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All right, then I reckon we'll get started. So thank you so much for all coming to join us tonight. Um and Ellie and part of the team that brings you the F three series via the Portfolio Clinic. And for those of you have joined us for our previous two episodes in the series, you'll know that we're focusing on the sort of unexpected F three. So we know that specialty training is, is really competitive and a lot of people don't get what they wanted maybe first time round. But our aim of this series to really showcase all those opportunities on offer and during an F three year or an F four year and, and how you can turn what you may feel is a negative now into a positive into something that can really help develop you and your career. And this series is also for those people who maybe haven't had, it, don't have anything planned after finishing their fy two year and, or those people who maybe aren't sure if they want to take an F three year or not. So hopefully, and you'll find this helpful tonight. We are joined by Saskia and she's had a really great experience in a wide range of rules which some of which I didn't even know were sort of possible at this level. So it will be really great to hear from her and there will be lots of opportunities for questions at the end. So keep, you know, if anything comes to mind and have to think about it and then pop it in the chat box at the end and so great. So, over to you, Saskia. Great. Thanks so much. L E so, yeah. Um I'm in my f five year now. So, um, I've had three years after training. Um, my current feeling is that I don't know if I'm going to go into training at any point. Um, and I didn't know that you could do an F five when I went to F three, I think. And, um, in my F three year I met an F seven. So there is the option to just keep, you know, in one sense, it doesn't really mean anything. It just means that you're not in a training scheme. Um, oh, that's how I think of it. And I just put on this, this front slide. Um, this icky guy which is a Japanese concept about a reason for being and I find that kind of my path in medicine, figuring out what I want to do with my life has I guess, been a maybe we're all doing this but trying to find that reason for being where, you know, you can, you can find joy through your work and, um, all of these other things. So, yes. Um, so I'm going to talk a bit about me, why I'm talking, why I pursued a three f 45, what I've done in the last few years. Um I'm going to touch on what might be next and then, yes, Ellie said we'll do questions. So, I'm a musician by background. Um I am a horn player. And um when I went to medical school, psychiatry was the thing that I wanted to pursue. That's why I went into medicine. But when I was in medical school, I got kind of swept up into really excited by anesthetics A and E things like that. And also palliative care became more of an interest. Once I was in my foundation years, I'm really interested in psychedelics and plant medicines and very involved or have been maybe not very involved, not as involved as I'm hoping to be, but in research into these things and um learning more about those traditional ways of healing that includes psychedelics, implant medicines, but also um you know, all kinds of traditional ways of healing. Um Yeah, yeah, I'm always never sure how much to talk about all that stuff because obviously, yeah, I think most people are aware that things like aspirin come from, you know, the willow tree and so many of our medicines come from these plants. So I just find it fascinating and I've gone kind of from a very um medical model way of thinking too much more nature based way and particularly with this interest in psychiatry and mental health and things, how we look at things from a wellness perspective rather than an illness perspective. Um So why did F three? So I was always going to do my F three year, I was never going to go straight into training. Um That picture on the right was my f one of my first f one jobs carrying three different bleeps on call. Um And you know, and you can do such things in your, your years out, you can do really intensive covers. Um But I haven't experienced that. I was much more fond of that, that lower picture of me lying on the grass on the last day of my F two job, which I was loving. I did general practice and I really enjoyed it. But just the, for me, it's about the freedom um of being totally in charge of my life, my timetable, you know, not, you can do rooted jobs, of course, but you can also do like 9 to 5 Monday to Friday jobs and get paid the same um more money, of course, the freedom of being able to take holidays whenever I wanted to. Um being able to try out lots of different things, see what interested me and actually boost my C V now, I know that this isn't the case for some specialties, some specialties you can take too much time out. But for psychiatry particularly, I'm sure things like palliative care and things like that, um, that won't be the case and general practice and things. Um, actually the more life experience you have and different experiences of different jobs, it's all quite beneficial. So, yeah. Oh, yeah. I was planning to go to India. That was my plan and then the pandemic struck. Um, so I ended up doing lots of work on COVID wards right at the beginning of my f three year. And actually I got a message saying that I've been in contact with some, with COVID and couldn't come to work between two night shifts. And that right picture is me just chilling out in my van and it was quite, that's one thing about locum work, which is probably going to be the main thing that I've done. Maybe we'll talk about, um, that you don't generally don't get sick pay and that might be something for you to consider. Um, and there are financial kind of things which I haven't done, but I've been thinking more recently about getting, um, some kind of insurance for, you know, if I was ever to have to be off with an illness or something like that to have my income protected at the moment up till now that hasn't felt, you know, important enough. I could always miss, you know, whatever it was two weeks of work at that point and it was a big impact on my finances. But equally, I was earning so much as a locum anyway that it didn't, you just kind of got to be clever about it. Just expect the unexpected. So, yeah, I've been off traveling, um done lots of festivals, both as punter as a volunteer and in paid roles. So I talk a bit about that. Lots and lots of low comms in lots of different roles. I talk a bit about that. I bought a van and did it