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Finance for Future Doctors



Join Sara, a certified accountant and A&E doctor, in an on-demand knowledge session tailored specifically for medical professionals. With prior experience in auditing, performance improvement, and big project improvement, Sara has combined her expertise in both finance and medicine to provide education on crucial financial factors for medics. This interactive session will not only break down the different types of student loan plans doctors might grapple with but also advise if you should pay it off early or just let it be. Sara will also explore other key topics like NHS Bursaries, electives, investing, less-than-full-time working, parental leave, and pension. Tuning into this informative course could help you securely navigate your financial journey in the medical field.
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Cyra is a dual qualified chartered accountant and medical doctor. This webinar is aimed at medical students who want to have a hold on their finances before they start their careers. Cyra will explain student loans, the NHS bursary, electives, investing, working less than full time, parental leave and the NHS pension. This jam packed webinar is brought to you by a Beyond Medicine x Medics Money collaboration.

Learning objectives

1. Enable students to understand, differentiate and recall the details of the three financial plans used in funding university education: Plan One, Plan Two, and Plan Five. 2. Equip students with the understanding of the implications of a student loan on their subsequent financial plan, including student loan pay-off algorithms and the impact of student loans on credit scores. 3. Ensure students have a thorough understanding of the intricacies of the tax implications when undergoing a plan crossover, with a focus on Plan Two and Plan Five. 4. Emphasize the potential downsides to over-paying student loans and the strategies behind student loan reduction, including the option of lump-sum payments. 5. Provide insights about career trajectories and income changes for doctors in the UK, which can impact loan repayment, and educate students on the basic principles of financial prosperity for medical professionals.
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Computer generated transcript

The following transcript was generated automatically from the content and has not been checked or corrected manually.

My name is Sara. I am chartered accountant and doctor. I'm currently working as an fy three doctor in A&E in Oxford and in my spare time, which I don't have very much. I also do financial education. I worked as a chartered accountant for six years and I specialized in audit, performance improvement and major project improvement. So that was my specialty. Now, I really enjoy um educating on payslips helping people understand how to invest and pensions today. What we were doing is going through quite a lot of information. So make sure you have a piece of paper or a word document open or something where you can jot down anything I say or any links I post in the chat because they will be very useful. I won't be going through everything in loads of detail, but I'll be pointing you in the direction to find more information based on what you might wanna know if you have any questions, just do, pop them in the chat. I've popped the chat on my other screen so I can actually see all your questions, which is good. Right. Let's get started. So we're gonna talk about student loans, which you already know a lot about NHS Bursary electives, investing less than full time working parental leave pensions. And next steps, if there's another topic that you wanted to talk about or you wanted me to tell you a bit more about just pop it in the chat. But it might be waiting as we go through because I might mention it anyway. Medic Money was founded by Tommy and Ed. Tommy is a GP who met Ed at work. Ed is a chartered accountant like me. He's also a chartered tax advisor and an independent financial advisor. The boy loves exams and a GP. And so together they created its money and that's where I come in. So I joined the team later on and I started the specialist side for medical students and very, very junior doctors. First of all student loans, a lot of you are going to be on plan two or plan five, some of you might be on plan one from a previous degree. So basically plan one was between 98 and 2011. If you went to uni then, and it had a much lower threshold than the two subsequent plans and it was wiped after 30 years or 25. If you were between 2006 and 2011. Plan two is if you started doing a degree from 12 to 2012 onwards, the threshold was much higher. So you started paying that back a bit later, depending on where you were in, in your income and again wiped after 30 years, the new Plan five is rather mean. So it's taken the threshold back down to a bit lower which considering we're in a period of inflation where wage increases are expected where we're striking, for example, and our wages are increasing. Taking that threshold down is rather mean and it's wiped after 40 instead of 30 years. So Plan five is the least generous I think. And if you are crossing plans, so for example, my partner did his first undergraduate degree under Plan one and then his um second medical degree under Plan two, he has to now pay back both simultaneously. So he pays back a lot every month. He pays back 9% of what he makes over 22 015 and 9% of what he makes over 27 295 because of the two plans. Whereas for me, I did both my degrees under plan two. So I only pay back 1 9% over 27 295. And this is a sneaky thing that you don't realize is going to happen, especially grad meds, please keep that in mind. Um So for example, you straggling Plan two and plan five, when it comes to paying it back, you will actually be paying back 9% over 27 295 and 9% over 25,000 So your repayment is gonna be much higher than someone who's done their degrees or degree under a single plan. So that student loans, I'm gonna pause for a sec if anybody needs to ask any questions about student loans before I move on. The thing I wanted to say about student loans is a lot of people ask me, do I pay it off early? Do I overpay? Our personal opinion at Medic money is there's no point over paying your student loan because the way it builds up with the interest rates are quite high because of that, the um value of your student loan accumulates faster than you could possibly pay it off. So, unless you have a massive lump sum at the beginning or you can avoid taking student loan at all, there's no point over paying your student loan because you're gonna end up paying more than everybody else. You're better off just treating it as a graduate tax unfortunately. And because it doesn't affect your credit score, it's not a true loan in the sense that a student loan is not going to make you worse off or better off when applying for other loans, you're better off just leaving it. I've got a couple of questions here. Does this mean starting the degree in those years or graduation years? It's starting the degree in those years is Plan two usually seen in Scotland as Plan five says degrees in England. So the one in Scotland is plan four. So there used to be plan one and then it became Plan four in Scotland. And so plan four in Scotland has been very similar to plan two. It's just, there's a couple of tweaks in the threshold. The reason plan four exists is because of Scottish students who don't have to pay tuition fees. So then their plans are all maintenance loan related. If you're a British or an English student studying in Scotland, you'll probably be on plan 12 or five. Will the rates apply if you work abroad? So when you say rates, do you mean the 9% repayment? And if that is what you mean, then yes. So if you move away, you can't get out of paying the student loan. Now, the system does expect you to tell them you're moving away and I have no clear details of how they find you. If you do move away, I've never been told whether they hunt you down or not, but you're expected to pay the money back even if you're working abroad, if one has the means to do so, should we pay off our loans fully as soon as possible? With one lump sum? If you do have the, the means to pay it, it would be better much, much sooner. Once you start accumulating your interest and it starts building to massive amounts, you're better off using that money for investing or for getting on the property ladder that, that, that money is really better off spent on other things. You could make better returns on them and they could be more useful in your life. But if you do end up getting a big lump sum, I would actually suggest crunching the numbers with a, an accountant or an independent financial advisor because it's very, very personal to you and what your life goals are. So, for example, if your life goal is to travel or to get on the property ladder, having the student loan isn't sort of this thing that's hanging over you because it gets wiped after 30 or 40 years, depending on what plan you are, it doesn't affect your credit score. So really if you don't pay it off with that lump sum, there's other things you could be doing with it if I started intercalation in 2023 but med in 2020 do both fall under two or is collation year onwards. Now plan five. So if you, what, depending on what you started with, you stay with that one. So you don't swap you once you finish your degree, depending on when you're doing another degree, that's when, whichever plan