Hating the NHS
I wanted to post anonymously and please don’t take this the wrong way but I need help.
I am on an f3 year and realised the freedom without the pain of negotiable with rota coordinators jumping through hoops for training and enjoy it. I also have a life and realise I am hating working I. The NHS as it’s still service provision. I have spoken to all trainees in medical acute medicine gp and surgical and they all have one thing in common. How underfunded he NHS is how he training is awful and how it’s majnly service provision and rubbish training. It’s not giving me hope for going back into training and as I am born and bred in UK the only thing stopping me from going to Australia or even US is family here in the UK.
Are there any suggestions how to change my feelings for the NHS? Can we train in the private sector.
Sorry if this thread has offended anyone but I can’t see a light at the end of the tunnel. I enjoy being a doctor. But don’t like the fact that we are a slave to the system and our lives are compromised
I am on an f3 year and realised the freedom without the pain of negotiable with rota coordinators jumping through hoops for training and enjoy it. I also have a life and realise I am hating working I. The NHS as it’s still service provision. I have spoken to all trainees in medical acute medicine gp and surgical and they all have one thing in common. How underfunded he NHS is how he training is awful and how it’s majnly service provision and rubbish training. It’s not giving me hope for going back into training and as I am born and bred in UK the only thing stopping me from going to Australia or even US is family here in the UK.
Are there any suggestions how to change my feelings for the NHS? Can we train in the private sector.
Sorry if this thread has offended anyone but I can’t see a light at the end of the tunnel. I enjoy being a doctor. But don’t like the fact that we are a slave to the system and our lives are compromised
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Unsurprisingly, you cannot train in the private sector. Though i have no idea why you think profit-driven healthcare would provide better training - private health in the UK doesn't even take on anything except the barn-door simple cases with the highest profit margins!
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s seem to spend plenty of time in theatre, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
GP is still pretty horrible in terms of service provision and seniors not caring but its only 3 years (and only 1.5 years in hospital). Medicine... well just don't do that! Although even there after ST3 I do think it gets better (except when you're the med reg obv).
You'll never get away from service provision but I do think it gets better the higher up you are.
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s seem to spend plenty of time in theatre, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
GP is still pretty horrible in terms of service provision and seniors not caring but its only 3 years (and only 1.5 years in hospital). Medicine... well just don't do that! Although even there after ST3 I do think it gets better (except when you're the med reg obv).
You'll never get away from service provision but I do think it gets better the higher up you are.
(edited 5 years ago)
Original post by nexttime
Unsurprisingly, you cannot train in the private sector. Though i have no idea why you think profit-driven healthcare would provide better training - private health in the UK doesn't even take on anything except the barn-door simple cases with the highest profit margins!
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s can do their own appendectomies, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
GP is still pretty horrible in terms of service provision and seniors not caring but its only 3 years (and only 1.5 years in hospital). Medicine... well just don't do that! Although even there after ST3 I do think it gets better (except when you're the med reg obv).
You'll never get away from service provision but I do think it gets better the higher up you are.
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s can do their own appendectomies, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
GP is still pretty horrible in terms of service provision and seniors not caring but its only 3 years (and only 1.5 years in hospital). Medicine... well just don't do that! Although even there after ST3 I do think it gets better (except when you're the med reg obv).
You'll never get away from service provision but I do think it gets better the higher up you are.
Can u be a gyno if ur on the register?
The point of the NHS is for the working man who can't afford healthcare and it's acessable for every person who lives in the UK and it's funded by NI. It's basic healthcare-what do you expect, 5 star treatment-then go private. Too many people use it and not enough pay in. 47 years tax contrubtions is not enough to cover the treatment. Your life long NI contrubtions equivalent to a deposit. As people are living longer and keeping the half-dead alive, it's getting more costly over 65's already take up 40% of the budget by 2030-it will be 51%. Under 16's and over 68's don't pay NI. So who's propping up the NHS, immigrants, young people.
Original post by Anonymous
I wanted to post anonymously and please don’t take this the wrong way but I need help.
