r/ConsultantDoctorsUK

Hi Everyone,

I'm in medical school and was looking at applying for the army as a medical officer. I have spoken to multiple people going through training and a few mates a few years ahead in uni and everyone speaks positively about it.

I was wondering what the consultant lifestyle is like especially for hospital specialties? I understand they are based in certain hospitals with military units but how flexible are they if they would like to relocate or even if they want to practice privately?

Thanks you!

Hi everyone, Just wondering what sort of advise you would give to someone starting off as a new consultant in August. Things like staying on top of admin, how you keep track of patients investigations in a clinic heavy specialty. Does everyone just use excel? As a reg I normally used excel but obviously my workload won’t be the same volume due to on call commitments breaking up my time and being in only one place for a year doesn’t really help with seeing the same people over a long period of time. Thanks for any insights

Do you normally get notified when someone requests a SAR? Is this anything to be wary of....?

🚨 BIG UPDATE for NHS Consultants, SAS doctors, residents & GPs!

Fresh off the press – my latest video is now live!

**BIG UPDATE! Exciting new 26/27 modellers (including PLATINUM), new PLUS tool, and 26/27 valuation**

We’re now in the 26/27 tax year and July payslips will soon let us estimate 26/27 pay. Here’s everything coming soon:

✅ Brand new **PLUS add-on** – drag in your payslips, TRS, ABS-RSS, RPSS, HMRC extracts & more. It reads everything in seconds so you can model your pension in minutes, not hours! (England, Wales, Scotland included – NI coming soon)

✅ Automatically pulls in your RPSS / HMRC extract or prior PSS to calculate remedy tax / carry forward

✅ Completely refreshed **26/27 Modellers** with a clean new menu design (no more super long pages!)

✅ New **PLATINUM** tier (includes concierge) for detailed forward modelling: future pay, increments, promotions, salary sacrifice, retirement timing, state pension, net pay gaps & more

✅ Key info on the **2024 Scheme Valuation** changes taking effect from April 2027

👉 Watch the full update here:  
https://www.youtube.com/watch?v=w9UJEi1cQB8

(NOTE: No need to re-register if you’re one of the 5,300 people already on our list from last year’s modeller – you’ll get automatic updates.)

Watch out for upcoming launch videos with Andy Pow specialist medical accountant (twitter: medicaccountant).

Please share with colleagues who need this!

Let’s make pension planning effortless this tax year 💼📈

This feels like a silly question

But

Can anyone explain why my Total Reward Statement is only updated to 31/3/2022?

I thought it updated every August?

Current FY3 here. I've noticed that within just a couple of shifts, regs and consultants seem to work out who they can trust to get on with things independently vs whose work they feel they need to double-check more closely.

What are your green and red flags you pick up on early?

First-year consultant here, 10 PAs, mostly outpatient-based specialty and on-call frequency a lot less than as a reg 1 year ago - around 2-3 weekends a year and off-site overnight on call every 2 months or so. Pretty varied work with clinic, subspec and general, DGH inreach/referrals, triage. It is more flexible but it is harder and I'm working late most nights to keep on top of admin.

Just before the recent small pay bump we got I was amazed to see my normal monthly net was actually just shy of £5k (curse you plan 2 student loan!), only just over that now the increase has been applied.

Spoke to one of our regs who replied they're now on around £5.5k/month net! Of course they do more OOH on calls (I was doing them last year, around 1 x 24/hr on call a week and 1:8 weekends).

I'm glad regs (and all resident doctors) are being more fairly remunerated but I think this just highlights even more the issue with consultant pay, taking on all the responsibility for even less money!

How much would you charge for an insurance report for a claim for critical illness benefit? It is a factual report for my own patient. (Consultant colorectal surgeon who hasn’t written one of these in a long time)

I would genuinely like someone cleverer than me to explain what has happened over the last decade to the balance of work, responsibility and risk between residents and consultants. It feels as though the system has quietly lowered what it expects of residents, while raising what it expects consultants to absorb. Gaps in knowledge, clinical judgement and practical competence that once felt exceptional now feel increasingly routine. Consultants are then left to carry the risk, usually without recognition, acknowledgment or remuneration.

Every year seems to bring a further erosion of professional standards in medical school and postgraduate training. We are now reaching a point where this is not merely frustrating, but utterly unsafe for patients, and for the consultants expected to hold the whole thing together.

There is a fantasy among non-clinicians and consultants who do very little clinical work that consultants can simply make the “big decisions” and everything else will fall into place. This is patently nonsense-on-stilts. It misunderstand, wilfully or otherwise, both the capacity of consultants and the way doctors actually learn to become independent practitioners. You cannot train people by removing responsibility from them, nor can you run a safe service by pretending consultants have infinite bandwidth.

I do not understand why this is not a national conversation.
Postgraduate medical training is becoming unfit for purpose. Consultants cannot keep absorbing the consequences indefinitely.

