We’re delighted to introduce a new course that many doctors have been asking us for: Presentation Skills for Doctors Online Course.
For doctors of all grades and levels of experience. Improve your presentation and lecturing skills to ensure you leave a lasting impression on your audience.
After decades without any coherent NHS workforce plan, some recent developments are encouraging for doctors in training. These new developments bring promise of a better future. First, the Medical Training (Prioritisation) Act improves the chances for young doctors from UK and Republic of Ireland in securing the training posts they desire. Then there’s the appointment of Prof. Dame Jane Dacre to lead the Medical Education and Training Review which promises to radically change the system. So, the future sounds bright? Does it?
There will be many doctors out there who are not getting excited. Unfortunately, they have faced numerous false dawns in recent years. These have included the new flexible approaches communicated by Dido Harding, who made a lot of sense in her early days as Chair of NHS Improvement before she moved onto other things. Then there was The Future Doctors Programme with the idea of Broad-Based Training. And who could forget the series of headline-grabbing “step-change” NHS funding announcements.
The sun was due to rise with new these initiatives but, each time, the new dawn was eclipsed by other events. The COVID pandemic, cost of living crises and energy shocks have taken their turns at getting in the way. Sometimes the new future didn’t appear due to changes in political direction. Other times, there’s been a simple lack of follow through. Words are easy – actions often less so.
Let’s hope those now in control learn from the past and that the future is indeed going to be bright.
Unfortunately, that bright future can seem a long way off from the dark clouds of career progression bottlenecks that are currently leaving countless doctors in limbo.
Much of the attention is focused on the early career training post bottleneck caused by the slow increase in spaces failing to keep pace with rapidly growing numbers of medical graduates. As a result, Foundation Years doctors have been dealing with ever increasing competition rates for securing a training post.
At the same time, the mid-career progression bottleneck facing doctors achieving their CCT or CESR via the Portfolio Pathway is getting less attention. But lack of attention doesn’t make it any less real. The numbers entering the GMC specialist register is increasing by around 3-5% each year and will continue to do so. But lack of workforce planning means there’s over-supply for some specialties and under-supply for others. While NHS patients are typically facing long waiting lists due to the high number of Consultant grade vacancies, NHS Trusts are trying to manage their funding-shortfall/financial-overspend through recruitment freezes. This results in 3 conflicting truths:
And what’s the current reality if you are an IMG? In addition to now being penalised for access to training posts, a government declaration to reduce reliance on IMG’s along with the general political discourse around immigration all adds up the UK sounding like an unwelcoming place than it was 2 years ago. Back then, IMG’s were filling important gaps in the medical workforce. But studying the GMC register and taking feedback from other sources, the flow of experienced doctors has suddenly dried up. It’s important to note that the Governments target is to reduce reliance on IMGs by 2035 – not immediately. There are still plenty of opportunities for good experienced doctors.
Combining the CCT/CESR progression bottleneck with the IMG slowdown limits the number of doctors who are able to supervise trainees. This in turn exacerbates the lack of spaces for higher training. It’s all linked. Urgent, radical change is definitely long overdue – but likely to take years to have any impact.
You may well be able to act as a part of a large collective to influence the system via the current dispute channels. In sharp contrast, you can’t shape the system as an individual – but you can shape yourself. In addition, you can’t wait for the world to change before you respond. To give yourself the best chance of success, it’s important to take the initiative and prepare yourself for the opportunities that will arise.
How can you become the best version of yourself? The answer to that lies in investing time and effort in own personal development. This includes fully participating, making good use of on-the-job opportunities and support available to you as part of your employment or current training programme. Lot’s of other doctors will be doing that too. So, if you also want to stay ahead of the competition, then it also includes seeking out additional opportunities for yourself.
As we say at Oxford Medical: Develop your abilities. Maximise your potential.
Stephen McGuire – Managing Director
There are definitely some difficult people in this world. They’re the people who are difficult on any given day for anyone who interacts with them. Then there are the “normal” people” who are difficult to deal with in specific circumstances. Doctors meet members of both camps on a regular basis. In fact, a recent study concluded that participants identified 1 in 6 patients as being “difficult”.
