An NHS Doctor REACTS to - Why are Doctors LEAVING the NHS?

so a lot of people you know comment they message they email me and they're like breeze You're not really talking about all the horrible things that are you know the awful things or the bad things that people say about the NHS why don't you do that so I thought do you know what are you guys hearing about it where are you reading it from let's just have a little look-see and somebody sent us this link and I thought you know what I think the easiest way to actually go about answering this question is just reacting to the video hey guys Breeze here so the link I was sent was from this YouTube channel called the aspiring Medics and it's about a video that's entitled why are doctors leaving the NHS so I just had a quick look obviously I'm not gonna spend crazy amounts of time stalking poor innocent people but from what I could understand is I think these are medical students who are helping individuals who want to get into medical school in the United Kingdom and from the description box in the video it says you know we interviewed medical students for this video I'm assuming when they say we they are also medical students so it's like medical students interviewing medical students but from what I could understand no one in the video actually works as a doctor in the NHS I could be wrong I mean we'll get into it and maybe I'm I'm actually completely wrong about this because I haven't fully seen the video myself I thought I just see it along with y'all and then comment as we went into it so let us get started so what I'll do is I will try not to pause too many times but just if I feel like we need to clarify or discuss one or two points I will do that accordingly here we are this is going to be quite a controversial video and it's one that we hesitated to make that we think actually it's quite important for the general public and especially for aspiring to know about the NHS is in crisis an increasing number of Junior doctors are now leaving the HS before even completing their training and this is something that we're seeing a lot of conversations and debates about especially on Twitter for example another thing is even medical students before even becoming a doctor are actually considering leaving the profession the very profession that they're training ought to be at Medical School we're going to hear from medical students from across the UK on their insights as to why junior doctors are leaving VHS this video took us a lot of time so I'd really appreciate it if you just smash that subscribe button and leave a like and without further Ado let's get into it so I think my initial suspicion is correct then it is I think medical students actually interviewing medical students about what they understand about others experiences rather than their own lived-in experience which I think can complicate issues a little bit especially because not to you know mitigate anyone else's reasons for leaving the NHS I know there are people who are leaving the NHS on a daily basis or monthly basis they're people who are also joining in the same manner but that's something I think is is a universal thing people will join and leave Healthcare forces around the world for whatever reason and that's just kind of the ebb and Tide of a lot of things um I do find that their little screen bit for the Ali Abdul is not necessarily the best I guess argument in their favor because from what I've understood from his channel I mean if if you have a side gig that's earning you substantially more and you're you love doing it and it's something that you find is lucrative as well as interesting and you don't want to do your main job anymore I would leave medicine too to be honest with you I don't think that would make a difference when I was working in the U.S or in the UK as a doctor but let's see what they say next well most people don't know is that a junior doctor is any doctor that's not a consultant level so that's all the way from when you graduate medical school as a foundation year level all the way up to registrar level so I have one small point of contention with this example that they've given here because I feel like it can be a little confusing um because the way I read it and then I realized oh maybe this is maybe what they're actually trying to say here is they're saying Foundation years one and two and then they're saying specialty register five to ten years I'm reading that as five to ten years on top of the foundation training so that means I would have to at least be in it seven years to 12 years before I could become a consultant because for the consultant part they've said seven to twelve years after medical school but GP training is only three years so I don't know if they mean three to ten or maybe I'm just nitpicking but I find I found this a little bit confusing honestly when I looked at it but yeah so Foundation years if you're an international doctor you'll realize things might be a little bit different for us on this spectrum and what they're mentioning about a junior doctor is yes that's true in the United Kingdom effectively if you're not a consultant you are considered a junior doctor I'm not a huge fan of the term myself I don't think it's an appropriate term considering our experience and our worth but there you are it is a term however they use anything before being consultant so the majority of doctors are therefore Junior doctors and depending on specialty you will be a junior doctor so when you graduate Medical School anywhere between five to ten years and that's again dependent on the specialty since 2008 Junior doctors in the NHS have seen a real-time speak out of up to 30 percent this means that Genie doctors today effectively earn 30 less than what Junior doctors earned 14 or 15 years ago so how did this happen so inflation is the general increase in price of Commodities in our economy so as inflation increases