The life of a medical consultant in the NHS
We all look up to our consultants who have achieved their life goals and are well settled. They lead ward rounds, make decisions and are available 24/7 to help us all year round.
Ever wondered how they have reached this position?
They have not had an easy life.
The consultants of today were the house officers and SHOs of the 90's and registrars in the early 2000s. They have not had an easy life as a doctor.
In the 90's- foundation year and SHO doctors were the ONLY doctors in the hospital. The registrar was at home and was available by telephone. At that time, no one would dare call the consultant.
As a result, house officers and senior house officers used to manage all sorts of emergencies in the hospital and they had a lot of experience. The hours were different and at times, junior doctors used to spend up to 3 days in hospital every few weekends ( and sleep in hospital) and used to be on call every 5th day ( and used to go at 9 AM in the morning and used to come back the following day in the evening.
By the time they became registrars, the rules changed again and registrars were to stay in hospital. And they used to manage all of the patients on their. The consultants at that time were available on the phone at home but the the registrars were still the first portal for help. As a result, they were the main doctors dealing with all emergencies.
When they became consultants ( which is the current situation), the trend changed again and consultants were expected to help discharge patients and thus stay late in hospital to ensure that no patients are admitted overnight inappropriately when they are on call on the general medical rota ( ie consultant in charge of admissions). If they are on call for their particular specialty ( renal, gastro or cardio), they are expected to come to hospital at any time out of hours. I have seen a gastro consultant come in at 5 AM to manage a patient on the ward who had an upper GI bleed and was hemodynamically unstable.
As you can see, the consultants of today have always had a difficult life. They have spent most of their lives in hospital.
You may have some questions which I will address here:
FAQs:
The life of a consultant is horrible! Why would anyone want to do it?
And this is the tax:
https://www.gov.uk/income-tax-rates
Do consultants here do any private clinics?
Overall, do you think that consultants here are well paid, well looked after and enjoy their jobs?
Ever wondered how they have reached this position?
They have not had an easy life.
The consultants of today were the house officers and SHOs of the 90's and registrars in the early 2000s. They have not had an easy life as a doctor.
In the 90's- foundation year and SHO doctors were the ONLY doctors in the hospital. The registrar was at home and was available by telephone. At that time, no one would dare call the consultant.
As a result, house officers and senior house officers used to manage all sorts of emergencies in the hospital and they had a lot of experience. The hours were different and at times, junior doctors used to spend up to 3 days in hospital every few weekends ( and sleep in hospital) and used to be on call every 5th day ( and used to go at 9 AM in the morning and used to come back the following day in the evening.
By the time they became registrars, the rules changed again and registrars were to stay in hospital. And they used to manage all of the patients on their. The consultants at that time were available on the phone at home but the the registrars were still the first portal for help. As a result, they were the main doctors dealing with all emergencies.
When they became consultants ( which is the current situation), the trend changed again and consultants were expected to help discharge patients and thus stay late in hospital to ensure that no patients are admitted overnight inappropriately when they are on call on the general medical rota ( ie consultant in charge of admissions). If they are on call for their particular specialty ( renal, gastro or cardio), they are expected to come to hospital at any time out of hours. I have seen a gastro consultant come in at 5 AM to manage a patient on the ward who had an upper GI bleed and was hemodynamically unstable.
As you can see, the consultants of today have always had a difficult life. They have spent most of their lives in hospital.
You may have some questions which I will address here:
FAQs:
The life of a consultant is horrible! Why would anyone want to do it?
The life of a consultant here is very different to that in my home country. However my father who is a consultant gastroenterologist in his home country had this lifestyle:
Monday to Saturday: Wake up at 630 AM, reach hospital at around 730-8 AM, work till 3 PM. Come home at around 330 PM, have lunch, nap and wake up at 530 PM . Then go to clinic and come home at 11 PM or sometimes at midnight. Some nights, he had to go to hospital to see a sick patient.
Yes, there were some consultants who had a very nice lifestyle. They used to come at 11 AM, do a quick ward round, scold a few junior doctors and leave for their private clinics at 1 PM.
Here, it is much more balanced. As a consultant, you lead clinical meetings, improve patients safety, work for the betterment of your junior colleagues and improve the NHS as a whole.
Do the consultants here regret their choices?
Monday to Saturday: Wake up at 630 AM, reach hospital at around 730-8 AM, work till 3 PM. Come home at around 330 PM, have lunch, nap and wake up at 530 PM . Then go to clinic and come home at 11 PM or sometimes at midnight. Some nights, he had to go to hospital to see a sick patient.
Yes, there were some consultants who had a very nice lifestyle. They used to come at 11 AM, do a quick ward round, scold a few junior doctors and leave for their private clinics at 1 PM.
Here, it is much more balanced. As a consultant, you lead clinical meetings, improve patients safety, work for the betterment of your junior colleagues and improve the NHS as a whole.
Do the consultants here regret their choices?
The consultants I have worked with in the NHS are all very happy and have actually motivated me to specialize in their field. They are always willing to help and are always approachable - even out of hours.
Do they get paid well?
Do they get paid well?
They have a reasonable pay and have a reasonable lifestyle. Yes, if you want a yatch made out of gold and want to drive a Ferrari with diamond clusters on it , then you may be better off finding oil in your backyard or marrying an Arab Sheikh.
