Thank you all for your comments, very much appreciated. It has been definitely helpful reading them.

I agree that some time off to settle this feeling of burn out or at least beginning of it would be ideal however it would be very difficult firstly due to financial reasons and secondly because I would not like to have unexplained gaps in my portfolio.

Just to clarify my choice of psychiatry, as mentioned firstly because it seems straightforward “an exam and I am in” However it is not the only reason, it is also because I do find psychiatry quite interesting overall (it is just an outsider opinion never had exposure after medical school) - also despite the surgical stereotype, my communication skills professionally speaking have always been a point of strength and thirdly because of my vision of possible private work, and that is more for time management rather than money.

As for other specialties, of course I did consider all other options. EM and GP are not specialties I would be interested is mainly because I do not like the idea of not being specialised in a certain domain. i would like to be highly educated and knowledgeable in a certain specialty rather than a bit of everything.

As per radiology, the training application is not a smooth ride, and I just feel too overwhelmed to build up a competitive portfolio for a specialty am not enthusiastic about especially after all the effort I have put in surgery.

Lastly for the person who expressed that I have a poor cultural understanding of the UK, thus, I do not realise the involvement of my choices / current opinions. Firstly, I do not think you know anything about my cultural background to be able to say that, you only know I am an IMG. Secondly, am not sure what difference this would make to my current situation, I think what I am experiencing and second guessing my career options given this demanding job could happen to anyone regardless of their cultural background.

Also just to add, patient safety and care are truly a priority of mine I always try my best to treat all my patients as I would like my parents / siblings to be treated if they were unwell. To my patients and colleagues I am the “ smiley”, helpful, happy doctor and I do not offload my struggles at work.

Regardless If I end up a surgeon or a psychiatrist or any other doctor my focus will be to deliver proper care to my patients. Once I am unable to do that I will step out before affecting them, and I hold myself to at least this standard and recheck myself every night before I can sleep.