Thread by @rahttled_doc

Hey @NHSEngland, @NHSScotland, and UK #Medtwitter

Those UK doctors who moved to my Aussie ED realised we never had an Exit Interview. We never got to share some of the examples of NHS culture that drove us away. Perhaps we can inform you a little with some anecdotes? 🧵

If you're interested, i've already done a thread on the employment conditions that enticed us to stay in Australia.

https://twitter.com/rahttled_doc/status/1647083658019495937?s=20

This however is the experience of 10 UK trained docs (now Aussie EM Registrars) and the NHS culture that drove us away.

If the owners of the anecdotes have consented i've tagged the relevant trust so they can consider their own trust culture.

We're not alone in UK #MedTwitter in our experiences (as @Xeon4f145d96s1 posts show) but here's just a sampling of why it was so shit in the NHS

1. As a medical student @NHSHighland I was holding the retractors for a surgeon in Oban. To have me change position he swiped at my hands with his scalpel and called me a "stupid cunt". Later he tried to play nice by giving me a chocolate bar, as if that wiped the slate clean.

2. As an FY2 @BlackpoolHospED my Registrar had full blown gastro on a night shift. The consultant refused to take her place for the night. She lay on a bed in resus and the juniors had to stand distant from her and ask her advice on how to manage while she vomited repeatedly

3. My English trust had to find locums for the Queens funeral holiday. HR offered locum pay to F1s. They accepted as good money. At 4, on the Friday before, HR then messaged to retract locum rates and told the F1s that they were contractually obliged to turn up. My F1 was crying.

4. We were told that if we didn’t show up for work during one of the worst blizzards in 50 years our contracts would be terminated

5. I was told that it wasn’t the ‘NHS spirit’ to ask for sick leave when I had an ulnar nerve palsy from a skiing accident and didn’t have the use of my hand. Note that I was required to assist in theatre despite this.

6. I was told I needed to finish my shift before I took a 4 hour train journey home when my grandma was palliated. I was also told it didn't count as 'compassionate leave' because she wasn't a first degree relative

7. I was sexually harassed by two orthopaedic consultants at an English trust who were already under investigation for sexual misconduct.

8. My shit car blew up on the M25 - about 300km away from where we were living. The consultant on call didn't care and told me to charter a plane if thats what it took to get to work.

9. As a student @NHSTayside I had an ID Consultant verbally abuse me in front of the entire MDT. I spent the next 2 weeks of placement up till 3 in the morning crying and having panic attacks thinking about the end of placement test he was in charge of. It still influences me now

10. I had diagnosed pneumonia and called in sick @BlackpoolHosp. I was told I wasn't allowed to take my leave and if I tried I would be called in for a meeting with management to discuss my sickness.

11. My (doctor) husband and I were commuting 1.5 hours in separate directions because it wasn’t taken into consideration that we were married.

12. I had to call my dad at a petrol station because despite me working 80 hour weeks - I didn’t have enough money to fill up my petrol tank.

13. @ESHTNHS reduced the SHOs from 2 to 1 (with no other doctors overnight) to clerk acute admissions for ENT and Urology, while also managing admitted patients for those specialties plus Orthopedic inpatients. Managing more than one acutely unwell patient became dangerous....

13.1 ....and the trust ignored me when I raised safety concerns. I started looking at jobs in Australia around this time. I remember it extremely well. I was seething at management.

14. I got told to shave my facial stubble or I should leave the orthopaedic theatre. I chose the latter, and came to Adelaide the following week

15. @NHSGrampian - As FY1 on call I was paged multiple times to fix a ward printer. No IT services available at weekends. It was deemed a medical task as discharge letters couldn't be printed.

16. @NHSGrampian - One F1 on shift, No SHO. Regs busy elsewhere. 60 bed Ortho dept with multiple sick patients, 1xWeekly Ortho-Geris and incredibly useless consultants….

16.1 …. Anaesthetics run the trauma meeting for some inexplicable reason which usually involves degrading the FY1 about patients they had little to do with

17. @BlackpoolHosp - Every woman who rotated through Orthopaedics was told by one of the consultants that Ortho isn't a career for women and you need to do GP for the work life balance when you have kids

18. @NHS_NCLICB on Day 2 as an F1 in Orthopaedics I was asked to do a ward round on 30 patients on my own

19. @NHS_NCLICB 1 month into F1 there's a cardiac arrest post hip replacement. It was chaos as the only doctor for 10 mins. I was shaken up and cried. Rang my Reg for support. Got told "crack on". Zero empathy. Went home and cried. I still remember the patients name to this day

20. @SHSCFT I remember being shouted at down the phone by a Surgical Reg for "wasting her time" when I called worried about a patient who had passed 1 litre of blood from their stoma and looked awful. They subsequently needed massive transfusion and went to ICU

21. @SHSCFT A surgical consultant who was my "supervisor", but who had never actually met me, wrote my end of rotation evaluation by filling in every mandatory field box with a full stop before writing "average" underneath.

22. @SalfordCO_NHS the ED Consultant went off at me about preparedness as I misread an obs chart about a fever and said my opinion couldn't be trusted because I had "lied" to them about vitals when I said "I don't think they have a fever but i'd need to double check"

23. @SalfordCO_NHS the ED Consultant lied and said my patient had a respiratory arrest because i'd prescribed an opiate without talking to him in a patient with recurrent calculi, opiate tolerance, and obviously needed it for pain. All just to traumatise me to do things their way

24. @SalfordCO_NHS the Spinal Reg was abusive down the phone because I made a referral when they had unilaterally decided that it was only a consultant or registrar that could disturb them.

25. @SalfordCO_NHS when I had closed all my cases in ED and was going to leave on time I was expected to take another case despite already working 7 days in a row and being hours late every day

26. @BlackpoolHosp despite being on the ward round every day for 4 months, and working my arse off, my supervising Breast Endocrine consultant asked "who are you" on my last day when I asked for my end of rotation evaluation. I was a nothing to them.

27. "To be honest the reason I stayed in Australia is that on my 1st day my consultant said thankyou for my hard work. It really resonated that nobody said thankyou to me in the NHS. After all the hours I stayed late, completed audits, and developed pro formas....nothing"

So there you have it. Direct and Indirect bullying, Sexism, Attempted Assault, Sexual Harrassment, Uncaring approaches to homelife, Uncaring approach to staff sickness. Every JD here had their story. FPR is only the start of what needs to be done to keep staff in the UK

Someone on #MedTwitter mentioned that ex-UK staff might return if #FullPayRestoration is achieved. If NHS toxic culture remains, we won't. If you ever wonder if you'll see our faces again i'd direct you to the words every Aussie knows.

"No way. Get fucked. Fuck off"

And in the interest of giving options to those in need. Come play in Adelaide if you're sick of the same shit. My main bullying complaint here is that @KitkatRom won't let me have a department dog

careers.pageuppeople.com/532/caw/en/job…

I've had quite a few DMs with experiences equally, if not more, horrendous for students and junior doctors in the NHS. If people want I can post a 'Part 2' of sorts with those DMs that give me explicit consent to do so. If you're interested feel free to DM me

And for those I haven't replied to yet please know its only because it's been night time here and I want to give my response the attention you deserve