I am in deep doubt + Banded/unbanded FYs

[cotroni]

Good morning everyone,

I could not sleep tonight ......too many questions are poping out of my mind......here is the big mess in my mind:

I have read some topics about FY1/FY2 contracts, I am not really familiar with the Bands during foundation years.

I understand that people who will be under unbanded contracts will not work during week ends, while the others yes , so I guess being banded brings more money....
However, I do not understand how do people get banded or unbanded contract, how do you figure this out?How do junior doctors find out which hospital pays the most during FY1/FY2?

After some readings through this forum, I also wondered how would people cope with getting paid only 1200£ month during FYs knowing that the cost of live is very very expensive in the UK?
I am really looking forward to hear your thoughts about that....

It is not reassuring to know that I left a job paying 40K and that I wouldn't get such salary before at least 9 to 10 years.....specially as a married mature student in his early 30's.....
Going back to the pharma industry would definitely bring a very confortable lifestyle in ten years.....


Another point I noticed,when we compare a 48 hours week of training to a 70 hours one in North America, I think it makes a huge difference in terms of clinical experience acquired during residency/specialty training,doesn't it? We don't know about the consequences of EWTD but do you think this will have a negative impact on doctors training...?

I am having difficulties understanding where the British curriculum fills the gaps in term of clinical experience lost compare to the previous years , with only 48 hours as the maximum allowed, and again compared to 60 to 80 hours in North America....
I mean isn't medicine supposed to be constantly challenging in order to achieve and maintain very high standards?....
I am not sure whether I would feel well prepared for a residency in the US/Canada or even in the UK itself...we'll see...

Regarding the FYs salary, 21000£ a year is a joke!!!!no offense at all...
There is really some wrong about that, isn't the government aware of that? it's like they want to produce miserable doctors...

Although I am willing to reduce my life style for the 5 years curriculum, I am not sure whether I would be willing to accept such poor contribution for 5 other years of my life.....

I mean in pharma industry, I was already in the 40k a year, so can you imagine how much I would get in 10 years from now?

I am married, I am a mature student, I am in my early 30's, when would I start living then? although my wife supports me wherever I go, whatever I do, I feel guilty to make her live this way for 10 years....just to become a doctor...just to realize a dream I couldn't realize earlier in my life for whatever reason?.......
I really feel selfish at this moment......

is it really worth that much sacrifice?........

I realize I should clarify this mess in my mind and certainly make the most important decision fo my life before classes begin in 2 months..

Either I get in or I simply realize that although I fought for almost 10 years to realize my dream, although I got in, the momentum might simply no longer be appropriate to me.........

May be I could pass this chance onto my children (once I get them) by ensuring now their tomorrow's career....

don't know what to think now....may be time to got to sleep...

Just my personal thoughts....

Cheers!

[Nestea]

hi cotroni

i'm sorry but i don't know much (next to nothing) about the FY program in the UK, but i can cover some of the following as i do know a little about how it compares to Canada.

Regarding the FYs salary, 21000£ a year is a joke!!!!no offense at all...
There is really some wrong about that, isn't the government aware of that? it's like they want to produce miserable doctors...

u would be starting FY after completing medical school, which is like beginning residency after med school in Canada. 21000 GBP/year is about $CAN 42000, which is about what you'd make as a resident in Canada. i asked my brother (who is a resident in BC) what he made when he started and it's around that figure, going up a couple thousand each successive year.

so regarding:

It is not reassuring to know that I left a job paying 40K and that I wouldn't get such salary before at least 9 to 10 years.....

u would be making that same 40K (CAN) in ur first year after med school so at least 5 to 6 years

lastly:

I realize I should clarify this mess in my mind and certainly make the most important decision fo my life before classes begin in 2 months..

cotroni i understand this doubt, and i do understand that it's different for u since u are coming from Canada (which is a long way away) and u are asking for a lot of support from ur wife. but ur not alone, i'll bet lots of the other students have doubts and by the time we're done we'll all have had a moment or period where we've doubted or questioned our commitment to being there.

