Crazylemon's Journal

Where are you and where are you going?
G_Dog
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Location: East Anglia, UK

Re: Crazylemon's Journal

Post by G_Dog » Mon Nov 28, 2016 3:27 pm

Hmm I don't envy you with that career decision. I suppose the most variety at the end point, comes from working in an urban hospital with a high turnover of patients as opposed to the more rural family centred units where you see the same people with similar problems. Then again there is a lot of talk at the moment about shortages in thing like A&E and you could end up overworked.

Changing speciality I can imagine would be quite difficult. It would probably boil down to; what you were changing from, what you're changing to, and how difficult the knowledge crossover. Then factoring in things like internal politics, how popular the programme is. I'm inclined to agree with the build a position where cash isn't an issue and go from there.

I'd speak to you're supervisor, and see which options leave you the most flexibility to change without boring you in the meantime.

Crazylemon
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Re: Crazylemon's Journal

Post by Crazylemon » Tue Dec 06, 2016 4:46 pm

@G_Dog the thing is A&E is in itself a specialty. Yes you see more different conditions than supreme professor of X who sees nothing but X and things other doctors think might be X but the environment remains the same and the general case load and your role remains the same: Is this person sick? How do I initially treat them? Do they need admission? Who do I refer to?

GP again has variety of conditions but is still the same job day after day. As is any job...Could always try and pick somewhere remote and become a Modern Dr Finlay although not sure the partner would be happy, and the job is rather different these days.

Well I spoke to my supervisor beyond 'you spend a long time in your final job' didn't really end up with career decisions. That statement also being debatable with respect to ERE for a given value of 'long'. In short practical advise or signposting not forthcoming. But then I guess I have to accept that asking the system for advise on how to work for the system on yours rather than its terms is not always going to be easy.

We will see how the applications pan out. I can always say no at the offer stage without penalty.

Back to work in the hospital tomorrow. Apparently it is a more stressful place than before. The general mood around the NHS from doctors is starting to get rather ominous. I know rather a few to many senior doctors jumping ship 10 years before workforce planning would have had them go, not helping with shortages. Add in the younger ones heading off the the antipodes... Working in a system under increasing stress is going to be 'interesting'. I am not sure there is political will to solve it sadly...

Crazylemon
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Re: Crazylemon's Journal

Post by Crazylemon » Mon Jan 09, 2017 6:00 am

1 month in to my most recent job it is certainly more exciting than my previous one, and at times rather more stressful. By and large I find it fun.

My latest dilemma is now with work. I have come to the conclusion It is probably best to at least start GP training next year assuming I get a job I like in a place I like. By the end of the scheme I would be pretty much or actually FIRE assuming no major hiccups anyway. So in that respect I guess it doesn't matter what route as I can always do 'not medicine' at the point and be fine in all likelihood. Or dead end medicine from a career perspective. I think I need to get hold of a copy of 'disciplined minds' and read it as seeing how it has been recommended I think it will probably apply to me.

Recently on discussion with friends I stated my 'probably won't be working for the NHS much longer if things don't improve' position and got in essence a guilt trip back of leaving makes it even worse and perpetuates the understaffed,miserable, leave cycle. Which I understand but also don't want to sacrifice myself for. Although there is still some lingering sense of duty that makes me feel bad about leaving colleagues proverbially out to dry. The 'you are replaceable' doesn't hold true once you already see the shortages in real time. Needless to say the Red Cross is right with respect to 'humanitarian crisis' felt like it where I work at least...

Savings have carried on well but I now need to actually reduce my cash position, getting to the point where any more interest I will pay tax on which isn't desirable at all. So making sure I am tax efficient for next year where I will enter higher rate really is the next priority on this. Likely going to need to read up on SIPPs, much as I am loathe to lock some cash up until 50 when I am already accruing a pension and state pension the potential tax savings are too large to ignore at the higher rate of tax.

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Chris
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Re: Crazylemon's Journal

Post by Chris » Thu Jan 12, 2017 10:04 pm

Crazylemon wrote:Likely going to need to read up on SIPPs, much as I am loathe to lock some cash up until 50 when I am already accruing a pension and state pension the potential tax savings are too large to ignore at the higher rate of tax.
As an American, I don't know anything about tax-advantaged accounts in the UK. But reading up just now on SIPPs, it looks like they aren't as well-tuned for early access as accounts we have over here. But as you wrote, they're still might be worthwhile due to tax savings.

