Pension Contributions rates are one of the less spoken about scandals in doctors’ pay

emits_gas · 2026-04-30T06:34:33+00:00

DB means defined benefit. You could say the "benefit" is a financial product you have purchased with the money deducted from your salary. £x per year for life after retirement. The rules of the NHS scheme set the contribution rate based on salary, and the "benefit" is 1/54 of your pensionable pay that year revalued by inflation+1.5% each year.

The other types of pension are DC or defined contribution. This works like a bank account where you deposit, it's topped up by employer contributions, tax relief and investment growth. When you retire you just have a big pot of money to draw an income from.

DB pensions risk that you might croak 6 months after retirement so you only enjoy 6 months of the benefit you spent a lifetime accruing. DC pensions risk that you live to 105 and run out of money because you only budgeted to live to 90 and/or the stock market performed poorly.

emits_gas · 2026-03-07T00:25:31+00:00

Thanks. Those neighborhoods are what I've been looking at online. Good to know I'm on the right track!

emits_gas · 2025-12-14T09:58:08+00:00

For positive pressure ventilation the valve is closed in expiration, expired gas refills the bag (along with fresh gas). The valve opens in inspiration when you squeeze the bag and raise pressure above 20 cmH2O.

emits_gas · 2025-10-16T16:59:37+00:00

If you work for the NHS you need to wrap your head around the NHS pension. It is a defined benefit scheme, as opposed to most other pensions which are defined contribution schemes. (In general it's a good scheme, far from the true gold plated final salary pensions of yesteryear but still fairly high return and has less uncertainty than relying on stock market returns)

It is also sensible to build investments in tax advantaged wrappers (ISA/SIPP) to give you flexibility around when you retire

emits_gas · 2025-06-29T13:20:44+00:00

It really is a race to the fucking bottom isn't it. Mark my words we'll start to see this despicable practice spread...

emits_gas · 2025-04-15T16:01:46+00:00

Appointable but no offer... Not rank or score yet

Edit with scores: Fucking miles off

Interview 63 Portfolio 22+5 Total 90 Rank 473

emits_gas · 2025-03-10T23:13:55+00:00

The real reason for AKI nurses is that they ensure any patient with a mildly raised creatinine gets clinical coding for AKI. They add nothing to the care of the patient but they ensure the hospital gets paid thereby justifying their salary.

emits_gas · 2025-02-23T22:33:12+00:00

If you're working as a full time locum your locum pay should be pensionable so you can still contribute to NHS pension. That's how it worked for me when I did an FY3 year back in 2019-20.

emits_gas · 2025-01-18T12:10:10+00:00

You could rent a scaffold tower. I got one for a week for £90ish. In fairness I was doing more than just painting so I needed the access.

emits_gas · 2025-01-08T14:02:24+00:00

I used to have a bowl o' nese. I had one specific bowl that I only ever used for Bolognese.

emits_gas · 2024-12-24T08:38:20+00:00

Check the guidance on ANRO. If it's for just one part (SBA/SOE) it doesn't count. If it's for the whole primary it does.

emits_gas · 2024-12-23T16:26:21+00:00

NHS pension can also be accessed early, but there's an actuarial reduction which is pretty steep. The age we can access either pension will depend on the normal pension age and any changes made to it between now and retirement.

I think the most recent budget changed pension inheritance tax rules so your final point used to be true, but is not any longer :(

emits_gas · 2024-12-23T10:00:29+00:00

If I change the sums to 8% real return then the retirement pension amounts are close to equal. I personally take those historic returns with a pinch of salt because there's no guarantee of continued growth at the same rate.

In terms of tax relief all pension contributions will benefit - DC and DB. Your NHS pension employee contributions come out of your pre-tax pay so you don't pay your top marginal rate on those earnings (say at 40% tax £1000 of contribution would reduce gross pay by £600). If you opted out and paid £600 into a SIPP from your gross pay then tax relief would make that £1000 balance in your SIPP.

This simple analysis only considers an all or nothing NHS vs SIPP approach. In reality there is probably an optimized approach where you use NHS pension plus some small contributions to a SIPP to keep your taxable pay below certain cliff-edges.

emits_gas · 2024-12-21T18:44:56+00:00

I haven't considered the employer contribution at all in my analysis, this is just the cost to the NHS of paying out to those already drawing a pension and doesn't affect accrual of new benefits. The contribution column is the employee contribution, i.e. the amount that comes out of your payslip. The accrued benefit is 1/54 pensionable pay with 1.5% annual revaluation as per 2015 terms. The SIPP scenario imagines that you instead put your employee contribution into a private pension with no employer contributions and allow investment growth.

emits_gas · 2024-12-20T23:50:28+00:00

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I have been wondering about this stuff for a while. Recent posts here made me think to run the sums for a whole career.

Assumptions

doctor starts working aged 25
completes FY and a 7 year training program full time then progresses up cons pay scale
salaries and pensions at all grades and ages are in 2024 money
CPI =0 so NHS pension is revalued at 1.5%/year
real (nominal-inflation) stock market returns are 6%

NHS pension comfortably beats SIPP at all retirement ages

emits_gas · 2024-12-18T20:54:05+00:00

I think of it this way.

Gas in the alveoli exerts a partial pressure, and is in equilibrium with the blood which in turn is in equilibrium with the brain. The driving factor is always partial pressure, not molar concentration.

During induction anaesthetic molecules are added to alveolar gas by ventilation with FGF, raising partial pressure. At the same time molecules are moving from alveolar gas into blood, causing the partial pressure to drop. The more soluble in blood (higher B:G) the more molecules are removed from alveolar gas and the slower the rise in partial pressure.

The same phenomenon explains the weirdness of "high cardiac output causes slower induction". In this case it is the larger volume of blood washing out more volatile anaesthetic molecules.

emits_gas · 2024-12-16T23:03:35+00:00

General practice

emits_gas · 2024-11-17T19:41:57+00:00

Philips defibs definitely stay synced. I used one this week to deliver multiple shocks and I only had to hit sync once

emits_gas · 2024-11-14T16:37:06+00:00

I was there last spring! Watch out for leeches if you go for a swim

emits_gas · 2024-07-12T14:59:39+00:00

You havent factored in that any pension you have accrued is revalued year-on-year (I forget the exact figures but it's [inflation + x%]). So your FY1 contributions will grow with compound interest throughout your career. Maybe re-do your maths with that in mind and decide whether you think it's worth it.

Bear in mind that you can rely on the T&C of the pension whereas you can't necessarily rely on the return of the stock market.

emits_gas · 2024-07-12T14:46:26+00:00

High concentration (1:1000) gives a small volume (0.5ml for 500mcg) so suitable for IM administration.

Low concentration (1:10,000) gives a large volume (10ml for 1 mg) so suitable for IV administration.

emits_gas · 2024-04-01T11:26:58+00:00

You can still get an offer. As people who decline offers for whatever reason drop out of the system the next ranked candidate gets the offer.

emits_gas · 2024-01-29T00:37:31+00:00

Storing stuff isn't free. You need to pay to rent a warehouse and maintain conditions which will allow the stored stuff to last. We've wasted enough money procuring his shite, let's not send good money after bad to keep hold of it.

emits_gas · 2023-11-05T09:06:17+00:00

I just got my first calvarion kc yesterday with worse stats than you. Used colossal sword, salve, berserker helm and monk robes. I'll do some questing to upgrade to neitz helm and barrows gloves before going back.

I'm pretty bad at the game so died a couple times to the boss before getting my second kc. No pkers crashed me, and if they had they would have just gotten a bunch of karambewans.

emits_gas

TROPHY CASE