Passed PLAB - OSCE ?
 
 
Life in UK

Weather:
English weather is very fickle. There have been days when one can experience warm sunshine in the morning upto 15-18oC which becomes cold to 4 degrees by night made worse by the "wind chill factor" - blowing winds. It could rain as well and indeed make your dress plan go awry. To the extent that they wish for a good day as their greeting. In India you have taken that for granted!

Broadly, it is summer between end May and late September of each year. The temperature is most in June and July and most August. Each year, some days will be 30oC hot and as the houses are designed to conserve heat rather than losing it (no cross ventilation), it results in real tormenting time. People spontaneously jump in the water fountain in Trafalgar square in herds! In the summer it is light by 4.30 in the morning (even earlier in Scotland) and will be light until 9-10 pm.

UK does not have monsoon season like India. April till June may have showers but they are never so horrible to require to take a day off. Children have to depend on other excuses to take a holiday. It may rain in winter as well. By and large the rains will be less than an hour or two at a time and only rarely longer.

Winter is mainly from October until April-May. Worst in Jan and Feb. In the winter, temperatures hoover between 2 - 10oC. Rains and wind make life miserable. It is dark even at 7 am and by 5 pm again. Sun may not shine for days on end and life is really miserable. Hospitals are always at mediterranean temperatures, around 29-30oC at all times of the year. Mostly for patients. You could easily move in corridors in your OT dress and not be cold. Maternity wings are even hotter. Heating your house is an expensive business and if one is paying the bill they keep temperatures upto 23oC. Clear cloudless skies are a rarity, no wonder astrology did not develop in this part of the world.

In your first days, you are tempted to use woollen clothings and innerwear, while within a year or so, you will get used to the weather. A big overcoat (woollen) often suffices. A simple way boys use is to wear 2-3 layers of clothings which traps air and keeps them warm. Girls find this advice less acceptable for obvious cosmetic reasons. Local teenagers still wear mini skirts in winter (though they need to smoke to keep at least some part of themselves warm!) Scotland is 500- 700 miles north of London and has much more colder times than south such as London and further south, Southampton. Manchester is midway and west and has a wetter weather than most other areas.

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Your journey from Heathrow to East Ham:

London Underground (called the "tube" and not "railway" which refers to British railway, BR) runs along different "lines" which criss-cross the whole city, especially the central area. Some of it is more than 100 feet deep and is served by escalator-stairs, so deep, your ears pop when descending or coming out! In the second world war, people used them as air-raid shelters! For our purpose of reaching East Ham, you are concerned with "District" line and "Piccadilly line"

Heathrow is served by only one line, and there is only one platform to both come and go, a circular sort of route. A single fare to East Ham costs £3.40. To come to East Ham, you need to change to district line which you could do at either Earls court or Hammersmith. But Hammersmith is a better option as you do not have to change platform unlike Earls Court.

From Heathrow airport to Hammersmith is approximately 50 minutes and from there to East Ham station is around 70 minutes. The order of stations before East Ham is Plaistow - UptonPark - East Ham.

Step out of East Ham station and in 10 feets is "Petchey Car" the cab company. Most distances in East Ham will be reached within £3.

East Ham Tube Station :

East Ham tube station. Has only one exit and it leads up to the high street north. Left and left again is Burges road. 182 Altmore Avenue is 3rd left, while St Pauls church is further down Burges road.

    

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Scenic Scotland :

   

    


Dress code :

For Gents
Dark suit (single breasted modelled here), plain white or any sober colour, leather shoes black most preferable. Dark glasses only to hide identity and prevent girls mobbing this dashing part-time model of ours, as insisted by his wife! Ties have become slimmer, and the size seen here is quite safe. Red, yellow are other favourite colours in ties, though avoid Disney characters on ties for formal interviews!

For Ladies
During the exams , interviews or formal meetings you are required to wear a skirt (you could have it made a little longer than your knee length generally, judge the right length when you sit, not only when you stand) with a jacket of the same material and colour and a plain white shirt (remember there should be no major embroideries on the white shirt) colour preference for the skirt and jacket could be Navy blue , or dark grey or similar shades . Stockings either skin colour or black would be expected as is the culture and tradition in UK , and you will not regret this either due to the extreme cold. Ornaments should be avoided as much as possible with only little makeup. Sober stuff.

Dr Ms SR asks:

Thanks for your mail.

The advice on dress code for doctors is obviously based on my personal observations over the last decade and more that i have spent in the UK. I am sure this opinion leading to the advice has been influenced in someways by what i saw during the scores and scores of interviews and conference- meetings that i attended as well as small talk and gossip that i must have heard during semi-social events and OT changing rooms.

I cannot imagine that there will ever be a formal code approved by a royal college, i cannot think that there will ever be a pope of the "church of sensible dressing" in the UK or for that matter anywhere else in the world. We go by simple findings and observations which unfortunately seem to carry more power when seen in the written form either a book or the internet. When you ask "are they not allowed to wear trouser..." i am sure you mean it in the sense of the general sense of disapproval rather than literally not allowed as in wearing jeans at the chancellor of the exchequers annual dinner at the city.

It is true that most Asian lady doctors will wear trouser suits for their examination and i can off hand remember only a handful who wore a skirt suit at their PLAB examination. They perhaps wore it not because we advised but because they would have done so anyway. Being comfortable and relaxed is the most important thing. Only recently i advised a devout muslim doctor to not worry about his beard and his tradional Pakistani dress of pre-ankle length trousers and no tie on his short-collar shirt. He was worried as all seem to advise him to appear British and i was the only person encouraging him to be himself. He not only passed the exam first go, but also subsequently got his job in fast time. I cannot say that his dress helped him, but certainly did not seem to have harmed him! Destiny not dress is what matters i say.

