Latest Blog

Introduction 1. What is your name, speciality, grade and what hospital do you work at? I’m Dr Seshni Moodliar, and I’m a Consultant Psychiatrist. I specialise with Adults with learning disabilities. I’m currently fortunate enough to work in both the private sector and the NHS in private practice. I also do on calls at Milton Keynes General Hospital and Chadwick lodge. I also do some Medico legal work. 2. What country did you relocate from? I’m privileged to have relocated from South Africa in 2003 when Nelson Mandela was still our President and who played a role in me being able to study at of . I graduated in 2000 and I was the first Indian/Asian to graduate from that university. 3. Would you share with us your personal mission as a doctor? I’ve always wanted to be a doctor the age of six. I’ve wanted to help and heal people that were ill and sick and would read about all the different illnesses and their treatments. This was further supported by my paternal grandfather Appodorai, who had Parkinson’s and I used to care for him. He used to say I had healing hands. I therefore decided to pursue my passion of becoming a doctor which was also a dream of my father, Deena Thirupathi Moodliar, who was a spice businessman. He wanted to become a his parents couldn’t afford it, so I decided I would do it for him too. I’m grateful to all my family, friends and colleagues who helped me to become a doctor.  4. At what point in your career did you decide you wanted to relocate to the UK? What were your motivations for wanting to do so? When I completed my medical training in South Africa, my husband Ferdinand Rensburg and I wanted to take a year out to travel with three other South African doctors and friends. Named Dr Jessica Maistry, Dr Debbie Jafta and Dr Loshni. My motivation for moving to the UK was to travel and experience a new place. 5. Why did you choose to specialise in Psychiatry? I have always been intrigued by the mind and body link. I worked within the Mental Health Services in South Africa, during my internship in Durban at King Edward Hospital and there I was exposed to a range of mental health problems and genetic disorders. I then discovered that Psychiatry was one of the those rich specialties where we actually see the holistic approach of treatment in its purest forms. It then became my desire to pursue a career in Psychiatry as I wanted to treat people holistically to get better. By holistically I mean an approach which uses biological interventions like medication, psychological like talking therapies and social like social support.  The Relocation Process 6. How long did it take you to relocate, how difficult did you find the process? Do you recommend the same process to other IMGs? I have been fortunate as the relocation process was handled brilliantly by the agency I was working with at the time. I had saved some money from working as a doctor for two years, I then made my application and organised my passport. I sat IELTS, but I was lucky and did not have to do the conversion exam. This meant that I got a full GMC Registration. I had my husband, family in the UK and another three doctors who were going through the process at the same time. When I arrived in the UK, I had to organise my National Insurance number and open a bank account, but again we were lucky enough to be guided through this. At first, I opted to work as a Resident Medical Officer as my friends and husband were going to travel on our weeks off. This was the best choice for us and I thoroughly enjoyed working for a week. The work was easy, the hospital offered me accommodation, meals and other facilities. The staff were friendly and the pay was good. I managed to use some money I was also able to send money home to my parents as my dad was looking at buying a spice shop. After I completed 6 months as an RMO, I then started to do Psychiatry locums to first get experience in how Psychiatry training and the Mental Health Services in the UK worked. I definitely recommend this to other doctors to consider travelling abroad to practice and study. I’m aware that BDI Resourcing does relocate doctors in the same way I was assisted and would definitely recommend their agency too. 7. Is there anything you would have liked to have known before deciding to relocate? And now once you live in the UK? I guess there will always be things we would have liked to have known, but as we had a good agency, family and friends the process was easy and everyone was extremely helpful.  Colleagues around were also very friendly and helpful. Thoughts on the UK 8. For you, what are the key benefits of living in the UK? The plan for me and my husband was to come to the UK, travel with our friends and then return to our families in the South Africa. However, as I wanted to then pursue a training in Psychiatry and he wanted to complete his law training we decided to stay.  Psychiatry training in the UK, in my view from doing locums, is much more developed in terms of holistic treatment and access to resources. This is something I felt and therefore, I decided to pursue Psychiatry in the UK.  9. How do you feel you in your chosen location within the UK?  We were always in limbo about going back to South Africa, especially as we do miss our family and friends a lot. However, as we started to have a family, we decided to stay for our three kids in order for them to have an opportunity in the country of their birth.  With the amazing advancement in technology, we are fortunate to continue to communicate with family on a daily basis with Skype, WhatsApp video calls and the telephone, so we are able to be in touch regularly. We are still passionate about helping people in South Africa and continue to remain involved in charity for children and adults in South Africa.  The NHS 11. How did you feel on your first day of working within the NHS, your first week, month and then how do you feel now compared to when you first started? I was excited about working for the NHS and I initially started with locum work. Again, the agencies were good and helpful. Locum work allowed me to learn a lot about the hospital, the systems, the people and the teams. Definitely I would say initially not knowing much can be overwhelming, however, within a few days and with the help and support, I adjusted quickly into the NHS.  12.  How would you describe the support you received from your hospital after starting your new position?  Hospitals initially did an induction and training in various aspects like fire training, first aid training, manual handling, infection control, IT system and care notes training to note a few. The hospital manager ensured that each new member of staff had a tour of the hospital, wards and induction of keys.  I was also given a badge and introduced to all the staff on the ward.  13. What year did you relocate to the UK? Do you think the UK/NHS system has changed much since then? I relocated in 2003 and yes, there has been many changes for the better the NHS in terms of working and providing effective, safe care and keeping our patients at the heart of everything we do. The NHS continues to go through various changes overall, it’s been good to see how it's transformed and continues to provide care for millions of people in the UK.  14. What is your opinion on the NHS? Working within it and as a patient receiving care? I have worked well in the NHS and despite the challenges faced, the NHS continues to provide effective and safe care. I’m a firm believer in the ethos of the NHS and upholding that we keep our patients at the heart of everything we do. I’ve been on the receiving end of NHS care too for the delivery of my 3 children at Milton Keynes General Hospital and I highly commend the NHS and GP services for the brilliant care I received.  15. Did you use the CESR pathway to become a Consultant? How did you find it and any advice to other IMGs who want to take the same pathway? I did my postgraduate training rotating in Psychiatry within the Hertfordshire, West Midlands and the Eastern Deanery. I completed my SHO training at Milton Keynes General Hospital and Oxford. I then started CT training in West Midlands and continued this in Hertfordshire. After I successfully completed my exams in Psychiatry of written papers and the CASC exam in 2010, I then started my ST training and my higher training in adults with learning disabilities in Cambridge and the Eastern Deanery.  I then became a Consultant with Adults learning disabilities in 2012.  16. How do you find working in the UK compared to your home country? I enjoy working in both South Africa and UK, however, the Psychiatry services in the UK are more developed. Podcast and YouTube 17. Can you explain your brand Happiness doctor’s kitchen? As a Psychiatrist, I can safely say with years of training and studying the mind and body I’m possibly one of the happiest people on this planet and I’m always complemented on this. I’m a firm believer in healthy body means a healthy mind. My aim is to share my secrets to happiness with others so that people who are suffering with mental health problems which are real, and a serious problem worldwide can recover and to educate them about the importance of health and well-being. I am also a firm believer in you are what you eat. I therefore have completed a book named Happy doctor’s kitchen which are researched and evidence-based ways of incorporating foods rich with serotonin, such as eggs, cheese, turkey and salmon - in order to keep you happy and healthy! My passion for food and people started in my childhood when I worked alongside my late dad Deena Moodliar, my sisters Tamara Valashni Govender, Sanusha Ponen and my mother in our family spice business RA Moodley in Victoria street market in Durban South Africa which was originally my grandfather’s Appodorai.  