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Working as a Non-trainee registrar


After working a big chunk of my career in the Middle East. I was very used to working in an environment where I could take independent decisions on my own and worked in a very supportive department. Not all departments in the Middle East are like that.

 I started working in my first trust. I decided to move from the trust, although it had a fantastic HR. In a few months’ time, I decided I wanted to leave the place and move on to my current trust. It was a big decision for me as I am not the type of person who changes jobs very often. I was very anxious when I took the decision. Luckily, the decision turned out to be correct,

In my new trust, I realized, how amazing NHS is. I agree nothing is perfect, there will always be a few things that would be overwhelming and disappointing however my experience has generally been very good.

I am in a very supportive department, they understood I am new so it will take me time to understand the system. I remained cautious, with my decisions until I was very confident. Now I have reached the point where I am mostly independent with my decisions, but I do run it by the consultants if I think if a decision is not straightforward.

 

My advice to people is regardless of specialty.

 

1. I fully endorse Omar Alam suggestion on stepping down for a while and then stepping up when you are confident. If this is something you can do then please go ahead.

 

2. If you can’t, for whichever reason, then that’s fine as well, but you need to know where you stand in terms of knowledge and how confident you are in taking decisions such as Ceiling of care, DNACPR, when to make a referral, who to make a referral. The working knowledge about how the NHS works, This comes with time.

 

3. Shadowing is very important, be it from other registrars or other colleagues you quickly can learn things by observing. I learned a lot from FY1s about how to use Electronic Medical Records.

 

4. Knowledge base is rarely different, it's just how you execute the same knowledge might differ here. If you are fairly confident in your decisions and have evidence to back it up preferably from a UK-based guideline everyone will support you. As a new registrar, it might be fine to ask questions every now and then but there should be progression in your level of independence as time progresses.

 

5. Consultants vary, some consultants can be downright mean to you if you suggest them something if they are stuck. Others would be very happy that you are contributing to patient care. Be careful when to volunteer suggestions. I attended a clinic with a consultant where I had reviewed the patients before as it was my first clinic with this consultant. After our initial interaction he was so happy he allowed me to see patients independently. He told me as long as you do things that an average UK doctor will do at your level then you will always be safe.

 

6. Be safe, if you are in a situation where you are not comfortable, it’s always good to reach out and discuss. Be honest about your knowledge base, if you don’t know the answer. Get in consultant help if needed. Sometimes discussing things gives you a different perspective.  

 

7. Be Kind & humble to people, be it patients relatives, juniors, nursing, HCA. People around you will support you if you are nice to people

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