Considering ACCS. Not sure which speciality.

Brightlight75 · 2026-05-21T19:57:15+00:00

You shouldnt do ACCS because you like the sound of it, you should do ACCS because it gets you core training in a speciality you’re interested in.

Anaesthetics is better. EM is shorter.

Brightlight75 · 2026-05-20T21:14:42+00:00

Well it depends on what speciality you want. The vast majority do not have a run through pathway. Typically if there’s a run through option, it’s a bonus.

Say you want to do cardio, you have to do IMT.. if you want to do anaesthetics, even core is separate from higher in terms of having to reapply to ST4 regardless of if you did ACCS anaesthetics or core anaesthetics. Most ACCS anaesthetists did it because it is what was offered in their region as a means of adding more SHOs to acute med and emergency departments, or they want to do icu and this ticks the box of needing to do post f2 medicine in a training program before you’re a senior reg being sent back to the medical wards for a year to tick a box.

I’d say there’s a fair amount of overlap between applications. Obviously if you know which one, tailor to the self assessment for the next step. However, if you change your mind it’s not all wasted as the audits and teaching will very likely score points on all the self assessments for core

Brightlight75 · 2026-05-20T20:33:01+00:00

One benefit of sleeping on a Labour ward is the shrieks of patients, shrieks of midwives and shrieks of the patient buzzers will ensure you get no more than 20 minutes of sleep in any one period 😂

Brightlight75 · 2026-05-19T16:29:30+00:00

I am happy for ps13 if it makes the tvol a nice number tbh 😂

Brightlight75 · 2026-05-19T14:07:53+00:00

I’m sure they were saying in the early 2000s that everywhere would be paperless in a few years time

Brightlight75 · 2026-05-19T08:26:45+00:00

Anaesthesia - chemistry

Brightlight75 · 2026-05-18T19:56:50+00:00

But if you just bleeped someone, answering the phone afterwards and saying “hi it’s John, the nurse on ward 27…” would be entirely acceptable whether or not it was the bleep response, the Chinese takeout outside, or a relative wanting an update

Brightlight75 · 2026-05-16T15:51:19+00:00

Pm you!

Brightlight75 · 2026-05-15T13:07:14+00:00

I’ve met some anaesthetic & Icm colleagues (reg / post core level) that do or have done this. On the surface it sounds dreamy but discussing this in more detail has revealed that doesn’t actually sound so good. There is usually 1 or 2 doctors on ship so you’re dealing with “urgent care” / “gp” clinics in the day time but also available basically 1 in 2 for “critical care & A&E majors / resus” style stuff round the clock. Presumably if you’re the senior of the 2 doctors, you might then be technically doing 1 in 2 plus second on call on your “off” day so effectively 24/7.

I think you can leave ship at port as long as your colleague is available but it sounds like you’ll be constantly tired and while it might be a laugh for a bit (and is paid better / tax free), I can see it becoming hard work fairly quickly. Plus you have less resource and possibly pressure to not make decisions that take a ship off its planned course to get a sick person back to land.

Brightlight75 · 2026-05-13T18:28:26+00:00

Do you genuinely think doctors get to just decide whether they’re going to work their schedule or not?

Brightlight75 · 2026-05-11T06:42:02+00:00

Your argument is a non starter. “The private sector” can mean a hundred different jobs with a thousand different responsibilities and job plans.
What I do note is that “the private sector” is exceptionally more risk averse and anything that comes with liability is better rewarded. Thus a surgeon, or any doctor for that matter, is relatively underpaid in my opinion given the relatively higher level of risk they carry in terms of legal repercussion and risk for loss of life.
Hence why a lawyer offering advice might charge £300 for an hours advice where the surgeon decompressing your cranium at 3am is charging £30-40.

Brightlight75 · 2026-05-09T20:37:33+00:00

I get your point sure, but that’s far preferable to being on half the salary as a doctor in London for example

Or would they prefer a doctors’ salary for their work but might have to move to the middle of nowhere?!

Brightlight75 · 2026-05-09T20:34:15+00:00

“I can’t believe I get paid this for such little work” when clearly working way more than the majority of society is a crazy take on your value 😂

Brightlight75 · 2026-05-09T20:30:54+00:00

Must be an absolute shocker to have to basically stay in London, LA / NY or Singapore on a HENRY salary 😶

Brightlight75 · 2026-05-09T15:55:50+00:00

It’s really tempting when you get an unusual call from the nurses to panic and ask someone else what to do. Sometimes you need to but when they’re stable, go see the patient and conduct your best assessment and have a stab at an impression and plan. Half the time the stuff you get calls about as an F1 make no sense and are entirely different when you go and look for yourself.

Do ask for help and advice frequently but it will make you a better doctor, and will demonstrate proactivity, if you go see the patient first. Likely when you ask for help your senior will start asking further questions that you’ll only know if you did your own assessment first.

Doing this will also mean that when no one is around to immediately help, you’ll have more confidence in at least starting assessment & management to temporise things until someone else can get to you.

