PROS AND CONS OF NHS

PROS OF WORKING IN NHS

1. TRAINING You are always supported clinically till you become a consultant. You always have a clinical and an educational supervisor attached to you who will be around you when you are working in the hospital, hence the burden of responsibility will always lie more on them, rather than you. In order to progress your career within NHS, you will need to get your competencies signed from your supervising consultant at each level and unlike back home, where you can get away with almost anything, it’s not the case in UK, because your supervisor will be held responsible for your work in the future. He will only sign the competencies, if he feels you have gained enough experience and skill and are competent enough for the job. Ultimately it all leads you to become a better clinician in future. Secondly, working in NHS not only makes you a good doctor, but also a better human being (ethically speaking). This becomes evident when you are preparing for cases like ‘Breaking Bad News’ or ‘Managing Angry Patients’ during PLAB 2.

2. EDUCATIONAL SUPPORT The trust provides you a study budget for the exams (even up to 600 GBP per year) to write post graduate exams like MRCP.  They also allow paid study leaves for your exams. They encourage out of training educational programs to widen your educational and teaching experience.

3. ADEQUATE SALARY Junior doctors have an annual salary package of 32,000 to 38,000 GBP. You do the math now. Senior doctors earn around 51,000 to 74,000 GBP and consultants earn around 100,000 GBP

4. EXTRA BANDING 7pm-7am time is called ‘non-social hours.’ So, if you are performing duties during this time period, you will get banding (up to 10-20% compensation) depending on your program and contract.

5. LOCUM MONEY You can earn extra money by doing locum duties. A senior once told me that he doesn’t usually do locums, but whenever he has to plan a visit Pakistan, he does two locum shifts during the weekend and voila, money arranged for the return tickets. (Avg Rate: 40 GBP per hour, you do two 8-hour duties at weekend and get 640 GBP or PKR 130,000) 

6. WORK-LIFE BALANCE Rota is really well balanced, let's say you have worked 3 nights in a row, next 2 days will be rest days. The maximum working limit is 48 hours/week. If you work extra, you’ll be paid extra but even then, there is a limit on that extra work.  You want less work, more party? Join NHS. You want more work, more money? Join NHS.

7. SOCIAL LIFE UK is small. The distance between London and Glasgow which are two extreme ends of UK is just 412 miles which can be covered in 7 hours on car. What I am trying to say is that if you have a car, you can always hang out with your desi friends (residing in different cities) whenever and wherever you want. 

8. EASY TRAVELLING A direct flight from UK to Pakistan only takes 7-8 hours. So, you can always come back in no time, in case of any emergency or in case your mother finds a dulha/dulhan for you. Don’t smile, teri nai hone lagi. 

CONS OF WORKING IN NHS

1. WORKING IN DIFFERENT CITIES This is, in fact, the only negative aspect in my eyes. You have to keep moving from one city to another depending on your job. Let's say for aspiring physicians, you'd shift from non training job to 3 years IMT training then to ST training in your desired specialty and then find another job as a consultant. However, you can keep working in the same city if the deanery over there has abundant vacancies.

2. HIGH LEVEL OF ACCOUNTABILITY This one is not a real con actually but for desi doctors like us, it may be. Let me explain, according to a report from The Guardian, NHS paid around 2.63 billion GBP in negligence claims in 2019. Patients can sue doctors on things which we can’t even imagine in Pakistan. For example, a patient can sue a doctor if he disclosed his diagnosis to his family without taking permission from him first. This is called ETHICS. Sadly, in Pakistan, Medical Ethics is only found in 4th year books of Community Medicine. Another time, a friend of mine told me that a doctor got his GMC registration cancelled because she used parking card of her handicapped sister while parking her car outside a market.

3. HIGH TAXES AT SENIOR LEVEL There is a 25% tax on junior doctor’s pay which can go as high as 40% when you progress to higher levels in career. But even that 40% tax won’t be applied on all of your salary, it will only be triggered if you start earning above a given threshold. Let’s say you make 100 quid a month, you won't be taxed for the first 50 quid, then 25% for the next 30 and 40% on the last 20 quid. So, the higher taxes are not on the whole income, rather they apply to the amount that goes beyond the threshold only