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REASONS I DECIDED TO GO LESS THAN FULL TIME(LTFT)/PART-TIME

Like many doctors moving to the UK my primary dream was to make money. However, moving with a family presented several challenges that made me decide I needed to take it slow.

Background

I started working in the UK as a non-trainee. My family joined after 5 months. After 1 year of working, I joined Psychiatry training in August 2021. This was the hardest period of my life. There were so many events going on in my life that left me both emotionally and physically drained as a doctor, mum, and wife. When the phase was over I had to reflect and learn from it and one of the changes I figured would help me juggle my life better was to work part-time. Now, this was not an easy decision as it comes with less salary and probably a longer training journey. I was however prepared for this. My priority in life is family and working part-time allows me more time to see my girls grow.

The process of applying for LTFT

At the time I made up my mind to go to LTFT, I was in the last month of my first placement. I, therefore, informed my clinical supervisor who was in full support.

HEE organized a seminar to promote awareness of LTFT which I was happy to attend. I was able to learn a few key things.

  • As a doctor on visa- i can only go up to 80% which was fine with me as all i needed was an extra day .
  • It is possible to progress after 6 months if your trust considers competency based training instead of time.

Secondly, I informed my College tutor as well. I then reached out to the LTFT champion/representative in my trust who then drafted an email and copied it to my supervisor, college tutor as well HR.

I then made the formal application and sent it to my Training Program director. I applied under Category 1. Details of the different catogories can be found on the website below.

https://www.severndeanery.nhs.uk/about-us/policies-and-procedures/less-than-full-time-working-policy/

My application was approved after 3 weeks. Once my application was approved an email was sent to my HR and the payroll informing them of when i will start LTFT.

Preparing for life as LTFT trainee

My first training placement was General adults(Inpatients). This was a hectic placement during which i was unable to complete my annual leaves. I then discussed with supervisor in my second placement to allow me take my carried over leaves from placement one in less than full time pattern. This involved me taking one day of leave every week untill the end of placement. This pattern has helped ease into my planned LTFT life.

As i conclude this, i would like to inform anyone reading this to please look after yourself first. Be keen on listening to your body and rest when you can. Whatever works for you, keep doing that. Untill next time, thank you for reading up to this far.

 

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DOCUMENTING REFLECTIONS IN YOUR PORTFOLIO

Reflecting is not only an essential aspect of the life of a doctor but I have found it applicable to day-to-day life experiences. In general, I’m a reflective person as this is one of the ways I learn and grow. Today I will focus on the different ways I reflect as a doctor. Below are some of the different scenarios you can reflect on as a doctor.

  1. An interesting case
  2. A significant clinical incident
  3. An exciting experience eg a community visit
  4. A teaching

The RCPSYCH portfolio makes it easy for you to reflect as it divided the entry into subheadings as follows.

  • Title of the reflection
  • Date (Start date & End date)
  • Tags( This is optional)
  • Description of a notable clinical or non-clinical experience
  • What you learned from the experience
  • The feedback you received from your colleagues
  • What further skills you need to develop as a result of this experience.

 

Tips for writing the reflection

  1. Anonymise patient information( make sure there are no patient identifiers)
  2. Aim to be brief and concise
  3. You can add an update as a follow-up to a reflection.

Finally, you don’t have to document many reflections in your portfolio but just practice the art of reflecting as a doctor. It’s very key to learning. On average 1 to 2 reflections every 6-month rotation should be enough.

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HOW I PASSED MY SPECIALTY EXAMS/MRCPSYCH

Passing Specialty exams is one of the hardest things I have encountered as part of adulting because it takes a lot of factors to pass these exams. 

One thing I have learnt is that failing is a very much expected possibility. Therefore, one has to design a fool proof plan that will enable you to pass this exam. 

It is for this reason I decided to share my experience in the hopes that it will help someone out there.

MRCPSYCH PAPER A.

I did this exam before I started training. I sat the exam on December 1st 2020.

I started preparing for this exam in September 2020. My reading plan was a combination of personal reading and discussion groups. I would invest about 2 hours of reading daily and then join the discussion in the evenings. The discussion group consisted of about 30 people plus. The discussion group would run for 2 to 3 hours.

Things that helped me pass this exam first time.

