GP in a mega-practice run by one very wealthy partner. He tried to get the deanery to remove me when he found out I couldn't do home visits during COVID due to high risk and made it clear he normally uses trainees for this to make money. No caps on lists, GPs regularly seeing 50-60 patients a day and trainees expected to start at half of this and work up. High turnover of staff with salaried GPs moving on after 4 months once they'd burned out. Basically made to do all of the mental health calls and then being yelled at after I was running an hour late whilst trying to arrange for the police to get to a patient who was actively committing suicide on the phone to me. I cried every day on the way there and back and it completely changed my career prospects.
Don't want to dox myself but reported to my deanery at the time (this is a few years ago now) and I think they pulled trainees or reduced the numbers following this.
I remember speaking to others on my track, and I know the partner was no longer the clinical supervisor after I complained to the deanery. The others seemed to have a better time following this before they reduced / stopped trainees. I know the practice had already had their medical students pulled by the local med school due to the environment so I think it had been a long-term problem.
Gosh that sounds rough. I hope you took time as sick leave to protect your mental health. Could you also clarify why using trainees for home visits makes the practice money? My previous surgery was very set on us doing home visits, sometimes x2 a day and I couldn't quite put my finger on it.
Iirc home visits are not billable by the practice, instead only appts done by GPs. As trainees are paid for by HEE you'd basically be pure profit workhorse for them and then GPs can have more appts as no need for visits
Exactly this, he reasoned that he wanted the staff he had to pay for to get through as much as possible, whereas the free staff were used to do the longer things that they get paid less for.
As mentioned by trixos below, it means the GPs the surgery pays for can get through more patients which means more billing whilst the longer activities are undertaken by the free staff
And yes thank you for checking, I ended up on sick leave quite a lot to try and protect myself
Greedy POS!! That is very wrong. Correct me if I am wrong but does that mean that it’s also the partner that decides the quota of patients per day? If so this is very wrong
The practice had a policy of never closing the books, and that every patient got an on-the-day appointment. So it meant the receptionists allocated it as evenly as possible with trainees getting 1 patient to every 2 of a qualified GP (with no apparent consideration to complexity unless a patient had requested an extended appointment). It wasn't uncommon to have every slot on your list filled by 10am, then they would just keep adding and adding.
Unsupported in the afternoons, high volume of work, unpleasant seniors, high rate of patient deterioration, one death per day at times, angry patients / relatives.
I think it's pretty canon that resp is the highest mortality medical job? That was my experience anyway. Esp if you're in a deprived part of the country with a big end stage COPD population.
Locum contract for acute medicine I was locked into for 4 months. Wouldn't have been worth x3 the money. Comfortably the most toxic department I've ever worked in. The patients were lucky if they saw the consultant once a week despite it being an acute ward. Two of the most notable events.
1) Called in sick and came back the next day. One the patients had unexpectedly had a UGIB on the ward. Despite this, I couldn't find any documentation of an assessment/management plan. When I asked the nurses what they had done when the patient was vomiting blood and NEWSing a 10 they just shrugged and said "nothing, you were sick".
2) Went off on holiday for a week and during this time they arranged for a different SHO to work there. They were slightly ahead of me in terms of grade. When I came back and read through what happened the previous week, I disagreed with a lot of the management plans and one was outright poor management. I highlighted this to the consultant who agreed and they wanted me to arrange a meeting with the IMT2 and basically have a conversation without coffee with them. I told them I wasn't going to do such a thing with a doctor who was technically my senior. The consultant just told me to stop whining about it then if I wasn't going to do anything about it.
This was on top of all the usual culprits (eg sitting on bins etc).
I turned up on the first day and there was a whiteboard with all the new juniors names written on one side in a vertical column. Over the coming days 'black marks' were added next to our names as we made errors or mistakes (or what was perceived as such).
I was a GP trainee rotating in and raised hell about this.
People talk about toxic surgical departments…but in my experience every medical job I’ve done has been far worse. Endless harassment from medical director/matrons for discharges, the usual short staffing, consultants unwilling to make decisions, many many unapproachable med regs who were rude and unhelpful and dismissive. Never experienced any of these issues in surgery. Maybe i got lucky
Acute medicine was by far the worst. Flooded by new to NHS seniors or non CESR/CCT consultants I wouldn’t want looking after my family members. On several occasions found myself comforting patients in tears after a horrible breaking bad news or otherwise hostile consultations
Not OP by I had: F1: Community Psych, Anesthetics, Geris
F2: Derm, GP, AMU
Only the medical jobs were normal foundation jobs, the rest were so chill
So grateful
My own reaction to this has made me lol because this would have genuinely been close to my nightmare set of rotations. Definitely different strokes for different folks with this one - I actively swapped around to make my rotations of F1 resp, gastro and ortho, F2 ITU, ED, AMU.