up and have been living in that for some of my locum shifts, which was really great and the festivals as well and all kinds of other things are touch on some of these. So, yeah, so these are pictures from North Devon and Cornwall. So I'm working in Cornwall at the moment. Um North Devon was another psych job. So, yeah, I've mainly done psychiatry over the years. So I did six months in general adult inpatient um about six months in forensic adult in patient's. That was medium secure unit. So step down from Broadmoor, Broadmoor is high secure. Um Most people have heard of that and yeah, medium secures, slightly less risky adults, but they're still kind of on a locked unit. It's people generally who've been come from prison and have quite severe mental illness need to be in a different setting. And then I'm now working in Cams outpatient, which I'm loving and that's in Cornwall. So, yeah, those are those ones. I've done lots of single day job things, um, in lots of different medical specialties, some surgery as well in Somerset, Devon Bristol, um, Dorset as well. And yeah, it's, the day shifts are great doing odd shifts to sign up for, um, for a shift as it comes in and there are all sorts of apps and stuff and I can talk about that if that's, if people have got questions about things like the RAND, you know, date, date, doing one day at time, I'm trying to say, but the jobs that I felt a lot kind of more securing other jobs where I've signed on with my agency. So Pulse is the agency I've been working through there, like kind of the uk's, um, probably top agency for Psychiatry and they've been absolutely brilliant for me. Uh So, yeah, kind of feel a lot more secure in the jobs where I've kind of had a rolling contract or I know that it's been like a certain amount of time that they've needed me for. And I also did, um, I can't remember how long it was for and it wasn't very often, it was less than once a week, but I worked for a private medical company which was called D for Drivers. Um, they were quite good. I found them quite good. I was quite quick at doing the work. So what it was, was making sure that H G V drivers or potential HDV driver's passed their medical checks, which is obviously quite a significant thing. There's, if people have heard about it, there was a lorry crash in Glasgow a few years ago where quite, I think a couple of people, or maybe more than that died. Um, someone had lied about their medical, their medical history on the medical check or something. And then I haven't quite what happened, but he wasn't, he wasn't conscious at the wheel at the point of running over a bunch of people in the crowd. ID street. So it's quite, quite a significant thing. And again, H G V driving is a lot more financially attractive than lots of other jobs. So it has been over the last couple of years. So it's been a real burst of people applying for this. Um And it's interesting, it's a clinical work because it's private work. I've worked all over the place and been putting some really nice offices for it. Um What I would recommend with doing something like that is obviously you need um like your insurance to cover it. So you need to have a conversation with your insurance insurance provider. But also um have a look online, like look everywhere at people's reviews of the company. I, like I say I found the for drivers really good, but I've seen some more negative reviews by lots of people who kind of the only give you 15 minutes appointments and it's quite a lot to fit into a very short space of time. So if you're kind of running behind with that, that can be quite, that can be more pressuring than your normal job. Um, the other thing about private work is that maybe it's not always like this, but with this particular company, they paid me directly and they don't take the tax and all of that stuff out of it. So that just makes things a bit more complicated to make sure that you're paying all the taxes and stuff correctly. Um Yeah, so festival work. So this has kind of been um some of my favorite stuff really. I've always been working in festivals for a long time. So I work with Psych A UK who are these guys up here? Um It's a psychedelic harm reduction charity. And so we offer welfare spaces at all kinds of festivals across the UK and outside the UK, but there's, there's kind of sister companies in different countries. Um Well, I'm one of the coordinators for it. So this is a technically a volunteer role, but because we work such long shifts, they have, we do get remunerated slightly. Um But it's much more for the love of it. So last year um where those photos with the red and white tent come from. Um In fact, most of the, most of the photos on here. Um We did secret garden party and we had the largest amount of volunteers to run um that we've ever had, which was over 80 volunteers running in the child welfare spaces. We had a safe space tent which was new. So we were looking after people who um were victims of sexual assault and things like that and anything to do with more sexual stuff so that we had a specific space to be dealing with that because that's the thing that's um been increasing on the festival season festival festival. Uh yeah, festival grounds or it's either increasing or people are becoming more aware of it and talking about it more. So that was a really important thing. Um Whilst also running these kind of welfare spaces and harm reduction spaces like giving people information about drug use and other things like that. It's really fun. I love it. But we were working, you know, up to like 24 hours at a time as coordinators, lots of doctors get involved with things like that because they're passionate about making drug use as safe as possible and um having really honest conversations with people and it's great to be a festival. Um So another of these pictures is from Shambala Festival. So there's, there's, you know, there's other ways of getting involved. Again, my experience is unpaid but in exchange for tickets. So um Shambala have an excellent medical team. So that was, I was working there with both in the Welfare Space Force. So as a kind of more psychiatry esque thing and then also in this other space of um acting as a doctor, medical doctor and reviewing people. That picture there was, I think probably before I was actually an F three when you're an F one or below because you're not covered by your insurance um to work as a doctor, I was a first aider there. I'm just gonna see if there's anything else to say about. Oh yeah, there was another festival called All About Love which in the year of the sort of pandemic and lockdown, it went ahead