i am sure u and ur wife already had many long long long discussions about this life changing decision before u moved from montreal to norwich. and u guys decided to go ahead with it which means she must support u and u must have the determination and ambition to fulfill ur "dream"

so let me just tell u: it's OK to have moments of doubt, it's normal and don't u think it would be strange if u didn't feel at least a little bit hesitant/scared considering the effect that moving continents/deciding on this career will have on u and ur wife's lives?? and i hope ur not just telling us here on the forum cause it's something u should probably be discussing with ur wife as well.

i'm glad to hear ur doing so much research on life after med school..i have a lot of questions myself but i don't know if i'm scared to think about life that far ahead or just too lazy but either way we will definately discuss this stuff when i meet u! in the meantime i suggest u worry less about this stuff cause they'll probably have advisors who will explain all this stuff to u once the course starts

[cotroni]

Hi Nestea..
Thanks a lot for your support and advice, I really appreciate....really...

I have friends in residency in Canada as well, usually the salary depends on where you go, for example a friend of mine is paid 60000 in edmonton while the other one is paid 45000 in montreal, however, the one in montreal will see his salary going up to 60000 by the time he finishes his 6 years Internal medicine residency.

I find this salary to be fair enough as he would living comfortably and still manage to reimburse his student loans...it definitely makes more sense than the hard living conditions of junior doctors here, some of them are even looking for jobs during week ends....and I guess this explains why we see an increasing interest from them towards sitting for USMLE.
Although, here 48hours per weeks gives lot of spare time, I don't think they would enjoy their sparetime without any penny in the pockets :-)
So certainly, it is better to do a 70 hours-per-week residency in the US/Canada


You were right when you said that 21000 pounds is equivalent to 42000$CAD, BUT...the quality of life is far from being the same...

In montreal, a one bedroom apartment costs between 560 to 700 CAD$ maximum (unless you live in a luxurious loft) which in pounds makes at least 350 pounds.
with 350 pounds in the UK you hardly get a small one room studio. if you want a one bedroom flat here, you need to pay at least 420 pounds which makes 840 dollars...
And believe me, the size of the apartment will certainly not be the same as in Canada, however, it is understandable due to the size of the country....
The food is very expensive, expect to spend at least 200 pounds (400 dollars) per month
Also, I never find milk with an expiration date later than 2 weeks, same holds true for lot of goods, so I can never buy in quantities in order to save more money, it's almost like buying stuff on a day by day basis which is really not convenient, but I understand that this is another way of life.....

in Canada we were spending 100 pounds a month for the two of us for a lot more goods...and believe me I already used to eat like two as I had 8 hours martial training per week
I did not count the extras such as sandwiches on campus or drinks when hanging out...
Then there is internet, clothes, books, extras etc.....
So you see it is really expensive here

Here is another good example I personally experienced:
when I was working in London my salary was at about 80000$CAD/year and I could only live in a one room studio where I was hearing my neighbor knocking on his sink with his razor every 2 days at 6am.....etc...Of course I could have moved farther than London city center but then I would have to pay between 2000 and 3500 dollars a years for the bus and subway pass... no way!
my pass in montreal used to cost me 60 dollars a month...

I had the same salary (80000cad$) and I could easily afford a big 60-70 m2 appartement at a rent of 570 $CAD (335pounds) at 15 mintues by bus from dowtown montreal, heat included,free water, I just had to pay my phone bills (28 $), electricity (43$ for 2 months), gas(30$ for 2 months)...
the rest of the money was to enjoy life
And believe me, this is one of my specialty enjoying life....

So really, it is far better to be paid 42000 $ in residency in Canada/US than 21000 pounds in the UK...it's just that here people are so used to living in the poor quality of life that they no longer feel it, it's normal standard here...and unfortunately, "money is power" takes its true sense here....no money in the UK=deep trouble..