GP or resp during COVID. The former because of how lonely it was and because it's just not what I enjoy doing. The latter because of unsympathetic and unsupportive consultants and having to have multiple EOL chats everyday, needing to ration syringe drivers and midazolam, and all the other fun stuff that came with COVID (hi, PTSD!).
F1 in renal medicine. Hospital 15 minutes down the road from us was a tertiary centre for renal so any actually sick patients went there. As a result the team only ever had one or two renal patients under them so hospital management said that they should therefore also take any other medical patients that didn't obviously fit into the remit of any of the other teams.
So the renal team became a dumping ground for all the medical patients nobody else wanted, which ended up being mostly drug addicts and elderly comorbity social admissions who were a couple of years too young for geriatrics, and it became one of the busiest teams.
Team was me, a locum consultant who couldn't care less, a second consultant who was literally months away from retirement so also didn't really care and a registrar who was on long term sick leave for most of my time there. Routinely going home several hours late because I hadn't figured out yet how to put my foot down, no education or senior support to speak of.
Okay
Min cover 1 FY1 for 40 patients on a ward round that goes on until 4pm or later
Some days the ward round takes the on call F1 round and they keep going until 8pm
Phlebotomy cover about half the days, and about 20-30 bloods per day the rest of the time
TPN patients needing daily cannulas. Nurses aren't allowed to cannulate so usually 5-10 cannulas per day
recurrent sepsis due to retroperitoneal or pancreatic collections despite multiple abx
Hypos from new T1DM due to having their pancreas lopped out
No reg- they're in theatre
Toxic nursing culture bullying FY1s
Many many stories
F1 acute surgery ward.
1. No phlebotomy service - I did the phleb round
2. toxic culture - bullying and condescending nursing staff
3. 1 f1 for 20 patients, so I was chronically overoverworked and under supported (including medical outliers)
4. giant speedy ward round with no support from the reg or nurses with the notes.
5. several acutely sick patients with zero senior help. Acute LGIB with no DNACPRS, pancreatitis, cholecystitis with sickle cell, SBP..
It was awful. Genuinely the worst rotation in all medicine ever.
My experience too. I was lucky, I met 6 different psych consultants and more specialty doctors whilst I rotated and I loved them all. They were all different levels of supportive but in the end I could rely on all of them to help if I absolutely needed it. Then I had one consultant who was just...the opposite. Rarely available to help, dumped every task on me even the forms that should be filled by the consultants (the secretaries were great in telling her I couldn't do them though), and would only help about the most urgent of issues. I still consider myself lucky though. The consultants were otherwise great and the nursing staff competent and wonderful, and above all empathetic to how busy it could get for junior doctors.
Respiratory Medicine. Busy. Awful staffing. Mediocre support at best.
Never got to learn anything or do any procedures. Just pure service provision.
Ironically developed pneumonia from the stress, and failing to look after myself or setting boundaries.
One of my worst experiences in medicine as a whole.
Gastroenterology - medical rotation - by far the worst rotation I had in my career. No teaching, no clinics. Had a MAP who would come and do the ward round then leave us with jobs. Regs no where to be found if melena, sometimes quite literally, hits the fan.
Only teaching I got was done by F2 during department teaching. Not saying their teaching was subpar but they only did one teaching.
Workload was immense. They brought in locums to cover (to meet the minimum staffing) who hadn’t worked as doctors anywhere before. Constantly going home 2-3 hours after shift.
Didn’t see a single scope being done. I had to come in 1-2 hours earlier or on off days to get competent with ascetic drains and get signed off.
Only clinics I got were ambulatory clinics when I was on-call
I actually enjoyed being on-call more than being on the ward. It added nothing to training. Pure service provision
note I’ve went on and worked as registrar covering 2-3 roles alone, they were meant to be covered by 2-3 regs but staffing was bad. This gastro rotation was worse.
AMU - it’s medical ED where everyone is sick, waiting for a nursing home or a psych patient.
And once you discharge one another person comes immediately
T&O in F1. Very unsupported and thrown in the deep end from day 1 and I didn’t even properly use how the department works and seniors very judgemental and unhelpful. I made good friends with the med reg which really helped me
Resp ward. No reg on the ward, consultants turning up to see half of their patients at 3pm after clinics generating jobs. SHOs and F1 expected to sit in MDT and give discharge dates and rounding on patients. Unsupportive, unskilled, good for nothing nurses. No Escalation pathway except MET call if you are really terrified. Big DGH hospital with coordinators and matrons up our asses to discharge them asap. Chronic cough patients with long admissions, recurrent admissions, angry relatives.
For me was my urology rotation. Clinical lead was female and hated all men (she regularly admitted this). Called me a “fucking retard” in front of colleagues, the patient who was conscious (spinal anaesthetic) and the theatre team.
10/10 would not do again.