anyway and they needed someone to run the welfare. So I kind of stepped up because I felt comfortable in that role and gathered a team of people to kind of do a bit of an impromptu welfare. They're so there's kind of, I guess what I'm saying is there's loads and loads of options and you can do kind of anything. Um Again, other stuff I've done. So this top right one. Um So in Bristol, there was the M D M A assisted psychotherapy for alcohol use disorder research going on quite a few years ago. So I was like a night sitter. Um this was paid and so they'd give people who detox from their alcohol had, would come in as part of this research project and um on like session three and eight or something like that of their therapies weekly, they'd get an MDMA dose and then they'd get redose later on and they'd have a whole day of therapy about 6 to 8 hours of therapy with that. And, uh, in the evening they needed someone to sit in on, on the clients essentially to make sure that they were safe. And they stayed overnight in the clinic and then they had another therapy session the next morning and then they went home. So I got involved with that on about four occasions. And that was really inspiring because firstly, I'm really interested in psychedelic research. I think, you know, that I'm really excited by psychiatry. I think that psychiatry is kind of the specialty that sometimes gets left behind a little bit in terms of like scientific advances. But actually all the psychedelic research, if anyone's interested in psychiatry and doesn't really know much about psychedelics, that's where it's at at the moment, there's loads of stuff, loads of resources that I can also share. So, yeah, I'm really interested to get involved with, with lots of research like that. That is the only thing that I've been involved with so far. Um And then these other pictures are from the national Youth Orchestra. So again, with my kind of music background, I've done a few gigs as well, but just as a kind of, you know, side thing, but the national youth orchestra um is an orchestra of people aged. I think they're like, 13 to 18, certainly under 18 year olds or under 19, I guess. Um, and they go on tour every three times a year, I think for about two weeks. So, for about two weeks. Well, yeah, one of the sessions over New Year's, I joined them for two weeks and, um, was a support team member of staff. So, not anything directly involved with music or medicine, but it ended up being that there was a lot of mental health kind of crises and less than crises going on. And the nurse could, you know, could deal with stuff to an extent. It wasn't my role to be there in a psychiatry or mental health capacity. But the, the knowledge that I had the background I had was really useful um on paper, it paid quite well, but we were doing about 16 hour shifts. So actually it wasn't really good pay. But it, again, it was just another opportunity to meet loads of people working in a different space who are really passionate about music and young people. And yeah, and it was really interesting for me because it was just, I did this just as I was starting my cam's job. And again, because I'm a locum, I could just take those two weeks out. I was in charge of my own schedule to go and do a different job and then come back to my normal job. And it was really interesting for me to kind of learn about from my colleagues at the National Youth Orchestra who were saying that it never used to be like that. It never used to be that so many of the teenagers are really struggling with their mental health that people were self harming like during the, the tour, things like that people needing a lot of support. Yeah. It just kind of reflected what I guess the media have been saying and now what I've seen in Cams myself. So it's just kind of a side thing just gonna see if there's what else I've been doing. Oh, yeah. So, also training into all kinds of other things. So, um, I did a level three in counseling training which was nine months long and a week course, um, intron to art therapy because again, I don't really know what, what the future holds for me. And I'm really interested in both building my own abilities as a doctor, particularly within psychiatry mental health. But I'm thinking about a bit outside of the box, bit outside the medical model, like counseling training, making a lot more, I don't know, patient focused. Maybe that's how I see it anyway. That's part of the reason I did it and really skilling up. But also I wondered if I could be a counselor or if I'd go into art therapy. So I just wanted to learn a bit more about it. Um, yeah, lots of more volunteering roles. So, again, quite heavily involved with breaking convention, which is a conference that's just been on in, in Exeter, which may be a few of you have been at, um, and spending time in the van. Definitely. It's been a big one. I was, yeah, I was living in the van for four months while I was working in North Devon in psychiatry in one of the lockdowns. And it was great because I had the whole beach to myself because no one was around and the hospital there was really close to the beach and it just, I don't know, I just really, I'm like, I know I'm pushing this kind of narrative of the positives. But I think, I think some, sometimes we go to medical school and we're quite shoehorned. This is how I felt, felt quite shoehorned into this is how we progress as doctors. And then this is what you will do here are the options and they're quite limited actually, you know, just because you're a doctor doesn't mean that you can't do literally anything else as well. So, yeah, I think that it's quite important to kind of pose these things. Um I got quite into wilderness medicine and extreme medicine and expedition medicine and um was going to interview to go and do an expedition in either Costa Rica or South Africa um later this year um with Rally International, but I actually pulled out the interview because I don't think I want to do that at the moment and I was going to have to pay to be a part of it. Um Again, I'm talking about pay quite a lot. It feels quite important to talk about it. And I think it's something that, you know, you have to prioritize what, what you want to do out of each role. One of the great things about low coming is that you get paid more, obviously, you have less job security than doing a more substantive role. Um But yeah, expeditions are a great one. And then, yeah, this is just a bit of a slide about part of this is travel, but I've been involved with ceremonies and pilgrimages. And, you know, from me, spirituality is quite important and