Now in regards to my deep doubts, again I sincerely appreciate your support, and of course it is never a easy decision to make....

I think this experience makes me suddenly realizing that I am more a runner than an achiever...which is certainly increasing my personal doubts even more...
the reason I am saying that is this underlying question:

why have I ran so long to get into medicine (almost 10 years) and finally wondering if I am made for it or not? it doesn't make sense, does it?

Shouldn't I be happy instead?.....but I am not (I mean regarding this issue only)

I even think of doing an MBA ...WHy is that?.... again it would requires me to fill out an application, and show up proof of my competitive profile....

Although I have always been aware of my addiction to challenges, nonetheless I am seriously wondering if I am not more driven by the challenge rather than the achievement itself....

If what I say is true, then it would mean, I have no interest in anything in life other than simply the challenge of running after everything endlessly.....my god...it's possible, yes it really is...

Which would lead to the conclusion that I might be a hyperactive person....

Wow, this would explain why I have always put myself into challenging situation my whole life.....man that is really crazy!

So it would also mean that in reality my deep doubts would probably be fake, and their meaning would be more related to an insconcious fear of achievement.....does it make sense?.....any med student or resident well informed about this topics here??....

Why would I fear to achieve anything? I don't know....but it definitely make sense to me....
I would fear the achievement itself.....may be because achievement means END of something.??????..

you gonna think I am crazy, but I sware to god I am not!

Nestea thanks for your reply.....I didn't know this would help me figuring out that my doubts lies on a fear of the "END"....

If I discover why, I would then be able to overcome this feeling and feel liberated ..certainly my wife would too lollllll......

let's think about it......

Any comment other than advising to consult a psychologist lollll?

Nestea when do you plan to get in Norwich?

Cheers!

Cotroni

[James]

I think you have to accept that if you are entering medical school now:

(i) You are likely (if not certain) to be in an unbanded post for F1 and possibly F2

(ii) Your training will be inferior to current training due to working less hours

(iii) There will be a significant level of medical unemployment in the UK (due to the massive increase in medical school numbers)

[yazoo]

I think you have to accept that if you are entering medical school now:

(i) You are likely (if not certain) to be in an unbanded post for F1 and possibly F2

I, personally, think most F2 posts will remain banded. If solely for the fact that they are cheaper than ST1s...

(ii) Your training will be inferior to current training due to working less hours

Agreed. The dreaded sub-consultant level looms to help compensate. Ultimately, I think this will lead to far less substantive consultant contracts, with people stuck at this sub-grade forever.

(iii) There will be a significant level of medical unemployment in the UK (due to the massive increase in medical school numbers)

And EU citizens will get preference at post-foundation level, which is relevant for all non-EU students choosing to study in the UK (I believe, please correct if wrong). Given that there are not currently enough training posts for EU applicants, this suggests anyone else will have to continue training elsewhere (and compete with the increasing numebrs of UK grads going for similar posts).

[James]

Also:

- House officers (F1) have now lost free hospital accommodation

- A recent article in BMJ careers estimates that post-grad exams, essential courses and training fees now top over 13K (this will come out of your pocket)

- The nurses have just been given a petrol mileage increase to 55p/mile; You will get nothing until your an ST, then 23p/mile, minus tax

- The government are essentially privatizing general practice with the introduction of polyclinics. So if you plan to be a GP, you are likely to end up working for Richard Branson, working evenings and weekends, and for a lot less money.

- If you plan to stay in hospital medicine, well as Yazoo says, chances are you will never be anything more than a sub-consultant.

[yazoo]

On the up side, Richard Branson will probably provide a more pleasant working environment :-) If only I wanted to work in a polyclinic - or to be a GP!!!

[Dr Noodle]

Doctors can be angry at nurses getting benefits and them not (not aiming this at you James, just saying in general) but the nurses fight for it unlike doctors who have to worry about causing trouble coming to bite them on the ass later on.

