IMG Guide for Medicine Doctors Relocating to the NHS

Are you an IMG Medicine Doctor? If so, you've probably considered working in the NHS. It's an enviable dream but one that you'll need to work hard to achieve. You might be wondering if you are eligible and what you'll need to achieve in your career to make your dream a reality. Perhaps you aren't clear on the difference between your own healthcare system and the NHS. Or maybe you just need some help creating the perfect CV and preparing for your interview.

In this incredible guide, my guest is Olivia Loizides. An expert in international medical recruitment specifically for Acute, General and Elderly Medicine Doctors. Liv has helped thousands of international doctors achieve their dream of working in the NHS and worked with over 100 NHS Trusts. It's easy to see what has made Liv such a prominent figure in international recruitment of Medicine doctors in to the NHS, when you hear the way she articulates complex issues and simplifies them so effectively. You'll leave this podcast behind, equipped and confident that you can achieve your goal of working in the NHS.

Topics Covered

• The requirements for Medicine doctors working in the NHS
• The types of Medicine doctor that will thrive in the UK
• The key challenges facing IMG Doctors 
• The difference between job titles and grades in the NHS vs Internationally
• Why specialist fields like Acute or Elderly Medicine might be better suited than General Medicine
• What makes SDEC a popular choice for IMG Medicine doctors
• Top tips to make a Medicine CV stand out to an NHS clinician
• The most popular questions that come up in Medicine interviews
• Which jobs are best suited to IMGs 

Useful links

NHS Doctors' Job Titles Explained

NHS Medical CV Template - Download

Medicine NHS Interview Questions - Download

If you are an international or domestic medicine doctor looking for a new role then please contact Olivia and the Medicine Team for more information on how they can help.

Full Transcript

00:01Hi, everyone, and welcome to the IMG Media podcast.

00:05For those of you that don't know, we

00:08previously had a podcast called IMG Advisor.

00:11We've rebranded it, renamed it and we're coming back

00:14for IMG doctors all around the world who we

00:17hope we will be able to provide advice and

00:19guidance and support for their relocation to the UK.

00:24I'm joined today by Olivia Loizides.

00:28Liv heads up our medicine division here.

00:31So the episode we're recording today is about medicine doctors

00:36and how we can help them relocate to the NHS.

00:40So we're going to talk through the requirements,

00:42the challenges that medicine doctors face, some interview

00:46advice, CV advice and the types of jobs

00:49that you might want to apply for.

00:50So, welcome, Liv. Hi.

00:53Thanks for having me, Dan.

00:55No problem at all.

00:56We actually work together every day, so

01:00we're going to cut straight into it.

01:02Liv, do you want to start by telling me about your

01:06experience working with medicine IMGs and with the NHS, so what

01:10you do and the candidates that you work with?

01:14Yeah, absolutely.

01:15So I've been doing this for, coming up four years now.

01:19I've been working specifically in kind of the general

01:23internal medicine field of this for that entire time.

01:26So throughout that, I've kind of been consistently speaking

01:30to medicine doctors and medicine departments all across the

01:33NHS about kind of bringing together doctors who are

01:37looking for new positions and really good trusts that

01:39are looking for kind of qualified and experienced doctors

01:43to join their teams.

01:45So I now kind of manage a team

01:48of the four of us, covering specifically medicine

01:51and the different subspecialties that fall within that.

01:55And between us, we've worked with kind of over 100 NHS

01:58trusts to help doctors start into these kind of roles.

02:02Wow. Amazing.

02:04So tell us about the kind of doctors that you

02:08help, so what kind of qualifications they have, typically, where

02:12they're from, the types of backgrounds, anything to do with

02:15the types of doctors that might be listening to this

02:18so that hopefully they can identify with it.

02:21So vast majority of the doctors that we work with are

02:24kind of initially or currently overseas, so maybe kind of qualified

02:29in their home country and thought at some point, I'm looking

02:33to work in the NHS and it takes a long time

02:36to get those qualifications to come here.

02:38It's not kind of an overnight decision, but

02:41we start speaking to people when they're sometimes

02:43right at the beginning of that journey.

02:45So maybe first starting to think about fitting their

02:48MRCP, obviously being the specific Medicine Royal College qualification,

02:53or also doctors who maybe have equivalent qualifications, like

02:58doctors who have got the Sri Lankan MD looking

03:01to come to the UK with that.

03:02Or also doctors with qualifications more

03:06generally, like PLAB or USMLE.

03:09So a lot of the doctors overseas at the

03:11moment, that's kind of what we specialize in, really.

03:13And that's why it's really important for us

03:16to kind of have a really good knowledge

03:20of how different healthcare systems around the world

03:23equate to the NHS, because I can imagine

03:26how confusing it could almost know you've trained.

03:31Your whole life and worked your whole life

03:32in one, maybe a couple of different healthcare

03:34systems, and then looking at the NHS and

03:36being like, well, there's different specialties that don't

03:38exist in the healthcare system I'm in at the moment.

03:40Or I'm working in this job title, but I'm

03:43not really sure how that would equate to this

03:44job title and grade in the NHS.

03:46So that's kind of something that we've grown

03:48really accustomed to in kind of understanding exactly

03:51how all these things go together really great.

03:56So in terms of the level of candidates that you

03:58work with, you mentioned PLAB there, you mentioned MRCP.

04:02Is it more junior doctors, middle

04:04grade doctors, or consultant level?

04:07So most of the doctors that we're

04:10kind of most able to help are

04:12registrar specialty doctor, consultant level doctors.

04:16That's just because at a more junior level, the NHS

04:20just tends to do really well from direct applications.

04:24So we'd always encourage we'll absolutely speak

04:27to junior doctors because we do sometimes

04:30have more kind of st twelve medicine

04:32positions that we're able to help with.

04:34We'll always have those conversations, make sure we

04:36got CVs for if anything comes through.

04:39But my best advice for junior doctors generally looking

04:42for medicine roles would be get in touch with

04:44an agency, but your main applications are going to

04:48be done directly on NHS and track jobs.

04:50But we want to have those conversations anyway

04:52to offer any advice that we can give.

04:53We've got great interview guides we send over

04:55to doctors, even if we're, like, right now,

04:57might not be able to help.

04:59And I guess at that more junior level, they're a

05:01little bit more doing more general work, so less specialized.

05:05And obviously the NHS is a highly specialized system.

05:10Consultants and registrars is kind of yeah, as I

05:12said, where a bulk of our kind of success

05:15with helping people into the NHS and that might be, you

05:18know, perhaps we've helped someone into a registrar job

05:21in their first role, and then they're looking to

05:22step up to consultant in their second job.

05:24That's absolutely the kind of thing that we can help

05:27with as well, because I know that sometimes coming in

05:29at a more junior level to begin with can be

05:32appealing and we can help from there as well.

05:36Okay, great.

05:37Tell us about the main challenges that IMGs face

05:40and maybe deep dive into some of these.