learning from nature and indigenous cultures. So, um I try and bring that into my work with my job in CAMS. It's really exciting at the moment. I think this is probably happening all over the country, but I can only really talk for Cornwall. There's big movements to try and move us into more outdoor working, which is really exciting um and try and bring nature into the clinic as well for obviously those kids that we can't really go and see out in nature. Um But it is happening and we're having conversations about how we try and work outside more because even if you can't get, you know, I'm kind of working with kids at the moment that often you know, aren't leaving the house and there managing to come only to the the clinic appointment with support of someone else like a parent. But that's about it that come to the clinic, they go home and that's it for another month. And actually if we can be meeting them outside, even if we can't convince them to go for walks between, we know, you know, there's, this is, this is not just hippie stuff anymore. This is, there's lots of research on the healing aspects of just being outdoors. So, yeah, I feel quite passionate about that um load, you know, to travel, which is a great thing about taking your years out. And also, of course, you can go, I haven't done this yet but um you can go and work abroad as well. So, but I think lots of people have talked about that in other jobs and this is my, just my slide to be like you can do anything, I think. Yeah, I think the more that you do whatever you want or, or dip your toe into it, the more you realize that actually like anything is possible and, you know, the NHS is in crisis right now, like there is going to be a job for you. If you want to go into something like ophthalmology, orthopedics, maybe you have to be a bit more sensible about, you know, make certain decisions about what you do with your times out. But with most jobs. Um, yeah, there is going to be jobs for you. So, for me, what's next, one of the things I've been talking about money quite a lot with is that I'm trying to buy a house right now. And I think that's the thing that probably lots of people are thinking about. I've been in a situation where, you know, my parents can't really help towards that at all. And, um, and again, that's probably super common. So, yeah, it's kind of thinking about finances getting, you know, making sure your pensions in is all in order. That's the other thing about low comming or doing other jobs that you might have to think about that you might not be paying to your NHS mention. Um, yeah. Um, for me, I'm thinking about what to do in terms of jobs because I'm not sure whether staying a doctor is for me and that's not a new thing that's been the case kind of from the beginning. Um, but I don't feel worried about it anymore. I'm quite happy to continue doing my, my current work and that feels okay right now, but something like health coaching feels like a really good option for me. It's something that one of my friends does who's an A and the reg, he low comes twice a week or once a week and then he's a health coach the rest of the time. Um, yeah, that's probably it for that. So, yeah. Any questions? Oh, yeah. Hi. Wow. Saskia. That was absolutely Incredibles. You've had such a broad experience of so many different things. It was really, really great to hear about that. Say, thank you. I really liked how you sort of, and talking about an F three, talking about how you can sort of take charge of your life and, and of your schedule and like the freedom to be able to do what you want and you know, have a holiday if you want to or if you find an opportunity you want to do and going to do that. And I think that is such a benefit of having time out of training and doing a non training job. You really do get to sort of make your own narrative. And I think that is such a big positive of it. I liked how you also did a, you know, sugar coated and said there are lots of practical things that you need to think about. And I think that's often something that really isn't covered enough, like just in general in life at school that you need, but, you know, touching on the finances part of things and then also thinking about pensions and taxes. And so I think it was good that you gave a really sort of brilliant overview of like the positives, but also things to be aware of as well. Um I was just wondering, you've had quite a range of rules. Um including sort of the private work that you've done. Did you get any formal training for these or was it just sort of something that they sort of said off? You go kind of thing? Yeah, that's a really interesting question. And I've heard again very mixed things from different people about various jobs. But, um, for the, for the H D V driver work that was, I got a little bit of training less than probably I would have liked, but probably very similar to, you know, suddenly being an F one. And you're like, so, but I did, yeah, I had a conversation with the doctor had been doing it for ages. He clearly listed out what you do and I think it was just kind of a done general practice before. So I had that kind of experience of a patient turning up and not really having any idea what was going to happen and it just being you and then, which I feel is slightly different hospital work. But, but, but I'm also not saying that was any that was beneficial. Like I didn't need to have that GP job before that. But maybe it gave me some sense of once you've seen that first person, you kind of get it down and you find your own way. But, and, and there was, there was kind of back up support if I had any issue with anything I could call the team for support. But it was like, one of the reasons actually I stopped doing that job was because I felt this kind of really, um, and I don't know that everyone would feel this and I feel like this is probably the people pleaser in me and that actually, you know, that that needs work and I probably have worked on it quite a lot. But one of the things I was really struggling with in that job was that if someone, generally, people were failing it because their BP was too high and they set really high threshold for you to fail. It can't remember. It was now, but it was like 180 over something which, you know, is the kind of BP that I get quite like, uh, maybe we should do something about this. Um, anyway. And, yeah, people would get, they'd get three readings and if it was over 100 and 80 I think, two of the times or three of the times then, or you couldn't get it below 100 and 80 then, yeah, you have to fail them. And then there was a system for that. But