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**This blog was updated on 20th March 2024 to comply with the most up to date information available**

The current economic situation is a regular feature in news headlines, political debates and our daily conversations. We always want to make it as easy and realistic as possible for you to arrange and access your CPD requirements. So, we’ve recently introduced some new payment methods for your course bookings and purchases.

You can now choose from debit and credit cards, PayPal and Klarna to make your payments.

If you have a PayPal account, you can use this to make your purchase. Choosing PayPal’s Pay in 3 option means you can make your booking today and split the cost into three interest-free monthly payments.

• PayPal Pay in 3 eligibility is subject to status and approval. Pay in 3 is a form of credit, may not be suitable for everyone and use may affect your credit scores. See Pay in 3 terms and conditions for more details.

Klarna provides a further alternative. You can use it to either pay in full up to 30 days from making your booking or, again, to spread the cost over three interest-free monthly instalments.

• Klarna’s Pay in 3 / Pay in 30 days are unregulated credit agreements. Borrowing more than you can afford or paying late may negatively impact your financial status and ability to obtain credit. 18+, UK residents only. Subject to status. Terms and conditions and late fees apply.

Whichever option you opt for, we secure your course booking or purchase whenever you confirm your choice and details at our checkout stage.

It’s been a turbulent couple of years in the world of politics. We’re now starting of a new chapter with Liz Truss becoming the UK’s new Prime Minister and Therese Coffey becoming the 3rd Health Secretary this year. The list of major problems they inherit means the turbulence is likely to continue for some time yet. Amongst all the noise, heat and chaos, It would have been easy to have missed some important developments in the ways that healthcare is organised in this country. In England, the Health and Care Act (2022) has come into effect. In Scotland, the Government have initiated plans to create a new National Care Service.

What’s changing?

For the past 30 years, NHS England’s structures and regulations have been designed to utilise competition between providers. Previous Governments believed this would minimise costs, drive efficiency and improve quality. However, despite several restructures over the years, there was a growing consensus that this approach caused more difficulties than it resolved. So, the new legislation introduces a fundamental change. There is a shift from competition between providers to an expectation of collaboration.

The new English structure is based on Integrated Care Systems, covering all aspects of health and social care. It includes the idea of provider collaboratives.  These collaboratives are where two or more previously competing NHS Trusts or GP practices work together to utilise the benefits of scale. One example could be collaborating when sourcing deals for purchasing requirements.  Buying higher quantities generally leads to a lower price per item. Another example is for independent providers to share staff. They should help reduce locum costs, improve consistency of service delivery, and give a more holistic approach to patient care. Sharing staff could mean you or your colleagues doing sessions in other hospitals at times. Your team may have to adapt to include others in a part-time capacity..

In Scotland, the creation of a National Care Service is now being processed through Parliament. The plan is to have a structure of local Care Boards which mirror the 14 Health Boards of NHS. It’s believed that matching structures and other changes related to defined responsibilities and sharing of information will enable more effective integration between health and social care. Health and social care professions should end up working more closely than ever before.

meantime, both Wales and Northern Ireland continue to develop their systems. The common threads across the UK are integration and collaboration.

So what does this mean for me?

We’ve been busy updating our books and courses to reflect the new system. But such changes are only ever successful if people adapt. Truly adapting goes beyond just knowing and complying with new system. There will inevitably be some snagging issues and the new systems will have it’s own flaws. So change has the best chance of success when people engage to overcome these challenges and adapt to utilise the opportunities created.

Our blog posts often emphasise the importance of good team communication. Doctors have to become experts at joining other teams and welcoming others. These are important elements for producing high quality care and continuity. Increasing integration, increasing sharing of team members and resources mean such expertise is likely to be more important than ever. So too are the skills related to good medical leadership and management.

So what steps are you taking to get to know the new systems? And what steps are you taking to develop your skills to play an active part in making the changes a success?

Stephen McGuire – Managing Director

In this recorded webinar, Doctors Subashini Wickramathilake, Himani Murdeshwar and Alex Rouse share their varied foundation years experiences. This is a must watch for anyone who is at this pivotal stage of their career or involved in supporting doctors during their foundation years in any way.

I’m delighted to say that Oxford Medical Training has been included in Healthcare Business Review’s annual listing of the top five UK companies that are at the forefront of providing Medical Staff Training and Development Services. We are on the cover of the September European and UK edition of their publication along with a main feature inside.

