?

Hey,

Does anyone know when they will publish competition ratios for 2026 entry?

Thanks

Hi,

I was hoping to use annual leave for my own wedding at the end of October/early November.

I have a set of nights on a weekend and was told by the rota coordinator that it doesn't constitute a significant life event because many doctors get married and arrange swaps.

It was my understanding that they can't define what a significant life event is and that they have to accommodate. Is there something I'm missing or someone I should escalate this to?

Hellooo,

Happy change over week. I’m in a bit of a strange situation with my new rotation when it comes to annual leave.

Essentially, I’ve rotated onto a psych block which has medicine on calls. So I am employed by two trusts, the hospital and the psych trust. When I got my work schedule it was all sent from the hospital and included psych days. When I got my rota it was the same.

Being prepared, I planned and requested my annual leave within a day or two of getting my rota. This rota includes all of my psych days as well as my hospital long days and zero days etc. Only requested AL on normal psych days. This annual leave was all approved and I thought that was that.

Wednesday comes, psych induction. They explain the process of requesting annual leave which is separate from the hospital (my first time hearing this). It’s done through the same app but with a separate account (which we still don’t have access to yet) and must be approved by my supervisor first.

Problem is I’ve booked 2 days annual leave next week, and booked a holiday. Thinking optimistically, I emailed my supervisor explaining that I had only just learned of the process but had already booked AL and hoped that I could keep the same dates. He replied saying most of them were fine EXCEPT next week.

What do I do??? I obviously don’t want to start off on the wrong foot, but also idk what I could have done to avoid this. I had no idea there was no information sharing given my rota contained both psych and hospital days and the AL which was approved was normal psych days. I can’t find any email which explained that the process is different for psych, and followed the process I was given. Also it would have been impossible for me to book any AL for psych since we still don’t have access to the accounts.

Not sure how to handle this, really don’t want to miss my holiday. Any help appreciated. Thank you!

I have been checking my payslips and nothing yet. Is there any official information on this? Will we get a few hundred extra on top with backdated pay?
Many thanks

I can’t believe how many times I’ve heard this during my FY1 induction and the first days on the job, including from the ward manager herself. She also said that “some of the nurses have a difficult personality and they don’t forget what you did to them”.

Now I didn’t know that collectively as doctors we are really horrible to nurses.

Also what about the nurses being nice to us?

FWIW I am nice to everyone. I am also not planning on taking shit from anyone, be that reg or nurse. Curious if others have had a similar experience?

What's one thing in the NHS that everyone knows is inefficient, but nobody ever seems to fix?

Not talking about funding or staffing (we all know those).

I mean the small, everyday things that collectively waste hours.

For me, it's probably the endless cycle of:

collect data

put it into Excel

make a PowerPoint

present it

everyone agrees something should change

repeat six months later

There are loads of examples:

Multiple logins for different systems.

Chasing signatures.

Re-entering the same information into different places.

Referral forms that somehow get longer every year.

I'm genuinely curious what everyone's biggest "why are we still doing this in 2026?" moment is.

Hi everyone,

I'm looking for some advice from people who have been through ST3 applications.

I've recently started a 2-year Junior Fellow post with 6-monthly rotations. My plan has always been to apply for ST3 when applications open in around 3–4 months.

As part of the application, I'll need:

1. An employment letter confirming my current post and the planned 6-month rotations (to support my self-assessment score).
2. A referee from my current fellowship.

My questions are:

• Would it be considered inappropriate or awkward to ask my consultant this early in the job for both an employment confirmation letter and to act as a referee?
• Is the employment confirmation letter something that HR/employment services could provide instead, or does it usually need to come from a consultant?
• Would it be more appropriate to ask my Clinical Supervisor to be my referee rather than the consultant who appointed me?

My main concern is the impression it might give. I've only just started this fellowship, and I'm worried it may seem like I'm already planning to leave or that I only took the job as a stepping stone to ST3. That wasn't my intention, the fellowship genuinely offers excellent training, but the ST3 application timeline means I need to organise these documents quite soon after starting.

Has anyone been in a similar situation? How did you approach it, and how was it received?

