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New to doc2doc? Introduce yourself here...

Posted in General at Fri, 27 Mar 2015 16:53:49

Sabreena

Posts: 1204
Joined: 07 Sep 2009
Hello

If you're new to doc2doc - welcome! We're delighted you've decided to join BMJ's community - we hope it will be a useful resource for you.

Please introduce yourself below - tell us which country you're from, what stage in your medical career you are, and what you would like to learn from being part of doc2doc. We have a very friendly and supportive community - I am sure they will give you a warm welcome and will be on hand to offer clinical insight, support and advice.

By the way, I'm Matt (mbillingsley) and along with Sabreena & luisad help to run doc2doc. We moderate the forum, and think about the types of discussions the community may be interested in discussing and also how we can help to in your careers. If you have any questions please do email us: community.doc2doc@bmjgroup.

And don't forget we have a New member of the month competition! where we offer a 3 month online subscription to any BMJ Journal for new members who post 20 times or more within their first month of joining!

We look forward to meeting you!



*Please note, this new thread is the new version of our previous thread: Introductions for new members

Should patients have the right to record consultations?

Posted in News & media at Wed, 25 Mar 2015 19:03:01

somany

Posts: 1
Joined: 25 Mar 2015

Hello everyone 

I'm replacing Matthew Billingsley as moderator (I've introduced myself in the new members' bit of doc2doc). So, here's my first discussion thread...!

An observation in the BMJ focuses on a discussion thread on a consumer forum about a patient whose doctor would not allow her to record her consultation. http://www.bmj.com/content/348/bmj.g2078

Patients were supportive of the patient's point of view, saying it was a form of note taking and she did not need to ask her doctor's consent. Doctors were, unsurprisingly, more cautious, saying that it could lead to defensive medicine. 

What do you think? Is recording a consultation a right? Or does it harm the doctor-patient relationship?

Mysterious severe right upper quadrant abdominal pain........please help

Posted in General clinical at Sat, 28 Mar 2015 13:15:40

Maxim

Posts: 363
Joined: 14 Dec 2010
I know of a 29 yo caucasian female of otherwise good health who developed acute,severe onset of right upper abdominal pain always localized to right under ribs as if gall bladder and occasional severe pain in back , most of the time nausea, vomiting occasionally.This individual has had this persistant pain for over two months now. Since her first visit to emergency dept. she has had an ultrasound,endoscopy, CAT scan, Hida Scan, MRI, blood work up with no indication that gallbladder,pancreas, stomach,intestine,kidney,liver is functioning abnormally. Finally a surgeon, is refering her to a gastro enterologist with much hesitation. He really was going to just abandon the whole problem and suggested to just manage the pain...that was his solution. To just have her continue on taking morphine....not even wanting to pursue the challenge of finding a solution.
She continues to suffer every minute of every day....
Does anyone out there know of a solution??
She desperately needs medical attention

Unfading Shadow of Ebola

Posted in Public health at Fri, 27 Mar 2015 14:54:39

Mukhtar Ali

Posts: 917
Joined: 14 Nov 2010

At least 3,700 children in Guinea, Liberia and Sierra Leone who have lost one or both parents to Ebola this year face being shunned, the UN children's organisation has said.

http://www.bbc.com/news/world-africa-29424919

Breast is best - but are we doing enough to support it?

Posted in General clinical at Sat, 28 Mar 2015 10:41:27

Mikey W

Posts: 194
Joined: 15 Nov 2009
Apologies to the doc2doc community but I've been rather quiet on the forums recently thanks to a new arrival to our family. This article (http://www.bbc.co.uk/news/health-28851441, http://www.theguardian.com/commentisfree/2014/aug/23/breastfeeding-may-be-natural-but-not-easy ) which was in the news thus week is therefore very close to my heart at present.
 
It has been known for some time and is well publicised that "breast is best" for babies. The health benefits to mother and baby are extensive and for baby seem to extend through into adult life. However, breast feeding is not easy and does not appeal to all mothers, hence campaigns over recent years to incentivise mothers to breast feed. 
 
After the birth of our daughter I've been through a very rocky time regarding feeding and I'm not ashamed to admit there have been tears and tantrums from both mother and daughter along the way. I've kept telling myself breast is best and thats therefore what I wanted to do, after all I preach it to so many parents at work, ideally should put my own teaching into practice. 
 
