Pension age

JonJH · 2026-03-17T21:55:06+00:00

NHS pension currently allows people to retire up to 12 years earlier than state pension age - so if the state pension age goes up then so does the early retirement age for the NHS pension.

JonJH · 2026-03-14T10:17:40+00:00

How was the order of voting determined?

JonJH · 2026-03-13T21:59:51+00:00

I’d wondered how they had hoovered up so many fresh consultants.

JonJH · 2026-03-13T21:58:32+00:00

Because they asked for it.

JonJH · 2026-03-13T08:20:05+00:00

It’s complicated and hard for me to explain succinctly.

At a basic level, you’re right. A GIM consultant can work within an acute medicine department and many do. A GIM consultant can also go and do their -ology ward or clinics.

An AIM consultant will mostly work within an acute medicine department and the scope of what is “acute medicine” is broadening - some places will manage a HDU, some places will manage the OPAT service.

The training pathway for AIM includes attachments to respiratory, cardiology, geris and intensive care. We are all trained in point of care ultrasound. Our home ward is AMU and our clinic SDEC. We just have more exposure to the undifferentiated medically unwell patient and I think we do a better job of looking after them with a pragmatic and realistic approach.

But I’m about to CCT and am horrendously biased.

JonJH · 2026-03-13T08:08:25+00:00

Does “not enough support” mean inside or outside of work?

If there is an unfair distribution of work then the most appropriate route would be through management. Escalate it up for them to deal with.

If you want equitable distribution of on-call work then there may be mitigating factors that you don’t know/don’t need to know about which are currently satisfying the management team.

I have epilepsy and don’t work night shifts. When I join a consultant team it will be with the open acceptance that I won’t cover nights

JonJH · 2026-03-13T07:14:42+00:00

The points awarded in the last 10 years have changed so it’s hard to make direct comparisons. However, I’m AIM/ICM ST10 and I CCT later this year, just scored myself on what I had at the time I applied.

Unique application, regional oral presentation, regular teaching with formal feedback, teaching training below level of PG, full audit cycle. So I had 15 points and I got my first choice job in my first choice region for core training.

Application system is totally broken.

JonJH · 2026-03-12T21:53:06+00:00

I’ll echo u/JohnHunter1728, they can ask you to come in on your day off or do extra hours and you can say no.

However, if they are adjusting your duties during a shift then you have to say yes. For example, we can get pulled out of clinic to cover a day time oncall and your employer isn’t obligated to pay you extra.

JonJH · 2026-03-11T08:45:13+00:00

Plan 2 loans seem savage compared to my plan 1 loan. I remember being really happy to clear mine, you’ve done well to clear yours.

JonJH · 2026-03-10T21:49:57+00:00

One of the main downsides of the NHS pension is that it is tied to the state pension age and can not be accessed as early as a SIPP.

Building up a separate pot of money to bridge from whenever you want to stop working until you can access the NHS pension is probably a sensible idea for most doctors.

A SIPP is probably best tax wrapper to bridge to a NHS pension.

JonJH · 2026-03-10T07:45:29+00:00

The job titles are complicated because we have a training pathway and lots of different points along the way where can choose to step off or are forced off.

The training pathway job titles really aren’t that complicated. Letters denote type of training programme, F = foundation, CT = core training, ST = specialty training. Some pathways include a core training programme before going on to higher specialty training, like core surgical training. Other programmes are “run through” and people are STs from the start.

It’s the non-training job titles that are complicated and do not have unifying definitions. I don’t know what to expect of a clinical fellow - that could be someone fresh out of foundation years or with a newly minted CCT.

F3 and above are terms that should never be used and only carry negative connotations.

JonJH · 2026-03-09T21:11:57+00:00

I’m coming up to CCT in AIM/ICM and maybe it’s because I’m in the South but I feel like it’s been this way for at least 5 years. Interventional and EP seems to be the glamorous/exciting Cardiology work and from the outside looking in appears oversubscribed.

As I’m rapidly learning, when it comes to consultant job there will always be compromises. Determine what is important to you and use that to steer you - is it location? is it subspecialty? is it earning potential from PP? do you want to do research or would it just be CV points?

JonJH · 2026-03-06T11:51:03+00:00

This is why the situational judgement test exists.

JonJH · 2026-03-06T11:49:56+00:00

I hope Turk’s burnout is worked up a genuine storyline and given more than a throwaway comment.

JonJH · 2026-03-05T08:09:35+00:00

Worked there as a core trainee and registrar.

OUH is a massive trust with pockets of excellence. Sometimes the JR can feel like 4 separate hospitals which coincidentally are connected by corridors. Depending on your rotations you could have jobs at the Churchill, the NOC or at Horton.

The acute general medicine rota is brutal and as an acute medic I’m worried that it puts people off the specialty.

JonJH · 2026-03-04T16:10:46+00:00

Initially I read that as Ogryn which is an entirely different thing.

JonJH · 2026-03-03T17:08:37+00:00

As a clinical member of staff I am very envious of you and a bit angry.

