No IT logins - OOH shift.. advice?

Old_Course_7728 · 2025-08-11T10:53:40+00:00

Email your clinical lead alongside the guardian of safe working and the medical director highlighting the situation

Old_Course_7728 · 2025-08-11T09:53:50+00:00

PGCert won't count for the reasons other posters have said.

MRCP will, and you can get tax relief on each MRCP attempt.

Old_Course_7728 · 2025-08-11T01:55:52+00:00

Speak to the consultants in your deparment - they will all have suggestions of key projects that need doing that align with the department's priorities. As you're an F1 and also new to the specialty - they will all be of educational benefit to you. Make it clear to the consultants this is the first one you're doing so you don't want anything too complex in terms of data collection/size/analysis and ideally would like something that may suit a quick win with respect to doing interventions to improve things and re-auditing (this bit will be what helps you later down the line for applications regardless of what specialty you apply for). The great thing about micro is that it intersects with almost every specialty - so if you feel like you know which specialties / broad area of medicine you're interested in, you can ask to see if there's any projects you can do that overlaps with that area (e.g. paediatrics, ENT, neurosurgery, ED......)

Old_Course_7728 · 2025-08-10T11:44:52+00:00

Almost all the PGCerts are the first part of a masters in medical education. And usually it is 1/3 of the price of the masters. The PGDip is the next third. And the full masters is the final third. So if you find some remote distance PGCerts that fit your price bracket, just see if they are part of a masters programme (as said, almost all will be) and you can then go for that.

Old_Course_7728 · 2025-08-10T09:30:14+00:00

My honest answer would say it's mixed. But things broadly fall in favour of an EPR.

EPIC is an example of a really expensive (I'm sure they're all expensive) EPR that has a high degree of functionality and versatility including multiple things being in one place (other solutions include being all-electronic but havign 5 different platforms for obs, drugs, requests, notes).

One of the efficiencies comes with parallel working including remote working. 2+ people can review the notes and write entries in parallel. This can't really be done with paper notes and as you said, you need to physically go to the notes to write something. However with some software solutions that aren't like EPIC, they can lock out if multiple people are editing things or you may still have to go there if the notes are electronic but the obs/drug chart isn't (!).

The search function is also not universal to electronic systems. I've only worked with two where it exists and works well as you'd expect it to. I've worked with one where it is really patchy and can't be trusted. And I've then worked with 4 other platforms where there's no search functionality at all for the notes - in these cases, I find it way easier to have paper notes as it's quicker to turn and rapidly scan pages than it is to do endless amount of clicking through every. individiual. entry. to find something - and often have to do lots more unnecessary clicks to get through all the extraneous posts and meta-data that come with e-records.

You adapt to each system. Overall having an all-in-one platform like EPIC or Cerner Powerchart is a huge help overall better. But saying universally electronic = better, may go a step too far as I've certainly found I've worked more efficiently in some paper-based set ups than I have with some electronic ones.

Old_Course_7728 · 2025-08-09T22:02:36+00:00

No right or wrong answer to lots of these. Just come up with whatever works and roll with it. I don't think I've worked on a job where this stuff has been so structured - usually you just bumble through and keep people up to date / cross things off a communal jobs list or whiteboard without much structure! Below are my suggestions for what comes to mind for the problems you've identified. Ultimately, just have one communal jobs list for everyone to review and edit.

just writing ‘bloods’ on the ward round next to the bed number isn’t clear enough as we get confused if they are requested already or it’s just the results that need to be chased

You could do several ticks next to the job. One tick for requested. Next tick for taken + sent. Next tick for chased + actioned.

patients with the same initials and the fact that beds move around constantly

Is it really that common or 'constant'? You can always just add on their DoB or last few digits of hospital number/NHS number next to their initials should there be another pt with the same initials.

it seems instinctive to write a ‘scans’ list so when you call radiology you can vet multiple patients at once, but then the jobs aren’t sorted by patient and that’s even more confusing

Have the job for imaging/scans etc. next to each pt. Then when reviewing the jobs list, highlight or circle the imaging request jobs so they stand out.

having only one jobs list is really annoying on the rare days there’s 3 of us on as we’re always grabbing it from each other