What is your drawdown plan? If your pension + SIPP can meet your income needs in your later years, then your FI cash to only last you until you reach 55. Sorry if you already mentioned this in your journal and I missed it.

Crazylemon
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Re: Crazylemon's Journal

Post by Crazylemon » Sun Jan 15, 2017 10:57 am

@Chris I was planing on some point to go through my rational on the various tax advantaged accounts available in the UK and how I (currently) am thinking on using them so now seems as good a time as any! Don't worry I hadn't clearly mentioned it!

Pensions:

Currently I have an NHS pension I pay in 7% of pre tax earnings (rising as I earn more). In return I get 1/54 of my earrings for the year at State pension age (SPA) (currently 67 for me) uprated with CPI + 1.5% each year while I still work for the NHS and up to 5 years after working for them. Past that I get only CPI protection. Once claiming payouts rise at CPI + 1.5% currently. Claiming earlier results in actuarially calculated reductions and loss of CPI protection if too early. This is unfunded but 'backed by the government'. This is too good a deal to give it up assuming it doesn't get overly messed around with and even if it does well it has to be REALLY messed with to become a bad deal. Also functions as a part insurance as if unable to work due to sickness you can claim what you would be able to get at 67 straight away assuming you meet the criteria.

SIPP - This is something I have mentioned considering opening next year. Because it is tax deferred in the same way 401ks are (ish). But, there are rather a few restrictions. Maximum tax free value is £1million and that is ALL pensions (including the above). Max pay in a year is £40k over all pensions too. Both limits are academic from an ERE point of view for me. Can't access until 10 years before SPA. At that point, up to 25% can be taken out tax free in one go. The rest can then be then widrawn using draw down/purchase an annuity. There are some restrictions on what you can do with this but because of the defined benefit scheme I have above currently that wouldn't be too much of an issue for me.

Stocks and Shares ISA: Essentially tax free (income and CGT) savings post tax. Current limit of £15k/yr rising to 20k next tax year. This is my currently only place I have S&S as I have yet to save enough in a given year to hit that limit while putting other cash into more advantageous areas. This is in my opinion the most useful single accounts for ERE as it has instant access without penalty while being totally tax shielded.

Help to Buy ISA: 25% boost to savings provided it is for buying your first house. comes out of the total ISA allowance when funding. Several restrictions on how much can be saved /month and in total (£200 and £12k respectively)

Lifetime ISA: Set to replace HtBISA in theory. Same 25% boost but 4k in a year limit and can only be accessed for first time house buying or, at 55. Some convoluted ways to get early access without penalty if odd situations.


So my current system has been to save into a S&S ISA and....Cash...lots of cash...far too much cash. Well other than the potential optionality of wanting to buy a house in maybe 5 years time meaning putting too much into the market would have been sub optimal. However, thanks to accounts juggling I have been able to keep savings getting 3-5% which with 1k of tax free interest outside of ISAs allowed hasn't been (I hope) too bad a decision long term. But I have now built up enough of a 'housing deposit' that the rest is now going straight into the S&S ISA. Because I will only but a property joint with my partner and currently I have far more savings than them so they will need to 'catch up' on the housing deposit side. Plus I don't want to buy anything too expensive as that would be counter productive!

The issue is next year. I will probably earn just over £43k and so be on the higher rate 40% band. This is what makes opening a SIPP to suck up the extra that is over £43k and not covered by my NHS pension contributions. Because it is just too much 'free money' to give up. Especially given at the other end it is going to be taxed at 0% or at most 20% (unless I over save and am drawing more than a total 43k income in retirement NOT including ISAs which I just can't see). The fact it is locked until 57ish does limit how much as a proportion I can put in there but for now, I can't think there is going to be enough OVER 43k minus NHS contributions for me to need to think it further for at least a few years (at which point I will probably reduce hours to keep the same total income anyway).

So yes I have to make sure I don't save tooo much into a SIPP that it gets lean at some point in my 50s. The exact maximum ratio I have yet to calculate because I am so far away from approaching it. I take the view of my NHS pensions and state pension being insurance that I can't count on so would want a 3-4% SWR from SIPP+ISA+other accounts.