We spent 2 days in hospital after delivery where I'm disappointed to say that feeding support was rather limited, and we only got to see the "infant feeding advisor" at 48 hours as we wee being discharged home. Once back in ether community, our community midwife visited on day 3 & 5 for about 15 mins each visit, where she had a set checklist of tasks including checks on mine and baby's welfare & health. "How is breast feeding going?" "I'm not sure..." "Keep at it, you'll get the hang of things". 
 
By the end of the first week I was in pain and ready to give up. If things were going to continue I needed more support. I tried the midwife, but as a colleague was off sick she couldn't come back until day 12. I tried NCT (a volunteer charity organisation) but their support group was unfortunately shut for the school holidays, and so in desperation I paid for a private "lactation consultant" to come out and spend 2 hours with us at home, observing a feed and giving hands on support. 
 
Now, at 4 weeks post delivery, we are doing much better and the feeding and my mood are much improved.  After lots of hard work we've done it without the need for formula (although a small piece of research from the US showed that limited formula use can actually improve breast feeding rates in the longer term http://pediatrics.aappublications.org/content/early/2013/05/08/peds.2012-2809.abstract)
 
I seem to have rambled but coming back to the point - breast is best, and there is such pressure to breast feed but such limited support to facilitate that. With such a balance is it any wonder than women who intend to breast feed but are unable to have such high depression rates? 
 
But with limited resources in thee modern NHS how can we better support breast feeding in those crucial early days? Surely with such proven health benefits, women should not be having to fall back on charity and even paid private support to succeed with breast feeding. What is the way forward 

Should eating on the street be banned?

Posted in General clinical at Fri, 27 Mar 2015 14:35:24

DuaneF

Posts: 1500
Joined: 09 Dec 2011

In The Times today Susan Jebb, obesity adviser to the UK government, said, "When I was small, eating or drinking on the street was really bad form." She suggests we should view snacking in public in the same way as smoking indoors.

On Radio 4's Start the Week programme, presenter Tom Sutcliffe emphasised this new angle on the obesity epidemic during an interesting discussion about shame and guilt. Jennifer Jaquet, one of the guests on the show, reiterated how valuable 'shaming' has been in reducing the amount of smoking.

Could the same be true about public eating? Could social pressure about snacking on the street reduce obesity?

Health advisers advise sitting toddlers down at snack times rather than letting them run around with drink bottles and food in their hands. Should this advice be escalated to adults?

Is eating on the street fuelling the obesity epidemic?

Should EM doctors be entitled to more annual leave than GPs?

Posted in Careers at Wed, 25 Mar 2015 16:17:44

Chappie

Posts: 4
Joined: 25 Mar 2015

BMJ Careers report about he recent College of Emergency Medicine conference quotes college president, Clifford Mann, as saying, "If you give up lots of nights, evenings, and weekends—which is par for the course for working in any acute specialty, whether that is interventional radiology, acute paediatrics, or emergency medicine—what you want is not more money. You want to be able to repay the lost time with your family, your friends, or your fishing rod that you have given up.

"It is about equity, not about identical contracts, because the identical contract we currently have discriminates against anybody who chooses to work nights, evenings, and weekends.

“What we’re saying is you simply link the proportion of out-of-hours work you do to the amount of annual leave you are entitled to get.”

And vice president Kevin Reynard said, "It is clear that the issue isn’t about recruiting people into the specialty. The issue is about retaining them once they get there.

"In terms of doctors’ contracts, there’s recognition by NHS Employers, the Department of Health, and the BMA—all the parties involved with the contract negotiations—that something needs to be done to adequately reward people who spend high proportions of their time working during unsocial hours and also in very hard pressed specialties."

Should EM doctors and doctors in specialties which require work during unsociable hours be compensated with more annual leave? Should they have different contracts to GPs and other doctors who can opt to work more sociable hours?

Jolie Effect

Posted in News & media at Fri, 27 Mar 2015 15:03:50

Mukhtar Ali

Posts: 917
Joined: 14 Nov 2010

Referrals to breast cancer clinics more than doubled in the UK after Angelina Jolie announced she had had a double mastectomy to prevent breast cancer.

http://www.bbc.com/news/health-29251765

MRCP Part 1 Question of the Day from OnExamination - SLE

Posted in General clinical at Wed, 25 Mar 2015 16:07:05

Sabreena

Posts: 1204
Joined: 07 Sep 2009

A 25-year-old lady with SLE (anti-nuclear antibody positive [1:6400], anti-dsDNA antibody positive) presents with a few weeks' history of feeling generally unwell, tired, worsening malar rash, and has mild pedal oedema.