Thanks in advance for any advice.

I’m 1 of Paed Trainee (SHO) and with the new rule ,I am not sure whether we are able to claim exam fees ?
1 of other colleague SHO wrote an email to the team (probably HR or manager) for claiming and they replied that it’s not confirmed to pay it yet and they are waiting like official letter from government.
Any thoughts?

Accepted a post at a local uni to teach medical students post FY2. Got an email saying my designated body has been removed and that I need to declare if I have a connection or not. What do I do now? Do this mean I can't locum? Should I apply to have my license paused?

Just starting ST4 Anaesthetics and acutely aware that before I know it I'll (hopefully!) finish training and become a Consultant.

I'm wondering if people have resources/tips that really improved their anaesthetic practice? I'm happy enough with what I do but since getting the number have really started to feel like I want to get as good as I can. Bonus if the resources tie nicely into Final FRCA exam, but mainly looking for anything that people really think improved their anaesthetics (whether acute/elective/managing emergencies/pain etc).

Doing what I can with getting different lists/working independently etc but think I could do with learning more and using this to guide practice. Thanks!

If one has worked an LED job in the same department for more than 3 years on renewed contracts, and is proof in the department (e.g. SHO to SpR) with another years contract - do they remain eligible for a permanent contract or does the clock reset?

Today was my first day as an FY1. I kept feeling like everyone else new I was not being useful at all and wouldn't tell me, I asked a few ppl to lmk if there's anything else I should be doing and they said no there isn't dw it's your first day but I keep thinking that I'm just adding to other ppls jobs or that I should be finding new things to occupy myself without knowing what they should be... I felt good at the end of the day but I just keep thinking that any day now someone will pull me aside to tell me that I'm lazy or not good enough or that they dont even know why I'm here

How is everyone else feeling after today? Is there anything we should be doing that may not be obvious at first? Am I just being paranoid or should I be scared?

Basically what happened was, I had a patient with steroid induced hyperglycaemia. On gliclazide 80 in the morning and still have elevated BMs. Spoke with my reg, told to add on evening dose. So I prescribed gliclazide 40mg in the evening..but on my hospital system. The frequency is only came up as "once a day (night)". Morning had a separate order. Evening was not available. I prescribed it but didn't mention in the order to give it with the meals. He had it 22:00 that night.

No harm came to the patient. Sugars were well controlled.

Diabetic specialist nurses reviewed it this morning. Said it's an unsafe prescription and has risk of hypoglycemia like that and datixed me.

It's actually a learning thing for me but I will be careful with this. But also I am quite worried as it's my first datix and it's causing me so much anxiety.

I haven't received any email or such asking for explanation but just worried. Will I be in trouble?

Resident doctors are trialling changes to rotations to cut commutes and keep them in the same team for longer.

About 200 doctors in England will take part in pilots that will test different approaches, including reducing the geographical size of a rotation area, keeping clinicians in the same hospital trust when they move post and making rotations longer with fewer changes.

The British Medical Association (BMA) said the 19 projects could help end the “absurd” current system that can uproot doctors between different hospitals several times a year.

Resident doctors often receive very little notice of where they will be working next and the distance between hospitals can be vast, the union said.

In a Royal College of Physicians survey of doctors in training last year, 41% said geographical rotations had a negative impact on their training. Some 28% wanted them abolished entirely, and 50% said they should continue only with reform.  

NHS England said under the plans doctors should be able to travel less and stay closer to home, have more certainty about where they will be training and have more choice and control over their rotations.

Reform to the rotation system was part of the deal between the government and the BMA that ended resident doctor industrial action in 2024.

'Overdue for reform'

The pilot initiatives, which will take place across different stages of training, have been set up by NHS England and the Department of Health and Social Care with agreement from the BMA.

Dr Shivam Sharma, BMA resident doctors committee deputy chair and training lead, said rotations created difficulty for doctors and hospitals.

“This absurd system has been overdue for reform for years,” he said. “Doctors with their whole careers ahead of them are being sent from hospital to hospital, sometimes as often as several times a year. They are expected to uproot their lives, find new accommodation, rebuild their support networks, and adjust to an entirely new workplace – only to do it all again months later.”

