My second year in the NHS
This blog is more of a reflection of my experience in the NHS in the past 2 years.
So basically, do whatever you can to help discharge patients faster, help your colleagues and nursing staff. When you work in the NHS for more than a year, you actually care for it and want to save it- Be part of the amazing team who will save the best healthcare in the world from collapsing.
I have seen a lot of international medical graduates change - I am in touch with people when they start preparing for their PLAB exams and see them mature and become amazing doctors in the NHS.
Never ever think that you are not wanted - you are the most important person not matter what your experience is. You should value yourself and stay positive.
Just remember - you are not alone and if I can do it, so can you. You are not a foreigner- You are part of the best healthcare system in the world and you are not only here to train but to save it. But also remember to enjoy - you can only enjoy if you have planned ahead and are mentally relaxed.
I came to the UK in January 2016 and work as a trust grade SHO in Slough. I did my ALS, gave my MRCP 2 and applied for core medical training in March, 2017 in round 2 and I started working as a Core Medical Trainee in Harrogate from August 2017.
I have spent 2 years in the NHS and have learnt a lot. My experience has been amazing and I have no regrets of coming to the UK.
I have spent 2 years in the NHS and have learnt a lot. My experience has been amazing and I have no regrets of coming to the UK.
This is what I achieved in my 18 months as a non trainee doctor:
1. Passed ALS
2. Passed MRCP 2
3. Got my drivers licence (Which is more difficult than any exam I have given)
4. Participated in and presented an audit
5. Did MSFs, MCRs, ACATs, CBDs, reflections via my e portfolio.
6. Attended core medical trainee simulation training sessions for lumbar punctures, ascitic drains, central line insertions, knee aspiration and chest drain insertions.
7. Lead 2 CRASH calls.
Personally I felt that I was almost ready for a registrar post after working at this however I wanted more experience so therefore I decided to go for core medical training to allow me more time to work on my skills and strengthen by portfolio.
So I started as a CT1 in Harrogate. It has been 6 months and this is what I have achieved:
1. Updated my e portfolio on a regular basis
2. Done respiratory procedures multiple times and I am signed off for all procedures including diagnostic pleural aspiration, rocket drain insertion for plueral aspriation, chest drain insertions for effusion and pneumothorax.
3. Presented at a conference.
4. Done ascitic drains and lumbar punctures.
5. I am currently working with the IT team of the hospital on an electronic handover which is also include patients results, letters, etc.
6. I am doing 2 audits.
7. Taught medical students.
8. Already filled 50 % of my a portfolio and have met most of the curriculum's requirements.
9. Attended simulation training for procedures ST3 medical doctors should know- like drains, lumbar punctures, etc.
Overall, I feel I have achieved as much as my British medical graduate colleagues.
I feel very confident now and I actually look forward to work everyday.
I have not only achieved a reasonable amount as a doctor but I have explored a lot of the UK- I have driven around 20,000 miles since I came here in January, 2016 (in the past 2 years).
When I was working in Slough, I used to go to London almost every weekend - I have seen every park, museum, tried every cuisine, been to all the popular theaters and seen all sorts of celebrations in London (New Years Eve being the best experience).
I have explored the tourist spots around it as well - Windsor, Surrey, Brighton, beaches in the south, etc.
I have also driven to Wales with a group of friends.
While living in Harrogate, I have visited most of Yorkshire and my wife and I will be able to see most of it by the end of this year.
I have seen almost every new movie in the cinema.
This too, is very important.
Working in the UK has also taught me a lot about my international medical graduate colleagues. Initially when they come to the UK, they are all very confused and shy. They do not speak up and some of them work alone and do not socialize a lot. I can understand that this is very hard for some people - coming to a new country, working in a new system without family or support. But slowly they start making friends. They get appreciated for their hard work and they become more confident. It takes a few weeks for some, a few months for others but by one year most international medical graduate doctors are at par with their British medical graduate colleagues in terms of experience and skills.
Some do remain confused and they are the ones who struggle the most - However they eventually find their way.
Some also discourage others from coming to the UK - most of these people are the ones who are struggling because of their personal circumstances and the decisions they have made (ie not given exams on time, keep changing jobs with the hope that the next job would be better when they have not settled in their first job, etc). However they learn with time too and settle in their lives.