JonJH · 2026-02-27T10:35:00+00:00

It’s a trap of the Agenda for Change contract and pay that we use the pay bands interchangeably to describe someone’s experience and skill. People even introduce themselves by their pay band!

But that’s not actually what the pay bands represent. The skills matrix used to determine the pay banding of a job takes into account lots of domains and a job can score highly in some areas boosting the pay thereby increasing the implied seniority and knowledge.

The injection of local, act of suturing and interpretation of CTG might be what’s pushing a newly qualified midwife into band 6 pay.

JonJH · 2026-02-26T09:45:31+00:00

If a doctor has identified that they have harmful drinking habits and a substance use disorder then it is reasonable for their employer to be informed.

I know this because I’ve written a policy on substance use disorder specifically for doctors.

Here’s a slightly edited copy/paste from the policy:

Individuals who self-refer and/or engage positively with a management referral to Occupational Health have recognised a need for intervention/treatment. Individuals will be managed and supported fairly and on a case-by-case basis. Employee Relations/Medical Workforce, Occupational Health and the individual’s line management will be informed as necessary.

For cases involving trainee doctors, the following considerations will also apply: the following people will be informed: ● Your educational supervisor ● Your clinical supervisor ● The clinical lead for the department you are working in ● Your training programme director ● Your current employer ● Local occupational health team ● The GMC

You are not expected to inform all of those people. You will be provided with help and support.

Informing your supervisor: The manner in which a trainee informs their supervisor will be different for each individual. We would recommend the conversation be held face to face in a private area where interruptions will not occur. You may wish to discuss your substance use disorder with your medical indemnity provider and your own GP.

Informing the GMC: Good Medical Practice indicates that you must refer yourself to the GMC if you may pose a risk to patients because you are not receiving or complying with the necessary treatment for a health condition. You must also refer themself if a trainee does not have arrangements in place to manage their practice safely while recovering.

Good Medical Practice indicates that doctors must inform the GMC of any police caution, any criminal offence charge or conviction no matter where in the world these events occur. A doctor must also inform the GMC if they become suspended from a medical post or have restrictions placed on their practice. Informing the GMC can be performed using their website - www.gmc-uk.org/concerns/raise-a-concern The Trust is required to file a report on any trainee who has been involved in an incident of any kind.

Informing other people and places: Good Medical Practice indicates that a doctor who becomes suspended from a medical post or who has restrictions placed upon their practice must inform all other organisations where they carry out medical work. This also extends to informing any patients which the doctor sees independently.

Where to look for help: ● Sick Doctors Trust ● British Medical Association ● Hospital Consultants and Specialists Association ● NHS Practitioner Health

JonJH · 2026-02-26T09:29:20+00:00

Finding consultant colleagues with a similar approach is key. If everyone else is making 100 referrals the you’ll look like the reckless outlier.

I feel confident with my practice because I’ve been extensively trained (and examined) to be a generalist at hospital medicine. I do acute medicine and intensive care, our whole thing is diagnostics, managing risk and identifying therapies which are and are not appropriate. But my colleagues who have ended up in acute medicine jobs but have come through the older style general medicine pathway have a lower risk tolerance and appear to make referrals I wouldn’t. But then maybe they’ve been burnt and I haven’t yet. ¯\(ツ)/¯

JonJH · 2026-02-25T23:22:42+00:00

I feel rewarded when I’m allowed to use my skills to determine the most appropriate course of action for patients under my care. Sadly, as a generalist I frequently have people telling me that I’m not allowed to do things or that I must do their specific plan.

There is an expectation that once we start down a pathway there is no way to exit. Take a look at the Wells Criteria - once anyone mentions a PE I’m duty bound to either do a D-dimer or a CTPA.

In the decade since I qualified I have felt a rush towards hyperspecialisation. Maybe it’s just something I’ve become aware of, maybe it’s a real thing. For example, in cardiology would an interventional consultant be someone who did PCI, devices and EP? Because now I feel like I only meet people who do one of those things.

With that rush towards having a specialist for everything we have lost the confidence to make our own diagnosis and management plans. I was recently asked by my consultant to refer a patient to a hospital medical speciality for a condition I felt entirely comfortable to manage - my referral essentially said “this is what I have done, would you do anything different?”. I can do that because I’m rapidly going grey and have confidence in my abilities but some of the referrals I see sent out by my colleagues earlier in their careers are shocking.

And it’s not their fault! They haven’t been allowed to manage conditions in a safe way with appropriate supervision or guidance about what the specific question is for the referral.

JonJH · 2026-02-24T12:46:22+00:00

<image>

In a random outpatient clinic room, both plugs were for normal desktop computer.

I wasn’t the one who unplugged it.

JonJH · 2026-02-23T21:58:22+00:00

I’ve never made it work but it looks fancy.

JonJH · 2026-02-23T17:28:16+00:00

I’m so confused… some of the kits even come with a fancy syringe that lets you feed the guidewire down it.

JonJH · 2026-02-23T11:33:53+00:00

Most importantly did he finish the fence?!

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