05:43I think it might be interesting for the listeners to

05:45see whether they can identify with any of them, and

05:47then we can hopefully work through some of the challenges.

05:51So I would say kind of some of the main challenges

05:54are it's just all between the difference in systems and that's

05:58kind of apparent throughout a lot of the process.

06:01And that's, I think, why it can be really helpful

06:03to work with an agency, kind of, as I was

06:06saying before, about how we specifically kind of really understand

06:11how a profile might fit in well to the NHS.

06:15It can be difficult to look at it and

06:16understand that, whereas you can have a conversation with

06:18us about kind of exactly what you're doing at

06:21the moment and how that might fit in.

06:23Because it can be really quite hard to look at

06:25your duties at the moment and really see where that's

06:27the best place for you to come in as.

06:29The flip side to that as well is knowing what to

06:33put on your CV to make it really stand out and

06:37clear to a consultant in the NHS exactly what you're doing

06:39and why you're suitable for that kind of level.

06:44So kind of a lot of it's about aligning those things.

06:49So when you talk about the differences

06:51in healthcare systems, are we talking about

06:53the differences between job titles or the

06:55differences between the specialities or the systems

06:59themselves and the duties that are expected?

07:01All of it, all of the above, which is why it

07:06can seem like a bit of a daunting task, but there's

07:09lots of resources out there to assist with that.

07:12So, obviously, grade is probably the one that

07:15we could start with in the NHS.

07:17You've got your kind of junior doctors anywhere

07:19from FY1 through to ST2 for

07:22Medicine, where you're going to be working.

07:25And you've always got a registrar leading you that

07:29middle grade level of doctor there to support you.

07:33Middle grades registrars, you report to consultants, but

07:37consultants are only in kind of mostly nine

07:39till five or eight or four.

07:40So overnight registrars are the most senior

07:43doctors in the hospital, making a lot

07:45of the senior decisions clinically.

07:48So when those job titles don't exist in your

07:52current healthcare system, it can be a bit difficult

07:54to think, where would I fit in?

07:56I'm a medical officer, I'm a resident.

07:58What would that equate to?

07:59That's why it can be really helpful to I know

08:01we've got a lot of resources out there about exactly

08:05what these different roles are in the NHS.

08:09Do you know what?

08:10We could post a link to the blog we've got on

08:12job titles in the NHS and how they kind of align.

08:15So I guess maybe we could walk through

08:18the different stages and the title differences.

08:21So FY1, FY2 is known as intern.

08:25Generally overseas, So that's kind of fresh out of

08:27medical school, first couple of years in a hospital

08:31setting, then we have CT medicines that's like

08:35core trainees, and at that point, they're rotating between

08:39medical specialisms, getting a broad kind of knowledge, broad

08:43kind of general medical understanding.

08:45What would that be overseas?

08:47So that I would generally equate

08:49to anything where you are.

08:52The way I kind of often describe it is

08:54like, do you report directly to your consultant or

08:57is there a more senior kind of middle grade

09:00doctor that sits in between you?

09:02So if I was talking to a doctor and

09:04they were saying, yeah, so I do this work.

09:07But overnight or during the day, there's always

09:10a senior resident or a senior medical officer

09:14or someone for me to report to.

09:15And then above them is a consultant, then maybe

09:17we'd be having a conversation about maybe coming in

09:21as a junior doctor might be most appropriate.

09:23 It's also about what you're comfortable with, because

09:26there's a lot of conversations that I have

09:28with people, and when you kind of explain,

09:30like, as a registrar, as that middle grade

09:34doctor, you are the one kind of leading

09:37things overnight, that's quite a lot of responsibility.

09:40And a lot of people come to it and

09:41say, yeah, absolutely fine, because that's what I do

09:43all the time in my current job.

09:45But for someone who's not really sure about that or

09:47even maybe does that in their current job, but is

09:49like maybe in a new healthcare system, I'd like to

09:52take a bit of a step down, then maybe joining

09:55at that kind of generally ST1/2, CT1/2

09:58level might be a bit more suitable.

10:00Okay, makes sense.

10:01And at that point, the qualification might be a

10:05PLAB qualification or perhaps MRCP One and Two.

10:10Yeah, and that's exactly the kind of profile

10:13of doctor that we've helped into these ST1/2

10:17positions when we've had them.

10:18It's not a necessity to have full MRCP.

10:21You can have PLAB, you can have USMLE.

10:23It's obviously a bonus if you've got part

10:25one or part two of MRCP, but it's

10:27not a requirement to have the whole thing. Okay, great.

10:30And if you were a UK trainee, of course, at

10:32that point, once you finish CT2, you would then

10:35sit paces and enter into ST3 level training.

10:39So I guess that's where we

10:40start talking about middle grade.

10:42So I'm guessing doctors with paces is a sort

10:45of marker for a base marker, I suppose, for

10:48coming in at a more middle grade level.

10:51Job titles here would be Senior

10:53Clinical Fellow Registrar plus Speciality Doctor.

10:59There's a whole host of middle grade level overseas.

11:03We're talking residents.

11:05Yeah, I've kind of seen residents in some

11:10healthcare systems working at a level that would

11:11be more equivalent to a junior doctor, and

11:14sometimes it's more equivalent to a senior doctor.

11:16And I think that because there's that variation that's sometimes

11:19why it's difficult to just look at a job title

11:21and say, I know exactly how that would fit in.

11:23Which is why it's important to understand exactly

11:25what this looks like in the yeah, registrar

11:30is a good kind of benchmark. As you said.

11:32There's a lot of other variations within that.

11:35And yeah, these are the kind of doctors where

11:37MRCP is generally a bit of a benchmark.

11:41Some trusts will say we will categorically

11:43not employ a registrar middle grade tier

11:46doctor if they don't have full MRCP.

11:49So that is sometimes just a hard truth.

11:53There are a lot of other hospitals out there

11:55who might have a bit of flexibility on that.

11:58So obviously, it's been quite difficult to get

12:00paces exams in the last three years, really

12:04due to COVID, which everyone's really aware of.

12:08So there are a lot of hospitals out there

12:10that might say, okay, well, this doctor's got MRCP

12:13part One and Two, and they've got their GMC

12:15registration, perhaps through PLAB or another route.

12:20We'll employ them as a registrar with the understanding that

12:23they're heading towards paces within their time to us, rather

12:27than kind of penalizing people for having not been able

12:29to get a pace of seat overseas.

12:31So there's a bit of variation there and that's

12:33the kind of thing where we've kind of spent

12:35a lot of time mapping that out.

12:36Like when I'm speaking with a doctor who's got MRCP

12:39one and two and four GMC registration and they're looking

12:42for a job, kind of know exactly what hospitals we

12:45can immediately approach and the ones that I'm like, they're

12:48not going to even look at it.

12:49So, qualifications, there's a bit of flexibility, but really,

12:53I would say one of the most important parts

12:55about making a good middle grade registrar profile is

13:02being a certain level of independence.