is in place applies. If you started on a particular plan and you're still continuing through that specific degree, you stay on that plan. I think I've answered all those questions. Is there an additional fee to pay off student loan in one go? No, there isn't, I'm likely to pay off my loan. I'm on plan to before it is wiped in 30 years. So, unfortunately, for us doctors, the way our pay works, it increases, but not enough to make a big dent in it. And then when you start, depending on what you decide to do and keep in mind that currently the training situation is not great for doctors. There's huge bottlenecks and training people are kind of stuck at sho level. So finishing F two and then with struggling to get jobs after and get the bottlenecks get even worse as you try and go through training. So the whole idea of I'm gonna do medical school and then I'm gonna do this and then I'm gonna do specialty and I'm gonna become a consultant that, that treadmill has long gone because the bottlenecks are so awful. People are having to find alternatives. They're being left without jobs when they're applying. Um There's just too many applicants to the number of places and the number of places have been getting smaller and smaller because of funding. So we depending on your trajectory, if you were going through the normal trajectory of F two core specialty consultant, then our pay only gets really good towards consultant. And at that point, you've accumulated so much student loan that we're going to end up paying a huge amount. So imagine 9% of however much we're making as a consultant, you're actually gonna be ending up paying off more then well over what your, what your loan was and you will probably actually end up paying it off before the 30 years because of how much you're paying towards the end. However, if you were a different graduate, so for example, if you decided to go and do banking, for example, and you start off on something like 80 K, you're already starting to pay off huge amounts if you imagine the 9% over the 25 or 27 295. And so by that point, your student loan isn't growing as much as it would with us as doctors. So you're more likely to pay off less in that situation. Now, if you decide to stay on a slightly lower income throughout your career, so for example, you decide that you don't really want to pursue all of those things, you just want to be comfortable, you want to have a good income, but you don't want to push the boat, then you will, you probably won't end up paying it off and it will probably be wiped at the end. So it really depends on your life trajectory. But what used to be a doctor's trajectory, the answer is you would have ended up paying it off and you would have ended up paying off a lot. However, doctors, career trajectories in the UK have changed. And so I can't really give you an answer of what it's gonna be like going forward. I hope that made sense all of that financially. If one has the means to pay for university fees each year, is it a better option to pay the fees or is it better to take the student 100% pay the fees if you can do it, pay it? Because then you have no loan whatsoever. You're not paying any interest. It's obviously the cheapest option because you're not taking any money from anybody and you're not stuck with any debt whatsoever. You get to keep all of the money you make. It is definitely the cheaper option. Does the same apply if an interruption for studies was done eeg on plan to take a year out, return to studies. So if you took the year out and you still were registered on that course, then you continue on the plan that you registered with. If you, for example, quit a degree midway and then started a whole new degree, then it would have to be the new plan. So NHS Bursary, I don't know how many of you are in, what, what years you're in or if you're aware, NHS Bursary is significantly less than your student loan. So if you're used to getting a certain amount of money in your student loan, you're gonna get way less than that in your NHS Bursary and it is dire and there are people striking for this uh Ns Bursary drops uh in your penultimate and and, and your, your final year. So depending on what kind of degree you're doing, if you're doing a normal sort of 1 to 3 and then not intercalating and then doing 4 to 5, then it will be years 4 to 5 that your NHS Bursary applies. If you're doing an intercalation, then 1 to 4 will be under normal student loan and years 5 to 6 will be under the NHS Bursary. And if you're doing a grad med, then your first year is loans and then you get some loan during the year for the rest of years, 23 and four, but the majority of it is under the NHS Bursary and it isn't very much. Would you recommend working part time as a medical student and paying some of your loan off? No, your studies are worth more than that if you're working purely to, to pay off your loan, don't, don't do it if you're doing working because you literally don't have money to survive. Otherwise that's when you do it, the loan is not going anywhere. I, like I said, the interest is so high that it's accumulating at a higher rate than you could attack it, especially if you're working part time as a medical student. So do not compromise your studies to try and tackle this this loan. Do you have to pay back? NHS Bursary for final year of medical school? No. Is it possible to pay off student loan? Whilst you are still a student, you can make payments. So if you're not earning over the threshold, you don't have to make those 9% payments. But you can choose to make the repayments, you can repay as much as you like. So if you want a lump sum and you want to pay it off, then fine, you can do that again. If you don't need that money, then perhaps you can use the money to pay the fees and not get the loan at all. Because not having the loan is the cheapest option. What is the interest on the loan? The interest changes every year and it's based on the different plans as well. You're also charged a different interest rate based on your income band and you're charged a different interest rate for when you're at medical school versus when you're not at medical school. The latest interest rate was 7.8%. However, for those who had already graduated, the 9% is calculated on your pretax pay, but it is paid out of your post tax pay. So it is the least tax efficient way of paying your loan back. Basically say you make 100 lbs gross, they calculate the 9% on 100 lbs. Then you pay out, pay out all your deductions, your py e your pension, your national insurance and then they also take the 9% they calculated on those 100 lbs out of that. So you're not even getting any tax efficiency from, from that 9% repayment. Um NHS Bursary is means tested and it's not very fair. So you can look up the means testing. We have a guide available at Medi Money, which you can get. So basically, if your parents are making over 25,000 lbs combined and it goes up all the way to a combined salary of 75,000 lbs. You can end up only getting one K, which is the non means tested bit of the Bursary. So literally 1000 lbs a year to live off it, it really isn't very much. Um I've written a whole guide on the NHS loans and NHS Bursary. Um and that will be available through Medics money. So do keep an eye out for that if you could pay off a big chunk of loan, is that worth doing? I'm in hopes of eventually paying off before 30 years to stop the high interest accumulating. This is really personal and it depends what big chunk means you'll see, for example, just how quickly it accumulates for yourself. And I think it depends on what you mean by big chunk. It's, it's so, II think the money is better off invested or put on the in the property market. I don't think there is any point in trying to take a chunk out of this. You're gonna end up paying more if you had already taken out a significant amount of loan but now have the means to pay your tuition. Is there any point in paying your way or is it better to max out your loans not having the loan in the first place is the cheapest? So if you can now pay your tuition, that's less loan that you take. So yeah, I would not max out your loans. You're just choosing the most expensive option there. Is it worth not getting a loan for one year and then still having tuition for loan for the other three years? I mean, it reduces your loan value. So obviously, it's less than if you didn't do it. But if you could, it just depends like if you need that money to survive, then you're gonna have to make that decision. If I'm applying for NHS Bursary as a grad med, will I need to apply for means tested or non means tested? That's up to you. That depends on what your personal situation is. So there's lots of information of what counts as um an independent student if you're over 25 if you've been supporting yourself for more than three years, if you're estranged from your family, that makes you an independent student, which means that you will be means tested on your own income and not the income of your family. Whereas if you live with your parents, then you'd be tested means tested. Ok. Side hustles. So this is because they mentioned I mentioned it because the NHS Bursary is not enough to live off. And there are always things that medical students are looking for because as a medical student, you can't guarantee a certain number of days or hours, you can't even guarantee which days because of our placements. Um because our placements are more or less like a full time job and you should be going to your placements because they maximize your