I am a higher trainee appearing for a consultant psychiatrist interview for a community mental health team. This is in the same trust I trained and will hopefully get the job. I would appreciate any guidance on things to negotiate on taking up the job. I understand that the clinical lead or medical lead would meet the candidate after the interview to discuss terms? What do people negotiate for usually? Extra trainees? Research or teaching? Or is it ok to not ask for anything other than what is offered?

I do a 12.5PA role for the NHS and it genuinely does involve me working 9-5pm Mon-Fri. Any ideas on some private work ideas? So far I've identified ADHD/ASD assessments remotely, DoLS, MHA's. Unless I do tons of extra work it doesn't seem to make sense to take out a limited company with the faff and accountancy fees.

About to hit year 3 as a consultant. 10pa 3% sup. Thanks to extras I’ve been within the tax trap for a few years. No PP

Aggressive spreadsheeting and a SIPP has kept me just behind the line but it’s time intensive. Our kids are. In state school and only use after school clubs twice a week so tax free childcare is nice but not a must so I’m toying with just blowing through the trap and be damned.

The extra net pay would be nice and we’re modelled/planned to retire at 60 anyway so tempted to spend and enjoy the nice holidays now.

Anyone else planning to just do whatever extras they fancy and blow the income on fun shit?

Just a warning to any first (few) years consultants previously under the £100k tax trap.

Assuming you are on one of the first three points, had the standard 3% on call allowance, a 10PA job, did no locums or wli and are a member of the NHS pension - you were previously just under the £100k taxable limit.

The 3.5% pay rise (from April) will put you over £100k taxable and hence into the tax trap.

If you have childcare credits paying these back could cost you far more than your pay rise. You may need to take action to reduce your taxable pay through additional pension contributions (annual allowance allowing), gift aid or salary sacrifice schemes - but you may need to take action soon if you want use that last one.

Tony Goldstone's calculator can help calculate.

Hi all, I am a consultant needing elective surgery in a few weeks’ time, surgeon recommends min 2 weeks off postop, of which I gave notice on the day I received the date. A weekend on call falls on first week. CL pressuring me via DM and email to swap it in advance as is the “departmental norm”. Except I know that senior colleagues have not been made to do the same. I have already offered to work extra days preop and volunteered for next Xmas on call to show willing (neither offer acknowledged). CD copied in but has not commented as yet. CL put a half-hearted call for on call cover on our group chat, citing “elective sickness”. I admit I am somewhat upset by all this as I am a hard worker, rarely ever off sick and thought I was being reasonable with my other offers. AIBU to have thought I wouldn’t have to cover my own sick leave by swapping the on call in advance?

Edit to add:

It is day case ortho, clinically indicated, will be on crutches at least 2 weeks. There is no fight about the standard shifts, just the on call. In a DM, CL wrote “Wondering if you are going to swap your weekend? If you are sick you don’t need to swap but just asking” - so I confirmed it would be sick leave. But then came the “elective sickness” broadcast and an email the following day copied to CD: “Over the years before my many elective (and emergency) surgeries I have swapped as have many others.”

I agree with those who have said employment law would be on my side but I feel that pulling that card will make me the villain of the piece and risk long term working relationships. I feel pretty crushed/humiliated by the whole thing having recently overcome a period of significant depression (managed without any time off, I might add).

The consultant who keeps their head down and does exactly what’s in their job plan is often financially no worse off than the consultant who takes on Clinical Lead roles, service redesign, innovation projects, governance headaches and organisational risk.

Then we wonder why nobody wants leadership positions.

We used to have a culture of recognising exceptional contribution through Clinical Excellence Awards. Whatever their flaws, they at least acknowledged that some consultants contribute far beyond their contractual duties

Have we reached the point where the NHS has effectively removed meaningful incentives for consultants to innovate and lead?

If so, why should anyone volunteer?

Has anyone completed one during higher training? What was your experience and are you now a fully certified therapist? How flexible was your clinical supervisor and how did you manage workload?

Hello,

What are the best and not the most desirable parts of training as a doctor in the UK? I have heard that you have to completely sacrifice your life for your career but has can you manage both without feeling burnt out.

This might sound unusual but do you get adequate amounts of sleep during work days or do you feel like that you have to not focus on your health due to your job?

And if you had a chance to redo everything would you pick it all over again?

Please share your honest opinions but also don't scare me too much

- From an aspiring student

I’ve been a doctor for 25yrs now, and I’m finding it increasingly difficult to deal with constant exposure to illness and suffering and trauma and death

I work in EM, so the clinical work is constantly high acuity and constantly getting more complex. Pts are sicker

As I get older, I can’t help but be affected by the patients I see. It’s quite hard to distance myself. I find it hard to remember that there’s a majority of the population who aren’t sick and distressed or suffering from multiple cancers at the same time

How do others cope with this?

Edit to reply: thank you all for commenting. Some food for thought.