13:04So if you can make pretty independent clinical decisions, obviously

13:08there are consultants to report to, but quite a senior

13:11member of staff, then that's going to carry you a

13:14long way into getting a registrar level role and making

13:16sure you're comfortable with doing it.

13:18Okay, great.

13:20So to summarize that, then, we're really ideally looking

13:24at paces plus and we're looking at people who

13:28can practice with a bit of independence, obviously.

13:30Consultancy support night on calls,

13:33pivotal to it, really good.

13:37There's a couple of greats that kind of

13:38sit almost in between registrar and consultant that

13:42we get asked about a lot.

13:43Specialist and speciality doctor, talk us through

13:47those and where an international doctor might

13:49see those as the best fit.

13:51So I'll start with specialty doctor.

13:54This one is used a little bit kind of

13:57differently depending on what hospital you're talking to.

14:00So I know there's some hospitals where they

14:02might have senior clinical fellows as the bulk

14:05of their middle grade cover intensively, working those

14:08on calls and things like that.

14:10And then they might have a tier of specialty doctors

14:13kind of above that, who the senior clinical fellows might

14:15report to and then the consultants above that.

14:18So sometimes it is quite graded like that.

14:22But then in other hospitals, specialty doctor is just the

14:25grade that they use to employ all of their registrars

14:28and so it's kind of less stratified and it goes

14:30more kind of junior doctor, specialty doctor and consultant.

14:34So I think sometimes there's a bit of a

14:36misconception that I want a specialty doctor role because

14:39it means more seniority, where absolutely, in some hospitals

14:42that is the case, but in others it's not

14:45really at all, it's just what they're choosing.

14:47Just a non training grade equivalent, I

14:49think, for ST3 plus specialist, though,

14:52is yes, that is more senior, definitely.

14:55So that used to be the associate specialist

14:59pay grade and job title and in 2021

15:04was kind of reinstated just as specialist.

15:09And what that is, my understanding of it is that

15:14your duties are effectively equivalent to that of a consultant,

15:17but as we know, if you're not on the specialist

15:20register as a consultant, you'll only ever be able to

15:23get a contract of a maximum of two years.

15:25So anyone that's going through CESR or isn't on

15:28the specialist register that wants to effectively act as

15:31a consultant but not be on that kind of

15:34fixed contract, could potentially go for a specialist position

15:38instead, where there's no limit on the contract length

15:41or renewals and things like that.

15:43So it's kind of almost been designed for people at

15:45that senior level who aren't wanting to go through training,

15:48looking to go through the portfolio pathway instead.

15:51Yes, portfolio pathway, the new title hot off the press.

15:55Yes.

15:56So it's an interesting one that, because it

15:59sounds like it's suitable to an international consultant

16:03because obviously they might not be on the

16:05specialist register, it's quite hard to get the

16:06specialist register from overseas.

16:08But that said, my understanding is that there's

16:10actually not that many jobs of that grade,

16:13so it's a great idea, but it's not

16:16quite filtered through to the system yet.

16:18And I think that's because obviously 2021

16:21was two full years ago now.

16:23But if you think about because the NHS is a public

16:26health care system, it can be quite hard to enact change

16:31in a system like that because it's public money and everything

16:34needs to be signed off 1000 times over.

16:37So sometimes I think specialist is something that we will

16:41see be used more and more and more, but it

16:45is going to be something that is going to grow

16:49fairly slowly compared to all of the pre established kind

16:51of local consultant specialty, doctor positions and things like that.

16:55But I think people are starting to see the value of it.

16:57But yeah, at the moment we're in a position where

16:59it is there, but the actual vacancies aren't there quite

17:02as much as we'd like them to be just yet.

17:04Yeah, fair enough.

17:05Okay, to summarize those ones then, I guess we're

17:07looking at again, paces completed MRCP type doctors, ideally

17:12those practicing independently, a senior reg or potentially consultant

17:17level with a I'm not going to say a

17:20step backwards, I've just said it, but a step

17:24into a specialist role, which could just be an

17:27appropriate step for them.

17:30And obviously specialists comes with quite an attractive

17:32salary scale, so that kind of helps if

17:35you do feel that you're a consultant overseas

17:37but not quite ready for here.

17:39We've mentioned consultant quite a bit.

17:41I suppose that's the final one in the scale.

17:43Do we see a lot of international medicine consultants

17:47joining the NHS as consultants straight away, or do

17:51they tend to take a stepping stone route?

17:54We see both.

17:55And that's actually something I get asked quite a lot,

17:58where I might see someone who's got five years of

18:01consultant experience saying, oh, you know, I didn't think I

18:04could become a consultant in the NHS for my first

18:07job because I don't have specialist registration.

18:10That's not true.

18:11We've helped lots and lots of really

18:12qualified medicine doctors from consultant roles overseas

18:18into consultant positions in the NHS as

18:20their first role, very successfully.

18:23So the main thing with that is obviously

18:25you have all of the experience and qualifications

18:28you need to be a consultant.

18:29No one's doubting that at all.

18:31The main thing to consider here is in the

18:35NHS, a lot of the differences will be about

18:39leadership and management and things like that.

18:42So that's kind of comparatively a little bit

18:44more of the thing that needs to be

18:46focused on when going for a consultant role

18:48as your first consultant position in the NHS.

18:51Yeah, okay.

18:52And for consultants stepping straight in, my understanding

18:57is that a lot of international systems are

18:58quite different in their training program.

19:00So do some systems lend themselves better than others?

19:05And also, I understand in some healthcare systems, the

19:09more senior you get, the more hands on sorry,

19:11the less hands on you actually are.

19:13And I think that's maybe sometimes seen as a bit

19:15of a bad thing because consultant here are quite involved.

19:19Is that right?

19:20Yeah, that is true.

19:21And I think that that is definitely

19:23the case in a lot of places.

19:25Like, for example, I know we're speaking to someone

19:27the other day who was saying, when I was

19:29a registrar, I was working, doing lots of procedures

19:34and working on calls and things like that.

19:36But since I've stepped up to specialists, I'm

19:39not really doing much inpatient work anymore.

19:40I'm effectively only really working outpatient clinics, which is

19:45really different from a consultant or a specialist in

19:48the NHS, where in medicine subspecialties, they are still

19:52expected to be really hands on.

19:53You're still going to be doing a lot of inpatient

19:55work, get involved in complex procedures when they're needed to

19:59be done, and also CPR and things like that too.

20:03So it is really important to kind of bear that in mind.

20:06And maybe if you have been out of kind of

20:09more hands on practice for a little while, just think

20:12about how that transition is going to be for you.

20:14If there's any way that in your current system you

20:16are able to get a bit more involved again, just

20:18to get used to that hands on nature before moving

20:21to the NHS, that probably really help you within that.

20:25And I guess if you're coming in as

20:26a consultant, the buck stops with you.

20:28So it's a safety issue for yourself and for patients.

20:31Obviously, you want to know that you're not

20:33going to feel out of your depth because

20:35ultimately there's no one for you to report

20:37to, actually, clinical director, but the registrars, the

20:40junior doctors will be looking to you.

