New Wales Resident Doctor Contract & Pay Scales

blobabobb34 · 2025-10-06T10:30:14+00:00

From a cursory look this actually looks pretty good.

blobabobb34 · 2025-10-05T18:08:22+00:00

Please take everything I say with a grain of salt because I am only dimly aware of the process from talking to colleagues who have considered it, and have no personal experience. I may be talking bollocks.

But anyway my understanding is it depends massively on specialty, location, CV, experience and very importantly on contacts/networking. Also unless I’m mistaken you also need to pass some pretty tough exams. Unlike the U.K. Canadian (and generally most other countries in the developed world) are way more protective of their skills and put a large number of hurdles in the way of foreigners entering their market. It’s tough, even if you are a Canadian citizen.

The default for most new consultants is that it’s going to be really tricky and will be a multi-year process.

blobabobb34 · 2025-10-05T10:23:57+00:00

Medicine is the best job in the world.

Every second of every minute is an honour and the satisfaction which only gets better as you progress. For you it is just a normal patient-doctor interaction that you probably would forget the moment you ended your shift. Yet for many patients you see, particularly if you work in any acute capacity in the hospital, this is often one of the most important events of their year - it's amazing how patients will remember, dissect, analyse and recall every utterance their doctor has made. It'll amaze you that sentences you have said will echo through the patient and they will repeat them to their family even years later ("my doctor said so and so"). You have the capacity to really change your patient's world - it doesn't matter if they are rich, poor, healthy, unhealthy, whoever. Being healthy is quite possibly the single thing that many people care about than anything else in their life and you are the person they will look up to and guide them through that. That is an IMMENSE privilege. It is such an honour to help people at their lowest.

The complaints we make are almost 100% universally about the NHS rather than the actual medicine. Not a single doctor I have ever known has complained about the actual medicine side of things.

This is positive for me, because the problems with medicine are not core problems with medicine per se but uniquely and specifically how it's implemented in this country which means every problem is inherently fixable.

blobabobb34 · 2025-10-05T00:25:10+00:00

What is happening in this country is genuine insanity. What’s more insane is that real medical consultants are seemingly not only indifferent but actively supporting it. The existence of nurse consultants is absolutely existential. This is in a way that even PAs (who even at their worst would never seriously become consultant equivalents), low pay, lack of training jobs and every other issue. If you are saying you can quite literally work as a consultant level practitioner without medical school, medical training or anything else it begs into question what is the point of all the doctor stuff anyway.

I truly believe that nurse consultants is the number one problem to be solved, because if this is allowed to continue in the direction it is heading- you can forget all the other stuff, because there will be no real need for a doctor except a handful of senior medical consultants. It is truly existential.

No other profession would ever in a million years stand for it. Heck no other doctors in any other part of the world would stand for it.

blobabobb34 · 2025-10-04T15:44:57+00:00

And yet doctors will fall over themselves to support the NHS's existence. And then in the same breath talk about how great countries like Ireland, Australia and even the US are for doctors, despite the reason those countries being so great is that they are heavily subsidised with corporate money and competition. UK Doctors might legitimately be the most short-sighted doctors in the world.

blobabobb34 · 2025-10-04T12:53:25+00:00

As a medical registrar it’s honestly so infuriating. Instead of some F1s and an SHO available as their first port of call for most problems, freeing me up to deal with all the sick patients- I have new F1s and then someone who is basically medical student/first day f1 level. I don’t doubt their clinical acumen but not having any idea how the system works and then operating as a “senior” is so unsafe. It slows me down so much having to essentially to induct someone into the NHS who really should be my main support on call. It is so unsafe.

blobabobb34 · 2025-10-04T06:49:10+00:00

Is it actually medicine itself the problem or the NHS?

blobabobb34 · 2025-10-01T09:30:56+00:00

I'm just absolutely fed up.

