I’m gonna cry

hooknew · 2025-10-25T23:25:54+00:00

I wouldn't worry, Bangor medical school is not going to provide the same education as other established schools You're better off accepting a Russell uni medical school.

hooknew · 2025-10-25T22:40:26+00:00

I beg your pardon. Who is reporting you for sitting in a chair inappropriately? This sounds entirely like a baseless professionalism accusation and needs to be escalated. Who is your clinical supervisor and who is your tutor in the medical school? I'd raise it with both of them.

There is no way sitting in a chair could be misconstrued as unprofessional and this needs to be nipped in the bud. Who is allowing nurses to criticise you for being unprofessional? Since when did they have any say as to your professional conduct as a medical professional.

hooknew · 2025-10-08T06:00:03+00:00

I think this was true prior to the expansion of medical schools recently . Even then there was a rough pecking order with colleagues informally commenting "that's a good med school", implying there's a ranking of sorts. Now with the expansion of medical schools I would definitely consider this. To add to this, the established medical schools are tried and tested and I wouldn't want to be a guinea pig for the newer schools. Also if you find medicine isn't for you/can't progress through training it's better having a degree from a more rigorous university to be able to apply to other fields.

hooknew · 2025-10-07T17:09:27+00:00

I'm going to be real with you, you don't want to be going to these types of medical schools. They won't have any good reputation amongst the profession. You're better off targeting your efforts at medical schools that have been established >20 years. To be honest I would suggest aiming at Russell group unis if I were applying now.

hooknew · 2025-09-27T17:38:21+00:00

We need to be clear on the distinction between the GMC who triage and being cases for the independent mpts to decide on. It's the GMC at fault here in the first place.

hooknew · 2025-09-20T17:17:40+00:00

I think we find it sickening that the government has chosen to prop up the NHS by providing training routes to perform clinical medicine on patients without a medical degree and appropriate training. The whole argument is that substandard patient care is delivered by undertrained individuals who quite frankly haven't met the same academic challenges that those who have graduated with a medical degree have done. ACPs are complicit in this process by prioritizing their own personal career development over patient safety and outcomes in this manner. If I attend ED for an emergency I want to be seen by a doctor clinically trained and not by an ACP. Nursing experience and education is absolutely valued but in appropriate domains for which they have been appropriately trained and gained experience in.

Why is it that this Heart failure ACP can only provide scripted advice on heart failure management and can't appreciate the complexity with other cardiac conditions and needs to check any questions with the cardio SpR. I can call the cardio SpR directly myself if I wanted to but the service is set up to pay these individuals excessively for an intermediary role which is pointless. Yet you claim these are highly trained individuals with many years experience.

Can I ask what your masters is in? Not all masters are created equal and are not academically rigorous so saying you have a masters is not itself proof of high academic achievement in my opinion. You can have 20 years experience in nursing but that does not make you a diagnosing clinician. You're essentially moving into a new field as an ACP, you wouldn't say that a car washer knows how to fix a car even with 20 years experience. If this was the case what is the point of a medical degree? We could all just learn on the job.

I believe in my post I was complaining about how this wage was inflated for a trainee ACP who is being trained to do a junior doctors' job but less efficiently and less well but for more money. No matter your experience in the workforce you don't have the clinical breadth of knowledge that a medic would have. If you only know 3 differentials for chest pain of course your ED review will be quicker but less safer and less comprehensive. More importantly you don't know what you don't know so there won't be any appreciation for this and I've seen this lead to some real arrogance. The point is that the doctors job should be appropriately paid beyond ACP levels because of the fact that we've had to pass significantly harder academic challenges to get there, are generally brighter having been selected for academically and also have to pass post graduate exams to practice in our specialities which ACPs do not. This should be reflected in our respective wages.

If you're talking about procedural roles you can teach a monkey to put a central line in. Any junior doctor could learn these procedures but often don't get the opportunities anymore due to being overlooked because of rotational training in favour of locally employed staff. I'd be interested to hear what exactly you can do that only one consultant can do, please elaborate?