actually for a lot of people, this was their livelihood and I felt this real conflict of, you know, like I've just spoken about with, you know, it's real, like, you know, your decision making does have impact on people's lives in terms of like, you know, a driver having a heart attack during the driving or a seizure or something and actually, you know, causing killing himself or others. But then there's this flip side. You don't, you don't really think about that when you've got this individual in front of you who's begging for and I didn't, I never experienced him and begging, but I can imagine it kind of being that situation of someone, you know, you're saying to someone you can't earn for a really significant period of time because actually the D V L A take ages to turn around papers and stuff like that and you have to get your BP down, you have to come back. So yeah, I can't do what you asked. That's all right. It was really interesting hearing just a bit more about it and no, I was asking about trading, which you answered. So that's great. And I think there's quite a lot of questions coming through on the chat. Walters. Brilliant. So we'll go through them and if anything else pops up. So the first question is as a medical doctor at festivals. If you're quite junior E F one F two, either senior clinicians you can refer to for advice or are you sometimes the most senior member of staff there? That's a really good question. And I can't answer for all. So each there's lots of different medical Festival services and they've all got their own standards and things and some are really great to work for them. Some are much less great to work for. So I have only worked with one medical group and I'm quite, I know quite a lot about another two, so I'll speak about those ones. So my experience was that there was always senior medics about one of the smaller festivals. I possibly was the most senior medic for one of the shifts overnight who was like awake. But then you'd have your senior medic who was asleep in the, in the tent right behind where the festival where the medical tent was. There's always someone around and that would have been the kind of festival where, you know, you're not expecting things to go seriously wrong. And if they do, there's lik someone's going to be with you in like quicker than you'd even get someone in the hospital sometimes. Um So yeah, that, that feels good and there was lots of support to kind of ask, but it really depends on the festival and, and the medical service of running it. If it's a massive festival, it's a much tighter operation. But it's also going to be really hectic in the medical tent. I never worked in A and E but I, I think it's, it's more hectic than that probably because you're kind of, you're not, I guess in some ways your time is better used in the medical tent because you haven't got like all kinds of computers and x rays and all these things to sort out, you kind of got what you've got in front of you, which is not to say there isn't like all the lifesaving equipment and they do incredible work and are able to do quite a lot in these bigger festivals. Um But yeah, again, I'm going off on my tangent, but yes, no, I always felt well supported. And I think if you were applying for, to work at a festival like that, it would be worth asking these questions. And I would say that as an F one again, if you're, if anyone's asking you to act as a doctor, uh such as prescribing, you shouldn't even be allowed. You're not legally covered to prescribe paracetamol for instants or anything like that. So, um if the festival just needs first aiders, that's fine. But if they're expecting you to act as a doctor, that needs to be a conversation because you shouldn't be doing that okay. That's really helpful. And how did you find those rules? Was it just a case of searching online for them? I don't actually remember. So Shambala was the one I've just been involved with Shambala for ages and I don't really know how it came about. Possibly, I applied for it, possibly it was through a friend. Um But yeah, I think usually what, what I've done in other roles is look at festivals that I like, look at the website and there's either information about who's, which who is doing the medical cover and then how to contact them or you can just contact the festival directly and say, look, I'm doing this and I'd really like to get involved. Can you put me in contact? And I know with things, you know, bigger festivals like Glastonbury, I don't last um very with the medics as well. I didn't talk about that. So that's obviously a huge festival and I think boom town and other things like that work quite like them where they have pro proper, you know. Well, I think Shambala did to like kind of 12 hours on 12 hours off shifts, they might have been shorter. And again, I think less than me because the tickets are so expensive, you don't get paid unless there's an option to get paid. Some of these things you can do like a shift in exchange for a ticket and some of them. And yeah, and often they'll also be an option where you do, you know, like you might do at work kind of on call shifts, 33 in a row and you're actually getting paid for it and then you still got the festival to go and enjoy it, but you might be quite tired for it. Um There's another question about how did you get the outpatient cam's job? Was that through Pulse Agency as well? And where are you on a locum contract? Yes. So that was through Pulse again, really recommend them. I know there's loads of agencies. But, yeah, pulse are the best for psychiatry and they've got the best links with everybody and also just as a kind of side thing I am. I signed up with another agency at one point and then had a, well, I was going to sign up. I kind of, I put my email in to something and the guy gave me a cool and I said I'm really interested in this psychiatry job that you've got in. I don't know what it was. Like, someone settle somewhere. Can you tell me a bit about that? And he said, oh, yeah, that's not actually a real job. I'm just trying to get hold of doctors to start making contacts and stuff. And I just felt really, you know, like, like they were lying, they were lying, just try and pull people in. And apparently it's quite a common tactic and I'm just yet, like, I haven't polls have always been great. I've worked them for, like, for, for, for maybe, yes. It's probably about halfway through F to, I've started with pulse. So, um, yeah, and then you just for psychiatry or do they do like other everything? But cycle is there kind of their main thing that's what they specialize in. Um, and I tend to