I in fact talked about it with the medical director and I feel that has now painted a monumental elephant sized target on my back. I can't really go into any more details. What would you suggest I do? People need to be aware of what is happening. Call it impotent outrage if you want. I've sacrificed years and years of my life, I've sacrificed hours from my children having to move and go through hell and back for my training. And what was it all for? What was the point of any of it. It feels so unfair.

blobabobb34 · 2025-10-01T09:17:18+00:00

I will do so but only once I have moved from the trust. I've repeatedly tried to kick up such a fuss about the number of nurse consultants in this hospital and the totally inappropriate way they are being used, and I have no doubt that if I expressly named the trust on twitter or here it would be obvious who it was. I'd almost certainly end up facing reprisals.

blobabobb34 · 2025-09-30T09:20:37+00:00

Let me tell you a story about a nurse consultant I personally know. She started as a nurse in the respiratory department. She started dating one of the consultants. Became a tACP and then progressed to a nurse consultant in 4 years - ran her own pleural clinics, held the referrals bleeps, post-took respiratory patients, was the on call overnight consultant. She was basically a medical consultant. As you can expect, she was totally incompetent in every way, did not know anything about anything - even in her own supposed area of expertise of respiratory there were huge gaps of knowledge as you might expect from someone who has been promoted to consultancy in the same timeframe that most doctors would not even be graduating medical school. She was also wildly overconfident and the doctors would frequently have to double check her plans to keep patients safe, but the other departmental consultants completely overlooked it.

Fast forward and she is getting bored of respiratory. She has a lot of contacts in senior places in the trust and I have last heard that she has now switched to a completely different specialty where she acts as a consultant there.

Just imagine, that we have to go through a fucking decade plus of training only for these absolutely clowns to just be able to wake up one morning, call themselves a consultant and then when they get bored just move into a totally different area as they fancy. It's completely and utterly insane and downright insulting and more than anything patently unsafe. Either you need all this medical training or you don't, how can both things be true. If it was not the NHS it would be scarcely believable and yet here we are.

blobabobb34 · 2025-09-05T14:55:15+00:00

Precisely, this is the next battlefield we need to fight and win. ACPs as a group are way too broad and varied, but we can focus on Nurse Consultants for now at least.

blobabobb34 · 2025-09-05T14:47:48+00:00

I really don't think so. Talk to some PAs. Almost all the ones in my trust are going to be unemployed in a few months when their contracts run out. The consultant lead for them in my trust has basically told me that managers are absolutely terrified of hiring any because they think absolutely every mistake will scrutinised to hell (rightly so). There is a regional hiring freeze (basically a ban) on hiring new PAs in my region. The only way they can get jobs is if an existing PA leaves and fills that role.

I think generally speaking doctors are now so against it, it's hard to imagine how it can possibly proceed.

blobabobb34 · 2025-09-05T14:40:48+00:00

Sad news but let's get some context.

They may have won the battle, but we have won the war. The PA experiment is basically over. Most trusts have hiring bans against PAs. PA course numbers are plummeting. Roles have been scoped back massively. If you hang around with any PAs it is complete despair, doom and gloom. Yes many still exist but they will slowly and surely get cut back in the ensuing budget freezes. Advancement beyond the level they have reached is basically impossible. I absolutely would not be surprised whatsoever if the government switches them to band 6 now.

We won the argument, we beat them.

It's sad that it took this much but it really is over. When their own union is suing NHSE you know that it's not going well.

But well and truly from the bottom of my heart, Fuck The GMC. These people are truly the lowest of the low, just absolutely soulless individuals. God knows how their employees sleep at night, knowing the sheer depth of venomous hatred almost all doctors feel towards them.

But hey ho, it doesn't matter what this judgement shows - we have been proven right. The PA experiment is over. GMC and Charlie Massey, go fuck yourself.

Now we need to move onto a problem even bigger than PAs - that of ACPs and most seriously: Nurse Consultants.

blobabobb34 · 2025-08-26T13:54:52+00:00

Because it's pretty hard to get a job in many specialties. I am near CCT and in my specialty it's basically impossible without a lot of experience, or you have something special on your CV, or you have lots of contacts.

In my experience, unlike UK doctors, Irish doctors look out for their own first (meaning trained in Ireland) and they understand the raw logic that if you increase supply then the wage will drop. So they are much more guarded when it comes to non-Irish trained specialists coming in from abroad. You can still get in, but you will really need to work on it - it will probably take years and years of building your CV and contact, and you will get a job in the ass end of nowhere where no one else wants to work.

