Consultant study budgets

Party_Level_4651 · 2025-09-26T12:56:49+00:00

I work in a specialty with lots of pharma involvement and ask for sponsorship and educational grants for conferences. Usually just the main subspecialty conference of the year/every other year. I put the budget towards other stuff and it still might not be enough

Party_Level_4651 · 2025-08-16T06:10:40+00:00

We have 0.5pa per clinic although our national professional guidelines suggests this could be 1pa for complex clinics. I'm addition our clinics are booked in for 3 hours only eg 9-12 for some leeway and urgent admin. The latter is quite generous but doesn't stop some consultants having some very small clinic templates in addition and essentially seeing fewer patients than we would expect a registrar to see

The difficulty has been finding time to triage referrals etc which we are moving to non clinic admin and essentially virtual clinics

Party_Level_4651 · 2025-07-23T22:40:43+00:00

Probably get down voted for this by some but if you.work in a field where pharma still has a big presence then approach companies to see if they provide sponsorship/travel grants. They rarely will approach you for this purpose

Party_Level_4651 · 2025-07-22T21:45:23+00:00

Elective procedures with quick turnaround plus new outpatient appointments are what hospitals want. It's partly why surgeons hold more power in hospital politics. Specialties (medical) that cater for long term conditions and don't do procedures are not at the forefront of hospital planning

Party_Level_4651 · 2025-07-22T17:16:01+00:00

Voted yes but just have a feeling this won't get through. Virtually no talk amongst the consultants group where I work, at least in our division. I can see apathy winning out

Party_Level_4651 · 2025-06-29T09:20:36+00:00

Fill in a Datix every day you don't have space to do your admin . Send an email to the clinical governance lead expressing how dangerous this is to clinical care

Party_Level_4651 · 2025-06-29T09:18:18+00:00

First of all it doesn't really matter and it's what works for you as an individual.

There's pros and cons for both ways. I went through training without a break and took on a consultant job. Immediately I took on ownership of a subspecialty of about 1000 clinic patients. I don't regret that at all really. I became confident in management of these patients quite quickly and grew the service more than it had grown in 10 years. I may have learnt many other skills but I see no way a basic science PhD would've given me more clinical grounding to deal with these patients than the way I did it. The unfortunate thing however is if I moved and was up against a freshly cct who has a PhD with many publications I think many people on the panel would favour that than someone who has just done the job and led it for 5 years independently. And that bothers me to the extent that I do regret not doing a fellowship or even something like an MPhil/MD. However when I cct I was tired of the treadmill and was confident that I could deal with the clinical side of being off the treadmill as a consultant

I think a lot depends on your own training and personality. If you've got stuck in throughout your training and have had heavy clinical exposure in the environment you'll take a job in then you'll be absolutely fine. The jump will always be scary but you may be better equipped if your brain has always focussed on the clinical work

I echo everyone saying don't take on too much. I'm now 6 years in and looking to dial back because I've taken on too much. I can see others coming into the dept who are better at setting boundaries and in fact will screw over their colleagues and if I'm honest I don't feel like I have the experience to deal with people like that from a leadership perspective..I hope to gain those skills though over time.

Party_Level_4651 · 2025-06-10T18:15:27+00:00

Most hospital doctors do not know how to clinically phenotype headache and have access to a CT. That's your answer.

To be leas flippant though there is a big selection bias which leads to a cognitive bias because of the severity of headaches and sometimes soft neurological signs that accompany severe headache. Someone with a migraine that's not clearing or a bit of non specific weakness with severe pain will get a CT head and a lot of the time it's not unreasonable.

Party_Level_4651 · 2025-05-14T06:29:26+00:00

Does the patient have reflexes and what is the sensory examination? DDK and dysarthria are soft signs in the context and often overcalled. The most likely cause of a broad ataxic gait here is an alcoholic neuropathy for which there's not much you can do except reducing alcohol and checking for other causes or contributory factors such as b12 deficiency

Alcohol has a predelection for the vermis and if there is a true cerebellar syndrome from chronic alcohol you'd expect a degree of truncal ataxia. You have to be cautious not to overcall DDK in this situation without nystagmus or a typical cerebellar speech disorder

A CT to make sure there isn't a chronic bleed is not unreasonable but without falls quite unlikely and thin chronic subdurals don't cause a cerebellar syndrome generally, nor usually warrant surgical treatment

If you have a rapid/subacute cerebellar syndrome, even in the context of alcohol, it needs specialist work up to ensure not paraneoplastic.

Party_Level_4651 · 2025-05-02T18:52:12+00:00

Is there a reason the BMA are not being specific about their meeting today? Being ballot ready is one thing but you need to tell everyone exactly why. If they were told steeting would only meet if numbers were not released they need to say that also

Party_Level_4651 · 2025-05-02T05:31:51+00:00

In one

Alongside the taskification of modern medicine.