Looking back at my own experience, I struggled initially as well. However I still remember my consultants words on my first day: "From today you are a junior doctor in the NHS - You are equal to everyone else. What you do from today onward is all in your hands".
That consultant was actually right - our future is in our hands. You can be outspoken, work hard, look at life positively, help others and you will see what an impact it makes in your everyday lives- You will become more confident, enjoy life more and have a good group of people whom you can call family. You will know that you are well settled when you wake up in the morning and look forward to work.
But I also understand when people cannot do the aforementioned things - I struggled when I changed my job and started working as a core medical trainee. However within one month I was well settled. So allow yourself some leeway- this is how we are but also try to change yourself.
Do remember to talk to the relevant teams if you have any issues. You will be surprised how much supportive your supervisors are. They are more like friends and they are happy to help you in any way and direct you to the right people if need be. Overall the NHS is like family. You may think you are an outsider (which will make everyone else think the same too) but if you believe that you are part of it (by being social and outspoken), you will be accepted easily. Once you become part of the family, then you will manage any where in any post at any time.
To understand how supportive our seniors are, read this blog made by a consultant:
https://sean9n.wordpress.com
The other issue which not only IMG doctors but British graduate doctors face in the UK is the current state of the NHS - due to political reasons there is understaffing in almost every post in every specialty, there is underfunding, junior doctors are overworked and less students are entering medical school. Everyone feels the brunt of this but we can all still work to save the collapsing NHS by:
1. Doing TTOs in advance.
2. Talking to families whenever they come to see the patient in order to get a complete collateral history to avoid delays in discharges.
3. Volunteering to do extra shifts by requesting the rota coordinator to inform you immediately when there is a gap in the rota to do as a locum shift.
4. Do loads of cannulations, basic procedures like NG tube insertions, ABGs, etc so that you do not have to call your seniors and colleagues to help you when you get stuck - allowing them to focus on discharging patients.
5. Make plans early - for example if you know that a patient is most probably due for a procedure like a lumbar puncture, ensure that a clotting has been done on admission.
6. At times there are no beds in the wards so patients accepted by a particular specialty may be in ED for longer - clerk patients accepted by your team in ED when you are part of the clerking team.
7. Help your colleagues whenever possible - if you are the clerking doctor but you see your ward cover colleagues struggle, offer to help. This will relieve their stress. Work as a team.
8. Sometimes the nursing staff can be very busy. Offer to do catheters, cannulations which they cannot do as they are still on their drug rounds. This will help ease the pressure off them.
1. Passed ALS
2. Passed MRCP 2
3. Got my drivers licence (Which is more difficult than any exam I have given)
4. Participated in and presented an audit
5. Did MSFs, MCRs, ACATs, CBDs, reflections via my e portfolio.
6. Attended core medical trainee simulation training sessions for lumbar punctures, ascitic drains, central line insertions, knee aspiration and chest drain insertions.
7. Lead 2 CRASH calls.
Personally I felt that I was almost ready for a registrar post after working at this however I wanted more experience so therefore I decided to go for core medical training to allow me more time to work on my skills and strengthen by portfolio.
So I started as a CT1 in Harrogate. It has been 6 months and this is what I have achieved:
1. Updated my e portfolio on a regular basis
2. Done respiratory procedures multiple times and I am signed off for all procedures including diagnostic pleural aspiration, rocket drain insertion for plueral aspriation, chest drain insertions for effusion and pneumothorax.
3. Presented at a conference.
4. Done ascitic drains and lumbar punctures.
5. I am currently working with the IT team of the hospital on an electronic handover which is also include patients results, letters, etc.
6. I am doing 2 audits.
7. Taught medical students.
8. Already filled 50 % of my a portfolio and have met most of the curriculum's requirements.
9. Attended simulation training for procedures ST3 medical doctors should know- like drains, lumbar punctures, etc.
Overall, I feel I have achieved as much as my British medical graduate colleagues.
I feel very confident now and I actually look forward to work everyday.
I have not only achieved a reasonable amount as a doctor but I have explored a lot of the UK- I have driven around 20,000 miles since I came here in January, 2016 (in the past 2 years).
When I was working in Slough, I used to go to London almost every weekend - I have seen every park, museum, tried every cuisine, been to all the popular theaters and seen all sorts of celebrations in London (New Years Eve being the best experience).
I have explored the tourist spots around it as well - Windsor, Surrey, Brighton, beaches in the south, etc.
I have also driven to Wales with a group of friends.
