Med3
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#1
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#1
As a junior
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Democracy
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#2
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#2
(Original post by Med3)
As a junior
I really enjoyed it and would happily recommend it - I think the skills and general experience you gain will be useful whatever specialty you end up going into.

I also liked that there weren't many early starts, no 12.5 hour shifts, and no real bleep (just the CDU bleep but that doesn't really count). I was fortunate enough to work with a very good consultant and nursing/HCA team, so that was another positive.

Are you asking for yourself? If you give us some more info, you might get more specific replies.
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Med3
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#3
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#3
(Original post by Democracy)
I really enjoyed it and would happily recommend it - I think the skills and general experience you gain will be useful whatever specialty you end up going into.

I also liked that there weren't many early starts, no 12.5 hour shifts, and no real bleep (just the CDU bleep but that doesn't really count). I was fortunate enough to work with a very good consultant and nursing/HCA team, so that was another positive.

Are you asking for yourself? If you give us some more info, you might get more specific replies.
Im a 3rd year medical student, trying to get insight into more specialties but i always hear negativity about A+E but it looks really interesting
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Democracy
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#4
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#4
(Original post by Med3)
Im a 3rd year medical student, trying to get insight into more specialties but i always hear negativity about A+E but it looks really interesting
I think most of the negativity stems from the SHO rota (in particular) which is demanding but personally I far preferred doing A&E shifts to medical on calls.

Give it a go and see what you think Even if you go into something completely different the skills you learn will still be relevant.
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Angury
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#5
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#5
(Original post by Med3)
As a junior
Agree with Democracy, you should give it a go. If your medical school doesn't offer A&E placements you can often do SSCs etc and shadow clinicians in A&E. It's also worth doing as an F2 (imo).

I did a four month rotation in A&E in F2 and it was one of my favourite jobs. I learnt more on that job that I did in any other during Foundation training. I loved the independence (which is why I'd recommend doing it in F2 rather than F1) and the breadth of 'cases' that you see. I also felt like I was using my knowledge and skills as a doctor - something that wasn't true of most of my other jobs at the time. It was also a great experience in learning how to manage acutely unwell patients and particularly trauma cases which I hadn't had experience of before. One of the more fascinating insights for me also came from dealing with people who literally walked off the street to attend A&E i.e. hadn't been 'filtered' through someone else (like you get when you're working on a ward for example). It's interesting to see what the general public expect from medicine in general and they assume we can do.

Definitely get involved and put yourself out there. If anything, it will be a great learning experience and really boosted my confidence as a doctor. I'm now working in Psychiatry but those skills have been invaluable.
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nexttime
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#6
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#6
(Original post by Med3)
Im a 3rd year medical student, trying to get insight into more specialties but i always hear negativity about A+E but it looks really interesting
I've not actually worked as an A&E junior myself, but can relay what I get told:

- Rota can be brutal, with lots of your own time spent trying to adjust sleep patterns to rapidly cycling early, late and night shifts. BUT, generally no 13 hour shifts.
- Dealing with people as they come in can be very exciting or very stressful, depending on who you ask.
- Lots of psych
- The team plays a HUGE part - seemingly moreso than in other specialities. If you have a bad team it can be hell, if you have a good team it can feel like you're actually in it together working against the elements to achieve something, which I don't know about you but to me seems pretty alien to anywhere else in the hospital!
- Lots of people come out of it saying they learned loads. I definitely think it should be mandatory in F1/2

Its classically a thing you're interested in in med school/early years then grow out of when you realise how much you hate having to rotate sleep all the time. But plenty of people love it so don't let me put you off. Do you have any optional placements? Would your hospital let you just pitch up to A&E and clerk when the wards are quiet? If you are interested I'd encourage approaching an ED consultant to ask them about it and how to find out more.
Last edited by nexttime; 2 years ago
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Democracy
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#7
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#7
I did my elective in A&E so that's something else you can consider doing if you want to get more exposure to the job.
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Etomidate
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#8
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#8
I’ve worked on both the SHO and registrar rotas and I have to say both are pretty miserable and it’s very department dependent. Contrary to the above, there are 12.5hr A&E shifts and they are awful.

It’s almost always a 1 in 2 weekend rota with lots of weird shift patterns and alternations. The rotas are designed purely for the convenience of the department and will be at the expense of your quality of life. If your family/friends work 9-5, you will regularly go weeks without seeing them.

The work is relentless and there is zero downtime during shifts which is unlike most other specialties. You will be expected to make lots of decisions on a rapid basis for the entirety of the shift.