18. Can you explain what led you to create a YouTube channel and your podcast? As a Psychiatrist I’m passionate about sharing mine and other's pearls of wisdom of happiness which led to my YouTube channel and podcast which I collaborate with different people who are also experts in their field. I’ve just completed a podcast with Dr Sanjiv the Dean in Harvard Medical School, Hepatology Consultant and Professor Medicine. In the podcast he shares his wisdom on Dharma, Happiness and living your purpose. He is also the brother of Dr Deepak Chopra. I’m so grateful for that podcast and the wisdom he shares too.  19. Can you tell us about your recent publication? Following the brilliant support from my husband and friends and family, I wrote a book Pass the CASC in 2012 which is currently in its 7th edition. It was my husband’s idea would you believe, and he believed in me when I didn’t even realise the merit of my book. It was peer reviewed by 50 other Psychiatrists, many of I’m grateful to as they helped me in my exam. I completed it before I became a Consultant and was still a Registrar. It’s currently being used worldwide by doctors for the final MRCPsych exam CASC/OSCE, which usually takes place in Sheffield, Singapore and Hong Kong.  It’s also being used in Australia and New Zealand for the RANZP exam. 20. What is your final advice for junior doctors who are looking to pursue Psychiatry? Or senior doctors starting their first NHS Psychiatry post? I’m biased as Psychiatry is my passion and I love being a psychiatrist. My advice to junior doctors and any person really is that whatever career you choose to pursue you need to be passionate about it and you need to therefore be able to do this for the rest of your life. You don’t want to do something that’s not going to make you happy.  When choosing a speciality choose something that’s going to make you happy, something you are passionate about, something which will be in line with your purpose in life and something you can see yourself doing for the rest of your life. My choice was also guided with choosing something which was going to give me a good work life balance.  I would urge junior doctors to pursue a career in Psychiatry as it’s definitely rewarding, especially when we can make a difference in a person’s life using a holistic approach and being supported by the multidisciplinary team. There are also opportunities to do research, teaching and to practice clinical governance which are all important in CPD activities.  The Future 21. What are your hopes and plans for the future? I’m so grateful to be in a happy place right now following my passion of being a Psychiatrist, teaching Psychiatrists worldwide to communicate effectively with their patients, carers and other professionals in order for them to be the best Psychiatrists. I’m excited about being the author of the Happy Doctors Kitchen and Happiness Psychiatrists - sharing mine and other's pearls of wisdom on happiness to others worldwide. I’m so grateful Asma Said Khan is providing the foreword for my Happy doctors kitchen. She’s the first British female chef to be on on was released on 22 February. She owns Darjeeling Express in and Calcutta canteen which both are my favourite places to eat! My focus is and continues to be in line with the Hippocratic oath I’ve taken which is to be of service to others, helping, healing and ensuring my patients' recovery, hope for their future and emotional well-being which is at the heart of what I do  I’m a happy mum and I remain a dedicated mother and wife to my husband and my three children who are all golfers. I truly have been blessed with family and friends not only in in the UK too who make it all the more worthwhile being able to do what I do and to help others as I’ve been helped which is my main aim.  I love writing and definitely love reading books. I have spent a lot of my time in libraries since a young age, so I’m definitely going to continue to write many books-sharing my pearls of wisdom. The recent books I’ve read is Turban and Tales by Amit and Naroop and SPIKE by Rene Carayol (MBE)  who are friends of mine. I’m reading The Art of Happiness by his holiness the  Dali Lama and Dr Howard Cutler (a psychiatrist) whom I would love someday to meet and interview. I also just met Author of Darjeeling Express who is supporting female chefs and has been featured Chefs table on Netflix. Thank you. Link to Dr Moodliar's YouTube - https://youtu.be/cMSmliCxDPQ  Link to Dr Moodliar's Podcast - https://bit.ly/2NtfQBv  Link to Dr Moodliar's CASC Book - www.passthecasccourse.co.uk Are you a member of our Facebook Group? By joining IMG Advisor, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional support and the chance to meet other IMGs.  

As an employee within the United Kingdom, you will need to pay both income tax and national insurance on your wages. Disclaimer: Tax figures are always open and to change and Her Majesty’s Revenue and Customs (HMRC) assesses everyone’s personal circumstances within personal tax codes and so this article is purely a guideline. How do I know if I need to pay tax? Every person is entitled to a tax-free Personal Allowance of £11,850 for the year (this is set to increase to £12,500 in the tax year of 2019-20). How much tax do I have to pay if I earn over the Personal Allowance? In the UK, the tax system is based on marginal tax brackets. This means that the amount you are taxed is worked out based on the income you earn against certain thresholds. As a UK employee: You will pay 0% of tax on incomes up to £11,850 (£12,500 for 2019-20) Then you will pay 20% on anything you earn between £11,851 and £46,350 (£12,501-£50,001 for 2019-20) You will pay 40% Income Tax on anything you earn between £46,351 to £150,000) (£50,001-£150,000 for 2019-20). If you earn over £150,001 and over, you pay 45% tax Examples of take-home pay for a doctor Annual Salary (before tax) Monthly take home (after tax) £30,000 £1,982 £40,000 £2,549 £50,000 £3,085 £60,000 £3,568 £70,000 £4,052 £80,000 £4,535 Please click here to work out your exact take-home pay with a salary calculator. Paying tax on foreign income You may need to pay UK income tax on foreign income. For example: Foreign investments and savings interest Rental income on overseas property Income from pensions held overseas This income includes anything from outside of England, Scotland, Wales and Northern Ireland. What is a National Insurance contribution? You will also be required to pay a national insurance contribution on your earnings to help build your entitlement to certain state benefits, such as the State Pension and Maternity Allowance. Dissimilar to income tax, national insurance is not an annual tax. You begin to pay National Insurance once you earn more than £162 a week and it applies to your pay each pay period (i.e. monthly, weekly etc). This means that if you earn extra in one month, you will pay extra national insurance. Your National Insurance contributions will be: 12% of your weekly earnings between £162 and £892 2% of your weekly earnings if you earn above £892 Please note, your National Insurance contributions will be taken off along with Income Tax before your employer pays your wages. How do I pay my tax and national insurance contribution? If your Personal Allowance is spread out evenly across your wages for the year, then your tax and national insurance contributions should be taken before you are paid. The UK Government know how much to take through a system called PAYE (pay as you earn). Where does UK taxpayer’s money go? The money is used to help provide funding for public services such as the NHS, the education and welfare system as well as investment in public projects, such as roads, rail and housing. Personal Savings Allowance When you open a UK bank account, you can also earn some income from your savings without paying tax. If you pay a basic tax rate, then you can earn up to £1,000 in tax-free savings. Higher rate taxpayers can earn up to £500. Join our Facebook Group IMG Advisor – Here, you will gain access to frequent relocation blog posts, the opportunity to ask questions and receive professional advice and the chance to meet other IMGs! References Moneyadviceservice.org.uk. (2019). How much Income Tax and National Insurance you should pay. [online] Available at: https://www.moneyadviceservice.org.uk/en/articles/tax-and-national-insurance-deductions [Accessed 1 Feb. 2019]. S, H. (2019). Tax Rates 2018/19. [online] MoneySavingExpert.com. Available at: https://www.moneysavingexpert.com/banking/tax-rates/ [Accessed 1 Feb. 2019].  

