Can someone remind me what's so good about being a doctor?
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When it comes to F1 job rankings, at the end of the day everyone is in the same boat with the SJT. Whilst it's easy enough to do a bit poorly on it, to have a disaster that takes you down despite an above average EPM is kind of on your own shoulders. Say what you like about it's efficacy as a ranking tool (no-one really knows if it's any good), but at the end of the day if you did badly on it, you need to suck it up.
As for the F2 rankings, how much teaching did you miss for it to push you down despite having a fully completed portfolio? I'm guessing quite a lot, and whilst having a busy 1st rotation is a burden at the end of the day you weren't the only F1 working under those sort of conditions. Plus you had several months after that rotation in which to make up for it.
You obviously have some genuine grievances with working conditions, particularly on your first rotation by the sound of it, but it sounds like you're dumping all your grievances at the feet of other people without taking any responsibility yourself to me. You could have done better on the SJT, and you probably could have got to more teaching with the right organisation beforehand.
Also this bit:
You've only been working for 9 months!
As for the F2 rankings, how much teaching did you miss for it to push you down despite having a fully completed portfolio? I'm guessing quite a lot, and whilst having a busy 1st rotation is a burden at the end of the day you weren't the only F1 working under those sort of conditions. Plus you had several months after that rotation in which to make up for it.
You obviously have some genuine grievances with working conditions, particularly on your first rotation by the sound of it, but it sounds like you're dumping all your grievances at the feet of other people without taking any responsibility yourself to me. You could have done better on the SJT, and you probably could have got to more teaching with the right organisation beforehand.
Also this bit:
Original post by Ciaran88
Every year they'll tell you you absolutely must do just one more year and then you can go do something else, it's always "one more year" and before you know it you're 65 and retiring (if you're lucky) no having done all the things you dreamed of.
You've only been working for 9 months!
I'm loving the stuff I'm doing at the moment, it only gets dull when its quiet. Perhaps you are looking for satisfaction in the care of the patients rather than the art of practicing in a speciality. Much of the stuff we do is arguably not worth the time and the effort for the patients involved but it is however stimulating to do on a practical level.
Original post by hoonosewot
When it comes to F1 job rankings, at the end of the day everyone is in the same boat with the SJT. Whilst it's easy enough to do a bit poorly on it, to have a disaster that takes you down despite an above average EPM is kind of on your own shoulders. Say what you like about it's efficacy as a ranking tool (no-one really knows if it's any good), but at the end of the day if you did badly on it, you need to suck it up.
As for the F2 rankings, how much teaching did you miss for it to push you down despite having a fully completed portfolio? I'm guessing quite a lot, and whilst having a busy 1st rotation is a burden at the end of the day you weren't the only F1 working under those sort of conditions. Plus you had several months after that rotation in which to make up for it.
You obviously have some genuine grievances with working conditions, particularly on your first rotation by the sound of it, but it sounds like you're dumping all your grievances at the feet of other people without taking any responsibility yourself to me. You could have done better on the SJT, and you probably could have got to more teaching with the right organisation beforehand.
Also this bit:
You've only been working for 9 months!
As for the F2 rankings, how much teaching did you miss for it to push you down despite having a fully completed portfolio? I'm guessing quite a lot, and whilst having a busy 1st rotation is a burden at the end of the day you weren't the only F1 working under those sort of conditions. Plus you had several months after that rotation in which to make up for it.
You obviously have some genuine grievances with working conditions, particularly on your first rotation by the sound of it, but it sounds like you're dumping all your grievances at the feet of other people without taking any responsibility yourself to me. You could have done better on the SJT, and you probably could have got to more teaching with the right organisation beforehand.
Also this bit:
You've only been working for 9 months!
It's easy enough to do a lot worse than I did, and there are people whose ethics are seriously questionable to ended up with very high scores making up for literally the lowest possible EPMs. I don't really know anyone that has any respect or faith in the SJT, not juniors, nor seniors, not even medical students that did particularly well.
I missed 50% in my first rotation and wasn't able to make up for it in the month or so (several months.. lol) of the second rotation, particularly as I had a week of designated leave right before the interim validation.
Also, I assume you can read? If so then I take it you read that my grievance was the way that my efforts to compensate for this, e-learning (the entire curriculum) were ignored, whilst at many of the other hospitals in my deanery they were considered 1-1 with teaching sessions in the hospital, after all, they follow the same curriculum. There is zero reason to have one rule for some and another rule for others.
So no I don't need to take responsibility for either of those. You can suck that up thanks, oh and by the way, does it mater how long I've been working when I am talking about something many people corroborate with?
^ That was all rhetorical, don't bother replying, you made too many stupid assumptions for me to be interested in your opinion and incorrect assumptions are generally a poor way to convince someone of anything
(edited 9 years ago)
/popcorn
Original post by -Neuro-
Whaaaaaaaaaaaa? 
...I'm just gonna back away slowly, pretend I didn't read this, and continue to be excited about studying medicine come September and continue dreaming of all the lives I will save and all the people I will help when I'm a doctor...
La-la-la-la-la
...I'm just gonna back away slowly, pretend I didn't read this, and continue to be excited about studying medicine come September and continue dreaming of all the lives I will save and all the people I will help when I'm a doctor...
La-la-la-la-la
LOL
Original post by Ciaran88
It's easy enough to do a lot worse than I did, and there are people whose ethics are seriously questionable to ended up with very high scores making up for literally the lowest possible EPMs. I don't really know anyone that has any respect or faith in the SJT, not juniors, nor seniors, not even medical students that did particularly well.
I missed 50% in my first rotation and wasn't able to make up for it in the month or so (several months.. lol) of the second rotation, particularly as I had a week of designated leave right before the interim validation.