The upside is you learn a huge amount about everything. There’s lots of practical things to do and plenty of sick people to see.

For me, personally, I think it’s a good specialty to rotate through but isn’t sustainable as a career, especially as conditions are visibly worsening each year. Every other specialty thinks you’re a bumbling fool and rarely appreciate the real nature of an emergency department. Your life will be at the mercy of 9-4 rota admin workers and you will be treated like a shift worker and not a professional.

Tl;dr - good as a rotation, bad as a career.
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Democracy
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#9
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#9
(Original post by Etomidate)
I’ve worked on both the SHO and registrar rotas and I have to say both are pretty miserable and it’s very department dependent. Contrary to the above, there are 12.5hr A&E shifts and they are awful.

It’s almost always a 1 in 2 weekend rota with lots of weird shift patterns and alternations. The rotas are designed purely for the convenience of the department and will be at the expense of your quality of life. If your family/friends work 9-5, you will regularly go weeks without seeing them.

The work is relentless and there is zero downtime during shifts which is unlike most other specialties. You will be expected to make lots of decisions on a rapid basis for the entirety of the shift.

The upside is you learn a huge amount about everything. There’s lots of practical things to do and plenty of sick people to see.

For me, personally, I think it’s a good specialty to rotate through but isn’t sustainable as a career, especially as conditions are visibly worsening each year. Every other specialty thinks you’re a bumbling fool and rarely appreciate the real nature of an emergency department. Your life will be at the mercy of 9-4 rota admin workers and you will be treated like a shift worker and not a professional.

Tl;dr - good as a rotation, bad as a career.
I thought these had long been phased out. Oh dear.
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Med3
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#10
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#10
Do people ever take locum A+E shifts whilst working as a registrar in another specialty?
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ForestCat
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#11
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#11
(Original post by Democracy)
I thought these had long been phased out. Oh dear.
Nope. Particularly on weekends including a delightful 12-12
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Chief Wiggum
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#12
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#12
(Original post by Med3)
Do people ever take locum A+E shifts whilst working as a registrar in another specialty?
Some people do, yes.
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nexttime
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#13
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#13
(Original post by Med3)
Do people ever take locum A+E shifts whilst working as a registrar in another specialty?
Yes definitely. I knew one ortho reg who was on minors pretty much every weekend!

Edit: I missed the 'as a registrar' bit - yes, but its pretty unusual.
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Helenia
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#14
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#14
(Original post by Med3)
Do people ever take locum A+E shifts whilst working as a registrar in another specialty?
Yes, though not hugely common - much more usual to locum in your own specialty.
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notespad
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#15
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#15
I did A&E as an FY2 and now rotating through as a CT1 (ACCS)

It has been the best placement I've had by far (I've rotated around adult medicine and surgery, as well as GP). Excellent senior support, clinical variety and a very social speciality (I feel that because the team is within a close proximity to each other when working, conversation etc. flows much easier between the team). The only negative for me is that the rota is not great in terms of intensity. I do not mind the anti-social hours (many twilights etc.) because I get to miss traffic, but I can see how it's a problem if you have school children etc. BTW we do max 10 hour A&E shifts in my trust - which is so much better than the 12.5 medical on-calls (especially in terms of sleep/recuperating post-shift).

Days before my FY2 post, I regretted picking A&E as a post, but I'm glad I did it.
Last edited by notespad; 2 years ago
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notespad
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#16
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#16
(Original post by Med3)
Do people ever take locum A+E shifts whilst working as a registrar in another specialty?
Four in my current dept (T&O, GP x2, medicine) - they all very much enjoy A&E, hence why they do this (i.e. not solely for the $$)
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Med3
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#17
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#17
Thanks for all the replies guys its interesting to hear peoples experiences
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Hype en Ecosse
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#18
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#18
(Original post by Etomidate)
I’ve worked on both the SHO and registrar rotas and I have to say both are pretty miserable and it’s very department dependent. Contrary to the above, there are 12.5hr A&E shifts and they are awful.

It’s almost always a 1 in 2 weekend rota with lots of weird shift patterns and alternations. The rotas are designed purely for the convenience of the department and will be at the expense of your quality of life. If your family/friends work 9-5, you will regularly go weeks without seeing them.

The work is relentless and there is zero downtime during shifts which is unlike most other specialties. You will be expected to make lots of decisions on a rapid basis for the entirety of the shift.