Introduction The General Medical Council requires all doctors to keep their knowledge and skills up to date. When you join the NHS, you will be expected to continue to learn throughout your career and the best way to do this is through Continuing Professional Development (CPD). CPD activities allow you to develop your knowledge, skills, attitudes and behaviours across all areas of your medical practice. CPD activities include both formal and informal learning activities, such as research, peer reviews, audits, attending courses, conferences, events etc. Why is it important for me to complete CPD activities? Continuing your professional development will… Help you update what you learned in your primary medical degree and during your postgraduate training Allows you to keep up to date with any changes to the needs of patients, the health service and policy changes Enables you to keep up to date and fit to practise, and maintain the professional standards required You are required to bring a summary of your CPD activities to your annual appraisal with your Educational Supervisor to show that you have met the requirements for revalidation It allows you to enhance your career opportunities, such as allowing you to work more effectively within multi-professional teams and to develop leadership and educational skills Remember to record your CPD activities It is important to record your learning activities, your reflections, learning needs and learning outcomes when evidencing your CPD. One to way to do so is to create an online portfolio – you can typically find this feature within your Royal College’s website or use the GMC’s CPD smartphone application. The GMC’S CPD App The GMC offers a free app to all those practising medicine in the UK. They appreciate that opportunities for learning and development will occur every day, but we do not always have time to write them down, not to mention reflecting on them. So, the app will allow you to regularly update your CPD quickly and easily. The app also allows you to: Export your learning activities in a PDF or Excel report so you can share this with your colleagues You can also transfer your activities to other systems, such as your appraisal or revalidation system Take photos and attach them to your chosen learning activity on the app, saving you time in filing certificates from conferences and seminars Access tips and case studies to help you reflect on your CPD and prepare for your next appraisal CPD Points for Appraisals Appraisals allow you to reflect on your scope of practice, reflect on whether you are up to date in every area and whether your continuing professional development is appropriately matched with your experience, identify personal and professional development needs and ensure that you are adhering to the GMC’s Good Medical Practice. Your appraiser will be allocated by your ‘Responsible Officer’ and this varies from Trust to Trust. It is likely that you will have more than one appraiser. Professional Development Plans During your appraisal, you will also create a Personal Development Plan (PDP) to help you plan your short-term and long-term career goals. What is a PDP? It is an individual plan designed to help identify and address your educational and professional development needs. For each learning need, you should ask yourself what you want and need to learn, what you will do to achieve it, what resources you will need and target dates for completion. The advantage of developing a good PDP plan is that it will allow you to achieve your potential by identifying your gaps in your knowledge and skills. CPD Points, PDPs and Appraisals for Revalidation If you hold GMC Registration with a licence to practise, you will legally be required to revalidate, every five years, through a regular appraisal which will look at your CPD points and your efforts to meet your PDP. This will all be based against the GMC’s guidance for doctors – Good Medical Practice. If you successfully revalidate then you will continue to hold your GMC Registration with a licence to practise. Types of CPD Activities Work-based activities Reflective practice Audit of service users Discussions with colleagues Peer review Learning from experience Work shadowing Secondments Job rotations In-service training Supervising staff or students Professional activities Teaching Mentoring Involvement in a professional body e.g. The Royal College of Surgeons Organising accredited courses Being a national assessor Formal and Educational Attending courses Further education Research Attending conferences Writing articles Attending seminars Self-directed learning Reading journals or articles Reviewing books or articles Keeping a file of your progress If you are an IMG looking for your first NHS post, email your CV to [email protected] and one of our Specialist Advisers will be in touch about UK opportunities. Join our Facebook Group IMG Advisor! Here, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional support and the chance to meet other IMGs! References Gmc-uk.org. (2018). Get the MyCPD app. [online] Available at: https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/continuing-professional-development/get-the-my-cpd-app [Accessed 20 Nov. 2018]. Gmc-uk.org. (2018). Continuing professional development. [online] Available at: https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/continuing-professional-development [Accessed 20 Nov. 2018]. Health Careers. (2018). Personal development planning. [online] Available at: https://www.healthcareers.nhs.uk/career-planning/developing-your-health-career/personal-and-professional-development/personal-development-planning [Accessed 22 Nov. 2018].

What is an on-call shift? When you are on-call you are expected to be available outside of your normal working hours to work as and when required, the number of hours will have been previously established within your contract. Your location during your on-call shift will also have been stated in your contract. Typically, junior doctors remain on-site and then consultants off-site to allow flexibility of work. In this post, we provide you with some fundamental tips on how to successfully work an NHS on-call shift and some advice from an SHO General Medicine working within the NHS.   On-call shift patterns Weekday on-calls Weeknight on-calls Weekend day on-calls Weekend night on-calls There are also different forms of on-call shifts. This can include on-take shifts, where you will perform examinations or history-taking. You could also cover ward-rounds, which is crucial for reviewing and planning patients care. Please note, the type of shift you will be undertaking will be determined by the specialty you work in. As a doctor-on-call, you must… Ensure you are available at all times of the required-on call period, and that members of the Trust and switchboard are informed of your contact details whilst on-call Ensure that you are in the right state to attend work and you must remain in a fit state whilst on duty i.e. not drunk Be aware of and follow the local standard operating procedures relating to on-call Be familiar with the local arrangements for reporting any unavailability BDI Resourcing’s top tips before going on-call 1. Preparation is key Before you start your first NHS on-call, you will need to prepare in order to have a successful shift. The first task is to bring food with you. Often, when doctors first start working on-call they decide to order pizza and drink cans of coke to increase their energy levels. However, fast-food will only make you crash later on in your shift and will also result in weight gain. Secondly, it would also be useful for you to organise your personal life prior to working on-call. This could include doing a food shop, paying bills, organising childcare etc. This will reduce stress and worry when you are working on-call, allowing you to focus on your job. Thirdly, when on shift, you should carry a list of common medications with their dose to save time. This will help you speed up routine tasks.  2. Maintain a healthy and balanced lifestyle By eating well and regularly exercising this will reduce the negative effects of working nights, such as fatigue, performance levels and your mental well-being. Tips on working a night on-call shift 1. Eat and drink properly as this will help you maintain your energy levels. 2. If you are unsure of the appropriate action – ask for help. Your responses will not be as reliable as they are during the day and nothing beats a second opinion. 3. Try and take naps when you have the opportunity Tips for after you have finished an on-call shift Once you have finished your on-call shift and you are making your way home, try and stay vigilant. Whether you are driving or taking public transport, your responses will be low so take extra caution to help you stay safe. Once you reach home and you get into bed, reduce all possibilities of waking you up to ensure you get a good-quality sleep and you wake up feeling rest. This includes, earplugs, blackout blinds and put your phone on aeroplane mode. Advice from an SHO General Medicine working within the NHS “Although everything will be taught and demonstrated within your induction, there is such an influx of information that some of it is often forgotten. In addition, as an IMG you will be used to practicing within a different system with different processes. Therefore, requesting a blood test or an x-ray can often lead to you feeling slightly confused or overwhelmed. However, it is important to remember to ask for help. This includes nurses, pharmacists and therapists as well as doctors– they would have previously been in the same position and so everyone will be happy to help you. And over time you will feel a lot more confident.” Although working an on-call shift can feel overwhelming and leave you feeling tired, the advantage is that you are essentially your own boss for the shift without too much pressure from senior staff. If you have any questions about relocating to the UK and working within the NHS email [email protected] and we will be happy to guide you. Join our Facebook Group IMG Advisor – here, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional guidance and the chance to meet other IMGs! References Medicalprotection.org. (2018). Surviving on call. [online] Available at: https://www.medicalprotection.org/ireland/new-doctor/volume-2-issue-1/surviving-on-call [Accessed 16 Nov. 2018].