Our “Excellent” rating for service on TrustPilot played a major part in the judges decision. So, I’d like to say a big thank you to all of our course delegates and learners who posted reviews as these lead to our overall TrustPilot score.

And, of course, a huge thankyou to the Oxford Medical team, to our Faculty of Tutors and to the team at Perceptive who develop our website. This wouldn’t have been possible without your contributions!

Stephen McGuire – Managing Director

Here are some thoughts from Dr Subashini Wickramathilake, winner of our recent blog-post competition:

You may have just left behind your childhood home, your inner circle of friends, the corner shop whose owner knows your first name or the adopted city that you’ve called home for the last five years of med school. You are becoming the shiniest new part of the intricate machinery that is the NHS. Just as you have to adapt to this new challenge, so does everyone else, who have spent the last few years or decades working at the hospital, have to adapt to you. You, a newly minted junior doctor, taking on the highest duty of all – responsible for the physical and mental health of fellow humans, who trust you with their life. Take a breath, congratulate yourself on getting into the program and learn to be comfortable with the uncomfortable.

You don’t need to know everything to become a reliable doctor. You do need to have a curiosity to learn and the courage to accept feedback. Feedback given in a busy ward with very ill patients and irate relatives may sting at times. Just breathe. Remind yourself to never take it personally, do not let the words of others undermine what you have achieved. Remember, a sailor that does not face rough seas will never learn to sail. Don’t underestimate how much you will learn from your most challenging night shift, even if you feel shattered by the end of that shift. However, please do reach out for help when you feel overwhelmed – this isn’t weakness. Looking out for your own mental, emotional and physical wellbeing is your most important priority in those two years, especially your first year. And don’t be afraid to speak up if you are treated unfairly. Whether it is your educational or clinical supervisor, a senior Registrar, the nurse in charge or the wellbeing team at your hospital, help is at hand. Everyone knows this is a strange new environment for you and most people are more understanding than you think. Don’t be afraid to ask when in doubt, just pick your moment well! A good tip is to first state what you already know, then ask what you don’t.

For your department orientation, you can expect anything from a detailed induction where you will have a clear idea on your job role and who to ask for help to a mere half hour introduction when the Registrar will ask you to complete discharge summaries as they run off to their morning commitments. Take a breath and focus on the task at hand. Remember that these departments were running efficiently before you showed up and they will continue to do so long after you have left. Learning in the NHS will come in bits and pieces, don’t expect the linear learning you experienced in med school. There won’t be daily lesson plans, flowcharts, a whiteboard or note taking. The ward rounds will not always be structured, your consultants will be pulled in many different directions, you may have to chase them for clear treatment plans. Discover your voice and use it wisely. Remember, every day, millions of people are being tended to at their most vulnerable, you are now a part of that. No role is too small, take pride even in the most mundane tasks. You will learn as you go. Don’t underestimate your ability to grow and adapt. Be kind to yourself and others, make time for people that uplift you and be positive – you’ve got this! Rome wasn’t built in a day, but they were laying bricks every day.

Dr Subashini Wickramathilake

Here are some thoughts from Dr Himani Murdeshwar, runner up in our recent blog-post competition:

Brimming with aspirations and nervous excitement, the cohort of young graduates made their way to the Induction. I was one among them and still have a vivid recollection of what was only the prelude to the symphony that followed.
We were primed with all the knowledge we would need to begin work, told where to look for support, and informed what we could and couldn’t do in our new role as foundation doctors. Yet, on the first day of our first rotation we continued to be haunted by the imposter syndrome. “Did we really know enough to make decisions for patients?” It all felt so new, often overwhelming. “Did I do it the right way?” “Should I have prescribed that?” “Did I answer the patient’s question correctly?”

Year after year, a batch of hopefuls embarks on the formative years of their medical careers. They come to the hospital each day, taking a leap of faith, pushing their abilities to their limits. And as you, my dear readers join the ranks, let me reassure you that it is perfectly normal to have mixed feelings. I would urge you to see the foundation programme as a rite of passage and to progress through it, with a view to discover and learn more about yourself, than anything else.

Life presents us opportunities to reflect on our lived experiences and more often than not, most would want to do things differently, if given another chance. Therefore I take this opportunity to share my thoughts on “What I wish I’d known for my foundation years,” hoping to relive that period vicariously through you all.

