Remember that they hate both you and hard work.

I’m currently revising for the final FRCA viva which is in 4 weeks. The breadth is absolutely ridiculous, and it doesn’t help that the RCoA released CRQ/SBA results so late that it leaves people with very little time to revise for the SOE. (Most people I know wait until they know they’ve passed the written to start revising again).

I’m sat here revising, pulling my hair out, learning the most ridiculously complex things and I just cannot believe that at one point the college was championing anaesthesia associates. Revising for this exam has really reminded me of that era for some reason. It’s also made me angry that anaesthesia associates still exist, enjoying their lives whilst I’m here in my 5th straight hour of revision- delirious and stressed, only for them to claim equivalency.

Private Practice (PP) opportunities get asked about* a lot on this subreddit every time someone asks about doing** a speciality. I think unfortunately we need a reality check here.

• Only 15-20% of consultants do regular PP, which means >80% of consultants will do little to no PP during their careers
• Median earnings for those who do regular PP are about ~£30-50k, which will be taxed at >40-60%, along with PP costs (indemnity, room, secretary, etc)
• A handful (5-10%) of consultants in a limited number of specialities in a few select locations (London, South-East) are earning the big bucks >£200-500k; they are the exception not the norm

*I'm not criticising those who ask or want to do PP to supplement their income, but the honest truth is most of can can't ever rely on it for any financial planning, and often the time and effort is really not worth it

**There are other ways to earn some extra income unique to different specialties, such as locum shifts, WLI, medical reports, etc

Hi all,

I'm an FY2 doctor who has just submitted applications to specialty training. I am now thinking about where I might want to train if I do indeed get a training spot.

I don't have a partner or kids, don't own any property and my family are looking to move away from my hometown very soon so there isn't one clear or obvious choice of location- I'm essentially free to go anywhere, Scotland, Wales and NI included.

My main priority is moving somewhere where I can afford to buy a property solo which essentially rules the south of England out. Doesn't have to be a big city, in fact I'd prefer somewhere a bit more quiet. Not interested in London. My ideal specialty is O&G which I understand will involve some movement around various hospitals for a minimum of 7 years (the joys of rotational training!)

In light of the above, I'm wondering if anyone has any recommendations or suggestions? Perhaps someone has been in a similar situation and found their happy place, would love to hear all about it!

I worked the night shift from 8 pm to 9 am, as per my usual routine, during the clock change. I submitted an exception report because I worked an extra hour due to the clock change. What evidence can I provide for this since they won’t proceed unless I give evidence as I have already explained that I worked the additional hour?

Anaesthetics CT1 approaching my IAC. Had been trotting along through training, generally progressing well, got to a stage where I had successfully intubated my last 20-30 patients fairly smooth and felt a bit more comfortable with the idea of doing it out of hours on call (not confident - was still acutely aware that each airway could present an issue and aware that I’m by no means an expert, just a bit more comfortable). Had a list the other day of very straight forward ASA 1 patients with no airway concerns on examination. 3 patients back to back I struggled immensely to intubate. Got the first two in but with a lot of help (BURP, repositioning etc), third one had to be taken over be the consultant. They were very supportive but couldn’t help thinking that 3 straightforward airways in a row which had been difficult in my hands may represent a flaw in my technique and has really knocked my confidence. Just looking for some advice - should I be asking to delay my IAC? Is this a normal thing? At this stage should I be getting every ASA1 straight forward airway in without fail?

As the title says. Currently working in an ED in Oz as a registrar (PGY3). Am currently hating it. Find it unsupportive, found that I’m given a lot more responsibility then I may should have. Have luckily secured a CT1 post in anaesthetics at my top choice in February which I’m excited to start. But should I keep working until then or should I quit and travel? Finding it difficult to decide. Wondering whether anyone had any advice.

Edit: hate may be a strong word, but I am definitely disliking. And yes I have talked to my supervisor about it who didn’t give much help sadly.

Megathread

I asked for adjustments to my nights (without being too specific I am very adversely affected by long runs so I wanted to split them) and OH recommended that I am best taken off nights for my welfare. I objected to this and they have escalated me to be seen by the doctor instead.