Also, I assume you can read? If so then I take it you read that my grievance was the way that my efforts to compensate for this, e-learning (the entire curriculum) were ignored, whilst at many of the other hospitals in my deanery they were considered 1-1 with teaching sessions in the hospital, after all, they follow the same curriculum. There is zero reason to have one rule for some and another rule for others.
So no I don't need to take responsibility for either of those. You can suck that up thanks, oh and by the way, does it mater how long I've been working when I am talking about something many people corroborate with?
^ That was all rhetorical, don't bother replying, you made too many stupid assumptions for me to be interested in your opinion and incorrect assumptions are generally a poor way to convince someone of anything
I missed 50% in my first rotation and wasn't able to make up for it in the month or so (several months.. lol) of the second rotation, particularly as I had a week of designated leave right before the interim validation.
Also, I assume you can read? If so then I take it you read that my grievance was the way that my efforts to compensate for this, e-learning (the entire curriculum) were ignored, whilst at many of the other hospitals in my deanery they were considered 1-1 with teaching sessions in the hospital, after all, they follow the same curriculum. There is zero reason to have one rule for some and another rule for others.
So no I don't need to take responsibility for either of those. You can suck that up thanks, oh and by the way, does it mater how long I've been working when I am talking about something many people corroborate with?
^ That was all rhetorical, don't bother replying, you made too many stupid assumptions for me to be interested in your opinion and incorrect assumptions are generally a poor way to convince someone of anything
Sorry but it's childish responses like that that help reinforce the impression to people reading this thread that you're someone who doesn't take any responsibility for your own failings.
Lots of people have a crap time in foundation years, and no doubt plenty have had far worse things to deal with than you have (indeed some are on this forum). Some people nut up and get it done regardless, some people fall back and whinge that life isn't fair. I struggle to sympathise with the latter.
You undoubtedly have some legit grievances, but it doesn't come across like you deal with them particularly well.
Original post by Ciaran88
Secondly, the fact that you're treating patients means that the wellbeing of staff is often considered secondary in importance, even though imo it directly affects performance and therefore patient care, so issues with stress and workload and problems with cultures on teams and in departments are just swept aside by so many at the top as not important.
The wellbeing of staff is secondary to the wider goal, usually ensuring the best dividend possible but can be saving chimps, in virtually any job, that's just how it works. Sometimes it can get a bit brutal, eg. you've got cancer you're fired, but generally that's right, you go to work to benefit the employer in a huge number of ways, the employer has to benefit you in one, paying you. In terms of NHS, you at least have the legal protection of the Working Time Directive and a pretty solid HR staff who follow what are very detailed procedures which are more pro-staff than would be the norm in the private sector (I spend a lot of time looking at these things, NHS is not incredible but pretty good).
Interestingly, there is actually a technical legal argument that if you work for an incorporated company the directors have a legal obligaion to make your wellbeing come below a list of other responsibilities, principally long term profitability.
A good first step if you are looking at leaving is to dig out your employment contract and see what the terms are regarding notice. As a training role you may be tied to the 2 years, it's uncommon but not unheard of, in which case you would have to pay the NHS a sginificant sum in damages for leaving now. More likely is that it is an indefinite contract but the notice period may be quite long as you are a professional who is quite difficult, and expensive, to replace. If you for example have a 6 month notice period to work that may affect how you view completing Foundation training.
(edited 9 years ago)
The other alternatives are:
1. Contact medical staffing directly if there are any vacant fy2 posts - careful they are lat / training posts.
2. Arrange a swap with a willing colleague then go to your foundation director that you want a swap
3. Contact the bma representative in your hospital and arrange a meeting with foundation director as he may be able to influence
4. Ask regarding swap policy - at the very least you should be able to swap jobs in the fy2 attachment. My deanery let me do this easily although it was hard to find someone to swap with.
The best option is applying for lat fy2 posts.
1. Contact medical staffing directly if there are any vacant fy2 posts - careful they are lat / training posts.
2. Arrange a swap with a willing colleague then go to your foundation director that you want a swap
3. Contact the bma representative in your hospital and arrange a meeting with foundation director as he may be able to influence
4. Ask regarding swap policy - at the very least you should be able to swap jobs in the fy2 attachment. My deanery let me do this easily although it was hard to find someone to swap with.
The best option is applying for lat fy2 posts.
Original post by Ciaran88
Because I cannot remember anymore. The last time I felt excited to eventually graduate and becoming a working doctor was probably the last time I remained naive and ignorant of what the job actually entailed, at least in this country.
Coming to the end of my first foundation year... I am struggling to think of a single solitary thing I have gained from my first year as a doctor, outside of moderately above average pay.
It started badly, with the godawful SJT making my above average test scores in medical school and extensive CV built for tropical medicine absolutely useless and landing me in a random DGH in the middle of the West Midlands, luckily I could live in the city I wanted to, but having dreamed of a nice big tertiary hospital to then be handed me ~150th choice of jobs, none of which I wanted, in a little suburban hospital, was disappointing.
The first job began with the first 4 days of work being 100% on my own with another F1 working on the ward. Black Wednesday and the 3 days after it were spent doing a ward round on our own, not knowing what was going on, scared ****less. One of our patients later died, not having been seen once by any of our seniors.
After bringing this up with management I then found myself permanently embroiled in departmental politics. Highlighting the issue "caused me a lot of problems" according to the clinical director, and I had a reputation of being a "complainer".
The rest of the rotation was spent on take roughly 75% of the time with patient lists of >50 whilst other firms had <5, sometimes 0. Again I raised this issue, and again it backlashed on me, and was only acknowledged and fixed after I had moved onto my next job.
Needless to say the job was too understaffed and the seniors too unwilling or too busy to teach that I learnt literally zero medicine in the entire 4 months.