20:41So it's important that you feel

20:43very comfortable at that level.

20:44So overseas, my understanding, is

20:46the title specialist sometimes equates to

20:49consultant confusion around that.

20:51Sometimes it's not always called

20:53consultant overseas, is that right?

20:55Yeah, that's absolutely something we've seen a lot.

20:57So it might be someone who's been working as

21:00a specialist for six years somewhere and they're working

21:02completely independently, effectively as a consultant, but the job

21:06title might not necessarily reflect that.

21:08And it's about kind of having the

21:09conversation with the NHS trust that you're

21:12going forward with for kind of explaining.

21:14And that's exactly where it's really important to have a

21:17really detailed CV, because if someone was just to look

21:21at a CV that just has a job title on

21:24it and not really understand how that fits into the

21:27NHS, they might not even really consider you.

21:30Whereas if you've got lots of detail explaining exactly why

21:34your experience and what you're doing at the moment is

21:37equivalent to whatever grade you're going for in the NHS,

21:40they're much more likely to give you the opportunity to

21:43interview and take you ahead with that.

21:44Okay, cool.

21:46I mean, I hope that's really explained everything

21:50to the listeners in terms of the grades.

21:52It's really, really clarified it for me

21:56in terms of the specialisms themselves.

21:58I think that's also quite an

21:59interesting anomaly in the NHS.

22:02You would like to think that general

22:03medicine is general medicine, but we've got

22:08quite a few different titles for it.

22:10Talk us through those and what

22:13they mean for international doctors. Okay, yeah.

22:16This is something I actually speak about loads with

22:19everyone, all the medicine doctors I'm talking with.

22:22So the NHS is a really subspecialized system.

22:28So I think where in a lot of

22:30care systems around the rest of the world

22:32you might be an internal medicine doctor.

22:34Meaning you are treating patients from across the breadth

22:38of internal medicine and all of the different subspecialties

22:41 that involves, like, cardiology, diabetes, everything else that falls

22:46within that in the NHS, it's kind of really

22:49broken down into these within your hospitals, particularly the

22:53majority of the bigger hospitals.

22:55So it's really quite rare to have general

22:59medicine teams, general medicine departments in the NHS.

23:02Instead, you're likely to have it all

23:04broken down into the different subspecialties.

23:06So you might have a team of cardiologists working

23:09with a team of acute medicine doctors and a

23:12team of diabetes and endocrinology doctors and gastroenterologists.

23:15And because all of these departments are so clearly

23:18defined, there's not really much space for general physicians

23:23covering all of this apart from in maybe some

23:26of the much smaller hospitals where it wouldn't really

23:29make sense to have all of these departments so

23:32defined if they're one or two people apiece. Yeah.

23:35Okay, so if I'm a general medicine

23:38physician overseas, that's my job title overseas.

23:41What should I be thinking about?

23:43How can I make the decision as to whether I'm

23:45best suited to acute medicine or general medicine or elderly

23:49medicine or maybe even one of the specialized fields?

23:51Yeah, so I would always recommend if it's your

23:54first job in the NHS and you're looking for

23:56a good place to settle in as someone who

23:58has quite broad medicine experience, I'd really recommend considering

24:03acute medicine, elderly care and any general medicine positions

24:08as and when they do come up.

24:09The reason for that is acute medicine

24:13is one of the broadest parts of

24:15internal medicine that exists in the NHS.

24:18So I know that this particularly is one

24:20of the subspecialties that just doesn't seem to

24:23exist really anywhere else in the world.

24:25I think it's maybe one or two countries that does it.

24:28And I think there's a lot of misconception about

24:30its involvement with emergency medicine and things like that.

24:33So I'll start with acute medicine and

24:35then go on to the others where

24:38it's essentially just treating acute medical emergencies.

24:43So I know that quite often I'll speak to

24:46a doctor who's working in ED overseas, but they're

24:49actually just treating medical emergencies because they've got MRCP.

24:53That's kind of what acute medicine is, or an

24:56internal medicine doctor overseas who's saying, oh, yeah, I'm

25:00very often based kind of near the ED, but

25:02just treating MI and stroke and things like that.

25:05So it's patients that come into the

25:07hospital and immediately need to be stabilized.

25:09But these are all medical issues.

25:12So as I said, MI, stroke,

25:13gastroenterological emergencies, things like that.

25:17And you are treating them in the acute

25:19medical unit along with other acute medical specialists,

25:23maybe some doctors from other subspecialties as well,

25:26who'll be called in for more complex cases.

25:29And the patient is generally there for

25:30kind of up to about 72 hours.

25:35Generally the patient is there for

25:36up to about 72 hours.

25:38After that, you would expect them to be either

25:41discharged or sent to the correct other medical subspecialty.

25:46So someone's come in with emergency respiratory

25:49failure, either they'll be discharged from the

25:51AMU once they've been stabilized and treated,

25:54or they will perhaps be referred through

25:55to the respiratory department for ongoing care.

25:58So obviously it's quite fast paced work because it

26:02means all the patients you're seeing are quite acutely

26:05unwell, but you're not treating any of the kind

26:08of trauma and surgical emergencies that you would expect

26:11more in the emergency department.

26:12So it's still very much

26:13geared towards medicine doctors.

26:16Okay, so coming back to the question about the

26:22general medicine physician from overseas, what you're basically saying

26:25is if I'm working in a busy inpatient type

26:29setting, I'm perhaps closely aligned to the ED department.

26:32I'm dealing with medical emergencies.

26:34It's that type of general medicine physician that's

26:37going to be well suited to acute medicine.

26:40So who's going to be better

26:42suited to say elderly medicine?

26:45So elderly medicine, again, is as with acute medicine,

26:48where you are treating patients from across all of

26:51medicine, but in quite a fast paced setting, elderly

26:54medicine is a bit more aligned with what you

26:56might see as general medicine overseas, in that you

27:01are treating cases from across general medicine because elderly

27:05patients have so many comorbidities.

27:08When you're elderly, it's rare that you're coming

27:09in with just a single thing wrong.

27:12There's going to be lots of different complex crossovers

27:14and things like that, but it's in a slightly

27:17less acute setting, so more ongoing care based on

27:21wards for kind of beyond that 72 hours window

27:24that we were talking about with acute medicine.

27:26Now, obviously, it does mean that all the

27:28patients you're seeing are elderly, but it does

27:31give you an opportunity to treat medicine and

27:35medical conditions in this setting.

27:40In the NHS, that's kind of a good

27:42option where general medicine doesn't exist that much.

27:45Okay, great.

27:46And then general medicine, you kind

27:48of just said it, though.

27:49It doesn't really exist in the NHS, not

27:52in a big way that it used to.

27:53I understand it's been almost replaced by

27:56acute elderly and obviously in subdivisions, there

28:00are definitely pockets of it.

28:01There are some hospitals that absolutely

28:03will still have general medicine teams.