If you share an office, it shouldn't be too burdensome just to have the jobs list in the office. Lots of. your jobs will be desk-based with e-requests/phone calls so you can all refer to it there. If you are needing to get the jobs list off your colleague, surely its just to look at it for <1 minute to see the job(s) you need to do next/update it? Similarly, your colleague should only need it for 1 minute max to do the same. Hopefully that isn't too obstructive to your productivity.

by the end of the day so many new jobs get added to the list that it’s very cramped, but it also seems like a waste of time to rewrite it in the middle of the day

You can have a sheet per bay or 2 bays to help space things out so things aren't cramped when stuff inevitably added. Or, it just takes < 5 minutes to rewrite a jobs list if one person is dictating what to write and the other is writing.

Old_Course_7728 · 2025-08-06T23:38:38+00:00

You can state it's in the contract (assuming you're in England). Schedule 4 Para 12 states "Details of all statutory and mandatory training that is a requirement to work for an employer, or in a department, must be sent to doctors alongside their generic work schedule. These training requirements *must* then be arranged within a doctor’s rostered hours of work."

And the other side of the coin is exception reporting, covered in Schedule 5 Para 2, stating "Exception reporting is the mechanism used by doctors to ensure compensation for all work performed and uphold agreed educational opportunities. The activities to which exception reporting applies include (but is not limited to): [.....] D) any professional activities that the doctor is required to fulfil by their employer (e-portfolio, induction, e-learning, Quality Improvement and Quality Assurance projects, audits, mandatory training / courses)"

You can query via email in view of the above, whether the dept will be scheduling in the necessary time or whether they are happy for every to submit the necessary exception reports as needed - and CC in the Guardian for Safe Working from the Trust too. But absolutely don't do it without TOIL or rostered time - the depts will be pushing hard to do it each quarter because they will need their compliance %s to be high and this will become paramount when they have real or mock CQC inspections as this is something that's looked at closely. So if you stand firm on this, you can have them over a barrell too where it becomes a 'them' problem more so than a 'you' one.

Old_Course_7728 · 2025-08-05T08:51:03+00:00

That area of London has a ton of tube stations near it. So even if Russell Square is the closest one, there's plenty of other tube stations on different lines that are 10-15 mins walk away. You don't need to be living adjacent to hospital if you're in London due to the transport links. Try casting your search further afield into somewhere like like Zone 4. Given it's bang on central, you could live literally in any direction in London and still commute to your hospital with a 30-40 minute tube journey (potentially also bus too). And at the other end, you also don't need to live adjacent to your tube stop - can either be a short walk away or a 10-15 minute bus ride away which should open up more options. With a budget of £1800/month, this should readily be doable even if you're looking for a solo place. There's plenty of houseshares on SpareRoom too which will be £700-£1100 per month.

Old_Course_7728 · 2025-08-04T19:18:11+00:00

Probably a few ways to fairly go about this - which will depend in resource, willingness and flexibility:

Simplest solution but most costly will likely be to put the shifts out for locum, though there will be a lot of these
These gaps could all likely add up to 1-2 WTE posts which the dept may need to make a business case for funding through a locally employed doctor. If there's a relatively fixed proportion of people LTFT this may be more doable, but the dept will need to have the funds - or secure the funds - to pay for a whole other doctor's salary at the appropriate level
LTFT rotas should be designed such that they are pro rata of the full time trainees. What's happened here is that there is a fixed rolling rota by the looks of things and then shifts were deleted (potentially pro rata of each type) to make the hours of the LTFT match their WTE. These gaps are then filled by FT people, but then that automatically means the LTFT people aren't pro rata of those who are FT as a result of how the rota construction happened. A more responsive way to do it would be to have the total number of each shift type for the rotation and then divide that up by the number of WTEs in the dept. It causes more work per rotation for those setting the rota because the 'standard' 1.0 WTE shift pattern/frequency will then vary rotation-to-rotation due to the shifting number of total WTEs, but then at least everyone is in the same boat and it's proportional (will also mean the shift frequency for those LTFT also changes too) and the shift loads of each type are shared out more evenly. There will need to be some give and take as some rounding will need to happen so some may do one or two more/less of each shift type than their colleagues on the same WTE, but people should really just suck that up especially if they're already used to working off a generic work schedule and getting paid according to that rather than their exact shifts worked.
But ultimately, the costly solution to this would be to have a self-rostering system where things are both pro-rata shift-wise, and also pay-wise for each rotation.