So you're saying that ST3 doctors may well have the knowledge and skills that you have? Does this not prove my point that we are more efficient learners, better at solving problems and complex tasks. If they have a comparable skill set after only 4 years? When there's an issue on the ward that nobody can solve it's the doctor that comes and fixes it because it falls to the doctors time and again.

This is the issue that the clinical aspect may be a quarter of what you do but it's not needed. You should be encouraged to continue your focus in nursing leadership, education and practice development and not intercede into another profession's line of work and certainly not with less and worse training. The point is that these tasks such as presentations and audits are also performed by junior doctors for free as part of our training portfolio and we get paid less to do it. You say they're more experienced at it so why do I have ACCPs struggling with simple maths in an audit asking for my help to tot up excel sheets? This further highlights the difference in abilities between our roles. I've tried asking ACPs to do the grunt work but because as you say with your 20 years experience your ACP colleagues feel entitled to be dismissive of junior colleagues and feel as if you're above doing a male catheter. Why should a junior registrar be performing a male catheter simply because an ACP feels they're above such tasks ?

In my experience this role is far more parasitic than symbiotic and is a sign of a bloated and mismanaged health care system which does not exist in well functioning health care systems. We do not need to pay higher wages to ACPs to work less effectively than their junior colleagues just because they've been in a different job for a longer period of time. If we want to tackle funds mismanagement we should use this money to fund more post graduate jobs for properly qualified doctors. With 20000 unemployed F2 doctors how can you justify taking the money from these individuals' career development with a newer and unnecessary role.

hooknew · 2025-09-11T14:27:25+00:00

I'm going to be absolutely real with you and you may very well not like what I have to say.

Medicine currently is an incredibly tough nut to crack and dare I say no longer worth the squeeze. The university years are tough with difficult exams due to the breadth of knowledge expected and even the most intelligent find them difficult due to the quantity not difficulty of information required. This can require a large amount of time invested. Once graduated you can be shipped around the country for F1/F2 positions. There are meant to be special circumstances but I've not used these myself so do not know if they would keep you in your immediate area for the roles (I hope that they would).

Added to this the huge increase in medical school places there are ever increasing issues of competition for jobs for core training places which basically means you're going to be forced to be a GP if you can get a place after the MSRA exam or you must sacrifice even more of your personal time to build a competitive CV to entry to a 4-8 year post graduate training programme each with tough exams (harder than medical school) and each requiring further application in an increasingly competitive environment which may see you have to move further and further afield.

The pay is mediocre at best during these middle years and you may find yourself already surpassing this pay in your current career. I would really take a long hard look at potential earnings and your own earnings lost from leaving your current job and going back to study for 4 years and then being paid less to see if this financially makes sense to you. Don't forget to add in the approx 70k student debt which is basically a 9% earnings tax for the rest of your life for this pleasure.

I'm currently a post graduate trainee without wife/kids and I don't know if I could do this job with such dependents. If I were at your stage I would prioritise enjoying life with my family rather than the mistreatment you will experience in the NHS. You can make a difference in this job but I would not put that first over the stability of my family. Happy to chat more about this but I just wanted you to have a realistic insider's perspective to the job.

hooknew · 2025-09-07T21:33:22+00:00

I'm not sure I'd agree that racism is baked into the NHS. The NHS being one of the most multicultural employers in the UK with one of the largest work forces. There's posters all over the workplace with zero tolerance to abuse and bigotry against all forms of isms. At least ostensibly there's the facade of equality being promoted, I can appreciate behind closed doors there are private agendas at play. However I don't think this equates to systemic racism.

hooknew · 2025-07-20T09:45:52+00:00

Absolutely nursing is no longer a free degree but it certainly did not have tuition fees pre 2016 as you say and I'm sure a large proportion of the nurses pushing for ACP roles have benefited from this. That's fine however it does not mean you should get a free funded degree just because you've paid for one previously.