In general the UK seems pretty well set up for ERE in that I don't have to worry about long tail health risks and we have a very flexible tax efficient counts with a rather generous contribution limit (ISA). Further to that income from capital is much more lightly taxed than employment income. No NI contributions and £5k tax free for dividends and a lower rate than standard income thereafter, ontop of whatever is in ISAs! Plus up £8k from lodgers. I find this slightly odd but I am not going to say no given most of it is very advantageous to me!


That turned out longer than expected.

In other news met up with a rather large bunch of my Medical student friends yesterday. Slightly scary to see how unhealthy some of them look and how unhappy pretty much everyone is with their work with no idea what to do...I am the only person who has applied for further training starting next year out of 10 of us, not going to be good for the NHS workforce. I perversely seem to be one of the ones (seemingly) coping best while also being the one that will probably get to the exit first. They don't know this, obviously. I am not sure how or if I can help them though.

Crazylemon
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Re: Crazylemon's Journal

Post by Crazylemon » Wed Feb 15, 2017 8:30 am

Work

As I have previously mentioned work and what to do about it has been something that has troubled me for a while. Having had a few particularly bad weeks on the job (staff sickness and various other things) had lifted the back burner thought of 'Should I leave now/soon and do something else'. Add in the NHS woes which anyone who reads the UK press will have an idea of (note: if anything they show a rosey view, in particular with respect to workforce)

Apparently this is a big deal when mentioned in passing to the Program lead. Queue meeting with them. Which was nice, although the system is clearly not designed for 'able bodied person without kids who is very good at the job wanting to do less/non of it' (surprise surprise). So not much career advice in the actual meeting. Slightly unnerving when you know the person in the room is doing a mental state exam on you while trying not to be too obvious about it. Because of course not wanting to work under poor conditions flags as alarm bells for mental health issues...Which I am pretty sure I don't have (I mean I could lack insight but given I don't have any flags I am pretty sure I am ok). I think in some respects it would have been easier for the lead to have had me sit in the room crying about how I can't cope :P I have finally ordered Disciplined minds (library doesn't stock alas) hopefully it will have arrived and been read before stage 2...

In short there seems to be a rather laborious route to getting any actual advice about alternative careers. Fair enough they don't want to train people to have us run off into the sunset too easily. The system is designed for 'struggling' trainees and so all the forms are 'risk to self/staff/patients' which don't apply or asking about health/financial/conduct issues. None of which apply...But I have elected to give it a go to see what happens.

Cycling

Sadly less now that I work within walking distance which has been a shame. Our city has free rudimentary bike check occasionally and I happened passed on my way back so I thought I would give it a go. They identified the small issues I was aware of but hadn't got round to fixing but also found the rear wheel needs truing. Having looked online there do not seem to be any particularly good ways to do this without a stand and given I will very much be moving in 6 months or so I don't want to have to buy more stuff so I may need to get it done for me (ugh) if I can't find a solution promptly.

Saving

Still at 70%, 80% inc pension. I have thrown more of the money into the market and out of cash finally!
Probably 5 years of work to get to a FIRE point. Assuming I stay Doctoring....
At some point I might try and graph things, now that I have more than a year of data I think it might be useful to visually see progress.

George the original one
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Re: Crazylemon's Journal

Post by George the original one » Wed Feb 15, 2017 11:33 am

> Because of course not wanting to work under poor conditions flags as alarm bells for mental health issues

Bloody hell, that is a broken system!

Crazylemon
Posts: 153
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Re: Crazylemon's Journal

Post by Crazylemon » Wed Feb 15, 2017 6:33 pm

@George Yes it is.

There are good reasons for concern. It is coming up to the year anniversary of a foundation doctor's suicide which made it into the news in a big way.

Doctors sadly are rather high risk because they know how and have access to life ending treatment while working in high stakes high stress environments.
Also if a doctor is unwell rather a lot more people are at risk than with a member of the general public.
Fortunately it is a topic that now is being talked about more and there are steps being taken to address it.

Crazylemon
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Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Sun Mar 05, 2017 4:07 am

Work

So as of August I will be unemployed. Currently.
They have given me a training job but given I would like to be within an hours distance from my partner if I am gonna lock down for 3 years so I am going to have to politely decline their offer and they can have another unfilled post. This could change between now and the 9th but I think it unlikely. This is my own 'fault' for 1) being fussy and 2) probably on one level not really wanting the job and it showing in my level of preparation for interviews.