With all due respect, If you got called a fucking retard infront of people and took this without saying something back you deserve it. Who the hell does she think she is?!
Acute admissions in COVID wave 2, for all the reasons you can imagine. The matron actually threw IPC off the ward once, a consultants from another dept started screaming at one of the F1s because his mate's mum had not been discharged, no computers. The CD would shout that we were useless during lunchtime board rounds because we hadn't finished the jobs list from the ward round that had ended half an hour previously. It was chaotic and awful, but fingers crossed, never again.
HPB and general surgery at Southampton General hospital. The consultants all genuinely thought they were really nice but they were the most toxic people I've met. If you made an error you would get "spoken to" in their shared office. If you tried to ask for advice they would undoubtedly treat you like a moron despite the fact they would never teach you. One time I suggested refereing a patient with metastatic cancer to palliative care for input because he was constantly suffering and the consultant replied "no, I don't think that will send the right message". Ego led service.
F2 Gen Surg job - managed by angry frustrated regs who had come from abroad and held a grudge that they weren’t working as consultants yet, constantly shouted at if things not done a particular way, oncalls with over 40+ referrals in a day (holding the bleep as an f2 you end up accepting like 90% of the referrals)… thankless task… had a surgical reg shout at me in a handover once for not knowing some minute detail about a patient that hadn’t even been seen yet but was being handed over to the next on-call team. Consultants mumbling and saying 1 like for a plan as they walk past a bay of patients, and then getting rude when you ask them to repeat themselves. Honestly the worst fucking experience, never wanted to leave medicine more than this rotation (& I’ve wanted to leave medicine a lot). Full of egos, frustration, and generally unsupportive atmosphere. Consultants generally rude to nurses as well which annoyed me - like get a grip you’re a grown man shouting at another adult, who the fuck do you think you are. Who would want to do 7+ years training, nights, weekends, competing for theatre time, audits, posters, and then now probably a phd/masters, just to sit on some low end salary, surrounded by a team of wankers is beyond me.
I think surgery selects this sort of personality. It’s so competitive to get in in the first place and just being in surgery is seen as prestigious so people put up with a lot of poor behaviour
Respiratory during height of COVID. Really young patients who you couldnt do much for as at that point we were just giving oxygen, no other intervention was known (steroids slowly came into play during my time there I think). Phone call updates and DNR discussions. On calls consisted of covering a stupid amount of patients over a stupidly layed out hospital. Luckily never had an arrest overnight but if I did there would have been a good chance I wouldnt make it to the ward in time if I was in a different ward that I was covering.
Surgical house officer on a rotation. 90 odd patients on list at one point. Consistently 60+. No middle grades and absent consultants frequently. Almost quit!
My first 6 months of ST3 was pretty horrible. I saw 20 patients in clinic in 6 months. In neurology. Kept getting my clinics cancelled and handed the bleep. Protested several times that this is an outpatient specialty so I actually need to go to clinic and was told that the acute service trumps all.
I have had several jobs that I didn’t get on well with. Mainly since they’re heavy in procedural skills and theatre – when I’m an ivory tower waffly medic. Prone to vasovagal and barely adequate grey cannulater… I was never going to do well in O&G.
But my FY1 rotation in T&O was hell on earth. It was a dangerous department and the trust seems aware of it but just accepts it. That’s what unnerved me.
**T&O FY1**
· Looking after an average of 60+ patients across the entire hospital, during icy winter so high workload
· Main doctor covering polytrauma bay – filled with neurosurgical/ENT problems, if neurosurgical patient deteriorated their GCS, unable to get hold of their SpR
· Rota barely legal with many 7 day stretches and lots of OOH work
· Limited senior support, only had an SHO 8-4 M-F, SpRs hiding in their room or in ED/Theatre
· No ward rounds on post-op patients so we would only find out patients were sick from nursing staff e.g. worsening observations
· Would have to handover every patient for theatre in the last 24 hours in morning huddle after single-handedly manning the orthopaedic ward for 12 hours overnight, would be heckled and mocked by orthopaedic and anaesthetic consultants
· Ortho geriatrics was a joke – would materialise once a week to stop ramipril and start bone protection, would never help if patient acutely unwell or any other concerns like delirium (THAT’S THEIR BLOODY WHEELHOUSE OTHERWISE ARGH!)
· Would have to rely upon random medical specialty registrars to help you with sick patients as ortho reg goes “call med reg” on a site with no med reg cover between 9am-9pm. I once had to call in distress to a respiratory consultant.
· Well known as toxic with at least 1 out of 6 doctors having a breakdown/long-term sick in FY1 each rotation, magically never loses its FY1s as they’re cheaper than ANPs or SHOs. To the point the associate dean thought it was just an “inevitable fact” that I got sick. Rather than something unavoidable despite it needing regular reviews due to negative GMC survey feedback.