Think of those patients who present with endless lists of symptoms. Then there are some who can’t stop talking about stuff that’s unrelated to their reason for visiting you. Others are demanding or angry. Some think they know it all or just won’t listen to what you have to say. Some patients are unable to articulate what you need to hear from them. Then there are the patients who don’t want to share information with you! I’m sure you can add your own additional categories to this list.
Maybe the fact that there are so many difficult patients is unsurprising when we consider the situation from their perspective. Factors such as physical pain, nausea and anxiety can affect anyone’s behaviour. Sometimes, it helps to pause and take things to extremes. What happens when you unexpectedly catch your finger in a drawer? Stub your toe? Or bang your head on a shelf? Your ability to hold coherent conversation is typically displaced by a full-body muscle reaction, a sudden deep inhalation followed paralysis of breathing, all accompanied by loud yelp – and perhaps an unrestrained string of expletives!
Something similar happens with any shock to our system, whether that be physical or emotional. In addition, low key, persistent nagging symptoms are typically accompanied by low key, persistent, nagging reactions. All of this impact on behaviour. How many of your patients fall into that category?
It’s interesting to note that the patients who were identified by their doctor as being difficult were less satisfied with their visit. The outcomes fell short of their expectations.
Of course, doctors are not immune to factors impacting behaviour. Tiredness, hunger and excessive workload are pressures that are all too common. Difficulties with team dynamics can add to these stresses and strains. Then there may be external personal matters that come into play. It’s just too easy to say that such matters should stay external and not affect you in your work – but we are all human. So, we all have some days when we are better than others. And there are some days where we struggle.
It’s important to bear in mind though that the rate of 17% of patients identified as difficult is the average figure from the study mentioned. What constitutes “difficult” is a perception which varies from one doctor to another. True, some may have a relatively easier patient demographic than others. But there are also individual variations due to levels of experience, abilities and general outlook.
One conclusion from the study is that Resident Doctors were more likely to identify a patient as being difficult than their more senior colleagues. In addition, a higher percentage of patients perceived as “difficult” by a doctors is directly related to lower job satisfaction and risk of burnout.
Your average patients don’t go on courses to learn how to communicate with doctors. They may well have no idea how to go about interacting with you. When they visit you, they could be having an experience which is unknown territory for them or frustrated in some way. All the complicating factors already mentioned come into play. Yes, their behaviour plays a key role in whether or not you can achieve the ideal of you working together in concordance. But do they even know what that means? Do they know that’s what you want to achieve? (Assuming that actually is what you want to achieve).
Your training means you are far more likely to have technical knowledge of their condition, assessment methods and treatment option. But that doesn’t mean you know it all. Your patient may well have valuable insight into what has changed with their body, the impact this is having upon them and what they want. Your challenge is to meet them where they are and make progress together from there.
Thankfully, although you may not be able to choose your patients, you can choose how to develop and maintain your own communication abilities. Enhancing your clinical knowledge, gaining experience and improving your communication skills are all essential tactics in reducing the number of difficult patients. The results are improved outcomes and an increase in your job satisfaction.
What steps are you taking to reduce the number of difficult patients you see?
Stephen McGuire- Managing Director
We’re delighted to introduce a new way for you to unlock the development of your professional skills: The 3 year Unlimited Online Subscription.
Whatever stage you are at in your career, you’ll benefit from this comprehensive suite which includes ALL our instant-access online courses for you to complete as and when it suits you best. You can then revisit the materials to as often as you wish over the 3 year period. Your subscription spreads the cost over that period of time.
Mike, a friend of mine, recently posted on a work-team chat congratulating me on becoming 22,222 days old. A short time after this, a reminder of the same fact had popped up on my calendar. Celebrating this rare milestone caused a bit of laughter amongst my colleagues who are members of the chat group. “How did you know?” they asked. Well, earlier in the year, I’d discovered my 22,000 milestone by chance and mentioned this to Mike. But, when I remembered the reason why I stumbled across this information, it made me stop and think.
I’d been considering the issue of procrastination as I was planning to write a blog post on the topic. It’s something that’s often discussed flippantly, mixed with flavours of amusement, bemusement and self-deprecation. Yet the reality is often far more serious. It’s a common trigger for stress and under-performance with potential long-term implications.