or as prices go up wages or salaries should also go up by the same amount so that people can afford to buy the same things however over the past 15 years as inflation and prices have risen Junior doctor wages have not increased by the same amount resulting in an effective pay cut other issues like the NHS R3 which is given to 4th and 50 medical students not being sufficient enough have also been highlighted recently and I would recommend checking out the hashtag livable NHS bursary campaign if you're interested in finding out more all of this along with the cost of living crisis that we're facing right now means that Junior doctors are not paid nearly enough for their efforts after working really hard through the pandemic many believe it's time to fight for a better future and most recently the BMA or the British Medical Association announced that a strike is inevitable and the last Union doctor strikes were in 2016. so just to kind of cap on from what this individual said yes I I definitely believe we need to have pay restoration which is a lot of stuff that's been talked about and discussed on social media newspapers for the last few months in terms of cost of living crisis it's unfortunately not isolated to the United Kingdom inflation is striking the you know countries across the world and a lot of people are feeling a little bit more of a pinch than they had before I'm not again mitigating anyone's circumstances but it is something that I believe is a reality in a lot of countries around the world I've had people say even in their own countries you know that's the situation people will argue back and say to me well this is you know a first world country it shouldn't be like that but it's not unfortunately always true that with you know inflation Rising that you know people's pay is also increasing there have been incidences throughout the United Kingdom where other individuals other unions have gone on strike and their pay has been restored and I think that's an important part of the process and if you know you know doctors do that in the UK that will be to a good end so one of the most commonly cited reasons for why doctors are leaving the NHS is simply the extraordinarily long working hours so doctors are on average contracted to work around 40 hours per week and this is going to depend on your specialty your seniority and a range of other factors such as if you're working during the day or during the night however either way doctors are very frequently exceeding these numbers by a long way with a study finding that over 55 percent of doctors are doing additional unpaid work on a weekly basis so this can lead to disruptions in your work-life balance your sleep and your relationships with another study finding that only 26 of doctors consider themselves to have a good work-life balance and this is further compounded by a very chaotic rotor for a lot of doctors which means that one day you might be working early morning shift and another day you'll be working a late night shift and they do okay so I'm sure you guys saw my face change quite a bit during this point um I find I don't know if they've cited this in the description box but he's he cited two studies I mean he's talked about two studies without actually citing them or like in the other parts of the video they've kind of brought up headlines or showed diagrams say this is what's happening so I want to know a little bit more about those studies one two he said that on average doctors work 40 hours a week in the NHS actually we work an average of 48 hours in terms of on-call and social you know unsocial responsibilities if we're working a normal basic kind of hours without any on-calls then it would be 40 hours per week Monday to Friday nine to five or eight to four or whatever so I don't consider 48 hours or an average 48 hours a week long hours we have a video talking about the working hours in the NHS and of course the importance of the work time directive which came out of the 2016 Junior doctor's strike which basically put into a place basically a huge cap that prevented us from becoming like a lot of American doctors are working crazy hours I will tell you now I have seen those crazy hours I'm sure a lot of you might be sitting there having work crazy hours in your own country you might be like wait wait a second what what is the explanation behind this so he said all right you know there are people who are working extra hours that are unpaid but I'm I'm gonna say this and I'm not again trying to mitigate anyone else's experiences but if you were working hours that you shouldn't be working because of Staffing shortages or Something's Happened you've got to stay on longer there are ways for you to say this so that you are fairly then reimbursed I have had this happen myself I've had to stay late for certain incidences or we didn't have enough staff and I put in an exception report and I was paid back that time I always ask for the money back but you can also ask for the time back if you want so if you stayed you know two extra hours you get paid back maybe on Friday you leave two extra hours early you know two hours early so there are systems in place so if something like that happens you would get that time back if you aren't raising those concerns if you aren't complaining then they don't know that there's a problem it's it's literally as simple as that so I'm not really certain where that kind of came from in terms of work life balance I think it would be very important to understand you know what are the range of individuals they're asking this question how many people they were asking what are their Specialties and what are the normal or average working hours maybe even in you know internationally to understand what we're actually comparing against I will say I have always said I suppose that we've got a pretty good work-life balance in the United Kingdom especially as compared to you know my