I hope this answers your question -perhaps more elaborately than you expected (or wanted), but that is what we are known for. No half measures!

Dr.Maha


    
What's in name -The name game:

"What's in a name" Shakespeare did not think much of a name, however the GMC thinks differently and perhaps for a good cause. This write-up is to make you aware about this so that you are not at the receiving end. This doctor from Kolkatta was refused registration as his name on the birth certificate mentioned his name as "Bandhopadhyaya" whilst that on his IELTS and passport and called him "Bannerjee". His MBBS certificate mentioned the name of his birth-certificate, "Bandhopadhyaya". The GMC was ofcourse bewildered that there is such a big difference between the name on his official documents. The poor doctor argued with the GMC and they asked him to get letters from the University mentioning that these names are of the same person. This is obviously impossible from here. We talked to the GMC and explained this peculiarly unique problem of Bengal. He made an affidavit and the our friends in Indian high commission wrote a letter mentioning this being a common practice in Bengal. The problem was resolved and the registration granted but not without giving our man a sleepless week! All the Gangoolys and Bannerjees (with 3 variations of spellings) and other watchout! More recently  we had a problem with this young lady whose confusion was caused by the Mumbai University. Sonal Joan D'costa was her name on her birth certificate, which is quite like names are in UK, both the middle name being the person's second name. The names on her passport were also on similar lines, except on her MBBS certificate we have her name entered as is practice in Mumbai, middle name being that of her father. So MBBS mentions Sonal Cyprian D'Costa. To complicate matters, the original passport has her fathers name mis-spelt to Cyrian. The GMC obviously got a bit confused and asked for a clarification from the University. Initially they sent the doctor packing without entertaining any alternative arrangements however with more phone calls from us, they resented and accpepted an affidavit mentioning this disparity. Lesson for all of us is to match the birth-certificate with the University certificate and that your name is the same. Your IELTS and passport should also have same names. If your name on any of the documents has initials  as CVK Murthy, do get an affidavit clarifiying what those intials  mean. Hopefully atleast your passport clarifies all the initials.


Housing in the UK:

Most hospitals have their own houses in the campus or just outside. Married accommodation is typically houses with 2-3 bedrooms or some hospitals have flats with 2-3 bedrooms. Single accommodation is available in most hospitals and you have your own room but have to share kitchen and toilet/bath with 3 others. In the good old days, single rooms would be free and still are in some remote district general hospitals, but more and more hospitals are charging a small sum (around £100) to have a room.

Houses in the UK are extremely stereotypical and the local council (local governing body) dictates a lot. You cannot paint the house a colour of your choice unless you first clear it with the council. Most houses are gray or brick colour and entire streets look the same, very easy to get lost! Typically a house (to rent) will cost you £8-900 pm + local taxes and heating and electricity which all come to another £100 per month. Life can be a bit more expensive in London than outside London.

Houses cost around £170,000 -£200,000 in cheap parts of London (read east Ham) and could go twice that sum or more in richer parts such as Finchley or Wimbledon. A same sized house will cost around 60-70% of this price in other cities such as Manchester or Liverpool. In London, there are more and more "flats" type of arrangements as there is a perpetual shortage of space.

Those who have visited this site earlier, will notice that the figures have been hiked. Last few years, real estate has increased more than 10% year on year and in some parts of London, the hike has been more than 25% pa. This has been a great source of discussion in the economic circles in the recent years. Recently YB has been working with our ex-students to use this information to our mutual financial advantage!

Housing in proper central London is really prohibitively expensive and a flat with 2 bedrooms facing the Thames river will cost more than quarter million pounds.

Rented houses will have washing machines and even vacuum cleaners and even cutlery included in the price, though not dishwashers.

Basically if you are married you will have to have such an accommodation and that means an expense of atleast £500-£600 pm. If you think that is a lot, wait until we tell you about looking after a kid or two!
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182 Altmore Avenue :

   

This is how Altmore Avenue looks on a bright day. 182 is on the near left.

    

Facts you don't want to know :

This heading includes facts on an aspect of social bit, usually taken from newspapers.

"Sports"

  1. The most popular game watched by the British is grey hound racing, not football as you may have thought
  2. Cricket is the tenth most popular game, even cycling, softball and angling (fishing) rank ahead of it in terms of popularity
  3. Horse racing is a national fad and more than 10 million people bet on the Grand national race every year
  4. While the highest paid British cricketer is Chris Ward (around £120,000pa) Shane Warne is reportedly getting £160,000 and Shoaib Akhtar around £180,000 for the season
  5. Footballers are probably the highest paid professionals, top ones like Beckham and Giggs earning more than £20,000 per week, more than a house-officer earns in a year!
  6. While the big cricket grounds such as Lords or Old Trafford seat around 20,000 people, Wembley stadium hosts more than 100,000 people for big football matches.
  7. Only boxers and F1 grand prix drivers have made to the top 100 rich people in the UK. Nigel Mansel, Frank Bruno are the usual ones