These two sides of this problematic coin are summed up brilliantly in Tim Urban’s “Inside the mind of a master procrastinator,” – one of the most popular ever talks on TED. It was one aspect of this talk, the idea of considering time in different ways from the norm, that led me to discover that I was almost 22,000 days old at that point. I shared this fact with Mike who, unknown to me, had set a reminder for himself to celebrate my 22,222 day birthday.
You may well be ahead of me at this point. It’s ironic that I had never gotten around to writing that blog post, even though I’d planned to do so on several occasions. Yes, I’d spent more than 222 days procrastinating on writing about procrastination – and more time has passed since then.
It’s something that we all do from time to time. Depending on the task in question, the earliest phase of procrastination can be uncomfortable. Whether we are prioritising other tasks, distracting ourselves with things we enjoy or simply staring out the window, that nagging feeling of inactivity is ever present. Yet, the longer we allow this to persist, the situation typically becomes normal and the initial anxieties start to evaporate over time. But then the real high stress phase kicks in as the unwelcome deadline comes looming into view, casting a dark shadow over everything around you.
During our Practical Leadership & Management Course for Doctors we explore the solutions and how to break the pattern. The first steps include becoming aware of exactly what we’re putting off and why. It’s also useful to clarify the outcomes of both action and inaction. It’s then often easier to identify a realistic way forward that you can commit to.
Every year, we see a sudden and major rush of bookings for certain courses whenever the application window opens for training posts. Why? Because young doctors will boost their chances of being short-listed for interview if they’ve undertaken training in these topics. Spaces on the most popular dates disappear fast and, inevitably, some doctors miss out.
On the other hand, many of their colleagues, who are competitors in the recruitment process, have taken their courses early. The scoring criteria for these processes have been publicly available for some time. They’re not a surprise. So, when the application window opens, this proactive cohort can relax, happy that they have secured the important points well in advance. They also have the added bonus that they’ve given themselves time to put what they have learned into practice. So, they’ll be able to demonstrate more experience when the time comes for their interview. In short, they’ve given themselves the best chance of success.
It typically feels good when we manage to break the procrastination pattern and take action. You get a sense of progress which can build into momentum.
So, what are you procrastinating on? And what are you going to do about it now?
Stephen McGuire – Managing Director
UPDATED 29th MAY 2026
There’s no point in pretending things haven’t been hard in recent times. It’s often better to acknowledge when this is the case and to take whatever actions you can to manage the situation. In a recent post, we drew attention to the potential risks of the current Resident Doctor dispute on your career progression. The financial impacts and uncertainty of strike action may lead to you making different choices than you would in better circumstances. Yet, it’s important to maintain participation in the courses that will boost your chances of success in securing the training post of your choice.
We want to make it as easy as possible for you to access your training requirements, to book your courses at the point where this works best for you and to be able to do this with confidence.
We’ve long been aware of the changing financial situation for resident doctors. So, we always focus on value for money for our course packages. For example, for the vast majority of courses taking place in our Virtual Classrooms, we provide you with an additional related online course for you to work through at your own pace, enhancing your learning experience and providing you with more CPD points. We also offer a suite of packages which collate more than one course and save you money, such as our 2-day Medical Leadership & Management Course, our Online Career Development Collections.
We recognise that your course is a significant but worthwhile investment for you. So, we offer a range of flexible payment options making it more realistic for you to undertake your learning activities now and gain good experience at this important time of year.
We already have a very flexible Transfer & Cancellation Policy. Yet the potential for more days of strike action and regular winter pressures with knock-on impacts to study leave can fuel uncertainty. So, we’re making a simple additional promise.
If you are unable to attend a course for any work related reason before the end of June 2026, then we will transfer your booking to another date free of charge.
If you are genuinely unable to attend a course for any work related reason, then we will transfer your booking to another date, free of charge, as long as you contact us beforehand. We will do this even when something changes at short notice. This over-rides our normal Transfer & Cancellation Policy section of our Terms & Conditions until the end of April 2026. We will manage any changes related to illness in our normal manner, again, as long as you contact us ahead of your course.