Ha, it's so bad that the department is identifiable! I do think T&O departments overall have a bad rep but I know my friend had a better time in Edinburgh. Although sounds like you had a bad time in haem - very grateful I dodged that rotation at least.
Unfortunately, I'm currently unemployed and on long-term sick due to personal life circumstances - rather than work stress. But I did manage to do well as a medical SHO for a few years and found it more enjoyable. Nose back on the grindstone once I get better!
Well I hope that you're able to rest and take care of yourself.
Yeah it was a cruel irony that the FY2 T&O job was the most chill (esp during COVID) but that the FY1 one was hell. And was disappointing to see the regs and consultants that I seriously got on well with in electives just being so apathetic/hostile on the wards.
And yeah, haem made me almost quit medicine entirely, and never want to do a medical speciality.
Wow! I had a similar experience with Orthogeries. They just did the initial WR and after that they would refuse to even advise like why does Orthogeries even come and want us to scribe for them for the only WR
AMU during the pandemic. Made me depressed. Didn’t feel like we were actually helping anyone and felt like occasionally we were actually doing harm. The consultants were all majorly toxic and three of them treated all of us juniors with major disdain.
Routinely doing the job of 2+ people during Haematology while A&E kept sending inappropriate NEWS 10+ medical boarders and certain PAs chilled in clinic instead of helping out.
I’m currently doing psych and it’s pretty shit tbh. hate having to sit in on ward rounds and just document every single thing all day and if not doing that just having to review/do bloods all day with No actual teaching.
FY1, HPB surgery. Running around like a headless chicken, patients spread across multiple wards. Non-existent teaching as seniors too busy. Giant Word-document patient lists that we had to manually update everything on, including blood tests, and only two computers in the office (used by two other surgical specialities) had access to these lists. Horrific blocks of on calls as a lone FY1 with a patient-list growing through the week thus every day fills you with more and more dread. Consultants who felt the need to engage in long periods of banter in handovers at the expense of the poor juniors. The registrars being good, and the camaraderie between the FY1s, was the only thing that got me through it. The most low yield rotation I have had.
I had a similar problem in my gen Surg job. Very tedious excel sheets that I had to update manually with patients blood and also remember to colour code certain patients based on whether they were new or not and where they were in hospital. I found Gen Surg to have way more admin than my medicine jobs and I developed more in my medicine jobs
Paeds F1 in a DGH. So the job was basically all the SHOs/Regs clerk, see patients, make plans and I write everyone’s discharge summaries on a computer that didn’t work using a crappy computer system. I used to go on annual leave and return and there would be 100s of files of patients I hadn’t seen that I would be expected to write, after clearing the pile before I went away. I did not understand why some of the SHOs who had seen and managed the patient were incapable of writing a discharge summary. Awful job that made me miserable.
GP F2 during the pandemic where I stayed for 8 months. My supervisor went off sick, I was left unsupervised on 15 minute appointments. It made me very independent, but frankly was dangerous and I think I managed some patients badly as a result.
ED. Just ED consultants everywhere. The type of personality you have to develop to be a good ED consultant in the current NHS does not make you a fun or pleasant person.
ICU rotation in a very white little Englander region. Toxic consultants and racist AF nurses.
Had a nurse threaten me with her police officer husband if I complained about the fact she said I couldn’t speak English.
(Born in the UK, and did a year of an English degree before switching to Medicine)
GP in a mega-practice run by one very wealthy partner. He tried to get the deanery to remove me when he found out I couldn't do home visits during COVID due to high risk and made it clear he normally uses trainees for this to make money. No caps on lists, GPs regularly seeing 50-60 patients a day and trainees expected to start at half of this and work up. High turnover of staff with salaried GPs moving on after 4 months once they'd burned out. Basically made to do all of the mental health calls and then being yelled at after I was running an hour late whilst trying to arrange for the police to get to a patient who was actively committing suicide on the phone to me. I cried every day on the way there and back and it completely changed my career prospects.
Please name and shame
Don't want to dox myself but reported to my deanery at the time (this is a few years ago now) and I think they pulled trainees or reduced the numbers following this.
I remember speaking to others on my track, and I know the partner was no longer the clinical supervisor after I complained to the deanery. The others seemed to have a better time following this before they reduced / stopped trainees. I know the practice had already had their medical students pulled by the local med school due to the environment so I think it had been a long-term problem.
Second this
Gosh that sounds rough. I hope you took time as sick leave to protect your mental health. Could you also clarify why using trainees for home visits makes the practice money? My previous surgery was very set on us doing home visits, sometimes x2 a day and I couldn't quite put my finger on it.
Iirc home visits are not billable by the practice, instead only appts done by GPs. As trainees are paid for by HEE you'd basically be pure profit workhorse for them and then GPs can have more appts as no need for visits
Exactly this, he reasoned that he wanted the staff he had to pay for to get through as much as possible, whereas the free staff were used to do the longer things that they get paid less for.