The upside is you learn a huge amount about everything. There’s lots of practical things to do and plenty of sick people to see.

For me, personally, I think it’s a good specialty to rotate through but isn’t sustainable as a career, especially as conditions are visibly worsening each year. Every other specialty thinks you’re a bumbling fool and rarely appreciate the real nature of an emergency department. Your life will be at the mercy of 9-4 rota admin workers and you will be treated like a shift worker and not a professional.

Tl;dr - good as a rotation, bad as a career.
I'm about to start my 3rd shift in A&E today, and already feel this. I have enjoyed my time so far, but quickly see myself getting burned out with it!

Had a mental day yesterday, which very much made me sympathise with one of my colleagues who likened the A&E department to the Gaza strip.
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RetiredAccount89
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#19
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#19
(Original post by Etomidate)
I’ve worked on both the SHO and registrar rotas and I have to say both are pretty miserable and it’s very department dependent. Contrary to the above, there are 12.5hr A&E shifts and they are awful.

It’s almost always a 1 in 2 weekend rota with lots of weird shift patterns and alternations. The rotas are designed purely for the convenience of the department and will be at the expense of your quality of life. If your family/friends work 9-5, you will regularly go weeks without seeing them.

The work is relentless and there is zero downtime during shifts which is unlike most other specialties. You will be expected to make lots of decisions on a rapid basis for the entirety of the shift.

The upside is you learn a huge amount about everything. There’s lots of practical things to do and plenty of sick people to see.

For me, personally, I think it’s a good specialty to rotate through but isn’t sustainable as a career, especially as conditions are visibly worsening each year. Every other specialty thinks you’re a bumbling fool and rarely appreciate the real nature of an emergency department. Your life will be at the mercy of 9-4 rota admin workers and you will be treated like a shift worker and not a professional.

Tl;dr - good as a rotation, bad as a career.
"I’ve worked on both the SHO and registrar rotas and I have to say both are pretty miserable and it’s very department dependent. Contrary to the above, there are 12.5hr A&E shifts and they are awful."

12hr shifts are increasingly rare now and all but vanished. I'm sure some weekend 12hr shifts will remain esp over next few years

"It’s almost always a 1 in 2 weekend rota with lots of weird shift patterns and alternations. "

The new junior doctor contract rules mean that in the next 18 months all departments should have a maximum of 1 in 3 weekend frequency. My department will have that by Aug 2020.

"The work is relentless and there is zero downtime during shifts which is unlike most other specialties. You will be expected to make lots of decisions on a rapid basis for the entirety of the shift. "
Yes, you actually have to both work and think in Emergency Medicine. True enough.

"For me, personally, I think it’s a good specialty to rotate through but isn’t sustainable as a career, especially as conditions are visibly worsening each year. Every other specialty thinks you’re a bumbling fool and rarely appreciate the real nature of an emergency department. Your life will be at the mercy of 9-4 rota admin workers and you will be treated like a shift worker and not a professional."
Not sure its true that conditions are visibly worsening every year. I've been doing it 10 years now and whilst certain parts are more demanding, others are less so. Juniors now get lot more SPA time, lots more protection around hours, compensation when straying outside that etc. The old diary card exercises were a joke by comparison.
As for the 9-4 rota admin workers. Most rota admin guys I have worked with have been pretty on it and in many places it is ED seniors who deal with the rota. Like me, I do my rotas. It is rather painful but absolutely necessary to have somneone who has lived the rotas doing them.

I pity my medical colleagues (Esp med regs) who finish their overnight shift only to then have to muck about doing post take ward rounds for 3 blooming hours.

Heck no. Handover 30mins starts, I handover, I'm gone. Same with my juniors.
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RetiredAccount89
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#20
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#20
(Original post by Hype en Ecosse)
I'm about to start my 3rd shift in A&E today, and already feel this. I have enjoyed my time so far, but quickly see myself getting burned out with it!

Had a mental day yesterday, which very much made me sympathise with one of my colleagues who likened the A&E department to the Gaza strip.
As with other jobs (but poss to a greater degree due to the variety of different conditions you see) the first few months are extremely taxing. Utter mental exhaustion. Decision fatigue. Feeling like a failure for constantly having to get advice. But its all because you are actually doing proper doctoring, not shuffling papers and ordering tests.

As for getting burned out - I would compare with driving. Think how you felt after those firs tfew driving lessons. Or heck the first few big road trips after you pass you test. And then compare with a few years down the line. Very different story.

[above only works for those who have been driving a few years...]
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