Helen's Blog : A Malaysian Doctor (IMG) to UK Journey

  Why locum?  - more money - full-time locum allows flexibility (e.g. obtained ILR/ under spouse visa) - free from responsibility like being a permanent worker Any restriction?  If you are under sponsorship for your visa, it was written that you are allowed a maximum of 20 hours per week of work with another employer. However, this must be either in a job on the Shortage Occupation List or in the same occupation code as the job described in your certificate of sponsorship. * Due to the Covid pandemic, there is no restriction at the moment.  According to BMA, " As a junior doctor, you can carry out additional activity over and above the standard commitment set out in your work schedule up to a maximum average of 48 hours per week (or up to 56 hours per week if you have opted out of the WTR). However, you are required to ensure that any additional hours of work do not breach any of the safety and rest requirements set out in Schedule 3 of the junior doctor TCS." How can a locu

Contract 2016  Break You can take each break that lasts for 30 minutes.  1 break - After 5 hours 2 break - If you work for 9 hours or more 3 break - if you work the night shift Comparison of rest requirements From BMA (2022). Available on https://www.bma.org.uk/pay-and-contracts/working-hours/european-working-time-directive-ewtd/juniors-who-opt-out-of-the-european-working-time-directive Rota From BMA (2022).  Remarks 1. night shifts - defined as a shift which begins no earlier than 20:00 and no later than 23:59 and is at least 8 hours in duration - receive an enhancement of 37% on basic pay for the whole shift, up until 10:00 the next day. Similarly, any individual hours worked between 21:00 and 07:00 get the 37% enhancement - but just the hours worked in that time window, not the whole shift. 2. If you notice an employer trying to start night shifts slightly earlier, for example at 19:30, in order to avoid paying the enhanced rate for the whole shift, you do not have to agree to it.

 Spend a random weekend road trip to South West England, departing from London. Tips for travel Wear a good pair of shoes Good to wear windproof cloth - England could be very windy  Bring some coins with you - some car park ticket payments may need coins A light backpack - with some snack and a water bottle  1. Stone henge Wikipedia:  https://en.wikipedia.org/wiki/Stonehenge Price: free if you are outside of the gate, charges you can refer to  https://www.english-heritage.org.uk/visit/places/stonehenge/prices-and-opening-times/   2. Devon Cliff You can spend one night there.  https://www.haven.com/parks/devon/devon-cliffs Taken by me.  From Tripadvisors -  https://www.tripadvisor.co.uk/LocationPhotoDirectLink-g551673-d659413-i263857289-Devon_Cliffs_Holiday_Park_Haven-Exmouth_Devon_England.html 3. Tintagel Castle Parking fee: 2pounds per hour Entry fee: free if outside, if you want to walk in you need to purchase ticket  https://gosouthwestengland.co.uk/tintagel-castle/ Picture by me. P

This is my experience sharing. You should always refer to the official guideline.  I called the LHDN in order to get that information.  If you are a taxpayer in another country, at this moment, you do not need to pay tax in Malaysia (subject to changes according to government policy).  However, you should pay tax for the previous year that you are receiving income for.  Eg. you left Malaysia Jan 2022, you should pay tax for income in 2021 in 2022.  You can do eFiling at https://mytax.hasil.gov.my/ The LHDN official advised me that, I can still do eFiling every year after despite I have zero income in Malaysia for the following year, it act as a declaration and avoids accidentally I was been charged the tax. (???) Good advice then.  When you left your ex-employer, you should ask them to fill up CP21.   My previous hospital's financial unit doesn't know about it as never done once.  However, my friend's hospital financial unit knew about it.  Further information:  How to a