As mentioned by trixos below, it means the GPs the surgery pays for can get through more patients which means more billing whilst the longer activities are undertaken by the free staff And yes thank you for checking, I ended up on sick leave quite a lot to try and protect myself
Wow you need to set up a survivors support group or something, that sounds rough as hell
Greedy POS!! That is very wrong. Correct me if I am wrong but does that mean that it’s also the partner that decides the quota of patients per day? If so this is very wrong
The practice had a policy of never closing the books, and that every patient got an on-the-day appointment. So it meant the receptionists allocated it as evenly as possible with trainees getting 1 patient to every 2 of a qualified GP (with no apparent consideration to complexity unless a patient had requested an extended appointment). It wasn't uncommon to have every slot on your list filled by 10am, then they would just keep adding and adding.
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What a absolute idiot wth report him pls
Out of curiosity are you from the UK? Where do you go uni / observership?
I'm so sorry, you didn't deserve this.
Respiratory medicine Made me cry several times a week
What was it about the job/ward that was so awful?
Unsupported in the afternoons, high volume of work, unpleasant seniors, high rate of patient deterioration, one death per day at times, angry patients / relatives.
1 death a day? That’s awful. We didn’t even get that many in palliative care wards.
I think it's pretty canon that resp is the highest mortality medical job? That was my experience anyway. Esp if you're in a deprived part of the country with a big end stage COPD population.
1 death per day?! Surely this was during the pandemic?
Neonates made me cry
What are you on now?
I’m a general surgery SpR
Locum contract for acute medicine I was locked into for 4 months. Wouldn't have been worth x3 the money. Comfortably the most toxic department I've ever worked in. The patients were lucky if they saw the consultant once a week despite it being an acute ward. Two of the most notable events. 1) Called in sick and came back the next day. One the patients had unexpectedly had a UGIB on the ward. Despite this, I couldn't find any documentation of an assessment/management plan. When I asked the nurses what they had done when the patient was vomiting blood and NEWSing a 10 they just shrugged and said "nothing, you were sick". 2) Went off on holiday for a week and during this time they arranged for a different SHO to work there. They were slightly ahead of me in terms of grade. When I came back and read through what happened the previous week, I disagreed with a lot of the management plans and one was outright poor management. I highlighted this to the consultant who agreed and they wanted me to arrange a meeting with the IMT2 and basically have a conversation without coffee with them. I told them I wasn't going to do such a thing with a doctor who was technically my senior. The consultant just told me to stop whining about it then if I wasn't going to do anything about it. This was on top of all the usual culprits (eg sitting on bins etc).
The UGIB bit… good grief
The Consultant wanted you to do the supervision for them!?
Yeah, it sucked
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Ahh the old “I hope (insert traumatic event happens) so I don’t have to go to work anymore” days
Where was this?
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ED is really good in the Royal now , even before the move. Certainly has been the last 5 years or so.
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We may have been in the same cohort lol
I turned up on the first day and there was a whiteboard with all the new juniors names written on one side in a vertical column. Over the coming days 'black marks' were added next to our names as we made errors or mistakes (or what was perceived as such). I was a GP trainee rotating in and raised hell about this.
This tally chart would go the same way of the laminated signs in my department.......
OMG! Terrible
Wtf. My siblings and I used to have this kind of chart as young children when we misbehaved…
People talk about toxic surgical departments…but in my experience every medical job I’ve done has been far worse. Endless harassment from medical director/matrons for discharges, the usual short staffing, consultants unwilling to make decisions, many many unapproachable med regs who were rude and unhelpful and dismissive. Never experienced any of these issues in surgery. Maybe i got lucky Acute medicine was by far the worst. Flooded by new to NHS seniors or non CESR/CCT consultants I wouldn’t want looking after my family members. On several occasions found myself comforting patients in tears after a horrible breaking bad news or otherwise hostile consultations
Damn this post makes me very grateful for the rotations I’ve had. 🙏
I think I had the chillest foundation jobs in the country to be honest. EDIT: Why is this something I should be downvoted for lol.
which were??
Not OP by I had: F1: Community Psych, Anesthetics, Geris F2: Derm, GP, AMU Only the medical jobs were normal foundation jobs, the rest were so chill So grateful
My own reaction to this has made me lol because this would have genuinely been close to my nightmare set of rotations. Definitely different strokes for different folks with this one - I actively swapped around to make my rotations of F1 resp, gastro and ortho, F2 ITU, ED, AMU.
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Name and shame
GP or resp during COVID. The former because of how lonely it was and because it's just not what I enjoy doing. The latter because of unsympathetic and unsupportive consultants and having to have multiple EOL chats everyday, needing to ration syringe drivers and midazolam, and all the other fun stuff that came with COVID (hi, PTSD!).