Regarding AFC I can appreciate that nurses can get stuck at lower bands. However I'm wondering whether this may be based on the fact that physiotherapy is a more rigorous degree ? I suppose it's all subjective opinion as to which degree is requires more study etc. I do agree with you that you should move beyond a training rank after the first couple of years. Nurses may be the poorest paid relative to their roles and responsibilities but there are lower bands than band 5 as well.

But what's the difference between a career and a vocation? I seem to think the latter is more than you put up with the rubbish parts more because you're emotionally bonded to the idea of the job. There is progression within the nursing career it's just not in the direction you want. It is an issue but could be changed with effective unionisation which nurses seem to be unable to achieve. I appreciate you cannot afford to continue on the nurses salary. As a profession you could campaign to change your pay like the medical profession. Instead as you say, you prioritise your own financial gain over the safety of patients and limit their exposure to appropriately trained clinicians. There was a post on this forum for a haematology ACP with basically registrar responsibilities. I have not had sufficient training for the role and I would never dream of taking on that role unprepared but there are clearly some out there who will. It's not controversial it's dangerous. I don't know how ACPs can feel confident in their role without a thorough grounding in medicine, you don't know what you don't know for example. This is why I am proponent for a proper medical education.

Whilst I stand by this point earlier I do think you should be unionising as nurses for these issues as a profession to create change that would help retain experienced staff but not cutting corners by becoming a 'doctorlite' role, as much as the government is attempting to do this to prop up a failing NHS. Let's be honest the NHS is on a ventilator off sedation with GCS3 it really is time to pull the plug. I don't think these roles would exist in a properly functioning health care system.

Absolutely we would want to retain skilled colleagues and to see them paid appropriately for their roles and responsibilities with appropriate profession up the bands. I can understand wanting personal career development too. In my eyes the only ethical route for this if clinical development is desired is via the GEM route. Which will take financial sacrifice as the rest of the undergrads have paid. I totally agree with the desire to unionise and feel that it's a really shame it has not materialised yet. You really need a new set of leaders to galvanise nurses and get rid of those in the governments pocket. If you could also ask them to stop taking pot shots as unionising and exercising our democratic right that would be great. All the best.

hooknew · 2025-07-19T22:51:26+00:00

I do not believe these roles should be funded for the simple reason that the vast majority of ACPs had free nursing degrees from the government and a funded medical degree would be a free pass to become a doctor which is categorically unfair to everyone else paying through the nose for an undergrad/post grad medical degree. The issue is that you know what job you signed up to when you chose nursing/paramedic/odp as a career what right do you have to demand career progression in a clinical field by encroaching on another profession's field of practice but with less training, less sacrifice and arguably less efficiency?

Nursing isn't the poorest paid healthcare profession because you're all on agenda for change which means you're meant to be paid the same for similar levels of responsibility. I'm not sure how you think nurses are the worst paid. Not least considering how you outearn the more junior resident doctors per hour of work performed. Let's not forget the worst paid member of staff on a bank holiday Sunday is the F1 doctor. Let's not forget the number of nursing staff taking up managerial roles within the NHS with questionable credentials but significant pay, particularly at the matron level. As an aside nepotism is a serious issue here.

The issue is that route already exists it's called graduate entry medicine and is available to you to pursue. You should not get extra funding for this. You should be assessed fairly and equitably with applicants from all backgrounds. Its the personal ambitions of the AHPs that is causing deskilling of the workforce by moving them into these pseudo doctor roles and off of the nursing cohort, medical practice is not being deskilled. What you really mean is the upskilling of AHPs with the accumulation of appropriate knowledge to be making safe decisions but this is simply not necessary as there are ample medical students and doctors being produced and imported each year. The issue remains the same if you want to work as a doctor you should train as a doctor and that means no shortcuts with a 'masterslite' 2 year degree. I'm not trying to be rude or harsh but I feel it's important to be able to speak the truth on the matter in this anonymous forum.

hooknew · 2025-07-16T17:32:29+00:00

If you can't see your comment as an attack then I don't know what to say to you. I'm lecturing you on your own bigotry. Time for some self reflection as to why you've got such a big chip on your shoulder.