“Help will always be given at Hogwarts to those who ask for it.” Professor Albus Dumbledore’s words are as true for those starting at Hogwarts, as they are for our new foundation year doctors. Do not hesitate or feel guilty about admitting to your inability to do something. Ask for supervision while doing a procedure or for a demonstration of how to conduct a difficult conversation. Make sure to debrief at the end of the exercise to optimize your learnings from the experience.Honesty, diligence and prompt escalation in challenging situations will help you win other’s trust as a safe junior doctor and stand you in good stead.
Every new rotation is your chance to wipe your slate clean and explore life in a new specialty. Take this opportunity to develop your long-term goal and work in that direction. Maintaining a logbook for surgeries you were involved in, updating your e-portfolio, undertaking audit and QI work are instrumental in demonstrating your commitment to a specialty.

With time, build your understanding of the roles of other team members, seeing them as more than just cogs in the wheel. Building rapport with the nurses, health care assistants and dieticians will develop your ability to function as an effective team member and in due course team leader.
The foundation programme can prove to be nothing short of a roller coaster ride. Certain rotations will be action packed and exciting while others might seem rather humdrum. It is for such days, that you must have a support system to rely on- friends, flatmates or family. Be sure to book your annual leave in time and plan any necessary swaps in advance to make the most of it.

The foundation years are an enriching phase that moulds us into better professionals and multi-faceted individuals ready for any curveball life throws at us. And as you take your first step in this direction, all I’d like to say is, “Believe in yourself!”

All the best!

Dr Himani Murdeshwar

Back in May, we launched a competition, asking doctors to volunteer a blog post with the title, “What I wish I’d know for my foundation years.” The idea is to support the latest cohort of foundation year doctors who have arrived in the NHS at the start of August.

We can now reveal the winners of the competition as:

• Winner: Subashini Wickramathilake
• Runner-up: Himani Murdeshwar

Both Subashini and Himani have now received their choices from our range of online courses as the first element of their prizes. We will be publishing their winning blog-posts over the next week or so on our News & Insights webpage and will also include them in our next Insights newsletter.

Our two winners also joined both Alex Rouse from our Faculty of Tutors and myself in discussion on a short webinar which will be posted on our News & Insights webpage in the near future.

The entry which made us smile…

We’d like to give a special mention to Rubab Batool, who provided us with the shortest entry to the competition:

“It’s okay to feel overwhelmed. It’s okay to feel absolutely clueless , it’s okay to make mistakes, it’s okay to feel as if you don’t know anything. It’s natural and it’s common. We all felt this way and most likely you will feel this way. Remember to ask your seniors about their favourite and cleanest toilets (apparently that is another secret ).”

Some wise words – and some which made us smile there! As a result, we decided to award Rubab with the 3rd prize which was one course from our online range.

Please share this page with anyone who you know who is starting their foundation years. The webinar is free and everyone is welcome.

Stephen McGuire – Managing Director

There’s no doubt that the normal paths of training to become a doctor can involve some stressful situations. So, if you have any involvement in this training, then it’s essential to be aware of how this can affect the ability to learn. It can have a critical impact on concentration levels and memory process. This may be temporary, but at its worst, can sow the seeds of depression and burnout which are all too prevalent. The best teachers realise that they need to watch out for this and support their learners on a human level where possible. We are all individuals, with our own stories to tell and it pays to make space for these stories to be told. I’ve recently had the sobering experience of corresponding with Bohdan, a final year medical student in Ukraine. (His name has been changed at his request). Here, shared with his permission, is his description of his recent experiences.

Bohdan’s Experience

“As a student you are mostly focused on studying, learning new things, on exams, tight deadlines and rising to the challenges.

But stress changes your priorities, your goals, your mental health, and even physical health.

Just a few days before our new semester started, I was excited to be attending classes in hospitals rather than online as covid cases have declined and most of the students and doctors are vaccinated.

As this is my final year, I was excited to learn new things and wanted to spread my focus beyond the standard curriculum. I was researching the PLAB exam. I was trying to join a research programme and preparing to attend a medical conference. Life was good until some news came that war was coming. At first, I thought it was fake news and continued with my university classes as normal. But it started to make an impact. During every class, I’d start to be distracted. If war starts, then what’s the future going to be like?

The worry grew day by day as it became clearer that war was going to start soon. All the embassies closed. Their staff started leaving the country. So, I decided to book a flight so that I too would leave the country. But then I remembered we are having live classes. I didn’t know what to do.

Then -it seemed suddenly in the end – war started and our teachers had to stop our classes. It was very upsetting for me to see the places I had visited burn. I stressed about friends and their family. Are they safe not? In this whole period, I couldn’t concentrate on my studies as it was very stressful. I felt depressed. I felt helpless.