family in the US or my friends in the US who are doctors or people I know in other countries who are doctors I think yes you'll say oh Breeze but you said it was an average of 48 Hours yes there are some weeks where you'll work more but then that time is made up for when you will have your zero days or your time off to you know recover because you've put in so much work so that it becomes that average of 48 Hours they've not really kind of said what those long hours are are kind of substantiated them so I'm not too convinced by that argument to be honest with you but let's see what they say next few reason for doctors leaving VHS is because of burnout and that can be broadly defined by three main factors one feeling negativity towards your job two feeling exhausted because of your job and number three having reduced professional efficacy which basically means not things if you can do your job properly and of course because the covid-19 pandemic he's been have only been exacerbated burnout is a really important issue and it's something that actually is going to affect the majority of healthcare professionals at some point in their lives okay burnout is a reality in Medical Specialties across the world I don't think anyone will ever tell you they they don't experience burnout so I don't necessarily think that is the only reason a person would leave the NHS I do believe that's the reason person might leave medicine and that doesn't matter the country people can't get burned up regardless of code 19 especially in really you know traumatically type Specialties where they see a lot of stuff that will emotionally impact you now the ways you can deal with that or help at least mitigate burnout is working less than full-time speaking to Occupational Health about modifying your working arrangement you know speaking to your GP if you need stress leave if you need time off from work because of that because you are feeling burned out and seeking you know resources locally or even nationally about support for stress relief and for Burnout it's really important as well for you to know like they said even about reflecting about understanding when you are burning out and what you can do because you're not a safe doctor if you're a stress doctor why many doctors well I think it stems from serious star shortages which have been sort of mounting the NHS for years and this has really been driven by the inadequate workforce planning a lack of government accountability which includes insufficient funding and and infrastructure to train and not new doctors and we can really see this in sort of uh emergency units GDP surgeries out there in the UK and I'm just going to talk to you about one of the emergency units so Dr Rob power here is closest to say here a lot of our staff are increasingly burned out and morale is a long-term problem because we're not able to deliver the standard of care that we believe our patients deserves and this can be reflected in the statistics from this hospital around 10 886 patients who are waiting longer than 12 hours to be treated in any in that single month and realistically the target is no one should be waiting for more than 12 hours and these are some of the worst waiting times in emergency units we also have a lot of GPS wanting to to lead by Red Paige and Kevin in the next five years I think it's around a third of GPS in England plan on doing that and a lot of Representatives have been trying to urge the government to take action because the mass Exodus of doctors leaving uh GPS would cause seriously to Patient Care and when we look at vacancies official Health Service vacancy figures show it remains short of more than 98 and 40 000 nurses and it's quite sensitive because a lot of Hospital bosses are forcing last minute shifts changes on Junior doctors and trainees below the level of Consulting up to the level of the senior registrar because you know staff sickness and scarcity of local Medics has left and strongly to ensure patients safety is maintained overnight and you know this this all takes all this sort of a really really big toll on a doctor's physical and mental well-being I think that when so in terms of Staff shortages I mean I've covered this in videos previously we know that yes the NHS does need more doctors they're recruiting heavily from overseas because of that things like the removal of rlmt or the resident labor market test has made it easier and easier for international doctors to come and work in the United Kingdom in terms of an overworked system yes I definitely believe that the NHS is not perfect I think conceptually having Universal Health Care is literally the best thing in the world because why else are we doing a service that should be a basic human right that's what it's there for um what the government is doing about it I'm not necessarily in a position to comment but I do think there are things at play that could be changed to allow the NHS to flourish I don't necessarily know in terms of their argument that people are being forced to come in last minute the thing about this is you know let's let's take it for an example if you're like in a training post and you're you've come in for your morning shift and they're like somebody's called you up and said listen you're the only person we can contact tonight can you come in tonight and do a night shift instead of doing your day shift just go home right now the thing is you have the right to say no you do and I'm not saying it's easy I'm not saying people might you know not give you the side eye or say well why aren't you helping out why aren't you being supportive why aren't you being a team player but you have the right to put your foot down and say actually I have training needs I have training responsibilities you can put in an exception report you can speak to your college tutors your training program director you can raise it through your deanery that listen the staff shortages