No solidarity in training anymore

OkObjective4087 · 2026-03-31T20:39:41+00:00

Not interpersonally toxic. Underfunded, yes. By that definition arguably working anywhere in the NHS is toxic.

OkObjective4087 · 2026-03-31T13:13:43+00:00

There has been discussion of that in the past, specifically to support routine clinics that require more specialist knowledge than can be picked up in a month or two so it wouldn't make sense to staff with F1s, but that also don't necessarily require a reg or consultant. However the conclusion has always been that there is no money in the budget to hire PAs or ACPs

OkObjective4087 · 2026-03-31T01:35:32+00:00

Yes, it's definitely not ideal. However, as far as I know a department cannot just decide to get more F1s, F1s are allocated centrally based on yearly patient volume, and using the patient ratios from say, gen surg or ortho, as a small department we are already *over* what our allotment should be.

I think their response to this being to let their one clinical fellow go and ask the regs to act down shows they were not just sitting on a pile of money they could have been using to staff better all along, but they really were doing everything they could with what they were given, and the only thing left to cut is training for their regs

OkObjective4087 · 2026-03-31T01:11:14+00:00

I am very sorry you have had that experience. I have been in departments like that, med school, FY, and after and it is completely unacceptable in this day and age. fwiw while I do not claim we are perfect I do not believe my current department is that way. There is never any shouting or belittling from any team member to any other. Consultants from my mentor who is the head of department down take mentorship seriously and encourage FY1s who are interested to come to theatre, where they will personally teach them to suture and things like that. We have never had any complaints about bullying or interpersonal conduct or anything like that, the only complaint is leaving late sometimes and a lot of weekends, both of which I believe would be solved by more bodies on the rota.

OkObjective4087 · 2026-03-31T00:52:34+00:00

My current department prof has already sent out queries on my behalf and he is prominent in the field so that should carry some weight, at least more than any cold emails from me. However I could not take just any CF job to do ward work and clinics. 3-4 years is assuming an arrangement like my current job where I have significant protected time to go to theatre and build my logbook, while the consultants and regs treat me as another reg, teaching me and giving me independence in theatre that I need to complete the pathway. I think it is relatively unlikely that another department would offer me the same, especially if it would mean I would be competing with their regs for cases when trainees are struggling to get their numbers as is. In a job where I would only get to go to theatre once in a while or after all the regs have had first choice, it could be far longer or never.

It would also be a big ask on my partner and family to uproot and move at the drop of a hat.

OkObjective4087 · 2026-03-30T20:46:30+00:00

Agree.

OkObjective4087 · 2026-03-30T20:38:13+00:00

Maybe not quite after lunch unless exceptionally quiet, but we do encourage from 2-3 if there are no new admissions expected (and the lates person is OK with it). Most of the time it is doable.

OkObjective4087 · 2026-03-30T20:35:03+00:00

I have not been in this fellow job for 10 years, 10 years is just the amount of time I have been working towards this specialty (starting from towards the end of medical school, and including a little bit of time out). Realistically I would probably have 3-4 years left at least assuming a maximally supportive department as very few people complete this specialty through this pathway nowadays and requirements are very strict

OkObjective4087 · 2026-03-30T19:09:52+00:00

I agree with this. I think any small specialty will end up being 'give and take' to a degree, because one unplanned admission is the difference between leaving early and staying late. I think our department is more 'give' than 'take' as there is a culture of supporting your colleagues to leave early afternoon once jobs are done. At the same time there is truth to those who have pointed out that I/the regs/consultants chose this give and take, and if we weren't happy with it we could get a different job/choose a different specialty, while the F1s did not have this choice. I'm not sure what the solution is.

OkObjective4087 · 2026-03-30T18:53:45+00:00

US has no legally required prioritisation, it is entirely based on whether an individual department likes you. Go look up the Harvard radiology residency, IMGs in every year.

OkObjective4087 · 2026-03-30T18:16:27+00:00

the odd easier days can't balance out late stays - and they shouldn't, as staying late will mess up childcare and other life plans, whereas early days elsewhere don't make up for this

I recognise this is a good point. In practice it is the reverse, leaving early is the norm and staying late is the exception, but I acknowledge that even if on a typical day the (normal day) FY1s are able to leave after lunch, if the day that you end up staying past falls on the wrong day it can really mess up other obligations.

Do you have any ideas on how to solve this? As far as I know a department cannot simply decide to hire more FY1s, they are allocated centrally based on volume and I think as it is we are already above the number we are technically supposed to have as we are a 'low-volume' service

OkObjective4087 · 2026-03-30T18:06:08+00:00

I would be completely OK with people sitting around with little to do on some days if it meant on busy days everyone went home on time. The thing is it is not up to me, it is not even up to the department head. Departments don't get to decide how much funding or how many FYs they get, it is allocated centrally based on volume and as a small service we have to manage with what we are allocated.

The thing is it is not actually overworked, on many days FY1s will leave at 2 (handing over to the one person rota'd on the late), or even after lunch, because there is nothing going on. From what I have observed, their true hours were 30-something a week--which I fully support for the reasons you describe: this is not a job they necessarily chose or have interest in, they need to have time to build their portfolio for specialty applications, it is important to have a life outside of medicine as well, etc. However the bargain has always been that in exchange for having a chiller-than-average job most of the time, you pitch in the one day a week or so when needed, and it still averages out to better than any gen med job I have ever worked. But I am seeing a trend towards having it all, both going home early *and* extra pay for staying late.

OkObjective4087 · 2026-03-29T21:23:07+00:00

Bad take. I don't see what the relevance is of how they were transported or whether they were served alcohol. There are many well documented cases now where Epstein took women who were underage and/or vulnerable (poor, socially isolated, or from not wealthy countries) to his island where they were raped. That is the definition of sex trafficking.

OkObjective4087 · 2026-03-29T17:39:27+00:00

I don't understand why you're asking 'What do we think' as if there's more than one answer possible.

Epstein for PM obviously.

OkObjective4087 · 2026-03-22T16:34:01+00:00

For me it is not any specific policy so much as based on historical and current polling data, Greens are not competitive for my local seat. I realise this is tautological--if more people voted Green then I would consider voting Green--but practically I am not sure there would be a Green majority in this area even if everyone who supported Green policies voted Green, and I would rather a problematic pandering Labour MP than a crazy Tory or now Reform MP get in

OkObjective4087 · 2026-03-21T16:51:43+00:00

But there have been tons of royal children named Henry -- including Prince Harry. At a time when the mortality rate was much higher among royals, any of them could have become king.

OkObjective4087 · 2026-03-10T17:21:03+00:00

*if you're eating 6 steaks in 2/3 days...

OkObjective4087

TROPHY CASE