On examination, the BP is 190/100 mm Hg, and there are 3+ proteins, 3+ blood in her urine.

Should medical publications include summaries for patients?

Posted in General clinical at Wed, 25 Mar 2015 17:30:31

Chappie

Posts: 4
Joined: 25 Mar 2015

Should medical publications have a summary for ?!

 

We've been asked this question on Twitter.

Should boxing be banned following Braydon Smith's death?

Posted in News & media at Sat, 28 Mar 2015 22:38:28

Maxim

Posts: 363
Joined: 14 Dec 2010

Doctors in Australia are calling for a ban on boxing following the death of 23 year old Braydon Smith. Smith was competing against John Moralde in the WBC asian Boxing Council's continental featherweight competition on Saturday. He died on Monday.

Where do you stand on this?

Best organisations to use for a medical volunteering programme abroad?

Posted in Student BMJ at Wed, 25 Mar 2015 22:51:52

NCantley

Posts: 425
Joined: 23 Dec 2011

Hi all,

I am really keen to go abroad this summer and do some sort of volunteering work with an organisation in a medical setting, however I'm not sure on many reputable companies out there. If anyone has done something like this before or knows of a company please do let me know :)

 

Thank you

Jolie's informed decision to undergo prophylactic salpingo-oophorectomy

Posted in General clinical at Fri, 27 Mar 2015 23:04:51

Dr Linda

Posts: 203
Joined: 20 May 2010

Proof, if any were needed, of Angelina Jolie's leadership skills is evident in this public account of her decision to undergo prophylactic bilateral salpingo-oophorectomy. The case for informed patient choice is indisputable but while people may have pulled the stops out to inform and share decisions with Jolie, are "ordinary" patients routinely getting the information and support they need  to do this? 

Question of the week: How well do TV dramas portray mental illness?

Posted in Psychiatry at Fri, 27 Mar 2015 14:34:13

babyoccdoc

Posts: 4
Joined: 07 Oct 2014
For the past 6 weeks, I've been filming four short films for training in mental health awareness. This project was led by West London Mental Health Trust, with help from Imperial College NHS Trust and London Ambulance Service, and funding from Health Education North West London.  The project aims to improve training in mental health for staff working in the emergency care pathway: paramedics, ambulance technicians, 999 control, and emergency department multidisciplinary staff. Four films depict psychosis, chronic obstructive pulmonary disease with anxiety, self-harm, and delirium in a person with dementia. The films each tell a story, and all had input from people with the experiences depicted. The films will be evaluated in e-learning and face-to-face training. 
 
It got me thinking about what happens in writing and filming portrayals of mental illness where the purpose is entertainment, for TV or on soap operas. My main purpose was training; I suppose keeping people's interest during training is a sort of entertainment but I didn't feel the same sort of pressure to make a film that made viewers feel excitement/frightened/sad/happy, I don't think. There are clearly often unhelpful stereotypes and myths portrayed because they make better telly - for example people with mental illness are more often portrayed as victims or perpetrators of crime, as the organisation Time To Change found: http://www.time-to-change.org.uk/sites/default/files/Making_a_drama_out_of_a_crisis.pdf
 
In general I think Holby City is fab UK BBC drama but a terrible portrayal of what actually happens in a UK hospital. However I've been pleasantly surprised by the recent portrayal of stigma towards health professionals with mental illness (a young doctor, Zosia, has bipolar disorder).  
I understand that Alison Kerry, head of media for the charity Mind (http://www.mind.org.uk/) worked on the (again BBC) EastEnders storyline where Ian Beale suffered depression: //www.theguardian.com/healthcare-network/2015/jan/22/soaps-mental-health-cancer-hollyoaks-eastenders-coronation-street
 
I realise my soaps view is somewhat UK focussed! Any recommendations/critique of soaps or TV drama where mental illness or treatment for it has been portrayed?

MCQ: A 50 year old man with multi drug-resistant tuberculosis and worsening vision

Posted in Respiratory medicine at Sat, 28 Mar 2015 12:55:07

nmia

Posts: 2
Joined: 20 Apr 2011

The following is a question from the BMJ Learning module Tuberculosis: interactive case histories

In order to support World TB Day, we've made this module free until Wednesday 1st April:

 

A 50 year old man with multi drug-resistant tuberculosis comes to your surgery because he has developed problems with his eyesight. He says his vision has worsened in the last few weeks. You test his sight with a Snellen chart: his visual acuity is 6/12. He is taking several different medications. 