Medicine was a slight improvement, mainly due to less than sociopathic personalities, but again, understaffing meant that every ward round was a business round, nothing was learnt, and the bulk of the job was still documentation and paperwork.
Now I'm in psycholiday, so my only hope to learn any medicine for F2 comes down to using my free time to basically revise.
So I'm basically told to just hang on in there, "it will get better", but I am struggling to see the evidence of that. From F1 all the way up to consultant level, it's once in a blue moon I see a doctor that actually seems to enjoy their job. I'm starting to think that for the older generation, they're so invested that since things have gone down hill they are just sticking it out until retirement, but for our generation, entering the NHS in it's current state, the only way you could convince yourself that this career is objectively better than x y z or being a doctor in another country is... basically... delusion?
Sit in your average doctor's mess up and down the country and what do you hear? Endless slagging off of the job, constant scheming of new careers or new ways to escape, doom and gloom predictions of the NHS falling apart in 5/10 years etc.
Whether the NHS survives, understaffing will only get worse, and to me that seems to be the root of almost all of these problems; no time for teaching, too pressured to spend enough time on individual patients to feel rewarded, everybody so stressed that even the best teams start to crack eventually.. And I can't see any reason to think that the government is going to change things, not for an extremely long time...
Now, if someone asks me whether or not to apply to medical school, I cannot think of a single reason to advise them to do this, heart of hearts I can only tell them to steer well clear, unless they have a very specific plan of a specialty to go into or a country to emigrate to where these problems don't ruin just about everything positive about the job.
I had started to feel some degree of excitement for the first time in a long time when applying for my F2 posts, but due to my experiences in that first rotation my score for teaching attendance brought my portfolio score down to such an extent that I once again have been handed my 150th choice job in a hospital I didn't particularly want to go to, doing three rotations I specifically wanted to avoid. I was told by the dean of my deanery that my score for teaching wouldn't matter so he wouldn't take my circumstances into consideration, this despite the fact that I have done literally every single e-learning module on the F1 curriculum to make up for it, and it made the difference between my 1st, and over 100th choice of jobs...
And the NHS wonders why more and more of us are leaving, lol.
Coming to the end of my first foundation year... I am struggling to think of a single solitary thing I have gained from my first year as a doctor, outside of moderately above average pay.
It started badly, with the godawful SJT making my above average test scores in medical school and extensive CV built for tropical medicine absolutely useless and landing me in a random DGH in the middle of the West Midlands, luckily I could live in the city I wanted to, but having dreamed of a nice big tertiary hospital to then be handed me ~150th choice of jobs, none of which I wanted, in a little suburban hospital, was disappointing.
The first job began with the first 4 days of work being 100% on my own with another F1 working on the ward. Black Wednesday and the 3 days after it were spent doing a ward round on our own, not knowing what was going on, scared ****less. One of our patients later died, not having been seen once by any of our seniors.
After bringing this up with management I then found myself permanently embroiled in departmental politics. Highlighting the issue "caused me a lot of problems" according to the clinical director, and I had a reputation of being a "complainer".
The rest of the rotation was spent on take roughly 75% of the time with patient lists of >50 whilst other firms had <5, sometimes 0. Again I raised this issue, and again it backlashed on me, and was only acknowledged and fixed after I had moved onto my next job.
Needless to say the job was too understaffed and the seniors too unwilling or too busy to teach that I learnt literally zero medicine in the entire 4 months.
Medicine was a slight improvement, mainly due to less than sociopathic personalities, but again, understaffing meant that every ward round was a business round, nothing was learnt, and the bulk of the job was still documentation and paperwork.
Now I'm in psycholiday, so my only hope to learn any medicine for F2 comes down to using my free time to basically revise.
So I'm basically told to just hang on in there, "it will get better", but I am struggling to see the evidence of that. From F1 all the way up to consultant level, it's once in a blue moon I see a doctor that actually seems to enjoy their job. I'm starting to think that for the older generation, they're so invested that since things have gone down hill they are just sticking it out until retirement, but for our generation, entering the NHS in it's current state, the only way you could convince yourself that this career is objectively better than x y z or being a doctor in another country is... basically... delusion?
Sit in your average doctor's mess up and down the country and what do you hear? Endless slagging off of the job, constant scheming of new careers or new ways to escape, doom and gloom predictions of the NHS falling apart in 5/10 years etc.
Whether the NHS survives, understaffing will only get worse, and to me that seems to be the root of almost all of these problems; no time for teaching, too pressured to spend enough time on individual patients to feel rewarded, everybody so stressed that even the best teams start to crack eventually.. And I can't see any reason to think that the government is going to change things, not for an extremely long time...
Now, if someone asks me whether or not to apply to medical school, I cannot think of a single reason to advise them to do this, heart of hearts I can only tell them to steer well clear, unless they have a very specific plan of a specialty to go into or a country to emigrate to where these problems don't ruin just about everything positive about the job.
I had started to feel some degree of excitement for the first time in a long time when applying for my F2 posts, but due to my experiences in that first rotation my score for teaching attendance brought my portfolio score down to such an extent that I once again have been handed my 150th choice job in a hospital I didn't particularly want to go to, doing three rotations I specifically wanted to avoid. I was told by the dean of my deanery that my score for teaching wouldn't matter so he wouldn't take my circumstances into consideration, this despite the fact that I have done literally every single e-learning module on the F1 curriculum to make up for it, and it made the difference between my 1st, and over 100th choice of jobs...
And the NHS wonders why more and more of us are leaving, lol.