International Pathology Day was established by the Royal College of Pathologists in 2014 to raise awareness and celebrate the contribution and importance of Pathology and laboratory medicine services in addressing global health challenges around the world. What does Pathology mean? The word ‘Pathology’ means the study of disease, acting as a junction between medicine and science, using advanced technology to study cells and genetics for better diagnosis, screening and treatment. Pathology reports provide over 70% of all the diagnoses which doctors use as the basis of their clinical decisions, whilst making up only 2% of global spending on healthcare. Pathology has three distinct specialties – chemical pathology (also known as clinical biochemistry), histopathology and medical microbiology and virology. Chemical pathology and histopathology encompass several subspecialties and medical microbiology and virology provide the opportunity to dual train in infectious diseases. Each subspecialty offers different combinations of laboratory and clinical research and all of them will offer you the chance to conduct research. Pathology also possesses several other smaller disciplines, such as genetics, immunology and toxicology. You should note that patient contact is limited in pathology, but doctors from all other specialties heavily rely on pathology to assist in diagnosis, often, to allow them to make life-saving decisions. Q&A with Azka Anees – Senior Pathology Resident, Jawarharlal Nehru Medical College, Aligarh Muslim University in India. 1. What is your personal mission as a doctor? Being a doctor, it is my personal mission to make my patients the priority. However, sometimes our mission gets lost as we can forget that there is a patient behind the slides and samples we regularly examine. 2. What made you decide to pursue a career in Pathology? I was interested in the pathogenesis of diseases. Pathology is all about understanding why diseases occur and what is happening at microscopic level. It is indeed a whole new world under the microscope, and the more I studied it, the more it attracted me. It is also a very satisfying speciality, when you are looking under the microscope and you find the reason for the patient’s symptoms, or perhaps you can shed light on whether a patient’s tumour is benign or malignant, it is a particularly satisfying and gratifying feeling. 3. Do you have any advice for junior doctors who want to pursue a career in Pathology? My humble advice would be to only pursue this specialty if you have a genuine interest in Pathology. It is a wonderful, but expansive field and people sometimes find it hard to cope if they are not ready for it or they did not realise the amount of work involved. 4. What are your plans for the future? I would like to relocate to the UK and work within the NHS. Whilst here in India, we do receive a wide variety of cases, we are, unfortunately, lacking the infrastructure that is available in the UK. We also do not have detailed countrywide guidelines as provided by the Royal College of Pathologists in the UK. Previously, I had the opportunity to experience the NHS on a number of occasions, and I really appreciate the friendly working environment. Currently, I am studying for the Fellowship of the Royal College of Pathologists. I have passed Part 1 and I am currently an Associate Member of the RCPath. I appeared for the Part 2 examination in the Autumn session this year and I am awaiting the results. I also need enough work experience, adequate documentation of my training and work experience to process my GMC Registration. So, I am not quite there yet, but I am hoping for the best! 5. Could you please describe your typical day at work? Typically, my day usually starts with a seminar or a teaching session with our junior doctors. That is then followed by lab work, which includes separate labs such as cytology, histopathology, haematology and chemical pathology. In India, we do not routinely subspecialise, however, there are options to pursue certain fellowships or courses in a few sub-specialties if one wants. Skills needed by a Pathologist: Methodical Communication Attention to detail Precision Advantages of working within Pathology: Reliable work-schedule Vital participation in the diagnosis and monitoring of disease Disadvantages of working within Pathology: Enhanced responsibility because of the serious implications from any mistakes Little contact with patients If you are an international doctor who is looking to relocate to the UK and work within the NHS send your CV to [email protected] and one of our Specialist Advisers will be in touch. Come and say hello! Join our Facebook Group IMG Advisor. Here, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional support and the chance to meet other IMGs! References Rcpath.org. (2018). International Pathology Day. [online] Available at: https://www.rcpath.org/international/projects/international-pathology-day-.html [Accessed 13 Nov. 2018]. Bma.org.uk. (2018). BMA - Pathology. [online] Available at: https://www.bma.org.uk/advice/career/studying-medicine/insiders-guide-to-medical-specialties/nhs-career-choices/pathology [Accessed 13 Nov. 2018]

According to the Office of National Statistics, 70% of mothers in the UK now work full-time. Being a full-time working mother can often lead to feelings of guilt, stress and worry because of the divided attention between your family and work life. However, it is important to remember that these feelings can be set aside by devising a plan and finding the right balance between your medical responsibilities and parenthood. In this article, we provide you with five tips to manage your time which will ensure that you, your family and your career are equally successful. We also provide you with a personal account from an NHS Trust Grade Doctor Paediatrics and her advice on juggling motherhood and being a doctor. Tip 1 – Do not feel guilty Rather than constantly feeling upset because you are not with your child, you should think about how your role within the NHS is benefiting both your family and the UK public. By working, you will be able to afford different educational opportunities for your child or perhaps save for their future whilst simultaneously acting as a valuable asset to the UK’s National Health Service. It is important to accept that there will be good and bad days. As a mum, you will not be the first one to feel this way and our advice is to discuss how you are feeling with your spouse, friends, work colleagues and the online IMG community. Tip 2 – Find good quality childcare It is likely that you will feel less anxious if you ask your personal network of friends and family to care for your child. If that is not possible, ask them for references of good quality nurseries or nannies. This way you can work knowing that your child is being loved, cared for and will be happy whilst you are away working. Tip 3 – Stay organised Another tip that helps you feel less overwhelmed is to stay organised. Often, this can start the night before, such as packing your child’s lunches, laying out their clothes (and your own to save extra time!), you could even lay out their breakfast, place bags by the door etc – allowing you to enjoy spending quality time with them each morning, rather than rushing around the house. You could also create a daily to-do-list to help you divide the schedule between you and your spouse. Another way to stay on top of household responsibilities is to meal plan. Plan for a shop to be delivered at the beginning of each week and then write down what you will all be having for breakfast, lunch and dinner. This way, when you have a busy day, you do not have to worry about what you are going to cook because it has already been planned ahead of time. Tip 4 – Stay connected during the day A good way to feel less emotion over being away from your child is to stay connected even when you are not together. If you have younger children, and if it is possible, you can FaceTime them during your lunch break or on your way home from work. Or perhaps, you could pre-record a video or voice message to leave with their carer to show them. If you have an older child, you could leave them a note in the morning or plan some one-on-one time for the next weekend ahead, giving you both something to look forward to. Tip 5 – Make time for your spouse and yourself Although it is important to make enough one-on-time with your children, do not forget about your partner! Setting aside a monthly date night can often lead to you feeling excited and rejuvenates your relationship. And remember to leave some time for yourself too! Finding time to read a book before bed, have a bubble bath, exercise, or spend some time doing something you love will allow you to recharge your batteries in order to take care of your family. A Personal Account from an NHS Trust Grade Doctor Paediatrics and a mother of a one-year-old daughter (Anonymous) I got unexpectedly pregnant during my post as a Paediatrics Emergency Medicine Medical Officer in Myanmar and whilst I was studying for my MRCPCH clinical exam preparation. At the time, I was contracted to work 48 hours per week and my department saw over 3000 patients a month. Although my husband is a very supportive partner, he is a military doctor who stays away from home, so I could not always count on him. I had a very tiring pregnancy and the only motivation was for me to pass my MRCPCH clinical exam with high marks – of which I did, and I am very proud of. My daughter was finally born and unfortunately, she was born with a hole in her heart (VSD). She underwent her surgery and we have been told she needs to have the second surgery in the UK as it is not possible in Myanmar – this was another reason for my decision to relocate. I was only given 90 days paid maternity leave and I took 28 days unpaid leave – giving me 4 months off work. Once I returned to work I decided to hire a day nanny who worked 7am to 7pm, I also used her as a night nanny whilst I was on-call. It was difficult being a doctor and a mother, so I decided to move in with my mum and my dad. This helped me relax as I knew that when the nanny was caring for my baby, my parents would be around too. After work, I always made sure I had quality time with my baby. I would sing her lullabies, read and dance with her. And then after she fell asleep my study time would come. My top tip to studying doctors would be to study at every opportunity you have. Make everything paperless by using a phone, tablet or laptop and put them on aeroplane mode to allow you to concentrate. Sometimes, I even practiced for my OET exam by speaking to my baby in English. By staying organised, you can still work, care for your baby and conduct extra-curricular activities – I managed to finish two audits and was a co-author of a research paper. My second piece of advice to IMGs with children is to relocate to the UK alone for the first month or so. Once you have settled and have everything organised, such as nurseries, schools and accommodation your family can then come over. I am worried about how I will manage when my baby arrives in the UK, I am hoping my mum can come for the first six months on a UK visit visa. When my mum leaves I will have to get a nanny, I tend to install CCTV to reduce my worries. My final tip would be to tell your child that you love them as many times in the day as possible. By giving them lots of hugs and kisses they will not worry about being away from you. Overall, being a mother and a doctor is a wonderful life and I am very grateful. Join our Facebook Group IMG Advisor! Here, you will have access to frequently published relocation blog posts, the opportunity to receive professional support and the chance to meet other IMGs! And if you are looking to relocate to the UK and work within the NHS email [email protected] and we will be happy to help you. References Ons.gov.uk. (2018). Families and the labour market, England - Office for National Statistics. [online] Available at: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/familiesandthelabourmarketengland/2017#mothers-with-a-youngest-child-aged-between-three-and-four-years-old-have-the-lowest-employment-rate-of-all-adults-with-or-without-children-and-are-the-most-likely-group-to-work-part-time [Accessed 7 Nov. 2018]. Parents.com. (2018). About Your Privacy on this Site. [online] Available at: https://www.parents.com/parenting/work/life-balance/moms-balance-work-family/?slideId=slide_a0a3f42c-07fd-42bc-ba34-f775b5623b2d#slide_a0a3f42c-07fd-42bc-ba34-f775b5623b2d [Accessed 7 Nov. 2018].

