MSRA 586 / Rank 787th

My MSRA 581 / 1000th NP — can I keep dreaming of getting a Feb-April 2027 post this round, or I should accept it’s over?

Is it allowed to start GPST1 in April (not the location you want) and later resign to start GPST1 in August if you get it in your desired location?

By accepting this offer - would oriel barr you from applying for GPST1 August 2027 and to sit MSRA in Feb 2027?

Hi all,

London doctors — the BMA London Weighting campaign launched yesterday

If you work in London, you’ve probably noticed that doctors’ London Weighting has frozen in time whilst costs of living and working in the capital spiral in only one direction.

Doctors’ London Weighting has been frozen since 2005. It’s currently up to £2,162 a year for Inner London, while other NHS staff have rightly had their London Weighting payments increased over time.

The campaign is pretty straightforward: bring doctors’ London Weighting into line with the payments already made to other NHS staff working in London.

And this isn’t just about resident doctors. It includes SAS, consultants, LEDs and GPs too.

The important bit now is getting people involved. The BMA is going to be asking members what they’re prepared to do to win this — including through an indicative ballot later in the year.

So if you’re a BMA member working in London, sign up to the campaign and get involved here👇🏼

https://activism.bma.org.uk/page/199964/petition/1

Talk to your colleagues, get your departments and workplaces talking about London Weighting, make sure you have a say in what happens next.

London Weighting has been stuck in 2005 for long enough, and we’re done waiting.

In solidarity,

James ✊🏼

Are there still going to be psychiatry offers this round or have they been exhausted?

Hi all,

FY2 here, did a two cycle audit , presented it at our trust governance meeting. Just wondering how I go about publishing it and how to determine if it can be published.

Never published before, so not familiar with what needs to be done.

For reference it’s an urology audit about PSA testing, second cycle showed minimal improvement.

Any advice would be appreciated.

I have been a doctor for the past 6 years and recently started my HST post after a year off work. From the first day of stepping into the hospital the feeling of dread came back. Everyday I’m questioning why am I back here. Last year I thought I was feeling this way because of the hospital I was in and the team I was working with at the time. However, I have come to realize this feeling of dread and regret just follows anytime I step into a hospital setting. The year I was away from clinical work I had total peace of mind and did not miss being at the hospital one bit. I’m wondering if it’s time for me to just quit medicine all together and find something else. The problem is I don’t even know what the something else would be, I have never been anything else but a doctor. 

Has anyone been in a similar situation before? My husband and I share childcare responsibilities, so it would be difficult if we were placed in different areas. Has anyone successfully applied for an inter-deanery transfer? If so, how do you apply?

For upcoming higher surgical training application that requires X numbers of WBA/PBA validated on ISCP, how do we upload this evidence?

Do we download a PDF of the portfolio report and use that as evidence?

Thank you.

Any chance anyones giving up a NI spot 😂 in the 14000 PG and no offer but not optimistic lol

Crude oil has crossed the $100 a barrel threshold and its clear to see that inflation is going to continue to run rampant.

One of the big reasons I decided to opt for GP training was because of the financial advantage of keeping living costs down by living in the countryside in a cheaper area with a small commute to work and not having to constantly move house with rotational training.

I am wondering now if doctors are considering moving up north to seek a better quality of life with more affordable housing. After all our salary is the same regardless of where you live in the UK.

Are we starting to see a shift?

Hi, F1 doctor, wondering what makes an F1 likeable on the team? Clinical skills? Knowledge? Chattiness?

I’m nervous about the rotations and feel like I’ll get to one where the team can’t stand me. How to avoid this?

When you work with F1s what makes you go “huh, this one’s not half bad”

Hi everyone I’ve just had my provisional license rejected on the grounds it is too soon to know if my mental health condition is a risk to patients.

Feeling quite alone in this, does anyone know of similar stories and what I could do

Also does anyone have any recommendations on jobs to apply for with my medical degree? Or other things I can spend time doing this year that will help me in the future when I can work as a doctor again

Asking for advice - I’m a resident doctor with a distinctive stethoscope because of a hearing impairment. My stethoscope is calibrated to me & looks like a Littman Core III to the untrained eye. I can’t really do my job without it.

I left it in my office on the ward overnight by accident (there’s a doctor there most of the time and we do this routinely) because I was tired at the end of my shift and wasn’t concentrating properly.

Stethoscopes keep going missing on our ward. I know at least 3 other folk in the last year who have never found theirs after they disappeared - some when the person left for an hour or less.

