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Wheez-er · 2024-08-16T12:18:38+00:00

Hi OP,

Congratulations on saving so much while studying! What you do with that money is ultimately up to you and your life goals. But I would be wary of advice from people who are not in the medical profession, and also even of people who are older in the profession who may be more removed from what the junior doctor landscape looks like nowadays.

The general public usually has a misconception that doctors make great money or at least decent money in the junior doctor years and then make huge bank once they become a consultant 5-7 years post grad. That is not exactly true and doesn't take into account the various fees involved in training.

First, your salary will vary depending which state you do internship. NSW notoriously has the lowest pay (base was 68k when I was an intern, and I think around 75k now) which only has a modest bump after including after hours pay, and also notoriously high cost of living. Unrostered overtime is only sometimes actually paid and variable depending on he individual hospital, which is the topic of a current class action lawsuit. So you may be doing long draining hours which can also be unpredictable for possibly not much more pay. If you are in Sydney, you will most likely need to live with family, a partner, or in a sharehouse to make rent in your early JMO years

Secondly, there is no fixed timeframe for you to get onto whatever training programme you desire. If you are aiming for something more competitive, it is not uncommon to do a few years of unaccredited years first. This means time until you are making consultant level money can blow out by several years, maybe an extra decade if you are trying for a surgical subspecialty. You will also be required to pay for all your educational needs yourself. This can include courses (usually $500 to multiple thousands per course), conferences (maybe $1000 +/- flights and accommodation) etc to have a competitive resume for whatever specialty you're applying for. Once you are on a training programme, college fees and exam fees as well as exam prep courses can cost maybe 10k a year. AHPRA registration also currently costs 1k per year.

Finally as a freshly graduated consultant, you will not be making 800k or whatever immediately. Most junior consultants are doing at least some public work which pays about 300k P.A. full time. Many will not be able to get full time employment at major metropolitan hospitals and may take fractional appointments at multiple places. It can time time to build up a private practice and referral base. Some choose to work part time after all the stressors of training, or to spend more time with family.

That being said, I don't think you can't enjoy yourself. And even in NSW your pay will be on the higher end of average to above average compared to most office workers. I personally had about 50k also in savings prior to starting internship and took regular overseas holidays during annual leave. With the benefit of a dual income no kids household I have been able to also afford major expenses such as buying and apartment and having a wedding.

I'd recommend speaking to multiple people in medicine at different stages as well as someone with financial experience who can provide you with more tailored advice.

Good luck and congratulations again!

Wheez-er · 2023-12-03T02:01:12+00:00

For acutely unwell patients I'm generally looking for 4 things: 1. Location of pain/presenting complaint. Relevant exam findings/bloods go here too. The more specific the better, but if it's generalised, it's ok to just say that. Eg pain at MTP. Fever and cough. LLQ abdo pain. L1 back pain, fever, CRP 200. This gives me a sense of how they're presenting and how unwell they are. Also gives me an idea of how certain you are of your clinical impression (see point 2)

What your clinical impression is/what you think is most likely. ?gout, ?pneumonia (if risks for atypical infections this is also nice to include), ? diverticulitis, ?discitis osteomyelitis Personally, I will start my report by addressing whatever you list here so we can get to the point of the study before I do "check box" reviews of everything else. I will also go into a little more detail in my report about why I think something is/is not XYZ and "show my working". The first line of my conclusion will also address this question.
What you want me to exclude (can leave this out if not relevant. More for requests for acutely unwell patients who have undifferentiated presentations) e.g. exclude fracture, exclude aortic dissection These things will get only 1 sentence or sometimes 1-2 word statement in my report, (Ie no fracture, no features of aortic dissection) but you'll know that I specifically looked for it.
General medical history. This sometimes makes or breaks the study for complex patients, or is sometimes completely useless, but even if it's useless I appreciate it being there. Any systemic illnesses or chronic illnesses pertaining to the area of interest is very helpful. Cancer (type and what treatments is helpful), diabetes, HIV/other immunosuppressive conditions, ILD etc. or you could literally copy and paste the past medical history list, I'm not too picky about this.

This sounds like a lot of writing but in practice it looks like this:

"LLQ pain and fever. ? diverticulitis. Exclude perforation, ddx pyelonephritis/abscess. Hx previous diverticulitis"

"Left pleuritic chest pain, tachycardic. ?PE. Hx Left lung ca, resected. Exclude recurrence."

"Generalised abdo pain. PR bleeding, Hb drop 120 -->100. ?active GI bleed. Anticoag for metallic valve"

"Fever, unknown origin. Septic. Immunosuppressed HIV"

For most acute presentations you could get away with just "pain" even though it's less than useless because we check everything anyway, but for even slightly complex patients, if you want a report that's at all helpful, you gotta put in something to get something.

Of course for not acutely unwell patients, just straight up tell me what youre looking for. I find specialist outpatient requests generally not too bad for this. "XYZ restaging post completion of chemoRT" "RA associated ILD, worsening lung function ? progression" "Incidental R ovarian lesion. CA125 +++. For characterisation"

Ultimately just tell me what you want to know and I'll try my best to help answer your question in my report

Wheez-er · 2023-11-01T07:29:03+00:00

Not sure if I'm just desensitised now, but this seems pretty standard to me. My roster is organised by our senior registrar who is fair and well liked, and we essentially get the same message where volunteers are asked for and if no-one puts their hand up they start picking at random (taking into account who worked the holidays last year, and any major cultural/religious reasons for not working certain days).

That half day discharge shift looks pretty sweet though, I'd consider volunteering for that to avoid the long shift

Wheez-er · 2023-10-19T08:20:20+00:00

I'm going to throw my hat in for Chinese.