An end to the routine use of manual thrombectomy in STEMI?

Posted in Cardiology at Thu, 26 Mar 2015 10:53:19

Sabreena

Posts: 1204
Joined: 07 Sep 2009

Earlier this month the results of long awaited TOTAL trial were presented at the ACC meeting and simultaneously published in NEJM. TOTAL is the largest randomised trial to date which investigated the routine upfront manual thrombectomy with PCI alone in STEMI. 10,732 patients with STEMI undergoing primary PCI were randomised. The primary outcome was a composite of death from cardiovascular causes, recurrent myocardial infarction, cardiogenic shock, or NYHA class IV heart failure within 180 days. The key safety outcome was stroke within 30 days. Manual aspiration thrombectomy was associated with lower rates of incomplete ST-segment resolution and distal embolization, however, this did not alter the clinical outcome.

The primary outcome was 6.9% with thrombectomy and 7.0% with PCI alone (HR 0.99; 95% CI 0.85-1.15). More importantly, this finding was consistent across all pre-specified subgroups, including in patients with large thrombus burden. Although, incidence of safety outcome of stroke was statistically lower in PCI alone group, both at 30 days and 180 days, the trial was underpowered to detect this difference and this finding may be due to chance alone.

There are several caveats in this trial. First, it was an open design which may have introduced a selection bias. Second, the inclusion of some patients with a low thrombus burden that would be less responsive to thrombectomy and lastly authors did not study the effect of selective use of thrombectomy versus no thrombectomy.

It would appear that the when put together the findings of TASTE and TOTAL will now put an end to the routine use of manual thrombectomy. However, for the protagonists, due to the lower rates of incomplete ST-segment resolution and distal embolization seen with manual thrombectomy, this adjunctive technique still has a role particularly in patients with heavy thrombus burden.

From the archive: Against the Rum Ration.

Posted in BMJ at Sat, 28 Mar 2015 21:57:10

Odysseus

Posts: 4553
Joined: 24 Feb 2009

One of the regular "This Week" items is  "From the Archive" of previous BMJ  issues.  This week's issue (28/3/15) is from exactly one hundred years ago, when there was opposition to the daily  Rum Ration then issued to the Army as well as the Navy.   Apparently the Army was keen to retain the Rum Ration as it "improved shooting" and that in the Navy, those known to be "good shots" were all rum drinkers.

Which is absolutely true!  When I was a student, I was a member of the Medical School Rifle Club.  We took part in leagues against other clubs in and out of London, visiting their ranges or at ours,  These were sober affairs.  You don't mess about with guns..

But there was one exception, against St.Elsewhere's, I'll say no more, that had a secondary contest attached to it.  By tradition the teams had a pre-match drink together, and each tried to get the other to drink that tiny bit too much.     A little can be agood thing because alcohol reduces tremor, in either clinical tremor conditions or the minor tremor that we all have, and that good shots can suppress. http://www.ncbi.nlm.nih.gov/pubmed/1167633    Of course, the dose is critical as too much and performance drops off, and the tradition was that each team bought the other's drinks.

So, the Army, and no doubt the Navy were right - Rum DOES improve your shooting.  Bring Back the Barrel!

John

 

 

PALcohol? No Pal Of Mine!

Posted in General clinical at Thu, 26 Mar 2015 04:59:41

ahyperdoc

Posts: 12
Joined: 13 Nov 2014

I'm not sure about the rest of the world but here in the United States there is a new beverage--going to market in a few short weeks--powdered EtOH mix sold in a pouch which you just simply add H2O and you're good to go. Marketed under the brand-name PALcohol, the distributors of this "instant drunkenness" can't say enough about how innovative the concept is and that it's gonna be the best thing since sliced bread. Does anybody--besides the biased makers/sellers--think this is actually a step in the right direction? It's disturbing to me. I mean, how labor intensive is it to grab a normal wine; beer or spirit, pour than consume? Maybe it'll be a convenient way to stockpile alcoholic beverages in a paranoid, doomsday-prepper's underground shelter. The truth is that the alcohol industry is ALWAYS trying/searching to find more ways to sell their products; what better than making EtOH easier to consume and convenient like mixing Kool-Aid for the kiddies. Speaking of children, do you suppose this PALcohol might aid in the underage drinking phenomenon? One could say that this is the 21st century after all and chalk one up for innovators of such a convenient mind-altering (literally) and novel creation. On the other hand, one could say this is the 21st century with more children experimenting; more chronic alcoholics; and deaths--from accidents and chronic usage--than in the last 20 years. I think this so-named PALcohol should be relegated to the nearest trash receptacle and become extinct like the Doe-Doe bird before it...Gone AND forgotten! Comments? Opinions? Thank you for your time.