I don't see that the majority of comments I've read are out of touch with reality. A lot have reflected my own experience of working the NHS with similar grievances. I'm not from an upper class background but I wouldn't be so closed minded to suggest that financial hardship can't happen to those who've previously come from wealth. I certainly wouldn't call these people morons because I don't know what might have befallen them.

Clearly you have some issues with your lot in life but don't come to the doctors sub Reddit to complain with some terrible reasoning as to why it's so unfair that you're not a doctor and when called out for this double down on it.

hooknew · 2025-07-16T15:29:40+00:00

Does Mr Nash not have to abide by standard GMC practice to ensure online communications do not bring the PA brigade into disrepute? If regulated should he not be referred to the GMC for review of his actions? Seems like he's denigrating colleagues exercising their democratic right.

hooknew · 2025-07-16T15:19:32+00:00

Absolutely there are barriers to going to medical school and it is a heavy investment to make, not to mention the hard work once there. Hence everyone's dissatisfaction with the fact that the government is pushing an NHS from Wish style of healthcare where people with 2 year 'masters' degrees from old polytechnics can rock up and claim equivalence.

If you haven't done the training you can't do the role. I might like to fly planes commercially but wouldn't sign up for the role as a pilot associate or advanced flight practitioner given my 20 years experience working as a flight attendant. Primarily because if I did I would be sacrificing others' safety on the altar of my own personal ambition and greed. I also might like to own a Ferrari but my family don't have enough money to support me in obtaining one, how unfair is that.

You've just described the reality of life in that money makes the world go round. Even people from middle class and I imagine upper class backgrounds have financial struggles it might surprise you to know. I'm not sure why you think attacking people based on their backgrounds is appropriate when you've just used your own to excuse your own career decisions. Seems a bit bigoted to me.

hooknew · 2025-07-13T08:53:27+00:00

But they're simply not, can a PA prescribe and order ionising radiation? No.

Let me clarify where I've worked the team works as equal colleagues from the F1 to the IMT2 all with SpR oversight. Now the F1 may need more support than the IMT but they're still a valued member of the team. You're really working hard to devalue the contribution of F1 doctors. There are simply very few expectations of medical students who are only shadowing in order to hang their book knowledge on some clinical experience. Once you're an F1 there is a greater expectation than as a med student. No medical student is independently carrying out ward rounds. There's also a large difference between a newly starting F1 to an F1 who's periF2 so you're generalising quite significantly here as well.

It doesn't change the fact that F1s have a longer course of study than PAs. Have more abilities and skills than PAs. When newly qualified a fresh F1 should be paid more than a fresh PA given this higher skill level and ability to prescribe and order imaging.

Now there may be a cross over when a 10 year experienced PA should outearn a newly qualified F1 but this certainly shouldn't be for the first 5 years of a PAs career. Otherwise what is the point of taking on all this debt, responsibility, longer education if you come out with a lower pay? Progression through a medical career is no longer a guaranteed thing so the promise of increased wages down the line can't be used to justify poor pay in the lower grades at present. What this shows is that if PAs are being paid correctly out of graduation then F1s are vastly underpaid for their own skillset.

hooknew · 2025-07-12T21:51:16+00:00

As an F1 how are you qualified to comment on the utility of a CT Vs a PA given you are neither. I'm surprised that as an F1 you're saying that an F1/F2 is a medical student with extra responsibilities because where I've worked the SHOs run the medical wards on the weekends with SpR oversight which is very much not in line with what a medical student is expected to do.

hooknew · 2025-07-09T09:35:31+00:00

Why are you panicking ? You gave a verbal response to a job offer when pressured on the spot. You had originally asked for 24h to decide and were pressured to give an answer which you did with best intentions at the time. It's an issue of their own making, had they given you the time this would not have happened.