Good communication, teamwork, teaching, leadership and management are essential tools in moving us forward from any problematic situation. So it makes sense to ensure that you are continuing to review and develop these skills. But what if you really can’t commit to attending a course on a specific date?
Our broad range of online courses offer you the chance to learn on your own, at your own pace, as and when you want. You can revisit the material as often as you like over the duration of your subscription. When you choose one of these options, you are unaffected by any uncertainties over availability for dates. Our Online Career Development Collections also mean that you can make considerable savings when purchasing multiple courses while broaden your learning experience.
So, book your course with confidence that we will work with you to find a solution to any challenges that may arise.
Stephen McGuire – Managing Director
The roots of the current Resident doctors dispute are well documented. They include demands for a fair salary, improvements to working conditions and resolution of the training post bottleneck problem. Some impacts of the dispute are more apparent than others. There’s been a thorough debate over the potential for strike action being detrimental to patient care and exacerbating waiting lists. The expectations for senior doctors working additional shifts to cover the gaps along with associated overtime costs for the NHS has also been given new media attention.
Resolving the underlying issues is clearly in everyone’s interest. But what are the impacts of the dispute on Resident Doctors themselves, both short-term and long-term?
There’s little coverage being given to the personal short-term financial implications of taking industrial action. Each day that a Resident Doctor withholds their labour and opts to strike, they take a direct hit on their next salary payment. Dependent on how many days they were originally down on the rota to work, a 5 day call off could easily equate to a shortfall in next month’s income of between 10-20%. Maybe even more.
As the old saying goes, there’s no gain without pain and any argument for continuing this course of action is that today’s losses are an investment in achieving a better future. Still, recurring short-term salary shortages, when already experiencing relative hardship, are adding to the financial pressures on Resident Doctors.
Any days missed from work for a training programme directly equate to a reduction in experience. One or two days may seem inconsequential. However, with an individual’s strike action now typically mounting up to between 10-15 days over a 6 month period, the impact risks becoming considerable. Absences of this level for any other reason would cause a doctor concern. Less time for direct patient contact; less time learning how things work and interacting with teams; and less time to implement what has been learned along the way.
The dispute has its roots in general dissatisfaction. There’s always a risk that such feelings can intensify when tackling issues head on. This is especially the case when met with a lack of progress or, even worse, when trying to address a problem spirals into conflict. Motivation and engagement with normal processes can easily become diminished in such circumstances.
At Oxford Medical, we’ve observed a pattern where Resident Doctors are less likely to participate in voluntary courses during periods of dispute. Back in July 2024, when the salary issues appeared to be resolved, there was a significant surge in the numbers taking courses. This feel-good bounce continued all the way through to June 2025 when there was a sudden dip in uptake, coinciding with the return of strike action. We observed the same pattern way back in 2016 during a previous dispute period.
This trend is unsurprising, given the impacts on finance and motivation. But there are long term risks here for Resident Doctors.
The doctors who give themselves the best chances of securing the training programme of their choice typically seek out opportunities. They undertake courses with the aim of gaining skills and experience – rather than to simply tick a box to gain points during the application process. So they take their courses early, giving themselves time to implement what they’ve learned and then use this to shine at interview. That’s true for clinical abilities and also for professional skills such as teaching, communication, leadership and management.
With numbers of Foundation Year Doctors higher than ever, and with training posts failing to increase at the same rate, competition rates are bound to be extremely high this year. The obvious financial, motivational and experiential impacts of the industrial dispute may also have real detrimental impact on the career progression of many Resident Doctors.
At Oxford Medical, we are holding our course prices unchanged again this year. We offer Virtual Classroom, in-person and instant access online options on a broad range of courses. We also have flexible payment options for UK based doctors to help manage finances.
We all hope for effective resolution of the dispute in the near future.
What steps are you taking to keep you career on track despite the current challenges?
Stephen McGuire – Managing Director
The BBC reports Health Minister Wes Streeting has stated that there are, “…too many layers of management, too many layers of bureaucracy… People want to see the front line prioritised, and that is exactly what we’re doing.” As a result, some 18,000 administration and managerial posts are to be cut across the NHS in England this year. This action comes with a hefty price tag to the healthcare system. It requires making significant redundancy payments to the people who are losing their jobs. The belief is that incurring this high cost in the short term will result in considerable savings over the coming years.