I am on an f3 year and realised the freedom without the pain of negotiable with rota coordinators jumping through hoops for training and enjoy it. I also have a life and realise I am hating working I. The NHS as it’s still service provision. I have spoken to all trainees in medical acute medicine gp and surgical and they all have one thing in common. How underfunded he NHS is how he training is awful and how it’s majnly service provision and rubbish training. It’s not giving me hope for going back into training and as I am born and bred in UK the only thing stopping me from going to Australia or even US is family here in the UK.
Are there any suggestions how to change my feelings for the NHS? Can we train in the private sector.
Sorry if this thread has offended anyone but I can’t see a light at the end of the tunnel. I enjoy being a doctor. But don’t like the fact that we are a slave to the system and our lives are compromised
I am on an f3 year and realised the freedom without the pain of negotiable with rota coordinators jumping through hoops for training and enjoy it. I also have a life and realise I am hating working I. The NHS as it’s still service provision. I have spoken to all trainees in medical acute medicine gp and surgical and they all have one thing in common. How underfunded he NHS is how he training is awful and how it’s majnly service provision and rubbish training. It’s not giving me hope for going back into training and as I am born and bred in UK the only thing stopping me from going to Australia or even US is family here in the UK.
Are there any suggestions how to change my feelings for the NHS? Can we train in the private sector.
Sorry if this thread has offended anyone but I can’t see a light at the end of the tunnel. I enjoy being a doctor. But don’t like the fact that we are a slave to the system and our lives are compromised
do what a lot of jr docs do after foundation training and locum
Original post by Other_Owl
The point of the NHS is for the working man who can't afford healthcare and it's acessable for every person who lives in the UK and it's funded by NI. It's basic healthcare-what do you expect, 5 star treatment-then go private. Too many people use it and not enough pay in. 47 years tax contrubtions is not enough to cover the treatment. Your life long NI contrubtions equivalent to a deposit. As people are living longer and keeping the half-dead alive, it's getting more costly over 65's already take up 40% of the budget by 2030-it will be 51%. Under 16's and over 68's don't pay NI. So who's propping up the NHS, immigrants, young people.
The OP is a doctor and is complaining about working in the NHS, not about healthcare provision for the patients.
Original post by nexttime
Unsurprisingly, you cannot train in the private sector. Though i have no idea why you think profit-driven healthcare would provide better training - private health in the UK doesn't even take on anything except the barn-door simple cases with the highest profit margins!
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s can do their own appendectomies, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
My impression is that outside of medicine, training significantly improves after FY2. Most surgical CT1s can do their own appendectomies, most gynae ST1s are doing lots of theatre work. In my old trust they even had specific training theatre lists with cases tailored to the trainee's needs. Psych CT1s have loads of dedicated training - my friend has 2 full days per week of just training, as well as admin time. Once you're actually going to be doing someone's speciality seniors start to actually take interest in you.
Lololololol. Maybe if you measure time with a calendar rather than a clock.
Original post by Helenia
Lololololol. Maybe if you measure time with a calendar rather than a clock.
Oh really? My exposure is obviously skewed then! I even knew of an FY2 doing her own. All DGH of course.
That does raise questions as to what the hell 'training' in the UK is doing across the board then!
Original post by ErinaNakiri78
I 100% agree with this and your feelings are definately NOT wrong for thinking this way. you have the right to have that opinion. my advice is start training to work in a private hospital. If you work for nhs, they will take loads of taxes from you to fund for the nhs so you wont get paid enough for the amount of work you do.
You still pay taxes if you work outside of the NHS 🧐
There are structures in place to protect doctors in training programmes and protect access to training.
If you aren't able to access training because of clinical workload then exception report. If the problem is consistent, talk to your educational supervisor. Hold a department to account for the training that is set out in your work schedule.
If your supervisor is not supportive then escalate to the guardian of safe working/foundation prog director/college tutor.
Book study leave, go on courses, take postgraduate exams.
Only when we start using these systems more consistently will our training become more high quality.
If you aren't able to access training because of clinical workload then exception report. If the problem is consistent, talk to your educational supervisor. Hold a department to account for the training that is set out in your work schedule.