Wow
Original post by Ciaran88
Just after making this thread I wrote to the BMA to ask them to investigate my ranking because I am really sick and tired of the way that all these new ranking systems in this job can completely screw you over and ignore your hard work. I doubt that anything will come of it but as far as I can tell I have a pretty objective argument: the difference between the way I was marked in my hospital and the way I would have been at another in this Trust meant the difference between my 150th and 1st choice job... In no world is that acceptable.
Gen med and gen surgery are the ones I'm dreading, these days these jobs seem to boil down to business rounds, TTOs and on calls so busy that you're basically just filling out a mental clerking pro forma and before you get a chance to actually think about a patient it's on to the next one while the Reg, or usually even just the consultant, comes along later to do the actual medicine.
I learnt nothing in these jobs as an F1 and I hear the same complaints from SHOs I know all over the place, I guess it's a bit of a cliché´but.. well.. They were the two rotations I constructed my job ranking (300+ jobs) around and I got both.
Thanks for your advice/thoughts though, I know that it's possible for many people to find their niche in this career without leaving the country, but I just think that it's getting more and more difficult. Levels of overstaffing can destroy the good in anything, I think you have to be very smart in order to find a career path that avoids that ever growing ****storm.
I know that I can finally escape and go and do what I actually want to do after F2 but it just feels like every single year I am convinced to stay just one year longer. I wanted to leave immediately after medschool, was convinced to hang on for F1, F1 was crap, convinced to hang on for F2 and like I say, not happy with my jobs at all.
I have just 100% lost faith in the system, I don't want to be a part of it at all. I have lots of plans outside of it but I am very impatient and the thought of another 12 months jumping through idiotic hoops, ticking useless portfolio boxes to make ignorant managers happy and so on is not filling me with much joy right now.
Work is ****, by and large work in the developed world is **** and is going to be **** because we are the people being squeezed in order to barely maintain economic growth (i.e. slow down decline as much as possible. I'm not disputing that, I know that quality of life is basically an irrelevance to the direction the western world is going now and I know that quality of life at work goes doubly so.
That said I think there are two specific issues that you also face if you work in the NHS. The fact that you're a doctor or nurse etc. means that ordinary people who genuinely do need help are always the ones that suffer if we fail to cope with stress or workload, that's an added pressure not every job has. Secondly, the fact that you're treating patients means that the wellbeing of staff is often considered secondary in importance, even though imo it directly affects performance and therefore patient care, so issues with stress and workload and problems with cultures on teams and in departments are just swept aside by so many at the top as not important.
Gen med and gen surgery are the ones I'm dreading, these days these jobs seem to boil down to business rounds, TTOs and on calls so busy that you're basically just filling out a mental clerking pro forma and before you get a chance to actually think about a patient it's on to the next one while the Reg, or usually even just the consultant, comes along later to do the actual medicine.
I learnt nothing in these jobs as an F1 and I hear the same complaints from SHOs I know all over the place, I guess it's a bit of a cliché´but.. well.. They were the two rotations I constructed my job ranking (300+ jobs) around and I got both.
Thanks for your advice/thoughts though, I know that it's possible for many people to find their niche in this career without leaving the country, but I just think that it's getting more and more difficult. Levels of overstaffing can destroy the good in anything, I think you have to be very smart in order to find a career path that avoids that ever growing ****storm.
I know that I can finally escape and go and do what I actually want to do after F2 but it just feels like every single year I am convinced to stay just one year longer. I wanted to leave immediately after medschool, was convinced to hang on for F1, F1 was crap, convinced to hang on for F2 and like I say, not happy with my jobs at all.
I have just 100% lost faith in the system, I don't want to be a part of it at all. I have lots of plans outside of it but I am very impatient and the thought of another 12 months jumping through idiotic hoops, ticking useless portfolio boxes to make ignorant managers happy and so on is not filling me with much joy right now.
Work is ****, by and large work in the developed world is **** and is going to be **** because we are the people being squeezed in order to barely maintain economic growth (i.e. slow down decline as much as possible. I'm not disputing that, I know that quality of life is basically an irrelevance to the direction the western world is going now and I know that quality of life at work goes doubly so.
That said I think there are two specific issues that you also face if you work in the NHS. The fact that you're a doctor or nurse etc. means that ordinary people who genuinely do need help are always the ones that suffer if we fail to cope with stress or workload, that's an added pressure not every job has. Secondly, the fact that you're treating patients means that the wellbeing of staff is often considered secondary in importance, even though imo it directly affects performance and therefore patient care, so issues with stress and workload and problems with cultures on teams and in departments are just swept aside by so many at the top as not important.
I can't speak for general surgery as I've never worked in it as a doctor, but gen med was better for me as an SHO (FY2) than as an F1. Yes, a lot of it is the things you describe, but that's what medicine is, and if you get on with it and do those things well, there are things you can learn, and even if TTOs aren't educational they still make a difference to your patients. The clerking in particular is vital - my on-calls as med SHO were crazy busy but I enjoyed them so much more than my ward duties as I felt like I was actually contributing something, I was the first person to assess these patients properly, pick relevant investigations and start treatment - isn't that was medicine is all about? And if you want to do tropical medicine you surely need a degree of general medical experience?
Revenged has given some good advice about trying to swap/get a LAT - there are still options out there. Don't forget that not all hospitals are the same though, and particularly with umbrella specialties like gen med/surg, there can be a huge range of experiences.
Finally, I realise you are going to get defensive about this, but it seems I'm not the only one to have noticed this. I get the feeling from a lot of your posts (not just this thread) that you feel you are somehow "above" medicine in the UK, that none of the bad things that have happened are in any way related to what you have done, and that it's all Just So Unfair. I know you want to get out and practice tropical medicine elsewhere, and that's fine, but a degree of realism is necessary. Do you think that there won't be worse understaffing in some developing country hospital than there is here? Do you think that management won't be even more hierarchical and problems more entrenched? Do you think that you won't get sick of seeing malaria/yellow fever/whatever disease is endemic in that region? Until you manage to unravel what it is you like about medicine, which currently doesn't seem to be much because you're busy thinking how rubbish the UK is and how you can't wait to get out, I fear that you may continue to be disappointed in the work.