Following the meeting with the program lead I now have a 'case manager' who has so far emailed me but nothing else. I am not sure how useful they will be...but given we have now got to the point where 50% of doctors at my grade stop working for the NHS for at least a year they should have a pretty good idea :P

So I now have to decide what to do with myself for at least the next year before training schemes open up again!

I have thought about working abroad and when the NZ jobs open in April/May I will be looking with great interest, as an element of slow travel and to also see a different healthcare service. I have also found a few 'service provision' jobs that are advertised that I am cautiously asking about given I think that they are in specialties a generalist should have knowledge of but the training programs disagree. Needless to say my partner isn't particularly enthusiastic about me looking for jobs on the other side of the planet, but it would only be fore a year!

This is also I guess an opportunity to try some sort of proto-retirement. One luxury ERE has given me is even though I have only been working for a year I have more than enough saved that I could do nothing income producing for a year, although obviously the would make a non insignificant dent in the FIRE time. For that I am very thankful. Although actually doing that and just being a tourist for a year really doesn't appeal and I don't want to end up 'defaulting' to it.

Other things I have thought about is becoming a SCUBA instructor, at least for the second half of summer. Club knows a few centres which normally take a few of us as guides. The pay would probably only cover costs + a bit but, I would in essence be being paid by living in a beautiful part of the world diving.

Having now read Disciplined minds I realise how lucky I am I could actually go up to my program lead saying 'I don't like this and want to leave' and get help rather than just being ignored/risking being sacked. Although it probably has a little bit to do with the powers that be slowly realising that there are rather a lot of shortages and that trainees have realised this and are getting fussy as a result. Pretty much everyone I know has only applied to their first choice job/region. Don't get it, don't take a job, and end up where I am now. Always next year. Whereas in the good (bad) old days competition would mean people would be thankful of their job in the middle of nowhere. No longer. That post...stays empty. There is still a lot that rings true from the book, especially for me that work is in itself political. It explains what I have rather disliked about my job so well. Plus the whole profession = work until the work is done.

I need to get out of the salaryman 'arghh I don't have a job this is a disaster' mindset which I am still in to an extent despite all I have just written. Any advice on that would be great, or what to do in my 'year off'. All suggestions welcome! Probably essential to stop me defaulting to something meaningless/allowing fear to take over.

Savings

Another month at 70%
I Hit that 50k point! This is for most here are pretty small amount but it feels rather big for me, even if it does mean I am still a rather long way of being FIRE. Next point of interest is 100k which is going to take a whole lot longer especially if I do have a year of sub optimal earnings.

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Fri Apr 21, 2017 10:35 am

Work

Well it took a grand total of 1st job application to get a job. So I know what I am doing from August now, which is another specialty I have no experience in post graduation (Paediatrics). I realised there was a shortage of doctors but I don't think I quite appreciated the shortage until I had to call a consultant who was going to be interviewing me with respect to 2nd Job application that I wouldn't be coming to interview having already had a (more suitable) offer. Most awkward conversation I think I have had to date. Definitely off the Christmas card list. People don't like it when the only applicant pulls out It turns out...

So I now have very little fear of ever being reluctantly unemployed. At least for the next 10 years by which point the increased med school intake might start to ease the shortage. Although, obviously I would have 10 years experience on them so even then hardly a precarious position.

This is making me feel better about the whole year out and letting my try a few more specialties. I will also get to live with my partner which is why I made the choices in the end. Slow travel can wait. For now I want to spend time with my partner.

Started working in the emergency department and honestly the best job I have had so far 90% of each shift seems to be spent in flow. Solving problems and puzzles where that is being sure someone is safe to go home or trying to get someone's heart restarted. Both happen within the same hour not infrequently.

I met with my allocated mentor who seems far more amenable to my concerns and seemed to hint if I was staying in the region that dropping to part time might be a possibility. As I am moving back to London the will not sadly be on the cards for now. But who knows, maybe soon. The Royal College of emergency medicine is piloting 'no reason' part timing for trainees. So there is yet hope that more Colleges will realise this is a good way to keep retention up. But I really an't currently see myself doing anything else other than medicine while enjoying ED as much as I am. I do think General Practice which is similar without the really sick people is probably where I will end up for at least a while, maybe after several more 6 month jobs in various specialties to try them.