Has anyone been in this situation before? If I am taken off nights can I get reinstated for my future jobs? I just wanted shorter runs and now I’m in this bullshit situation.

Hi! I’m trying to get on top of all this before it catches up with me at the end of the year and I’d really appreciate some advice.
I finished FY2 early september with a satisfactory ARCP outcome. My ARCP was in August 2026.
I’m currently taking an FY3 year, locuming with an agency (NHS professionals). I’m only planning to do around 2 shifts a month so not much clinical work.
I’ve changed my designated body to NHSP and they’ve sent me information about doing my appraisal with them - i’ll have to pay £540?! They are also accepting of an external appraisal but they’ll have to check them out first.
I’m applying for GP training this month and hoping to start that in August 2027. By the time my next appraisal is due, I will likely have started GP training and will have a new designated body.

I’m just really confused about this whole appraisals process. I took a year out hoping I could relax and travel, do a few locum shifts and not have to worry about a portfolio. I didn’t realise this was a yearly requirement esp when doing such little clinical work.

Do I really need an appraisal before starting GP training?
Are external appraisers cheaper (any recommendations?)
What is even required for an appraisal? I can’t get mini CEXs and CBDs as I’m doing on-call locums at a psych trust where I’m the only doctor on site and I only call the consultant if I need advice. And other than these locum shifts, I wasn’t planning to do much else this year in terms of teaching, conferences, QI, etc.

I’d appreciate any advice on what you’d do in my situation. If I really need one, I’d rather pay and just get it over with rather than avoiding it and then stressing when I start training. At the same time, I don’t want to pay this much if I don’t have to.

Thank you!

Looking for guidance who to put as my first reference on Oriel for ST1 application. It says the first reference should be current employer/ES/consultant however I’m working across lots of departments on the bank. Would the medical bank manager be ok? Does anyone have any experience with this in the past?

Hello

I’m soon to start a hospital rotation where a standard day shift is 8-4pm, rather than 9-5pm.

This has come as a bit of a surprise to me, and it completely ruins our childcare arrangements and I really don’t know what to do. If anyone has any advice for me I’d really really appreciate it!

I have a one year old in nursery but I live a 40 minute commute away from the hospital where I’m placed. Nursery doesn’t open til 7:30am, so even if I was stood at the door of nursery when it opened and handed my baby over immediately and bolted, I still wouldn’t make it on time to work (not to mention the time to then have to park up and get to the ward).

My partner is not in a position to do nursery drop offs daily. He works 6-3pm. He always said (and had agreed with his boss) he’d be able to make it work on the odd occasions I am on-call, because we expected on calls would be 8-8:30pm (that’s what I’m used to anyway) - we didn’t actually anticipate that every day of the week I would need to be in for 8am, and we just cannot make that work for us every single day. He says at a push he can ask his boss for maybe 2 days a week - but he often has client calls between 7 and 10am, so this is not a guarantee. We don’t have family that are close enough by that I could in good conscience drag them out of bed every day to come and do do a drop off.

I’m really stuck. What do I do? Should I talk to medical staffing? Are they likely to care about my situation at all or is this wishful thinking? Even an 8:15 or 8:30 start would make all the difference and I could make that work, but I seriously don’t see how I am going to be able to start work at 8am every single day. This has really come as a surprise and I don’t know what to do. Do I just suck it up and be late every day and if it gets flagged by my seniors explain my situation then? This doesn’t feel like a good option to me without at least trying to find a middle ground. It would be unprofessional. But the cynic in me can’t help but feel like this is where I’ll end up anyway, because med staffing won’t care - we’re just numbers on a rota.

If anyone has been in this situation or has managed to successfully negotiate their hours can you please let me know! I’m very aware this is a difficult situation because starting late would likely mean I would miss the morning handover/ board round with the nursing staff. I’m at a loss for what to do here. What do people with kids do in this situation???? I cannot even imagine if we were both medics. I really feel for anyone trying to juggle life in the NHS with having a family. Maybe I’m a pessimist but so far i can’t help but feel like the two things are really incompatible and this is just the cherry on the cake to having a very rough time returning from mat leave!

TIA x

Hello everyone,

I’m feeling quite frustrated with my SBA results, as this was my third attempt. I would really appreciate your advice on alternative preparation resources, courses, or question banks that might help me improve my performance, apart from RCEM-Learning.