that are happening here are not my fault they're not my responsibility I I have a portfolio responsibility and if you decide to go ahead and pick up and cover that shortage let's say one of two things happen here one you're going to lose your opportunity you need to ensure you're getting that opportunity back two you need to see if because you've now filled a shortage are they actually considering the fact that they had the shortage that day because you know if you think about it in terms of they had a shortage they had to find a Locum or they had to look around and find a doctor to come and place it you know fill in that space they had to Source money in order to do that and there's a fund for them to know how many doctors are they sourcing emergency wise as locums to fill in you know the spot if internally they were able to do this that means it was at no extra cost to them so is it actually then recorded that might be a little misanthropic on my end but that's why it's really important for you to stand your ground if you're ever in a situation like this to say actually no and if you are then that doctor who's working at night and it's dangerously understaffed you have the right to put in an urgent exception report if you are for instance on the medical ward and you're working overnight you have a medical consultant who's also on call overnight and they can be asked to come in if things are that short so there are safety nets available the unfortunate reality is we are oftentimes too reluctant to trigger those safety nets to make sure we allow The Dominoes to fall properly instead we feel like we need to put all the burden and stress on ourselves which isn't right it's not good for us and it's not good for the citizen because then in a way the system doesn't actually realize this problem exists and someone is studying to become a doctor as a medic you're learning all this really detailed information you're you're finding out of treatments the management plans the investigations for hundreds of different conditions you know all this really rich knowledge and you feel prepared in a way to become a doctor and then if you become a doctor and then you're stuck with sitting on a computer ordering scans ordering blood tests for hours every day it just doesn't seem rewarding there's no patient facing uh interaction which is what you were expecting when you spent all those years training and so this sudden realization that actually you've learned all this stuff and you've expected all this patient interaction just to have that not come to fruition as soon as you become a doctor can be rather almost heartbreaking and that can really be behind someone's decision to leave the NHS in my opinion there are okay so this is this person's opinion I'm assuming of what an F1 is doing because it's saying he's saying it right after they become a doctor I don't know how much I agree with this statement mainly because yes I will not deny there isn't an element of what people call service provision in your job where yes you will have to request scans request Bloods and do follow-ups that involve paperwork writing discharge summaries but that's a reality throughout your entire you know training or non-training when you're working as a doctor I don't agree when they say that there isn't any sort of patient facing care because there definitely is even as an F1 you will do on calls and you're not following a consultant for your on calls you're not following a registrar for your own calls when you're doing a night shift an evening shift a weekend shift it's you you're there on the ward seeing the patient taking care of them yes if you're seeing a patient and you're writing in their notes you know you're typing up what they need yes you're going to prescribe stuff you're going to request Bloods you're going to request scans but that's part of the care that you're giving that patient so it's not that you're sitting in a room by yourself and then somebody comes in and says yeah I just need you to do that stuff and you never go see a patient you never put in a cannula you never do a procedure there are certain Niche Specialties where you may not have as much hands-on experience just because they are super Niche but that's even true for you you know when you're in a core level role because of how specialized that role is and they're trying to get you trained up before you can actually do some of those things like for instance when I was in Internal Medicine training there were times where I was you know just watching the consultant do an endoscopy but then it got to a point where they would let me hold the scope myself and I would understand we would do Sims and then you know go from there but there's going to be a process of you getting into it I definitely don't agree with the statements at all in terms of you just sit in a corner somewhere and you're just you know requesting scans or Bloods for hours on end it's part of the process when you're doing the word rounds I at least have always tried to do with the word rounds to try and minimize how much I'm doing afterwards because in case there are other jobs that needs to be done but when I'm doing the wardron I'm still with the consultant seeing the patient I'm not just kept separate from everyone else which is kind of what this sounds like for many reasons why junior doctors are leaving the NHS one of those reasons is due to a lack of senior support senior support can be hard to come by on boards and can lead to Junior doctors taking on much more responsibility than they are trained for also when issues are escalated Junior doctors feel like they're not being scared of or it's being taken seriously all the while they feel that there is little recognition from the NHS on their behalf another okay this statement seems really contradictory to the statement before because if you're on the wards without support that means you're facing patience um