If you are planning on relocating to the UK permanently, you may consider buying a property over renting one. Buying a house in the UK is a complex and often a very lengthy process, so in this post, we provide you with a summary of the steps you will have to take when buying a house. Step 1: Save for a deposit Typically, you will need to save for a deposit of at least 5-15% of the price of the property you want to buy. However, it is often worth saving more if possible because a bigger deposit means a better mortgage deal. When saving try and save into the following types of bank accounts: Help to Buy ISA’s or Lifetime ISA’s – these accounts will give you a 25% top-up from the UK government. For further information on each account click here. Other options: Help to buy equity loan: you save a 5% deposit and the government loans you 20% of the property price (40% in Greater London) meaning you only need a 75% mortgage (or 55% in London) Shared ownership – you buy a 25%-75% share in a property and pay rent on the rest of it. Help from family – some mortgage lenders will take parents’ incomes or assets into account, making it easier for you to borrow money. Step 2: Enquire about how much mortgage you are entitled to borrow The amount a mortgage provider will lend you to buy a house will depend on the size of your deposit, your income and your credit score. If you are buying a property with a partner, the lender will also take their finances into account. Tip – budget for additional costs such as property surveys, conveyancing fees, stamp duty etc. What if I have little credit history within the UK? We are proud to partner with Fox Davidson Mortgage Brokers. Fox Davidson is an independent property finance broker and specialise in securing finance for professionals such as doctors and surgeons. In addition, they can secure finance for clients without permanent rights to reside and that have little credit history in the UK. As a benefit to using BDI Resourcing we have negotiated direct access to the team at Fox Davidson that specialise in mortgages for doctors. Fox Davidson can help clients with: 10% deposit or more Little or no UK credit history Tier 1 and 2 Visa To discuss your mortgage requirements in more detail please contact Pete Lloyd on 01179 897950 or email [email protected] Click here to access their full mortgage guide. Step 3: Apply for a mortgage agreement in principle This is a confirmation from a mortgage lender that they would, in principle, be willing to lend you a certain amount should you find a property. Having an agreement can make you a more attractive buyer as it shows the seller that you will be able to secure the amount of money you need to buy the property. Step 4: Find a property Once you have found the perfect property it will be time to make an offer. It is common practice to offer less than the asking price, however, if other people are making offers for the property, you may need to offer the asking price or more. When making an offer mention any points that will enhance your profile e.g. you are a chain-free first-time buyer. Step 5: Apply for a mortgage You will now need to start thinking about the type of mortgage you want to apply for and how long you want to spend paying your mortgage off. Click here to visit a mortgage calculation site. Step 6: Find a conveyancer or a solicitor Conveyancing is the legal process after your offer is accepted. This includes conducting property searches, checking documents, drawing up and checking contracts, dealing with the land registry, paying any stamp duty and transferring money. Conveyancing fees can range from around £500 to £1,500 – this will vary depending on the cost of the property and the complexity of the transaction. Step 7: Exchange Contracts You can exchange contracts with your seller when the legal representatives swap signed contracts and you have paid the deposit. Completion of the transaction typically takes place two weeks after the exchange, however, the date is flexible, and you can agree a convenient time with the seller. On completion day, the money will be transferred to the seller and you can then collect the keys from the estate agent and move into your new home. Congratulations! And enjoy your new home! If you have any questions about the above information or relocation to the UK in general, get in touch with us at [email protected] and we will be happy to help. Join our Facebook Group IMG Advisor – here, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional support and the chance to meet other IMGs. References Cheung, C. (2018). How to buy a house. [online] Which? Money. Available at: https://www.which.co.uk/money/mortgages-and-property/first-time-buyers/buying-a-home/how-to-buy-a-house-alm0r9l4yf5x [Accessed 31 Oct. 2018].

The decision to relocate to the UK is a big one and so understanding how much your new life is going to cost you per month is vital before making the decision to relocate. In today’s post, we provide you with a monthly breakdown of living costs in the UK, from accommodation to travel costs. Please note, that the below breakdown is a guide, and this will differ depending on the size of your family and the lifestyle that you lead. Expenses will differ depending on what part of the UK you live in Generally speaking, the further up north you go the cheaper the cost of living is. If you decide to live in London, you will be paying around 60% more than cities in the north. In 2018, London was ranked the 30th most expensive city to live in the world, according to the latest research from the Economist Intelligence Unit. How much will it cost to live in the UK each month? Expense Price Details Rent £550 per month outside of London The average rent you will pay in the UK will vary depending on where you live. Typically, a one-bedroom flat averages around £550. Council Tax £100 per month When you move to the UK, you will have to pay council tax. The price will differ depending on your property size and the area you live in. The tax contribution goes towards your rubbish collection, police forces and street maintenance. Utilities £160 per month These are bills that are not included in your rent, such as gas, electricity and water. Please note, that if you live alone and you are not often home due to long hospital shifts, socialising or studying these costs could be less. Television license £150.50 per year In the UK, if you are watching a television in your home, you will have to pay for a license – even if it is on your computer. The cost is per home not per person, so if you share with others you can split the cost. Travel     Monthly bus pass - £50 on average   Monthly train pass – This price can differ depending on the distance you are travelling. The price can range from £50 to £500 a month. It is popular for people in the UK to buy a travel pass instead of using a car. As the cost is a lot lower and often the commute can be a lot quicker. Mobile Phone £40 When you relocate, you will probably want to get yourself a local phone number to communicate with friends, family, colleagues. You will have a range of networks to choose from and some plans will be cheaper than others depending on the services they can offer you. A monthly contract of £40 should typically provide you with a phone and plan of unlimited calls and texts and 3gb of data per month. Miscellaneous Costs: £240 Other monthly costs you will incur include food, internet, toiletries and other items and services you may need. Total    £1290.50 per month What additional costs can I incur? Health care and Dental Costs Healthcare in the UK is mainly provided by the National Health Service (NHS) – a system that provides free health care to all permanent residents of the United Kingdom and is paid for by public taxation. Although the NHS is free at the point of use for the patient, it is important to know there are charges associated with eye tests, dental care, prescriptions and other aspects of personal care. Eye Test - £20-25 Dental Care Please note you do not have to pay for NHS dental treatment if you are: Under 18 Under 19 in full-time education Pregnant or you have had a baby within the 12 months before the treatment starts Staying in an NHS hospital and the hospital dentist carries out your treatment You receive government Income Support, Jobseeker’s Allowance, Employment and Support Allowance or Pension Credit guarantee credit or Universal Credit You are entitled to a valid NHS tax credit exemption certificate You are named on a valid HC2 certificate However, if you do not meet the above criteria, there are three dental NHS charge bands: Band 1: £19.70 covers an examination, diagnosis and advice. If necessary, it also includes an X-ray, a scale and polish and planning for further treatment Band 2: £53.90 covers all treatment covered by Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth Band 3: £233.70 covers all treatment covered by Band 1 and 2, plus more complex procedures, such as crowns, dentures and bridges. Prescriptions - £8.80 per item If you take in a prescription that lists several types of medication, you will pay £8.80 for each one. Prescriptions are free in Wales, Scotland and Northern Ireland. Education When relocating to the UK with children, making the right choice when it comes to picking a school for them will be your top priority. If you are a parent, you should note that you will have access to primary and secondary schools – completely free of charge. Factors that will affect your choice of school will include your child’s previous schooling experience, their academic ability and their English language capability. Please note, there is also the option to choose private schooling. On average, a private pre-school monthly fee is around £1,039 and a primary and secondary schooling annual fees are around £15,250. Furthermore, when your child is ready to attend university there is a fee of £9,250 per year. The UK Government has a Student Loan Scheme, which allows students to pay their university fees back once they are employed and earn over £25,000 a year. For further advice and support on relocating to the UK please email [email protected] and we will be happy to help! References Secret London. (2018). London Is Now Only The 30th Most Expensive City in The World. [online] Available at: https://secretldn.com/london-cost-of-living/ [Accessed 16 Oct. 2018]. TransferWise. (2018). Cost of living in the UK: Your guide. [online] Available at: https://transferwise.com/us/blog/cost-of-living-in-the-uk [Accessed 18 Oct. 2018].