learning. I know sometimes it feels like we're standing in a corner, but some of the best learning I've received is through my placements. Um So side hustles that I did were tutoring. Basically, I did tutoring as my main side hustle. But I had lots of friends in you in med school. Some of them did bar work. Some of them worked as HC A s at the hospital. So they were able to do things like nights and weekends again. II did phlebotomy in my undergrad. So I worked every Saturday as a phlebotomist in the local hospital. You can get rid of your old things through vintage. You can sign up to upwork fiber as a freelancer. If you've got any skills that you'd like to market and don't worry, don't feel like I don't have any skills, blah, blah, blah, you have more skills than you think. So have a look at the kind of things that are available on those websites and you know, just, just put yourself out there and in you know, the worst that will happen is you don't get any work through it. So that's the worst. Like, there's no downside to putting yourself out there. The good thing about the NHS Bursary though is you can claim back mileage to placement, but the mileage is between your university and your placement, it's not between your house and your placement. So for example, if you live five miles from university, but your placement is three miles, you won't get the mileage back for that because it's less than how much you'd normally be traveling to university. However, if you live five miles from university, but you live 17 miles from like your placement, then you'll get the difference back. So you'll get 12 miles back and parking as well, you can reclaim and if you have to get some accommodation because of your placement being really far away, then you can claim some of those costs as well. And the best bit about this as well is you can claim elective accommodation costs and there's a cap but at least it helps. Which is great. Did you offer tutoring through a specific platform? I used tutor for. That's where I got mine. Does the money you claim back also apply to public transport. Yes, it does. How come other courses like physio and Midwifery get a large Bursary. Frankly, they want allied healthcare professionals. Those are hard to fill positions to make them attractive. They've make them obviously more lucrative and there are different bodies lobbying for these things. So for example, the, you know, the Midwifery Council and the NMC are lobbying on behalf of those people, whoever supports physiotherapists are for them. Whereas we've not really got enough lobbying from our side for good funding. When do you apply for NHS Bursary? So you apply in the year before you start to get it. So you start. So if you, if you were in year four, then you would apply in September for year five and six. Does the money you can claim back also apply to public travel. Yes, some of this information isn't correct for NHS Wales Bursary. No, it's not. This is for England only. So do do your own research for NHS Wales and Scotland because they are different, especially if you're a Welsh student, then it will be different for you. So if you're a Welsh student studying in Wales and in England, then Wales student loan actually covers you and your tuition fees are lower as well. They're 9000 instead of 9250. Can you apply for NHS Bursary if you're a Scottish student studying in Scottish med school? Yes, because you'd apply from NHS Scotland if you're applying for NHS Bursary for next year, the application is open now. Thank you, Matt. Do you know when we can claim travel expenses up until? So your medical school, they basically manages your NHS Bursary travel like substance travel expenses and they'll have their own deadlines. Like, for example, ours was you, you have to claim within the three months. If you don't claim within the three months, then you won't get it. So it was a good habit to at the end of every placement to submit your expenses basically. So it, that's the deadline for each one and it'll be based on your medical school if doctors training is not being lobbied for as well as I, what does the BMA need to do differently? The lobbying. So II personally feel that there's lots of different things that the BMA could be doing. And I think the problem is that it's kind of torn in lots of dire different directions because there's so many issues with our training now that it's really hard to focus on just one area at a time. And so and, and we are quite as doctors quite unhappy. So there are lots of different directions the BMA is being pulled in, but the main thing. So for example, the BMA should be lobbying and there are medical students like BMA students who are lobbying for better NHS Bursary, for example, that is that is a, a proper example of lobbying on behalf of medical students to have a better NHS Bursary. But other things they could be lobbying for is not having to rotationally train the issues with the study budget, not being high enough for. Well for our pay for one thing being sub and actually the quality of life that doctors lead now and not the quality of life that doctors used to lead before. How are you getting your maintenance from student loans? I think we all do. We get a small amount like a cap sum of like 2.5 1000 then the other half comes from NHS England. That's really good to know. I might have to update that. So like half and half. That's not, I didn't get that. Thank you so much. Yeah, perfect. I will update that and thank you, Terry. That's, that's fantastic. So, Terry has just said you can get um a small maintenance loan from student loans um and from Bursary. So that's fantastic. So I will update these slides. I do apologize, reduced student loan, maintenance loan. Do you get? So tuition is covered by Bursary still, isn't it? Yeah, it's just the maintenance that it's changed a bit like half and half. Ok. Ok. So when I did mine, which was three years ago, all of the maintenance came from Bursary. However, I think they've changed it to some of it from being loaned, which is kind of mean actually, um, because you have to pay some of it back now, whereas before you didn't have to pay some of it, pay it back because it was all NHS Bursary. Oh, that really sucks. But I will update that. Cool. So, flights and accommodation. So the reason I we've listed all of this is just so that you know what to research. So look at your flights accommodation, like I said, you can get a, there's a cap, there's a cap to it, but you can get help with accommodation costs for your electives. Um You won't get help with food and domestic travel and all of that stuff. But keep in mind that you'll have to have your vaccines up to date. There'll be application fees for some place for when you want to try and apply. Very popular ones. There will be an application fees. I think a lot of, there are a few American ones that don't. So Ollie Burton did his elect sorry, applied for his elective. We didn't get to do our electives unfortunately, because of COVID, but he applied in America and he found a small handful that you didn't have to pay for applications. But the majority of them you did make sure you have travel insurance. You might want to do activities while you're there. Make sure you have an emergency fund and you're gonna have to have indemnity because, and that's not very expensive by the way, because you're covered by M MDU or mps for a really small amount. So keep those in mind, I suggest if you're in first year, start putting things like 10 lb a week away from now for your electives. So by the time you actually get to your final year, you'll have plenty saved up for your electives but do save up for that because they can go, they can be very, very expensive, especially if you're trying to fly because the flights can be the most expensive part of your electives investing. Right. Did anyone have any questions about electives before I move on? Yeah, I think we've got everything. Ok. So in the chat just pop or use your, are there any like reaction things on this thingy cos I just wanna know how many of you actually invest. Oh yeah, there's a raising hands. Lovely. Lots of you. Lots of you investing. That's fantastic. No, I'm really, I'm really pleased to hear that there's so many of you investing well done. So investing is now much easier than it used to be. You don't have to have the big bucks to invest. You don't have to go through stockbrokers or anything like that. Investing the platform and the market has changed substantially. So I do recommend starting investing very small, start small, learn, you don't have to learn everything at once. You don't have to read all the books. You don't have to watch all the youtube videos. You will learn slowly as you go. And the investing platforms that are available have so much free education. You really don't have to pay for someone to teach you to invest. So you have all these investing courses and stuff like that. Look, don't waste your money, you will learn it. You're smart, you're obviously smart enough to be in medical school. You're smart enough to learn how to invest without needing any, you know, expensive courses or anything. So basically there's two ways to invest. There is um well, there, there three technically if you mix them together, but either you can get someone else to manage your portfolio for you. So you just give them your money and then tell them what your risk appetite is and what your preferences are and they'll invest for you or you completely invest and you choose to invest yourself depending on what you want to do. You