Working as a doctor in Australia: culture shocks, pay, work life balance

hi everyone my name is serena and a quick summary of my journey if you haven't been following it so far i was born and studied in the uk i did my medical school there then graduated and did my first two years of training as a doctor the foundation years f1 and f2 in the uk and then instead of potentially going into a formal surgical training program because surgery is the speciality i want to pursue i instead took a career progression break informally known as an f3 year and chose to come to australia i've been avoiding confronting any decision making for quite a while but today i thought i'd sit down and chat to you about my thought process and what my ultimate decision is it will be quite a chatty video so grab a drink i've made myself a little iced coffee and yeah let's just have a little chat so perhaps i can lay out what my options actually are so we're on the same page i need to decide about my career and also the location where i'm living so that kind of boils it down to two reasonable options one which is to stay in australia and continue full-time work and or pursuing surgical training formally here and the other is to go back to the uk with a view to take up surgical training there spoiler alert i didn't go with either of these options so do keep watching to find out what i'm actually doing with my life next year let me take you back to pretty much exactly a year ago when i was sitting in my hotel quarantine probably in bed eating crisps off my stomach watching friends on netflix again it was the actual dream i actually really miss it and the hospital emailed me my first rotor that i was due to start in a couple of weeks which was vascular surgery and i was scanning through the rows looking to see how many hours there were how many weekends out of hours etc was doing and it all seemed to add up fine but then i did a double take and realized that my start times were at 6 30 in the morning 6 30 a.m now i don't know what it's like where you work but if they sent us a roto like that in the nhs all hell would break loose 6 30 a.m is very much night shift team territory and there's no way a day team would start that early wardrobes usually started around 8 a.m for surgical specialties and more like 8 30 to 9 for mostly medical specialties so this was the first pre-work culture shock i experienced everything else looked pretty reasonable the hours were as promised the 38-hour work week which is you know 10 hours less than the nhs 48 hour contracted work week so everything looked promising or so i thought it turns out that the roster is very much a suggestion rather than an actual guide of what hours you'll be working so i got out of quarantine and was very welcomed by my new vascular team but there were a few things that really threw me firstly the start time was even earlier than the crack of dawn hours that were on my roster because it turned out the wardround started dead on 6 30 in the morning and before that we had to get the ward list sorted the patient notes prep because there was such a volume of patience we had to see which meant getting in even earlier so i was getting in for 6 a.m in the end and let me tell you there are very few things that are as soul-destroying as setting your alarm for 4 45 a.m so you can leave the house at half five and be in work for six given that our start time was so early i thought it was pretty reasonable that our end times would also be a little bit earlier than i was used to back home in the nhs and i believe our roasted finish time was around 4 p.m which with that early start is still a 10 hour work day which is a far cry from the work day that dolly parton envisioned for us all [Music] but it turns out that finish time was also very much a suggestion i've done many busy world jobs before so i think i've gotten pretty good at knowing how to prioritize and how to do jobs efficiently by now and i remember in that week pretty comfortably finishing our jobs by three three thirty only really having one or two things that i thought were very acceptable to hand over to an evening team three three thirty rolled over and suddenly my whole vascular team all the registrars and everyone appeared on the ward telling me it was time for the pm ward round now as a health service concept i think an afternoon ward round actually makes so much sense you can check in with your seniors ask them any questions that you had for them go over any results that have come back during the day and maybe even discharge patients that you weren't so sure about in the morning but the thing is ward rounds generate ward jobs so we'd be doing these pm ward rounds at you know 3 3 30 sometimes even four when i'm meant to finish and then there would be a list of jobs generated from it and then you had to stay back and do them there's no way you could possibly hand over an entire ward round list of jobs to any evening teams this wasn't even the craziest thing that i had to wrap my head around staying late is no new concept to me in this career it was more the fact that when we didn't have stuff keeping us late those magical days where the pm round was a reasonable time like two o'clock-ish which meant we actually wrapped everything up by four and we could go home on time my fellow residents still didn't go home they would find jobs to do just to stay late and these were all non-urgent jobs things like preparing discharge summaries for the whole ward catching up on old discharge summaries preparing paperwork patients might need later on in the week and i was so bewildered really to just watch this happen in front of my eyes i would just be getting my bag and stuff to go home and then i would look around and see my other residents still working that was a bit strange but this phenomenon can be explained by one very simple word and that is overtime is that one word or two no no that is just one word yeah so over time as i've been through in a lot of detail in my australia payslip video overtime pay is a in existence unlike in the nhs b it is lucrative so you're paid at around double time of your normal full-time rate and c it is very easy to obtain there's no you know 10 different types of paperwork approval from someone sacrificing your firstborn child just to see that money there's just one form you just pop in your hours that you've done over time in the columns hand it in and then the money was included in your next pay slip that was it this demonstrates one of the big cultural differences between working as a doctor in the uk in the nhs and working as a doctor in australia in the nhs the pay is far less for far more hours in fact it's not even kept up with inflation so much so that you're in a 12-month contract you're basically working one month for free that is a whole other video in itself i'm