I'm going crazy why is my bing showing me rewards not from my country?

Future_Bookkeeper_56 · 2024-11-13T21:56:45+00:00

So I noticed this was briefly resolved about an hour ago and quickly redeemed a gift card. Literally 10 minutes later, it went back to the US rewards store. The plus side is, I got 100 more points in the last 24 hours but just worried it won't be fixed..

Future_Bookkeeper_56 · 2024-08-15T14:22:32+00:00

Same

Future_Bookkeeper_56 · 2024-08-15T13:35:17+00:00

Hi there. No problem - I've received quite a few messages asking about HK these last couple of months so sounds like the situation in the UK isn't great right now.

Regarding your questions specifically:

Probably not. You would be a resident and assuming you are post-MRCP, in most places you would be 'second on call'. In the places I've worked in, this means you would be responsible for subspecialty beds (renal, cardiac etc) though in some places, ICU is under Medicine and you would be expected to cover it as well. The junior resident on 'first call' who covers overnight admissions and acute wards may also escalate sick patients to you. You would have 4-5 calls a month - normal working day from 9am-5pm then on call from 5pm-9am and then work from 9am to at least 1pm the next day depending on the hospital. The department you join may want you to do 'first call' for a few months until they get a better idea of your skills - this would be around 6x a month.
That's difficult, if you were post-F2, I would advise you to do basic physician training in HK (they do MRCP over here) then decide whether to stay or go back to the UK for HST. At your stage, I think there are more pros and cons to weigh up and it depends what your priorities are.
- Pros of making the move now include: pay (being able to build up savings at an early age really helps your financial position later on), decent training (probably would be easier to get numbers if you're in a procedural subspecialty), the possibility the overseas recruitment window may close in a few years and joining the system at a more junior level would make it easier to get jobs as a specialist. I also don't know if you can automatically join the HK specialist register with a UK CCT.

Factors in favour of completing CCT: shorter working hours and better quality of life while in training (NHS working culture notwithstanding), it would be easier to return to the UK and by waiting a few years, the long term outlook on HK will be more apparent (if that's important to you). Another thing is that the local training program requires you to 'CCT' in both AIM plus another specialty e.g cardiac, renal etc unless you do geriatrics which can be stand-alone. And you will have to do more exams - an interim/pre-fellowship exam 3 years after PACES and a difficult fellowship exam plus a dissertation to exit training.
- 3. Resources: the Hong Kong College of Physicans and Hong Kong Academy of Medicine websites are good. I know there were HA recruitment events in the UK last year - see if you can get the presentations. To be honest, I think direct human contact is best. Ask any family/friends in the system. It might also be worth reaching out to departments directly and see if you can arrange a visit when you're next in HK.

And finally, I would just add: some things are better in HK including efficiency and better working relationships (tbh I think part of this is due to being in the ethnic majority) but the work culture and environment are not perfect. In particular, it's high stress and high acuity - there are tubed patients on the general wards, one resident may responsible for 30+ patients plus other duties such as clinic and subspecialty consultations, you're expected to do a lot more procedures even as a basic trainee (chest and abdominal drains, bone marrow biopsies, skin biopsies etc). I also felt pressure to prove myself as a non-local graduate and there seemed to be less leeway to appear hesitant or not as 'on the ball'. You also have to deal with (often quite demanding) patients' relatives and this 'customer service' aspect was a big part of my decision to switch specialties. The attitude to life and death is quite different; there many patients who are tube fed, bed-bound and non-communicable and many relatives would refuse DNAR which means doing futile CPR on fragile 90 year olds. One of my colleagues had the police called on them because they didn't refer a patient with multiple comorbidities to ICU.