  1. My family had not joined me yet in the Uk therefore I had no other responsibilities or distractions.
  2. My work schedule was 1 week on, 1 week off therefore I had plenty of time to read.
  3. Consistency 
  4. Discussion group

Resources I used

  1. Mrcpsychmentor question bank. 
  2. SPMM mocks( I subscribed for these with a group of 4 friends from the discussion group). I never subscribed for SPMM high yield because of the cost but luckily other people in the discussion group had subscribed thus I benefitted from these. 

I never attended any courses for this exam.

MRCPSYCH PAPER B FIRST ATTEMPT

I attempted this in September 2021 and unfortunately, I failed and below are my reflections on why I think I failed.

  1. My family was now around therefore I had other responsibilities to juggle.
  2. We were in the middle of moving home to join training so this was a major distraction by the time I settled properly to read it was 1 month to the exam
  3. I had just started a new training job therefore was still adjusting to this as well.
  4. I only subscribed to MRCPsyhmentor and SPMM mocks only. I never did any questions from high yield.
  5. Total actual preparation time was 1month ish.

Looking back, I wish I had pushed this exam, there were so many things going on and I thought my resilience would push me through but I was wrong.

MRCPSYCH PAPER B 2ND ATTEMPT

After failing I decided to reattempt in March 2021 as I still had a fresh memory of the last exam.

I started preparing for this exam in November 2021. I subscribed to Mrcpsychmentor first and went through it once then I subscribed to SPMM high yield question bank. 2 months before the exam I subscribed to SPMM mocks and bought one mock of Pschymentor.

Things that I believe helped me pass this exam/Resources

  1. Investing adequate time for personal reading. I used to wake up at 5 am every day and read for 2 hours before the rest of the house woke up.
  2. Discussing with a discussion partner daily from 7 pm to 9 pm. This time I chose to discuss with one person and I found that a big group can mislead you into thinking you know much when you don’t. 
  3. On slow workdays, I would do some questions at work. My placement in old age psychiatry was less hectic than the previous general adult inpatient placement.
  4. I used Maudsley and NICE guidelines to familiarise myself with the management of common conditions. These also helped clarify confusing/conflicting information in the question banks.

RESEARCH/APPRAISAL SECTION

This was my most feared section and these are resources I used to help me pass this section.

  1. SPMM videos. I found these videos really helpful. I would watch the video and then do questions in SPMM to assess my understanding. 
  2. MRCPychmentor section- I went through this section as well.
  3. I bought a book that was useful in understanding the basics of research.( Making sense of Critical appraisal by Olajide Ajetunmobi. Below is the link and the picture attached. http://https://www.amazon.co.uk/gp/product/0340808128/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
  4. Random YouTube videos on topics I found tricky.

I hope you find this information useful and good luck with your exam.

Extra tip: Please consider splitting the cost of question banks with someone, it will help you save some pounds.

Happy to answer any questions. 

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Working as an RMO in a busy Psychiatric hospital

RMO stands for Resident medical officer. This basically means you reside at the hospital and are on-call 24/7. Starting a new job can be daunting for anyone but starting a new job as a doctor in a new country is even more daunting. I have had many situations that evoke great anxiety and over the years i have learnt to deal with anxiety no matter the situation. However in this particular situation i was really overwhelmed; all the strategies i normally use were not working for me this time.

The only thing that kept me from breaking down is scripture, i was led to very powerful scriptures in the bible that really worked wonders throughout my entire week. My anxiety started with the journey to the hospital, i really dread travelling with luggage by public means. I travelled by train from Aylesbury to Bristol ( the cost of this journey alone made my blood race).

On reaching the train station in Bristol, I was stuck on how to proceed to the hospital. I contemplated calling a taxi but i had no contacts and was weary on spending more money. So using google maps i hopped on the bus that was supposedly headed towards the hospital. I got off the supposed stop and google maps was telling me to walk a small distance to the hospital. I walked, walked until it started raining and i realised that i could be lost. In the midst of my frustration, my colleague who was waiting, decided to give me a call and this was the end of my misery. She sent a taxi to pick me up only to realise the ride was 3 minutes to the hospital and it cost me 8 pounds!!!

I started my job with shadowing. This was supposed to be for a week but due to staff shortage it lasted only 3 days. Weekends are the busiest time for RMOs in this hospital and my shadowing was over the weekend. Looking back I am really thankful that it happened like this because i learnt most of the skills i needed to take me through the next week when i was to work alone. Having concluded shadowing, i started my job on Monday 24th August 2020.