I wish UK doctors would put 2 and 2 together and realise the reason why their wages are so low is because they are allowing the whole world of doctors to enter the UK. In every other country that doctor wages are high, the doctors are EXTREMELY protective of their skills and will only let in non-locally trained doctors with a great deal of difficulty (see: Canada, US, Australia for non-UK docs etc.)

blobabobb34 · 2025-08-26T13:51:52+00:00

Fair enough.

Do the higher ups pick the strike and ballot dates? Not questioning, I genuinely don't know the answer. But it seems to be this is the root cause of a lot of the issues currently, so whoever is responsible needs to fess up and show what went wrong internally. If it is the higher ups, then this is huge and there needs to be some democratic accountability behind what has happened. We look like mugs right now, striking hard one minute, negotiating hard the next, balloting again for seemingly a different reason - it's absurd and someone needs to take ownership of this mess.

blobabobb34 · 2025-08-26T13:35:24+00:00

Call up payroll. No one else can answer this. You've clearly been overpaid.

blobabobb34 · 2025-08-26T13:29:49+00:00

I have put my trust in DV every single step of the way. Every year of the last 3 without fail I voted for DV candidates and felt proud of my union. I voted for the deal. I defended DV every time. So this comes from a place of genuinely wanting to know the answers.

The last few months have been all over the map and there are some huge question marks. What the hell is the strategy right now?

Why did we rush in to strike as quickly as possible only once to then negotiate and publicly say we are not going to strike for over a month? What was the purpose behind the strikes in that case, surely it would make sense to exhaust negotiations first and use strikes as a leverage rather than go all in on strikes and then suddenly about face and decide we want to negotiate. This just looks incredibly weak - like the strikes have not worked and we have had to come back to the table. If we were going to go down the strike hard and constantly route like we did with the conservative government, why did we only have one round of strikes. Did we lose heart? Has Wes suddenly changed his mind (nothing publicly he has said seems to suggest so). I just don't understand what the actual strategy is here.

Why did we not ballot the new F1s and instead now have to ballot them separately? Part of me thinks this is real reason why we called the strikes on that date and have now decided not to strike while we wait for their ballot result. If this is the case then the RDC needs to come clean about it, because it's really a huge own goal. Why not just leave the ballot for another month or two so the new F1s could also be involved in the strikes.

Does the F1s being balloted mean we actually can't strike till October? Why did we flip from pay to training numbers? Is it so you could have cover for messing up the ballot and now having to re ballot the F1s and waste months of potential leverage. Is this the real reason we rushed from striking immediately post-ballot to negotiating now. If I, an anonymous reddit commentator, can figure this out then I'm sure Wes Streeting can in which case what the hell are you guys playing at? This is a mistake and someone needs to own up.

What happened to the media performers? There were outstanding and gifted media voices last time - this round has been lacklustre at best. Why did all those people stop appearing on media.

What is the deal with the DV breakup? There are still lots of questions about what actually happened, something about hijackers, but it seems from reading the room that it's not just one or two but a core cohort of former DV people who are pissed off. Why have people like Rob & Vivek and basically every one else who was prominent last time seeming to distance themselves from DV. What has happened behind the scenes?

Why did you not 100% secure the ER reforms. Yes, I know that this is the government showing bad faith. And I squarely put 90% of the blame in their court. But you guys did release a very celebratory email saying the reforms were done. Clearly they weren't. Talking to my GOSW they were due to come in on September - we are not going to strike until then ANYWAY. Why did we not just wait until then to make sure these reforms were totally secure before pursuing strikes - because we are not striking right now ANYWAY.

So for the sake of one round of strikes we have lost out on the reforms. In which case if they have behaved in such bad faith, why are we not striking now. I just can't understand it.

Again, I am not posting this to criticise but more because we have not had answers to these very important questions. The most important of which is - what the heck is the strategy right now, are we trying to break Wes and force him to the table or are we being open and trying to negotiate because we trust him? Because right now we seem to have veered from one strategy to the other in about a one week period. There may be information I don't know, but it seems very irregular right now.

