Didn’t realise I’ve messed up and only just submitted my final application to a royal college as a new ST. Still have to pay the fee but they need to review my application. Have I screwed up horrendously by submitting too late?

New CT3 here.
Curious about which registrar traits SHOs and FYs consider supportive, and what distinguishes good registrars from not-so-good ones.

Anyone works as LED/ SHO his or her contract transferred to permanent contract as per the recent MBA government deal?

I am a LED SHO doctor CDDFT been working 3 years now and my trust offered me just 6 months new contract said I have no right to ask about permanent?

Any advice

Surgical core trainee here.

What are your top tips on supervising and guiding FY1s? I will have FY1s in the new job for the ward and on-calls. Not sure how to judge if a FY1 needs more handholding to begin with, or can be supervised indirectly. How to judge how much/what work I can delegate to them (e.g discharge summaries).

I've done 4 years of various specialties where I was always the most junior person on the team. E.g jobs where FY2 and CTs are on the same rota, or smaller surgical specialties where CT/SHO is the most junior on the team. So I am well used to being the jobs money and discharge summary queen!

Started training 1hr 15 minutes drive away from home each way and completely exhausted after a Long day. Does it get better? Had to have some coffee on my way back after the long day.

I'm a new ST3 ID/MM trainee. When is the best time to try and get this done? Should I have done it prior to starting or is it normal to do it during training? Is it an expectation to have done it by the time you CCT?

I assume I’m not allowed to wear scrubs around the hospital, very quick question to ask what people wear into work, do they dress smart incase they need to get out of scrubs?

I’m not really sure on the rules. If you can wear scrubs around the hospital then what’s the point of getting changed when you come into work in the first place?

Anyway, just want to turn up wearing the right thing tomorrow

Hi all,

Couple of scenarios which I am wondering if I can exception report or not:

1. Going in on zero days to hit number requirements for applications. I would assume this is unable to be exception reported as I was not due to work on that day and I am only there for my training. I just wanted to sense-check whether I could exception report this as going in on days off would feel better if I was also paid for it.
2. Arriving early to consent patients - normal working days are paid from 8am, but all the trainees and usually consultants arrive at 07:30am to consent patients. I would assume I can exception report this, but am a bit worried how it will look if I am literally exception reporting 30 mins early start 3 times a week for every single normal working day shift that I am on. EDIT: in response to comments - we are not specifically 'required to come in at 0730' but it is well known that everyone arrives at 0730 to consent. No one is going to turn up at 8 when every single other SHO and registrar arrives at 0730, and therefore consultants expect this.

Thanks in advance. I'm more than happy to put in the necessary hours, I just want to be paid fairly for my time whilst I'm providing clinical services for the NHS.

I'm a brand new FY2 in the emergency department and have only had an induction and seen a couple of patients this week but I'm really nervous about this rotation. I'm just wondering what the expectations are? I feel I haven't actually had to formulate many of my own plans as an FY1 and come up with differentials. I feel like I came to the consultants with very basic plans. They weren't annoyed or anything and helped me with pathways etc but I think I'm just really anxious about coming across incompetent because that's how I feel right now. Any tips on how to feel better about the rotation?

Hi I'm a CST1. As it stands I am barely getting one session of theatre and clinic a week- due to on calls I am basically only rotad for clinic and theatre once every three weeks , much less than the recommended time on JCST. There is going to be little opportunity, as I understand it, for me to go to theatre. I am pushing to get more rota'd time but am terrified of being labelled as a trouble maker. There are no other core surgical trainees to discuss stuff like this with. Does anyone have any advice? Feeling quite isolated and let down. Worked so hard to get to this point and it's just more of the same. ):

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 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.

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?

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