Introduction 1.What is your name, speciality, grade and what hospital do you work at? My name is Dr Raja Adnan Ahmed and I am working as a Consultant Psychiatrist in       South Wales currently based in Ysbyty’r Tri Chwm Hospital which is part of the Aneurin Bevan University Health Board. I have been working on this substantive consultant post for over two years. 2.What country did you relocate from? I relocated from Pakistan having graduated in 2003 and I arrived in the UK in 2005. 3.Would you share with us your personal mission as a doctor? My mission is to raise awareness about mental illness amongst the general public as well as healthcare professionals and to reduce the stigma associated with mental health. I believe due to the lack of awareness many people, including doctors and allied health professionals, suffer in silence and treatable mental health conditions become disabling. I would like to see mental health receive the same attention and parity of funding as physical health. I would also like to see an improvement of training in Psychiatry as a discipline among medical students in the UK and in Pakistan.   4.At what point in your career did you decide you wanted to relocate to the UK? What were your motivations for wanting to do so? I moved to the UK following my house job (internship) in Pakistan. In fact, I started to plan during my final year of medical college. I was interested in Psychiatry and started to research the Royal College of Psychiatrist Training Curriculum and various training programmes within the UK. I undertook the necessary IELTS during my internship as well as studied for my PLAB1 exam. My main motivation to pursue training in the UK was the highly organised and carefully structured training programmes available in Psychiatry. There were excellent training opportunities, emphasis on a work life balance, a rewarding salary, recognition and clear pathway for progression of one's career, all of these factors contributed to my choice in migrating to the UK. The Relocation Process 5.How long did it take you to relocate, how difficult did you find the process, and do you recommend it to other IMGs? I relocated to the UK in 2005, at that time under the labour government, the visa regulations, especially for highly skilled migrants were quite straight forward. Unfortunately, this also meant that the job market became saturated quickly. A single non-training vacancy would attract hundreds of applications. It was not unusual at that time for IMGs to start with unpaid clinical attachment work for months whilst simultaneously applying for post across the country. The situation changed around 2006-2007 as many IMGs started to leave due to lack of posts. When I first moved to the UK within first few months of passing PLAB I was able to secure a clinical attachment and within 8 weeks of that I was able to secure first locum post in the same department which led to further short-term locum positions. However, it took me more than a year to secure my first training job as a foundation year two doctor. Certain specialities continue to have a chronic shortage of doctors, but I can see that the situation is improving, therefore, I advise young IMGs to pursue their ambitions at this current time. 6.Is there anything you would have liked to have known before deciding to relocate? And now once you live in the UK? When you move countries, you are leaving behind all the support networks, family and friends. It takes time to settle and for me at first it felt like I was starting my life from scratch. The initial months can be very anxiety provoking due to lots of uncertainties and challenges but as times goes on most of us adapt to the changes and the new cultures and working environment. Once a job is secure the rest comes naturally. You are never too far from a supporting figure, colleague or mentor. In my experience, Wales, has been a very welcoming and friendly place to live hence, I have chosen to stay and work here. I advise new IMGs to keep an open mind and be prepared to face the initial challenges. There is a lot to learn about British cultural norms, culture of NHS as a health service and British society in general. But once you start to settle the you will find British society and NHS is very welcoming and inclusive towards IMGs and you will get many of opportunities to grow.   Thoughts on the UK 7.For you, what are the key benefits of living in the UK? I see plenty of benefits living in the UK. The society in general is very liberal, inclusive and welcoming, people are very friendly and value your hard work, intelligence and dedication. The UK is at the cutting edge of medical research and innovation and there are excellent training opportunities which include training in the hospitals, Royal Colleges and opportunities with the local universities. The training and qualifications you gain in the UK are recognised globally. The NHS has the mechanisms to make you a well-rounded doctor. Our children also get better education via the school system here in the UK and hopefully will get excellent university education which will open opportunities for their future progress. The UK also offers you a very healthy work life balance and there is a lot to explore and enjoy as a family within the UK and also in Europe. 8.How do you feel you settled in your chosen location within the UK?  I grew up in a small town in Pakistan which was surrounded by beautiful countryside and mango farms. I think because of my upbringing and the lovely early childhood memories, I love the countryside. I remember my very first days in London when I was preparing for PLAB-2, visiting the city and travelling around on the London underground during the peak hours, as much as I enjoyed this experience my heart has always been drawn to the idyllic country atmosphere. Fortunately, I had the chance to work in the South Wales which offered me good balance or city and rural life with proximity of cities like Cardiff and Bristol along with the lovely countryside with rolling hills, peaks of Brecon Beacons and sandy beaches of the Welsh coastline. The cost of living is lower in Wales if you compare it with areas around London or the South West of England. 9.Have you applied for permanent residency in the UK? How did you find the process? The visa regulation has changed a lot since 2005, generally speaking, it was a lot easier 10 years ago. IMG doctors applied for a HSMP visa (highly skilled migrant programme) which lasted for certain number of years leading to ILR (indefinite leave to remain) and there was no need to change visas with every job.    Unfortunately, I don't understand the current visa rules so well as so much has changed but I believe the UK government should make it easier for highly skilled professionals to acquire British visa’s and provide them a clear pathway to permanent residency. The NHS 10.How did you feel on your first day of working within the NHS, your first week, month and then how do you feel now compared to when you first started? My very first experience of working in the UK was clinical attachment which led to a locum SHO job in the same hospital. I was very excited and nervous at the same time. I met very helpful experienced seniors to guide me through that period and I slowly gained experience and confidence. There is no doubt that the first few weeks or months in the NHS can be difficult as there is a lot to learn about the system and functions of the multi-disciplinary teams. I advise doctors to be honest about their skill level and do not ever hesitate to ask for help when you are unsure. Also, do not feel ashamed to ask plenty of questions and identify areas of your weakness, reflect upon them, discuss them with your supervisors and develop a personal development plan (PDP)  to constantly learn and improve your skills. 11.How would you describe the support you received from your hospital after starting your new position? I received good support from seniors in the Royal Gwent Hospital, Newport when I was doing both my clinical attachment and during my locum SHO position in medicine. I was lucky to work with the seniors who understood that IMGs require periods of induction into the NHS system and require extra support and supervision at the start.    My first training post was in Yeovil, Somerset as and FY2 in 2007, again I was warmly welcomed by the staff and received appropriate support in settling in and achieving my required foundation competences and application process for the core psychiatry training. I think all departments in NHS are familiar with new IMGs starting their first job in the NHS and they are usually very helpful. I also advise IMGs to look out for mentors both at a peer level and senior levels who can guide and support you during the initial years. 