Cycling

Les than I would like, ED rota doesn't help that...

Net worth

£53k. This seems less meaningful when I feel at least currently I don't want to hit a 'number' and pull a the trigger on work. But I am young and this will all surely change again

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Mon Aug 14, 2017 10:31 am

Many changes. Left my old A&E job. Moved back to London and in with my partner.

So far living with a partner has been a rather steep learning curve. I am used to making decisions completely unilaterally rather than with discussion and compromise. By and large it seems to be going well, we agreed to split 50/50 groceries/bills/rent/general household items rather than end up with a joint account (there is, of course, a spreadsheet). He clearly has more desires to nest than me though, which is fine but I have refused to contribute to decoration that I would not consider buying myself (hello map of the British empire at its zenith...) I suspect when it comes to doing the monthly accounts I will end up with increased spending due to this and the slightly higher rent. But well worth the trade off to be with partner and also to escape from some particularly 'interesting' former flatmates (I did mange to get one of them evicted a few months before I myself moved on, thank god).

I am pushing the other way and he has certainly had more pulses based meals than he ever had before we moved in!

He also seems to be happy, other than the odd me not registering he wants more attention when I have come back form a 12 1/2 hour shift and he has been on his own over much of the weekend. I will work on this. I just need to make sure no screens are around.

Work

2 weeks in I am loving my new job. I help keep newborn babies/kids alive/healthy. Hard to argue with those goals. The intensity (so far) is also far less than any of my old jobs. I got to have MULTIPLE TEA BREAKS over weekend on call shifts. None of my previous jobs have had this, just many mental calculations of working out whether drinking or peeing was more important because of only having time for one. So big pluses there. There are very nice perks too. Despite only being at the last few minutes of any given birth to set up resuscitation equipment and hope to god you don't have to use it on the newborn (you almost never do) for some reason I get to hand the kid to mum/dad rather than anyone else in them room. This seems unfair given the midwife might have been with someone for hours...but I guess in totally normal deliveries I am not around. The reduced exposure to 'problems as a doctor I can't fix' also helps with mood.

Which leads to the dilemma of what to do next. I have a job for 6 months. Then once again I am 'unemployed'. There is a job in a very niche specialty that I might want to try for experience for which the deadline is a week away. But, it would mean moving to the other side of the country for it. If you had asked me 2 months ago I would have obviously said to apply. But now...I wonder whether I should. I would again be long distance. I would probably be paying even more in travel + rent than I am now. My partner understands why I would want to do it but obviously would rather it was nearby (this is not possible). The job comes around every year. I could do it later but if I join a training scheme (which I think now I probably will at least apply) getting permission to leave and come back might be tricky. Or, I could possibly try and do it post full qualification. What I don't want to do is apply now, ham up an interview because my heart isn't in it or turn an offered job down as they will remember and that world is small (the specialists in the country amount to less than a A4 page of names, even with their addresses on it). The clock is however ticking.

Any training scheme wouldn't start till next August though so I would have 6 months to fill with other work/something else. What the good alternative is I don't know. I took my current job to learn which it is certainly helping me to do! It also pays 6k better which is nice.

This is the first time I have had to deal with having so many options since applying to university. It is wonderful and terrifying. If anyone has any suggestions...

Cycling

I once again have a bike commute, yay free exercise.

Net worth

£60k

wolf
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Location: Germany

Re: Crazylemon's Journal

Post by wolf » Sat Aug 19, 2017 8:45 am

Crazylemon wrote:
Mon Aug 14, 2017 10:31 am
Which leads to the dilemma of what to do next. I have a job for 6 months. Then once again I am 'unemployed'. There is a job in a very niche specialty that I might want to try for experience for which the deadline is a week away. But, it would mean moving to the other side of the country for it. If you had asked me 2 months ago I would have obviously said to apply. But now...I wonder whether I should. I would again be long distance. I would probably be paying even more in travel + rent than I am now. My partner understands why I would want to do it but obviously would rather it was nearby (this is not possible). The job comes around every year. I could do it later but if I join a training scheme (which I think now I probably will at least apply) getting permission to leave and come back might be tricky. Or, I could possibly try and do it post full qualification. What I don't want to do is apply now, ham up an interview because my heart isn't in it or turn an offered job down as they will remember and that world is small (the specialists in the country amount to less than a A4 page of names, even with their addresses on it). The clock is however ticking.
Hi Crazylemon. Nice nickname, btw. :-)
What does your head say? What is logical, rational, ...
What does your heart tell you? Is there a passion, ...
Of course you have considered aspects, but have you already thought about the "big picture", e.g. 5 years from now or from a higher perspective?