28:06It's just nowhere near as common as you

28:09might expect if you're coming from overseas.

28:12So there will be lots and lots of

28:13hospitals where it just doesn't exist at all.

28:15So if you're looking for a general

28:17medicine position, it's always worth considering it.

28:21Definitely.

28:22But you don't really want to limit

28:23yourself to the handful of hospitals that

28:25have these general medicine teams.

28:27Which is why it's always a really good idea to

28:29consider things like acute and elderly medicine as well.

28:32Which will still mean that you can

28:34practice your kind of general internal medicine

28:36skills, but just in slightly different settings. Yeah.

28:40Okay, I'm going to say one word.

28:44SDEC.

28:46Yes.

28:47So, same day emergency care.

28:49That's four words, actually.

28:52So this is coming up more and

28:54more recently as part of acute is.

28:58I think it's been recently put as part of

29:00the NHS's long term plan to essentially improve patient

29:06pathways in the NHS, and particularly within the acute

29:09and emergency departments, where prior to this, patients would

29:13perhaps be coming in through the emergency department and

29:16the acute medical unit.

29:18And people who are needing urgent care, but perhaps not

29:23necessarily needing a bed, so not needing to be admitted

29:26overnight were still kind of needing to be assigned a

29:30bed in order to receive the care, because there weren't

29:32 facilities to do it any other way.

29:34So what the point of same day

29:37emergency care, or SDEC is, is to

29:40filter out patients, where if a patient can be

29:43seen there and then, and the necessary investigations and

29:46treatment be carried out on that day or overnight,

29:50but without needing to be admitted into a bed,

29:52then they'll be treated in same day emergency care.

29:54Now, again, these are kind of I know

29:57it has the word emergency in it, but

29:59they are generally kind of medical emergencies rather

30:01than traumas and things like that overall.

30:04So it's still MRCP and medicine doctors that

30:06are being sought for these kind of roles.

30:09And what that means is it helps

30:11alleviate bed shortages in acute medicine and

30:15emergency medicine and things like that.

30:17 Helps free up beds for patients who do

30:20kind of really need the urgent care to

30:22be admitted overnight, become an inpatient.

30:25And my kind of understanding on that from an

30:28NHS perspective is because it's a new job type

30:30and a new role, they're actually struggling to recruit

30:33lots of people because not many people are searching

30:36for them, looking for those types of jobs.

30:37Yet it's obviously such a growing field as

30:41well that I think for international doctors, it

30:44can be quite a good route in because,

30:47of course, there's more demand for their services.

30:50There is that 30 seconds. Absolutely.

30:52And because it's growing and obviously if you're looking at

30:55it and you don't know what SDEC is and you

30:56see it on NHS jobs or something, you might not

30:59necessarily apply if you don't know what it is.

31:02Now, also, this one's interesting because it can be quite

31:05good for a specific for anyone, but also quite a

31:08good pathway to quite a specific profile of doctor where

31:11perhaps the thought of going into a busy acute medical

31:15unit sounds a little bit daunting.

31:17Maybe you've been doing a bit more

31:18outpatient work recently and things like that.

31:22SDEC can be a great way to join because, as we

31:24were saying, a lot of the patients, it's still urgent care,

31:27but they're not quite that same level of really highly critical

31:32acute cases that you would see in an AMU.

31:35So if you are someone who's maybe been a little

31:38bit more hands off recently, maybe been leaning more on

31:41outpatient work, this can be quite a good way to

31:43transition into the NHS because it can sometimes be a

31:46little bit more intensive than working in AMU.

31:50Now, some hospitals, their acute medicine doctors know they

31:54might have a shift in the SDEC and have

31:55a shift in AMU and things like that, whereas

31:58some hospitals, they will have their acute medical team

32:00and they will have their SDEC team.

32:02So some hospitals subdivide it, some it's kind

32:04of all falls within the acute medicine.

32:06Dr Remit amazing.

32:09All right.

32:10I think as my hypothetical general medical physician, I know

32:14where I should be now, which is really helpful.

32:16Thank you for that. You're welcome.

32:19The bit we haven't touched on, and

32:21I'm sure lots of the listeners might

32:22identify with this is subspecialist medicine.

32:27There's something like 15 to 20

32:30different strands of medicine.

32:31I don't even know how many. Lots. Yeah.

32:34And obviously lots of international doctors are specialized

32:38to some level within one of those.

32:41Why is it a challenge getting straight

32:44into those roles in the NHS?

32:45And what advice would you give to

32:48international doctors if they want to?

32:50So I would say if you are an individual

32:52who has really specialist experience, so say you've been

32:59working in nephrology or respiratory medicine for years and

33:03years and years and not doing any general medicine

33:06within that, then, yeah, I would say going for

33:09a subspecialty role would make a lot of sense.

33:12I totally agree with that.

33:14I think that if you are a doctor who's

33:16been working in internal medicine, maybe doing a little

33:20bit of maybe doing some endocrine clinics every now

33:23and then, or have a bit more of an

33:25interest in Cardiology, I would definitely still be entering

33:29the NHS in one of these three kind of

33:31more broad subspecialties, like acute elderly or general.

33:35Because you are going to be going up against doctors who

33:38are hyper specialized in that way that we just said.

33:41So I would really recommend making that

33:43entry point in that more general way.

33:46Now, the reason that is such a good position, a good

33:50pathway as well, and one we've seen a lot of times,

33:54is because it means that your first role in the NHS,

33:56you get a really broad view of medicine in the NHS.

34:00And generally these subspecialists are still going to

34:02be working general and acute medicine on calls.

34:05So doing general or acute medicine or elderly

34:08care as well for your first position can

34:10mean you see that as your introduction to

34:12the NHS before then moving laterally into your

34:17subspecialty of choice, quite often into training.

34:20So that's something I've helped a lot of doctors

34:22to do, who maybe have had a bit of

34:24experience in their subspecialty, but not enough to really

34:28qualify in a really specific subspecialist role.

34:32Come in, in something general, do a year, do 18

34:35months, and then quite often from there get their core

34:38competencies signed off and just go straight into subspecialist training,

34:41which I know is the result that a lot of

34:44doctors are aiming for from coming to the NHS.

34:47Or if you're looking to go through the

34:48Caesar or portfolio pathway, starting in a general

34:52role and then going from there, just getting

34:54another service job in a different subspecialty and

34:57working through your CESR or portfolio pathway through

34:59that, and that lateral move is very possible.

35:03Something we've seen thousands of times over. Yeah.

35:06And I think it's a real double edged sword, this one.

35:11From the NHS perspective, they don't want

35:13to take a risk on someone who's

35:14not worked in a hyper specialized setting.

35:16So they would deem an international doctor who had

35:19done perhaps half of their work in nephrology or

35:23whatever alongside a lot of general medicine work, they

35:25would deem them not specialized enough yet.

35:27The international candidate would probably be worried about losing

35:31their skills by going into a general medicine setting,

35:34which is there's a bit of an irony to

35:36it, but I think, as you said, usually one

35:38or the other do give.