Original post by Helenia
Finally, I realise you are going to get defensive about this, but it seems I'm not the only one to have noticed this. I get the feeling from a lot of your posts (not just this thread) that you feel you are somehow "above" medicine in the UK, that none of the bad things that have happened are in any way related to what you have done, and that it's all Just So Unfair. I know you want to get out and practice tropical medicine elsewhere, and that's fine, but a degree of realism is necessary. Do you think that there won't be worse understaffing in some developing country hospital than there is here? Do you think that management won't be even more hierarchical and problems more entrenched? Do you think that you won't get sick of seeing malaria/yellow fever/whatever disease is endemic in that region? Until you manage to unravel what it is you like about medicine, which currently doesn't seem to be much because you're busy thinking how rubbish the UK is and how you can't wait to get out, I fear that you may continue to be disappointed in the work.
People seemed to try to tiptoe around this before now in the thread and I was readying myself to post something to the effect before I saw this elegant piece of prose before me.
The shortage is doctors which means less people are given sufficient healthcare is kind of lowering the reputation of doctors. Not their fault, but there just arent enough, and the NHS is importing foreign doctors to deal with it. I could never become a doctor. Everytime I hear the stories of a doctor saying a patient had minor illness like flu, and then you hear a few days later the patient passed away because they had cancer or something that wasnt found out. It just seems to scary!
Tropical medicine. How and where do you see yourself? In a non-tropical country just seeing what could be deemed to be ID / tropical medicine? Or in a tropical country? I work in a tropical country, as you know, and have been here for 3 years. Probably 80% of what I see here is not specifically tropical medicine. People here still get UTIs, bronchiolitis, ectopic pregnancies, acute psychosis... A LOT. Heart failure, strokes, diabetes, strangulated hernias... And actually, whilst treating malaria is interesting, and seeing patients with tetanus, and pneumonic plague and TB meningitis – there are still cannulas to do, huge number of TTOs to write, and a massive GP-style outpatients clinic every day, with precious little ‘interesting’ tropical medicine. I have to know gen med, gen surg, obs, paeds, psych, ortho, ophthalmo and more – equally. I currently do an old-style 1 in 3 on call at best, often 1 in 2 (=36 hours on, 12 off, lather rinse repeat) and regularly get shafted having to cover the rota at the very last minute Staffing is horrendous, resources are low and rationed. There is no teaching – I have no seniors here, therefore I have to do the same thing that you described doing this past year – reading and self teaching. By comparison the NHS is absolute luxury on all fronts. Yet I love the work, I really really do, despite all the difficulties. I wouldn’t change it for the world. (Even though sadly I’m going to have to, am coming back to the UK this autumn). It’s tough and it’s challenging. But I love medicine in general. And you have to. I found FY1 a real slog, I disliked it, I had the same moans and struggles as most other people and I regularly felt like a TTO machine. But not all days were bad. You seem to dislike it when you have a busy job, yet also when you have a quiet job? Busy job = plenty of acute clinical care to learn, even if sometimes you’re spinning plats and working long hours. Quiet job = get some audits done, do a poster, prepare for exams, generally do some CV building. Advantages and disadvantages to both, and you need to play them to your advantage. As someone else said, right now – learn some acute psychiatry! I never did a psych job and I regularly see acute psychiatry here in Africa that I’m dealing with on my own, and I wish I had paid a bit more attention in med school...
As others have said, you will certainly have sympathy from people here; many of us know what it’s like to have a tough and long first couple of years – we have been there, we have done it, most of us have lived to tell the tale. However, as you have found within these posts, there is a limit to which people will genuinely sympathise – you need to take some responsibility as well, suck up the bad times and get on with it, have a bit of a moan, sure, but not always make things other people’s problems. You seem desperately disgruntled with medicine as a whole, and I wonder if you have some slightly romanticised ideas about tropical medicine, I don’t see how suddenly everything is going to be better if / once you do tropical medicine. Surely doing gen med in FY2 is a good thing if you want to do tropical medicine, as this is the basis of tropical medicine, whichever country you study it in. I hear you that you’re having a tough time, and feeling very disillusioned about the whole thing. And that’s allowed. But I think you need to have a bit of a reality check, make some clear goals, some clear ideas, and be realistic about what it’s going to be like. The grass may not be that much greener...
As others have said, you will certainly have sympathy from people here; many of us know what it’s like to have a tough and long first couple of years – we have been there, we have done it, most of us have lived to tell the tale. However, as you have found within these posts, there is a limit to which people will genuinely sympathise – you need to take some responsibility as well, suck up the bad times and get on with it, have a bit of a moan, sure, but not always make things other people’s problems. You seem desperately disgruntled with medicine as a whole, and I wonder if you have some slightly romanticised ideas about tropical medicine, I don’t see how suddenly everything is going to be better if / once you do tropical medicine. Surely doing gen med in FY2 is a good thing if you want to do tropical medicine, as this is the basis of tropical medicine, whichever country you study it in. I hear you that you’re having a tough time, and feeling very disillusioned about the whole thing. And that’s allowed. But I think you need to have a bit of a reality check, make some clear goals, some clear ideas, and be realistic about what it’s going to be like. The grass may not be that much greener...
