Hi, we are Tanzina and Ayesha, NHS doctors and IMGs from Bangladesh. Today we will share with you our personal experience regarding UK clinical attachments. A lot has been explained already in the previous blog on clinical attachments in the NHS, please have a read - how to get a UK clinical attachment. Also, it may be worth reading the GMC guidance on clinical attachments.
How do I find a clinical attachment?
• Search online for any program of clinical attachments. The list of the hospitals which run clinical attachment programmes is provided below.
• Ask your colleagues, friends or family members who work in the NHS if they could introduce you to a consultant who will agree to supervise you.
• Email a Consultant directly by searching hospital websites or calling them through switchboards of the hospital.
Click here to watch a 1-hour interactive and engaging learning session to understand how to secure your clinical attachment with the NHS. Career development and learning professional from the British Medical Association will guide you through the whole process of finding and applying for your clinical attachment.
How to get the contact of a consultant
You will need to access the Trust website and search for the Consultant directory via the attached link. Let's take for example the University Hospitals Birmingham https://archive.uhb.nhs.uk/consultant-directory.htm. When you have found the name of the consultant in the speciality you are interested in, you will need to contact the appropriate department and enquire about the availability in the department. Once you have secured the consultant’s agreement then email it to the Medical Honorary Contracts for paperwork. Email address - MedicalHonoraryContracts@uhb.nhs.uk
Also, here are the switchboard numbers of some NHS hospitals:
0121 371 2000 - Queen Elizabeth Hospital
0121 424 2000 - Good Hope Hospital
0121 424 2000 - Heartlands Hospital
0121 424 2000 - Solihull Hospital
Some trusts run formal clinical attachment programmes:
Salford Royal NHS Foundation Trust - clinicalattachment@srft.nhs.uk
Pennine Acute Hospitals NHS Trust -
How to make the most of a clinical attachment
• You may want to contact a rota coordinator to make a rota for you (including long day shift/ night shift) and discuss this with your consultant.
• Use your time as much as you can to learn the system.
• Try to do clerking yourself after observing a few.
• Learn how to put an investigation request or a discharge request from a junior doctor.
• Attend every weekly departmental meeting to learn the system.
• If possible, do an audit jointly with any other junior doctor. This will boost your portfolio.
• If you have time, read patient notes before the round starts.
• Learn how to deal with difficult patients and how to break bad news.
Monitoring and evaluation
• Try to keep a logbook with you.
• Write down everything you do/observe.
• After every week send an email to your consultant for feedback.
• Try to contact HR if there are any vacancies for junior doctors.
• Keep your CV UpToDate.
• If there are any vacancies then apply for the job. Moreover, you can mail to your supervisor consultant for the job, if the consultant is happy with your performance they might create a post (JSD/SHO/FY2) for you in that particular trust.
• During your clinical attachment always try to be proactive, smile and be friendly.
• Do not touch patients and do not do any procedures if you do not have GMC registration.
• During clinical attachment tell your colleagues that you are interested in observing procedures/writing a discharge letter/requesting an investigation/talking to a patient regarding results.
• Do not miss morning rounds with the consultant. Try to read patient notes before the round.
Is a clinical attachment mandatory?
A general answer would be no, but it may depend on the individual.
''I used to work for 3 years in psychiatry in the NHS as an occupational therapy assistant while I was doing my PLAB exams. So I was confident and I knew the system, so I did not really need an attachment. However my registration was taking too long and to utilise that time effectively, I did my attachment for 4 weeks and that was the right decision.'' - Ayesha.
Your daily life as attachee
The timing of your attachment depends on a mutual agreement between you and your consultant. Usually, it is 9-5 on weekdays. You will be provided with a Trust identity card which you must display at all times whilst on Trust premises and return when you finish your attachment. You may also have access to the library and knowledge services during your placement. Usually, your supervising consultant will ensure that you receive appropriate induction to the Trust.
Important note! Before you first observe the examination or treatment of a patient or attend a patient yourself, one of the doctors supervising you or a member of the nursing or midwifery staff will normally explain your status and the reason for your presence to the patient and seek his/her consent. A patient may decline to participate without prejudice to his/her treatment. You must not question, examine or undertake a procedure on a patient unless his/her prior informed consent has been obtained. It remains necessary for you to introduce yourself to a patient and identify yourself as a clinical attachee.
Ayesha's experience
''I used public transport and used to start at 8:45 or 9:00 am sometimes. My main team included one GP trainee, one foundation doctor, one consultant, and to maintain our schedule 1 medical secretary/admin. However, as we worked as a multi-disciplinary team (MDT), we also had an occupational therapist, psychologist, healthcare assistant (HCA), nurses and more admin staff. In the morning we had a 1-hour MDT meeting, where nurses would hand over to us what happened over the night with the list of more vulnerable patients. After that, we used to do ward rounds for 2-3 hours where the consultant would tell us how to manage patients and what the crisis plan was for those patients. Usually, by the time we finished, it would be already 1 pm and time for lunch. So by 2 pm we divided our work between us and tried to do it alongside all ongoing problems if they emerge.
I am a person who always likes to work in an organised way so that I can manage my time accordingly but there was no timetable during my attachment. For example, I would have 2 patients' notes needed to write (under supervision), and then the nurse comes and tells me that a patient is not taking medications or is at high risk. Of course, I would need to leave whatever I was doing and see a patient. After a patient is settled and I am back in the room 30 minutes are gone. No worries, you will get used to it and this type of excitement will keep you busy before you get free time and you won't get bored.
Things I did during my 9-5 shifts: taking history, one to one conversations, medicine counselling, getting blood forms ready, writing referral letters, taking notes during ward round, asking questions, filling out patients notes proforma, gathering collateral information, performing mental health assessment, writing discharge summaries, checking vitals of the patients. During my 4 week placement, I learned a lot and it was a good experience.
Take away tips from Ayesha
Carry a small notebook, with multi colouring pen to jot down only important points.
If you use public transport please manage your timings, arrive to work in advance, make a cup of tea and get ready as sometimes ward rounds get busy.
Pack your lunch box or breakfast bar in advance
Give your best, focus, always ask questions if uncertain.
DO NOT do anything unless you have permission to do it.
Breaks is a must. If you are feeling tired or exhausted - inform your seniors and take a short break (walk in front of the main building, breath fresh air). I am stressing the importance of having regular breaks because we rarely take proper breaks (checking your phone or replying to emails do not count as a break).
Always show your enthusiasm and interest to learn because after attachment you may get a job interview offer in the same trust. It definitely happened to me after my attachment.
I think that’s all today, hope you enjoyed reading, I tried to keep it short but interesting.
If you have any questions feel free to ask on the TrewLink website, we are happy to help. Please also share our website with your IMG friends & colleagues.''
Good luck,
Tanzina & Ayesha & Julia
Written by Tanzina & Ayesha
Edited by Julia