choose a platform, there's loads of platforms available online loads of apps. So these are just examples. They are not advice, they are not recommendations, but there's vanguard free trade, Dool nutmeg. Yeah, there's loads. Um Those are the ones that are only coming in my head, but definitely do your research and there's lots of really good online comparisons that explain to you what the different options are, how many investment options are available, how much the fees are. So, you know, you, you've got plenty of information available, trading 212. Thank you. Basically decide how you want to invest. Do you want someone to do it for you? So a managed investment portfolio or do you want to do it yourself? I do mine myself. I learn a lot that way. I'm not perfect. I've made mistakes. I've not lost huge amounts of money because II invest very small. So I have just learned by doing myself. I'm a chartered accountant. I never got any official education on how to invest. I never did a course. Even through all my training, they never taught me to invest. I had to teach myself. So if I can do it, you guys can do it. Choose a platform. Um Ideally with low fees, there's some good guides online then. So there's different ways you can invest in a general investment account. Now, a general investment account is the first one. It tends to be free. You don't actually have to pay more Feess for it. And any gain you make on your investments, any dividends and any interest are all taxable based on your personal circumstances at the moment, if you're a medical student, you're unlikely to be taxed because, but they do take tax at source. So you do have to claim it back. But basically you're, you're not taxed up to the savings allowance, which is 1000 lbs and then you're taxed after that. If you want to have your investments tax free, you can do it in three ways. You can do it in a stocks and shares isa, you can do it in a lifetime stocks and shares isa and you can do it in a pension or a sick self invested personal pension. All of those are tax efficient. However, do keep in mind that there's a limit to how much you can deposit for is a overall of 20,000 lbs in a lifetime. Isa you can only deposit up to 4000 lbs a year. You do get a 25% bonus back from the government. However, you can only take the money out for three reasons. Otherwise you'll, you'll have to pay a 25% penalty, which is more than what you put in. And the reasons are to buy your first home for when you're aged 60 you, you're retiring or if you have less than 12 months to live. So those are the different options. Um but you can start investing from as little as a pound and that's what I did. I opened. So my personal experience was I opened an account on free trade. I got a general investment account I put in a Tenner and I started playing from there. Basically, you have different types of investment options. You can invest directly with a company and you can invest in funds. So they are a fund that's already purchased shares in different companies at different proportions and they've managed the risk themselves by spreading the money out and then you buy into the fund. So ETF is exchange rate of funds. So those are your different funds that you can go. So like the S and P 500 is an ETF for example, rates are real estate investment trusts. So these are funds that have property. And so again, you can buy shares in those. So there's lots of different ways of investing. There are some questions here. If you're looking for Sharia investing, then there are options for that. You do have have to go to specific places. So their investments will be like in businesses, for example, and then you'll get a dividend or a share in the company's profits rather than interest, for example. So there are options, I don't know which platform. So you will have to do your own research. Is there a limit to the price of your first home to use Lysa tax free? So there is a limit of the price of your first home to use your lys A tax free. And Y Martin Lewis money saving expert has been lobbying for that limit to be increased because you can't, the house prices have risen so much you can't really expect especially in the more expensive parts of the country to stay under that limit. So do look for yourselves. 00, I like that. Trading 212 has a practice mode. That's good. Try that see how you get on. Hi there any methods other than the three you mentioned to avoid tax in the UK for investments. So there are, these are all under the isa bracket. So there are venture capital is a which are ones where you invest in a new business or new businesses they are looking but haven't introduced something called the British Isa, which is looking at an additional 5000 lbs over the 20,000 lb limit, which would go into new small and medium enterprise businesses. It is therefore quite risky. There are capital gains tax exemptions, there are capital gains tax limits so you can come under those and then not have to pay tax, for example. So it really depends on the value of what your, of your investment and what you're investing in. But in terms of, if we talk about investments as purely buying shares and stocks and things, then your is a are the main ones um of your options there. Which account would I have to open for a self invested pension if I don't have a pension scheme with the NHS, it's called, it's called ACI so self invested personal pension. And so for example, on free trade, you can open ACI and that's a self managed one. So you buy your own stocks and shares on dodo as well. You can do a self invested pension, personal pension and that's self invested like self uh managed. But there are lots of places like Aviva, for example, where you can get a managed private pension if you want. So self invested pension. So self invest in personal pension is a sip. If you wanna separate that term from in doing the investments yourself and self managing, those are different things as well. The difference between a stocks and shares. Isa and a cash. Isa is a stocks and shares. Isa allows you to buy stocks and shares on the stock market. You can hold cash in there as well, but it doesn't have a, they don't normally pay interest on the cash sitting there. Some do. And a cash isa is it just your cash, whatever interest rate they've told you you'll get plus if it's a lifetime isa the 25% bonus up to 4000 lbs. Can you have type multiple types of I A open? Yes, you can. Now, from April 2024 you can have multiple types of is a open simultaneously and you can pay into them simultaneously as well. Uh Up to a limit of 20,000 lbs. What used to happen in the past is you could open a new ISA of any type in every new tax year, but only one and you could only deposit in each type of ISA. So if you have a stocks and shares, you have a cash, you have a lifetime. You could only deposit in each type in like in, in one type, one of them, of each type. Whereas now you can deposit in any of them across whichever ones you want and you can open multiple ones in the year as well. So the the rules have changed is the tax threshold for your total across all is a Yes, it is. So 20,000 lbs is your total across all I a and they haven't changed. That self would mean I could take the money whenever I want and want to have a contribution for my employer. Yeah. So the self invested. Yeah, that's what you can do. But there tends to be limits of when you can take them. So you're not allowed to take it whenever you want. You have to, based on whichever place you're doing it with. Sometimes it's 50 sometimes it's 55 in exceptional circumstances, you can agree with them to have it to, to take it out later. But the whole purpose of these funds or the CIP and the fact that they're tax efficient is so that you can save for your future and save for your retirement. So if you were planning to take it whenever you want, then they wouldn't make it tax efficient because then everybody would use it like that. So basically, if you're opening a sip, know that you're basically signing up to say you can keep this money until I'm 50 or 55 depending on whichever provider you go with. So we can place up to 20,000 into an ISA and this money is tax free. Does it reduce your earn income? No, it doesn't. So you can place up to 20,000 in all your is a across your isa any interest you make on that 20,000 is tax free. Any dividends you make from the stocks and shares you purchased using that 20,000 is tax free and any growth from the stocks and shares that you purchased using this 20,000 is tax free. You can't in reduce your tax liability for your income. This way, you can reduce your tax liability for your income if you put it in a pension because your pension is meant to be tax efficient. So if you want to reduce your earned income by 20,000, for tax purposes, it needs to go in a pension, not in an isa. So I wanted to touch on less than full time training because things are hard at the moment and don't shy away from less than full time training. Don't let people make you think that oh, you need to rush and get through your training as quickly as possible. It's a marathon, not a sprint. Your mental health comes first, your personal health comes first and it's very important that you have a good work life balance because they don't care if you do or not. So in foundation training, your ta training is time based, which means if you do less than full time during foundation, it will extend your training. The same goes for GP training as well for the remaining. So any other specialty, now, each trust will be finicky about this. But