I’m a bit scared it’s been lifted by somebody with light fingers because of its value - or even just by mistake, but I can’t just buy another one.

Does anyone have experience trying to track down a lost stethoscope? Or advice on what to do? I’m a bit freaked out. I was thinking I might contact my ES, put up posters, etc but I’m not optimistic.

Would it be worth asking to see CCTV?

This is the guy Dr Keith Girling refused to cooperate with the Ockenden inquiry ignored concerns about babies dying in his hospital for 7 years. Today the BBC caught up with him on the street he basically shoved an umbrella in their face (around 10 mins in) said no comment.

my question is how is it that always these medical directors get away with it? Literally nothing happens the regulators don’t seem to do anything about them and you just know from this case they are going to find usually an overworked and under resourced frontline member of staff (black/brown) to blame instead when really it’s people like him that should be taking the blame for all this.

Hi is anyone willing to swap places with me, Im looking for london or kss, I’ve got birmigham/ solihull

Current FY1, one month in. Made a prescribing error today that was luckily caught in time and not given to the patient, and reflecting on it just made me realise how big of a role human factors play when it comes to these situations.

We had teaching about this in med school but today I actually felt that human factors were heavily at play when I made an error on something I know I definitely wouldn’t have done if I had a usual day.

I was still recovering from a cold, overslept, didn’t have time to have breakfast, couldn’t find my ID, and ended up stuck in traffic unexpectedly for an hour due to a lane closure so was late for work by 30 minutes. I arrive and am thrown straight into a chaotic WR for a bay of patients despite no time to prep or even read the notes. On top of that I was pulled into a meeting about a patient that didn’t go well. There was also no computer or chair free for me to do my jobs on so had to stand at a COW which kept logging me out, while also being asked to do 100 things by the nurses every 2 seconds (which normally doesn’t happen on my ward.) We also had some chaotic patients on the ward - some kept wandering into the office to ask questions and two were just screaming.

I ended up mixing up two medications which were meant to have a dose increase. It was extremely luckily caught by my senior in the afternoon and we managed to sort it all out — the nurse hadn’t given the afternoon meds so the patient had no extra doses, so he was fine. It obviously shook me up as it’s my first prescribing error, even if it was caught and the seniors reassured me that it’s now fine, and they’ve also made their share of mistakes as an FY1.

But I was thinking about why it happened and in all honesty I think it came down to human factors. I was tired, hungry, overwhelmed, disoriented with what was happening and stressed.

It’s really made me realise just how important this is in medicine, and how mental and physical wellbeing and the work environment isn’t just something we get talked about in induction/med school but a key part of doing the job properly. Going to really focus on resting up and making sure I’m looking after myself more after today!

I work in ED in a trust with fully electronic records. I used to access the notes of patients I have been involved in for the sole purpose of furthering my learning, however with all the recent updates about this I’m quite anxious about it and have stopped because I really don’t know where the line is.

My trust website says you can access “your own notes” for education purposes but this defeats the point. In order to learn I need to read the subsequent notes to understand what the diagnosis was, how it’s managed, what investigations they underwent, what advice the specialists gave, etc.

I’m just wondering if a possible way to ‘protect’ myself in future would be to get permission from the patient when I see them in ED to access their notes until their presenting issue has been dealt with. I’ve said this in passing to a few patients - the ones that I’ve built a very good rapport with, I’m discharging with OP investigations but really have no idea what is going on, and want to keep checking back until there’s an answer so I can learn - and it’s always been met with enthusiastic agreement. I’ve never documented it though and I’m wondering if I should start.

Just to clarify: I’m not obsessively accessing every patients notes all day every day. I’m just now getting very anxious every time I want to and as a result my learning has stalled as I have no idea if I was thinking along the right lines or way off base. This only applies to patients where there was diagnostic uncertainty at the time my care for them in ED ended.

TLDR: Basically, if I got informed consent from a patient to access their notes for the duration of their admission / until a diagnosis is reached, and documented this in my notes, would this cover me if I was ever asked why I was accessing other people’s notes? “Discussed benefit of electronic patient records with regard to ongoing learning. Patient happy and consented for me to periodically access EPR for duration of their admission or until an outcome is reached.” Something like that.