so I'm not really sure how I feel about this one either but lack of support means they don't know who to call sometimes because I've seen that sometimes um when I've been the medical register on call I've realized that there's an F1 who's floundering and they just didn't realize it was okay to call us because either they feel like they shouldn't have to call out you know to for help because they feel like somebody might think they're not capable enough or they're new and they don't want it to seem really evident that they need help and I get that but remember there is actually always a port a call so if you're working in any specialty most of the time people end up calling the medical registrar and that's okay that's what we're there for we can try and troubleshoot if it's you know you know the medical register I can't help call your reg surgical reg obscany Peds find an ed register when I worked in emergency medicine there was never a Time on the shop floor I wasn't finding someone be it a consultant or a register that I could go up to and be like hey listen I need to run this past you yes there are times where people will be busy there might be emergencies but that doesn't mean you can't find people if you go looking for them worst case scenario you know if a person arrests or there's a medical emergency there are ways in place for you to actually escalate and put out those calls and then a whole bunch of people will come and help you so I don't necessarily agree completely with that they're not being senior support I can understand why people will be reluctant to seek senior support I can understand certain hospitals there may be a scarcity of senior sport if they are understaffed but like I said there are ways for you then to raise it you can put in exception reports you can put an incident report saying we actually aren't able to conduct safe patient care because we don't have that support and worst case you know there are other ways to escalate like I said through you know a registrar through a consultant through if you have like a hospital at night or an acute care team or an Outreach team or anyone else that you feel would be that person for you to call even if it's the ICU registrar or you know if even if you're not working in ICU whoever you believe is your next Port of call it's important to know because that's how you would then raise that concern to get that support the reason why doctors are leaving the NHS is because of the high competition rates competition to get jobs to get spaces and this starts at sixth form where there are so many applicants but such a few Medical School places people often say that getting into medical school is the hardest part but that simply is not true anymore because getting into medical school is only the first step and there are more Medical School places than Junior doctor positions recently you might have seen that 800 medical students who passed their exams did not get a foundation job of their choice and were later accommodated in places that they didn't even apply to I just want to pause and say they were accommodated and they weren't actually aware that so many people were going to apply into it mainly because since rlmt has been lifted an increasing amount of international doctors have been applying into the UK Foundation program that doesn't mean it's not an issue I think they just weren't aware of how many people were actually gonna get that far the ukfp later did release a statement about how there's a certain percentage of individuals who tend to withdraw their Foundation application and that's what they had initially anticipated it would have been okay they could have adjusted just fine but I don't think they were prepared for this hopefully this year they'll be a little bit more prepared but um yeah let's get back into that but the bottleneck doesn't stop here there are more foundational posts than specialty training posts and more specialty training posts than registrars than consultants and so on this bottleneck has led to so many doctors who have actually passed the exams to move on to their next level of training just stay in the same post because there's simply no training jobs so I just kind of want to say a little bit off of that this isn't necessarily true for all Specialties this is a very very vast generalization the Royal College of Physicians just last year talked about how in the next few years they're not going to be enough medical consultants and yes there are competitive Specialties out there in terms of there aren't as many as many training seats or training numbers but as you guys have known from other videos I've talked about there are other ways to become I'm a consultant in the United Kingdom through a non-training route and yes training is something that a lot of people do aspire to but it's not necessarily the end-all be all there are even a lot of local doctors who do opt for the cesr route so I think that's something to really be mindful of otherwise in terms of getting into the foundation schools I also want to point out as an international doctor you don't have to apply for the UK Foundation program you can directly apply into either a non-training job or a training job as is applicable they have not increased training numbers or training seats that much across the country and that is true I think that's something I hopefully they will look into and try and accommodate for but I do find it interesting that they aren't increasing the training numbers but they are very woefully aware about Staffing shortages so I feel like it's it's a strange line that they're walking between because they know they need more doctors but they just haven't increased those training numbers I don't necessarily think though that prevents training opportunities or at least the progression of a person to become a consultant because of that imagine doctors who have passed all of the exams gone through over 