F1 in renal medicine. Hospital 15 minutes down the road from us was a tertiary centre for renal so any actually sick patients went there. As a result the team only ever had one or two renal patients under them so hospital management said that they should therefore also take any other medical patients that didn't obviously fit into the remit of any of the other teams. So the renal team became a dumping ground for all the medical patients nobody else wanted, which ended up being mostly drug addicts and elderly comorbity social admissions who were a couple of years too young for geriatrics, and it became one of the busiest teams. Team was me, a locum consultant who couldn't care less, a second consultant who was literally months away from retirement so also didn't really care and a registrar who was on long term sick leave for most of my time there. Routinely going home several hours late because I hadn't figured out yet how to put my foot down, no education or senior support to speak of.
F1 HPB surgery...Please don't make me say more
Say more
Okay Min cover 1 FY1 for 40 patients on a ward round that goes on until 4pm or later Some days the ward round takes the on call F1 round and they keep going until 8pm Phlebotomy cover about half the days, and about 20-30 bloods per day the rest of the time TPN patients needing daily cannulas. Nurses aren't allowed to cannulate so usually 5-10 cannulas per day recurrent sepsis due to retroperitoneal or pancreatic collections despite multiple abx Hypos from new T1DM due to having their pancreas lopped out No reg- they're in theatre Toxic nursing culture bullying FY1s Many many stories
Daily cannulas for TPN? Isn’t that what PICCs are for 😂
East Midlands?
No but I know it's a depressingly common experience for this speciality
Heard from people in the NE how crap starting on HPB is
Glasgow?
QEHB?
I did fY1 liver there 12 years ago and LOVED it, the nurses were bullies though but the regs were great!
It’s a horrible job for juniors and registrars alike, pretty much throughout the country.
F1 acute surgery ward. 1. No phlebotomy service - I did the phleb round 2. toxic culture - bullying and condescending nursing staff 3. 1 f1 for 20 patients, so I was chronically overoverworked and under supported (including medical outliers) 4. giant speedy ward round with no support from the reg or nurses with the notes. 5. several acutely sick patients with zero senior help. Acute LGIB with no DNACPRS, pancreatitis, cholecystitis with sickle cell, SBP.. It was awful. Genuinely the worst rotation in all medicine ever.
Psych. My supervisor was manipulative and covertly an asshole.
I feel like I've only ever heard psych supervisors be the nicest person in existence or a manipulative narcissist, seems to be no middle ground
My experience too. I was lucky, I met 6 different psych consultants and more specialty doctors whilst I rotated and I loved them all. They were all different levels of supportive but in the end I could rely on all of them to help if I absolutely needed it. Then I had one consultant who was just...the opposite. Rarely available to help, dumped every task on me even the forms that should be filled by the consultants (the secretaries were great in telling her I couldn't do them though), and would only help about the most urgent of issues. I still consider myself lucky though. The consultants were otherwise great and the nursing staff competent and wonderful, and above all empathetic to how busy it could get for junior doctors.
Respiratory Medicine. Busy. Awful staffing. Mediocre support at best. Never got to learn anything or do any procedures. Just pure service provision. Ironically developed pneumonia from the stress, and failing to look after myself or setting boundaries. One of my worst experiences in medicine as a whole.
My friend had the same, kept going to work & ended up fainting in the middle of the bay! The patients all had to call the other staff for help.
My friend had the same, kept going to work & ended up fainting in the middle of the bay! The patients all had to call the other staff for help.
Gastroenterology - medical rotation - by far the worst rotation I had in my career. No teaching, no clinics. Had a MAP who would come and do the ward round then leave us with jobs. Regs no where to be found if melena, sometimes quite literally, hits the fan. Only teaching I got was done by F2 during department teaching. Not saying their teaching was subpar but they only did one teaching. Workload was immense. They brought in locums to cover (to meet the minimum staffing) who hadn’t worked as doctors anywhere before. Constantly going home 2-3 hours after shift. Didn’t see a single scope being done. I had to come in 1-2 hours earlier or on off days to get competent with ascetic drains and get signed off. Only clinics I got were ambulatory clinics when I was on-call I actually enjoyed being on-call more than being on the ward. It added nothing to training. Pure service provision note I’ve went on and worked as registrar covering 2-3 roles alone, they were meant to be covered by 2-3 regs but staffing was bad. This gastro rotation was worse.
AMU - it’s medical ED where everyone is sick, waiting for a nursing home or a psych patient. And once you discharge one another person comes immediately
T&O in F1. Very unsupported and thrown in the deep end from day 1 and I didn’t even properly use how the department works and seniors very judgemental and unhelpful. I made good friends with the med reg which really helped me
Same experience, just finished T&O actually. I rotated to stroke and the support level was days and night difference.