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Way of Life

Social Dont's

  1. Smoking is social taboo and smokers have been put under tremendous pressure. Don’t even think of smoking in the hospital, airport, plane or London underground (though the station may be "over-ground" such as East Ham) .
  2. Don’t discuss politics. This is regarded as a personal area and only friends discuss their likes and dislikes. Italians don’t mind doing it, but they too have coffee-shops on the pavements like Calcutta!
  3. Don’t crack politically incorrect jokes-such as those on homosexuals, women, disabled, and ethnic minorities. "Pakis", "chinks" referring to Indians and orientals are offensive words. I have heard ex-opener K Srikanth describing the Pakistani team in the 1992 world cup final thus "the pakis fought like cornered tigers" . I am sure he meant well, just that it would have raised eyebrows in the UK with the choice of his words.Those of African origin are best described as "of Afro-carib origin" or "black British".
  4. Don’t eat with your fingers ("hands") in a formal party. Though most sandwich and other informal meals provided by drug representatives can be had using your fingers.
  5. Don’t break the queue while boarding a bus.
  6. Honking while driving. This is reserved when you cannot swear at your incompetent co-drivers. In summer you can roll down the window and show him your two fingers.
  7. Don’t show the Churchillian Victory sign backwards. This means "up yours" which is quite rude, used when someone calls you an insulting name..
  8. Don’t falsify your record keeping. If you have not seen a patient and landed in complication, own up and it may be tolerated, not if you lie and falsify your documents or write wrong observations. A president of the RCOG had to resign as he gave his name to a rogue publication of re-implantation of ectopic pregnancy in the uterus. Both the editor and deputy editor of the British Journal of Obst-Gyn had to leave together!
  9. Don’t slurp hot soup or tea. Blowing your nose loudly in public (using a handkerchief) is quite an acceptable practice!
  10. Letting a swing door swing back on the face of someone following you. Doors in all workplaces will have automatic swing-shut mechanism and you are expected to hold the door open for someone following you.

Making a phone call :

There are pay phones in Heathrow, which could be coin operated or BT telephone card operated. Cards can be bought at utility stores or newspaper shops which abound. Instructions on the set are quite clear Pick up the phone. Insert the coin/card. Put 10p coin as your call may be short and not need any more money. For longer calls, you can put more money as and when needed. You will know what credit you have. Dial the number Speak.. The screen keeps on reminding you how much credit left. Replace handset or press "next call" which is especially clever if you have credit left on putting a larger denomination coin. Remember, the pay phones do not give you change, just return un-used coins. Eg if you inserted £1 coin and made phone calls worth 40p, then you do not get back anything on replacing the receiver. However, if you had put two 50p coins instead of the £1 coin, you would have got 50p back.


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British Sense Of Humour :

What's cheap in the UK and what's expensive

UK is no longer a manufacturing economy. Most consumer items are made in China, Taiwan or Malaysia and other developing economies. Service industry (banks, insurance, tourism) is big and of course armaments (which is their biggest export, only the US exports more). Thus most tape recorders and CD players and TV-videos are much more expensive than in Hong Kong or the US. Computers literally cost the same in dollars as they cost in pound sterling. Petrol is 73 pence a litre which is quite comparable to that in India and far more expensive than the rest of the world including Australia, US and Nigeria. Cars are quite expensive, identical models costing as much as 30-40% more than in Europe and recently the car industry has been exposed as having all come together to artificially keep up the prices and cheat the poor purchaser.

Cars typically range from 1.1L engines (Ford Fiesta, Nissan Micra etc costing £7,000 new) to 2.0 L or more engines (Ford Mondeo, Volksvagen Passat costing around £15,000 new) etc. But the cars are far smaller than in Australia or US, though a bit bigger than the new Indian cars. The cars have different images as well compared to their Indian market. Fiat is quite a neglected brand in the UK and Daewoo is essentially looked at as an un-original maker of cars whose chief marketing strategy is "buy direct and save money". Consultants will be most often seen with Honda / BMW / Jaguar / Mercedes models costing around £30,000 new. Sports models with detachable hoods can be more expensive, though you may not get more than a few days which are good enough to drive with the hood down! Most cars come at half the price, if purchased 3-4 years old, with 40,000 miles on the clock. Most cars are good for more than 120,000 or more miles and the average life of a car is 11 years. The thing that makes a car go bust is the body work.

Even telephone calls costs are far more than in the US or Australia though far cheaper than in India or Pakistan. Ten years ago, British Telecom (BT) used to charge us as much as £1.50 per minute for a call to India or Pakistan. In the last 5 years competition has opened up and you can make a call as cheap as 30pence per minute There is nothing which can be said to be cheap in the UK as compared to the rest of the developed world. Gold is perhaps cheaper than in India so are dry fruit and saffron. These make good gifts when returning for a holiday home.

Leather items are expensive, reading glasses typically cost upto £100 to make (including optometry) and lenses can be prohibitive. It is best to have this in mind when coming here especially from India or Africa where it may be cheaper. Sods law states that you will sit on your spectacles sooner rather than later . Our friend Dr. Amit in the picture learnt it the hard way ! So those with specs, better get a spare pair !

Cotton clothes are a sign of taste and affordability. Silk is only for wedding purposes and it is prohibitively expensive. The best way to please your consultant is to gift him a silk tie!

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Racism:

Racism, "equal opportunity" etc:

That racism does not exist in a particular society would be a ridiculous statement. It exists in UK as well. However racism is something that people take seriously and the vast majority would not practice.It is generally known that a UK qualified doctor would get jobs more easily than an overseas doctor. However that cannot be called racism, as it does not matter if that doctor is white or black or asian. They would generally prefer "their own" doctors in a training position and in some ways that is understandable. There is enough jobs for all the others as well, so I guess it does not make any difference practically.

It is well known that women doctors will be less preferred than men doctors in higher surgical positions, though that is not the official policy. The RCOG laments that there are not enough to increase the number of women gynaecologists. Whether this is because women find career progression more tedious than men or whether men gynaecologists make un-realistic commitment demands from women junior pushing them away, is another matter. In brief, you cannot be denied a career progress because of being a black or asian or a woman or a homo-sexual. An admission to that effect will be suicidal to anyone in power! Even if in indirect preferential or deselection process if proved, would not be acceptable. A good example is the recent award (of nearly a million pounds!) by the industrial tribunal against the BMA (publishers of the BMJ) in their case against an Indian urologist, Dr Rajendra Choudhary. Details of this case are on Dr RC's website.