12.What were your thoughts on the UK/NHS System in 2005, do you think either has changed much over the last 13 years? This is an interesting question. Certainly, a lot has changed within the NHS and as an organisation NHS is constantly evolving as it is trying to improve and find more effective ways to perform. Although we use word NHS as if this is a single organisation but in reality, the NHS is formed by lot of different bodies and as doctors we experience interactions with various different trusts, hospitals, training schemes, royal colleges, deaneries and universities. Since I started working in the NHS I have noticed there are certain negative streams of media that denigrate the health service and portray it to be unsustainable. I remember IMGs back in 2005 were worrying if the NHS would survive another 5 years. It is true that certain Trust services and hospitals struggle to manage safely but on the other hand there is a lot more positivity about the NHS and its excellent performance which is not reflected fully in the media. I now advise my colleagues and new IMGs to avoid concentrating on all the negative media coverage about the NHS and focus on all the positives NHS offer you. By working within the NHS, you become part of a diverse multicultural workforce and get exposure to excellent training opportunities, cutting edge techniques, chance to work with worlds experts in certain fields, frontline academics and mentors. I believe NHS will continue to offer excellent training despite the austerity measures.    13.What is your opinion on the NHS? Working within it and as a patient receiving care? NHS is an excellent health system and simply one of the best in the world. The staff show real compassion and commitment and generally the training of the staff along with safety standards are exceptional. I believe your hard work and dedication are recognised and commended within the NHS and you are given opportunities to bring about the change. 14.What pathway did you use to become a UK Consultant? I have a CCT in Old Age Psychiatry which I achieved in 2016. I started the training pathway in 2007 with a Foundation Year 2 job in Somerset, which led to core psychiatry training. I finished my membership exam, core and specialist training within Wales Deanery. For IMGs who are interested in psychiatry training, I always advise them to consider the proper training pathway with membership exams and aim for the CCT. Given the shortage of applications on core training jobs, the core training places have been under filled for the last 10 years (although in 2018 we had a much better year for recruitment). Similarly, when core trainees are finishing their membership exams, they are getting specialist training posts fairly easily leading to CCT. Although I have nothing against CESR pathway, generally speaking in Psychiatry it is easier to get a CCT with better exposure to training which helps you to become a confident consultant.     15.How do you find working in the UK compared to your home country? When I left Pakistan in2005, the life of a trainee doctor in Pakistan was very difficult due to shortage of training places, shortage of supervisors and very low salaries. But above all, I was most concerned with the lack of training opportunities. In comparison to Pakistan, I felt the training in the UK offered a better structured and clear pathway to progress along with several excellent opportunities to refine my skills as educator and leader. Working and training in the UK also gives you financial independence and a peace of mind so you can focus your energies on training needs, membership exams and clinical skills. When I was working in Pakistan, I knew I would have been financially dependent on my parents, but in the UK, my wife and I moved into our first house in Wales when we were both Foundation Year 2 doctors. The Future 16.What are your hopes for the future? I am currently working on a Consultant Psychiatrist post with NHS Wales and pursuing a Master’s in medical education with Cardiff University. I would like to develop myself as an experienced educator, I am already involved with Cardiff University Medical School, the Welsh Deanery and my local health board in teaching and examining roles but I would like to expand my involvement and improve my own experience as an educator. I am interested in raising awareness about mental illness in general public and healthcare professionals and improve recruitment into psychiatry. I am also interested in Qualitative research methods and currently exploring and learning more about qualitative research and designing my first Qualitative research project. In the future, I like to establish myself as an experienced researcher with publications in reputed psychiatry journals along with my clinical and educational role. In my personal life, I am blessed with an extremely supportive wife, who is a GP herself and we have three lovely energetic children. I always try and find ways to spend quality time with my family and maintain a healthy work life balance. We enjoy hobbies such as cycling, hiking, running and swimming. The future holds so much more! Thank you for reading! Join our Facebook Group IMG Advisor! Here you will have access to regular relocation blog posts, the opportunity to ask questions and receive professional support and the chance to meet other IMGs! 

Warning! This blog may result in Wanderlust… Recently, our Paediatric Specialist Sebastian and his girlfriend Clare just returned from a once-in-a-lifetime trip to the beautiful island of Santorini, Greece.   Relocating to the UK and working for the NHS has endless advantages including the opportunity to train within the NHS, increased job stability, and the opportunity to receive a good source of income. Another advantage and the purpose of today’s article is that living in the UK will provide you with the prospect of travelling to incredible European locations. There are 51 countries that belong to the diverse continent and home to some of the world’s most vibrant cities, iconic architecture and amazing art – all of which are on the UK’s doorstep. Travel gives you time to relax and refresh, obtain new perspectives, the opportunity to meet new people and it is a fantastic stress buster!   So, in this post, we wanted to take the opportunity to inspire you to relocate to the UK and travel to beautiful destinations like Santorini by sharing some amazing pictures from Sebastian’s holiday. Santorini Santorini is one of the Cyclades islands in the Aegean Sea and it is an island that will offer you sweeping ocean views, picture-perfect beaches, traditional Grecian architecture and fine dining. Flights London Heathrow – British Airways offers flights from May to October London Gatwick and Manchester – EasyJet offers flights from April to October Accommodation in Oia Santa Maris Luxury Villa and Suites Hotel Sebastian and Clare stayed in an exquisite hotel neatly tucked away from the centre of Oia. The hotel will offer you an authentic experience, with views overlooking the Aegean Sea and exclusive sunsets. Sebastian’s Must-See Places The Red Beach – Depending on how long you are visiting the island for, you may like to rent a car. This will allow you to visit the South of the Island, including the pre-historic town called Akrotiri. Here, you will find the red beach, a rare sight of an enormous volcanic rock situation in the sea next to dark blue waters. Ancient Thira – Ancient Thira is an ancient city and home to Messa Vouno Mountain – the visit will offer you spectacular views, markets and historic ruins. Fira – Fira is the capital of Santorini and it is a beautiful area that will offer you endless cafes, bars, restaurants and amazing views. Sebastian’s Must-Do Activities A boat trip – Exploring the island by boat will offer you a unique opportunity to see different towns and villages in all its diversity. Visit the pre-historic towns and ancient sites – This will give you a chance to learn about both the island’s history and Ancient Greek history Eat out at as many restaurants as possible – The food in Santorini is Mediterranean-Greek. You will find a great array of seafood and meats with the opportunity to try the islands finest-grown tomatoes, olives and wines. Go on the cable cars in Fira – This is an absolute necessity! Giving you beautiful views across the whole island. Plan to watch the sunset – Santorini sunsets are among the most sought-after phenomena in the world and so you should definitely make time to see the sun set in a variety of locations. Thanks for reading! And remember to share your European adventures with us when you relocate to the UK! Why is travelling important for my career? Join our Facebook Group IMG Advisor – Here you will receive access to frequent relocation blog posts, the opportunity to ask questions and receive professional advice and the chance to meet other IMGs!