not going to go into details there is no proper system for reimbursement of overtime but as a result of this the culture of finishing on time and handing over reasonable things to the next team that's coming on is widely accepted and widely honoured from what i've experienced in my previous jobs in the uk in australia it seems that because you are reimbursed for all these extra hours that are not included in your roster but are kind of a given and an expectation from you it's almost okay for the roster to abuse you as much as it likes because hey at least you're getting paid for it it's almost quite sadistic in a way i distinctly remember a conversation with one of my vascular wedges at the time i had just gotten to australia and was talking about how surprised i was by the extra hours etc with him and he turned and just looked me dead in the eye and said well i've earned more from my overtime pay than my actual salary and then i just looked him straight back and said yeah but do you have any time to spend this money and what is the point and i think that threw him a little bit because i generally get the impression that the money is valued so much more than the time here because it's almost an expectation that this is what a career in medicine looks like that you have to hustle you have to grind you have to work all hours of the day but it's okay because you get paid for it but listen you can talk about the time versus money debate for hours and hours and if i'm being totally honest the money it felt good now i don't believe that money should or can be the sole reason you go into medicine but i cannot deny that i felt really really good to see all of that money rolling in and to be paid for every minute that you're working as you should be really but there's some sort of culture of ickiness surrounding this concept when it comes to medicine with all of this money rolling in for all the hours i was working including the overtime premium the weekends premium together with the reduced living costs i was experiencing when compared to living in london there's just a lot more disposable income and i was really enjoying that feeling of being able to afford everything i wanted to do as well as have savings and pay for living costs which with the way the pay is in the nhs plus the way that living costs are absolutely rocketing it seems in the whole of the uk would be totally unheard of it was basically a bit of a stockholm syndrome situation where i was slowly burning out by these constant overtime hours and 60 hour work weeks that i was racking up but submitting all that overtime pay and watching the overtime pay roll into the bank account also felt really good so i kind of just kept letting it happen and of course by week five or week six i think it was i fully burnt out and i was not in a good space at all so was the money really worth it i don't think so we were coming to the end of the calendar year and it felt like i'd only just gotten to australia but the nature of a job in medicine is that you often need to make decisions now for what you will be doing in a year's time because of how the application processes work and so in amongst all the craziness of getting used to a new healthcare system moving into a new flat meeting loads of people trying to cram in as much traveling as possible around australia i was also mildly aware in the back of my brain that the surgical application process for surgical training in the uk was opening up and i might need to do something about that i'll be honest in amongst all the craziness and new experiences i just didn't want to confront making any life decisions but turns out i didn't have to worry because it got confronted for me on one fateful day in december my partner and i both realized that the application deadline had passed and neither of us had done anything about it the feelings i felt during this realization were pretty telling about my state of mind and what i actually wanted i had unknowingly committed to not having a potential surgical training job in the uk the following year and i was totally okay with it i think we both knew deep down that we wouldn't be ready to leave australia after a very quick year here and now a year later i think the surgical trainees are starting literally this week or next week and the thought of being back in the uk about to start a training job right now fills me with so much anxiety especially when thinking about leaving everything here behind already and i know for sure that yep it was definitely the right decision not to hop onto that conveyor belt just yet as we came into the new year i was just coming off a day surgery job which i have done a day in the life vlog about if you want to go and check that out but basically it was a lot better than my vascular surgery job and it did reassure me that i actually still did want to do surgery i was in theater a lot the hours were a lot better and i actually learned so much so really really glad i stuck it out and didn't quit after five weeks of vascular surgery my next job was in the emergency department and i have never felt more at home than i did there if you stood in the middle of the department and just closed your eyes not only would you look incredibly weird but you would also hear so many british accents that you'd forget you were in australia at all i think at least half of my seniors the registrars in ed were british doctors who'd come over at a similar time to me and settled down in australia and decided to stay and become emergency physicians and i can totally see why working in the emergency department as a doctor here in australia is objectively infinitely better than what i understand from the uk there's a few reasons it is so much more hands-on and practical the ed doctors do their own cardiac arrests their own intubations and loads of specialist skills that i would otherwise see speciality teams doing back home in the uk and i think a big reason for this is probably that the emergency department is much less busier i never did an ed job back home but from what i understand from my colleagues it just seems a lot less busy and a lot less pressure to get through the patients and quickly make a decision about discharging or referring to a speciality team it seems there's a lot more autonomy you have as an emergency doctor and a lot more of the management plan that you can initiate in ed without that pressure to quickly refer before you can actually get stuck in a bit it was a really great rotation i learnt so much and the uk doctors were all so happy it was a job where they were very very stimulated they could easily go part-time if they wanted and a lot of them did and the salary progression was absolutely fantastic they were just earning so much more than their equivalent counterparts in the uk i'd say at this point i was very much swinging