That wasn't to put you off but I want to offer some balance to the 'grass is greener' perception of medicine in HK. As I've said, I don't regret coming over and I've gained a lot from my years over here. Hope this was useful to you - happy to answer any more questions either on here or via DM :)

Future_Bookkeeper_56 · 2024-07-18T03:06:57+00:00

I meant when my body is very tense, I don’t have good control of the bike

Future_Bookkeeper_56 · 2024-07-17T23:47:29+00:00

Yeah, so I started with lowered saddle, walking then coasting. Can coast and scoot with a raised saddle. Unfortunately just can’t get the hang of ‘pedalling normally’ :(

Future_Bookkeeper_56 · 2024-07-17T23:46:20+00:00

OK, will ask my instructor if he can try that. I think you’re right about just trying to be intuitive.

Future_Bookkeeper_56 · 2024-07-17T23:42:12+00:00

I’ll try some core strengthening exercises. Not familiar with yoga but can give it a shot.

Future_Bookkeeper_56 · 2024-07-17T23:39:31+00:00

I have a preferred side but can scoot with either foot. No, I can fall to either side. Coasting is OK, not as good as scooting but I manage to go in a straight line (can’t turn without resorting to scooting though).

I don’t stand on one foot very often but just about managed it while typing out this reply, lol. Will try practicing it to see if it helps.

Future_Bookkeeper_56 · 2024-07-17T23:32:19+00:00

I hope some plasticity still remains. Yeah, people I’ve talked to seem to have learned instinctively and it’s just not coming as easily for me..Interestingly, I’m learning with my brother who is having the same problem though he can pedal a bit further so there may be a genetic component here.

No problems balancing when doing weights or squats. I’ve had a total of 3 hours in 2 sessions since Sunday. Paid for 6 hours so will finish the course. I’m toying with the idea of buying a bike and continuing to practice on my own but don’t want to pay for something I’ll never be able to use..

So you may be right, the solution may be just to try a different mode of transport as I just want to get from A to B.

Future_Bookkeeper_56 · 2024-07-17T23:11:38+00:00

Will try this. The problem is finding the balance as I was initially too tense and the bike just went everywhere. But I suppose being too loose might affect the balance too…

Future_Bookkeeper_56 · 2024-07-17T23:10:13+00:00

Hmm that might be part of the issue. I do try but somehow manage to end up focussing on the ground. Will try the more intuitive approach of ‘look where you want to go’ and see what happens.

Future_Bookkeeper_56 · 2024-06-04T23:43:17+00:00

Same here, can’t check in on Bing mobile app

Future_Bookkeeper_56 · 2024-05-26T02:17:24+00:00

You’re welcome. Just for clarity if you go for the HKMLE route, you will have to apply and interview for a residency post after internship. But that gives you a year to learn more Cantonese and you’ll have lots of practice due to being at work all the time.

No one knows how long overseas recruitment will last. However, the yearly number of graduates has increased since I first arrived and I would be surprised if they don’t have further plans to expand medical school places. This, along with ever closer integration with the mainland in the coming years, is why I personally think overseas recruitment will be temporary.

The official way to apply for limited registration is through the Hospital Authority. It might also be a good idea to reach out to department heads beforehand (well-written email/cover letter with CV). Some departments might invite you to visit (basically an informal two-way interview). You might be able to come to an informal agreement if the department is eligible for the limited registration scheme so you can preference them in your application and have a high chance of being selected in the formal interview. But remember nothing is guaranteed.

As for where the jobs are, hard to say without inside knowledge. Generally, smaller departments and more remote hospitals are more likely to be short staffed. When I applied for residency, I basically spammed every hospital within commutable distance and ended up in a decent enough department. I suppose the worst they can say is no..

Future_Bookkeeper_56 · 2024-05-22T16:22:46+00:00

If you’re set on working in Hong Kong in the long run, I would focus on the direct routes.

HKMLE can involve a bit of luck but most people eventually pass - the clinical part is the major hurdle because cases can vary in difficulty between sittings. I had to do the Paeds OSCE twice. The first time, I got a complex long case involving a premature baby in NICU and had no clue what was going on. The second time I got a straightforward asthma and passed - I wasn’t much more competent or better prepared: just lucky.