I'd say come to Ireland but I think we may wind up going down the same hole with the number of med school places increasing from 305 to 725 next year (and the recession).

A Google GP clinic would be a deadly place to work in Have you seen pictures of their offices in Switzerland? It's class.

[cotroni]

Cotroni,

You have my total sympathy. I am younger than you (mid 20s) and am currently not in a relationship so can move anywhere plus I havent got a great alternative career like you (pharmacy). Despite this I still doubt so I can understand the pressure you are under.

I, like you, now feel I may be attracted to the challenge (though not sole reason). I think it might be because i feel i have to prove something to myself and others, a bit of an inferiority complex you might say. I dont know why. Or maybe we just have really, really itchy feet!

I think we have to accept that there is no ideal career, this is really hard. I seem to be looking for some amazing career that I will love but I must accept that this does not exist. Some people may be massively passionate about their career but I think I am just a good all rounder career wise and this is why my career choice is so so hard (aswell as the fact i overanalyse my decisions, maybe simplicity is the key, going back to basics when making decisions...).

I've worked hard for my med place (albeit only for 2 years after my first degree) but Ive pretty much made up my mind that medicine is now not for me. In other words, reality has hit me. What is hard is declining this opportunity when so many people wish for it (as ppl around me keep saying - "are you mad?!?") and when I thought it was right for me when I applied. What if i decline and change my mind again...

Its so hard but you just have to do what is right for you and only you (and your other half of course!). It is a long course and a tough career. What i have noticed is that there is a lot of negativity (positivity too...) on this site as to the future of med. Try not to dwell on this too much, just try and make the best decision you can and the future should sort itself! That is all we can do.

Good luck!

Hi Dentist...

Thank you very much for your comments...
You clearly see that you understand very well my dilemma
you seem to have similar charateristics in your personality as mines
may be that's why I found your comments so true...

I don't even know what to answer, you are simply right..
Probably I am already in the psychological bereavement of med school...

may be I am afraid of declining because inscounsciously I want to stay in the illusion that I didn't fight so many years to get in for nothing...

On the other side, I did not want to stay in pharma companies because it does not fit at all with my own values, I am definitely convinced that money drives them more than human health...and you can not imagine how much...

So what would I do then if I decline my offer?
I would have to build a new life, but like you said, there is no ideal job...

I thought about doing an MBA and then work in humanitarian organisation...but then why not simply become a humanitarian doctor for doctors without borders...oupsss....the loop is looped....

There is really something going wrong here.....so med school or not med school...that is the question....

reality is certainly hitting me, but I am a very stubborn person, so you see, I am the kind of person who needs to get hit very hard i order to see reality as it is really....but I can perceive how right you are so it's a good start...loll


What about you dentist? did you decline? if so what are you doing now?

I understand this might be a personal question you would not answer publicly, so please feel free to pm me if necessary, I would be please to take any advice or comment from anyone
this is supposed to make things moving foward lollll one say....

cheers!

Cotroni

[Nestea]

cotroni
maybe ur epiphany that u have a fear of achievement and ultimately the "end" are merely over-self-analysis, probably stemming from the stress of the move and insomnia (u said u couldn't sleep)

i think ur thinking about this all too deeply, and u probably need to realize that u've already made ur decision, u've packed ur whole life in a few suitcases, moved 5000 km away, ready to start school in a couple months. the ship to turn back and go about ur life that u had a year ago has sailed. if u and ur wife hadn't already decided u wouldn't be where u are right now!

as for wondering what's going to happen after graduating..i think don't worry about it right now - there's major changes going on in healthcare in the uk and here, and a lot of stuff is going to change in the next few years. but i do understand that it's comforting to be kept in the loop and to follow what's happening, cause u are right u will want the security of knowing u'll be taken care of after graduating.

don't let the stuff being said on the grim future of healthcare in the uk bring u down too much. the world will always need docs.

and i'm arriving Sept 12. have u found a barber shop? i was wondering where i'd be getting my hair cut over there