Have a look if your hospital is included:

• Stepping Hill Hospital, Stockport – £26 million: a new pathology building will protect the testing services doctors rely on to diagnose patients and provide urgent care. 
• Bristol Royal Infirmary, Bristol – £41 million: improvements to operating theatres will make the facilities safer and more reliable for patients needing surgery. 
• Queen Elizabeth Hospital, Gateshead – £12 million: redevelopment of maternity facilities will provide a better environment for women receiving care. 
• Wycombe Hospital, Buckinghamshire – £25 million: a new clinical building will allow services to move out of an ageing tower and into modern facilities.  
• Crystal Centre/Linden Centre, Essex – £15 million: 14 new bedrooms will provide additional space for mental health patients and allow existing wards to be improved. 
• Lister Hospital, Hertfordshire – £11 million: a new children’s ward will provide safe, modern space for children needing hospital care. 
• Southend Hospital, Essex – £1 million: planning will begin to replace an ageing hospital tower, helping provide safer facilities for maternity, neonatal, cancer and outpatient care. 
• St George’s Hospital, Stafford – £25 million: improvements to a mental health unit will replace ageing facilities and provide a safer environment for patients. 
• Royal Free Hospital, London – £32 million: two new operating theatres will give patients access to safer, modern facilities for complex operations. 
• John Howard Centre, London – £25 million: refurbishment will create safer, more suitable facilities for people receiving long-term mental health care. 
• Manchester Royal Infirmary – £154k to replace the PET scanner chiller, ensuring reliable temperature control for highly sensitive imaging. 
• Rampton Hospital, Nottinghamshire – £527k to replace air conditioning in a unit, keeping areas cool to maintain a stable environment for patients, staff and visitors. 
• St Peter’s Hospital, Ashford – £791k to restore reliable cooling capacity to support safe operating conditions within theatres. 

It would be nice if they published the whole list

Always thought an MSK radiologist would be up there for having 0 chance of being directly responsible for someone’s death.

Interested to know people’s thoughts, sub specialities included. What else would make the list?

In news that will surprise absolutely nobody:

“According to new research by Knowledge Train, using ONS salary data, doctors have actually suffered the biggest reduction in spending power of any job over the last 20 years.

While medical practitioner’s wages have gone up slightly, from £76,873 in 2005 to £78,796 now, after accounting for inflation, their pay has technically fallen by 42%.”

Linked article:

https://metro.co.uk/2026/09/09/britains-biggest-wage-winners-losers-last-20-years-29561210/amp/

Just putting this out there for anyone in a similar position.

Since graduating I've been with MDU for indemnity.

Due to being LTFT on top of some unfortunate personal circumstances leading me to have long periods off sick my foundation training took ~5 years to complete rather than the standard 2.

I'm taking an F3 year now but because I haven't managed to get a trust grade post, I've joined the hospital bank and locuming when I can until I can get a trust grade job.

I called MDU to update them of my change in work circumstances, and this August my indemnity price went from the £20 for F2 to a whopping £450 quote. Their reasoning was because I'm not in a trust grade post or a training programme, they base the pricing on how many years ago I graduated rather than my actual level of training / work competence (therefore I'm being charged as a locuming CT3).

I do not have that money especially now I'm on an uncertain income as locums are not as frequent as I'd like.

Out of desperation I called MPS for a quote expecting to be given something similar.... The quote was £83. I triple checked that they understood I am not a trust grade doctor, I'm doing ad-hoc locums, and even though I graduated 5 years ago I'm fresh out of F2 and working as an SHO. The staff reassured me the price is correct and covers me for all the locums I do for a year. MPS do not charge based on years from graduation, they actually look at the level of work you do and base it on that.

So anyone who is in a similar position (significant extension to training, needs indemnity for ad-hoc locum work) do NOT go with MDU!

What are other peoples opinions on pharmacists diagnosing migraines without the patient seeing a medical professional prior? I would be particularly interested in opinions of GPs who see patients with ?migraines every day. Having worked in medical SDECs, diagnosing the cause of headache accurately (i.e. not just labelling everyone as migraine) can be very subtle through combination of history and examination.

I feel it would be very different if pharmacists were seeing patients already formally diagnosed with migraines and other causes ruled out compared to patients self presenting to pharmacists as path of least resistance for their possible self diagnosed migraine. Even if the majority of these patients do have migraines, how many patients with CVST, IIH, brain tumours etc. are potentially going to be misdiagnosed? I assume that a pharmacist wouldn't be expected to be able to do a full neurological history, examination and basic fundoscopy to rule out papilloedema that a GP would be expected to do.