The Soho experience:

This article is written for men only. Some ladies may find it difficult to digest. You are warned. I bet you are not heeding my warnings though!

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Soho is the red-light district next to Leicester square, central London. It is famous for it's peep-shows and cabarets and generally things that make red-light area interesting. Like most red-light areas of the world, there is always good eateries around and Soho is no exception. If Foras road in Bombay has Delhi Durbar, Soho has good Chinese joints and that gives an excuse for (harmless) people (like me) to visit such areas with a ready excuse if found!

The purpose of this article today is to recount the common con-tricks employed in Soho because each month a doctor or two falls prey to it! I know because in the last 2 years alone, more than 6 of my ex-students have told me how they were conned, and I guess this just the tip of the iceberg.

The typical story is as follows. You have passed the PLAB examination and are happy or you are employed and are even more happy and a friend from home comes to London. On the last occasion, the friend was an upcoming liver surgeon working in a famous trust hospital in an Indian metro. Both our friend and his friend come from a conservative business community in India, the more conservative the background, the more susceptible one is, I guess. What happened next was typical. They happy team was moving around Soho, enjoying the first time thrill of actually being in a red-light area. They then felt more adventurous than before and actually decided to go to a "live-show" bar. The typical board outside says, pay and entrance fee of £5 and then stay in as long as you want to, watching the live dance shows (strip-tease). "Any drinks extra" and this is the catch. Our team entered and took a table not too near the stage (but not too far either) and waited a little for the show to begin. A young good looking girl (perhaps not that young and not that good looking, but in the dim light, it all seems that way) came and asked their permission and sat next to them. She smiled, and asked if they wanted to buy her a drink. Our team accepted and she ordered a "bubbly" (champagne), probably because we have great inhibitions of saying no to almost any request made by a British citizen! Anyway, after the drink and perhaps 10 odd minutes, our team begins to lose patience and courage and gets up to leave. They are then presented with a bill for "drinks and service" total £380 ! Our team protests but are confronted by 2 heavies, who insist that they pay. They protest but the heavies don't listen and insist that they pay the money right away. Our team tries another tack and pleads poverty. No cash. Which makes the biggies ask for a credit card. They threaten going to the police which scares the team of a scandal in the newspapers! The entire mob then goes to the nearest ATM and withdraw £300 and the big men take it away. On one occasion our friend tries the "I am a doctor" angle and it the bouncer asks which hospital and our friend tells him. Later on this hounds him. Will they now go the hospital and tell the medical staffing and my consultant about this episode? The other thing that bothers the victim is that "have they recorded my card number and will they now misuse it?"

The purpose of this article is mainly to prevent you from getting conned. The problem is that you lost your piece of mind and I don't have to spend time counselling you and reassuring you. These calls typically come at 11 pm, so that is the other hassle. The next time a girl asks for a drink, be sure that this is not happening in Soho. And if they threaten you about going to the police, thank them.

Alternatively give all of this a miss. If you are so keen on a strip show, consider waiting for summer and going to Brighton beach. Far cheaper that way and safer! So far as Soho is concerned, just enjoy the Chinese hotels there I guess !

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 Job Hierarchy:

The first job that most of us will take will be that of SHO or HO (house officer). A typical appointment will be for 6 months however, more and more branches are encouraging longer appointments (2 year rotations are fairly common). Often and HO job is the one you may take up. Such a decision becomes simpler if you have never worked before at all (fresh intern), however sometimes we know those with MD and 3-4 years experience have chosen to take up an HO job. Possibly out of anxiety after being unemployed for a couple of months. HO post is comparable to the internship in some countries except that the HO is paid well and expected to work hard, not just carry investigation tubes from here to there!

During your HO and SHO jobs, you are best advised to give your exams and finish your part I and II of your memberships. That will gear you for the next step in your career, the registrar's post.

Registrar's post is not your right, and does not come to you if you don't try actively for it. However, if you do the right things, pass the exams, publish and generally get good references, you have a 40% - 60% chance of being a registrar atleast in branches such as anaesthesiology, radiology, psychiatry, medicine, OG etc. Surgical registrar jobs are the toughest to get, perhaps orthopaedic registrars are more easy posts to get than general surgical.

Registrar's posts are of two types, I and II. Most such jobs come under the "structured training" programme instituted by the various deaneries since 1995 (Calman's structured training). Only those with "right of indefinite stay" will be awarded the type I training positions. CCST (certificate of completion of specialist training) is acquired at the end of the stipulated training period, which is generally 4-5 years. After that, you can apply for a consultants job. If you have worked in other European countries or in USA, part of that registrars training is approved and you may be given that consideration.

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Progress in your career:

The first job that most of us will take will be that of SHO or HO (house officer). A typical appointment will be for 6 months however, more and more branches are encouraging longer appointments (2 year rotations are fairly common). Often and HO job is the one you may take up. Such a decision becomes simpler if you have never worked before at all (fresh intern), however sometimes we know those with MD and 3-4 years experience have chosen to take up an HO job. Possibly out of anxiety after being unemployed for a couple of months. HO post is comparable to the internship in some countries except that the HO is paid well and expected to work hard, not just carry investigation tubes from here to there!

During your HO and SHO jobs, you are best advised to give your exams and finish your part I and II of your memberships. That will gear you for the next step in your career, the registrar's post.

Registrar's post is not your right, and does not come to you if you don't try actively for it. However, if you do the right things, pass the exams, publish and generally get good references, you have a 40-60% chance of being a registrar atleast in branches such as anaesthesiology, radiology, psychiatry, medicine, OG etc. Surgical registrar jobs are the toughest to get, perhaps orthopaedic registrars are more easy posts to get than general surgical.