do, I've tended to do my, like, medical jobs directly through the hospital because I was already linked to them through, for F one and F two. So psychiatry has I think all my jobs have been through Pulse. So, yeah, they found. So. So I was actually the last two jobs I've done in Psychiatry for Pulse. I've actually been abroad when I got the interview, which has been really nice to just be like in somewhere really nice in a hot country and have a quick kind of phone conversation. And also again, as a sort of side thing what I really like about low comming and low coming through an agency. I don't know how it is. It's probably, maybe it's even more relaxed if it's not to an agency. But all my interviews over the last few years have been kind of a quick chat with a consultant who's been really sound and just kind of wanted to check that, you know, there's no glaring issues rather than a really formal sit down thing which I have to prep for. Um, yeah. And so my, my, what I really wanted to do was psychiatry job and I really wanted to do an outpatients job and because I haven't done that and I wanted to stay in the Southwest because this is where, like, I, I live in all my family and friends, most of my friends are. So, yeah, I kind of that those are my only, um, ideas of what I wanted to do. So I kind of waited for maybe 23 weeks and then this Cam's job, which was out was the only outpatient job at that point for someone of my level, um in the whole of the Southwest. And so, yeah, I interviewed for it and got that. So, and I think I'm, I, yeah, I think it's worth saying that all of my psychiatry jobs I've interviewed for, I've got, except one where they already knew someone. She, she literally just finished working with them. So they picked her. So my experience is that it's really easy to get these roles. Um, obviously as I get more rolls, my C V looks more impressive and things like that. So that's worth saying and it's worth putting together really good CV, which really just shows off what you've, it doesn't matter if, you know, I haven't had any kind of prizes and things like that. I haven't got any kind of study publications. I've just written interesting things, anything that kind of gets you into, particularly in terms of psychiatry, I think because they're so interested in the person that you are and what you're interested in. So I think that's kind of, that will give you a leg up. Um And then, yeah, just if you're, if you're easy with wherever you go, like there are jobs in psychiatry all over the country, you'll get a camp's job easily. Um But outpatient has been really nice for me having done a lot of kind of hospital work, which obviously every specialty has its own thing. Um But my experience of psychiatry is that it can be quite overwhelming in the hospital at times. Um, it's, yeah, when things I, this is like the whole of medicine, isn't it? When things go wrong they go really wrong. Um, and it can leave a bit of an imprint. And so, yeah, I'm quite enjoying my, my 9 to 5 outpatient job at the moment. Yeah, I bet, I bet. Um, well, the next questions is, um, again about sort of locum agencies and then also how does tax work if you locum with an agency and do private work, like HDV? And I had talk shifts from your hospital? Yeah. So, again, I think it will depend on both the agency but also the trust that you're working in. So, even though I'm employed by the agency, um, the trust are the ones who decide what, what happens to my pensions. So, when I was doing, um, so most of my psychiatry work's been in Devon and they, I'm pretty sure this is the case they paid into the, or I paid into the NHS pensions, which is really good. I'm now in Cornwall where they don't, they pay into like a private one and something, something, you know, I'm not, I need to really sort out my pension's this year. I'm paying like 40 lbs per paycheck into my pension's, which is really not enough for what I'm earning. Um, but I just kind of left that. So there is. Yeah. Keep an eye on all these things. Save up all your paychecks as well. I'm not so good at checking them for like tax and things. And there was a, when I was in F two, I did loads of locum shifts whilst in F two in a different hospital and I somehow ended up not paying any tax and I just didn't, I never checked, um, I looked at my paychecks but I just didn't clock that I wasn't paying any tax. And so at the end of the year I owed like, thousands of pounds in tax, which was a bit of a shock. So, yeah, it's good to, it's good to have a bit of a, like, you don't need to be a financial expert. You just need to make sure that, that, you know, stuff is getting sorted. Um, yeah, and you can always call HMRC, which is such a PFAFF, but you can do that to sort out that your pay tax code is right, if it doesn't matter to you that much and you're not kind of trying to save up something that year, which has been for me the last few years. I haven't really been that bothered about it and then I've waited till the end of the year to hopefully get more tax paid back to me at the end of the year, the last two years. Actually I've owed them tax and I don't really understand how, um, but it is. It's, yeah, it's worth saying all these things I would have, like, I just have an emergency fund. I mean, this is like, standard kind of financial stuff that I never sorted an F one and F two because the money went straight out as soon as it came in. But if you're low comming particularly, or even if you're not just, you know, as we, as we age, we need to get better about having a spare fund pot kind of thing for emergencies. Um So yeah, I can't, I'm a bit blase about all the tax stuff, but I know it's important. So, um yeah, no, I think that's very fair. I think it's also very individual, isn't it? And the individual circumstances. So um yes, I think it's definitely like you say something to be aware of so that you don't end up with a big bill at the end of the year. Um um we have another question. So when it comes to maintaining clinical competencies, as I understand, you have to demonstrate evidence of this throughout your time out. How did you do this? Did you maintain a portfolio? This is a great question actually. So yes, I do have a portfolio. It's very minimal because it doesn't have to be much. So, um what do we use? So it's so what you do in your years out is you do an appraisal. I've been out for so long. I can't report you. What you call the like in training thing, but an appraisal, I didn't realize until I did it in F three with a really kind consultant who explained, you know, I've done so much work for it and you can do it and