This is their pay:
https://www.bma.org.uk/advice/employment/pay/consultants-pay-england
This is their pay:
https://www.bma.org.uk/advice/employment/pay/consultants-pay-england
And this is the tax:
https://www.gov.uk/income-tax-rates
Do consultants here do any private clinics?
Some do private clinics.
What are the earnings from private clinics?
What are the earnings from private clinics?
Here is a random figure:
https://hcaselfpay.co.uk/finance/price-list
https://hcaselfpay.co.uk/finance/price-list
Doctors are usually 20% of the fees mentioned in this list.
Private consultations vary from 150 to 200 GBP.
Private consultations vary from 150 to 200 GBP.
Overall, do you think that consultants here are well paid, well looked after and enjoy their jobs?
Yes - I certainly do. I think that when you work hard and are passionate about your job, the money follows. Even as a junior doctor, we are paid a reasonable amount and the pay increases as we progress in our career.
They are certainly well looked after by the trusts which employ them. They are always trying to improve things by encouraging their juniors to do QIPs and they chair patient safety groups. Yes, they have a certain budget for the service they provide and they have to be answerable to the management. It is good in way that there is no corruption this way.
I have been very lucky to work with consultants who love their jobs. They love them so much that at the end of the rotation, I want to work in that specialty.
What does a consultants job involve?
In medicine, they have 2 types of on calls:
General medical on calls:
They are in charge of all admissions to hospital.
They make sure they see as many patients as possible seen by the juniors ( known as post take) and some consultants stay till 10 PM in hospital.
Some specialties, like cardiology do not have general medical on calls.
Specialty on calls:
They are on call for their specialty and if they are needed, they come to hospital immediately. If do not thing this is necessary, they give advice on the phone.
Ward patients:
They see ward patients everyday. If the patients are stable, they let their registrars and junior doctors see them and get updates later on.
They are always available to address any concerns juniors have about those patients.
Referrals:
They try to see inpatient referrals the same day. Usually, they let the registrars and SHOs see referrals who can approach the consultants if they have any concerns.
Taking calls from GPs:
Every discharge summary goes to the GP. The consultant responsible for the care of the patient is answerable to any ambiguities in the discharge summaries. They also chase up any follow up bloods or imaging which was requested as an inpatient.
Clinics:
They see patients in clinics, dictate letters and request investigations.
Procedures:
They have specific procedures. Like gastroenterologists do endoscopies, colonoscopies, NJ tube insertions, sigmoidoscopies, ERCPs and a few more.
Supervision:
They are educational and clinical supervisors for foundation, core and specialty trainees. They teach medical students.
Chairing meetings:
They chair patient safety meetings, morbidity and mortality meetings, are part of governance meetings.
Research and QIPs:
They are involved in researches in their specialties, encourage their juniors to do the same and present papers in conferences.
Do you think that their work timings are too much?
They are certainly well looked after by the trusts which employ them. They are always trying to improve things by encouraging their juniors to do QIPs and they chair patient safety groups. Yes, they have a certain budget for the service they provide and they have to be answerable to the management. It is good in way that there is no corruption this way.
I have been very lucky to work with consultants who love their jobs. They love them so much that at the end of the rotation, I want to work in that specialty.
What does a consultants job involve?
In medicine, they have 2 types of on calls:
General medical on calls:
They are in charge of all admissions to hospital.
They make sure they see as many patients as possible seen by the juniors ( known as post take) and some consultants stay till 10 PM in hospital.
Some specialties, like cardiology do not have general medical on calls.
Specialty on calls:
They are on call for their specialty and if they are needed, they come to hospital immediately. If do not thing this is necessary, they give advice on the phone.
Ward patients:
They see ward patients everyday. If the patients are stable, they let their registrars and junior doctors see them and get updates later on.
They are always available to address any concerns juniors have about those patients.
Referrals:
They try to see inpatient referrals the same day. Usually, they let the registrars and SHOs see referrals who can approach the consultants if they have any concerns.
Taking calls from GPs:
Every discharge summary goes to the GP. The consultant responsible for the care of the patient is answerable to any ambiguities in the discharge summaries. They also chase up any follow up bloods or imaging which was requested as an inpatient.
Clinics:
They see patients in clinics, dictate letters and request investigations.
Procedures:
They have specific procedures. Like gastroenterologists do endoscopies, colonoscopies, NJ tube insertions, sigmoidoscopies, ERCPs and a few more.
Supervision:
They are educational and clinical supervisors for foundation, core and specialty trainees. They teach medical students.
Chairing meetings:
They chair patient safety meetings, morbidity and mortality meetings, are part of governance meetings.
Research and QIPs:
They are involved in researches in their specialties, encourage their juniors to do the same and present papers in conferences.
Do you think that their work timings are too much?
There is a reason behind this. Every patient needs to be assessed by a senior doctor everyday. Referrals from other specialties are seen by registrars and are then discussed with the consultants on the same day.
The consultants read through all the discharge summaries us junior doctors make and address any concerns GPs have with ambiguities in them.
They also take referrals from GPs directly and manage their clinics.
Overall, consultants here take full responsibility of their patients.
Dedicated to all my consultants who have not only supported me, but have made me love my job.
The consultants read through all the discharge summaries us junior doctors make and address any concerns GPs have with ambiguities in them.
They also take referrals from GPs directly and manage their clinics.
Overall, consultants here take full responsibility of their patients.
Dedicated to all my consultants who have not only supported me, but have made me love my job.
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