Question for the Doctors of MN

[Regularmumnetter]

DC considering doing a medicine course and have done a fair bit of online research so far. But have a few questions left:

1. after doing FY1 and FY2 in the NHS is it possible to move abroad, say USA, to begin speciality training? (would honestly be happy to work for anyone but the NHS)
2. can you choose each rotation you do during FYs?
3. what was the hardest year of med journey, e.g med school, FY, core training.
4. As I have found online after FY there are 3 years core training and 3 years sub speciality - how does a surgeon speciality pathway differ from this? and is it possible to take maternity leave during these years?

Would honestly be happy to work for anyone but the NHS? After taking all that funding for their training? Definitely not the right attitude for a doctor, they shouldn't even consider doing this.

Then they should go and train elsewhere instead of taking the training place, paid for by the NHS, of a doctor who will work in the NHS. At least make clear at interview that they have no plans to work in the NHS and are just looking to be trained and bugger off.

Also, if you're close enough to medics to know that the NHS are "notorious for treating junior doctors like shit" then maybe you should address your questions to those doctor friends, see what they think. Being a doctor has never been an easy, cushy option in the training years. And to be thinking about future mat leave when they are what, a teenager? Bizarre.

I concur with @unfortunatelyno . Seems unethical to use NHS training as a springboard for a career in another country. Send your child abroad instead of depriving someone truly committed to the entire training. If you think the NHS treats it’s doctors like shit (I don’t disagree), quit moaning about it and don’t enter the system.

13 years post graduation here and in the very last stages of my training so will answer….

It is possible to train elsewhere post foundation but very very difficult in the US and I know people who have really struggled trying to get training in Australia. It isn’t just doing their exams and hoping, it is incredibly challenging and especially so at such a junior stage. I really wouldn’t see it as the most realistic option at all!

It isn’t pick and mix for each one in the foundation programme but picking either one year and then a second year or both together with the jobs grouped together - I think the latter is more common but again things change. And hugely depends on how you perform to decide which rotations you get.

Hardest year - I can’t pick! I’m nearly at the end and counting down to my CCT date but none of it has been particularly easy and meant a lot of sacrifices.

Length of core training depends on the specialty and things are changing all the time with new curriculums etc so I wouldn’t be too wedded to what you read now! But generally 2-3 years core training and then 5-6 higher training and for lots of the surgeons I know time to do an MD or PhD which seems increasingly common or additional time for fellowships. It is a long slog with professional exams and lots of hoop jumping. It is possible to take maternity leave of course!

@unfortunatelyno First of all please tell me a med school that is not NHS trained and I will happily enquire there. Also your second point makes 0 sense because notorious means well known so your clearly unaware of the meaning to suggest I’m friends with junior doctors who have told me this - all you need to do is read the news to see how the NHS treat their workers. “And to be thinking about future mat leave when they are what, a teenager?” and when you are entering into a possible 15 years of training your going to wonder if you would like kids before 34 and if this will even be a possibility.
Wow do I love people that just come on MN to write hate on all threads. If any doctors would be able to give me the answers to my questions that would be great!

OP, MN are totally wedded to the fact that HCPs (and only HCPs) must live a life of servitude after a university education. Not maths or economics or PPE graduates. Just medics... despite them having to fund their own education in the same way.

Possibly not the best place to ask this Q!

I will add, it has been incredibly tough and I love what I do. But the long hours, the weekends worked, the night shifts, the sacrificing time with loved ones, the postgraduate exams….it has been exceptionally hard and I’m relieved I am near the end of my training. It isn’t something to enter lightly into. I did medicine as a post grad and glad I did.

your daughter needs to go into this with her eyes open - it is an amazing job yes but really not an easy path. And moving somewhere else also doesn’t make it easy!

Thank you, I found this very informative!

1. they’d would have to do the American exams on top of U.K. training at the very least. If electives abroad are still allowed by the time they get there it’d probably be worth going to America to see what healthcare there is like (it’s very different to U.K…. I wouldn’t want to work there).

2. ha ha, nope! Certainly when I was in training (& I think it’s roughly the same now) you rank where you want to be/what jobs you’d like and get matched up depending on how well you score in application.

3. different people will find different things hard.

4. Breezing through, core training might last 3 yrs and specialty training may take 3-5 yrs depending on specialty. In reality failed exams (which are very common), life-in-general, taking time out to do research etc can add more time. Not everyone becomes a consultant/GP - there’s a whole army of us who, for many reasons, follow unconventional career paths. Of course you can take maternity leave. Many parents chose to come back to work part time though, with implications for length of training. The unpredictable nature of where the next job may be/ doing on-call work etc can make childcare stressful but lots of people manage.

it sounds like your DC needs to get some real careers advice, ideally from people in/recently through the system. The NHS, medical schools and deaneries are not all the same thing and so lumping all the bad stuff as examples of how terrible ‘the NHS’ is makes no sense. If long hours in the NHS is a problem then the USA certainly isn’t going to be any easier! Training programmes are well regulated by the Deanery’s… it can be much more stressful once you’re out of the training system.