If your supervisor is not supportive then escalate to the guardian of safe working/foundation prog director/college tutor.
Book study leave, go on courses, take postgraduate exams.
Only when we start using these systems more consistently will our training become more high quality.
IMO exception reporting is never going to make our training high quality. Mostly because that assumes that all of our very minimal timetabled training committments would feel like high quality training if only we could go to them all - exception reporting just allows you to whinge a bit when you miss scheduled things. I find most of my own 'training' requirements are untimetabled - clinic time, for instance, or opportunities to do procedures - and it's not possible to exception report missing something that isn't scheduled. Or you might do jobs where the senior review is never the consultant and so as a CMT you can't get any CBDs/ACATs signed for any of the patients you see because only consultant led assessments count for something. Can't exception report that either. I strongly resent the idea of paying more of my own money to go on courses because my supposed training post will not offer me this kind of training. Often these courses are at the weekend and not re-coupable time. Escalating issues such as not being able to make clinic requirements is met with 'why not come in on your zero days'!
And to top it all off, if I stay late the idea of staying even later to fill in some bureaucratic forms fills me with an acute and painful sense of irony. My time is more important to me than a small amount of compensatory money.
/negativegrumbling
To be honest I think the best thing you can do is try and find something in medicine/surgery/whatever you actually really enjoy doing (if there is such a thing) to try and compensate for the way things are otherwise. And also to try not to think too much about the above. I think dwelling on training and rotas and so on is non-productive, it's the only way through 'training' unless you want to be stuck at the same grade forever and arguably the lower down you are in the pecking order the more like service provision you feel. If nothing else inspires you to grit your teeth and keep moving on, let it be that.
And to top it all off, if I stay late the idea of staying even later to fill in some bureaucratic forms fills me with an acute and painful sense of irony. My time is more important to me than a small amount of compensatory money.
/negativegrumbling
To be honest I think the best thing you can do is try and find something in medicine/surgery/whatever you actually really enjoy doing (if there is such a thing) to try and compensate for the way things are otherwise. And also to try not to think too much about the above. I think dwelling on training and rotas and so on is non-productive, it's the only way through 'training' unless you want to be stuck at the same grade forever and arguably the lower down you are in the pecking order the more like service provision you feel. If nothing else inspires you to grit your teeth and keep moving on, let it be that.
Your clinics should be in your work schedule and there's no reason you can't write in "10 consultant led CBD/CEXs" into the work schedule when you agree it with your supervisor or "at least 5 attempts at procedure x".
If you put the relevant courses in your work schedule and your ED supervisor agrees it then you are entitled to have it paid for by study budget as there is no per-trainee limit now, and you are also entitled to time back in lieu if you do such a course on a weekend.
Being asked to come in on zero days to get the clinic time you are entitled to can also be escalated to the guardian or director of med ed.
I'm sorry you feel that ER cannot support you but I'd suggest it's significantly more likely to bring about change than grumbling on the internet.
If you put the relevant courses in your work schedule and your ED supervisor agrees it then you are entitled to have it paid for by study budget as there is no per-trainee limit now, and you are also entitled to time back in lieu if you do such a course on a weekend.
Being asked to come in on zero days to get the clinic time you are entitled to can also be escalated to the guardian or director of med ed.
I'm sorry you feel that ER cannot support you but I'd suggest it's significantly more likely to bring about change than grumbling on the internet.
Anyone else think it's starting to take the piss the number of non-medics who've started coming in the forum to give our doctors *****y advice?
Original post by nexttime
Oh really? My exposure is obviously skewed then! I even knew of an FY2 doing her own. All DGH of course.
That does raise questions as to what the hell 'training' in the UK is doing across the board then!
That does raise questions as to what the hell 'training' in the UK is doing across the board then!
I wouldn't anaesthetise for a lap appendix with only a CT1 operating. Don't mind them being the lead surgeon but I would want a reg present, and virtually all of the ones I've done have been painfully slow (so are some ST3/4s tbh!) It's not just about being technically able to get the appendix out, it's knowing what to do if there is peritonitis, a perf, something not-appendicitis, plus ability to fix any complications that may occur.