10 years of training to become a consultant and then just simply don't find a consultant job ooh can I counter with imagine all the doctors who don't match in the United States after they finish medical school they're um eight years total because they've got the four years of undergrad four years of medical school potentially maybe a little bit less if they do the six year medical route and then they put all that money they're in a lot of debt and they can't match and in the US you can't do anything if you don't match there's no non-training route that you can take so I don't necessarily think this part the competitiveness is isolated everyone knows how crazy it is in a lot of countries for a lot of different specialties that is what the NHS looks like right now that is why so many doctors are choosing to leave and go to other countries where the competition isn't as high and where they're guaranteed a job as long as they complete their training I wonder why they haven't said what countries those are because again even in the United States if you're an international doctor even if you've completed residency or Fellowship that doesn't guarantee you a job especially if a lot of you this is anecdotal of course a little bit because I've not had to think about visas for the United States but I've understood at least from some of my friends and colleagues that the ways and the types of visas that they put you on you might actually have to return back to your country and do kind of like a cooling off period before you can come back or sometimes they don't want to sponsor you any further because not all the Visas in the US are immigrant visas like you know in the United Kingdom if you're here for five years on your working Visa you can apply for indefinite leave to remain but that's not necessarily the case in the United States so another reason that Junior doctors are leaving the NHS is due to the location barriers the lack of location flexibility means that locations can sometimes dictate what kind of Specialties Junior doctors are going into if they're unable to move or require some stability in their early careers it may be difficult for them to move their entire lives to a new area for a specialty that they would like to practice additionally if they get placed in a larger deanery it may be difficult to travel to and from hospital placements in a safe or appropriate manner so they've put moving across the country but I think appropriately as she's actually said here is moving across deaneries you don't move across a country in your rotation so if you look at the deanery map you'll actually understand how everything's kind of broken up and there's some DNA's that are really big and some dinners that are really small um and yeah if a DNA is really large depending on what your rotation your placement is you might have to move every year and maybe that's an hour away from each Hospital like you're about an hour away each time the ways you can mitigate this of course is when you were ranking your Specialties to not choose areas that you know will be covering a wide you know base of space when I applied for Internal Medicine training that's why I didn't apply for Yorkshire and Humber because I saw how their rotations work and I was just like no I don't want to be moving like that and in fact where I ended up taking my internal medicine training the reason was because I stayed in the same hospital for three years and I didn't rotate at all so that is also a reality you may not have to move or you don't move that much or you don't move that far but rotating through hospitals is not a UK specific thing um I did a video where I know I you know I talked with my sister who who was doing her Internal Medicine Residency in the United States and she was also moving through hospitals sometimes on a weekly basis like one week she was in one hospital or another month she was in another hospital which is definitely not the case at least in the United Kingdom you're finishing and one hospital and then you move into another hospital so that I won't say is necessarily unique to the UK I'm not saying it's a perfect system um and there are things that have happened I know where people have gotten into areas they didn't want to get into or it's been difficult for them to get accommodated into but I'm not you know well versed enough to talk about that at length I just want to say there are ways for you to stay in one area if you do an on training job and you might be like well what if I don't want to do an on training job or what if that non-training job actually is not available because of the type of specialty there is totes understand just saying there are ways to kind of get around this in terms of rotations throughout the deaneries you can see how far apart they are and you can try and find a central place to live and then try and see how you can get there but like I said there also are some places where you don't really move around that much or you just move in an infrequent manner so it's not all bleak so I think one of the reasons why doctors could be leaving the NHS is because of the lack of perks that come with the job I know a lot of employers that Medics typically go to offer things like house travel insurance all the insurance is covered for they get credit cards they get gym memberships and just just to name a few and the list is really extensive whereas with the NHS despite working in a Healthcare System you're not getting any Healthcare benefits there's no Private health insurance I kind of say I feel like the reason maybe they don't I'm not saying it's not a good idea that they don't give us Private health care but I wonder it's because maybe they feel then we also don't have faith in the NHS that's why they don't want I don't know I'm not sure how I feel about that but the the thing I will say is that the NHS is a government organization and I isn't it's kind of a thing isn't it