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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

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When The Dream Seems So Far

I normally write about moments that passed but this time I have chosen to write about something that’s ongoing because I believe this blog post will one day serve as a testimony. On 22nd November 2019 ; 4:53pm,  I received an email from the General Medical Council of UK that my application for registration as doctor has been temporally closed because they needed to scrutinise my medical qualification further as it seemed rather different from the ones they usually assess.  Never at any one point during this journey have I ever felt like giving up, but for the very first time this feeling engulfed me I almost felt like suffocating. I thought about all the emotional and financial investment I had poured into journey . Now you see if there is one thing I have accepted in my life is the fact that am different and because of this so is my journey. My degree transcript is unique in such a way that it only captures half of journey in Medicine with the other half being captured on my nursing transcript so it appears as if i did Medicine for only 3 years. In Uganda this never really bothered me and over time I had fewer explanations to give about the nature of my transcript

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This moment reminded me of several moments in my life when it seemed like just one decision would overturn everything. However the only constant in all these moments is the fact that there was nothing much I could do but wait, and TRUST GOD to make that final decision. Let me just take a moment to remember the GIANTS that the Lord has conquered.

  1. The time I felt I was ready for marriage and God led to the right marriage partner. If you have ever been a young girl ready for marriage and you can’t seem to find the right person, you understand this struggle.
  2. The time I applied for Medicine after completing nursing, and I was the only one selected that year.
  3. During that time, there was a battle by the Board of Medicine on whether I should do the complete 5 years or receive exemption for the courses I did during Nursing. I conquered this battle and I was exempted.
  4. The time I prayed to God to receive an internship place in a hospital in Kampala as i wanted to stay close to my family; He answered this prayer.
  5. The time I was ready to have another child after 3 years of medical school, God showered me with a blessing of TWINS.
  6. The time I decided to pursue this journey to the UK and I was only relying on my next month salary to start a journey that costs several million Ugandan shillings. The Lord provided for me during this journey and I still cant believe I have come this far. This journey had many ups and downs but the fire that was burning inside me never ever burnt out until now. Right now I feel that am faced with a GOLIATH.

So the Question is; Did the Lord who just did all this amazing stuff suddenly go quiet on me. Well I don’t think so. As much I’m going through this horrible feeling, one thing remains firm in my heart. The God I serve is for me. Sometimes he gives me short term problems to prevent me from getting into long term problems. So I choose to believe that even in a moment like this when my hope is hanging on a string, God will come through for me. So just like my former school motto says “GAKYALI MABAGA” literally meaning  “The struggle continues”, all I can do right now is Pray and Surrender. I believe this will be a testimony one day.

Mukiibi Photography on the Lens

 

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My PLAB 2 Experience: A Ugandan Doctor’s Journey To The UK

MY PLAB 2 EXPERIENCE.
This post is meant for doctors pursuing UK practice through the PLAB pathway. I did my exam on 3rd October 2019 and I cleared it in first attempt. I scored 156 and passed 16 stations. Well for those that know how tricky this exam is, know what this statement means.

Freedom after Plab 2 exam.

Academy
Unlike PLAB 1 where you can pass with self study, PLAB 2 requires attending academy. However experienced you are, I strongly recommend you attend an academy of your choice. There are several academies committed to ensuring that you pass your exam as this also reflects on their quality and authenticity. Personally I chose Samson’s Academy because all the previous Ugandan doctors had go there and majority passed in first attempt which is what matters most. I went to academy with a clean slate; You know how people send you all sorts of material before academy and they tell you to read through, well I failed to read this material as it did not make any sense to me till Day 2 of the academy. Once I reached academy the information provided was a lot that i didn’t have time to read through other material therefore don’t stress yourself out trying to prepare before academy, enjoy your life while you can because once you join academy it is so intense that your social life will migrate from 100% to 0%. I joined the September 1st to 15th Class, and I had roughly 3 weeks to my exam. Classes run from 10 am everyday in those 2 weeks and they end between 7 pm and 10 pm.

Discussion/Practice Groups

My practice group on a sunny day in the park

My favorite reading resource

As much as attending academy is vital to pass PLAB 2, the backbone of passing this exam is practice, practice and practice. And I will repeat this phrase that while you can get away with reading on your own in PLAB 1 preparation; with PLAB 2 you will need a practice group/partner. I strongly advise that you start sketching through your course mates once you join academy for potential practice partners. It is advisable that you discuss with those on your date or closer to your date. Our PLAB 2 discussion group consisted of four people and our PLAB exam dates were one week apart. The ideal group should not exceed four people as you will then have less time to practice. I preferred a discussion group to having a study partner as this exposed me to people from different backgrounds thus bringing a variety of skills and experience on to the table. We started practising between 8 am and 10 am before classes started since our exam dates were 2-3 weeks after academy classes officially ended. Initially we would let a pair simulate while the other acted as examiners, and as the exam dates approached we kept switching practice partners among-st ourselves which helped us identify each other’s  weaknesses from different perspectives.