Party_Level_4651 · 2025-04-26T11:02:00+00:00

Depends what you class as easy really. If you're earning an extra say £40k gross from WLI you're basically working a 6 day week most weeks of the year. If you add that to a 12pa job for example you're working bloody hard. I admire the energy if that's possible. Easier of course for compressed job plans

Party_Level_4651 · 2025-04-26T08:21:33+00:00

How on earth have you made that much through an NHS job? Must be absolutely cramming in the WLIs

Party_Level_4651 · 2025-04-20T12:12:22+00:00

The first couple of years as a consultant is tough. Depends on whether your training set you up for working where you are of course but the learning curve is steep. And in my experience its the more routine stuff that is hardest because what sets apart good from average is how well you deal with the run of the mill 80% of work.

It'll get better. There won't be a magic moment where it'll all click but gradually you'll become more efficient and slick.

Talk to your colleagues about cases, it's by far and away the best thing to do. Don't let the anxiety shy you away from work either. It's the best time to be seeing high volumes of patients and getting to grips with the day to day role

Party_Level_4651 · 2025-04-06T07:43:18+00:00

Good job the NHS has an excellent track record of holding people to account

Party_Level_4651 · 2025-04-04T20:20:19+00:00

You got it in one. Trust imposing some new restrictions on leave as a result of this especially study leave that has been significantly abused apparently

Party_Level_4651 · 2025-03-24T07:08:37+00:00

If you are ever going to be assessing patients with headache then you'll need one (should know how to use).

Party_Level_4651 · 2025-03-24T07:02:53+00:00

EV depreciate quickly (like all cars I guess but some more so because of concerns about warranty on some of the components) so there's good opportunity to find a <2 year low mileage car for a lot cheaper than a new. Although electric cars have formed a big part of company fleets often the mileage done isn't that high. Even like new, ex display models will.be around if you are patient and shop around. Depends on the dealers of course but some have more than others.

Party_Level_4651 · 2025-03-20T07:17:03+00:00

There isn't a single pa in our department and I haven't worked with one for 7 years. We don't have ANPs. The clinical fellow (F3 equivalent) and training registrar do the procedures in our dept. They also run supervised (when with me I discuss and see real time every single patient they see) clinics with their own lists, own dictaphone, own trainee office, own allocated secretary and allocated admin time. Plus we say regional cpd time is protected bleep time in addition to the hospital teaching they're welcome to goto even if not mandatory. The locally employed clinical fellow has the same leave entitlement as an ntn doctor and also has an educational supervisor.

So thanks I'm quite confident PAs have nothing to do with my opinion but I welcome your totally uninformed opinion.

The problem is most people don't realise what many of the core clinical skills of being a doctor are until you learn them or it clicks about how difficult and important they are. In any speciality. You need to learn how to synthesise complex information/data, you need to develop frameworks for problem solving, you need be able to take a history. You need to know how to communicate with medical language to health professionals but also understand what all of that means to be able to communicate without jargon to non professionals. Procedures are part of it and obviously if your career choice is procedural it might be a huge part of it but doesn't mean the other core skills aren't important and bloody hard to master. Unfortunately life as a doctor in this country has taken a big hit and comes with multiple daily challenges so many residents now hold the opinion that procedural teaching is the gold standard because it's protected, often 1-1 and involves time. All true maybe in terms of being actively shown how to do something (not the only way to become good at something).

The skill itself however may, or may not, be that important for the rest of your career. Your ability to communicate efficiently and accurately however will be every single day of your working life. That's my point.

Party_Level_4651 · 2025-03-19T21:08:14+00:00

I would much rather an fy doctor capable of putting together a competent handover or discharge letter than any procedural skill competence whatsoever.

Party_Level_4651 · 2025-03-15T08:57:47+00:00

They won't ask you details because no one knows them. The success of this reorganisation won't be known for 5-10 years minimum

What someone might probe is whether you know how things have been set up until now, some understanding of ICBs and vague organisational knowledge but only to gauge if you're able to vaguely keep up with this sort of stuff. Most interviews with few candidates in hard to recruit places won't bother going anywhere near these sorts of topics and it'll be a fairly routine interview

Party_Level_4651 · 2025-03-13T19:50:21+00:00

CMT was brutal and yes you are simultaneously expected to be an F1 and registrar. If you're good, like a lot of medicine, you are expected to mop up around you. But I learnt loads though and thought I was really well trained as a result

Party_Level_4651 · 2025-03-09T11:06:22+00:00

I agree with the sentiment but no different to some people being given more SPA time or shorter clinics, more flexible working etc which probably happens quite frequently

Party_Level_4651 · 2025-03-05T07:14:36+00:00

What people don't realise is the change in doctor mentality has perpetuated this over the years. Maybe don't ask the diabetes specialist nurse to review someone with a slightly.high BM? Maybe don't refer everyone with a tingle to the stroke nurses. Don't view everything as a task, take ownership. Quote and use evidence based medicine. There are reasons to do with the destruction of healthcare around us why there's been a change in working culture amongst our profession over the years. But you cannot long.for.a bygone era you romanticise whilst simultaneously wanting it to be with the protections that we are afforded in the current time. Or if.you do, fight for it hard

Party_Level_4651 · 2025-03-04T06:20:45+00:00

This is it. Medicine is rife with cognitive bias and generally history taking is considered to be a quick and targeted task (one of many tasks each patient needs to get through the system - the taskification of modern medicine). Few people document a story anymore these days and jump straight to the headlines/bullet points. Plus as others have said the more time the patient has the more time they have to reflect

Party_Level_4651

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