technically, according to the BM, all other training is competency based. So as long as you meet your competencies and you're doing something reasonable. So, for example, if you did 40% and tried to tell them that you've met all the competencies within the same time period, that's probably not gonna fly. But if you're doing something like 80% maybe even 60% you can, you can try and get an ACP at the same time, you would have done at 100%. And as long as you've met all your competencies, they should sign you off. So have a good think about less than full time. A lot of people tell me, oh my God, what will I do about the pay? Because obviously your pay goes down if you're working less, so you can be using your tax free allowances so you can become self employed and start freelancing in certain things, using your other skills there. I've mentioned rental income and rent a room scheme only because I wanted to have like an encompassing tax free allowance area. But you know, it, this may not be relevant for you, but basically tax free allowances. You, you're allowed to earn up to that certain amount without having to fill in a self assessment tax return. And you don't have to pay tax on that, any money above that, that you make out of those things that you do have to pay income tax on develop passive income streams. Monetize your skills. I promise you, I do so much more for my projects than I do. Well, I am an F three, but the reason I became an F three was because I couldn't do any of my other projects. And actually when you're in training, you're not being paid super well. So you, you know, II personally feel like we're such, we're bright, we have lots of extremely good skills. We're just terrible at recognizing them. We're made to feel like we can do nothing more than medicine. And that is absolutely not true. Take the time to actually learn about yourself what you can do and take that stress out of your medicine career being your sole income stream. It doesn't have to be doctor Ellie Todd. She's on our, we've so medics money have done a podcast with her. She works less than full time or well. She works part time as an A&E doctor and she owns two businesses and there's so much free advice that she provides on. She's got an ideas incubator. She's got guides on starting your own business. There's loads of options. So think about less than full time, especially if you feel like, um, so give it, you know, start off full time if you want. But if things are really, if you're struggling, you're not struggling because of you. Ok. The, the system is tough, the job is tough. The rotor is tough and if less than full time is going to keep your sanity, then don't disregard it as an option. The one K trading allowance is basically if you're making any money as someone who's self employed. So this is from freelancing tutoring, even filling in surveys like market affiliation stuff. So basically if you're making any or if you're making stuff as in, I, for example, I crochet, I made this, if I was selling my crochet, the money I make from, that would be from, would come in, come into my trading allowance. Oh, thank you. So that is your trading allowance. So any money that you make from freelancing side hustles anything that you're self employed if you're not under a limited company. Um So basically you're, you're acting as a sole trader or a self-employed person. I locum. I do, I do so that this is not 100% relevant to the slide. But would you recommend locum a shift to make more money? So, you know, it's based on what the locum pays. So if you can make more money, not locum and doing something else, then why would you, so it's very personal to you and what your situation is. So for example, I work in Oxfordshire, the ICB have basically come together and said that they're not gonna pay any more than 45 lb for social locums and 55 lbs for unsocial locums, which are, you know, still good rates. But compared to I know in London, some people are like down on th on 35 for example, but that is nowhere near as good as rates used to be. So, Tommy, who I said is one of the GPS who started medics money. He used to get 75 for sho locums in A&E per hour. So our locum pays have drastically reduced and locum is just not as, it just isn't as good. I mean, it's better than the money you make when you're on a training contract. Cos in F one, for example, we're only making like 16 quid an hour. So, you know, locum is still more than that. But if you can make more a different way, then why wouldn't you, you don't have to fill out a self assessment tax return if you make less than 1000 lbs. Not sure if it's a thing. But I wanted to ask about locum under a private company. So you can't do that anymore in hospitals. So you can locum in GP practices as a GP locum using a limited company. But the NHS trusts don't do umbrella companies or limited companies anymore. Um, you either come under them as pa ye or you work in their bank or you, um, work through an agency. Um, does the trading allowance of one can mean that is what you earn through one whole tax year. Yes. Um, for tax free allowances with the NHS contract. Yeah. So those are your tax free allowances with or without an NHS contract. So those are just your tax, your self employed, tax free allowances regardless of whether you have a job or not. Um, but so for example, if you don't have a job at all, then you have the nil rate, 12,570 lbs banned for income tax. So you'd still have to fill in a self assessment because of the trading allowance being over 1000 lbs. But you probably wouldn't have to pay tax on it because if you have no other income whatsoever, then you come under the no rate band. Um But you do have to fill in a self assessment isn't tax cut at source here. So th this is separate, this, this tax, this trading allowance is for self employed income only. Um If you're working in an NHS contract, then the tax will come out atso you don't have to file, do you have to file later on if we don't work or earn another way and have savings of? No, you don't, you don't have to do that. So there's II think I'm creating a bit of confusion here because the tax system is bloody confusing. So basically your income tax is in bands. So your first rate band, II, let me just double check whether I have these bands here or not. I don't. Ok. So basically you just Google Google income rate tax bands, but there's a nil rate band where for the 1st 12,570 lbs that you make any income whatsoever. Actually, employee, self, self blah, blah, blah. Even your, um, savings above the savings allowance, your capital gains under the cap over the capital gains allowance, your dividends over the dividend allowance, your pensioner, certain benefits, uh, all income. This is for your income tax. There is a nil rate band of 12,570 lbs where you don't pay any tax. When you go above that up to 50,000 and something, you pay 20% between the 12 5 70 the 50,000 or something. And then when you go over that, you pay 40%. And then when you go over, I think it's 100 and 20 K, you pay 45%. Your one K trading allowance is separate to that. And the trading allowance is based on whether or not you complete a self assessment for tax purposes. And if, for example, like, say you're an F one, you're a full time F one you're working for an NHS trust, you're gonna make about 30 sevenish, I think. Um, they've changed it now. So 37 K a year. So you're going to have lost your nil rate band because you're already making over 12,000, 570. And so anything above that between the 50 K ish is all 20% taxed by income tax. Then say you start freelancing as a website designer, if you don't have a limit limited company and you're just doing this as a sole trader self-employed, then if you make over 1000 lbs in the tax year, you have to complete a self assessment to HMRC and any money over the 1000 lbs that you make doing your website design is gonna be taxed at 20% in this example because you're still under the 50 K tax band for the next spending. I hope that made sense, but it's obviously fluctuant based on how much you're making. So, for example, if you were registrar and then you were making over, so you were making 2000 lbs doing website design, then you will probably be in the 40% tax bracket. Now. So any income you make over 1000 lbs in your website design would have to be taxed at 40% not 20%. It's, the tax system is very confusing. So, don't beat yourselves up if you're confused about it, it's, it might, I have like a spreadsheet calculator that took me literally 16 hours to build and, and it, and it just, ah, it was COVID might be a silly question, but I assume the self-employed income is cumulative. So, if you have multiple income streams from self-employment, like tutoring crafts. Yeah. Yes, they are cumulative. Absolutely. Ok. Lovely. Thank you. Ok, cool. I think I'm gonna go for another 15 minutes or so just because, um, I'm on nights this week, so I need to eat before I go. I might skip past shared parental leave. If you want me to talk about it, then, then say now or forever hold your peace. Cos many of you might not be thinking about others. Oh, ok. One person wants it. Ok. In the UK, you can get something called shared parental leave. Shared parental leave is a shift in the paradigm. So what used to happen is mums used to have maternity leave and they could take up to a year off, but only 37 weeks of them would be paid so they could take up to 50 weeks off. There we go nearly a year. But obviously the other two weeks would be with would be the annual leave anyway. So, but 37 weeks of paid