35:40And I think there is a

35:41middle ground there for specialized doctors.

35:44And we certainly see lots of jobs coming

35:46through for cardiologists and neurologists and respiratory doctors.

35:50There's some that are maybe more in demand than others.

35:53So, yeah, it's definitely there.

35:55I think patience is probably the key for someone

35:58who wants to work in a specialized field.

36:01Does SCE help?

36:02Yeah, it definitely does because obviously MRCP

36:05is such a broad qualification, covering so

36:08many different subspecialties of medicine.

36:10Having that SCE can really help because it

36:13also shows trust that you're not just applying

36:15to this subspecialty on a whim.

36:17Because I think that that probably

36:18would also be their worry.

36:19If they see that you've just worked in

36:21internal medicine and you're applying for a gastroenterology

36:24role, they might be a bit like, is

36:26this person actually interested in gastroenterology or are

36:29they just applying for the job?

36:30I'm not really sure, whereas if they can see,

36:32okay, well, this individual actually does have the SCE,

36:35then it shows that they're actually committed to a

36:37career in this subspecialty and maybe we are more

36:39likely to take a chance in that.

36:42Okay, great.

36:43All right, that's some of the challenges.

36:44And I think, as you were saying, that this

36:47maybe segues quite nicely into the next section we

36:50were going to do on interviews and CV advisors.

36:53We start with the CV.

36:56Let's say I've made my decision.

36:58I've come to the conclusion I'd like to be

37:00an acute, an elderly or maybe a specialized doctor.

37:04What is the best advice or the top tips

37:08that you can give to an international doctor to

37:10make their CV stand out to an NHS employer? Information.

37:17Write everything that you can about what you have done.

37:20I think there's a big misconception about kind of and

37:23I know this from when I was applying for jobs

37:26years ago when it was like, I've got to have

37:27a really concise CV with the NHS.

37:30That is not the case at all.

37:32I've had consultants on the phone to me, NHS consultants,

37:35saying, wow, this doctor must be great because they've got

37:37a 14 page CV that's longer than mine.

37:39And that was a clinical director for medicine.

37:43And so obviously you want to keep it relevant.

37:45You don't need whole sections about things that

37:47aren't clinical or kind of managerial or related

37:51to that, but have your qualifications and all

37:54of your qualifications really clearly.

37:56Life support courses, anything

37:57that's relevant, really clear.

37:59But the biggest thing I would say is

38:02when you are describing your positions, your current

38:05role, but also every position you've held in

38:08the past, say exactly what you're doing.

38:11So don't just write the title and

38:12the dates that you did it between.

38:15Write down what the hospital is like, write down

38:18how many patients you're seeing a day, what shift

38:21patterns and on calls are you working, what kind

38:24of teaching and training and things do you do?

38:26Anything that you can write will be super helpful

38:30towards someone reading your CV and understanding it.

38:33And this does loop back to what I was saying

38:35earlier about if I'm a consultant in the NHS reviewing

38:39a CV to come and join my medicine department in

38:42my hospital and I see a CV in front of

38:45me and I see a job title maybe that's I

38:47know we've said it already, but resident or medical officer?

38:50And I maybe don't know what that means because I've just

38:52worked in the NHS my whole life, so they might not

38:56really understand the context of what that job entails.

39:00So if they then had a list of bullet points

39:02of every single thing that you do every day, they

39:05might look at it and go, oh, that's exactly the

39:08same as what all my registrars do.

39:09This person sounds great.

39:11So I guess that's where we talked about the

39:14difference right at the beginning, about the difference between

39:19a physician job title and a registrar job title,

39:22or resident and senior clinical fellow.

39:25So the guy in the NHS who's recruiting

39:28for a Senior Clinical Fellow and seeing the

39:30title resident, he might not understand that.

39:32So you're painting a picture of why that resident

39:35role is applicable and maybe even what the differences.

39:38Yeah, true.

39:40Yeah, absolutely.

39:41And things that they might look at it and go,

39:43oh, that's actually more than what my registrars do.

39:47Particular things, I would really say.

39:49If you're going for any kind of junior

39:52or middle grade registrar level position, please include

39:56your on calls and shift patterns.

39:58Because this is such an important part of being a

40:01middle grade and junior doctor in the NHS, is the

40:04shifts patterns and on calls that you work, night shifts,

40:06things like that, whether they're in the hospital or whether

40:09they're off site, super important to include that and the

40:12kind of cases that you're seeing as well.

40:14It's all really helpful and that's kind of all about

40:17the job, but also anything you can include in later

40:20sections about here's, all of my teaching experience, all of

40:24my research, all of my quality improvement.

40:26The more you can involve towards that,

40:28the more your CV will stand out.

40:30Yeah, I think that's a really good

40:32point, particularly on the quality improvement stuff

40:35that's so big in the NHS.

40:37It's absolutely huge.

40:38And I know it isn't as prevalent in other

40:40healthcare systems, it's maybe not a standard part of

40:43the job, but most healthcare systems are doing it,

40:46of course, but maybe not quite as formally.

40:49So is it worth adding anything that people see relevant

40:53there just to show that you are doing it?

40:55Yeah, definitely.

40:56And kind of anything you're halfway through, or even

40:59if it's just day to day quality improvement that

41:01you're kind of doing with your team, include that.

41:04It doesn't have to be big formal projects, even if you

41:07can show that it's something that you are thinking about daily

41:10in your everyday work, that will all be really helpful to

41:14display on your CV as long as you make it clear

41:16the kind of context that that's being done in.

41:18Okay, great.

41:20We always include on our template CV, which

41:24you can download, by the way, on the

41:25website, a skills and competencies section.

41:29So independent and assisted.

41:32And I'm not sure, maybe you can talk us through some

41:34of the ones that are key for medicine doctors and why

41:39it's important to put even maybe the more trivial it might

41:42be seen as more trivial if you're a senior doctor as

41:45well as those that are a bit more so.

41:50Yeah, as we were saying earlier, being a

41:51doctor in the NHS is incredibly hands on,

41:54so being skilled in procedures is really important.

41:57And I have seen CVS where there's only a handful of

42:00procedures on there and thought, that's strange, and phoned the doctor

42:04up and it's been like, why would I include some of

42:07the things that I was doing in my internship?

42:09That's so obvious.

42:10But then on the flip side of that, I was

42:12speaking to the clinical lead for acute medicine once,

42:15and he went through an entire CV with me.

42:17He was like, it's all well and good that this

42:19person can do a lumbar puncture and paracenthesis and thoracentesis,

42:23but I want to know, to be comfortable and happy

42:27inviting them to my team, that they can do the

42:29really basic things well so that I know that we

42:33can just double check the more senior procedures together.

42:36So any procedure you can do, include it.

42:38There's nothing that seems too junior.

42:41Also, yeah, I know the big three big

42:44procedures that are kind of particularly noted for

42:47senior doctors, as I was saying, lumbar puncture,

42:49parasynthesis, thoracinthesis, and also resuscitation as well, actually.