Registrar's posts are of two types, I and II. Most such jobs come under the "structured training" programme instituted by the various deaneries since 1995 (Calman's structured training). Only those with "right of indefinite stay" will be awarded the type I training positions. CCST (certificate of completion of specialist training) is acquired at the end of the stipulated training period, which is generally 4-5 years. After that, you can apply for a consultants job. If you have worked in other European countries or in USA, part of that registrars training is approved and you may be given that consideration.

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A Sample CV :

CURRICULUM VITAE

NAME:

SEX:

ADDRESS:

TELEPHONE:

DATE OF BIRTH:

NATIONALITY:

MARITAL STATUS:

MEDICAL EDUCATION:
(College: M.B.B.S. in: Month, year.)

POSTGRADUATE QUALIFICATION:
(Degree, diploma, year and University)  
(even if you have a good USMLE score, avoid the temptation to mention it as it makes the British wonder if they are you second choice. Besides, they do not know how difficult an exam it is and that 90 centile is a good score!).

REGISTRATION WITH THE GENERAL MEDICAL COUNCIL, UK:
Eligible for limited registration, LR2, passed PLAB of …………

CLINICAL TRAINING:
(Most recent appointment first, i.e. reverse chronological order)
All the above posts have been full time resident posts, supervised by consultants.
 

CLINICAL EXPERIENCE IN VARIOUS SPECIALTIES:
(you can write this as per each specialty or as per job that you have done)

  • Do mention small things including siting IV lines and taking history as well as intubation or LP (only if you have done it!)
  • You can mention the experience that you have got in each hospital or at each level (if you have a lot of clinical experience).
  • The first paragraph should describe the hospital itself e.g. how big, how many beds, what facilities (blood bank,all hours radiology etc.)
  • You should mention the duration of your work, and the details of your job such as 1:3 on call, Casualty work etc.Whether you attended clinics, theaters and special clinics (asthma clinics, urodynamics, “stress test” etc.). This paragraph should also mention the work you did in the ward including what you are good at. These are simplethings such as putting IV cannulae, clerking (taking history on admission) patients, counseling and consenting them, arranging pre-op fitness and checking investigations etc. Basically, it should convince them that you canwork as an SHO.

COURSES ATTENDED:
 
TEACHING EXPERIENCE:
 
RESEARCH AND PUBLICATIONS:

CAREER PLANS:
 
INTERESTS

REFERENCES
(Write the name, degrees, hospital of attachment and full address including tel and fax numbers).
Generally 3 references are needed

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Sample Testimonial

General “testimonial”

  • This should be on a letter head of the hospital, but signed by the consultant and not the head-clerk !
       
  • General letter such as “worked from ………to …………. And his work was satisfactory” is a certificate, it is not a reference. You need references.
       
  • Should the hospital be a teaching hospital, it is best. But if it is a peripheral hospital, try to get the letter from the parent hospital.
        
  • If the hospital is one of the new corporate hospitals, such as Apollo or Sundaram Medical Foundation, Leelavati or Medicare, then the first paragraph should describe the hospital itself e.g. how big, how many beds, what facilities (blood bank, all hours radiology etc.). Mention if the consultants have British and American experience.
        
  • In the second paragraph, you should mention the duration of your work, and the details of your job such as 1:3 on call, Casualty work etc. Whether you attended clinics, theaters and special clinics (asthma, urodynamics, “stress test” etc.). This paragraph should also mention the work you did in the ward including what you are good at. These are simple things such as putting IV cannulae, clerking (taking history on admission) patients, counseling and consenting them, arranging pre-op fitness and checking investigations etc. Basically, it should convince them that you can work as an SHO.
       
  • The last paragraph is the one that tells us that you have been good, sincere, punctual. “reliable” is one word they love. Do not go over the top and get the consultant to write about how their loss will be the new employer's gain etc. It is always nice if your consultant mentions that he/she will be happy to clarify any point that the new hospital may want to know.
      
  • Try to get your consultant to give an E-mail address or fax number or personal telephone number on which your new (potential) employers will be able to reliably contact them.
      
  • And lastly, your consultant should remember you and the post you did, if they ring him!  So find a way to do that.

    Your first job requires a testimonial, after that, your consultants write directly to the one who asks.

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Interview techniques:

In the UK, every job is given after interviewing you, this is a formal event. Your CV gets you the interview, the interview gets the job. Typically after shortlisting you, the hospital will ask for your referees opinion about you and your capabilities. So once shortlisted, do check with your friendly referees if they have been asked for their reference or in short warn them to wait for one such letter. Sometimes the referee may know some one in that hospital and he may want to ring him about you and put in a good word.

You have to be formally dressed for the interview which means jacket, trousers and tie and leather shoes. Look clean, smell nice (so get the jackets from out of the cupboards and air them. Curry smell can stay deep!) and practice your mock interview.

The first step is to show interest so do ring the hospital and ask them instructions about reaching the hospital. Try and reach there the day before and have a look around. It matters a lot to consultants that you took that extra effort to know the hospital. Medical staffing will try to put you off saying, there is no accommodation the night before etc but you need to persist. More on will be on the YBCC soon.

Find out who is interviewing you, that is not a secret. Do find out a bit more about that person, his interests, his latest success, pet project and what not. If this cannot be through the internet, ask his registrar when you reach that hospital.

The interview typically starts with "what have you done so far in your career" which is basically running them through your CV quickly. Don't linger on silly things such as "I was in a convent school" that makes sense when you are not in front of me, now your English will speak for itself!