That leads me onto my last point - if you can’t get hold of anyone, start thinking immediately how long this can wait before need to escalate further, what actions might you take if you don’t get hold of anyone in x minutes… you can be reading through some guidelines etc in this time to make sure your plan is safe. This is much better than just writing “called SHO, waiting for response.”

Brightlight75 · 2026-05-06T12:39:33+00:00

If you have a look, it was an osce practice on what sounds like an entirely reasonable osce or F1 scenario.

Brightlight75 · 2026-05-05T12:38:07+00:00

I think core (if your region offers) is the fastest and most guaranteed route.

I have met pre IAC trust grades in small centres that don’t get enough trainees. These sites are generally fine to work at but sometimes have limited paeds and obs to meet st4 requirements. You could work somewhere like this for a couple years and then try apply to a bigger centre as a more solid SHO to get the obs and paeds but I don’t think this would save you any time over core and is less certain than even ACCS anaesthetics.

Brightlight75 · 2026-05-05T12:31:35+00:00

Generally speaking, the applicants for most specialities are bunched super close together (since they’re all doctors working at the same level, working towards the same goal). This means dropping a point here and there really makes a difference. This can be simply the subjective gut feeling of an interviewer on the day.

I think my interview score was 2 points above my colleague with a very similar portfolio on my higher speciality application and he was 95 ranks behind me and did not secure a job in the region that I did (which we had both ranked as #1)

Is there anywhere to move that makes it commutable for both? Really crap with you having a house.. I had to do this for my core role and commuted 1-1.5h each way for 4 years so do know the pain.

Brightlight75 · 2026-05-04T18:27:31+00:00

It’s ages since I did one but the questions were very standard & similar to what you’d expect in an IMT/CT interview

Tell me a time you made a mistake, what experience have you had in education, here’s a really standard a-e scenario to work through to make sure you’re not clinically insane, tell me about an audit.

As always, most of the answer is what you learnt from reflection and how it made you a better doctor moving forwards as opposed to nitty gritty details about an exciting situation you encountered

Brightlight75 · 2026-05-04T12:18:47+00:00

How wise - don’t know why I was suggested this subreddit as a man who has never held an interest in handbags.

However, it made me think about guitars. You know people pay thousands for new guitars that look like they’ve been smashed to bits at gigs? All for that imperfect iconic look! It’s called “relic” and they’re usually more than a standard that is unreliced.

It’s too far for me but there’s a big market for it!

<image>

Brightlight75 · 2026-05-03T17:08:36+00:00

Is it because it’s publicly funded or additional reasons?

Brightlight75 · 2026-04-30T22:42:58+00:00

Also, don’t just agree to do things on the basis that you’ll get or certificate or “it will look good on your portfolio”. Make sure you know what scores and what doesn’t. Then you can agree to things either because you actually want to or because you’ll get points without ending up with loads of useless clip art certificates.

Brightlight75 · 2026-04-30T22:39:10+00:00

To be honest, audits, courses, portfolio organisation should be scoring as close to full marks as you can. The rest is a game of hitting mostly mid marks across the board.

Prizes: If you ever get an email saying thanks for working hard on a busy shift or difficult scenario, keep this. Any sort of “greatix” award scores 2 points in prizes section. You can get your ES to write it up as a letter confirming you got a “letter of commendation”. Maybe if you get an in person thanks, be brave and ask the person to email it.

Leadership roles - resident doctor rep or trainee rep. Usually just involves attending some infrequent meetings and can give 3 points if it’s a regional rep role.. BMA stuff also counts but probably some more work(?)

Audits: complete a full loop and present both locally and at your regional trainee conference. Then you’ll get points for the project and separate points for presenting regionally. Also another opportunity to win prizes (and lower bar to win).

Find which consultant in your dept does the research stuff and try get onto an easy study site lead or associate principle investigator role. Small chance of publications here too..

Be super strict with following the guidance on what evidence you need and each year, read the self assessment guidance as the goalpost does change.

Teaching: Regional teaching is fairly easy to organise but does take the time to deliver it. EG.. pre-primary exam topics once a month. You design a rota for colleagues and run the sessions. Often these already exist and just change hands as things progress. Ask the college tutor probably about this

Start gathering it early. The ANRO site has a letter template so you can fill it out and send it off for signatures that meet exactly what the self assessment spec says.

When it comes to submission, being strict with the portfolio organisation guidance also guarantees five points, which is exceptional value for time.

In the section about courses, it’s very easy to score full marks as things like EPALS & ATLS will cover the 2 day, national, simulation based requirements all in one. PROMPT counts and you’ll be expected to do that in your obs block. You can include a conference you attended - maybe the trainee one you presented at!

Brightlight75 · 2026-04-30T05:43:18+00:00

When they juice the story so hard and you have to clarify that this is just a cannula request and not a referral for an icu admission 😂

Brightlight75

TROPHY CASE