nhs fellowship

NHS International Fellowship Programme: 

NHS International Fellowship Programme Dr Lars Fuhlrott Consultant Psychiatrist Bristol, UK

Background/ Limits: 

Background/ Limits Psychiatrist: Limited knowledge about other specialties Worked in US and Switzerland: Limited knowledge about the German Medical System Less than 1y appointed: Limited knowledge about the NHS etc.

History of the NHS: 

History of the NHS Set up in 1948 to to provide healthcare for all citizens, based on need, not the ability to pay funded by the taxpayer and managed by the Department of Health

Structure of the NHS: 

Structure of the NHS

The NHS Plan : 

The NHS Plan published in July 2000 a radical action plan for the next 10 years biggest change to healthcare in England since the NHS was formed in 1948 promising a 6.3 per cent increase in funding over five years to 2004

The NHS Plan: 

The NHS Plan ·  More power and information for patients ·  More hospitals and beds ·  More doctors and nurses ·  Much shorter waiting times for hospital and doctor appointments. ·  Cleaner wards, better food and facilities in hospitals ·  Improved care for older people ·  Tougher standards for NHS organisations and better rewards for the best

NHS recruitment campaign : 

NHS recruitment campaign 1.  Global Recruitment Scheme (August 2001), 136 offers of employment have been made 2. NHS International Fellowship Scheme (February 2002), currently Round 5, England only 3.  International Recruitment Job Fairs 4. Managed Placement Scheme: short term placements prior to doctors applying for substantive posts, England only

NHS Fellowship Programme: 

NHS Fellowship Programme Application Medical Royal Colleges Sifting Choosing group of Trusts NHS-Trust sifting Short listed Interview week Conditional offer Contract IELTS References Police check GMC registration Specialist registration

IELTS (International English Language Testing System): 

IELTS (International English Language Testing System) EEA nationals: Not required for GMC, but for International Fellowship Programme 2 types: 1. general training 2. academic Listening, Reading, Writing, Speaking Nearly a whole day British Councils in several towns Cost: ca. £ 200, will be reimbursed average score of 7.0, minimum of 6.0 in each section (out of 9)

IELTS (International English Language Testing System) : 

IELTS (International English Language Testing System) Band 6: Competent User Has generally effective command of the language despite some inaccuracies, inappropriacies and misunderstandings. Can use and understand fairly complex language, particularly in familiar situations. Band 7: Good user Has operational command of the language, though with occasional inaccuracies, inappropriacies and misunderstandings in some situations. Generally handles complex language well and understands detailed reasoning.

Interview week: 

Interview week Hotel in London with partner Visiting Trusts of your group Interview: Member of Royal College, Trust managers, ca. 45 min., no questions about skills but “system related” questions Impression of the area, not of the different jobs

Relocation process I: 

Relocation process I Phoenix ARC, private relocation service Moving to UK and back: maximum of £12,000 (8000 tax free) Includes: “preview trip”, moving, temporary accommodation, domestic goods, taking up tenancy

Relocation process II: 

Relocation process II Rented accommodation: up to to £25,000 per year dependent on location within England two journeys per year back to the normal country of residence

Relocation process III: 

Relocation process III finding accommodation choosing schools for dependent children finding employment for partners if they are permitted to work in the UK connecting with utilities (electricity, water and gas) opening bank accounts tax and other financial issues

Bristol: 

Bristol

Bristol: 

Bristol Ca. 500 000 inhabitants 2 universities young city Old harbour town at the river Avon for middle and south America Very high tides (14m)

Isambard Kingdom Brunel: 

Isambard Kingdom Brunel 1806 – 1859 Great Western Railway (London to West) Ships, bridges etc.

Alexander Selkirk 1709: 

Alexander Selkirk 1709 Rescued by Thomas Goldney, Bristol Robinson Crusoe

Giovanni Caboto: 

Giovanni Caboto John Cabot Ca. 1450 – 1499 Genua, served England Matheu NW passage: Goal to find China 1497 Newfoundland American Mainland before Columbus Son Sebastian, born in Bristol, South America Explorer, Paraguay

Airplane industry: 

Airplane industry Spitfire Concorde (1969 – 2004), she came home…

Music: 

Music

Starting work: 

Starting work Introduction period: shadowing consultant colleague for several weeks Meeting “important people” Induction courses (e.g. Basic Life Support, Mental Health Act) Quite difficult time, very different system

The cold water: 

The cold water

The Job: 

The Job Consultant Psychiatrist for South Gloucestershire (North Bristol), patch Severnvale ca. 150.000 people based in a little pretty town Thornbury: “in the community” clinics at 2 different hospitals home visists ward in a 3rd hospital academic lecture 1/week supervising SHO, Staff Grade only local research at the moment

The Team: 

The Team 2 consultants 1 Staff Grade 1 SHO 8 CPN (Community Psychiatric Nurses) 3 ASW (Approved Social Workers) 1 CCW (Community Care Worker) Occupational Therapist, Reflexiologist, Art Therapist, administration staff

Medics structure UK: 

Medics structure UK Consultant: most senior grade in medical posts, ultimate decision on patient care SpR: potential consultant, 2y in specialty already Staff Grade: no “consultant career”, very experienced but less responsibility SHO: “Assistent”, hospital based

Example “Sectioning”: 

Example “Sectioning” Switzerland: every doctor, incl. GP can send patients against their will to psychiatric hospitals, minimal paper work UK: regulated in the Mental Health Act 1983, Section 12 Organized by Approved Social Worker with 2 recommendations of doctors, one Section 12 approved Much higher threshold for detaining Much higher risk in community

Suicide Rates (per 100.000): 

Suicide Rates (per 100.000) WHO, 2004

Bern, Switzerland: 

Bern, Switzerland

Bristol, UK: 

Bristol, UK

Food, Switzerland: 

Food, Switzerland

Food, England: 

Food, England

Driving, Continent: 

Driving, Continent

Driving, UK: 

Driving, UK

Weather: 

Weather

 Experience: 

 Experience 1. work: More “Freedom”, but more responsibility Financial + (£ 67.000 +) “9 to 5” (most of the times) Real teamwork, less hierarchies Completely different system Improving language skills Improving working skills

 Experience: 

 Experience 2. Personal: Feeling “welcome” and “needed” Much easier to make contacts, informal invitations Very helpful colleagues (DIY, introducing to others etc.) No experience of racism or “Anti-German-Feelings” Pubs

 Experience : 

 Experience 1. Work: No real introduction “new system”, everything is different Too much bureaucracy Too much paperwork Closer to the court 2. Personal: No help in cultural differences adaptation Not enough help in relocating High living costs (rents, buying, food, alcohol, tobacco etc.)

Conclusions: 

Conclusions Good move for me Not as easy at it looks like at the first glance Clearly recommended

The cold water: 

The cold water