it's going to carry it, it's going to carry you through to if you do go into training or you do, go into something where you need to show all of this off. It can be really good to have a really full um appraisal to, you know, it will because you kind of get a print out of it of each year. And um yeah, but this consultant explain to me, you know, it's not a pass fail thing. It's just to make sure that like you've kind of, I don't think that's completely true. I think probably you can failure, but then you just redo it and it wouldn't, I don't think it would like Black Mark you like it would if you're in training and it's quite significant if you don't get through that end of year thing. But yeah, with an appraisal, it's quite like, have you done all your CPD now? CPD is like teaching, just record all your teaching hours. It's going to conferences so find, you know, don't go too boring conferences, go to stuff that really interests you, you can volunteer at them as well, um and get, you know, get chatting, they're great places to mixed with people. Um what else? Yes. CPD is the main thing and you don't have things like in F one and F two, you have to, you know, prove that you've sutured someone and you've catheterized someone. You don't have anything like that. And obviously, like I'm doing psychiatry, but the appraisals are for everybody. Um, you know, whatever specialty urine. And last year my appraisal again, I was, I was not in a building, I was outside somewhere. Um And I logged on for just 15 minutes to um connecting with the consultant just, you know, have a quick go through, make sure that we've done all of the stuff that we need to do if there's anything missing, which one of my friends who was also in her F four? Um She did, she didn't have enough CPD. I think that was it. Um And he just said, great. Are you going to get it sorted by like next month? And she said yes, and that was, it signed off. Now, it's not always going to be like that, but just to, just to know that it's so much easier than what your core trainee colleagues will be going through. And the last thing to say about that is also that um yes, if you go through an agency, they probably will charge you a lot of money. So I did my f 31 through a hospital, even though I was mainly working through the agency, I managed to wangle it because I was working through the hospital enough that the hospital just did it and they did it for free. And I think all hospitals would offer that for free that service. Um And do they organize a consultant? Because I've just seen one of the questions that come through, how do you sort out a consultant to do your appraisal? So did you find at the hospital sort of almost arranged a consultant for you or is it someone that you've been working with a few times or it was someone I've never met before? And I can't remember why you picked. Yeah. No, I was organizing my appraisal quite late in the year because I just, I just left it. I've heard this thing and I don't, I'm not gonna, don't take my word for this at all because I didn't do this in the end because I panicked because I've heard different things from different people. But when I was an F two, I heard that you could have, you could be missing one appraisal and that it wouldn't mean anything. So you could have one year where you don't do it. And so I was going to do that and then quite a few people said to me, are you sure maybe you should just do it. Um, which I, yeah, I'm going to say like it's so easy to do, just do it. Um, so, yeah, I left it quite late and there was a long list of consultants to choose from. And I picked too that I knew and both of them got back to me and said, I'm really sorry, I've got no spaces and I started going, oh God, okay. So I then just started going through the list. But the third person that I picked, um what was I think? Possibly I put it in a group chat with colleagues. Do any of, you know, any of these people who do you recommend? So he did come recommended. But it also came with a message that what they found in their appraisals. These were all like f three plus doctors. They said that because of the way the appraisal works, it should always be a kind doctor because they've all self selected to um support, you know, do an appraisal for people who are out of training. So they should all get it. They've been trained to be to review appraisals which like I say is different to whatever it is that you do in training. So they get that. It's, it's less pressure and all of that. And so the agency um they just organize it all and yeah, with the agents in my age. So pulse were going to charge 400 lbs. So I didn't do it that first year I did it through the hospital and then the second year I was going to pay it and then which was last year and then my one of my friends who also signed up with pulse just kind of, it's not really cheeky at all. But to me it occurred cheeky at the time. She just emailed and said, like, I don't want to pay it. Is there any other way? And her agent? So you work with one agent specifically? But like within the agency, he was like, yeah, I'll cover it. So I was like, oh, I should just do that. I should have done this last year. So I just emailed and he said, yeah, I'll cover it. So I haven't paid for that. And the same thing this year I've got organized a bit earlier and I said again, you know, you happy to cover this and he's gone yet. That's absolutely fine. So, it's always worth either. Basking. Definitely better found of things. Yeah. Yeah, definitely. Oh, that's really interesting to hear about the appraisal doing that in the hospital and with the agency. That's certainly something that I would never have known. So, really interesting, um, information on that just on that quickly. That one of the questions is, how much CPD do you have to do in F three? Is there like a certain number of points you have to hate in the year or is it just show that you've done a general wide range of things there is, I'm just another quick look to see if I can find the answer for you and if I can't in about three seconds and I went, that's okay. No, it's going to be an email too far away. But I think it's very easy to find out. It's something like, it's either like 24 hours or 48 hours or something like that, that kind of ballpark. So it's quite hard to hit from just going to like, hourly teaching each week. But if you go to one or two conferences or like training and again, it probably depends on who's doing your appraisal maybe. But you can, the CPD, I think for an appraisal is a lot more broad, you can, you can put a lot kind of more random, you know, because again, maybe