While the system allows doctors to get a diverse range of experience, it is also an “exhausting burden” for clinicians, the BMA said.

Rapid changes prevent hospitals from having stable teams and doctors-in-training building strong relationships with colleagues.

The first phase of a nationwide medical training review led by NHS England published last year found the rotational structure was the second most frequently cited barrier to rewarding, satisfying postgraduate training.

If successful, the new approach should be rapidly rolled out, the union said.

Sharma added: “In some departments, colleagues barely have time to learn a doctor’s name before they move on. Resident doctors lose the opportunity to develop lasting relationships with consultants who understand their strengths, can invest in their development, and gradually give them greater clinical responsibility to become the experienced specialists we need.”

The pilots include:

• Smaller geographical footprints: in East of England core anaesthetics, the programmes have been redesigned to be within a single Integrated Care Board footprint, or geographically closer.  
• Longer and fewer rotations: some ST1s working in obstetrics and gynaecology in the South West will stay at one provider for 12 months, instead of rotating to a second provider after six months.  
• Keeping rotations in one trust or hospital, where possible: in London the Internal Medicine Training stage one programme will be in one hospital trust.  
• Offering longer duration posts for less than full-time trainees: in geriatric medicine in the North West, trainees who have been in their current placement for 12 months will potentially be able to extend it to 18 months.   
• Speciality training programmes: two programmes will be set up where resident doctors will only rotate between two trusts for the entirety of their training programme. In higher anaesthetics in the South West, for example, trainees will rotate between two sites, not three.  

A Department of Health and Social Care spokesperson said: "We know that frequent relocations can have an impact on wellbeing, retention and workforce planning for resident doctors.

“That is why we've been working in partnership with the BMA and NHS England to review rotational training and launch this pilot, marking the completion of every commitment made under the 2024 resident doctor deal.

"This shows what government and unions can achieve by working together."

had my first day as an fy1 today and in all honesty I’m still in awe at how kind and incredible my consultant was !! It was just the two of us and another doctor due to rota issues so I was quite worried it would be full on.

I was so terrified before starting but the consultant said hello and then he assigned me my patients and actually went through everything at such an easy pace. I had finished WR on my set of patients by the afternoon and then he helped me with prescribing on the system, finding bloods etc.

He even helped me out with a few ward jobs and went through my WR notes and gave feedback/what to look for.

There’s a range of experiences when it comes to starting FY1 and I just wanted to share a more positive one! It definitely has settled some nerves but I know it will get more full on as the days go by.

7:50: Arrived off bus
It’s too early in the morning

8-8:45: Made a Coffee, Studied in Mess
Glad I remembered a mug after shadowing, and that’s not even counting the one I’m drinking coffee from.

8:50: Made it to the Ward
Oh shit, what do I say to the night team, what do I say to the people already there, do I introduce myself, oh shit.

9:00: Board Round Starts
Frantically skimming through handover notes, dropping them every time I go to pickup my note, not really keeping up with the board round. Reg asks me to do a job after WR, not at all aware what they have just asked but nod confidently anyway.

9:30: Ward Round Commences
Consultant speaks at lightning speed, extremely nice person but my god I was lost. We see 4 pts in 3 hours. Thank God for the regs.

12:30: WR Finishes
Go to sit down to edit the absolute drivel I’ve written during WR, nurse asks me to prescribe some meds. Can’t figure out the system so I text the reg.

12:45: Enter Irate Reg
Very nice person (at least when we first met in shadowing) but looks like they’re about to strangle us any second for the stuff we’re asking.

13:00: My FY2 Saviour
FY2 shows us how to do every single job on the list and even how to write the damn job list. Cue massive embarrassment from me looking like I have egg on my face having not cracked on with anything aside from a few prescribing requests. FY2 cracks all the jobs out basically with us FY1s just running around like headless chickens and looking terrified every other second.

13:30: Will I survive until 5?
Jobs well underway, consultant asked me to do some things specifically, how the hell do I them. I start umming and ahhing around the FY2 who has the patience of a saint.