42:54Really important.

42:55And that's why it's important to include any

42:57life support courses that you have as well.

42:59Yeah, amazing. Good.

43:00So I guess similarly to where we're talking about explaining

43:04the difference between the job that you're doing overseas in

43:08terms of its rota and its duties, you're also trying

43:10to talk through the skill set that you've got and

43:15how that aligns with a UK trainee.

43:17Because you have to remember, the person reading

43:19your CV didn't train in your healthcare system.

43:22They don't know anything about your healthcare system.

43:24Fortunately, that's where we're here to bridge

43:27the gap and explain that to them.

43:28But for them, they need it spelling

43:31out, even if that might seem like

43:33you're including things that seem trivial.

43:37Good, okay.

43:39Anything else you'd mentioned for CV?

43:41Tips, basics, formatting, anything like that?

43:45Keep it simple, keep it simple.

43:48One font throughout the whole thing.

43:51I know it sounds silly, but try and keep it

43:54fairly simple in the design, well formatted in terms of

43:59fonts and font sizes and things like that.

44:01Don't feel like you need to make it look really

44:03kind of lots of different designs on it or a

44:06really high quality picture or anything like that.

44:08Just make sure you've got the

44:10information really clearly laid out.

44:13The rest is kind of not that relevant.

44:15It's just so they can see exactly what

44:17you're doing and it'd be really clear. Okay, cool.

44:19And you've got a template, right? Yes. Good. Absolutely.

44:22If any of the listeners do want a copy

44:24of that email medicine@bdiresourcing.com and we could maybe post

44:30a link to the downloadable version as well.

44:32We've used that one thousands of times

44:35and clinicians seem to really like it.

44:37The feedback is really good.

44:38Well, that's because, if you remember, we made it.

44:44We made it based on, as I was saying earlier, that

44:47consultant that went through a CV with me on the phone

44:49and said about the procedures, he spoke to me for half

44:52an hour or so about exactly what he would want to

44:55see on an IMG CV for medicine.

44:57So we then went away and created this CV template based

45:00on the feedback that we got from this NHS consultant.

45:04That's what we've been using since.

45:06And we've had loads and loads of positive feedback from

45:08other people within the NHS about how clear it is

45:11and that's about how when they're looking for something on

45:14a CV, it's always just exactly where I want it. Great.

45:19All right, we've come a long way in this chat.

45:23The final step, then, in getting a role in

45:26the NHS is hopefully going to be the interview.

45:29So you've hosted hundreds, thousands maybe,

45:34of medicine and specialist medicine interviews.

45:38What are the top questions for our listeners to

45:41brush up on what's coming up every time?

45:45So, generally, we're always just going to start

45:48with a really simple, tell us about yourself

45:50or walk us through your clinical background.

45:52Now, this one is always going to be fine

45:55because it's your life, you've lived it, you've got

45:57all the answers, but the main bit to consider

46:00here is how you're going to structure it.

46:02So if you're being asked this question, do

46:05not spend too much time on your internship

46:07or your positions quite a long time ago.

46:09They are going to want to hear the most about

46:11your most recent positions or, like, if you did some

46:14training a few years ago that's really relevant to this.

46:17Those are going to be the things you

46:18want to spend the most time on.

46:19If everyone's done a fairly similar

46:21internship, there's not really much use

46:23in describing that in great detail.

46:24So I would spend the most time on

46:27your most recent and most relevant position and

46:30just make sure it's quite clear and structured.

46:31It's never a bad thing to maybe sit down

46:34in the days beforehand and maybe just talk it

46:36through with a friend or a family member or

46:38something to see how it rolls off the tongue.

46:41So that's kind of the intro.

46:43And then generally we're going into clinical scenarios.

46:46These are quite similar to MRCP style questions.

46:50Quite often, even when they're medical subspecialty

46:53questions, they are often quite acute based.

46:57So it's quite often quite acute kind

47:01of situation that you're dealing with and

47:04it will often be displayed to you.

47:06Sometimes they're done almost as a role play, but it's more

47:09often in a way that's like a patient comes in displaying

47:13X, Y and Z, what would you do next?

47:16Or how would you deal with this?

47:18Or alternatively, patient comes in for this reason.

47:22What questions would you ask about their history?

47:24You would then say, these are the questions I'd ask.

47:27They might then give you the answers and then say,

47:29based on the history, what would you now do? Right?

47:31And so sometimes they can be kind of

47:33multi parted and then, oh, this is the

47:35way the patient responds to that treatment.

47:36What would you do now?

47:38Good.

47:39Do ethical scenarios come up? Yes.

47:42And actually, this is the one that quite often

47:45when I'm doing kind of one to one interview

47:47preparation with the doctor that I've kind of got

47:49a medicine interview for, this is quite often the

47:51section that people feel the most unsure about because

47:55everyone's confident in their clinical abilities because you're doing

47:58that kind of work every day.

48:00But it's the ethical scenario, the differences

48:02between the systems suddenly become quite obvious.

48:06So my best advice with this would be I know

48:09these kind of questions are asked in MRCP exams, so

48:12do a little bit of revision if you have time,

48:14go over them again, find some resources.

48:16There's loads of MRCP groups online as

48:19well that can be really helpful.

48:22And I would also just make sure in your

48:25answers that patient safety is at the very, very

48:29center of every answer that you give.

48:31So anything that's going wrong, maybe with a

48:34colleague or a patient or anything like that,

48:36that you're being asked an ethical scenario about,

48:38always make sure patient safety comes first and

48:40everything else can kind of follow after that.

48:43Okay, great.

48:43I guess they're the questions where by their very

48:46nature there's not a right or wrong necessarily answer.

48:49I'm sure there's more wrong answers, but I guess

48:53that's why they sometimes trip people up because they're

48:55a bit harder to find an answer for. Absolutely. Good.

48:59So what are the kind of final questions

49:01that we tend to see for candidates?

49:03And keep in mind, this might seem

49:05like quite a short section here, but

49:06interviews typically last, what, half an hour?

49:09Yeah, about half an hour.

49:10Sometimes consultant ones are longer, sometimes

49:12registrar interviews are 20 minutes. Right.

49:15Because they will have gone through the

49:16CVs in loads of detail beforehand.

49:18And have just a couple of questions they'd like

49:20to ask to kind of make that judgment.

49:22So final questions really would be they might

49:26be asking about your aspirations and your motivations.

49:29So always look into the hospital that you're interviewing

49:33for, because if you are asked, why do you

49:36want to come and work in our specific hospital?

49:38And you don't have an answer because maybe

49:40you haven't really looked into it that much,

49:42it's not going to come across very well.

49:44They're going to know this person's not

49:46really that interested in us at all.

49:48Let's go for the other

49:48person who seems really motivated.

49:50So they might also ask you about what your

49:53long term goals are and things like that.

