About to be a consultant. Is this it ?!?!

7 posts in this topic

Dear All

Have not posted on this group previously but being in the current situation that I am I felt compelled.

Im about to finish my training and obtain CCT - only to be exposed to the dark world of being a consultant - something I previously looked at as the holy grail for all medics ! An unlimited amount of politics  , beuracracy and inundated by paperwork all the price of £4000 a month which does not go far when you have a family to support.

The locum world is also filled with its own challenges , with locum rates capped, IR35 and fewer locum availability around the country. Not to forget dealing with the "locum" title and in some trusts having eye witnessed consultants being treated like SHOs.

The private sector does seem to be appealing and will be something I'll be looking into however I present I have limited knowledge and would appreciate input from peers in the group.

 I just feel as though after working through medical school, navigating myself through training and exams , the end goal is not what it is really cut out to be. Perhaps the knowledge of knowing that a  clinical research colleague of mine recently managed to secure a salary of £250,000 in a pharmaceutical company may have precipitated my inner distress.

I am sure people especially younger Trainees might find this post quite demoralising. It's important to remember that as medics we are privileged in many ways despite the current climate. However if your quest is for a thirst for knowledge you will be far more satisfied rather than it being purely economic gain.

Apologies for the long winded post just had to get it off my chest !






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We earn decent money being in this profession but totally  agree that what we earn is disproportionately low  considering the hard work, stress and responsibility that comes with practising medicine.  Some doctors do earn well but  mostly we have poor financial and business acumen. 

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Things seem pretty bleak not only in psychiatry but current NHS climate given "austerity measures ".

 options I'm considering include exploring pharmaceutical industry, looking into management roles , private practice/ working in the private sector amongst others.

Have thought of moving to USA/Canada/ Australia but I'm sure these places have their own challenges.

Just feel I'm too young to "settle"and accept my situation for what it is.

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There's nothing demoralizing about £250 000. Which company was that?

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On 12/08/2017 at 22:20, Zoran said:

There's nothing demoralizing about £250 000. Which company was that?

I think he means it's demoralising because his friend got the £250k job rather than him. 

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Sure, but it also means that other psychiatrists can try for those jobs as well. I am pleasantly surprised that pharmaceutical companies are paying that much, I thought it was less than clinical work pays.

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This really isn't a surprise. We all knew consultant salaries were 4-4.5k post tax when we first came to the UK. 

There's two ways I can see this.

One, is that 4-4.5K is actually 99.84 percentile of highest salaries on the face of the planet. 
It's more than enough money to live well with. That's solid food, clothing, rental income, with enough set aside for leisure and saving. 
It's still enough to pay for a flash car, a great pad, and solid holidays during the 6 weeks you're allowed. 
If you have children, it is a lot tighter, but schooling is free, healthcare is taken care of, and if you cut corners, there's still enough for childcare expenses and a tiny amount to save. 
Pretty much EVERYBODY else on this forum (outside of locum/IR35) subsists on that much. 

The other side, is it isn't enough for a Lifestyle. 
There's little leeway to save money especially if you have children, or they are in private schooling. 
It's hard work paying for a mortgage on a 8-900K London property. 

A few weekend section 12's, DOLS, private work, and prudence with money and that's taken care of.

Court work, and private consultations can net you hundreds of pounds extra a week for not muc

Most NHS consultants do a little work on the side. 

You can also earn 

But c'mon, there are SHO's who leave core training with a couple of houses in the kitty. 


If you still feel it isnt enough...

I felt the same way as you did. 

I got my consultant post, IR 35 rules, and thought whoa, I can't do this for the rest of my life? 

I can't afford a flash car in London, or a downpayment or mortgage on a house. 

But a friend of mine said that isn't true. All his locum consultant colleagues are earning 4K a week! And that seems about right. 80 quid an hour with 40 hours a week, plus a 16 hour on call works out to 4500 a week. Keeping solid accounts, finding non IR35 jobs can greatly increase that take home pay. Private work can greatly increase that. Working in boondock territory like small town Scottish towns, or Northern Ireland can give you £130 hourly rates. That's over £30k a month pre-tax! 

There's also private practice. 

Traveling out of the UK - Oz locum consultants earn $2000 a day. Private practice can bank a whole lot more. 

The issue here, like with most other things where there is a difference between claims and possessions, isn't a lack of resources, but a lack of resourcefulness. 

You Knew substantive consultant payrates would be 4-4.5K when you first came to the UK. 

How much did you prepare for that? 
How much have you saved? 

How much is your money working for you?
Have you made private work plans since? 
Have you looked into budgeting? 
Have you streamlined expenses? 

My intuition is you wrote this post. Worried about finances. Are still worried about finances, but have done little about it. 

If you have (and others in the same boat reading this), and I'm more than happy to be proven wrong, then great!


Look around you - most consultants earn in the 99.9% almost. Forget 1%, this is 0.1% territory. 

Most consultants have nice cars, flash houses, and live in a reasonable amount of style. 

If you want more, you have to work to get more. And there are more than enough options. 

The good stuff in life is on the other side of FEAR. 

The comfort zone is where the really uncomfortable stuff happens. 

Your level of happiness or unhappiness is determined by a simple formula. You think your life is better than it's supposed to be - great life. Worse than it is supposed to be- misery. 

You can easily think 4-4.5k, all this hard work, woe is me. Or phew, lucky me to be 0.1% of population in a brain dead piss easy job like a NHS consultant. 

Sure, it's more difficult than a SHO or SpR post, but not exactly the most taxing job in the world. 

I'm in a reasonably difficult central London locum consultant post that has been impossible to fill substantively in years. 

My stress level is pretty much zero as the only consultant in a busy 570 patient, central London, old age CMHT and I work like a dog, and I'm doing a lot more than just my 9-5, and doing a shedload of extra work to develop the service, and keep managers happy with their KPIs and stuff. And I'm IR35 capped to boot. Sure, I'm meditating for 20 minutes twice a day to get there, but it's not a big ask. Every single day gives me incredible joy and fulfilment. 

Find another job that pays you 4-4.5K with the ease and hours of consultant pay. I'd be fascinated to find out! 



You always knew consultant salaries would be 4-4.5k

It's still 0.1% level income, and more than enough to live a more than decent lifestyle.
Pretty much every other consultant manages a decent enough living and lifestyle with this salary.
Every single SHO, nurse, secretary or social work colleague would be thrilled with your salary - all of them manage a lifestyle, savings, and have managed to buy, or have bought London properties too. 
You can always do private work to massively supplement income. 
Locum consultants earn £4000 a week on average. 

Boondock territory Scotland Northern Ireland jobs can gross £30k a month easy. 

Find another job that pays you 4-4.5k that's as easy as a normal consultant job. 

The problem isn't a lack of resources, but a lack of resourcefulness. 


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