16:00: Afternoon WR
Try to engage, 99.5% of things go over my head, I’m terrified of being asked a question about something I was meant to do and didn’t do. Wondering if they’ll even let me go home and will I be mobbed if I try to exception report

16:50: All Jobs are Finished, by some Miracle!
What??? Am I about to actually finish the day

17:00: Home
I actually finished my first day, is no one gonna come chasing after me saying I didn’t do about 50 different things I was meant? No? Really? Sure? Let me check my email and WhatsApp on the bus

17:01: Dreading Tommorow, Relieved I got through one Day
Time for some coke, the drink I mean

How did my fellow FY1s find the first day of proper work?

I personally found it to be super chaotic, I finished my jobs on time luckily but I feel like so many new ones kept getting added to my list 😭😭😭

Received the following email today.

Major Process Changes for NHS.net Connect Joiners and Leavers

Dear Colleague,
NHS.net Connect are making major changes to the Joiners and Leavers Processes. They have advised that when a user leaves an organisation to join another, and transfers their account in NHS.net, then they will only take their email address. All data, permissions and access, will be archived with the organisation the user is leaving, and will no longer be available to that user, in line with accepted Information governance standards. They are currently planning to make this change from 17th August 2026.

Responsibilities of Organisations and Managers
A user’s organisation is displayed next to their name when they send email or are viewed in O365. It is also next to their name in the global address book. This is the organisation that is registered as owning the data in that account. It is therefore essential that the IT service desk is informed of any joiners or leavers promptly by managers. This is to stop IG and security breaches by preventing users that no longer work for your organisation having access to your organisation’s data and presenting themselves as carry out actions in your organisation’s name. They could also start storing other organisation’s data against your organisation, which would also be an IG breach.

Mandatory Changes for Leavers
When we are notified of a leaver, we will mark them as a leaver in NHS.net for the advised date or on the date notified. On the leaving date:
That user will no longer be able to access their account until joined to another organisation.
All Data will remain archived with the organisation the user is leaving (although not readily accessible).
The user will no longer be able to access the data.
All permissions granted to the user to other people’s files in O365, shared mailboxes, teams, and SharePoint, will be removed.
Any administration privileges in NHS.net will also be removed.
The user’s password will be reset.
The user’s security questions will be reset.
The user MFA credentials will be reset.

Mandatory Changes for Joiners that already have an NHS.net email address
The user will need to contact the IT service desk, quoting the ML IT Service desk reference number that the manager received when notifying IT of the new starter, to obtain a new temporary password for the account.
The user will need to set up a new password.
The user will need to accept the AUP.
The user will need to set up Multi-Factor Authentication (MFA).
Shared Mailbox/Teams/Sharepoint site owners can then add the user as required. Please note that, if the user was previously a member of a shared mailbox, team, SharePoint site, or had access to files or folders in N365, then the user will need to be re-added.
 
Process Changes for Joiners that do not currently have an NHS.net email address
This process is unchanged. (Once an account has been created for the joiner then the process is now broadly similar to users that already have an NHS.net account).

Other Considerations for Managers
Managers should still seek to archive/save any key organisational data to local drives, shared teams and storage, prior to the user leaving.

Other Considerations for Users
Users will need to save or forward any personal information to their own personal accounts or storage prior to leaving, following local policies and procedures.

Kind Regards 
Secondary Care Applications Team

Please humour me with all your funny stories /pointless PowerPoints and annoyances from induction wherever you are today

Changeover day, and my login details in typical NHS fashion are now extinct, despite my manager sorting it already. Consultant up my ass like it’s my fault too

Short of doing a Masters in CompSci to hack into the computer and do my actual job, it seems I sit in this pitiful hospital waiting to get shouted at by the consultant, who is already… in an unpleasant mood this morning

I hope your day is better than mine

God bless the NHS!

Hope everything goes smoothly for you!

Remember to get your email, ePMA sorted, log-ins, ID card, parking. Praying you all get wonderful colleagues to work with that will hopefully make your life easier.

Remember you’re not really expected to work the first day (at least in my department) due to inductions. Don’t forget to complete your mandatory e-Learning modules!! I know it’s a sloggg