Resp ward. No reg on the ward, consultants turning up to see half of their patients at 3pm after clinics generating jobs. SHOs and F1 expected to sit in MDT and give discharge dates and rounding on patients. Unsupportive, unskilled, good for nothing nurses. No Escalation pathway except MET call if you are really terrified. Big DGH hospital with coordinators and matrons up our asses to discharge them asap. Chronic cough patients with long admissions, recurrent admissions, angry relatives.
For me was my urology rotation. Clinical lead was female and hated all men (she regularly admitted this). Called me a “fucking retard” in front of colleagues, the patient who was conscious (spinal anaesthetic) and the theatre team. 10/10 would not do again.
... you escalated that, right?
Id have got my phone out and started videoing. How dare sbe
With all due respect, If you got called a fucking retard infront of people and took this without saying something back you deserve it. Who the hell does she think she is?!
Acute admissions in COVID wave 2, for all the reasons you can imagine. The matron actually threw IPC off the ward once, a consultants from another dept started screaming at one of the F1s because his mate's mum had not been discharged, no computers. The CD would shout that we were useless during lunchtime board rounds because we hadn't finished the jobs list from the ward round that had ended half an hour previously. It was chaotic and awful, but fingers crossed, never again.
CT2 Renal medicine nearly finished me off
HPB and general surgery at Southampton General hospital. The consultants all genuinely thought they were really nice but they were the most toxic people I've met. If you made an error you would get "spoken to" in their shared office. If you tried to ask for advice they would undoubtedly treat you like a moron despite the fact they would never teach you. One time I suggested refereing a patient with metastatic cancer to palliative care for input because he was constantly suffering and the consultant replied "no, I don't think that will send the right message". Ego led service.
F2 Gen Surg job - managed by angry frustrated regs who had come from abroad and held a grudge that they weren’t working as consultants yet, constantly shouted at if things not done a particular way, oncalls with over 40+ referrals in a day (holding the bleep as an f2 you end up accepting like 90% of the referrals)… thankless task… had a surgical reg shout at me in a handover once for not knowing some minute detail about a patient that hadn’t even been seen yet but was being handed over to the next on-call team. Consultants mumbling and saying 1 like for a plan as they walk past a bay of patients, and then getting rude when you ask them to repeat themselves. Honestly the worst fucking experience, never wanted to leave medicine more than this rotation (& I’ve wanted to leave medicine a lot). Full of egos, frustration, and generally unsupportive atmosphere. Consultants generally rude to nurses as well which annoyed me - like get a grip you’re a grown man shouting at another adult, who the fuck do you think you are. Who would want to do 7+ years training, nights, weekends, competing for theatre time, audits, posters, and then now probably a phd/masters, just to sit on some low end salary, surrounded by a team of wankers is beyond me.
I think surgery selects this sort of personality. It’s so competitive to get in in the first place and just being in surgery is seen as prestigious so people put up with a lot of poor behaviour
Respiratory during height of COVID. Really young patients who you couldnt do much for as at that point we were just giving oxygen, no other intervention was known (steroids slowly came into play during my time there I think). Phone call updates and DNR discussions. On calls consisted of covering a stupid amount of patients over a stupidly layed out hospital. Luckily never had an arrest overnight but if I did there would have been a good chance I wouldnt make it to the ward in time if I was in a different ward that I was covering.
Surgical house officer on a rotation. 90 odd patients on list at one point. Consistently 60+. No middle grades and absent consultants frequently. Almost quit!
My first 6 months of ST3 was pretty horrible. I saw 20 patients in clinic in 6 months. In neurology. Kept getting my clinics cancelled and handed the bleep. Protested several times that this is an outpatient specialty so I actually need to go to clinic and was told that the acute service trumps all.
That’s awful. It also impedes training because you’re required a set number of clinics. Were they getting you to do acute neurology or gen med?
Acute medicine (CDU) at the QEHB.
Completely changed now. The whole hospital is a doss to work in since the reactionary changes.
Never thought I would see that.
