Medical training - comparison of options

pc11

Given all the horror stories about doctors' working hours, can anyone compare the various routes/specialities/hospitals in the sense of which are relatively bad and those which are relatively reasonable?

I'm considering doing GEM this year, but I'd be a fair bit older than average, and frankly the stories of extreme working hours frighten me. I'm more than willing to work hard, but I worry I simply might not be able for it.

Are there any routes or specialties or hospitals that are more reasonable in terms of hours and rotas than others? I'm guessing it depends a lot on the consultant you're with also?

Does anyone actually have any good stories of their training path where they had quite a manageable load and conditions? Please let there be some good news!

Ryder

Any hospital based specialty will take at least 6-8 years at least to qualify, and will almost certainly involve 1 or more years training abroad. Very few of my colleagues have gone from training to jobs and many spend a few years abroad in a holding pattern

Traditionally general practice is very competitive but has a shorter training time, 6 years I think, and doesn't involve training abroad.

Either way, you should try and do what interests you. Work is very tough, but if you like what you're doing its easier. However things have changed since I finished and many trainees aren't getting paid now for the excess hours which must really grate. There was a thread here last week on funding GME funding and it may be worth looking at

pc11

Ryder wrote: »

Any hospital based specialty will take at least 6-8 years at least to qualify, and will almost certainly involve 1 or more years training abroad. Very few of my colleagues have gone from training to jobs and many spend a few years abroad in a holding pattern

Traditionally general practice is very competitive but has a shorter training time, 6 years I think, and doesn't involve training abroad.

What does 'qualify' mean exactly in this context? Is it eligible to apply for consultant posts? I presume many docs work all the way through the years as a registrar and can't get consultant posts for ages, do they typically stay as a registrar indefinitely?

I thought GP training was 4 years after intern year?

Vorsprung

pc11 wrote: »

What does 'qualify' mean exactly in this context? Is it eligible to apply for consultant posts? I presume many docs work all the way through the years as a registrar and can't get consultant posts for ages, do they typically stay as a registrar indefinitely?

I thought GP training was 4 years after intern year?

GP is 4 years training, whether you get on 1st time is far from guaranteed, this year there were 3 applicants for each post for some schemes.

Ryder is talking about total amount of time after intern year I think, if you managed to get radiology straight after your SHO years, you'd be looking at 8 years from intern to completion of training here, but as Ryder says you'd realistically need to go abroad for fellowship before applying for consultant posts. If you finish SpR and can't get a job, you would be end up going abroad for a consultant post and waiting for a job to come up, for which there might be a few candidates. In short, it's tough to get a consultant job despite all your years of hard work!

Ryder

The 'beauty' of medical training is that its all or none. ie, after your basic medical degree, you need some sort of training (4-8+ years) before you can work independently. Training is competitive to access, but everyone eventually gets on some scheme.

There are very few opportunities to get off the career ladder and work say as a hospital staff grade (Registrar). It was possible, and relativly common, in the past for career registrars who would obviously be very experienced and provide a specialist service. However there was a law introduced which made anyone working in the same place for 3 years permanent, so now everyone tends to get moved on after 1-2 years.....which may be even another reason why hospitals are finding it hard to staff

pc11

So, would it be fair to say that the GP route is one the most 'straightforward' career routes, with a reasonably well defined path and duration (if you pass exams on schedule) and with pretty assured jobs at the end? Do many trainee GPs take much longer than the nominal 4 years?

Also, are the salary scales for trainee GPs the same as the hospital NCHD scales? If not, can someone post the typical scales please?

FYI this website was posted on another thread and it seems like a good resource for explaining the various specialties and career paths, though with a UK focus:

http://www.medicalcareers.nhs.uk/

What are the most and least competitive and difficult specialties?

Ryder

GP is the most direct and shortest. I dont know of any unemployed GPs, but as far as I know, which is really based on classmates stories, its not especially easy to get a partnership, so you can be locuming/ assistant for a number of years.