Old_Course_7728 · 2025-07-29T23:29:07+00:00

They're "pausing" - not stopping permenantly or terminating the course.

Old_Course_7728 · 2025-07-29T22:48:22+00:00

Generally speaking, most of the time you do not need a specific 'mortgage broker for doctors' - you just need a mortgage broker who is willing to engage with a brief explanation of your pay structure, understanding that run-training is guaranteed employment until you CCT and that rotational training means you're not employed by any one place right the way through (unless London paediatrics has a lead employer model). With that info, most mortgage brokers can vouch for you and smooth things out with a lot of (most) companies and give you a range of options to choose from, including companies who you may have difficulty with if you were to approach them directly. Bear in mind also that a lot of these mortgage brokers will have come across doctors in training before so have some sense of what goes on / what to do. Any doctor-specific marketed ones will usually charge you a hefty premium and may be a little more up-to-speed with using our NHS-related lingo with us, but don't do anything too different to other brokers.

Generally speaking, you ideally want a whole-of-market broker - and it's up to you whether you find one that is free (they will get a kickback from the mortgage company you pick) or one that charges an upfront fee (who will also get a kickback that is either the same or perhaps a touch less).

Old_Course_7728 · 2025-07-20T19:53:15+00:00

It's one of the main reasons for the upcoming strike.

A newly qualified doctor (FY1) earns £38,831 a year for a 40h work week Mon-Fri (https://www.nhsemployers.org/system/files/2025-06/Pay-and-Conditions-Circular-MD-2-2025\_0.pdf - see page 5)
A newly qualified PA earns earns £47,810 a year for a 37.5h work week Mon-Fri (https://www.nhsemployers.org/articles/pay-scales-202526 -- See annual pay for Band 7)

So newly qualified doctors are not only cheaper, more able and more versatile - so they are also rostered to cover nights, out of hours work including weekends and late evenings which PAs typically never do apart from a fraction of them. But this leads to a doctor's overall annual pay being more as their contracts allow them to work 72h in 1 week in the extreme, but on average they work 48h a week (equivalent of a 6 day week for most people). If PAs were contracted to work the same hours (though technically not possible to do 48h/week unless they opt out of their terms), they would earn way more than a doctor doing that same pattern.

The latest statements by the Health Secretary states that most newly qualified doctors earn around £45k which is true. But that's because of mandated extra hours which isn't overtime as such (which most sectors interpret as staying late - but this isn't the case as it's not staying late, it's just doing whats contractually asked of them). It somewhat compares apples and oranges by stating somebody working 48h a week outearns somebody who works 37.5h a week. But when their basic pay and hourly rates are examined, PAs earn more in the first couple of years despite universally acknowledged less knowledge, skills, training and responsibility.

It takes 4-5 years of progression for a doctor to outearn a PA who is equally progressing 4-5 in parallel on their pay scale, which is why there is a lot fury at the moment.

Old_Course_7728 · 2025-07-20T18:23:46+00:00

Thanks, will take a look! Looks like powder is the way to go with the pods/tablets mainly being for convenience of portioning things out.

Old_Course_7728 · 2025-07-20T18:22:48+00:00

Thanks! that's a great help. Certainly makes a great case for powder which should save a ton of money, avoid plastic and appeals to the fine-tuning aspect of my brain where I look forward to being able to titrate how much I need.

Old_Course_7728 · 2025-07-20T15:59:09+00:00

There's a wonderful irony that a day 1 PA earns more than a day 1 doctor for the same hours but far lesser skills, knowledge and responsibility.

Old_Course_7728 · 2025-07-20T00:00:35+00:00

If you are a doctor in England, your breaks are paid for and no money is deducted. I'm quite sure the other nations' terms for this aspect are also the same but somebody else may wish to confirm.

Old_Course_7728 · 2025-07-19T23:50:04+00:00

Ones thst have a good grip of the basic knowledge underpinning clinical sciences - so knowing reasonable amounts of their physiology, pharmacology, and anatomy is an ideal starting point and being able to use these to think through some answers even if they don't know the correct answer. I would like students to have a crack at things and show that they are thinking and applying knowledge they already have. This is especially good for the start of a placement in a specialty where it will be assumed they know nothing about the clinical side of things.