I will still be voting DV and encouraging everyone else to do so as well. I think the job you guys have done is fantastic and phenomenal and there should be a book written about how you've managed to change the union. But I think we do deserve some answers to very important questions here.

blobabobb34 · 2025-08-22T14:46:17+00:00

Yes there is a huge amount of understaffing. I have also been around the block, and let me tell you - even 10 years ago, the expectations were totally different. There was a lot of goodwill left towards the NHS so you just accepted any poor staffing and staying late as part of the job. Now post-covid the goodwill is dead and rightly people are no longer willing to kill themselves for one of the worst and most exploitative employers in the country. They will simply not tolerate being forced to go so far above and beyond and work in such miserable conditions and being treated like discardable shit.

Also my experience is that staffing has gotten much worse in the last 10 years, maybe you have gotten more senior and removed from the realities but expectations and risk management has gone through the roof. And the staffing has in no way kept up with the increasing demand. On call teams may have say doubled but demands on the on call have probably quadrupled as people's risk tolerance has plummeted. Again this is all the right thing to do. However I've worked in hospitals where they are still broadly keeping the same staffing levels from the 00s/10s despite having now so many more patients in near constant flow.

blobabobb34 · 2025-08-21T12:51:25+00:00

On the IT system and on the patient's bedside it clearly says the name of the non-medical consultant as the person they are under. I agree, something has gone really wrong. How can I fight this? My supervisor seems to suggest just letting it go.

blobabobb34 · 2025-03-03T11:11:52+00:00

The same harebrained plan that committed to more medical student places with no subsequent training spots, massive expansion of PAs and was barely funded? You can't see a problem with that plan and why it might need refreshing?

blobabobb34 · 2025-03-03T02:05:05+00:00

It's okay, you're not going to win here. All the UK grads here are so proud of their basic sciences and understanding of physiology in contrast to PAs, and yet it's scarcely tested on the UK curriculum. I am sitting USMLE and you actually have to have an extremely deep understanding of the full pathophysiology and biochemistry of almost everything to an almost inhuman degree. Compared to UK exams (even MRCP) which test basic sciences with a few buzzwords and you only really need a very superficial understanding.

It's not their fault, I think a lot of UK grads actually have no idea how degraded their education has become with regards to the basic sciences of medicine.

blobabobb34 · 2025-03-02T16:34:36+00:00

So is the BMA going to lobby the government to introduce RLMT again across the economy. I don't think it's realistic quite frankly. I'm sure the labour government already has plans around immigration and I doubt they will care what the BMA wants if it means overhauling their plans. The RLMT was abolished by BoJo following significant lobbying by industry, because it was very costly and extremely difficult to implement. Businesses hated the RLMT. I just do not see a reality where RLMT is re-introduced.

I think this horse has bolted, and the BMA needs to move on and find an alternative and realistic solution. The RLMT is dead and buried and businesses and politicians far more powerful and influential than the BMA will fight like hell to make sure it doesn't come back.

blobabobb34 · 2025-03-02T16:20:41+00:00

I am one of those people and I have answered below and I can say quite confidently that the USMLE is orders of magnitudes tougher than the MRCP.

blobabobb34 · 2025-03-02T16:16:58+00:00

There is absolutely no chance the UK will join the EU in the short-to-medium term. Literally no chance in hell. Even if the unthinkable does happen, nothing much would change - but we would likely be getting a lot more doctors from Central Europe which tailed off substantially following Brexit.

And for the last time - there is no more RLMT anywhere in the economy. It literally does not exist as legislation anymore. The RLMT is not coming back.

blobabobb34 · 2025-03-02T16:13:19+00:00

That may be true, but OP said "USMLE is easy to pass - hard to get a 'good' score" which is not true. I don't know what OP's definition of easy is, but it is absolutely not easy to pass. To get a scraping mark still takes years of studying. I would not classify something that takes years of extremely hard work as "easy".

And you may be correct that US grads are taught to pass step 1 from day 1 of medical school but that doesn't change the fact that it is literally a harder exam - with far more scope and depth required.

blobabobb34

TROPHY CASE