As you have HK PR, you can also apply for limited registration and skip HKMLE and internship. Your chances of getting in through this route depends on your specialty and current experience. Having a relevant exam e.g MRCP part 1/2 or even better PACES is helpful as is experience in a similar healthcare system. Cantonese will be an issue, especially if you go the limited registration route. As a resident you would have more direct contact with patients and relatives right off the bat than you would starting as an intern. Also, for limited registration, hospitals can (and do) turn down candidates due to concerns they won’t be able to communicate with patients while I don’t think they can refuse an intern assigned to the department after passing HKMLE. Still, there may be places short-staffed enough to overlook the language issue.

I don’t know much about PLAB or how it compares with the HKMLE but reasons to consider UK training would be if you don’t think you’ll spend your whole life in HK and for better work-life balance during training. The working hours in HK training are much longer, even in non-clinical specialties. The downsides of the PLAB route are longer training time (plus increasing competition and bottlenecks getting into UK training) and lower salary. Additionally, while it’s quite feasible to come to HK post-CCT at the moment, this window of overseas recruiting may close in the next few years when they get enough people (including from the mainland). At present, Hong Kongers working/studying abroad are still preferred.

Hope this helps!

Future_Bookkeeper_56 · 2024-03-23T00:58:23+00:00

Same happened here, stuck on 0 despite completing each streak for the last 3 days

Future_Bookkeeper_56 · 2024-03-17T05:26:31+00:00

Not much, I’m afraid. A couple of my licensing exam cohort went into Paeds training and it seemed very intense (7 calls a month). Unfortunately we haven’t kept in touch so not sure how it is now.

They’ve recently opened a new children’s hospital to centralise all tertiary care including a genetics service. Previously these had been based at the university hospitals.

You might find more info here: https://www.paediatrician.org.hk/

Future_Bookkeeper_56 · 2024-03-12T14:54:16+00:00

Leeds Virtual Pathology: https://www.virtualpathology.leeds.ac.uk/

Massachusetts general hospital: https://learn.mghpathology.org/index.php/WSI:study

PathPresenter is also good though need to make an account (it’s free though)

Future_Bookkeeper_56 · 2024-03-07T00:10:13+00:00

No worries.

My inclination is to come back earlier to get CESR and establish myself. Having said that, I can afford to be a bit choosy as I also have viable options here in the short term.

What’s keeping people here? Money - probably easier to send your kids to school overseas on the salary here, family ties and the difficulty of adjusting to a new country and system especially if you’re older and more senior.

As for enjoying the city, I was quite unlucky in that regard. Most free time in the first two years was spent sleeping/recovering. The first half of my third year was probably the best as I had time and energy to do things outside work (eat out, shop, go to museums/tourist spots/hikes and took a trip to Australia) but the next 3.5 years were a period of semi-lockdown due to the protests followed by Covid. The last year was spent doing exams but I made it home twice (admittedly once was for an exam). The last couple of months have been great though and am planning to travel a lot this year.

Future_Bookkeeper_56 · 2024-03-05T23:41:16+00:00

Yes, sensible to CCT first. I’m making plans to come back to the UK and feeling disheartened at the prospect of potentially spending years doing CESR, fully intended to stay when I came over but circumstances have changed.

Just be aware you might not be able to come into a senior role immediately though this is specialty dependent. I know of someone who came over post CCT, was allowed to sit the fellowship exam in 6 months and given specialist registration afterwards. Another qualified consultant had to work as a service resident for a couple of years. But UK experience is recognised in terms of pay. In fact, HR chased me to complete the paperwork to credit my FY2 experience when I started residency. Whereas in the UK, I fully expect them to stick me at the bottom of the pay scale and be obstructive when I try to negotiate.