(edited 9 years ago)
Original post by Helenia
Finally, I realise you are going to get defensive about this, but it seems I'm not the only one to have noticed this. I get the feeling from a lot of your posts (not just this thread) that you feel you are somehow "above" medicine in the UK
Finally, I realise you are going to get defensive about this, but it seems I'm not the only one to have noticed this. I get the feeling from a lot of your posts (not just this thread) that you feel you are somehow "above" medicine in the UK
Not sure how one can feel "above it" I simply have lost faith in it for myself.
I don't need anyone to reassure me that my first rotation was a complete disaster, the department I was working in is now being gradually shut down ... The fact that the difficulties it created in just one aspect of my portfolio made the difference between my 1st and 150th choice of jobs is also not something I need anyone to reassure me is ok to feel pissed about - it is.
My only reason for making this thread is I am trying to find a reason to bother anymore. The same box ticking bullcrap has completely taken over training, even consultants are being roped into it, and understaffing isn't an isolated issue that is going to go away, it's the future. So why should I expect any better of the future?
If in medicine, why in the UK? That's why I mention the UK specifically.
I'm genuinely worried about how little I care about this job anymore. I have gone from having my post-grad training planned out and being on the verge of booking my MRCP Part 1, to literally not wanting to spend a single moment of my life more than I have to doing anything related to medicine. I feel completely claustrophobic in this world, and with good reason imo, whenever you criticise it the finger tends to end up getting pointed back at you, such a cliché reaction for doctors - whether it's raising issues of unsafe understaffing at work, or just pointing out how **** some things are on here.
I suppose it's obligatory I take some form of blame for the fact that I have hated the last year? Well how about this, I know that everything I have described is nothing unique, I can think of numerous people that I know alone, around the country, who have had similar experiences - by this point, it's pretty standard. They're not as desperately sick of it as I am, granted I am a lot less patient than most people, but I also think there is a real risk that people who defer their frustrations to later in life will find it bites them in the ass a lot harder.
If you enjoy your job, great, that's all that matters, I am not going to criticise anyone for it, I wish I was like you. But I know a hell of a lot of doctors who tell themselves that they would love to do this or that other thing with their life because they're sick of this grind but they're been convinced to hold on for this or that qualification so that they've got it "in the bag" "just in case" (as careers advisers in the NHS recite).
Maybe that's right, maybe if I leave to do something else and it fails then I will end up screwed because I left too early, but on the flip side, what happens when you get to 65 and you look back and realise the boat has sailed? All I know is that my personality = I can't suck it up for very long and probably I will take the risk, at the point I am just trying to figure out if I even want medicine to be a part of it at all, I want to be able to see past all the cynicism that the last year has put in me so that I can possibly salvage some of the career I spent the last 5 years working for rather than starting completely from scratch.
(edited 9 years ago)
Original post by Ciaran88
Not sure how one can feel "above it" I simply have lost faith in it for myself.
I don't need anyone to reassure me that my first rotation was a complete disaster, the department I was working in is now being gradually shut down ... The fact that the difficulties it created in just one aspect of my portfolio made the difference between my 1st and 150th choice of jobs is also not something I need anyone to reassure me is ok to feel pissed about - it is.
My only reason for making this thread is I am trying to find a reason to bother anymore. The same box ticking bullcrap has completely taken over training, even consultants are being roped into it, and understaffing isn't an isolated issue that is going to go away, it's the future. So why should I expect any better of the future?
If in medicine, why in the UK? That's why I mention the UK specifically.
I'm genuinely worried about how little I care about this job anymore. I have gone from having my post-grad training planned out and being on the verge of booking my MRCP Part 1, to literally not wanting to spend a single moment of my life more than I have to doing anything related to medicine. I feel completely claustrophobic in this world, and with good reason imo, whenever you criticise it the finger tends to end up getting pointed back at you, such a cliché reaction for doctors - whether it's raising issues of unsafe understaffing at work, or just pointing out how **** some things are on here.
I suppose it's obligatory I take some form of blame for the fact that I have hated the last year? Well how about this, I know that everything I have described is nothing unique, I can think of numerous people that I know alone, around the country, who have had similar experiences - by this point, it's pretty standard. They're not as desperately sick of it as I am, granted I am a lot less patient than most people, but I also think there is a real risk that people who defer their frustrations to later in life will find it bites them in the ass a lot harder.
If you enjoy your job, great, that's all that matters, I am not going to criticise anyone for it, I wish I was like you. But I know a hell of a lot of doctors who tell themselves that they would love to do this or that other thing with their life because they're sick of this grind but they're been convinced to hold on for this or that qualification so that they've got it "in the bag" "just in case" (as careers advisers in the NHS recite).
Maybe that's right, maybe if I leave to do something else and it fails then I will end up screwed because I left too early, but on the flip side, what happens when you get to 65 and you look back and realise the boat has sailed? All I know is that my personality = I can't suck it up for very long and probably I will take the risk, at the point I am just trying to figure out if I even want medicine to be a part of it at all, I want to be able to see past all the cynicism that the last year has put in me so that I can possibly salvage some of the career I spent the last 5 years working for rather than starting completely from scratch.
I don't need anyone to reassure me that my first rotation was a complete disaster, the department I was working in is now being gradually shut down ... The fact that the difficulties it created in just one aspect of my portfolio made the difference between my 1st and 150th choice of jobs is also not something I need anyone to reassure me is ok to feel pissed about - it is.
My only reason for making this thread is I am trying to find a reason to bother anymore. The same box ticking bullcrap has completely taken over training, even consultants are being roped into it, and understaffing isn't an isolated issue that is going to go away, it's the future. So why should I expect any better of the future?
If in medicine, why in the UK? That's why I mention the UK specifically.
I'm genuinely worried about how little I care about this job anymore. I have gone from having my post-grad training planned out and being on the verge of booking my MRCP Part 1, to literally not wanting to spend a single moment of my life more than I have to doing anything related to medicine. I feel completely claustrophobic in this world, and with good reason imo, whenever you criticise it the finger tends to end up getting pointed back at you, such a cliché reaction for doctors - whether it's raising issues of unsafe understaffing at work, or just pointing out how **** some things are on here.
