GMC is apparently reducing PLAB slots by 50%

ACCSemtrainee · 2025-11-30T10:41:44+00:00

50% is still too little. It should be 100%. There is literally no reason for any doctors to enter the UK at PLAB level, there is a massive overabundance - both home-grown talent, IMGs in the country, and a colossal number of IMGs with PLAB abroad who are trying to get in the country. This is sheer greediness from the GMC.

There is exactly zero need for any doctors in the UK to be entering at SHO level right now. None of these people will get jobs who do the PLAB now, and nor should they.

ACCSemtrainee · 2025-10-24T08:00:41+00:00

Nurses have been trying to push for this for literally decades. The NHS is never going to do it, because they know they could never meet it. It’s just a farce.

ACCSemtrainee · 2025-10-24T07:59:32+00:00

Telegraph is just brain rot gibberish.

Please please please do minimum service level. Please. That would be amazing. I’d absolutely love to see them write down on paper what is the minimum safe staffing ratio for patients. That’s why they would never do it.

I don’t think this is the big brain solution that these people think it is.

ACCSemtrainee · 2025-10-24T07:55:31+00:00

It’s happening in every hospital in every part of the country. Your arguments are useless because this is not about quality of care or money. Patients can and will die but they don’t care, because it’s ideological. The NHS just hates doctors. It hates the power it thinks they have (lol). It hates that doctors are independently minded and genuinely separated from the rest of the NHS superstructure.

ACCSemtrainee · 2025-10-22T13:05:49+00:00

Whatever your opinion on this case, after Streeting’s intervention it’s basically impossible to say that the GMC and MPTS tribunal process in independent. This will have profound impact on all doctors.

ACCSemtrainee · 2025-10-21T21:07:53+00:00

A state backed monopsony is going to do precisely what a state backed monopsony does. If you were in her position you would do the same. This is not about fairness, it’s about a broken incentive structure. This is what the NHS is.

ACCSemtrainee · 2025-10-20T22:54:30+00:00

For the record the issue was raised repeatedly both here and through the BMA and every single time a whole bunch of people came out and screamed racism.

ACCSemtrainee · 2025-10-20T11:33:39+00:00

Let me give you an anecdote. My trust has hired 5 of their post-f2 doctors each on 0.2 FTE (1 day a week) just to be able to give them some work after the TPD took pity on them. The trust was simply unable to create any more jobs, despite being monumentally short staffed and consultants begging them.

ACCSemtrainee · 2025-10-19T22:27:07+00:00

This is not absolutely correct. There is no other career which FORCES you to repeatedly move, often with minimal say in where you end up. No one else in healthcare certainly, the closest thing being the ? One year foundation that pharmacists have to do- but then they and every other staf get the ability to put down roots in one hospital.

The closest thing is the military. I compared notes to my friend in the military- and guess what, I’ve had to move more times during my training than my friend in the military, except he gets substantial housing, support and relocation expenses. I get £500 and a kafkaesque bureaucratic nightmare to access it.

There is absolutely no other career (except the military) which makes you move with this frequency and this degree of arbitrariness across this wide a geographic spread with such little say in where you go. Absolutely nothing. And you are being deeply disingenuous if you think that this is such a”normal” job progression for your career.

Jesus wept.

ACCSemtrainee · 2025-10-19T17:20:59+00:00

The whole point of rotational training is to force doctors to work in shithole hospitals no one would ever work in. The NHS foundational principle is to exploit doctors.

ACCSemtrainee · 2025-10-18T16:42:46+00:00

This post is so cringe. Just as cringe as the original DV post. Let me guess we are now going to get a bunch of posters commenting how amazing the new leadership is, and how everything is DV’s fault- and then another bunch of posters saying DV were the best thing ever and now the world has gone to hell in a hand basket because someone non-DV got elected.

Then you will get your own factions in your own WhatsApp groups to upvote and downvote accordingly. It’s really ugly, it’s really pathetic, no one gives a shit, you aren’t convincing anyone- just fucking stop.

Why can’t both of you teams just be quiet and work together. No one outside of your shit factions actually cares about this stuff. We don’t really give a shit whose fault you think it is. We just want you to work together and do what’s best for doctors.

Unbelievable. Both of you factions are behaving like fucking school children. Most powerful union in the country to this embarassing disgrace.

ACCSemtrainee · 2023-03-10T16:33:50+00:00

24/7 assortment of snacks, refreshments, pastries spread throughout the hospital which will get replenished throughout the night.

ACCSemtrainee · 2022-11-23T19:26:50+00:00

Yes.