I think @unfortunatelyno has a point actually. Unlike other degrees, medicine costs the NHS a huge amount to train - a nurse costs a fraction the amount. Your dd is effectively asking the NHS to give her a hundred thousand pounds worth of training that she then fucks off with. I think that's quite immoral given the financial and physical resource she would have been given. I'm glad others are suggesting that isn't likely to be a viable option.

Whilst I agree with the point that we shouldn't expect servitude amongst medics, and we don't amongst other professions, the training for pretty much all other professions are paid for by the person themselves with no or very little subsidy. The subsidy to medics is enormous.

And if you want a med school that isn't NHS funded just look abroad and pay overseas fees - nothing to stop her applying, many do.

@titchy yet, in my opinion, junior doctors are largely underpaid and go out with a first salary of a lot less than other graduates despite having 2 more years of education. Due to the low funding of the health sector doctors are stretched and the treatment towards them is driving a lot of them away to private healthcare for better salary’s, better work benefits and in some cases more respected. Yes maybe it is unfair to take the governments funding and not give up your whole life to the NHS but if the government would focus a lot more on the health sector then I’m sure a lot less doctors would be moving to private.

Friends son doing medicine New Zealand are looking for this, he's thinking of applying

I think it costs around 250k to train a uk doctor, so the tuition fees barely scratch the surface.

It would be significantly easier to train where you plan to work, at least until speciality training is completed.

America is especially difficult as you have to pass their board exams. Each step on in medicine is like running a gauntlet, you have to hit the ground running. Transferring part way through is tough, and nobody on the wards care that she trained somewhere else, she'd be expected to do the job the same as everyone else.

So? I agree salaries are poor - no one is suggesting otherwise. It's the immorality of taking all that money in training costs and then fucking off with it I have an issue with.

The moral thing would be to train elsewhere at your/her own cost if she has no intention of working for the NHS.

Bit of course you won't do that because it's too expensive with you...

@titchy so how long exactly would you like for your DD to be working in the NHS? Is it a life sentence, is she a bad person if she ever leaves?

I think it’s ignorant to think that as a doctor your not going to take 2x the salary, better benefits and the possibility of being respected and treated better. But you expect doctors not to take this because it’s immoral?

Out of curiousity how many years do you think you should put in before it becomes moral for you to leave?

NHS isn't the best employer but not sure USA any better. Much shorter holidays for one.

We desperately need doctors to stay. I'm retiring next year and I'm very concerned we won't get a replacement for me. In 2010 we had 60 applications for one job. Now lucky if we get 1.

Benefits of NHS is good holiday/sick/maternity pay. Good pension even if newer one not as good as previous schemes. I know our accountants are very envious of it!

Can go part time
Training has protected time especially in GP. Our trainees do far fewer hours than I did as a GP trainee 30 years ago.

Personally I'd tie doctors whose training has been paid for by the NHS to do at least the equivalent of five years post foundation with the NHS.

They've invested huge amounts in you - the least you can do is let them reap some of the benefit of that investment.

Does your child WANT to do medicine? Or are you looking for kudos-by-proxy?

medicine is not a career path for wealth-orientated - is it not a calling?

but, if your child wants to be a doctor AND earn lots of money, I too feel they should train outwith the NHS. I once chatted to a lady on mn who was doing her medical degree (in English) in Budapest if memory serves me right. It cost about the same as attending a British university and no obligation to practice in Romania.

or, your child could study in the US - one of mine is aiming for full scholarship to MIT.

I personally think it’s immoral to batter and criticise “overworked nhs medics”, only to take the training and rob them of… a medic.

you’re either part of the problem or part of the solution.

fwiw, a friend got pregnant during FY1 and did her FY2 pt over 2 years - however the deaneries are under no obligation to help you out by keeping you close to home.

NHS HR here, to answer the questions you've posed... It's pretty common for junior doctors to spend at least some time abroad from after f2 onwards, Australia/New Zealand/Canada all popular, USA harder due to licensing requirements. Normally they go across to do locum work/fellowships initially and if they want to stay apply for speciality training from there. F1/F2 rotations come in bundles to ensure balance etc., usually 1 or 2 popular rotations per year and 1 or 2 less so, the higher ranking candidates (based on exam results etc) get first pick... Surgical training minimum 5 years IIRC, 2 years core surgical and at least 2 or 3 speciality training I think. But very few surgeons go straight through, most take time off at some stage to do further academic qualifications, research, a fellowship, maternity leave (yes this is possible, in fact common), go abroad or just to consolidate skills or earn extra money as a locum... All years of medical training hard in different ways so can't answer that one for you! Hope that helps

Honestly, I hope that your dc won't get into medical school in the UK. It's unethical to let the NHS absorb the cost of the training if you're not intending to work in it. Just go overseas and pay for your training there.

Personally, I'd like to see university fees waived for students doing medicine and nursing, with the caveat that they will have to pay back their fees with interest if they don't work in the NHS for a specified period.

If you want a private university in the UK, look at Buckingham. Cost is £170k.

@maxelly thank you!

There you go OP - that's great solution. She could train and keep her morals intact at the same time!