The day started with a doctors meeting where i had to introduce myself and meet the other members of the team. I will never forget this meeting because i remember i left this meeting happier. This was mainly because i felt at home; the meeting had 8 members, 4 women and 4 men.Furthermore out of the 8 members, 4 were international medical graduates and out of these four,3 of us were black African. Now people, there is power in representation, because of this i was represented as not only a woman but as a black African doctor as well.

The RMO main shift in Bristol priory starts at 5 pm and ends at 8 am. During this period you will be called for all sorts of things mainly: prescription refills, changes in patient condition, and the most important of them all is admissions. Admissions in psychiatry are really important as the history is comprehensive and there is a lot of paper work involved. In addition to this, the admitting doctor is expected to take off the patients bloods and do the ECG as well. I need to emphasise this as many IMGs(International Medical graduates) find this annoying because in most countries, nurses do the ECG and bloods, and the role of the doctor is to interpret the result. Therefore be prepared to take off bloods and do ECGs as an RMO. 

My first week went by so fast and before i could realise it the weekend was here again. During the first few days i would jump every time the phone would ring, but by the end of the week, my confidence was back and i felt like myself once again. Having concluded the first week and now halfway into my second week, i can confidently say i love my job. Reasons why i love this job is i get to rest during the day( 8am-5pm); in addition not all nights are busy especially during the week i get to sleep through out the night most days so basically I am glad i chose psychiatry.

While at work, I am provided with food and accommodation. This really works for me as i hate daily commutes to work. I will be back again a few months down the road to update you how its going so far as am only covering this hospital for a month.  As i conclude this article, i want to encourage all the doctors out there in the process of ” chasing the UK dream” please don’t give up, the journey can get frustrating but the best is yet to come. For the women out there, let nobody ever stop you from chasing your dreams, start late, start scared, as long as you start. And finally I will leave this scripture for those that are going through scary moments; Isaiah 43:1-2. It says” Fear not, for i have redeemed you; I have summoned you by name( Carolyn); you are mine. When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. When you walk through the fire, you will not be burned, the flames will not set you ablaze. 

If you are a visual feel free to check out my video on You tube in relation to this topic

Pros/Cons of working in the Private sector

 

 

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GMC REGISTRATION; Faith over Fear

blog 2The process of GMC registration roughly takes about 2 to 6 weeks for most doctors with some lucky ones even getting it within 5 days. I had anticipated mine to take roughly 6-8 weeks little did i know mine was going to take 8 months; yes eight tough months. This was a period where i had the chance to exercise the following virtues; faith, patience, persistence and the powerful duo of fasting and prayer.

My timeline for GMC registration in summary was as follows; Please note my experience is a very unique one but i believe it will speak to someone out there.

  • 1st November 2019; Applied for GMC registration having collected all the documents required;  internship completion certificate, Certificate of good standing, Degree certificate and the IELTS certificate.
  • 21st November 2019; My application was closed awaiting an inquiry into my Primary medical qualification( please check out my blog post”When the dream seems so far”
  • 21st November- 2nd March 2020; Primary medical Qualification inquiry.
  • 2nd March 2020; Primary medical qualification accepted.
  • 12th March 2020; Re-applied for GMC registration
  • 9th June 2020; Received GMC registration.GMC Registration

The two most important milestones in this journey were 2nd March and 9th June. There was a point along the way i though these two things may never happen. I did a lot of fasting and praying because there were many times i reached a point when there was nothing else i could do but surrender to God. This journey taught me great lessons that i will surely use in the next phase of my life.

Lesson 1; Faith can only be exercised in the valleys of life.

Many times as Christians we desire to have faith not knowing that it can only tested in trials. Case in point is Isaac in Genesis 26:2. The Lord instructed Isaac “Do not go down in Egypt, but do as i tell you. Live as a foreigner in this land and i will be with you and bless you…”. Isaac lived in Gerar after this encounter with God. We would expect his life to smooth in this land after all he was living under the Lord’s instruction. Isaac however faced lots of resistance from the Philistines living in that land but this did not stop him from thriving in this land. He built many wells in this land that later benefited his descendants.

Lesson 2; The Lord’s plan is to prosper you.