Surgical training is very hit and miss from what I can tell, and I feel sorry for them because they know that everyone is rolling their eyes if they take too long.
Original post by Hype en Ecosse
Anyone else think it's starting to take the piss the number of non-medics who've started coming in the forum to give our doctors *****y advice?
I want to know where these private hospitals are where I don’t have to pay tax
Spoiler
Original post by ErinaNakiri78
I know that.... but when you work as a doctor for example, they take much more taxes from you. And the whole nhs system is messed up
Doctors get taxed the same as everybody else - it doesn't matter if you work in the NHS or private sector. Your taxation is directly proportional to your income - doesn't matter where it comes from or what you do.
Original post by Helenia
I wouldn't anaesthetise for a lap appendix with only a CT1 operating. Don't mind them being the lead surgeon but I would want a reg present, and virtually all of the ones I've done have been painfully slow...
Oh ok i think we misunderstand eachother then - I meant the CT1 (or FY2) was doing the whole procedure skin to skin, but there was a reg or consultant present yes! Not necessarily scrubbed, but present.
I do think getting to that stage still requires a degree of personal education and mentoring that just doesn't come close to existing within Core Med.
And again limited experience, but from what i saw the pressure put on the surgeon by the team to be quick was much less than the pressure the surgeons put on the anaesthetists to be the same!
Original post by Smile88egc
Your clinics should be in your work schedule and there's no reason you can't write in "10 consultant led CBD/CEXs" into the work schedule when you agree it with your supervisor or "at least 5 attempts at procedure x".
I mean, what you say is all technically correct, there's no disputing that. But i do still wonder what planet you're on!
I mean, to give one example: We need 21 clinic sessions per year as mandatory training. Last year, one of my rotations scheduled me for 6 sessions, the others scheduled none. I didn't even need to raise this with the deanery as at the induction we were told that they know about the issue regarding clinics and that they were negotiating with the departments. One year later: no solution, still have to fight tooth and nail for everything, got by with highly dubious, completely not-educational workarounds and some come in in days off for mandatory clinics.
That's for a nationally agreed mandatory requirement that the deanery is already advocating on our behalf for! Getting opportunities for our 4 mandatory procedures - again nationally agreed - is equally awful. The very idea of in addition to having to fight for your mandatory minimum training, we should also be fighting for a full ten consultant led assessments (!!! I think I had 4 all of last year - none of which actually occurred of course but the consultant agreed to just sign the form) and five supervised attempts at any procedure when we can't get one attempt at a mandatory procedure with the full support of the national training program... that just seems madness!
I honestly think you'd be laughed out of the room. Both by the ES and by the deanery.
Cmt varies a lot unfortunately. I had a great 2 years it has to be said. Received a great education but was worked like a dog also. I didn't mind though My service provision was great training I wouldn't have swapped it for what I saw in Australia. But I count myself lucky ss I know everyone wasn't the same
It is quite disheartening when you think that in reality it should only take us around 3 years to become consultants (see US residencies), it really comes to show that our 'training' is diluted almost fourfold with service provision..
Original post by nexttime
I honestly think you'd be laughed out of the room. Both by the ES and by the deanery.
I'm so sorry that your training is of such poor quality and I can imagine if you have been in that training programme for a year and everyone around you is accepting the status quo then it would be harder to challenge things.
But I don't think I would be happy to go through "training" as you describe it and then consider myself trained at the end. What a disservice to your patients as well as yourself, and your future colleagues who will experience the same the next year.
On my planet I get scheduled clinics and my work schedule describes i should get at least my minimum CBD/CEXs and should attend a 4 day course over the next 6 months.
You cannot be laughed out of a room for demanding access to your minimum training requirements.
I understand completely it is hard to be a lone voice so get some allies, agree a position with the other trainees, book a meeting with your guardian of safe working and DME. Hold them to account.
The standard you walk past is the standard you accept.
(edited 5 years ago)
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