not only towards staying in australia but i was also having a bit of a career or speciality crisis because ed suddenly looked so appealing i could drop down my hours easily i could still get very practical and hands-on skills which is one of the bigger reasons i want to do surgery it's not as competitive as surgery from what i understand so it would be maybe a little bit easier to get a job and of course the pay is fantastic as well so yeah that was definitely a win for team australia the next key event that happened on this journey was going back home back to the uk we went back a couple of months later in may for a friend's wedding and a few revelations happened on this trip firstly it really emphasized just how much more exciting my life is here in australia i will caveat that by saying most of my working life in the uk was all during covid so of course we weren't socializing as much and traveling as much as i might have otherwise done but working in a place like brisbane my casual weekend trips involve snorkeling and diving on the great barrier reef jumping into waterfalls meeting up for outdoor dinner and drinks etc and it was just miles apart from what my time away from work looked like back home so another win for team australia then obviously was the whole experience of meeting all my family and friends in a really short concentrated amount of time doing a year's worth of catching up feeling like you've missed out on things and also being reminded of just how much you left behind even now in this video or in any conversations i always refer to the uk as home without even realizing it because it will always be just that because of the memories and the growing up and all the roots that i've put down there so yeah i remember just feeling not sad as such but definitely quite wistful that i had been missing out on things and that i did have a lot of history and strong connections that i'd left behind the third thing that happened was going back for a friend's wedding meant that meeting all of my friends from medical school again most of whom who like me had taken an f3 year it's a very common thing to do and it kind of feels good when you're in line with what your peers are doing it feels like you're on the right track but now fast forward a year later most people are getting ready to finish their f3 year like me and had training jobs lined up for starting in you know august of this year so starting now it felt like everyone around me was now moving on and now progressing with their career and by this point obviously the ship had sailed for going on to training in the uk and i obviously had no training jobs lined up in australia either so it felt like i was slightly missing out on the career progression that everyone around me was now starting to do soon annual leave came to an end and it was time to come back to australia and i was starting on a breast and endocrine surgery job which is kind of what i think i want to do when i grow up so i was looking forward to it i've really been enjoying this job not only because i'm genuinely interested in what's happening but also the team is just fantastic and they've picked on quite early on that this is a career that i actually want to pursue and it's been a very interesting experience to be in a team where they know that you want to do their speciality the expectations have been so much higher my consultant after one of my first experiences of doing a breast clinic took me to the side and said that i needed to start thinking and acting like a registrar formulating management plans and basically managing patients more independently and that was quite terrifying because i feel like i've been coasting almost career-wise for quite a while and kind of building on what i already know but not really actively moving forward and i've been totally fine with that that was the plan of this year but given that i was a bit more invested in this speciality i feel like i was a bit more invested in actually learning and really enjoyed that experience of being mentored by my seniors i was now hovering in this position where i was pretty sure i wanted to start pursuing surgical training soon but i still wasn't sure in which country yes australia was this beautifully sunny haven that were literally throwing money at me to work on a very lawless rotor but it wasn't as straightforward because getting into surgical training here is a little bit more complicated than i would say it is back home as i've alluded to in some previous videos getting onto surgical training here is a bit of a game of who you know and who's willing to back you coming as an international graduate who's not already part of the system this can feel pretty difficult to penetrate sometimes this is largely because you need a lot of consultant references to make your application strong enough to apply i think you need about five or six consultants to give you excellent references it takes time to build these relationships and develop that rapport and it's not uncommon for doctors here to work in non-training jobs and apply three four sometimes even five or six times before they successfully get onto the surgical training program i know this door wasn't firmly closed to me but it would take a lot of grafting and a lot more years of experience before i could possibly think about opening it with the pull of family and friends back in the uk and a relatively more straightforward procedure for applying to surgical training i was being pulled a little bit back towards the uk but still quite unsure people often talk about this career being like a conveyor belt where you kind of just get on and keep moving and jumping through hoops to get to the next step i could kind of see that happening for me in the uk whereas in australia it felt like i would not be on that conveyor belt for a while it would be more like a hamster on a wheel or i'd have to keep working but i wouldn't actually be moving forward for quite a while that was until i had a pretty pivotal conversation with my breast registrar which threw a bit of a spanner in the works to be honest and made me rethink everything as i tried to redecide what to do next goodbye my lover goodbye my friend i feel like i've been talking for a really long time and i think this will be quite a long video so i'm gonna split this into two parts so tune in to part two which should be up soon where i will go into details about what i discussed with my registrar how that changed my thinking process as well as what my final decision was if you want to see videos of my journey in australia so far do check out some other ones on my channel and i'll see you in the next part bye [Music]

Channel: Surina Taneja

Views: 199,995

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Id: BrpeLK1oodw

Length: 20min 55sec (1255 seconds)

Published: Sun Aug 07 2022