maternity leave, not full pay, just I'll come back to that in a sec. And then dads would only get two weeks of statutory paternity leave, only one week of which is paid, which is not very nice at all times have changed thankfully. And now mum and dad can share the leave between them. This is if both mum and dad are employed as employees, the rules are different. If one parent is working under a limited company and the other person is working for the NHS, it's very nuanced. So this is all very big. Please talk to someone else about more details about your personal experience and your personal cir circumstances because it's very nuanced. So basically, now what happens is both parents take the first two weeks together, they have to. So dads have to take the first two weeks as well. And then they can choose how they split the rest of the 50 weeks up between them and be sensible. They can choose between blocks or they can choose to take it simultaneously. So for example, if there's 50 weeks, mum and dad can take 25 weeks each and take them at the same time. So tandem together and then both have to go back to work. Or mum can take 25 weeks and dad then takes 25 weeks. So you can basically share it amongst yourselves. You can't take it sort of like he takes one week, I take one week, he takes one week. I take one week, like you have to be sensible and basically, I've not included this on here and I'm not 100% sure what the NHS one is. But ba the first, I think six weeks don't quote me on this. It might not be right. The first six weeks are full pay. I might not be right actually. And then the next six weeks are half pay and then the next are statutory and then the next are unpaid. Don't quote me on that. But basically the pay over parental leave gets smaller and smaller. Basically. Maybe a stupid question. But if both parents are employees under the NHS, do they each get 50 weeks or is it shared only it's shared because the other partner isn't also pumping out a baby. So only one of you is making this baby come out when you face first say two weeks have to take them together. Is that the first two weeks or first two weeks of leave? That's a really good question. And I really don't know, is the honest answer to that. I think for dads you take the, you take it after birth. I don't think dads can take leave beforehand. Mums can so they can choose when they decide to go on maternity leave and it could be before delivery. But I think dads do take it. Does this still apply if you're a GP partner that would depend. So GP partners are self employed. So it is based on the GP practices um parental leave policy. So people, everybody's entitled to shared parental leave per the UK law. However, how different entities decide to administer that varies entirely and a GP practices its own independent entity with its own policies. So it will depend on their policy. Um but they are still entitled to shared parental leave. I hope that helps. What I will say about shared parental leave is it's an excellent way for two people who respect each other and want to ensure that neither suffers as a result of the reduced income that comes with that first year with, with Babby because women lose out on pension contributions, they lose out on employment opportunities, they lose out on the income at the time. Women are disproportionately negatively affected because of having Children. And so shared parental leave provides an opportunity for the hit to be cos there's no like it's a hit at the end of the day, like you are getting less income, your pension contributions are lower. So it's, it's a way of both parents equally taking the hit. So no one parent is worse off than the other. What's statutory shared, shared parental leave? And how much is it? I don't know what statutory shared parental leave is and how much it is. That's a government thing. So it will be on the government website. Just bear in mind to get statutory maternity pay and paternity pay. You do have to have a certain income threshold, I think otherwise you just end up on maternity allowance which again has its own thresholds. So do have a look, um, on those. So in theory, the male partner can take the entire leave even though they did not give birth. Yeah, if, if that's what the woman wants. Yeah. I mean, the mum, like I said, would have to take the first two weeks and um, she might just be very upset about going back to work, um, two weeks after giving birth, but it's completely personal choice if that's what they wanted. Um, yes, if you take more than 50 weeks maternity leave, it will be unpaid and maternity leave is only classified as maternity leave for 50 weeks. So once you start going over the 50 weeks, it's no longer maternity leave. So it's just unpaid leave briefly going to go over the NHS pension. If you take one thing away from this, don't opt out of the NHS pension unless you've spoken to someone who knows what they're doing. It is not a decision you should take lightly. There are two types of pensions available. So when I was talking about the private pension or the self invested personal pension, that is a defined contribution pension. That means that you contribute to a pot. Most private sector, if not all private sector now has defined contribution pensions for their employees because defined benefits are very expensive but very generous. Defined contribution means that you contribute a certain amount. If it's um part of your employer's pension scheme, the employer will also contribute, this contributes to a pot. The pot is gambled on the stock market to grow. That's how it grows and it can go down or up. And when you start drawing down your pension, the pot is finite. So when the pot is finished, the pot is finished, you could be 60 you could be 90. The pot is finite. A defined benefit pension scheme is more generous. It basically it is more, you continue to receive a stated or defined pay out until you die. So it is more generous, obviously more expensive, which is why there are fewer and fewer places that do it. Public sector still do it. And that's, that's one of the ways public sector try and retain talent is by having a more generous pension scheme, our pension scheme over the NHS has become less and less generous over the years. So this pension scheme that we have now is nowhere near as generous as the 2008 chapter, which is also nowhere near as generous as the 1995 chapter. So yeah, and that's all cost based. Basically the good thing about it is it's paid out until you die, it pays a death in service benefit. So if you haven't started drawing down your pension yet, but are still working as a NHS employee and you die, your whoever you've nominated gets a lump sum. In the event of your death, you can nominate certain dependents. So even after you die, they continue receiving pension payments on your behalf. The dependents have to be very specific. So they have to be like literally financially dependent on you like your Children or someone you care for the pension grows. But because it's government backed, it's an in inflation beating as well. So the government backs it. It's not gambled on the stock market for growth, it grows at a specific rate that the government has already set out and basically you contribute a certain amount. So most of us will be contributing 9.8%. There's a table based on how much your pay is on what you contribute. So we contribute 9.8%. The employer contributes 27%. Neither of those figures really mean very much in terms of what you get out of the pension because your pension is based on a career average of your contributions and how long you've been working in the NHS. So it's more like a fee to be part of the NHS pension than an indication of how much your payout is gonna be. Let's get some questions. Can you be part of the NHS pension even if you go work abroad long term. Do you advise two pension schemes? So I have both the NHS one and the private one because I said, uh I think you may have remembered that I said to try and reduce your, your tax liability. Now you can um deposit into a um private pension and get your tax refunded for later on. And the reason I say having both is because you can't, I don't think it's appropriate, especially in this day and age to have all your eggs in one basket. There's your Love Island quote for the day. So having your own pension as well as the NHS pension gives you more of a safety net. Plus the NH SS pension is linked to state pension age. That's one of its downsides. So at the moment, state pension age is 67 or 68 and, but you can't draw down your NHS pension until the state pension age, which will likely be going up. Whereas your private pension, you can start drawing down from between age 5055 depending on the provider that you go with. So you might say I only want to work full time until I'm 55. Then I want to work part time and draw down from my personal pension until I can start drawing down from my NHS pension. You can be part of the NHS pension scheme if you go and work abroad long term in the sense that if you're still like, say it, this is really nuanced for. So for example, I don't know if you guys follow nomadic medic on Instagram. He is one of the urology registrars that I actually worked with when I was in F one. So basically, if you stay, if you sign up to the bank of an NHS Trust, you can still continue to make contributions to your NHS pension and he's abroad for the year. And so you won't get any employer contributions but can you, you can still continue contributing to your NHS pension? And also your NHS pension will pay out