My 700 days in NHS UK: My Journey – The 1st Joy

“Settling down” is a word you will never be able to appreciate unless you migrate to another country leaving your roots behind. However, everyone settles down, slowly and gradually. It took me 1 month roughly to properly settle down.

Today, the story is about my 1st NHS job. I finished my MRCP in December 2016. I got my GMC application approved in february 2017. I applied for a job straight after the approval of my GMC and it was an acute medicine registrar job.

I waited for 20 days before I received the first call for my interview for acute medicine Specialty Registrar post. I was extremely apprehensive about applying through Nhs Jobs thinking the HR might not see my application ( they do see all the applications dropped in NHS jobs – lack of my knowledge ! ). so I took help from a recruiter. I only had 3 days to prepare for the interview.

20th march 2017 – The interview day

I was all dressed up in a formal shirt, trouser and pump. Looking appropriate for the interview is the key. It really matters. Although I am not a nervous person, I can still remember , my hands were so freezing cold that I had to put them under the hot dryer for few seconds before entering to the interview 👀

There were a couple of people in the interview board, one was the clinical lead of that hospital. I remember nervously smiling at them but shaking inside.

I made a portfolio, no where close to my current one, just a brief but organized portfolio with my certifcates, which I handed over to the clinical lead. I will tell you what answers I gave at that time and how I could do make it better.

First question was – tell me about yourself.

I introduced myself , briefly with my graduation, post graduation and work experience , told them what I did so far and what I wanted to do in future. I mentioned my wish to be trained in medicine/ neurology. And here comes the twist. The interviewer asked me if I want to do neurology or stroke medicine. No way, I had an idea that in this country, these are two different specialities run by 2 different set of clinicans ( not everywhere in the UK though). I got confused and randomly made a preference of Stroke Medicine. He seemed happy with the answer as he could incorporate acute medicine with stroke medicine. I think this part went well.

I was asked why I came to the UK. I always find this answer tricky. You cant say something inappropriate about your own countries facilities. I hovered my answer around better training opportunity and research interest.

I was asked about audit. I certainly had not much idea. I was honest and said I dont have experience but I am keen on doing one. Now, I knew they would ask me about audit. So I roughly prepared a plan – I said I would do one on AKI ( Coincidentally – my first audit and my 1st QIP poster was on AKI – I could see it coming!! ) .

Now the clinical scenario

A 34 year old man, admitted on AMU with Shortness of breath – How will you manage?

I put my differential and plans quite correctly with chest infection, Sepsis, PE, MI, Pneumothorax etc.

How I could do better – I had no idea that NHS and UK practice bank on ABCDE approach. Thats what they want to hear in every single junior doctors interview . That was my learning.

Although I mentioned most of the key points of ABCDE , If I knew about it, it would have been a structured answer worth 5/5 points whilst mine one was probably a 3.5/5. Nevertheless, I learnt one new thing and thats the important bit.

Ethical scenario:

If this patient deteriorates despite the antibiotic and IV fluids at 3 am in the morning, what would you do provided he has learning difficulties?

I said I would optimize the treatment in the ward setting and if still does not help, I would call the ITU on-call to assess.

Then I was asked if he lacks capacity – who would make a decision – I said the medical team will make the decision.

He made it one notch difficult and asked if the relative does not want him to be ventilated – I explained I would discuss with ITU people and I definitely feel he is for ventilation . I would listen to relatives opinion but end of the day it was medical teams decision.

I said I will also call my consultant to get his opinion ( safe answer although the interviewers prefer situations to be managed by registrars 😀 )

I think I did pretty well with the ethical scenario with my limited knowledge from Paces. However, answers sound more appropriate if we can quote the GMC terminologies for ethical scenarios. So reading the GMC website is extremely helpful.

The interviewer asked me if I have any question – I did not know what to ask. So I thanked them and gracefully made my way out of the room 😀. The most important issues you can discuss in the interview board are – rotations, educational superviser, audit and research opportunities, competence sign off, future plan ( you want any clinic opportunity/ teaching opportunities etc). I knew nothing about above mentioned issues so I was just happy that the interview was finished and I was able to explore beautiful Leicester city 🏃‍♀ī¸

Yes, I got the Job. My 1st post was as a Specialty Registrar in Acute medicine in University Hospitals of Leicester. That is a lovely place to work in, trust me, I will give you more reasons to believe.

I received a call from HR before I even reached home. I could not express the delight and sense of comfort of that moment. 1st job in the UK – excited, happy and butterflies in the stomach and what not . I remember I was so happy and didnt know what to do at that time so I gave 10 pounds to a homeless person in leicester train station and bought a little smile from him 🙂

Why I took up the registrars post straight away? I had 3.5 years experience in Bangladesh and I was post MRCP, but that was not the reason. I learn from my life experiences. When I started to work in Square Hospitals, I joined as an RMO despite having MRCP part 2 completed before joining. I could have easily joined as mid level but I was told I was too young ( 1.5 years post internship) and they will upgrade me in a few months time. I had to wait for 1.5 year to actually get to the mid level pay scale after a lot of drama. Lesson learnt!

So I decided to start as a registrar in the UK. Simply because I wanted to experience the role so that it helps me for my training post since the job responsibilities are same in both training and trust grade registrar posts. It turned out to be an excellent plan although I experienced it as “baptism of fire “. I will share that experience of an essentially new, tiny, polite Asian Registrar in the next episode – hang in there 🙂

I would advise everyone applying for a job in the UK to wait until you get the best one for you. Especially, the duration of contract must be 1 year or more otherwise you have to change visa again. Find something close to your caliber and choice of specialty if possible. However, we dont live in a dream world so we might have to adjust accordingly. Please be patient as committing to a job is not only a job, it is your visa and future career. Number of jobs you applied for is never a problem, sieving the best out of that list and having the patience without getting tempted is a difficult ask.

Everyone has a story. It only matters when you appreciate both your good days and tough days. There is no bad days – you have only tough days which will pass eventually.

Leaving today with a promise of more tempting stories of my 1st job to come ~ Stories of overcoming my shortcomings 🙂

Dr Mahjabin Islam Aurin

ST4, Neurology, Royal Hallamshire Hospital

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