49:55So whether that's getting into training or getting

49:58into the CESR or portfolio pathway, those are

50:00all good things to have a chat about.

50:03And then the final section is your

50:07opportunity to ask them some questions.

50:09Yes, of course, is crucial, so it shows

50:13them that you're really interested in the job.

50:16So anything you'd like to know about the area

50:20or what will my first six months in the

50:22job look like, what will my induction look like?

50:24 If you don't have any questions, again, they might come

50:27away from it and think they're not really that interested

50:30if they didn't have anything to ask us.

50:32So have some prepared to ask them at the end,

50:35and I think that can make all the difference.

50:37If you're up against five or six other doctors

50:40and they all pass the clinical scenario and they

50:42give a good answer to the ethical scenario, then

50:45I guess the clinician are looking for what separates

50:48them, and that's not unusual for that to happen.

50:50So it does quite often come down to who shows

50:53that they're most motivated to do the job and gives

50:55the best impression of fitting in, I guess. Yeah.

50:58And also because it opens up the end of the

51:01interview to be a bit more of a conversation.

51:03Because obviously a lot of the rest

51:05of the interview can be quite like

51:06you being asked questions and you answering. Them.

51:08Whereas if you have some questions, you might get an

51:11opportunity to just have a bit more of a chat

51:12with them and they might be able to see a

51:14bit more of your personality and you get to see

51:16some more of their personality as well.

51:18And that's really what might stick in their heads a

51:20little bit when they come away from it and think,

51:22I can really see that person in our team.

51:24So it's definitely a worthwhile thing

51:26to invest a bit time into.

51:28Okay, that is honestly amazing advice.

51:31I hope that's been helpful to the listener, too.

51:34Just one final kind of part of this.

51:38Tell us about the NHS trusts that you

51:40work with, the types of jobs that you

51:43tend to see and who they might sue.

51:47So generally we're looking at

51:51medicine registrars and consultants.

51:53So generally, this will be kind of

51:57people with quite broad experience or the

51:59subspecialists, like we were talking about earlier.

52:02It can be someone who's looking to come straight in

52:05at consultant level, someone who's a consultant at the moment,

52:07who wants to start a registrar for a year and

52:09then will help you get your second job.

52:11At a consultant level, it might be someone who

52:15is working as a registrar at the moment and

52:17is looking to do exactly the same thing in

52:19their first job in the NHS, we help people

52:22from across kind of all medicine subspecialties as well.

52:26But a lot of the positions that are kind

52:28of out there for doctors with internal medicine experience

52:33are often going to be these broad subspecialties, like

52:37acute general and elderly care medicine.

52:40But if you're someone who's got really kind

52:43of extensive subspecialty experience, particularly at a registrar

52:48consultant level, that's absolutely the kind of thing

52:50that the NHS are kind of absolutely crying

52:52out for as well. Great.

52:53So if I'm an overseas general medicine

52:57physician, acute medicine physician, and I'm thinking

53:00about embarking on this journey, it's obviously

53:01a long one, is it worth it?

53:04Is there a big demand for doctors at the moment?

53:07What are you feeling from

53:08the kind of recruitment market?

53:11There's huge demand at the

53:13moment, registrars and consultants particularly.

53:17There are so many jobs out there for

53:20doctors who fit these kind of profiles.

53:22And obviously there's four of us doing this

53:24at the moment and we are just kind

53:26of inundated with positions at the moment for

53:29doctors at this level, even junior doctors.

53:33We might not have as many kind of roles right

53:36now in medicine, but I know that I often speak

53:39to people who are like, oh, I've heard the junior

53:40doctor market is drying up and things like that.

53:42That is not true.

53:44It's always taken a while to get these jobs.

53:46That has always been a case.

53:47Just be patient and keep on making those applications

53:50because you will get what you're looking for.

53:52Everyone always does.

53:53And I have these conversations a lot where

53:55people are like, I've been looking for three,

53:57four months, I've not had anything back and

53:58I'm really starting to lose hope of it.

54:00And it's like, just keep going because

54:02you will get what you're looking for.

54:05So, yeah, just a bit of patience and if

54:07you need any advice or anything, then obviously we've

54:09got loads of resources or here to have conversations

54:13with you if you need them as well. Great. Amazing.

54:16And for doctors who've maybe got one particular area in

54:20mind or a particular type of job in mind, should

54:23they stick to their guns, should they go for it,

54:24or is it better to get into the system and

54:26to be a bit more flexible in their search?

54:29I would generally say that the more

54:31flexibility you can allow the better.

54:34Whether that is a subspecialty or whether that's location or

54:37something like that or only want to work in a

54:40hospital that has over 1000 beds or something like that

54:43which anything that you can do to limit your search.

54:46I think you need to sit down and have

54:47a really good think about how important that is

54:50to you because your first job in the NHS

54:53is probably not going to be your dream job.

54:56And that is fine.

54:58 It's about getting into the system and maybe sitting down and

55:03thinking about a handful of things that are really important to

55:05you and thinking which of these are an absolute must for

55:08me and which of these for my first year, year and

55:11a half, I could probably put to one side.

55:13Because you don't want to be sat there applying

55:16 for this handful of jobs that you're applying for,

55:18for years when you could just get a job

55:22quicker in something you're going to do for 18

55:23months and then really easily transfer into the job.

55:27That is the one of your dreams.

55:28Yeah, I think that's really good advice. Good.

55:32Are there any kind of pitfalls that people

55:34should look out for in their job search?

55:37So any kind of roles that maybe stand out

55:41and actually people apply to them and then they

55:43get a bit lost or they find themselves in

55:47a job that they maybe didn't want to do.

55:50So I would say generally, things like, if it's

55:56in a location that maybe you haven't looked into

55:58that much, that's something that I see a lot,

56:00where it's like I kind of just did a

56:01really brief search, but didn't really look into it.

56:03And now I'm working in a hospital that's in

56:05the middle of nowhere, and actually, I wanted to

56:07be in the middle of a really big city.

56:08So things like that, that can be

56:13something that we see a lot.

56:16So well worth doing research and making sure that

56:19you're kind of well aligned because I guess we

56:21see some doctors that they go too far the

56:23other way and they think I'll just accept anything

56:26and they hate it when they're right.

56:27It's better to be a little bit

56:29cautious and do your homework before and

56:33that's particularly for yourself and the job.

56:35But also in terms of thinking about

56:37family and things like that as well.

56:38Obviously that's really important if you're moving over with

56:41a family to have a think about what is

56:44important for you and your job, but also what's

56:46important for your family as well and trying to

56:48make those things align as much as possible. Great.

56:52Liv, thank you so much for sparing the best

56:55part of an hour to talk to me today.

56:58Really appreciate it.

56:59I hope all of the listeners have enjoyed

57:01that and it's helpful in some way.

57:03I hope so too.

57:05Yeah, we hope you'll tune in next time as well.

57:07We will post this up on the website.

57:10It'll be up on all of the.

57:11Usual spots you can find it.

57:14And we wish you all the best.