Jeremiah 29:11″ For i know the plans i have for you, they are plans for good and not for disaster, to give you hope and a future” This is one of the verses that reminds me that everything happens for a reason. My original plan was to start work in February 2020 but because of the above circumstances this did not materialize then shortly after my degree being acceptable the world went into the COVID 19 lock down. During this time i thanked God that i was at home with my family. I surely saw the hand of the Lord in my life so i want to remind you today that even the delays are for your own good.

Lesson 3; Be still…

Psalms 46: 10 ” Be still and know that iam God”…My journey reminded me of the Israelites in Exodus 14. While the Israelites had camped at Pi Hahiroth, they saw the Egyptians pursuing them and became terrified. They started blaming Moses for taking them out of Egypt but Moses n vs 14 reassured them”The LORD will fight for you; you need only to be still,” I had many trying moments along this journey but this verse really calmed me. I was reminded that the Lord works when we are still therefore however bad the situation is you need to be still and surrender to the Lord, he will definitely come through for you.

I have been so lazy to write this article but i hope that it blesses someone out there. If you have any questions feel free to contact me below, remember the Lord blesses us to bless others. This process has been a big testimony in my life because there were so many times i would have chosen to given but the holy spirit kept me persisting till we won this battle so as i conclude this article i want to remind you; DO NOT LIMIT GOD; REACH FOR THE STARS!

Yours truly

Dr Carolyn Nansubuga.

Don’t forget to cehck out my You tube video about GMC registration journey

http://https://youtu.be/3Ti4MZ2Rv50

 

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PLANNING YOUR PLAB JOURNEY

The Journey to the UK is not for the fainthearted but it is a doable one. Before you start this journey you really need to be sure you want this. This is not a journey you embark-on in trial and error because it involves investing time, knowledge and money. So Commitment is an essential requirement to start it. If you are a spiritual person like me, i encourage you to pray about it first to make sure this is part of your life’s purpose and plan. Many doctors have been asking about the estimated cost of the entire journey so i decided to break it down in this post. If you think about acquiring this money as a lump-some first then you will not start. Start by committing your next month’s salary to doing the English exam and the rest will fall in line.

Estimated costs include;

IELTS : Approx 1,000,000 ( This keeps changing depending on the pound rate)

Resources required for this are usually free on You tube: My recommendations are IELTS by LIZ and E2 LANGUAGE by Jay. Make sure you go through the free British council resources as well, they are worth it.

PLAB 1: 230 POUNDS ( APPROX 1,250,000)

Resources: Online subscription of Plabable costs around 20 pounds.( 100,000)

Plab 1 related travel costs. Approx 4,000,000 Ugx : Plab 1 is not held in Uganda, I did mine in Dubai and it cost me this much but it can cost half this amount if you plan to just go do your exam and come back. I stayed in Dubai for 4 nights to tour the area. I used a travel agent who i gave the lump-some of 4 million for everything( visa,ticket and accommodation) I later found out i could have gotten it cheaper if i had chosen to book everything myself.

PLAB 2 EXAM: 860 POUNDS ( Approx; 4,300,000)

PLAB 2 ACADEMY: 600 pounds

PLAB 2 VISA: 425 Pounds ( priority)

Now this acquiring this visa is a sensitive part of this journey. I will dedicate an entire post to this.

RETURN TICKET TO UK: Approx 4,000,000 ( You can get this cheaper if you book your ticket early enough)

EPIC VERIFICATION: 225 DOLLARS ( This involves sending your degree for verification to an independent body Designated by GMC. It takes a while so its best to be done immediately after PLAB 1)

LIVING EXPENSES IN THE UK. ( 500- 1000 POUNDS)

 

This is honestly variable depending on where and how long [irp]you stay in the UK. If you choose to stay with relatives this cost can be cut down to half of this.

GMC REGISTRATION:

153 Pounds if you graduated in the last 5 years. If more than 5 years approx 300 pounds

CERTIFICATE OF GOOD STANDING: 100,000

TIER 2 VISA  COSTS:

TB CERTIFICATE: 100 USD

POLICE CERTIFICATE: 80,000

VISA: 400 POUNDS

HIS: 400 POUNDS

ONE WAY TICKET: 2,000,000

In conclusion the journey is doable; all you need to is to start. Remember; Everyone’s journey is different. Feel free to post any PLAB related questions or comments in the comment box below.

I talk about the PLAB journey in detail on You-tube