After a few days, our classes restarted online. One brave doctor took our classes from the war zone – I could literally hear sirens in the class. Sadly, I had left my possessions there – all my clothes, my books and all my notes. Now I can only study from the internet and am trying my best to learn – but my concentration is not that good at the moment.

Not long ago, we were taking classes in hospital and preparing for our future. Now we are just surviving. It is a lot to go through. These stressful events changed my life in every aspect. In the past, I could study for hours. Now I feel exhausted after 1 hour. I’m losing my hair. But I want to be a good doctor. So, I am trying to get back to the track, to increase my knowledge and achieve my goals.”

Reflections

I’d like to thank Bohdan once again for sharing his experiences with us and for giving us permission to share them with you.

Our medical students and registered doctors include people from a broad variety of cultural backgrounds and nationalities.

How well do you know their stories?

Stephen McGuire – Managing Director

Footnote: We have provided Bohdan with free access to our Teach the Teacher Online Course to show our appreciation for allowing us to share his story.

The Leaders Council of Great Britain & Northern Ireland recently interviewed Peter Charlesworth, our Chief Executive at Oxford Medical Training. Here’s their podcast where Peter discusses our experiences over the past two years. He describes the challenges we faced and how we have adapted to support the training requirements of more doctors than ever before.

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You may, or may not, have noticed that the Health and Care Act 2022 finally passed through parliament recently. After a great deal of contentious debate, the mainstream media gave it very little coverage in its final stages. Much of its focus is on paving the way to enable significant reforms to the way the NHS in England functions. At its heart is a shift from using competition between providers to collaboration and integration with other care services to improve quality and efficiency. You may well soon find that you are working more closely with doctors from other trusts, sharing equipment and even team members.

Integrated Care Systems will now use this, in part, to address issues of staff shortages, whether due to short term holiday, absences or long term vacancies. As a result, you will want to be skilled in team communication. You need to be capable of efficiently joining new teams. You also need to effectively welcome other doctors to temporarily join your team if you are going to work together efficiently.

What’s wrong with weighing the pig?

One key aspect of the new legislation is that it creates a duty for the Health Secretary to publish a report on workforce planning at least every 5 years. With staff shortages being one of the biggest issues which the NHS is facing, critics argue that this requirement falls far short of what is needed.

There’s an old saying that “weighing your pig doesn’t make it any heavier.” If you were a farmer, you’d want your livestock to grow big and healthy. That’s what increases their market value and feeds your family well. So, knowing how they are progressing is important. And the obvious thing to do is to weigh them regularly. But weighing them alone is not enough. You need to take action if you want to make a difference. That starts with nourishing them properly. You want to provide a good environment with exercise and intervene by calling the vet if things are going in the wrong direction.

So, simply reporting on numbers of doctors or nurses by age, specialty, grade and ethnicity along with numbers of vacancies will, in itself, only take us so far. Making the badly needed difference requires well considered and well executed action planning. Otherwise, our Health Secretary will be doing the equivalent of just weighing the pig.

What’s going on in your own back yard?

The vast majority of us don’t have any direct influence over the way the Health Secretary goes about his business. So, let’s switch the focus to your own daily activities. How many targets are you aware of that you or your team have? What scores are your organisation comparing against other providers, against local or national averages? How often are you keeping track, ticking boxes or filling in forms, contributing to the collation of these statistics?

Now, here’s the big question. How often are you and your team actually using this information? Are you genuinely utilising them or is their generation a pointless bureaucratic exercise? Our peer reviewed research published in BMJ Leader found that 40% of doctors felt they don’t effectively discuss progress toward goals with their team. Sadly, it appears that many are wasting time weighing the pig rather than taking actions that will make a difference.

Making a difference

On our Practical Leadership and Management Course for Doctors we discuss how to go about making a genuine difference. Yes, making measurements is important. But it has to go hand in hand with clarifying why things are the way that they are and how your performance compares to others. Next, it’s about defining what you want to achieve and why? Before going on to develop clear, allocated and time action plans. Then, it’s about making sure things get done. Making sure everyone is taking the agreed steps, dealing with procrastination and overcoming obstacles.

Often the difference comes when we understand why something matters. Is your team tracking how well you keep to appointment times? Or are you striving to see patients when they are expecting to be seen as you realise they currently have to take a half-day off work for a 10 minute appointment with you?

So, are you simply weighing pigs or are you striving to make a difference?