Some typical questions are "why have you come to the UK?", "tell me about an interesting article you have recently read", what is the difference in medicine in UK and that in your country", "what are your long term plans". Often they ask silly sounding questions such as "tell me your good qualities" or "tell me your weaknesses". You cannot sound too boastful and tell them about your good looks or incredible medical knowledge. Neither can you be too honest and confess about your love for things spiritual (especially distilled and bottled) whilst answering the second question.

We hope to put some excerpts from real interviews as they happened to our boys and girls and their advice on the YBCC soon.

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Clinical Attachment:

This is an example of an audit, Thanks to Dr Anup our ex-student now an SHO surgery.
Click here to know more ....
Please press forward arrow key to go forward through the Power Point Presentation slides.

"In the pipeline"

"In the pipeline" experience nothing happens for a long time and then suddenly (hopefully) you are flooded with offers.

This is what you do after you have given the PLAB-II. You may have done PLAB-I in UK or come a few months before the PLAB-II, then now is the time. If you have failed the PLAB-II, you are best advised to spend time doing a clinical attachment, that way you are not wasting your time, just making friends with consultants who will hopefully atleast give you good references if not jobs.

Clinical attachments can be made to work more efficiently for you if you are sensible about it. Here are few points to ponder about clinical attachments.

  • Choose your branch of clinical attachment well. If you have surgical aspirations, dont choose medicine to do your clinical attachment. Even clinical attachment in your own subject can be boring, doing it in a field of disinterest may prove very boring!
     
  • However, doing a clinical attachment somewhere is far better than doing nothing! Spending time in East Ham or watching TV at a family friends house is not the best way to spend your time!
        
  • Be regular with your clinical attachment, punctual, well dressed and well mannered. Remember, this is the medical equivalent of an arranged marriage. People are watching you all the time!
     
  • Show them you are interested. Ask if you can help with an audit. That is the best way to a consultant's heart.
  • If you are given an audit to prepare, work hard and do that in time. Presentation should be crisp, using good overheads or computerised presentations. Writing on acetates with crude drawings is not the best thing to do.
  • What is an audit ? Watch out for the YBCC area next week.
  • Ask the consultants permission before using him as a referee. If he denies, you cannot pressurise him.
  • Dont ask him above in the first week! Give him a chance to know you for a week or two.
  • Always check with the medical staffing about forth coming vacancies. If there are in the department you are with, do tell your boss about those.
  • Always meet the medical staffing and tell them you are available for locums at NHS rate. Use these magic words, "NHS rates" and they will love you.
  • Always keep a mobile phone ready for above communication.
  • If the consultants seem to be indifferent or not very helpful, dont stay there any more than necessary. 6-8 weeks is about the most you want to be anywhere. Unless ofcourse they tell you that you will be a strong contender for a job that is upcoming. They often say something like this "the job in Feb, we dont have anyone particular in mind". It means you be nice, it is yours.

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Definte dont's during a clinical attachment:

  • Dont be late or generally unbecoming of a student. Dress well etc.
  • Dont make un-necessary photocopies especially if they are free. Most such places have ways to monitor their photocopying output!
  • Dont make personal calls as hospital work. There is a huge temptation of using hospital system for your own calls, to get job applications etc. You pick up the ward phone and go so switch and ask for say, Oldham hospital. They may ask you, is it hospital call? Dont pretend it is. Best dont use the ward phone for personal calls at all!
  • Dont hog on drug-lunches. It looks a little unbecoming of a doctor.
  • Dont get drunk at dinners and ward parties or consultant's dinners (if you happen to be invited). On those occassions, best to declare you are a teetotaller! Once one drink, others follow and very soon you may become "man of the match"!
  • Dont try to use your time to chatup young nurses! Your registrar may not like it!!

FAQ on clinical attachment:

  1. Do I have to pass the part II before clinical attachments ?
    Not really. Some hospitals ask you to wait for your part II, but enough will let you do that without the part II. If you are in the UK for part I, it stands to reason that you do an attachment as soon as you finish giving your part I examination.
  2. Do I get paid for the clinical attachment ? Is my lodging free ?
    You must be joking! You are lucky to get a clinical attachment without paying now-a-days! In some hospitals they do give free lodging, but these hospitals are becoming rarer by the day!
  3. Do I require GMC registration for attachment ?
    No you dont. In the current times, GMC will give you LR at short notice for short locums so you are OK for doing locums, until then, you dont require GMC registration.
  4. How do you get a clinical attachment ?
    Ask your friends to apply on your behalf. If you dont have friends, ask us! YBCC will be doing this for all our students in the coming month. At the minute we have this suppport only for those who are sponsored candidates. Soon it will be for more doctors, all those doing our courses.

There are other agents doing this sort of a service, we have noticed, however we think we can do more for less, and the offer comes up shortly. Do send your CV's (as attachment) to us at cv@ybes.org should you want help on this matter.


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How to get an attachment (in this life!):

By Dr.Owais Mohsin

Finding an attachment in London is not difficult, it's just expensive! They usually charge you something like a hundred pounds per month (or more!) for an attachment in London. Elsewhere, it's free but still you will have to arrange your accommodation as usually it's very hard to get accommodation in the hospital while doing a clinical attachment.
You can try finding an attachment in a city where one of your relatives lives so that you can stay with them while doing the attachment. Ideally, you should apply in person or at least by post but you can apply by e-mail too. It's cheap and easy and believe me that here they do almost all the work by e-mail and they WILL reply to you. You should first find out the hospital and the name of the consultants in it and then apply with a letter addressed to that particular consultant.
I have included a sample application for you to modify and here it is:


Your street address here,
Your city, county and post code here,
Your e-mail address and mobile no. here

31/03/2004

Dr. Eggs,
Consultant in Cardiology,
Acme District General Hospital,
Acme Acres, West Toonland AC10 3DL

Subject: Application for clinical attachment in Cardiology

Dear Dr. Head,

Your hospital has a reputation for being progressive and able to provide a comprehensive and structured learning programme. I intend to pursue my career in the field of medicine and I feel that a clinical attachment in your department will allow me to become familiar with this system.