the government organizations don't necessarily cover you the way that private organizations will um but let's see what they've got to say or anything like that um so it's easy to see why that could be behind someone's decision to leave the NHS so I think that's a really really short reason just say that private companies offer a lot of things and a government organization doesn't so I'm going to leave the NHS especially because the NHS does offer a lot of other things there are a lot of places where I can get an NHS discount it could be varying percentages um I just show them I have my here's my Hospital ID you know at a just discount thank you very much um in the pandemic I know everything wasn't perfect for us but at least there were situations where if I needed to get groceries they were like this is you know protect a time for NHS staff which I thought was really nice because I was doing weird hours Sometimes Late At You know at night or early morning would be my shopping time and I was able to get stuff done during that time and in terms of you know salary sacrifice for like your car there's a car scheme for that there are a lot of other things that potentially I'm not 100 you know fully sure on but I have seen and read about and there is one perk that I always thought was very good which is the NHS pension and arguably I've always heard people say that it's the best pension you can get out there even better than private pension so I will say if that's not a good perk then what is Private Practice the Dark Side of medicine something that isn't as well known is that only Consultants can actually practice privately and whether doctors should practice probability is something that we'll cover in a later video what I do want to cover though is that for junior doctors it's something that's not available to them oh no I have some friends who are rmos or even medical officers in private hospitals so I'm not sure about why they said that so you yeah private practices on their own typically yes you are a consultant you've got to have a good background and standing and then people are like yes we'll come to you privately and usually most people are tied you know affiliated with the NHS hospital as well so people have a private practice and they have their NHS practice or if you're in a really good area you might have a complete Private Practice especially GPS have a lot of private GPS um now the likelihood of you as someone who is not a specialist who's not a consultant trying to open a Specialist Clinic I mean if you are still in training and you haven't completed any sort of training what would you be holding your private practice open for you know what would you be doing in those roles I don't know um I know there are some people who supplement their time by working in private clinics in other ways either they completely do private care as rmos or medical officers and they have whatever schedule they have working there outside of the NHS or there are some people who will work part-time with their NHS work doing stuff in private clinics like you know Botox or et cetera and other kind of stuff like that but I don't I don't think that's necessarily true to say that you can't at our level find private work you definitely can there have been people who have done that Junior doctors can't practice privately but what they can do is actually local locuming is where a doctor can basically work temporarily and fill any gaps on a rotor basis any shortages that exist welcoming pays relatively well compared to salary doctor it comes with a variety of cons and that includes either feeling isolated not supported and also having a regular work schedule so I think that kind of also depends a little bit in terms of Locum work because if you are someone who can take a contractual look if you work with a bank within your own hospital I mean you look them all the time so if you're a pure 100 Locum then it won't be as much of an issue because you've already you already know the place that you're working in a lot of hospitals will even say listen we need a nine to five doctor in this department and we'll pay you Locum pay for that if you stick around for a year so you've got a job every day others who are on the bank a lot of hospitals will email them first like Hey listen we need some doctors here there can you fill up that Locum Locum rates like you said it's very good yes depending on your experience so if you're red you'll get paid better than you would if you were in SHO and so forth but Locum pay is good Locum work is also good if you're an international doctor you can't be a full-time Locum unless you already have a settled Visa status so you don't need like a work visa you can however locom otherwise like on your annual leave like when you're on vacation or on the weekend so long as you're not you know messing with your work time Direct so you're not overworking or you're not working too many long hours but yeah Locum pay is real nice a survey of doctors leaving the NHS has sadly found that bullying is still a major issue for a significant number of doctors in the NHS and we can speculate that this might be because the NHS operates on a hierarchical system where on your team there will be people who are superior to you and there will be doctors who will abuse this in order to make other doctors feel uncomfortable there are also interestingly differences between different Specialties so for example Obstetrics and Gynecology has one of the highest percentages of bullying among those doctors leaving NHS in addition doctors who have been identified to have a fitness to practice the issue in the past also report much higher levels of bullying so the difficulty lies in how do you address this uh you're operating within a nationwide system uh and yet bullying is a individual problem on a case-by-case basis so this sadly is a problem that remains unsolved in addition to bullying abuse from