I'm coming from quite a psychiatry perspective where it's a lot more open to these things. But my art therapy training, my counseling, all of these things went into my CPD even then, you know, they weren't about prescribing for instances. But I think that's fine. So you can have a wide range that's really useful to know, isn't it? And then we have another question which is a bit more about the counseling course that you did. And so the question is, did you do it full time for the whole nine months or is it possible to do other local work alongside it? Yes. Sorry, I should have said that. So that was part time. So the course there's loads of loads of different courses that you can look at that run in completely different kind of what time per week you give to them. So there's a lot of courses, counseling courses that would be like one Thursday evening a week for instants. Um, I picked a course that was in a place that I really wanted to study, which was Glastonbury cause I didn't really know Glastonbury and kind of was intrigued and, and it was a course that I really liked the sound of and it was one weekend a month which seems to be really well because then I could go and have the rest of my month as you know, my life wherever I was low coming wherever I was or traveling or whatever and then have that kind of, you know, commitment to being there with my group and don't dive quite deeply as a group together in that weekend, which I also felt like, you know, this didn't occur to me beforehand. I really liked that. I think you can't do that if you're doing one night a week. Um It's worth saying that the level three, you know, at the end of the level three, you're not a trained counselor. That's the end of the level four, which is a two year part time course. But the level three gives you really, really good grounding. Um And taught me so much and taught me so much about myself. I'm sorry to interrupt. I was just gonna say, was that something that you self funded. Yes. Yeah. So, I think if you did, if you didn't locum, but you were doing a substantive post. I think that you can have a conversation with your employer about whether they would give you any study budget as a locum. There's nothing like that. So I did self fund. Um, and again, yeah, it's an interesting one. I'm a big fan of low coming because you are in charge, you know, in charge of all these things yourself. But you do have to if finances your main thing. But actually you don't worry, you don't mind too much having the freedom to, um, you know, get longer holidays and things like that. It might be that once you figured out because you don't get holiday pay, don't really think about sick pay unless you think you're likely to do that because you don't get holiday pay once you've kind of mixed holiday pay back into it. And, oh, yes. Sorry. And study budget. It might be that in your particular area because I know some trust pay way less than others. Um, that it's working as a substantive doctor might actually work out fairly equal to being a locum. And then, you know, that's, that's just another tangent. Sorry. But, yeah, but the counseling one, yeah, just, it kind of managed to continue my life, which is quite nice. Yeah. Really good. Definitely good to do something outside of medicine that, you know, you're really interested. And passionate about and can sort of get your teeth stuck into by the sounds of things. So that sounds really great. Um We probably have opportunity for maybe a couple more questions. But um so if anyone has any, please do pop them into the chat box and I am going to take this opportunity if that's okay to do a bit of a plug for the Portfolio Clinic, um which is the sort of organization that is bringing you this talk today. So the Portfolio Clinic has almost like two arms, one arm is the F three series which brings to you um these webinars um about the different F three opportunities. And then the other arm is the mentor mentee scheme. Um This is a scheme which is free. Number one and number two is sort of a near peer mentorship scheme. So if you're interested in going into a training program or even if you're not interested in going into a training program, but I want to make sure that you keep a portfolio and keep your options open into the future, then this is something that you can get involved in and please do check out our website and our social media platforms to find out more. But excitingly, we are recruiting new mentors at the moment and we're also expanding to all specialties. So I'm I understand on good authority that we have a brand new radiology mentor who's hot off the press. So if that anyone's interested in, that pleased to take a look into things. Um, if we haven't got any other questions for this evening, then what we might do is is sort of begin to wrap things up. So, thank you so much of for joining us and thank you for asking. That was really, really enlightening to talk about all these different experiences you've had. And it's just really fantastic to hear all the different things that, you know, you can do with being out of training and that having a medical degree doesn't mean you have to, you know, definitely work in a hospital, doing medicine. You can use that too, do lots of different things and, and how I really liked what you said at the start about, you know, experienced during your F three and rules you have during your F three is always going to be helpful and it's always gonna be useful forever program or if you do want to go into training long term, it is going to be useful obviously, with some caveats about too much time out of things. And so that was, that was really great. Have you got any last things you want to say at all before you wrap things up? No, thank you all for being here. Brilliant. Ok. So I will just send a feedback form which has just gone on to the chat box. So if you can make sure that you fill in the feedback for. Um it means that you get a certificate at the end of things. It also just helps us know what we're doing right and what we could improve on. So please do fill that out. It's really, really much appreciated. Um This is actually the last episode we have in our series for now, but all of our episodes from the past couple of years, they're all still available to watch on Catch Up on Medal. And we really have spoken to so many different doctors who have done so many different things. So if you aren't sure what you want to do or you have a bit of an idea, but you want to find out more than please do, check out our page on Medal. There's lots of things to catch up on, on there. But thank you so much for all joining us by.