In this attachment, my objectives would be to:
1. Improve my clinical knowledge in cardiology through observation.
2. Take part in case presentations, journal clubs and other academic activities.
3. Observe specialised procedures and learn more about NHS.
4. If possible, to do an audit in this field.

Currently I am doing an attachment in Respiratory Medicine in this X-Y-Z hospital. I have recently passed PLAB and am now eligible for limited registration. I have over 4 years of cumulative experience of working and teaching in different professional capacities.

Research and audit work interest me very much and I can also offer my expertise in computer sciences for case presentations & audits. I can start the attachment after 18th of June 2004. I have enclosed my CV for your kind consideration.

Thank you for your time and consideration.

Yours sincerely
(Your sign here)
Dr. Owais Mohsin

Ok so let me make one thing quite clear here. DON'T and I repeat, DON'T copy this application word-to-word. Use you head and modify it before sending. Try to make your application as specific to the specialty as possible and if you are modifying the same application for different specialities then don't make the mistake of writing in your application that you want to gain clinical skills and knowlegde in cardiology while applying for an attachment in histopathology! (this is what happened to me by mistake!).

Your CV:

The format of the CV is very very very important but there is no single correct way to do it (I mean that there are more than one). Anyway, the format that my CV is in currently, has been reached by a lot of experimentation and research in CV writing by me (I am not bragging here ok!) and I will be writing an article on CV writing soon so watch this space. You are certainly welcome to modify it to use your own information. The same goes for the clinical attachment application.
PLAB Master provides much more than just the accommodation (it means that they provide accommodation too!). They work in a very professional manner and provide long-lasting support which goes way beyond the original course (especially to the sponsorship candidates). They can also provide you with accomodation until you find a suitable job without any upfront costs (you can pay them after you have the job). They also help you in getting an attachment although I would recommend you to try on your own too.
Apply to as many hospitals and consultants as possible and don't waste your time, effort (and money!) by applying to the medical staffing as they will turn down your request faster than you can say the word "No!".
That's all for now folks. Keep watching this space for more but in the mean time - start applying already you lazy bones!


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Letter regarding new PLAB visa circumstances

Date:2nd Apr. 06

Dear Friends,
    This open letter is for those who are considering PLAB as an option for their future careers in the medical field. PLAB had a long history of nearly 40 years and it has served aspiring medical doctors as well as the British people through an efficient NHS, in an excellent symbiotic relationship . In the recent months the delicate balance between demand and supply was awkwardly affected due to an unprecedented increase in the plab places for approximately 2000 per year in 1995 to 11000 per year till 2005. The resulting chaos not only meant that overseas doctors found it difficult to secure a job but even local graduates found the going tough.
This of course was unacceptable and as a result new rules related to the visa status and eligibility for jobs have been announced. The new rules mean that whilst you can give the PLAB you can get a job only of you have a suitable visa that allows you full time work in the UK. In the past and NHS job would let you get PFT (permit free training) visa, now that category of visas is abolished. You will now have to secure some other visas and these could be a work permit or HSMP or "dependent on spouse". The same rule applies for dentist as well. Nurses have always been on work permit, so there isn't a serious change on their score.

How does it affect the job situation.
It has never been easy to get a job in the NHS afterall very rarely have there been far too many jobs for far few people. Stories I hear from consultants who had arrived in the UK in the late 70's early 80's still speak about months and months of joblessness or honorary jobs which paid them no money. In 1990 i remember being unemployed for 2 months searching for jobs. So it is not true that "in the good old days" jobs were for the asking. We are talking of relative depravation here.
It has been a known fact (though not officially accepted) that the local graduates would get preference over overseas doctors. In 1990 local graduates were joined on the preferred list by Europeon nationals belonging to the first generation EEC. Germans, Spaniards, Italians have been getting selected ahead of those who gave PLAB, and those who hail from Asia/Africa, however, if a consultant did like you for whatever reasons he had a chance of chosing you. This happened not uncommonly, sometimes because they saw you at clinical attachments and sometimes they wanted an experienced doctor for the job they had. Often they saw you better than the europeans on a given occassions (as Europeans often dont have the experience many PLABers have)

How has abolition of PFT made things more unfair ?
The game for jobs was never played on a level playing field. The bar was always a bit higher for the overseas graduates compared to the Europeans. In the last year with more competition and fewer jobs you can say that the overseas doctor had to jump a higher bar wearing heavy lead shoes. Now with the work permit rule they have effectively made it next to impossible, unless they work their way round the visa. They have nailed your shoes to the ground saying jump if you must!

Would these new rules benefit anyone at all ?
The new rules will obviously benefit the Europeons, but the second line of beneficiaries are overseas doctors who have their visas intact, some of us intraining have an HSMP. A few others have their spouses employed, as a dependent they have a right to work. Some of our friends are dependent on their wives or husbands who have come to the UK on a student visa. Such people we find that the competition have reduced remarkably. It has never been better for a dependent spouse! You can be dependent on someone who is working (nurse, IT, teacher whatever) or even a student for that matter. If you have the right to be there and work, you will have an edge over those who came on their own with nothing but PLAB!