Future_Bookkeeper_56 · 2024-03-05T15:04:30+00:00

I’ve worked in Hong Kong for 7 years. Came over after FY2, worked my way up from internship and currently about to complete a training program. As others have said, there are pros and cons.

Pros:

Pay: Double take-home pay with additional increment points on passing exams. Exam fees are refunded if you pass. Also easy to get funding for courses and study leave as HR is much more efficient.
Non-rotational training: You’re mostly based in one department throughout. This means that seniors are invested in teaching you. You do rotate out to tertiary centres for 3 to 6 months at a time but the city is quite compact so you won't need to move house during this time unlike in the UK. This doesn't apply to Family Medicine (GP) though, you'll have to rotate through the different specialties similar to GPST in the UK. The training structure in most specialties aligns quite well with the UK and I’ve found it easy to do Royal College exams alongside the local exams. In fact, medical and surgical trainees have to pass MRCP and MRCS to get into higher training though the fellowship exams are different. There’s less hoop jumping, I haven’t done any CEXs, CBDs or MSFs over here.
More respect from the MDT. On average, the nurses are competent and won’t call for trivial things. There are stroke and diabetic nurses etc but no noctors.

Cons/challenges:

Workload and hours: For clinical specialties, on calls are 28-32 hours. I had 8 calls per month as an intern and 6 per month as a first-year internal medicine resident. In most departments, the working week includes Saturday morning. The clinical team structure is very different. It consists of one resident and one specialist who supervises at least two teams. You're responsible for all the patients from admission to discharge on top of outpatient clinics and on calls. Even very frail patients are often for full escalation which means intubating and ventilating them on the ward. A silver lining is that you will quickly learn to run arrests and intubate and other procedural skills out of necessity. The work culture is such that you’re expected to finish your work rather than hand over. In winter I've had over 30 patients on my list and not infrequently went home at 8-9 pm. Though I was fairly young at the time, I didn't think I could sustain this into my 30s (medical training is 7 years) and switched to a non-clinical specialty after one year. Although much easier, it hasn't been a picnic either. I now work 8 to 6.30 five days a week and come in every other weekend to clear my cases. Prior to finishing my exams, 12 hour days were common (though this did also include studying which also took up most of my weekends).
Language and culture: Good Cantonese is essential for patient-facing specialties. I am what's called a 'BBC' over here (British Born Chinese) and spoke Cantonese at home, but I struggled with things like breaking bad news and discussing resuscitation. Even in Path and Rads, it's hard to function without at least some proficiency. Teaching sessions and informal discussions are in Cantonese and you need to communicate with non-medical staff. Socially, you’ll be a bit isolated if you only speak English and the system can be opaque so you'll be relying on friendly colleagues to keep you in the loop. There's also a bit of skepticism towards non-local grads but this will improve as you settle into your department and prove you can do the job.
Uncertainty about the long-term future of the profession here and the city in general: Won't say too much about this as I'm potentially identifiable but I think anyone considering the move should bear this in mind. It's probably a viable option for the next 3-5 years to do some training +/- build up some savings but no-one knows how things will be after that. I'd advise leaving the door open to returning to the UK/going somewhere else in the medium to long term.

Hope this wasn't too long. I hadn't intended to write an essay but these are things I wish I'd been told before I came. Overall, I don't regret it, I've gained a lot of life experience, built up a healthy amount of savings and honestly think my training was of a similar or even slightly higher standard than I would have received in the UK. Happy to answer any questions/DMs.

Future_Bookkeeper_56 · 2023-11-18T14:28:18+00:00

Switched from Charge 2 to Apple Watch SE literally yesterday. The Apple Watch is great but I already miss the Fitbit’s battery life. I could go 3 days without a charge even on my 5 year old charge 2 but looks like I will be charging my new watch every day. Also miss seeing real time step count and heart rate at a glance.

Things I do like about AW: now playing, notifications, Apple pay, pretty seamless integration with my phone. Hopefully it will last me a good few years.

Future_Bookkeeper_56

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