patients and the general public remains a problem with doctors frequently reporting cases of sexual harassment and other forms of harassment as well which can majorly impact your general well-being as a doctor so I just want to say as my I suppose Declaration of interest that I I've worked as a freedom of speak up Guardian for two years at my hospital and I've definitely heard a lot of people talk about bullying and my role is to try and mitigate that type of bullying the whole reason the freedom speak up Guardian exists was because of this that they realized this was a problem and there was now this is their way of saying this is how we can try and understand what's happening and how we can kind of prevent it from happening I'm not going to say bullying has disappeared overnight I think we all know bullying exists in various forms throughout the world no matter what your setting is um and it's an unfortunate reality I I kind of want to say I don't feel the NHS is necessarily as hierarchical as I've seen for instance like the us working environment for doctors or even when I was an intern or worked as a medical student or sorry it was a medical student in Bangladesh I definitely felt like that structure was much more hierarchical like I could not say anything to a consultant without potential backlash or somebody getting really angry and I think it is a little specialty specific but I have felt that Consultants as a whole are more approachable in the NHS I've I've had coffee with my consultants and we've had pizza you know we've sat there we've talked about little things and you know mundane things and just had a normal conversation which wasn't something I was able to do you know in a previous role so maybe my take on it is a little different um in terms of abuse from patients again not something sadly that's isolated to the NHS I do know in my hospital and I'm sure it must be the same at other hospitals that there is a red card system that if a patient is behaving in a manner not fit for you know being seen there are ways to keep patients like that from from re-entering to the hospital and they're effectively banned how that entire process works I'm not exactly sure but I know there is a protocol in place and there are things that flag up in the system if someone is someone who's been previously warned um and they've come back into the hospital again relocating to practice the board as a doctor is becoming an increasingly popular option amongst Medics from as early as medical school there are a range of reasons for doctors wanting to move aboard including better pay better working conditions quicker training um more Hands-On work compared to the admin heavy job of Junior doctors in the UK and overall a better work-life balance okay guys okay moving abroad ultimately your choice I moved from the US to the UK I'm not necessarily sure if I'm the poster child for the U.S Healthcare System is you know why are doctors leaving the US type stuff um but I do think it's your own personal preference and choice so do what you feel is right I I guess now reflecting on this video as a whole um no one's actually kind of introduced themselves or the role so I am assuming again that they are all medical students and again I'm assuming their experiences they've mentioned are anecdotal or things that they have read about I don't know necessarily experienced so I think that there is an element to taking kind of things like this with a grain of salt understanding your own experiences and understanding what they are going through for sure but also understanding lived-in experiences and understanding things that are practically explained is also really important let's just see how they wrap this up guys thanks so much for watching all the way up to the end this was quite a controversial video but we think ultimately it was one that's going to be quite worthwhile and interesting to you guys the viewers basically guys I think those of you who kind of see these videos or see things like this and you're concerned I get it it's it's a valid concern to have I think it's important sometimes to to understand the viewpoints of everyone and where they're coming from I don't necessarily believe that my viewpoints reflect that of the entire IMG population um I'll never say that but like I said I put forth what I see and how I work and what I think is the way you know is best for me so live your life that way too maybe you know like if somebody asked me you know would you still work in the NHS I'd still kind of be like well well yeah because I I think it works out just fine for me and I've talked about that in different videos like why it's the best time to be here and all the things that are available to us right now do I think it's a perfect system no nothing is perfect you got to go out there and make the change that you want to see and create the differences of what you want to do and remember to always know your rights always know what your contract States and always make sure you know where to go for help and raise concerns I think that's probably the Crux of what I want to say but yes I hope this has answered a lot of those questions that people have kind of been messaging us about about I hear this or I hear that and you have a little bit of an understanding of where everything is coming from and how it actually is I know it's really difficult for you to do that until you actually step into the NHS yourself but if you're on the fence make the decision that's best for you so until next time please continue to subscribe to our YouTube channel follow us on Facebook Instagram and Twitter check out our roads UK Forum maybe you want to have a personalized guidance session we can talk a little bit more about this but until then we will see you next time bye [Music] foreign

Channel: Road to UK

Views: 20,036

Keywords:

Id: BneAnJ9BUlQ

Length: 42min 47sec (2567 seconds)

Published: Wed Sep 21 2022