How do we see the future ?
As things stand now, it does not look terribly brilliant. PLABMASTER will have to remove "PLAB" from it's name and perhaps become only "master" perhaps stitching clothes (tailor master) or what! Jokes apart, we think that the NHS will come to it's senses in a year or two. I give it 18 months max. This is because i have had the personal experience of the NHS getting egg on face with the doctor-shortage crisis of 1994-95 and nurses crisis in 1999-2001 and social workers crisis last year and Psychiatrists crisis last 10 years. For some reassons, Brits who ruled the world not so long back cannot get their numbers right. Too much power has been handed down to the managers and poor doctors and consultants who know what they need on the ground, are powerless. The problem was compounded by GMC and NHS not discussing solutions and doing fewer PLAB dates in the last 4 years. Now that the PLAB entry will come down to less than 1000 each year, the demand for doctors will increase over the next 18 months.
I think those of us who will survive this time, will win in the long run. Only those who can afford the money and emotional hassles of waiting this long should start this PLAB journey!

The use of student visa
This is a good idea provided done with proper planning and intentions. Coming here as a student should be for improving your CV and your career chances anywhere in the world, UK or back home. A course in public health will give you opportunities in the preventive medicine, WHO as well as paediatrics. A course in Research methodology and law and ethics is good for any clinical career as well as pharmaceutical industry. More specific courses can be too costly and too specific, e.g. no point in doing a MSc in cardiac medicine when you have not worked in medicine at all.

The student visa is for 18 months. You can work 20 hours a week during term (34 weeks out of 52) and 40 hours between terms (18 weeks). More than the money you generate, it is the staying busy which is more important. The course should allow you clinical attachements as well as contact with consultants so that you are in the job framework anyway. If your spouse is doing a course or getting a job nothing like it, you then have the full right to work as a "dependent". We are compiling lists of good recognised courses which will keep all the above points in perspective. We are not interested in cheap courses which are nothing but visa scams but serious ones which will be good for your CV and opportunities in the long run. Do write to us for more information.

         Comments or questions, write to info@ybes.org

 



The YB Air Freight service

YBES began its quest to help doctors desiring to work in the United Kingdom about 9 years ago. Since then, we have evolved from offering a single service ( PLAB 2 coaching) to offering a bouquet of services.

This bouquet now consists of PLAB 2 coaching, accommodation, sponsoring candidates, ticketing, freight services etc.

Currently, our freight service is limited to Sea Freight. But starting from 15 November, we are adding Air Freight to our freight offering.

When traveling to London, doctors are often in a dilemma. The weight restrictions on luggage mean that most of their medical books, clothes etc. have to be left behind. Recognising this problem, we have launched the Air freight service. This will enable you to carry your medical books and other necessary items that would otherwise have to be left behind.

Also, you do not have to lug the luggage upto your accommodations. It will be a lot easier to travel on the Tube without having to be weighed down by the baggage.

As you are aware, medical books are prohibitively expensive in England. You can save a lot of money by carrying them from India. Even after paying for the air freight, you end up saving a sizable amount of money.

Air freight is more preferable to sea freight, even though air freight is costlier.

Advantages of Air Freight

1. In case of sea freight, we had to depend on ships that came once a fortnight to the JNPT port at Nhava Sheva. If a ship got more cargo at any previous port, it was likely to give India a miss resulting in delays.

But, in case of Air freight, airplanes fix in advance the weight of the cargo that they will pick up at any airport and so, delays are extremely rare.

2. In case of sea freight, a ship takes about 27 days to travel from India to England. This time can be further stretched due to bad weather, storms, lack of berthing space etc.

In case of Air freight, aircraft can be delayed for a couple of hours due to weather conditions. But since they can go from India to England in under 24 hours, they arrive about 26 days earlier than ships.

3. Since the ships call at JNPT, and since there are infrastructural problems at the port, the sea freight service has been running behind schedule.

On the other hand, Air freight related infrastructure at India’s premier airports is of international standards and up to date. This has made air freight more convenient and easy to coordinate.

Thus, Air freight is more safer and timely than sea freight.

Doctors opting for our air freight service should send the following to the company along with the luggage.

1. Keys to the baggage. ( We may want to inspect the luggage or the customs
officer may want to check for contraband)
2. Xerox copy of passport ( All pages including blank pages.) ( This would
be required if the customs officer gets suspicious or finds something that
should not be there )
3. a LIST OF ITEMS BEING SENT. ( Please give as detailed a list as possible)
4. Xerox copy of Air ticket. ( This is required if the customs officer wants
to confirm the authenticity of the doctor's travel to U.K.)
For rules, pricing and declarations to be given by the doctors, see the relevant sections.


Rules for Air Freight

The rules governing air freight services are given below.

Please note that the company may change the rules at any time and you should check this section regularly for any changes or modifications.

1. The Air Freight service shall be a point to point service. It shall be the responsibility of the doctors to ensure that their luggage is delivered in a sealed condition to the company’s office at 4, Neelkamal, Bhaskar Colony, S.V. Road, Naupada, Thane (West) or to any other place the company may specify in this regard.

Similarly, it shall be the doctors’ responsibility to collect the luggage from our British associate’s office in East Ham or from any other place the company may specify in this regard.

The company’s responsibility shall begin when the cargo is received at the specified place in India and shall end when the doctor takes delivery in England. The company shall be responsible for storage in England before giving delivery.

2. For ease of inspection of the baggage by Customs, please pack the items in the following manner.

a. Similar items should be packed together. For example All books can be put in one box/bag, all clothes can be put in one bag/box.
b. All these bags/boxes can be put in a single suitcase for delivery to the company’s office.
c. The internal bags can be plastic bags or of some similar non durable material. The repacking of the luggage in corrugated boxes shall be done at our end.

3. The doctors should deliver their luggage to the company’s office in India not more than six weeks before their departure for England and notless than two weeks before their departure.

This period will enable us to coordinate the delivery of the baggage to England and the period of time before the doctor leaves for England will also allow us to solve any problems that may arise.


4. The following items are not allowed to be transported by air.

a. Electronic items including calculators,