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Fri Sep 01, 2017 1:32 pm

@MDFIRE sorry for the delayed reply.

In the end I chose to withdraw my application.
Several reasons but mainly that I am very much enjoying being where I am now. I also suspect I don't have that much passion for the specialism. It would be a continuation of my current 'try a bit of everything' but the cost of needing to move location for now is too high for me.

I think I have realised I enjoy practicing medicine, but, I don't have any one niche area I could see myself doing forever. Certainly none that I have so far experienced. Much that most colleagues seem to think I should become some sort of hospital specialist.

Having spoken to the General Practice Trainees I work with and form my prior experience I think this is the way to go. I like the work and it gets me out of unsociable hours the fastest way possble. Given when registering with a GP recently when they discovered I was a Doctor they pretty much started offering me a locum position until I pointed out I wasn't quite qualified for that gives an idea of how short the UK is of doctors. This is sad and makes the job far less pleasant with a feeling of not being able to provide the service you would like due to not having the numbers. On the other hand it means quite possibly being able to dictate most terms (if not pay because of a Nationalised system) so that flexible working/part time/sabbaticals mean I could keeping working while having vastly more time off appeals. This is what I intend to offer my current employer once my 6 months is up. Happy to work for the department but won't want to do it full time. If they can't do that goodbye and I will work half the same shifts as the locum covering the empty slots (+other departments) and perversely end up with more control and higher pay. The NHS and its inflexibility to try and maintain control of most Drs doesn't work so well once there are shortages...Again I was offered an immediate extension by my supervisor after doing only a handful of shifts.

Looking on the longer horizon somewhat feels odd because within 5 and certainly by 10 there is no way that I will need to be working and so I think I would just jump ship if I totally hated it.

Maybe that isn't a particularly high perspective...

wolf
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Re: Crazylemon's Journal

Post by wolf » Sat Sep 02, 2017 12:05 am

Crazylemon wrote:
Fri Sep 01, 2017 1:32 pm
In the end I chose to withdraw my application.
Several reasons but mainly that I am very much enjoying being where I am now. I also suspect I don't have that much passion for the specialism. It would be a continuation of my current 'try a bit of everything' but the cost of needing to move location for now is too high for me.

I think I have realised I enjoy practicing medicine, but, I don't have any one niche area I could see myself doing forever. Certainly none that I have so far experienced. Much that most colleagues seem to think I should become some sort of hospital specialist.
Good to read an update in your journal from you. :-)
I think you are ok with you decision. It is always good to consider the trade-offs and necessary changes of decisioins. Besides the pros and cons I think one should also look for the future. As you say, maybe within the next 10 years you can decide freely without worrying about the money aspects. What is also important in my opinion is, that you don't suffer at your current work place. I mean, that you don't become unhappy or ill, because of stress, colleagues, etc.

What kind of medicine do you practice? Maybe there are other career paths available for you where you work right now, e.g. becoming a hospital specialist but in a sort that you like.
Take care.

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Sat Sep 02, 2017 2:27 am

I am happy with my decisions :D

Currently I am working in paediatrics. I enjoy it but the rota is too antisocial to want to do for any length of time. I had a particularly bad on call over the bank holiday weekend that really took it out of me. That sort of thing is why I feel it isn't for me. Colleagues are great, no issues there (although I sometimes feel with paediatricians are they being too nice and not telling me about blind spots I am not aware of? not easy to tell...)

I took the job in the first case to get experience that would be useful in GP. It gives more more flexibility in jobs once in a training scheme. Which is good.

I don't want to be a hospital specialist! I like general practice/family med. Everyone else just seems to think that would be a 'waste'!

Crazylemon
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Re: Crazylemon's Journal

Post by Crazylemon » Thu Sep 21, 2017 11:53 am

Currently on night shifts.

As a result any resemblance to health diet has evaporated as has all exercise beyond my commute in to work.
This always seems to happen. I will get to a point where I am just starting to ingrain healthy default options and then BAM an awful bit of rota comes along to trip me up.