Whether you think this is a good idea or not, there are some things that everyone can agree upon. No-one wants to waste precious time or effort in battling through pointless red-tape, completing ambiguous and overcomplicated documents or responding to demands for information which is never acted upon. It’s frustrating to work in systems designed by people who lack insight. In addition, considering the financial challenges, we should definitely not be paying salaries to people who don’t make a worthwhile contribution.
But not everyone is in agreement that dismissing these thousands of NHS workers is the correct course of action. For example, in the same BBC report, the Royal College of Nursing shares their concerns. “Expert registered nurses working across NHS England and ICBs don’t just run vital public health programmes and oversee care programmes for the vulnerable – they connect the NHS and social care services with one another… To imply these are administrators shows a complete lack of understanding of their roles and how they contribute to patient care.”
So what do you think of managers? How will this change impact you in your everyday practice?
During our tutor-led courses, we frequently hear some doctors identifying “management” as being a problem. They may even cite management as being THE problem with the NHS.
Let’s pause and differentiate between management as a job title or job role versus management as a behaviour. Management as a behaviour is when we are getting things done through organising people, projects and resources. There are numerous skills which fall under this umbrella, including time-management, root-cause analysis, planning techniques and decision making.
We all manage things on a daily basis in numerous aspects of our lives. We all manage our personal time. For example, we ensure we get to where we need to be to meet friends, to do things with our families or organise days out. We make sure we get things done around the home, keeping it clean, tidy and well stocked with food. From time to time, we undertake a change projects to redecorate or rearrange the furniture.
Now it’s fair to say that some of us are better at this than others!
What about management behaviours in the workplace? Medical leadership is broadly perceived as a noble pursuit. But what about medical management? Medical management is often interpreted through the narrow focus on processes related to patient treatment plans. That’s essential, but there’s much more to consider. What about a doctors ability to make good decisions, manage their own time and delegate effectively? What about managing the processes for making sure things (or people) are getting to the right place in the right quantities at the right time? And what about quality improvement? These practical management skills are essential.
Going back to Wes Streeting’s action, the 18,000 employees who are being removed will leave some significant functional gaps which will need to be filled. Some of these gaps will be filled by the administrators and managers who remain. Others will fall to the healthcare professionals who work in the front line. That includes doctors who are already juggling numerous challenges. The demands for being well organised, able to prioritise and get things done only ever seem to increase.
There’s general consensus that poor management practices exacerbate the challenges which face the NHS and these problems must be addressed. But that has to be true whether it’s poor management by some faceless worker in a distant office or by a doctor who is part of a busy team.
In sharp contrast, good management behaviors across all levels and all roles is an essential element for achieving improvement.
What steps are you taking to improve your management capabilities?
Stephen McGuire – Managing Director
We’ve discussed the training post bottleneck in the pages before. The number of Foundation Years doctors has increased significantly in recent years. The NHS workforce plan intends to continue this growth trend, fed by the increased numbers of medical school students. Competition rates have also been growing year after year for spaces on medical specialty training programmes that these early years doctors want to further their careers. That’s because, for numerous reasons, the rate of increase in training post availability has failed to match the FY doctor cohort’s expansion rate.
In response, NHS England has recently announced that they have taken some steps to reduce competition rates. First of all, “Applicants . . . will now need to be fully registered with the General Medical Council (GMC) at point of application.” Secondly, they, “. . . will only be allowed to submit a maximum of five applications . . .” This second point has been introduced in response to the trend of individual doctors who submit applications to multiple programmes.
These changes should mean that each programme will see a reduction in the number of applicants they have to deal with. That will definitely make life easier and reduce the workload for those involved in the recruitment administration at this stage.
However, this doesn’t change the ratio of eligible doctors who want specialist training versus the overall number of posts available. Competition rates at that level are still increasing due to the shortfall in training post growth. In addition, if the recruiters for each programme decide to shortlist the same number of doctors for interview, then the competition rate once you get to that stage is unchanged from previous years.
The bottleneck effectively persists and is tighter than ever. It’s easy to see why this has become such a hot topic, particularly for these early years doctors.