I suppose it's obligatory I take some form of blame for the fact that I have hated the last year? Well how about this, I know that everything I have described is nothing unique, I can think of numerous people that I know alone, around the country, who have had similar experiences - by this point, it's pretty standard. They're not as desperately sick of it as I am, granted I am a lot less patient than most people, but I also think there is a real risk that people who defer their frustrations to later in life will find it bites them in the ass a lot harder.
If you enjoy your job, great, that's all that matters, I am not going to criticise anyone for it, I wish I was like you. But I know a hell of a lot of doctors who tell themselves that they would love to do this or that other thing with their life because they're sick of this grind but they're been convinced to hold on for this or that qualification so that they've got it "in the bag" "just in case" (as careers advisers in the NHS recite).
Maybe that's right, maybe if I leave to do something else and it fails then I will end up screwed because I left too early, but on the flip side, what happens when you get to 65 and you look back and realise the boat has sailed? All I know is that my personality = I can't suck it up for very long and probably I will take the risk, at the point I am just trying to figure out if I even want medicine to be a part of it at all, I want to be able to see past all the cynicism that the last year has put in me so that I can possibly salvage some of the career I spent the last 5 years working for rather than starting completely from scratch.
I definitely see your point and agree with you. Honestly, if you don't like it, just leave. No point complaining about it. Medicine is painful, and we all know that. Why go through the pain if you don't enjoy it? You only live once.
But, remember that doing other forms of work outside of medicine aren't a walk in the park either. If you want a decent career with decent compensation, be prepared to work
(edited 9 years ago)
Original post by Ciaran88
x
Have you considered other options in detail and looked into how you would go about extricating yourself from your current contract? Like I said above quitting a job is rarely so simple and the last thing you want is the NHS suing you for breach of your employment contract, an option which is all too easy for them given how their legal teams work.
With regard to other options get in contact with your old uni careers service, I imagine you have had absolutely negligible contact with them during your time there for obvious reasons (most medics career paths are pretty uncomplicated and careers stuff is handled internally by med school) but they're usually pretty good and often stay open to graduates for a further 2 years (call me cynical but coincidentally the last time figures on employment for grads are taken). They will be able to help you with both exploring the other options that are out there and then help you with CVs and covering letters, the former of which you would otherwise have no help with and you'd have to pay for some chinny from your preferred field for comparable help with the latter. On top of this many will also have contcts with businesses for internships which are specifically targetted at their grads. Obviously the world of unpaid internships and crazy grad application stats isn't a particularly great one to be launching into, but it's probably worth it if a career in medicine at this point is likely to make you miserable for life.
Original post by shahbaz
Bare dollar.
Nah brah, most docs can barely afford a decent timepiece.
It is very easy to leave the foundation programme, many doctors leave, you just need a month notice but the hospital trust will make you work it !
Core medical training may not be for you if you are not enjoying foundation programme. Core medical training is interesting but it and core surgical have very well known problems with poor training that continue into higher speciality training. The BMA is currently renegotiation the junior doctor contract so it may change for the better and training is a big issue at the moment in CMT. The likely worst case is junior doctors are made to work longer hours with more hoop-jump style 'compulsory learning' with larger portfolios and ever more ridiculous reflection requirments (GP trainees have to do a 'reflection' every week in their 'diaries' ! ) Worse case I am expecting is current trainees are forced to work all the gaps in rota to safe the hospital money on locums. I am not sure the BMA will win for us.
That said there are some lovely jobs in the NHS and you have to search for them. I found the national survey quite helpful, particularly the range in satisfaction of trainees. It show that ST4+ have the highest satisfaction, followed by core trainees, lastly foundation trainees (which have the lowest) - so it does get better! Also GP / anaesthetic / pathologist / psychiatrist trainees - all rank quite well and are superior in satisfaction to core surgical and core medical linger on the bottom.
http://www.gmc-uk.org/National_training_survey_key_findings_report_2013.pdf_52299037.pdf
GL
Core medical training may not be for you if you are not enjoying foundation programme. Core medical training is interesting but it and core surgical have very well known problems with poor training that continue into higher speciality training. The BMA is currently renegotiation the junior doctor contract so it may change for the better and training is a big issue at the moment in CMT. The likely worst case is junior doctors are made to work longer hours with more hoop-jump style 'compulsory learning' with larger portfolios and ever more ridiculous reflection requirments (GP trainees have to do a 'reflection' every week in their 'diaries' ! ) Worse case I am expecting is current trainees are forced to work all the gaps in rota to safe the hospital money on locums. I am not sure the BMA will win for us
.That said there are some lovely jobs in the NHS and you have to search for them. I found the national survey quite helpful, particularly the range in satisfaction of trainees. It show that ST4+ have the highest satisfaction, followed by core trainees, lastly foundation trainees (which have the lowest) - so it does get better! Also GP / anaesthetic / pathologist / psychiatrist trainees - all rank quite well and are superior in satisfaction to core surgical and core medical linger on the bottom.
http://www.gmc-uk.org/National_training_survey_key_findings_report_2013.pdf_52299037.pdf
GL
(edited 9 years ago)
Original post by Ciaran88
Not sure how one can feel "above it" I simply have lost faith in it for myself.
I don't need anyone to reassure me that my first rotation was a complete disaster, the department I was working in is now being gradually shut down ... The fact that the difficulties it created in just one aspect of my portfolio made the difference between my 1st and 150th choice of jobs is also not something I need anyone to reassure me is ok to feel pissed about - it is.