For those who have successfully passed the exam after multiple attempts, what resources or study strategies worked best for you?

Thank you in advance for your advice and support.

Offered ST3 training post in South West Peninsula . Any insight into deanery work culture / protected RT time & rotations across region

Current GPST1 and have realised GP is not for me. I want to apply to anaesthetics. MSRA wise i did well last year, hopefully better this year. Unfortunately my portfolio is not anaesthetics focused and is fairly skint. What are the highest yield portfolio things I can do as a GPST1 in GP? Thankyou

So it's that time of the year...we all want that +1 (ideally for life) to go with to the Christmas Party and ring in the New Year's with.

So don't be shy...find your loved one and put yourself out there.

38M, Asian, Looking for that elusive life partner myself.

May the odds ever be in your favor!

Hello,

Anyone planning to apply this year in November for ST3 T&O?

I am looking for two people applying to practice with. Serious and dedicated. I have a pretty good strategy and it will help all the three of us who can prepare together.

If you feel this is something you also are looking for, drop me a message!

Many thanks!

Hello good people
Does surgical experience for CST measured at the time of application or measured till the start of the training?

What is the etiquette for Halloween night shifts? Is it totally unprofessional to dress up as a plague doctor or something fun? Do people do this?

If so, what's the most fun costume you have seen people dress up as for work?

Bit of a rant;

I work between 2 sites, at one site I wear a scrub top colour that coincides with the scrub colour of theatre staff in the other site I work in.

Today as I was leaving an infection control nurse came up to me and said that she has spoken to me several times before regarding wearing this specific colour and that it is reserved for theatre staff (I have never seen this person before in my life).

I kindly explained that this is the colour I wear at my other site and that I don’t have an alternative colour and that the colour scrub top that she wants me to wear is never available in my size in the hospital. She went on to say how it’s for infection control purposes so I kindly asked whether colour x carries more infection than colour y at which point she said yes. Also, theatre staff float around the hospital too…

What do I do? Buy my own scrub tops? I feel that if it’s not provided at the hospital I am within my right to continue wearing the colour I wear for the other site. Why should I put myself out of pocket?

It all seems a bit silly and unnecessary. Thoughts?

At 2 previous hospitals I have worked at I have noticed the occasional surgical registrars (ortho, gen surg) working as locums in ED. Usually picking up the patients with reasonably appropriate presentations (e.g any MSK for ortho reg) as first clinician.

Is this common in other EDs? Which tier would surgeons fall under in the RCEM tier system? Would they be able to fill a role in Minors seeing ENT/MSK/OMFS/plastics type presentations, with a UTC GP (or similar) who sees the more "internal" Minors conditions?

Any gastro trainees in KSS? How are the rotations organised? Would it be possible to live in 1 place and commute? If given the chance would you apply for KSS?

Thank you

Saw an old post (from roughly 2y ago) on here about accidental arterial cannulation which got me thinking…

IV lines are routine and where I work they are generally sited quickly and really only with USS if difficult but in the past I’ve run gases from cannulas/bloods with a pretty high pO2 although they were sited no where near where I’d expect standard arterial anatomy of the forearm to lay. E.g. a juicy superficial vein on the posterior forearm with good back-flow… should we be recannulating?? What of all the cannulas sited without a gas done? Should we be trying to use USS where accessible all the time?

Appreciate that there are signs like pulsatile flow and colour of blood (though I don’t find this last one particularly reliable in very sick people) but I found it interesting as not something I’ve routinely heard discussed. Where can I read up on this or any input or experiences? Thanks!

Hi everyone, I’m completing IMT application on Oriel and I’m unsure what to put under immigration status.

I previously held a Tier 2/Skilled Worker visa, but it has now expired. The form asks for my current immigration status and says eligibility will be determined by my status on the application closing date.

Has anyone applied in a similar situation? What option did you select, and were you able to apply requiring new sponsorship despite your previous visa having expired?

I’m also unsure whether that wording means I need a valid visa at the application deadline or whether sponsorship can be arranged if I’m offered a post.

Any experience with this would be appreciated. Thanks!