Salary for CT1

Posted in Careers at Sat, 28 Mar 2015 13:16:02

DrS

Posts: 1505
Joined: 25 Jan 2009

I recently received a job offer in London for two years as a core medicine trainee. I had a look at the rent prices and was horrified.

I have been told that the jobs I will be doing are the equivalent of 1B banded but I am having a great deal of difficulty understanding the point system on the BMA's pay for doctors website. I gathered my minimum pay in CT1 is 30,000 but do I then get another 40% on top of that as I used to as a FY2 if I have a 1B banded job?

Can anyone tell me how much I would earned after tax per month as a CT1?

GP Locum work locations

Posted in GP Locums at Fri, 27 Mar 2015 11:54:05

Kloud

Posts: 1
Joined: 27 Mar 2015

Hi,

 

Im currently doing market research on the ways GP locums find work, is this through Agencies, word of mouth, recommendations etc?

how is technology used is this process?

 

 

Thanks

 

Andy

Who should one sue?

Posted in Careers at Thu, 26 Mar 2015 12:21:45

sken

Posts: 906
Joined: 13 Oct 2009

The failure to take adequate steps over blood products when HIV and Hep C were emerging problems is pretty emotive stuff and is in the news again.  But there seem to be 2 groups who must share some responsibility - firstly the providers but secondly the prescriber. Patient groups often did their best to educate about the risks but doctors often seemed to have a simple-minded trust about risk - and often used blood products when they were not clearly indicated clinically. One of my first bits of HIV education came from a haemophiliac deling treatment for a minor joint effusion because of the HIV risk , whereas the doctor was trying to insist. 

It would be interesting medically and legally to know just how often these products were given unnecessarily - certainly that applied to blood transfusions to a major extent and I expect it is still much the same. Management had an interesting response too - surgeons often cross-matched blood (sometimes same blood for more than 1 patient) but often did not use it and were therefore wasteful , whereas physicians crossed matched lots and lots of blood and always seemed to pour it in and were therefore more efficient !

Self Confidence Psychology

Posted in General at Sat, 28 Mar 2015 05:11:48

JoeFulton

Posts: 1
Joined: 28 Mar 2015

Success comes from who you are. The significant problem with self confidence is that in one or other way we are programmed to pay attention to our faults instead of our expertise and qualities. With this thought processes, your intention to treat the faults can't affirm a solid self-confidence. It is best to focus with developing ones capacity and also abilities to understand your pure talent and also strengthen ones confidence in yourself. Everyone is unique in her or his way. There can be nobody nowadays that is precisely like other individual. People fail in their life endeavors given that they try to be like somebody else, do not make an effort to replicate someone else's career journey or fashion. You may weaken ones resolve and also hinder your individual progress by doing this.

Have confidence in yourself, you skill and ways to do the idea differently to other people and this will offer more than any other person. After you look within the mirror, you ought to see one who cannot become compared. There's uniqueness on this individuality, irreplaceable in its one particular uniqueness. You cannot begin to find success without having self-confidence. The luck and a circumstance is needed for someone to attain ones goals and that can easily manifest only in the event you believe in yourself.

How can be anybody about to confident in you when you not confident in yourself? You may glow like a beacon attracting all of the positive circumstances of success for those who have self-confidence. Here is the simple way the entire world works, as you project ones plans think of this as perspective and work on this facet of development.

Employ your time and energy in improving yourself by means of other people’s writing so that you shall come easily with what others get labored hard for.   After you spend period improving on your own, you turn out to be better person and produce your self-image; the most effective way to reach one's destination is to follow along with what others must impact as a result of their lifestyle experience.

The difficulties about our appearance; how we are perceived and also understood; may perhaps, to a great extent, impact self-confidence in ourselves. Our upbringing and also circumstances of your childhood and also education can make us produce negative thinking about you. Those people with a noticeable charisma haven't any such problems, and with the power of self-confidence can easily forge a definite path in direction of their goals and ambitions.