Hello, nice to meet you! What is your name, speciality and where do you work? Hi! My name is Dr Ramirez and I work as an SHO in Urology at the Royal London Hospital. Where is your home country? I am originally from Costa Rica. Why did you decide to relocate to the UK and what were your motivations? I came to the UK with the hopes to specialise in Surgery and to learn about minimally invasive procedures which are more common in the UK than where I come from. Relocating to the UK was very easy for me, I have been an expat for a long time and in my opinion, the UK is one of the easiest countries to relocate and find a job in, there are many people willing to help and everyone has been very welcoming since I arrived here. What are your thoughts on living in London? London can be a very hectic city to live in, as with any city it has its pros and cons, but I can assure you all that you will not be bored for a second if you decide to relocate here. The number of things to see and do is just amazing! What are your thoughts on the NHS as a system? I find it amazing how people in the UK respect and value the NHS as an institution and because of that support, doctors, can bring an amazing level of care to people for free. Do you have any advice for junior doctors who are considering specialising in Urology? I believe this is a great time to pursue Urology training in the UK, as it is a speciality that is suited for those interested in recent technological advances and research. I personally believe the most fascinating branch is urologic-oncology but there are many areas to specialise in, such as: -Sexual health -Infectious conditions The main path for a doctor who aspires to become a Urologist is to complete the MRCS exam and then apply for a Registrar post, this can either be a training or a service post – both routes can lead to you becoming a Consultant. I thoroughly enjoy working in Urology at the Royal London Hospital, it is a great speciality especially if you like video games. This is because now, everything is done through an endoscopic approach, so you are usually controlling instruments and see what you are doing via a TV screen. We recently got a surgical robot in RHL that we use for benign procedures, as a result, it has shortened the patient’s stay at the hospital and they can leave with practically no visible scars. Plus, it is really easy and fun to use compared to traditional laparoscopy. I find this minimally invasive approach very exciting and I hope every day we will be able to offer this to more people in the UK and around the world. Do you have any advice for Urology patients? I am going to split my answer into to parts, for the two patients that I have treated: A)Patients suffering from renal/ureteric stones The cause of a patient suffering from stones can vary. The most common stones are calcium oxalate and they are caused by a combination of factors including genetics, dehydration and consuming a high quantity of oxalate in your diet. Foods that are high in oxalate and ones you should avoid if you suffer from this condition include spinach, bran flakes, rhubarb, beetroot, potatoes, chips, nuts, nut butter and many others. Other types of stones can be caused by other factors such as recurrent urinary tract infections or gout, in this case, the main prevention is to treat the underlying medical condition as effectively as possible to prevent recurrence of calculi. B)Patients suffering from BPH or more commonly known as an enlarged prostate BPH stands for benign prostatic hypertrophy and it is a condition that affects up to 40% of men over the age of 65. It is an enlargement of the prostate gland that envelops the urethra making it difficult for the affected individual to pass urine, usually requiring them to depend on a urinary catheter to be able to empty their bladder. BPH is typically caused by environmental factors that are still relatively unknown however, it has been theorised that it is caused by an increased conversion of testosterone to DHT or dihydrotestosterone, which is the hormone responsible for some changes in ageing males such as male pattern baldness. Theoretically, men who produce higher levels of testosterone have a higher chance of it developing BPH and just anecdotally I can confirm that many of my patients who suffered from this condition tend to be very muscular and ‘manly’ looking men, which is something I tell my patients which never fails to get a smile out of them. It has been reported that aerobic exercise and a diet low in meat can prevent the incidence of BPH, but I believe the evidence is not yet conclusive on this matter. Currently, the best treatment available is for surgery and the most common procedure is called TURP (transurethral resection of the prostate) which involves passing a camera through the urethra and using an instrument called a resectoscope to ‘shave off’ a larger channel for the urine to pass through. This is done using an endoscopic cautery knife called a resectoscope. The surgery involves no cuts and is all done through this keyhole approach and it is currently the most effective way of treating this condition. There is a relatively high (5%) risk of causing erectile dysfunction which is why we are constantly looking for new ways to treat BDP which are safe and effective. At Royal London Hospital, where I did my Urology placement, we are studying a new technique called Uro-Lift, which is a less invasive procedure which involves ‘clipping’ the prostate with two clips that open the urethra clearing the passage. This new technique has shown promising results, but it is still in its early stages and we require more patients to undergo this procedure to confirm its superiority to the traditional TURP. Thank you for your advice, Dr Ramirez. What are your plans for the future? Eventually, I would like to go back to Costa Rica to help improve my home country with what I have learnt here. But for now, I have a lot of training ahead of me and so the UK is my current home.

After you have settled into the UK, found your way around the local area, obtained a UK driving licence, you will begin to think about purchasing a car. Buying a car can be an expensive venture, therefore, in today’s post, we provide you with all the costs involved in running a car. To drive a car on public roads there are certain requirements you must meet by law: Car Insurance The amount you pay for your car insurance is called a premium. Insurance companies will take various details from you to work out what your monthly or yearly premium will be. This includes personal details (such as age and postcode), the cars details, the level of cover you are looking for, previous car insurance claims etc. This information will allow the insurance broker to calculate your premium based upon the provided information. The best way to get cheaper car insurance is to use comparison sites to find the best deal. Once you have a couple of good quotes, you might want to call an insurance broker and ask them to beat it (it’s free, they will do all the work and then call you back).  We also advise for you to pay your premium all at once, rather than monthly instalments as you will have to pay interest on instalments.   Useful Car Insurance Comparison Websites: Compare the Market Go Compare Car Tax Car tax is also referred to as road tax and it must be paid on all registered vehicles that are kept or driven on public roads. The price of road tax can vary depending on how environmentally friendly your car is. When you purchase your road tax online, it will be automatically transferred with the vehicle. It is important to remember that you must tax your car before you use it. Choosing the right car can make a big difference to your tax costs, as choosing a low-tax car could mean it holds its value better as more people will want to buy it. If you have already bought a car and you want to find out how much its tax is going to cost, please click here. Please click here for a list of tax free cars. MOT Testing An MOT is a yearly test for all cars over three years old. The vehicle, by UK law, must pass its MOT to ensure it is safe and roadworthy. The maximum price for an MOT costs £54.85, however, some garages offer cheaper prices to guarantee they get the repair business too. Other costs involved in running a car: Fuelling the car The average price of a litre of fuel in the UK is around £1.29 (September 2018) for petrol and £1.33 for diesel, however, this price will fluctuate from street to street and town to town. To calculate how much it will cost for you to fuel your car each month please click here. Tips for reducing your fuel costs: Careful driving: gentle acceleration and not driving quickly all the time will reduce the amount of fuel that you use Efficiency: The bigger your car's engine is the more fuel it will use in general Shopping: If you buy your fuel from the same petrol provider then they are likely to offer a loyalty card, which will allow you to build up your rewards points to spend on other shopping Travel for your fuel: Buying it from a supermarket petrol station over a motorway/local stations – the prices can be considerably lower Servicing and Maintenance Costs Upon considering how much it will cost to run a car, it is important you do not forget about maintenance fees of the car. The RAC, a UK motor car service states that it costs around £472 a year to maintain a used car. This fee includes an MOT, a service and any repairs needed. However, please note that if you buy a new car it is likely that you may not need any repairs at all. It is important to service your car regularly, as it will help maintain its value and reduce costs in the long-term. To read our blog: How to get a UK driving licence please click here. References Moneyadviceservice.org.uk. (2018). Car insurance for young drivers – the key facts. [online] Available at: https://www.moneyadviceservi