While living in Harrogate, I have visited most of Yorkshire and my wife and I will be able to see most of it by the end of this year.
I have seen almost every new movie in the cinema.
This too, is very important.
Working in the UK has also taught me a lot about my international medical graduate colleagues. Initially when they come to the UK, they are all very confused and shy. They do not speak up and some of them work alone and do not socialize a lot. I can understand that this is very hard for some people - coming to a new country, working in a new system without family or support. But slowly they start making friends. They get appreciated for their hard work and they become more confident. It takes a few weeks for some, a few months for others but by one year most international medical graduate doctors are at par with their British medical graduate colleagues in terms of experience and skills.
Some do remain confused and they are the ones who struggle the most - However they eventually find their way.
Some also discourage others from coming to the UK - most of these people are the ones who are struggling because of their personal circumstances and the decisions they have made (ie not given exams on time, keep changing jobs with the hope that the next job would be better when they have not settled in their first job, etc). However they learn with time too and settle in their lives.
Looking back at my own experience, I struggled initially as well. However I still remember my consultants words on my first day: "From today you are a junior doctor in the NHS - You are equal to everyone else. What you do from today onward is all in your hands".
That consultant was actually right - our future is in our hands. You can be outspoken, work hard, look at life positively, help others and you will see what an impact it makes in your everyday lives- You will become more confident, enjoy life more and have a good group of people whom you can call family. You will know that you are well settled when you wake up in the morning and look forward to work.
But I also understand when people cannot do the aforementioned things - I struggled when I changed my job and started working as a core medical trainee. However within one month I was well settled. So allow yourself some leeway- this is how we are but also try to change yourself.
Do remember to talk to the relevant teams if you have any issues. You will be surprised how much supportive your supervisors are. They are more like friends and they are happy to help you in any way and direct you to the right people if need be. Overall the NHS is like family. You may think you are an outsider (which will make everyone else think the same too) but if you believe that you are part of it (by being social and outspoken), you will be accepted easily. Once you become part of the family, then you will manage any where in any post at any time.
To understand how supportive our seniors are, read this blog made by a consultant:
https://sean9n.wordpress.com
The other issue which not only IMG doctors but British graduate doctors face in the UK is the current state of the NHS - due to political reasons there is understaffing in almost every post in every specialty, there is underfunding, junior doctors are overworked and less students are entering medical school. Everyone feels the brunt of this but we can all still work to save the collapsing NHS by:
1. Doing TTOs in advance.
2. Talking to families whenever they come to see the patient in order to get a complete collateral history to avoid delays in discharges.
3. Volunteering to do extra shifts by requesting the rota coordinator to inform you immediately when there is a gap in the rota to do as a locum shift.
4. Do loads of cannulations, basic procedures like NG tube insertions, ABGs, etc so that you do not have to call your seniors and colleagues to help you when you get stuck - allowing them to focus on discharging patients.
5. Make plans early - for example if you know that a patient is most probably due for a procedure like a lumbar puncture, ensure that a clotting has been done on admission.
6. At times there are no beds in the wards so patients accepted by a particular specialty may be in ED for longer - clerk patients accepted by your team in ED when you are part of the clerking team.
7. Help your colleagues whenever possible - if you are the clerking doctor but you see your ward cover colleagues struggle, offer to help. This will relieve their stress. Work as a team.
8. Sometimes the nursing staff can be very busy. Offer to do catheters, cannulations which they cannot do as they are still on their drug rounds. This will help ease the pressure off them.
9. When you have free time on your regular days, ask your colleagues if they need any help. help around in understaffed wards. At times, the rota coordinators are too overworked themselves and may oversee under staffing which you can help with.
So basically, do whatever you can to help discharge patients faster, help your colleagues and nursing staff. When you work in the NHS for more than a year, you actually care for it and want to save it- Be part of the amazing team who will save the best healthcare in the world from collapsing.
I have seen a lot of international medical graduates change - I am in touch with people when they start preparing for their PLAB exams and see them mature and become amazing doctors in the NHS.
Never ever think that you are not wanted - you are the most important person not matter what your experience is. You should value yourself and stay positive.
Just remember - you are not alone and if I can do it, so can you. You are not a foreigner- You are part of the best healthcare system in the world and you are not only here to train but to save it. But also remember to enjoy - you can only enjoy if you have planned ahead and are mentally relaxed.
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