When on my own I tried to get round this by having pre cooked frozen healthy meals I could just take out the freezer and go with. Naively living with my partner I thought I might be able to lean on them to cook healthily and maintain the flat while I am doing 12 1/2 hour night shifts, assuming I leave on time... Didn't quite work out that way. I get he had a bad Monday at work too but, the rest of the week has been poor planning (I can cook myself expensive burgers and pizzas even in my sleep deprived state. This is just as much my fault so mea culpa. I don't really know the best way to solve this other than trying more planning. Might need to have a chat about this with him so we can synchronise on it or I will just have to do what I did before. It is difficult for him to and I imagine not seeing me other than saying goodbye just as he gets in from work doesn't feel great.

During the shifts isn't much better. Unhealthy food is everywhere and very tempting when you are just trying to eat *something* between trying to fix sick kids. The last few shifts have been particularly bad as well (apparently, I haven't had any of these 'good' night shifts on this job people talk about, there always seems to be an emergency where I am spending hours with one very sick kid).

I am not really sure the best way to fix this.
Maybe when not sleep deprived on my week off I can think up a more robust system, because until I finish training I have to deal with the necessary evil of night shifts. Maybe it just isn't possible and I should be thankful I at least function relatively well when actually working overnight and am practicing safe medicine for my patients. Maybe it isn't possible for me to eat right, exercise and do night shifts at the same time and this is just an attempted to increase the rate of extraction. But I feel I still need to try.

wolf
Posts: 601
Joined: Fri Jan 06, 2017 5:09 pm
Location: Germany

Re: Crazylemon's Journal

Post by wolf » Sat Sep 23, 2017 12:56 am

Crazylemon wrote:
Thu Sep 21, 2017 11:53 am
I am not really sure the best way to fix this.
Hi Crazylemon. Good to read an update from you. I'm sorry that it doesn't work out as you planned it would be.
Regarding food. I can say you what works for me. Maybe you can use it or give it a try.
I have experienced, that a healthy diet depends on some good portion of self-discipline.
Well, self-discipline is usually low when you have a low energy level, e.g. after nights shifts.
What I do is, that I buy ONLY healthy food in the supermarket. So, there is no unhealthy food at home and I don't have a temptation to eat unhealthy food, because it is not there.
Another thing I usually do, is pre-cook food, when I feel energized or have free-time. Then I can eat it immediately after work and I don't have a temptation to buy/cook unhealthy fast food.
Another thing is routine. I try to eat by a strict routine. Nothing in the morning. Lunch btw 11-13, Dinner before 18. I have to admit that this is only possible because I have regular working hours. I don't know it in your case.
Also, I feel motivated to eat healthy food, because I know about the mid-term/long-term implications, e.g. health diseases...

Well, I hope I could get you some inspiration. Take Care! Both of you!

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Sun Oct 29, 2017 8:38 am

@MDFIRE

Thanks, sorry for the very delayed reply. I already do as you mention normally. Pre cook food and I never buy 'junk' to have in. I was just hoping I could replace my own work with that of my partner and it backfired :P My coming set of shifts the freezer is already prepared for.

On shift I just try and avoid the food around me as much as possible. As of yet willpower from known long term it isn't a good idea is somewhat lacking at 3am.

Work

I am really enjoying my work and finding it satisfying which is nice. Feeling slightly sad to be planning leaving in February to 'something else' But I have pretty much deliberately locked myself in to doing so.
One thing I can say for paediatrics is that it has a much higher ration of 'nice people'. All of my immediate colleagues I like working with and are generally good fun.
Everyone works generally towards a common purpose and the only gripes are with senior management multiple levels removed who come up with some 'interesting' ideas that magically never end up happening. As a junior grade I get the luxury of only being vaguely aware of their existence.


Exercise

Bike commuting continues and judging by the difficulty in finding spaces in the bike rack indicates that at least the hospital staff get the benefit of active travel. Also awesome about paeds is most of the juniors and about half the middle grades also cycle in!

I have join a gym which while being hardly frugal is for the express reason of starting back with strength training. I have never been good at doing this and only really did it at the end of university for a few months. Work and a move to a place there the hospital gym was just treadmills with no gyms nearby meant 2 years of not doing this. Vaguely following starting strength for now and a month in I feel much the better for doing it. Even if I dislike being there for 6am so I can get it done before cycling to work I always feel better after the workout. It makes cycling in somewhat more challenging after.
Seeing the amount I am able to lift going it is much more satisfying for me at this point than my NW!