no matter where you are in the world. So if you decide I'm gonna do F one and F two and then I'm gonna work abroad, then perhaps it's not worth having the NHS pension, but you never know what life's gonna bring you because Tommy had gone to Australia and thought he wasn't gonna come back and then ended up coming back. So, you know, you, you need to really be sure. But say you did 10 years in the NHS and then decided to go work abroad. Your NHS pension will still continue to grow while you're working abroad. If you're still on your trust bank, then you'll still be able to contribute to your pension if you wanted to. And when it comes to state pension age in the UK, and you start drawing down your NHS pension, you can do that from anywhere in the world for NHS pension. Can you opt in later? That's a really good question. And the thing is when you first start F one, you're automatically enrolled and then you opt out. So you can't like opt in later and not opt in at first. And I think there's a five year limit to when you can opt back in. So if you opt out and then after five years decide you wanna opt back in, that might be hard. And that rule might change as well if you leave the country after retirement, do you still receive pension up? Yes, you do. What if you go and work for a company? Can you still have an NHS pension? You can't keep contributing to it, but it'll still be there. Whatever you contributed will still be, be there and it will grow and you can draw it down at state pension age. I'm applying for bank staff as an international med grad. Am I also automatically enrolled? You're not. Unfortunately, so it's only substantive NHS staff, you can go on to the NHS pension bank staff get enrolled in a government backed pension scheme called Nest. In fact, I'm on the bank. Therefore, I'm in Nest. Have a look. So Nest pensions are a government pension scheme for. They created this so that everybody could have a pension scheme if even if they were on zero hour contracts. And so you get enrolled on Nest, can you only come back and work in the UK if you left the country after consulting over or can you leave after after two and still come back and work? Not a clue. My friend, I have no idea. I think consultant level will be easier. But I, you know, I know people who left after F two and then depending on like where they were in their training level and then who they decided to join in terms of trusts and what the trusts recognized as the level they could work at, they could join as locally employed doctors locums, as registrars. So, you know, that's very like nuanced, I think. And I think as medics, we try and find certainty where there is very little of and actually, you know, there might not be a straight forward answer to that question. It would depend entirely on where you are, what experience you've had, what you did when you were abroad cos you, you know, lots of people go on fellowships and what the rules are when you come back and things change over time if I opt in and work for 10 years. Yeah, I'm a non British citizen. Now. Would I still have an HS pension and be able to draw it from my home country at the age of 60? Not at 60. You y yes, to everything else but not at 60. It's linked to state pension age. So it would be based on the UK state pension age. What does pension look like for locum doctors? So, Bank is Nest, like I said, otherwise it's your self invested pension that you do yourself theoretically. Can you take out your pension contributions at any point in life or you do need to be of retirement age or declare retirement? And can you take it in a large sum and so small payouts? This really depends on which pension you're talking about and you can take your, you can't take your pension contributions out after a certain point. I think the limit is two years, but I'm don't quote me on that, but after two years, you can't have your pension contributions back. I think I cos I have a civil service pension as well for when I was a chartered accountant and I couldn't get the money out of that. But I, you, you can't get your contributions back but you can get like the value of the thing back. So I don't know if that's the same for the NHS pension, but for my civil service pension, it's not very much because I didn't spend very long in the civil service. Um, but it gives me this, like what the value of the pension is now if I was just to take the money out, um, and I could just take that money out. It's substantially less than what I put in. Um, but there is that option. Um, this is, it's very unique to wherever you're for NHS pension. You have to be the state pension age to draw the money down. There's no like declare retirement and things like that. You have to be state pension age. You can take a lump sum, you can't take all of it, but there is a tax free lump sum. Again, the figure 30,000 comes in my head, but I'm not 100% sure on that, that you can take tax free. But then the rest of it, obviously you draw down monthly. But yeah, you can take a lump sum. You can't take the whole thing as a lump sum, um, tax free. So if you decided to take the whole thing as a lump sum, which I don't even know if it's possible or not, especially with the N HSP pension being defined benefit. If it was defined contribution. That would make more sense because you know what the pots value is, but defined benefit. It, it doesn't really work that way. So you wouldn't really be able to take an entire lump sum, but you'd have to pay quite a lot of tax on that as well. Um How much percentage of your income would you recommend putting into your personal pension? That's really personal to you in terms of what you can afford? I suggest not going on what people recommend but actually doing a good, I've got a free budgeting spreadsheet on. Oh, I should have mentioned this. Hang on. So that's me at the finance medic on Instagram and I have a free budgeting spreadsheet. It's just a link in my bio. It's completely free. I don't even ask for your email address. I don't care what you do with it and it just helps you understand your financial position. And what you can do is figure out how much you can afford to put away because you don't wanna go on what someone else has recommended for you and then end up not being able to pay your bills. So that that is very personal to you. However, you need to make sure that you do it regularly that it's automated and you do it before your once. So it you know it should be income and then pay yourself first. So pay your savings, pay your personal pension, then it should be needs and then it should be once, not the other way round. Are you an F three plus ac A? How did I manage to have very difficult degrees? I don't do. I look really like old and tired because I feel it seriously. It was really hard. I actually found my Chartered Accountancy much harder. Medical school was emotionally like a roller coaster. The exams weren't as difficult though as the Chartered Accountancy ones. But the Chartered Accountancy side, you had a lot more support. You got paid to work and learn, you got study, leave a lot of it. You got college that you went to full time for certain blocks and your exams were paid for and like one was paid for. So in terms of like emotional burden, it was less but the content was extremely challenging. Whereas with medicine, the emotional burden was a lot higher and the content was more sheer volume rather than in charge of the accountancy where it's all applicability. So they'll in charge of the accountancy, they'll give you like a case study. There's this company, they want to buy X company or they have this whatever and you have to basically apply every single piece of financial knowledge that you've gained over the course to answer a whole bunch of questions and apply everything which is not the same as rote learning. Oh, do do, do sorry. This isn't pensions but any tips for things in fy we can claim claim back as tax refunds. So, in foundation, yes. So o you can only claim back tax relief in um, years that you've paid income tax. So you can't claim back tax relief for med school stuff unless you've paid income tax and stuff that you can claim back on are things like your BMA, your GMC. Any royal colleges fees you can claim back for your second stethoscope onwards because that's classed as a replacement of medical equipment, but not for your first stethoscope. But you probably bought that in med school. So you can claim that back anyway, things like asset fees and stuff like that. You can, you can claim back. Um For those, basically, there's like a list of entities whose fees you can claim back, but you can't claim back courses, things like pass med or if you needed to get a question back for the M sra for example, which that reminds me I need to do that. Then you couldn't claim that back for tax relief. Um What led you to the decision to leave accountancy and become a doctor? Frankly, I was, I think a bit stupid and I thought I could help people. II just felt like at the time I enjoyed what I did, I enjoyed the people I work with. But I think I was searching for more purpose and meaning so all that rubbish. And basically I realized that now this isn't what was gonna give me purpose and meaning and, but I've learned a lot, I've learned a lot about myself. I've learned a lot about people. I've learned about the definitions of success and how our internal definitions of success are driven by things people tell us rather than how we feel. So now things are very different than what I was when I first started medicine. And I think I had