More typically than not necessarily, it is not just talent that will uplift these people. Many averagely gifted people range the heights of their chosen career fields, based on the self-confidence and also an easy drive to ensure success. We head to school, get qualifying measures and shell out our dues so that you can advance yourself in tasks, in rank and in lifestyle, but many of us forget the thing that can easily guarantee good results with almost all certainty: self-confidence.

What practical programs should implement a student organisation for preclinical years? Ideas

Posted in Careers at Fri, 27 Mar 2015 07:05:35

george0razvan

Posts: 2
Joined: 24 Mar 2015
Hi, i'm 2nd year! My medschool has a student society, and we do different activities, but we don't have a department to implement practical activities to help students in medical practice. Recently I was at a conference where, in some workshops, I learned how to do a urethral catheterization, how to put a catheter, some basic clinical techniques. I want to create such a department and want some ideas of such practices. If you can help me and guide what and how to do it, I'd be happy. Excuse my English.

if you want to talk more about this , and give me some help, i have a email : nokia3244@yahoo.com ( stupid email, don't ask)

 

What practical programs should implement a student organization for preclinical years? Ideas

Posted in Student BMJ at Fri, 27 Mar 2015 06:58:20

george0razvan

Posts: 2
Joined: 24 Mar 2015

Hi, i'm 2nd year! My medschool has a student society, and we do different activities, but we don't have a department to implement practical activities to help students in medical practice. Recently I was at a conference where, in some workshops, I learned how to do a urethral catheterization, how to put a catheter, some basic clinical techniques. I want to create such a department and want some ideas of such practices. If you can help me and guide what and how to do it, I'd be happy. Excuse my English.

if you want to talk more about this , and give me some help, i have a email : nokia3244@yahoo.com ( stupid email, don't ask)

Performers List problems

Posted in Careers at Sat, 28 Mar 2015 22:57:08

Maxim

Posts: 363
Joined: 14 Dec 2010

I returned end of January from 15 yrs in NZ as a fulltime GP ( UK trained MRCGP FRNZCGP - fully and annually revalidated in NZ ) and was told prior to my departure from NZ by East of England Area Team that I would only need to complete the requirements of the Performers List application ( which is a 29 page document), show them original documentation on arrival and could start work. (GMC registration was straightforward and sensible.)

I arrived and found that the team dealing with me had been re-deployed a week before and that I had to start the process all over again, CV, Police check and OH check including repeated bloods and an archaic Mantoux test which took them 3 weeks to organise. After that they said that I would be signed onto the Performers List and I could start work at the Practice that had recruited me from overseas and who were desperate for me to start. During this time  I had a 3 week induction training at the practice and did all my IG, safeguarding, ICE , Emis Web, QOF, DrFirst etc. training and sat in with all the clinical staff and admin staff and went out on visits with the outreach teams.

Once the OH bloods and Mantoux were done and I was signed off 'fit to practice with an EPP certificate' we heard nothing  from the Performers List team - so I got in contact and they then said it had to go to a Panel Meeting which was a week later - now I have been out of work for 10 weeks since leaving NZ .

At the Panel meeting on Thursday despite acknowledging that I was a well qualified and experienced GP working in an equivalent GP situation in NZ  they decided that  I have to do the new I+R scheme which doesn't start til 1st April  - this means unemployment til at least June when I can pay to do the MCQ as a first hurdle. This may be followed by simulated surgery assessment and then being placed under supervision for 3-6 months in a Practice not of my choosing anywhere in East of England and Midlands.

I am a single parent mum to 4 still financially dependent- on-me children. Two of my children are with me in the UK, two completing Uni education in NZ and were going to follow. I have a shipping container of goods about to arrive in the country in the next week or so and an offer in on a house based on my estimated earnings as a Partner in the Practice and close to the surgery . I am now unemployed and will soon be homeless as I am renting a holiday cottage.

On reviewing the situation I am not the only UK trained GP returning from Aus/NZ/Canada who is undergoing or has had to go through this blatant discrimination against UK GP's working overseas and this humiliating and resource wasting process.

The UK is short of 8000 GPs - so why are they making it worse by turning away/stonewalling experienced UK trained GPs who are motivated to return from Australia and New Zealand because they miss the good things about the UK and family and friends ? The Practice that recruited me are not only embarassed and disappointed but are overwhelmed themselves due to the recruitment crisis and have been  3 doctors down since last September and were eagerly awaiting my starting work with them. Week after week has been a rollercoaster of being told ' once you have done this ....you can start , followed by no... didn't we say ? you also have to do this .....'

I am saddened and disgusted.