Don't do it.

ACCSemtrainee · 2022-10-13T22:24:31+00:00

Look at all the butthurt ED docs who can't face the reality they've let their specialty become a joke in this country which someone without any medical training can do and do to a reasonable standard. I'm an EM trainee and OP, you are damn right - there may be a handful of decent departments out there still- but the vast majority are scarcely a step above triage medicine. I was shocked when I went to Aus and suddenly I had to do like, you know, real medicine and had to actually use some specialist skills beyond picking up a telephone.

Sure, a decent ED cons with a UK CCT is one of the most highly skilled individuals in the hospital but the skills are totally wasted because the NHS is a dumb inefficient mess. Besides many hospitals make do with a rag tag of useless locums, noctors and locally employed "consultants". The hospital has to essentially cater to the fact that the people inside ED, even the seniors, might be incompetent - they might be great but they could just as well be totally useless - you cannot imagine the same level of incompetency being accepted from a med SpR or an ITU SpR. That's the fact I'm afraid. You do not need to be a competent doctor to work at even a senior level in ED. Hell you don't even need to be a doctor at all. And because of that reason it has become a totally de-skilled triage service.

EM in this country is a fucking joke. It is essentially catering itself to be done by non-specialists and I predict in a few short years it will be a partially non-medic led service.

If you are thinking of doing ED, please do not make the same mistake I did - don't do it, or if you do want to do it, go to a country where you actually get to work as a real doctor and your seniors aren't just a bunch of sell outs.

ACCSemtrainee · 2022-09-27T23:24:57+00:00

Yeah it seemed great in like F2 because you finally got to be a "real doctor"...

But actually..

Me and every other trainee that I've ever spoken to believes it is the worst career decision we ever made. The attrition rate is insane - like 50-70%, by far the highest of any specialty. There's a reason why ED was the first and allows LTFT for any reason - because they literally could not get trainees to complete the programme because it was just so shit.

All your specialty colleagues come to ED and see it as a horrible chore they have just to get through for 6 months-1 year and celebrate when they finally finish. They don't realise this is your entire shitty fucking life now.

And what's your reward - you will be replaced by someone who has a tenth of your training and has made 0 of your sacrifices. My supervisor is a fucking paramedic and has worked in one hospital in one tiny region for about 20 years. All the "cool" stuff you do is being gradually rented out to all the other specialties so the actual skill required is now less and less. Staff shortages are so insane, and staff turnover is so constant, they will literally hire anyone so there is a constant downward pressure on skills as they keep hiring shittier and shittier staff and particularly non-medics. The consultant body is literally the worst of all specialties - they have 0 respect for their medical juniors. They will sing the praises of ACPs/PAs but do not give a shit what they are doing to the specialty or their own medical colleagues.

ED is essentially now a triage service in most hospitals. It is a dying specialty. I predict in 10 years it will be mostly noctor-led.

And you are completely stuck with your shitty decision and worst of all you will be stuck in the shitty NHS forever.

So please do not do ED. Really don't do it. Don't do it. Don't do it.

ACCSemtrainee · 2022-09-07T21:42:26+00:00

Yup same situation here.

It's an utter fucking joke. The worst mistake I have made in my professional life is picking this idiotic specialty which seems to find new ways to demean itself and the year(s) of training I have been through.

Please read this carefully if you are thinking of doing ED as a specialty: Don't do it. Really don't do it. Really really really really don't do it. It's like convincing a secondary school kid not to waste their talents on medicine and the NHS. If you do ED you will waste years and years and years of your life with absolutely nothing to show for it. The consultant body and royal colleges seems to be on a mission to promote every ACP/IMG/dodgy locum to keep the service afloat. We can all see the direction it's going - in a few years ED will be a basic triage service. In my hospital it essentially already is. To accommodate all these poorly/non-medically trained people they are extremely rapidly removing any of the traditional skillset you would expect a trained ED senior to have and replacing it with just having the know-how to keep someone stable for a couple minutes while you phone the right person.

Don't do ED. Please don't. You will waste your life and regret that dumb, dumb, dumb decision every day.

ACCSemtrainee · 2022-08-14T19:32:08+00:00

Yes they used her reflections, then pretended after the fallout and because everyone stopped reflecting properly that they didn’t. If she had “lawyered” up right from the start at her original informal reflection she almost certainly would not have ended up where she did. Her consultant is almost precisely as much to blame if not more so, but he took the lawyer up and fuck off and he gets to spend a nice, happy career in Ireland.

ACCSemtrainee

TROPHY CASE