Accommodation.
You can plan your accommodation depending on where you will be attending academy; Samson’s academy is in East London so living close to the academy really helps as classes sometimes end really late. Accommodation rates range between 150 to 160 pounds per week depending on whether you are sharing or not. Personally I chose to live with my cousin who lived 45 minutes away by bus and 35 minutes by train from Samson’s academy. This definitely saved me lots of money and since the transport system in London is efficient the latest I ever got home after class was 11.00.am. Some people preferred to rent accommodation close to academy as they would practice till late after classes. So you can choose whatever works for you. You will also need to book accommodation in Manchester for the night before your exam. This should ideally be done once you confirm your PLAB 2 visa. A hotel is preferable as you will need the heavy breakfast to take you through the day. I stayed in AIRBnB because by the time I remembered to book the hotel the prices had doubled. The most convenient hotels are Premier Inn and Travel Lodge.

The Exam

Exam Venue in Manchester

PLAB 2 is a subjective exam and this is what makes it tricky. You really have to sell yourself as the best doctor that the patient has on that day and because of this you will need all the confidence in this world. Confidence comes with practice and knowing your stuff; this means you need to immerse yourself fully into the entire PLAB 2 preparation process. The classes can get so long and boring but please stick in there; you will need to know all these cases they take you through. In addition to the material they give you at the academy; make use of the NHS website, this helped in simplifying diseases making it easy to explain to the patient. If you feel deficient in a particular system take off time and read about it as this is key in boosting your confidence. I was personally weak in Psychiatric topics since I rarely saw psychiatric patients back home . I therefore made it a point to give more time to psychiatry and this indeed paid off, as I scored all the 12 marks in the Schizophrenia patient I got in my exam.
After all is said and done, PLAB 2 is a doable exam; I actually preferred it to PLAB 1 as it is more practical but I would not want to do it again as the energy and resources invested into the exam are way beyond my understanding. In summary these are my top tips to having a smooth PLAB 2 experience;

KEY POINTS

  1. Join an academy of your choice.
  2. Practice, Practice and Practice.
  3. Take your mocks seriously as there is a high chance these topics may come in your exam.
  4. Accept criticism and feedback from the Mock examiners and your practice group.
  5. Good Interpersonal skills are crucial in this exam so if possible take a few videos during practice and watch yourself later.
  6. Consider your exam as a busy day in an outpatient (GP) clinic. This way you will be comfortable talking to the patient.
  7. Approach each station with an open mind. During the final days of practice we made sure we have at least 3 differentials for each presenting complaint , this way you won’t need to cram stations.
  8. If you feel you didn’t do well in a particular station, leave these feelings in that room and move on to the next station with a clear mind. You can only learn this through the Mock exams. Chances are you will pass the stations you feel you didn’t do well.
  9. Do not forget to ICE your patient wisely and safety net whenever it is applicable.
  10. Finally be confident and feel confident; Take charge of the examination room because you are the doctor.

All the best in your journey to the UK.

Feel free to check out my Youtube video on my plab Journey

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SHAME; LEARN TO DESPISE IT

dr-nansubuga-carol

Your Opinions About Yourself Regarding Shame

Have you been going through life looking down on yourself over something that happened in your past? Have you or other people been judging you too harshly because of what you did? Well today my message for you is Learn to despise shame.

You need to learn what the Lord thinks about you for he alone has a say over your life; In Jeremiah 29:11, We are reminded that the lord has great plans to prosper us; Even our own beliefs about ourselves cannot hold us back from what he has in store for us. Remember charity begins at home; so start feeding your mind with scripture that builds instead of tearing yourself down.

nansubuga-carol

People’s opinions.

Learn to despise people’s opinions about you. Focus on to Jesus the author and giver of Life. Whoever continues to judge you by your past does not belong in your future. Why do they hold you back?; to something you are no longer part of…These are people who don’t wish the best for you . Please let them go. So please look around you, are your friends for you or they against you; Take an inventory.

Even you have no right of bringing your shame against you. You have a job of personally leaving all the baggage behind and open a new page. Don’t let the weight  of your past keep you down. The Bible says in Acts 3:19; “Now repent of your sins and turn to God, so that your sins may be wiped away. Then times of refreshment will come from the Lord…..” Take note of the Key word; Repent, turn to God , sins being wiped away and times of refreshment following thereafter.

Your Opinions About Others

We should be careful not to judge people. You too have to learn not to judge people whether you Know their circumstances or not. You don’t know it all. The bible in Mathew 7: 1-3 emphasizes this; “ Judge not and ye shall not be judged ” Proverbs 11:12 furthers reveals that he who despises his neighbor lacks sense.

We should learn the art of forgiving easily,of course this takes spiritual maturity.

In John 8: 1-11 we see the story of the woman who was caught in adultery and was brought to Jesus or Judgement. According to the Law of Moses this lady was supposed to be stoned to death. Jesus in Vs 7 instructs them “Let any one of you who is without sin be the first to throw a stone at her.” Indeed no one had the courage to do this. Jesus knew much more about that woman’s future  that’s why he never judged her. Therefore let us take a conscious effort not to judge others.

Look Unto God

As i conclude this, i need to emphasize that whenever shame tries to bring you down focus onto God; Our God is a healer; a comforter and listens to us in time of need. Find time and relay your worries and shame to him; Believe me he will answer you.

Have you ever battled with shame at any one point in your life? How did you handle it? Do you consider yourself as having overcome it? Below are some links to guide you more into overcoming shame.

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