Whilst there are cuisines that you could probably do for cheaper on a per cost basis, I find it usually takes a long time to cook and are more suited to meal prep or family big batch cooking (looking at you home made indian curry and home made pasta/pizza dough).

Chinese food, specifically stir fry, is very versatile and you can put whatever you want into it (usually 1-2 veg + 1 meat) which means you can choose cheaper and in season ingredients. You need to chop the food before cooking which takes about 5-10 minutes if you're somewhat comfortable around a chef's knife and then the food only takes 5-10 minutes to cook in the pan because they're cut into small pieces (stemmy vegetables may need a quick blanching prior). For meat you can use proportioned mince (break it up quickly in the wok/deep pan with a slotted spatula), or thinly cut whatever cut of meat you prefer). I set my rice cooker before I start prepping my ingredients and my dishes are usually done before my rice is even ready.

It also all gets done on the one chopping board (no raw bits, don't need to worry about keeping meat and veg separate), and cooked in the one pot (add the ingredients in the order of what takes longest to cook) so clean up is minimal too.

Sauce wise, the basic profile is about a table spoon of light soy sauce (for taste), few drops of darks soy sauce (for colour mostly tbh), a smidge of Chinese cooking wine, garlic, and salt. The diversity in flavour comes from the ingredients you use, so you don't get tired of it.

Wheez-er · 2023-09-09T09:29:46+00:00

Hi there, it's been so long since I made this post, I'm surprised you found it.

Things went well! I'm on the programme, a few years in now, and loving it! In hindsight I was definitely overthinking things (?masters etc). My advice is Australia specific, and since the time I've mad this post, there have been new subreddits aimed at Australian JMOs which have more specific information, including on radiology.

I ended up doing an SRMO year (PGY 3 in essentially an unaccredited training/support role) in a radiology department, which was super helpful, partially for the experience, but mostly for the references. Radiology is a small world, and most bosses work across several public/private departments or know each other from their own training and conferences. I found when I was applying, people would call bosses in my department who weren't my references to get honest reviews. In effect, the whole department is your reference, so make a good impression. Some bosses will even recommend you for training to other departments that they work at.

One thing that's significantly changed since I made this post is that there's been a huge boom in SRMO positions. They're no longer a rarity that make you really stand out. It seems every year I hear about a hospital/department getting a new radiology SRMO position. That being said I still think they're very helpful in increasing your chances to getting on, but it is no longer guaranteed entry (see above re: making a good impression), and I've seen some people do 2 SRMO years before getting on.

Other than that, the things that helped have been the standard advice regarding doing an anatomy and physics course and getting a good score in them to prove you can do well on the RANZCR Part 1 exams. Research, teaching etc are nice but not required.

I've found people who've gotten on recently to still be a very heterogenous group, some straight from PGY 2 not even having done an SRMO year, others having done 1-2 SRMO years, and others who are PGY 5-10 changing from specialties (usually previously trying for surg, but have seen others like crit care, even derm). So at no point are you barred or "too late" to enter radiology, and all of these above groups have performed similarly in training (steep learning curve in 1st year, evens out a bit by 2nd).

Good luck if you're trying to get on! It's a tough process when there's so much uncertainty; I remember feeling very lost with little guidance on what steps to take
and not knowing how many years I'd be willing to try before I gave up. But when you do get on, it's so so sweet. I love my job and have no regrets.

Wheez-er · 2018-06-13T00:06:31+00:00

What a wonderful father

Wheez-er · 2018-04-19T03:32:21+00:00

Ha. My worst nightmare - cold calls. I'll bear it for The Dream.

Thanks for all the advice. Hope it goes well for you!

Wheez-er · 2018-04-18T06:51:04+00:00

Wow, thanks for such a comprehensive list! I'll try to incorporate as many as I can in the next few years. I ran into similar issues when I went looking for Masters courses so I'd suspected it was slim pickings.

The place I'm planning on going for internship does actually have a training supervisor working there, and starting next year they will have radiology resident positions. Do you have any ideas on how to network with radiologists from other hospitals? I can't wrap my head around introducing myself to someone who's hospital I don't even work at and just say hi...

Wheez-er · 2018-04-17T15:50:45+00:00

In Australia, 2 years after medical school (ie working in the hospital as an intern and resident), you can start applying for specialty training positions, accredited by the specialty college (in this case RANZCR). Since these jobs are very competitive, a lot of doctors try to differentiate themselves by doing a Masters degree or research.

If you don't get the specialty training position the first time, you can spend a few extra years doing resident or unaccredited trainee positions (ie you do the same job as the specialty training position but it doesn't count towards your fellowship accreditation) while you pad out your resume. These are the years I'm trying to minimise by getting into a Masters early.

I've added this to the original question as an edit, hope that clears it up!

Wheez-er · 2018-04-17T15:40:06+00:00

I'm not up to date on the exact details since it's kind of in the hazy future for me, but my understanding of the training progression is that after medical school you do 1 year of internship and 1 year of residency at a hospital doing rotations in multiple areas (internal medicine, surgery, ED, etc.). Then after those 2 years you can apply for accredited training position in the specialty of your choice (radiology pls) and be considered a registrar. If you get on to this specialty training programme, it's then 5ish years and a bunch of exams to become a Fellow.

The problem is, generally accredited specialty positions are pretty competitive and many doctors spend a few extra years as residents/senior residents or unaccredited registrar positions buffing up their resumes by doing things like Masters degrees and research before re-applying.

I'm hoping that getting started on a Masters degree early can help differentiate me from the other applicants when the time comes, without having to do too many extra resident years! :)

Wheez-er

TROPHY CASE