My only reason for making this thread is I am trying to find a reason to bother anymore. The same box ticking bullcrap has completely taken over training, even consultants are being roped into it, and understaffing isn't an isolated issue that is going to go away, it's the future. So why should I expect any better of the future?
If in medicine, why in the UK? That's why I mention the UK specifically.
I'm genuinely worried about how little I care about this job anymore. I have gone from having my post-grad training planned out and being on the verge of booking my MRCP Part 1, to literally not wanting to spend a single moment of my life more than I have to doing anything related to medicine. I feel completely claustrophobic in this world, and with good reason imo, whenever you criticise it the finger tends to end up getting pointed back at you, such a cliché reaction for doctors - whether it's raising issues of unsafe understaffing at work, or just pointing out how **** some things are on here.
I suppose it's obligatory I take some form of blame for the fact that I have hated the last year? Well how about this, I know that everything I have described is nothing unique, I can think of numerous people that I know alone, around the country, who have had similar experiences - by this point, it's pretty standard. They're not as desperately sick of it as I am, granted I am a lot less patient than most people, but I also think there is a real risk that people who defer their frustrations to later in life will find it bites them in the ass a lot harder.
If you enjoy your job, great, that's all that matters, I am not going to criticise anyone for it, I wish I was like you. But I know a hell of a lot of doctors who tell themselves that they would love to do this or that other thing with their life because they're sick of this grind but they're been convinced to hold on for this or that qualification so that they've got it "in the bag" "just in case" (as careers advisers in the NHS recite).
Maybe that's right, maybe if I leave to do something else and it fails then I will end up screwed because I left too early, but on the flip side, what happens when you get to 65 and you look back and realise the boat has sailed? All I know is that my personality = I can't suck it up for very long and probably I will take the risk, at the point I am just trying to figure out if I even want medicine to be a part of it at all, I want to be able to see past all the cynicism that the last year has put in me so that I can possibly salvage some of the career I spent the last 5 years working for rather than starting completely from scratch.
I don't need anyone to reassure me that my first rotation was a complete disaster, the department I was working in is now being gradually shut down ... The fact that the difficulties it created in just one aspect of my portfolio made the difference between my 1st and 150th choice of jobs is also not something I need anyone to reassure me is ok to feel pissed about - it is.
My only reason for making this thread is I am trying to find a reason to bother anymore. The same box ticking bullcrap has completely taken over training, even consultants are being roped into it, and understaffing isn't an isolated issue that is going to go away, it's the future. So why should I expect any better of the future?
If in medicine, why in the UK? That's why I mention the UK specifically.
I'm genuinely worried about how little I care about this job anymore. I have gone from having my post-grad training planned out and being on the verge of booking my MRCP Part 1, to literally not wanting to spend a single moment of my life more than I have to doing anything related to medicine. I feel completely claustrophobic in this world, and with good reason imo, whenever you criticise it the finger tends to end up getting pointed back at you, such a cliché reaction for doctors - whether it's raising issues of unsafe understaffing at work, or just pointing out how **** some things are on here.
I suppose it's obligatory I take some form of blame for the fact that I have hated the last year? Well how about this, I know that everything I have described is nothing unique, I can think of numerous people that I know alone, around the country, who have had similar experiences - by this point, it's pretty standard. They're not as desperately sick of it as I am, granted I am a lot less patient than most people, but I also think there is a real risk that people who defer their frustrations to later in life will find it bites them in the ass a lot harder.
If you enjoy your job, great, that's all that matters, I am not going to criticise anyone for it, I wish I was like you. But I know a hell of a lot of doctors who tell themselves that they would love to do this or that other thing with their life because they're sick of this grind but they're been convinced to hold on for this or that qualification so that they've got it "in the bag" "just in case" (as careers advisers in the NHS recite).
Maybe that's right, maybe if I leave to do something else and it fails then I will end up screwed because I left too early, but on the flip side, what happens when you get to 65 and you look back and realise the boat has sailed? All I know is that my personality = I can't suck it up for very long and probably I will take the risk, at the point I am just trying to figure out if I even want medicine to be a part of it at all, I want to be able to see past all the cynicism that the last year has put in me so that I can possibly salvage some of the career I spent the last 5 years working for rather than starting completely from scratch.
Look, I don't know you, and I haven't worked in the places you have, so I don't have the same insight into your situation that you do - obviously. What I was trying to get across is that over time there has been an undertone of arrogance in some of your posts - not just this thread - that you perhaps don't realise but which may be coming across at work and causing trouble for you when you try to (quite rightly) blow the whistle on unsafe staffing etc. I don't know for sure if that's true, or if there's anything can be done about it, but it's worth thinking about how you're presenting yourself to people. I've seen how nurses etc can move mountains for one F1/SHO who is polite, listens to them etc, but will deliberately make life more difficult for those they perceive to be cocky. The cocky ones probably don't realise this is going on, and think the nurses are being stupid/difficult, which makes them ruder, and the cycle perpetuates. I have accidentally done it myself and had to work hard to rectify the relationship.
You are obviously very unhappy, and nobody here is telling you that's not valid or that being an FY1 doesn't sometimes suck. But you asked us to tell you what's good about medicine - we've tried to do that! If you really want to get out, it's up to you how solid you want your exit strategy to be. I, and others, have previously told you why we think it's worthwhile getting through FY2, but if you don't think it's worth it then it's your career and your decision. I don't think any of us have told you to stay on beyond that if it's really not what you want, so your talk of getting to 65 is not really necessary.
Have you talked to anyone about how you're feeling? Not necessarily about the job, but from a mental health point of view.
Are you a member of DNUK? There is a forum on there called "The Couch" which you might find helpful - you'll get advice from lots of experienced people, both about careers and about how to survive the job at the moment.
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