Networth

Rising nicely but I don't I will find it exciting until it hits 100k now

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Tue Dec 05, 2017 5:32 am

Life is good at the moment. Much easier to meet up with all my friends in London. Even it id does end up being at insane times of day due to shift work. At least other Doctors get this!

Is this intentionality beginging to pay off?

Work

This weekend was very busy and short staffed but fortunately I just entered 'flow' and it was all ok. All non urgent paperwork was not done which did sort of suck to hand over but hey, boring non-life saving stuff just had to wait (lets face it, saving lives the more fun bit of my work). I have volunteered as tribute to do an extra night tonight due to yet more short staffing. In any of my other previous jobs where I have had night shifts I don't think I would ever have even considered doing this other than for a stupid per hour rate, showing how much I respect and feel part of a team as opposed to a transitory service provider, even though this is my first job that is technically pure service provision...
I will get time back for it so all good AND I get to avoid more paperwork and a boring presentation, noticing a theme here? ;)

Had some especially grateful parent this weekend which was just lovely to here.

Same with the ward sister saying I did a brilliant intro and explanation for the parents of a new admission to special care :D

I have a horrible feeling I actually enjoy playing the 'hero' despite being an INTJ

Plan is to stay in the same hospital in a slightly different part of the same specialty that has no nights and fewer weekend and....LESS PAPERWORK :D


Much as I like paeds though I don't think I would be able to do it as a full time career job. Too many nights for too long. Even longer if I did go part time and in all likelihood I would be well past FIRE before I became even vaguely close to finishing training and even then isn't one of the specialties where many of the seniors spend time on the golf course so to speak...

I have also due to cunning/blind luck after new years day got most of January not doing work but a combination of study leave and annual leave.

Wondering if I should prep for and take the DCH exam as well as for my training entry exam. Pricey piece of paper though. Might be able to get work to pay for it if lucky, or at least part.

Exercise

Starting Strength is going well. Past lifting my bodyweight for deadlift and squat. I won't give numbers because I am a hobbit. But for me this feels an achievement and I am now past where I left off 2 1/2 years ago. Appearance hasn't changed much but this is secondary. It felt so nice yesterday when despite missing earlier training due to working the weekend I was still able to add weight to all the lifts I was doing that day.

Cycling carries on. I need to get some new tires soon and overhaul the bike. Gonna probably have to wait till next week.

NW

Due to Both my phone and computer breaking not a great month of saving at only 40% first since starting work this low :(
Yes I bought almost the shiniest toy in the apple store but now I have a phone that can run apps that are super useful for work in particular Neomate and the cBNF. Saves me so much time and worth it for that (amusingly the apps themselves are free). Anyone with any other particularly inspired medical apps let me know!

Crazylemon
Posts: 153
Joined: Sat May 30, 2015 2:29 am

Re: Crazylemon's Journal

Post by Crazylemon » Wed Feb 07, 2018 1:03 pm

Sometimes you just get blindsided. Brother has just had a scan that shows something potentially very nasty. The universe clearly has a sense of humour in choosing one of the non-medics in the family to be affected. The waiting game begins with another scan and the first specialist appointment all being sorted within a week. I am glad I had already taken the next 2 weeks off, well; I know what I am doing with them now. I am resisting the urge to research things at this point. It won’t help, until at the very least we know what we are dealing with. Being there is going to be more important especially as the most geographically close family member.

Parents are in the fortunate position of having been able to retire early so are able to drop everything, times like this highlight how important that sort of option can be.


Work

I scored highly enough on the entrance to further training paper that I immediately get a place, just as well given I don’t really feel like interviews right now. Left my old job and the new one starts in 2 weeks. Hopefully I enjoy it as much as my last job, I think I will. My more adventurous plans that might have seen my leaving for 3 months to be a dive instructor abroad are now firmly canned for now.

I was going to write about the recent UK court case that is currently causing a lot of concern among colleagues but that is going to have to wait for a while now I think.


Exercise

Went on holiday with parents so did nothing for a week. First session back was bloody difficult picking off where I left it. Slightly scary how quickly you begin to decondition. Need to keep at it!

NW

It goes up

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