Well, at time of writing, the application window for the current round of recruitment has just closed. If you are one of the many who are in the process, then it might feel like it’s time to sit back, relax and wait to find out if you are to be invited to interview. No doubt, that’s what many will do. But how could you use your time more effectively?
Are you going to tread water or are you going to use the coming weeks to make a difference to your ability to perform at interview? Will you practice putting the teaching skills you acquired from attending a course into action in order to have some real life examples to share? Could you develop your abilities as a mentor? Could you be learning how to reflect more effectively in order to be more capable of sharing your strengths and development needs? Could you be brushing up on your communication or leadership skills? These topics will inevitably be explored on the day of the assessment centre. Will you be able to share your recent approach to personal development?
What will the best interview candidates be doing in the interim?
Develop your abilities. Maximise your potential.
Stephen McGuire – Managing Director
Take a moment to put yourself in the shoes of an interviewer. Now imagine you are interviewing a large number of young doctors with just a few training posts that are available. How would you decide who should be prioritised for offers? How do you go about fairly ranking them from highest to lowest? Next, add the pressure of knowing that all the candidates have already shown good potential via the application shortlisting process. Finally, increase the complexity by realising that your assessments and recommendations need to be consistent with all of the other interviewers who are also interviewing doctors in the same process.
Thankfully, if you were an interviewer for any of the higher training programmes, such as IMT or CST, then the process has already been designed for you. The scoring criteria are already defined. What’s more, if you are one of the doctors preparing for the interview, then scoring criteria are freely available to you. So, both interviewers and interviewees can use this information to effectively prepare for the task in hand.
Communication is an important element for grading in any medical interview – more so now than ever.
This year’s IMT interview scoring format has increased the emphasis on communication with dedicated points now available in both Station 1, where you are asked questions, and Station 2, the Clinical Scenario.
Core Surgical Training CST1 interview scoring criteria explicitly lists points for communication in the management question section and clinical scenarios. You should also expect to respond to questions at the end of the Presentation section.
Although the exact interview scoring criteria vary from one programme to another, we can consider communication from 3 aspects which are relevant to all:
In the earliest stages of your preparation, this may seem like the most obvious of the 3 aspects. You want to be able to respond effectively to the interviewers questions. You want to be able clearly articulate your experiences and opinions, to demonstrate your skills and potential to the best of your abilities. Good interview preparation includes proactively reflecting on your on your key experiences, learning how to remain calm and also how to present your information in a coherent, logical order.
Improving performance on this level is a common motivation for doctors choosing to take our interview preparation courses.
You ability to directly communicate with your patients will be assessed in any medical interview process. However, the approach taken varies from one programme to another. Some processes will expect you to be able to share previous patient experiences. They may want to hear more than just good examples. They may well be interested in those which went less well and what you learned. Other processes will present you with a situation and ask what you would say to the patient in such circumstances. And some processes observe your interactions with a trained actor. You can check which method will be used in the webpages of any programme you are applying for.
You may already be good at this aspect of communication. After all, you are probably interacting with a broad range of patients every day. But are you confident that you are the best you can be? Have you set aside time to consider the fundamental elements of patient communication? Have you identified your strengths and where you can improve?
You can also expect your interviewers to scrutinise your interactions with your colleagues. The assessment may overlap with the patient communication scenario if it includes a handover stage. Alternatively, you may be asked to share a difficult experience you had with your team members. The interviewers may want to explore any challenges where you had to make your voice heard, to raise concerns or to gain support from someone else.
Again, you may already be good at this. The other candidates in the interview process could also be good. So, how much time have you spent on improving your awareness of what your fellow healthcare professionals need from you? What methods have you consciously adopted to ensure that you are clearly heard and understood?
It’s always important to recognise that, when there are an excess number of applicants, an interview process is a competition, rather than a pass/fail style exam. The interviewers want to find out as much as they can about each of the candidates in a consistent manner.
Your challenge, as the interviewee, is to at least prove you are appointable. But you need to be more than that. You want to ensure you at least avoid a low score in any of the set criteria. A high score requires dedicating time and effort for proper preparation in all elements. And that includes focusing on your communication skills.
Develop your abilities. Maximise your potential.
Stephen McGuire – Managing Director