  Born in Johor, Malaysia.  1. Worked as House Officer in Sabah, Malaysia.  2. Worked as a contract medical officer in Johor, Malaysia. 3. Worked as a permanent medical officer in Sarawak, Malaysia.  4. Currently, in the transition into NHS after passing my PLAB.  Copy right: www.mapsofworld.com (2020). Taken from https://www.mapsofworld.com/malaysia/malaysia-location-map.html#google_vignette PLAB1 - 2019 PLAB2 - 2021 Currently, I am doing PLAB2 coaching, for a one-to-one session.  I found it is one of my interests.  At the moment, I spend some portion of my time on this.  Why did this idea start? I failed my first PLAB2 attempt because there are too many things I don't know about when coming through this pathway.  I think if I have a coach, I could have fewer hurdles.  I am sharing with you my failure,  to avoid anyone else having such a painful journey again.  If you are interested, you can drop me an email.  I can share with you a video recording of my PLAB2 journey as a repeate

Trust - feeling (it is subjective, but include some objective elements) work in different levels: yourself, your colleague, leader and organization Positive relationship -Make time to build the relationship -Talk to people - Show interest in your colleagues - Share about yourself Empathy - Able to understand and share the feeling of others + non-verbal communication - body posture, put phone always Show vulnerability -Ask for help - Be open about what you don't know - Listen

  Personally, I felt hard to get the first rent in the UK, especially if we are not physical presence here.  There are different apps that you use to find rent, eg Zoopla or spare room.  Be extra careful about scammers.  Tips : Don't do any transaction without any physical viewing of the house.  It is good to start renting hospital accommodation.  Besides that, you can always get a hostel/ temporary place first (e.g. Airbnb) before committing to a long term.  Tips : If you are using "spare room", you can go to their website (no the phone version) and use the commute distance as a filter.  My temple for room stratification :  Do I need a tenancy agreement?  People faced different conditions with their tenants. It is good to insist on a contract as you can avoid the conflict or disagreement that could arise later on.  There are free tenancy agreements provided, you can google and find it out easily.  e.g  https://www.lawdepot.co.uk/contracts/tenancy-agreement/ Tips : Read c

 This is a very common question.   What do I  need to do?  After around one month of full GMC registration, you will receive an email from GMC asking about a connection  (trust/ employer/workplace) for your revalidation.  It will be looking like this.  Tips : Don't be worry even if you are not yet having a job. You will be given one year time to submit your connection. If you still can't get a connection, you will be asked to give out your license. Don't be worry, you can get back your license again at any time after that with the submission of a few documents.        - including a good standing certificate from the current licensing body and GEN form from your consultant/ colleague that you working with (it can just take to 4days to restore it) If you have a doubt, you can refer to https://www.gmc-uk.org/registration-and-licensing/managing-your-registration/revalidation or you can call GMC. They are very helpful and understanding.  Step 1 : Login into your portal. https:/

This post aims to share my personal experience.  NHS email :  nhs.net     https://portal.nhs.net/Home After the induction, I was given my first NHS personal email account.  I enjoy the privilege.  Yet I met the first obstacle with the NHS email account when  I tried to send out my first email.  Everything went fine. I was able to receive and read the daily emails from the trust.  Why? Ans: It is because I haven't agreed with the user's policy. Step 1 : Go to the portal. You need to log in first . (at the right top corner).  I used to go straight to the " access email".  Step 2: Fill up the personal detail and security questions. Agree with the term and conditions.  Tips : You need to remember by hard your security questions and answer, as it will be used when you forget your NHS password or NHS mail is locked.  Then you will be asked to log out. They need to process it and it will take some time.  Maybe 1-2 days.  Here is the table of contents for other topics:  http

Reproduced from  Scottish Government Polypharmacy Model of Care Group Terminology   Polypharmacy = many medications (two or more) Appropriate polypharmacy - all drug prescribed for the purpose of achieving specific therapeutic objectives that have been agreed with the patient. eg polypharmacy is beneficial in secondary prevention of myocardial infarct (antiplatelets, statin, ACE inhibitor, beta blocker) Inappropriate polypharmacy - one or more drugs are prescribed that are no longer needed According to the Scottish Government Polypharmacy Model of Care Group, 5 stages which trigger: 1. Prescribing (and risk assessment) 2. Medication review 3. Dispensing and administration 4. Communication and patient engagement 5. Medication reconciliation (at care transitions) High-Risk Medication for Adverse Drug Reactions (ADRs) 7-Steps Medication Review 1. (Aim) What matters to patients? 2. (Need) Identify essential drug therapy 3. (Need) Does the patient take unnecessary drug therapy? 4. (Effe