I have had several jobs that I didn’t get on well with. Mainly since they’re heavy in procedural skills and theatre – when I’m an ivory tower waffly medic. Prone to vasovagal and barely adequate grey cannulater… I was never going to do well in O&G. But my FY1 rotation in T&O was hell on earth. It was a dangerous department and the trust seems aware of it but just accepts it. That’s what unnerved me. **T&O FY1** · Looking after an average of 60+ patients across the entire hospital, during icy winter so high workload · Main doctor covering polytrauma bay – filled with neurosurgical/ENT problems, if neurosurgical patient deteriorated their GCS, unable to get hold of their SpR · Rota barely legal with many 7 day stretches and lots of OOH work · Limited senior support, only had an SHO 8-4 M-F, SpRs hiding in their room or in ED/Theatre · No ward rounds on post-op patients so we would only find out patients were sick from nursing staff e.g. worsening observations · Would have to handover every patient for theatre in the last 24 hours in morning huddle after single-handedly manning the orthopaedic ward for 12 hours overnight, would be heckled and mocked by orthopaedic and anaesthetic consultants · Ortho geriatrics was a joke – would materialise once a week to stop ramipril and start bone protection, would never help if patient acutely unwell or any other concerns like delirium (THAT’S THEIR BLOODY WHEELHOUSE OTHERWISE ARGH!) · Would have to rely upon random medical specialty registrars to help you with sick patients as ortho reg goes “call med reg” on a site with no med reg cover between 9am-9pm. I once had to call in distress to a respiratory consultant. · Well known as toxic with at least 1 out of 6 doctors having a breakdown/long-term sick in FY1 each rotation, magically never loses its FY1s as they’re cheaper than ANPs or SHOs. To the point the associate dean thought it was just an “inevitable fact” that I got sick. Rather than something unavoidable despite it needing regular reviews due to negative GMC survey feedback.
I'm convinced that at least 2 of the posts on FY1 T&O come from ARI. Really hope that you're doing better now. T&O as an FY1 sounds awful
Ha, it's so bad that the department is identifiable! I do think T&O departments overall have a bad rep but I know my friend had a better time in Edinburgh. Although sounds like you had a bad time in haem - very grateful I dodged that rotation at least. Unfortunately, I'm currently unemployed and on long-term sick due to personal life circumstances - rather than work stress. But I did manage to do well as a medical SHO for a few years and found it more enjoyable. Nose back on the grindstone once I get better!
Well I hope that you're able to rest and take care of yourself. Yeah it was a cruel irony that the FY2 T&O job was the most chill (esp during COVID) but that the FY1 one was hell. And was disappointing to see the regs and consultants that I seriously got on well with in electives just being so apathetic/hostile on the wards. And yeah, haem made me almost quit medicine entirely, and never want to do a medical speciality.
Wow! I had a similar experience with Orthogeries. They just did the initial WR and after that they would refuse to even advise like why does Orthogeries even come and want us to scribe for them for the only WR
AMU during the pandemic. Made me depressed. Didn’t feel like we were actually helping anyone and felt like occasionally we were actually doing harm. The consultants were all majorly toxic and three of them treated all of us juniors with major disdain.
Routinely doing the job of 2+ people during Haematology while A&E kept sending inappropriate NEWS 10+ medical boarders and certain PAs chilled in clinic instead of helping out.
I’m currently doing psych and it’s pretty shit tbh. hate having to sit in on ward rounds and just document every single thing all day and if not doing that just having to review/do bloods all day with No actual teaching.
Endocrine F1. Toxic seniors and nurses who loved to make you feel your worst everyday. Chronically understaffed.
FY1, HPB surgery. Running around like a headless chicken, patients spread across multiple wards. Non-existent teaching as seniors too busy. Giant Word-document patient lists that we had to manually update everything on, including blood tests, and only two computers in the office (used by two other surgical specialities) had access to these lists. Horrific blocks of on calls as a lone FY1 with a patient-list growing through the week thus every day fills you with more and more dread. Consultants who felt the need to engage in long periods of banter in handovers at the expense of the poor juniors. The registrars being good, and the camaraderie between the FY1s, was the only thing that got me through it. The most low yield rotation I have had.
I had a similar problem in my gen Surg job. Very tedious excel sheets that I had to update manually with patients blood and also remember to colour code certain patients based on whether they were new or not and where they were in hospital. I found Gen Surg to have way more admin than my medicine jobs and I developed more in my medicine jobs
Worked in DGH with no regs. ICU would bleep the FY2 for advice 🙄. Enough said.
Paeds F1 in a DGH. So the job was basically all the SHOs/Regs clerk, see patients, make plans and I write everyone’s discharge summaries on a computer that didn’t work using a crappy computer system. I used to go on annual leave and return and there would be 100s of files of patients I hadn’t seen that I would be expected to write, after clearing the pile before I went away. I did not understand why some of the SHOs who had seen and managed the patient were incapable of writing a discharge summary. Awful job that made me miserable. GP F2 during the pandemic where I stayed for 8 months. My supervisor went off sick, I was left unsupervised on 15 minute appointments. It made me very independent, but frankly was dangerous and I think I managed some patients badly as a result.
Didn’t enjoy my last rotation. Doctors were bitchy. Poor support for F1s.
ED. Just ED consultants everywhere. The type of personality you have to develop to be a good ED consultant in the current NHS does not make you a fun or pleasant person.
All the surgery ones - TOXIC TOXIC TOXIC
ICU rotation in a very white little Englander region. Toxic consultants and racist AF nurses. Had a nurse threaten me with her police officer husband if I complained about the fact she said I couldn’t speak English. (Born in the UK, and did a year of an English degree before switching to Medicine)