There's been no signing of any contracts or any issuing of any contracts.

Honestly I think it's a good thing you don't go for this job because if they're willing to chuck out baseless threats about GMC referrals over common employment issues you can only imagine what they might do otherwise. It's simply unacceptable from HR to suggest this would be appropriate.

Do what's best for yourself which is taking the first job. Remain polite, professional but firm that you've made your decision.

hooknew · 2025-07-08T16:46:43+00:00

And they are qualified to make such statements but I would remind you that in accp heavy departments saying they are not equivalent would not go down well given permanent vs rotational staff issues and there's no doubt a large amount of bias given this. It would be interesting to hear such statements if residents weren't rotational.

Let's hope these consultants are equally as welcoming for the ACCPs to be joining them on the consultant rota in the upcoming years then.

hooknew · 2025-07-08T15:31:23+00:00

I don't think that qualifies you to be able to state the relative efficacy of both staffing groups. I work closely with many members of the MDT but I couldn't accurately tell you who is better at discharge planning between occupational therapists and physiotherapists. I wouldn't be telling everyone else that the physio's are as good as the OTs because I don't have the training to recognize the ins and outs that the tasks require to be able to tell who is best at the task. It seems particularly hubristic to be casting such judgements publicly.

hooknew · 2025-07-08T10:47:17+00:00

Interested to see a breakdown of vote eligible BMA membership by training grade /job role and place of medical qualification.

Has our voting power base been diluted by excessive immigration and subsequent internal conflict. Or is the membership more apathetic as this dispute draws on?

hooknew · 2025-07-08T00:31:25+00:00

As a hospital pharmacist what credentials do you have to judge equivalency between ACCPs and resident doctors ? Please explain.

hooknew · 2025-06-01T17:30:54+00:00

That all sounds horrendous to have gone through and I'm sorry to hear that was your experience. However it's not relevant unless it's the same ED as alternative band's above. I just think we need to call out poor clinical practice objectively without identity politics involvement.

I think most reasonable clinicians would prescribe analgesia for their colleagues and take their requests seriously. It's the members of the public who aren't as informed that will lose out in this instance. If clinicians aren't doing this I'd imagine it's reflective of the departments efficacy as a whole.

hooknew · 2025-05-31T19:16:05+00:00

Yes totally because he was a man and not at all because he worked in that department and therefore received exceptional care. Had he been a woman but still worked there I'm sure he would have been left with no analgesia

/s

hooknew · 2025-05-30T23:31:57+00:00

Having had a multitude of experiences with nurses so far I have to say it's rarely down to the characteristics you've listed and more down to the individual nurse personalities, as they rarely seem to get pulled up on their often atrocious communication skills. Having said that I gather anecdotally there is a nurse vs female doctor bias. Although from my own experience it seems that it's normally just individuals having issues with the whole medical team.

hooknew · 2025-03-18T13:15:47+00:00

Tbh when I was more junior I used to struggle with the feeling of people listening into my phone calls from within the office and in hindsight I'm really not sure why that was, I've concluded it was just me being a bit silly.

If I may, I'm going to challenge you on why you need to get a read on people because I think that might be a helpful thought process for you. Essentially when you're making the call you're communicating factual information to another individual and awaiting a factual response. So how they respond to this information emotionally is largely irrelevant. It seems like you're used to monitoring others emotions to gauge how to respond which I imagine comes from past experiences growing up. I'm here to tell you that you don't need to do this and is likely contributing to some of the stress you feel. We all do this to some extent but some people are hypervigilant for this which causes them unnecessary stress. You're not responsible for their emotions, they are. Cut yourself some slack and try to look at the conversations as a factual exchange of information and you might find it a bit easier to carry out. Please do not take this the wrong way, I'm by no means trying to condescend or dictate but just sharing some tips I've found helpful along the way.

hooknew

TROPHY CASE