Few keynotes:  - You are responsible for what you sign on. - You should keep yourself up to date . - You should get the patient's consent on treatment and make an informed decision .   -Wherever possible, you must avoid prescribing for yourself or anyone, you have a close personal relationship with.  You should reach an agreement with the patient on the proposed treatment, explaining: the likely benefits, risks and impact , including serious and common side effects what to do in the event of a side effect or recurrence of the condition how and when to take the medicine and how to adjust the dose if necessary how to use a medical device the likely duration of treatment any relevant arrangements for monitoring, follow-up and review, including further consultation, blood tests or other investigations, processes for adjusting the type or dose of medicine, and for issuing repeat prescriptions - Reporting adverse drug reactions or any reactions to products marked with a Black Triangle

 United Kingdom - is an island country located on the northwestern coast of mainland Europe - comprises the whole of the island of Great Britain (England, Wales, Scotland), the northern portion island of Ireland, and many smaller islands within the British Isles.  Taken from  https://en.wikipedia.org/wiki/Unionism_in_the_United_Kingdom As a practician, we should be aware of  Clinical guidelines published by: a National Institute for Health and Care Excellence (England):  https://www.nice.org.uk/guidance b Department for Health, Social Services and Public Safety (Northern Ireland):  https://www.health-ni.gov.uk/ c Healthcare Improvement Scotland (including the Scottish Medicines Consortium and Scottish Intercollegiate Guidelines Network) (Scotland):  https://www.sign.ac.uk/ d All-Wales Medicines Strategy Group (Wales): https://awmsg.nhs.wales/ e medical royal colleges and other authoritative sources of specialty specific clinical guidelines References:  1. Britannica (2022). United Kin

 SWOT  Analysis:  Taken from hwww.business-to-you.com/swot-analysis/ SWOT  Strengths - positive behaviour, eg teamwork, decision making Weakness - eg nervious, dependency, inflexible Oppurtunities - eg greater opportunity for hearing from other people who are in parallel role or same path to me. Threats - eg daily stress * Based on the strengths and weakness, I am going to improve my active skills and simultaneously beat my problems.  References UKEssays. November 2018. Self-Reflection and Self SWOT Analysis. [online]. Available from: https://www.ukessays.com/essays/education/self-analysis-and-self-awareness-education-essay.php?vref=1 [Accessed 11 March 2022].

Adults are those aged 18 years (16 years in Scotland) or over. An adult must consent to their own treatment At 16 years of age a young person is presumed in law to have the capacity to consent, so young people aged 16 or 17 years should consent to their own medical treatment. The Children Act 1989 sets out who has parental responsibility for a child. Mothers automatically have parental responsibility for their children. A father usually has parental responsibility if he is: • married to the child’s mother • listed on the birth certificate (after a certain date, depending on which part of the UK the child was born in) • has a court order confirming parental responsibility Where someone aged 16 or 17 years consents to vaccination, a parent cannot override that consent. Young people who understand fully what is involved in the proposed procedure (referred to as ‘Gillick competent) can also give consent, although ideally their parents will be involved. If a Gillick-competent child consent

  Bullying (def) = persistent, offensive, abusive, intimidating or insulting behavior, abuse of power or unfair penal sanctions which makes the recipient feel upset, threatened, humiliated or vulnerable, which determines their self-confidence and which may cause them to suffer stress Harassment (def)= conduct that is unwanted and offensive and affects the dignity of an individual or group of individuals. It can be intentional or not.  Term: # the perpetrator of the bullying, # victim, # bystander It can exhibit on different levels: Taken from HEE.  Flow chart.  Taken from HEE. My light bulb moment: - Be prepare -  Know the pathway for escalation within the local and to the higher level - Reflection in portfolio -KIV improve medical indemnity  Useful blog:  Omars blog :  http://omarsguidelines.blogspot.com/2020/01/bullying-and-stress-in-nhs.html GMC guideline:  https://www.gmc-uk.org/ethical-guidance/learning-materials/raising-and-acting-on-concerns-flowchart HEE - Support for trainee