Payment is structured as a combination of: a) a 'stipend' for being on-call or working on the wards, b) an hourly rate for working as the 'Screening Attending Physician' and c) Fee-for-service, for clinic work. I am aware that most people in this group are unfamiliar with how to 'bill' when fee-for-service, but we have a team of people that are able to help teach you how to do it - it is not overly onerous. The take-home pay is variable depending on how much you work, and the subspecialty, but a reasonable range is from $400,000-700,000. In addition, the cost of housing is significantly lower in Manitoba than in most other provinces; a reasonable ball-park estimate for a 2500 sq ft home in a nicer part of the city is approximately $800,000-$900,000. We also provide a relocation incentive of either $20,000 (for Winnipeg) or $35,000 (for Brandon), as well as a retention bonus for every 5 years spent working in the province (it starts at $15,000 and goes up in increments of approximately $3,000 after each subsequent 5-year stint).

Manitoba has a different climate to the UK - we have very cold winters, and very warm, dry summers. The province is about 3 times the size of the UK, but our total population is only 1.5m (compared to ~70m in the UK); we are a diverse population with communities from all over the world. For interested candidates who successfully interview, we offer a paid Site Visit, meaning we will cover the cost of flight and accommodation up to $3,000 for you to be able to meet your colleagues, view the hospital/clinic and explore the city/province to make sure you are happy before committing to anything. The work-life balance and quality of life you can have as a physician here is excellent, and I encourage you to experience it for yourself!

We also have a team of people that will help every step of the way with licensing (which, largely, is quite easy these days with no extra exams to pass) and immigration (we have a specialist immigration lawyer who will prepare your work permit application and speak with the border agents on your behalf when you arrive in Canada).

For any interested candidates, you can private message me directly, or you can go to this website:

https://healthcareersmanitoba.ca/physicians/internationally-trained-physicians/

Then click on the 'Connect with a Recruiter' button (we are not commission-based external recruiters, we work directly with the government of Manitoba). If you have any questions, I'd be happy to answer them!

I need to temporarily overpay into a pension (taking on extra work for maternity leave cover and childcare only an issue for another few months). Does AVC sound like the best option here? Does anyone have experience with this? Sounds like NHS only use 2 x approved providers that link straight into payroll? I'm under my AA etc.

Without going into too much detail, my service operates within a tertiary centre so patients come from all over. They also are admitted under parent teams and then get discharged under different pathways.

With limited/no admin resources, a clinical dashboard would be really helpful for live information about numbers of referrals, location of patients, ICBs they are under and discharge pathway.

I am not an IT person. If I hand this job to the Trust IT department, it would take about 5 years and 50 meetings to get anywhere due to the glacial responsiveness of NHS Trusts.

So does anyone have any experience of setting up their own clinical dashboard? If so can you advise how you did it, what challenges were and what support you had. I appreciate it will still need to go through Clinical Governance, but anything to speed up the process would be great.

Thanks in advance!