a romanticized idea of what medicine would be like. And it's just not like that all of and, and I just like doing stuff with my hands. Like I'm very artsy and crafty. Like you've seen, I really like procedures. So I was very surgery orientated. I still love it. I still am but the, the life is just not for me. So yeah, that that kind of led me to to swap. But actually I do think for work life balance and it obviously depends on the role I had a better work life balance and uh better pay prospects when I was in finance than as a doctor. And that realization kind of hit me quite hard. So, yeah, II don't know if that helps. You can't put a LS on a study budget if you work on bank unless they say you can, this tends to be for trainees on study budgets. A AA said I look very young for too difficult to degree. Oh, thank see, I feel better now. Thank you. Ok. So at least doing something. Right. Ok. What is the tax relief? Is it just that or full cost? So, basically, you know what I said about the income tax brackets, it's gonna be 20% unless you're a higher income tax payer. So 40 or 45 your tax relief is gonna be 20%. So you get 20% of the, whatever you spent on it back. So say your second stethoscope was 200 lbs. I don't know how much they cost. Now. They, then you would get 20% of that back because you technically paid 20% tax on the money that you spent on it. There's a lot of discussion about not claiming back hours, you stay behind post shift because it's your duty to help. Do you recommend still claiming back 100 and 10% exception, report, exception report, exception report because this is the, you know what I said about lobbying and when I said about like we don't have people fighting for us. It's this shit like because we just lie down and take it. We don't, you know, the, the other professions, they don't do that, they fight. I mean, how many times have you seen nurses go? No, I am not doing that. That is not acceptable because they have a strong um workforce and they stand up for themselves. We don't stand up for ourselves at all. We, we've so, we're so scared, we're so scared about our careers and we should, it, it's reasonable that we're scared. Like the evidence out there suggests that our careers aren't really in our hands, they're in the hands of our supervisors, they're in the hands of the GMC. And we, you know, that, that's kind of what we're told all the time. So standing up for ourselves is really, really hard. And so if there's an exception reporting, there should be, every trust has an exception reporting way or policy. It's either an app or it's a whatever a form exception report. And if consultants and seniors are saying, don't exception report, you have to tell your guardian of safe working that they're telling you that because that's what your guardian is safe working is there to do. When did you train to be AC AC A? Oh, so II started off as AC A. So I was 19, I started and I didn't actually do a degree. I ended up doing like a four year fast track and then qualified as a chartered accountant, worked for six years and then decided to do a physiology degree because I knew I wanted to do something, science, something medicine. But I didn't know if after all that time, I still wanted to do medicine or something related to it. So I did a physiology degree and I worked as a phlebotomist at the same time. And I really enjoyed being a phlebotomist and I really enjoyed being like talking to patients and things. So I decided to do medicine as afterwards. So I did graduate entry medicine after that. So seven years later and I'm still making, like, nowhere near what I made when I first started accounting. So, yeah, if we have any future. Yeah. Absolutely. So, if you follow me on, at the finance medic, then you can just message me absolutely. Fine. Does exception reporting apply to NHS Wales or is it different because they're a different junior doctor contract? That's a really valid question. And I genuinely have no idea. And I would actually, if you've got any junior doctors that, you know, or if you can just see online because it's a different junior doctor contract. So I think it's still using banding, uh Wales because Scotland's the same and I have a friend who's in Edinburgh, she's the same as me in F three. And I remember her saying that you can't exception report. But what you can do is everybody has to like together work and this is the big thing. Work together. Don't like, you know, you're not alone together as a team. You have to say, I don't think the banding is appropriate for the amount of work that we're doing and you can ask for the banding to be reviewed. So the Bandings they work by basically, if you're on, say a placement that has no, on calls by. So no weekends and no nights or whatever, you'd be on like banding one which is the base salary and then if it has like a certain amount of hours or, you know, added things on top, the banding increases to say 1.31 0.5 et cetera. And so you can, if you think the banding isn't representative of how much work you're doing as a group, you can lobby for the banding to be reviewed. And if the banding is reviewed, unfortunately, it's not you who benefits from the reviewed? Banding, it's the people who then join after you, which is a bit annoying. But then what you're doing is like hoping you also benefit from people who, when you join a place that people before you hopefully got the banding changed for your benefit. And that's my understanding of it, but that's from, you know, from what she's told me, it's, I don't know what the official thing is. What are your next steps after a three? I do not know. I don't know what to do. I'm, I'm a bit, I'm a bit phobic of commitment with the NHS right now after the experience that I've had and I'm not entirely sure whether I want to continue in training or not yet. II really genuinely don't know. I have no idea. I'm enjoying my F three. Like I do like, say 32 to 3 locum shifts a week, which is so much nicer and sometimes I don't get the locum shifts, which can be quite stressful because the the locums are, they're fewer now. But I do prefer how it is at the moment. Like, I don't really feel like I go, go back into like a full time training contract. I just, I just felt like the last two years in F one and F two were just spent on autopilot and I had no life and I was actually really unhappy and that's not what I want the rest of my life to look like. So I genuinely don't know. And the thing is I'm ok with, if I don't continue with medicine, I'm ok, I'm not gonna be like forcing myself to continue if it's not going to make me happy and if it's not going to be a sensible decision for what I want out of life. Um And I think that the problem is that people, especially at the moment, people who've, who want to do medicine feel like, oh, once I do med school, I can decide. But actually, you have no idea how much becoming a doctor becomes intertwined with your being like it becomes your identity and it becomes everything that you are. And that's because of just the environment. So actually untangling from that is so, so hard. And then the longer you spend as a doctor, the worse that entanglement gets, which is why people find it harder and harder to just make a jump and then you get the sunk cost fallacy that you've worked so hard so far you can't leave now and then you just get more and more trapped. So, like, you know, just keep that in mind that this is why I'm sort of not jumping into anything or desperately trying to get on a training contract or anything like that because I know those kinds of factors will feed into it and I'll go, oh, well, I should just see training through or I've worked so hard now, I've got, you know, I can't leave now and things and those shouldn't be factors that keep you in a, in a place that you don't see yourself being happy. I know I don't have forever to make a decision, but I don't think I'm just ready to make a decision. Now. Long winded answer to that question are international students allowed to apply for the NH Bursary? I really don't know, is the honest question. I genuinely don't know. It'd be worth just checking the NHS BSA website because II genuinely don't know the answer to that question. Oh, Abby has said we can't accept your report in Wales and we're still on the 2002 contract. So it's that banding thing I was talking to about talking about, which is rather rubbish. Ok. You're very welcome. I'm really grateful that you found it useful actually. And I really, really hope the best for you all. I just want you to remember that just because you're about to start med school just because you're in the middle of med school or just because you're about to finish med school, doesn't mean this has to be the rest of your life and really make decisions for you and what's important to you and that will change over time and it's perfectly reasonable to change your mind. Don't let anybody say to you or, you know, like the worst thing is when supervisors try and convince you to do something because they're seeing everything from their own perspective and they're seeing things from how things were for them a long time ago and things just aren't like that now. So if you're asking for advice from people, asking for advice from people who aren't even remotely connected to or aware of how your situation is it, that advice is really not gonna be as applicable to you as you think. Um, Fatima, thank you, international students aren't allowed to apply for the NHS Bursary. Um Lovely. Ok, I'm, I'm going to close this now. Um Thank you so much.