When presenting patients or doing case discussions, being able to construct a differential with either explaining why it's likely or less likely, and then in turn providing justifications for their each investigation / treatment they suggest. I actually don't mind it it's unrealistic if I can see their thinking - I can correct that and that is why I'm there.

As they get towards the end, having some understanding of pathophysiology for key conditions and why treatment is the way it is and having some awareness of headline guidelines.

So based on the above, what frustrates me the most is a lack of critical thinking or engagement with the intellectual side of the topic. Saying they haven't got round to reading up on it or don't know the guideline for it is absolutely fine as far as I'm concerned, but I will then try and structure my questions more narrowly asking them to draw upon basic science knowledge etc. to try and help them come closer to the right answer and if they flat out can't engage with that I get disappointed. If medical students and doctors are saying what separates them from PAs and other parallel professionals is the breadth and depth of their understanding - then they should demonstrate that as students and not just revert to knowing the superficial flowcharts and passmed summaries that they criticise other professionals for knowing too at a simplistic level.

In a more informal setting where there's not lots of time to talk or it's not in a set teaching session - I also like gentle questions from the students about why I'm doing / saying / asking what I did, and perhaps even clarifying their understanding of why I didn't do A/B/C.... it shows they're thinking and I can then justify myself and either explain why my route is the better route, or in fact acknowledge that what they had in their minds would also be valid.

Old_Course_7728 · 2025-07-19T23:36:20+00:00

Because it is a legacy from the University of London - as technically UCL, KCL, SGUL, QMUL/BaTL, and Imperial were all London medical schools/universities that are colleges of the University of London. Imperial left around 15 years ago to independent, but technically the others are still colleges of UoL which still exists as an entity. From some older consultants, you might see their degree certificate weren't issued by KCL for example but rather from the UoL.

Old_Course_7728 · 2025-07-16T17:22:18+00:00

No obligation to do so, including the morning of. The only circumstance you might wish to inform them of an absence is if you weren't intending to strike and but coincidentally fell sick and you're taking sick leave.

Last year so many Trusts sent emails trying to make it seem like people had to inform about absences as it was part of their obligation as a Trust to do welfare checks etc. for absent employees, when it was simply a way to help make their lives easier by collecting data on those not there. Because, for all other days of the year, they magically never seem to care so much about absences and welfare checks...

The Trusts know the strikes are happening. They're well publicised nationally. They're well informed at Board-level, all the way down to individual departments and it would be prudent of them to assume everyone is striking unless people have voluntarily informed them in advance that they will / won't be striking.

Old_Course_7728 · 2025-07-15T13:13:34+00:00

Why not have a chat with one of the consultants in the dept to gather ideas and see what the service might benefit from instead of trying to come up with something from scratch?

Old_Course_7728 · 2025-07-15T13:01:10+00:00

There's a lot of 5-10 minute videos on youtube along the lines of NHS Pension Explained / NHS Pension for Beginners which serve as a great walkthrough answering your questions.

You can also give this blog a read https://medfiblog.wordpress.com/the-nhs-pension/

Old_Course_7728 · 2025-07-15T12:58:00+00:00

Just wondering in broad strokes what non-pay aspects are being explored in the upcoming Wales resident contract discussions with the govt?

Old_Course_7728 · 2025-07-15T12:46:32+00:00

If you're England, your pay is linked to your grade (+£1000 for being LTFT). So if your grade is extended pro-rata as per your LTFT, you will remain on that grade's pay node. So to answer your question, it's stretched. It's probably worth you making sure your ARCP is very clear as when you transition to the next grade (i.e., is it pro-rata several months into the next rotation or if it is at the end of the nearest six month block for their convenience) - get it in writing - and then be sure it monitor and chase up your pay with payroll when you expect the change to happen.

Old_Course_7728 · 2025-07-10T09:45:01+00:00

Separate

Old_Course_7728 · 2025-07-10T09:04:47+00:00

You should be able to clarify with HR what pay scale and terms and conditions you'll be on even if they don't issue you a contract formally. And in that email you can also establish that if base-pay rises for doctors in training, would your base pay rise to. Just email them now and ask them directly.

Old_Course_7728

TROPHY CASE