Emma Coombe
@dr_emmacoombe
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Paediatric Junior Doctor. RCPCH Trainee Rep
South West, England
Joined December 2014
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If you're a 50+ yr old doctor who graduated med school with no debt, lived in hospital accommodation during training, & has paid off your mortgage on a house you bought for £100k,
you don't have the right to dismiss the financial difficulties faced by younger colleagues
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The dreaded email from nursery arrived
Fees going up by 9.6% this year
My wages went up by 2%
Priced out of working more hours, the NHS' loss
#WorkforceCrisis
#FairPayforNHS
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If junior doctors don't feel valued, they will just leave.
They will leave the NHS, many will leave the UK.
This poses a threat to patient safety and the existence of a National Health Service.
Royal Colleges, SEBs, GMC, NHS leaders, & politicians need to WAKE UP to this.
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Fantastic support from the public and our patients this morning on the Bristol Picket lines!
#DoctorsStrike
#PayRestoration
Photo credit Ben Birchall
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Today there is a huge lesson for all of us working in the NHS.
Speak up.
Keep speaking up.
Our patients are relying on all of us to keep speaking up, and to take action when others speak up.
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Nurses
The offer is rubbish!
You are worth so much more 💙
Reject it 💪🏼
Know your worth
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2% pay rise last year
0% pay rise so far this year
Sons nursery fees up 11%
Mortgage soon to go up by £430!!
Why should this Junior Doctor stay in the NHS?
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Got my covid booster jab, especially important as I'm heading into the third trimester soon!
#FullyVaccinated
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Hey Tweeps,
10 days ago I gave birth to a baby boy,
and I've never known love like it 💕
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Junior Doctors
A strike is not a day off
It's a protest
It's important we see you on the picket lines.
You voted for this,
Now do the needful!
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Approaching CCT?
Did you know if you've been LTFT as a Junior Doctor that you're entitled to start your consultant post at a higher point on the consultant pay scale
to help account for the time it's taken you to get there 👍
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Really miffed to hear of a consultant scoffing at a junior doctor today who was helping to advertise
@BMA_JuniorDocs
pay campaign.
A consultant who likely didn't graduate in ~£80K debt and could afford a deposit for a house as a junior doc.
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We have NHS doctors being paid £13.80/hour this week 🤯
My 16yo niece, in her first paid job, is earning £20/hr (£40/hr on bank holidays) to dress up as an elf at an evening seasonal tourist attraction. £2800 for a Christmas holiday job. I’m delighted for her, but it starkly illustrates how undervalued NHS & social care staff are.
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Approaching CCT?
Did you know if you've been LTFT as a Junior Doctor that you can start your consultant post at a higher point on the consultant pay scale to help account for the extra time it's taken you to get there 👍
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It looks like Junior Doctors are going to have to schedule more strike dates to get this government talking about fair pay😩
Can you support a junior doctor to strike?
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I really hope the Junior Doctor Strike doesn't have to go ahead next week.
But if it does, will you support us?
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So now junior docs in any specialty can apply to work LTFT without having to give a specific reason.
What's stopping you?
#LTFTLife
#JuniorDoctors
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Junior docs in England have no strike dates scheduled
Where are government ministers?
Why are they not eager to get this dispute resolved?
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Bristol Junior Doctors demand fair pay!
Come and say hello, give us a honk Bristolians!
@BMASevernJDC
@SouthWestBMA
@BMA_JuniorDocs
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@julesnorton
I had this colour hair for several years as a junior doctor and patients loved it!
Funnily enough the dye never did seep through my skull and affect my practice 🤷♀️
Policies like this reduce diversity in our profession for no good reason.
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Those who want all NHS docs to work full time only (i.e 48hrs a week for junior docs) should check their privilege (what's you're retirement age again?) before criticising docs who want to work LTFT.
If I have to work to 70 it sure as hell won't be 48h weeks.
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@Thornton_health
Leadership 101:
Don't refer to essential parts of your workforce as "just workers"
Please reflect and reconsider
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Approaching CCT?
Did you know if you've been LTFT as a Junior Doctor that you're entitled to start your consultant post at a higher point on the consultant pay scale to help account for the time it's taken you to get there 👍
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Dropped off my donation to the milk bank today,
Hope it helps the poorly & preterm babies of the South-West 👌🏼
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Was working with a PA student this week, concerning to find out they don't read ANY textbooks as part of their 2 year training
This student was about to interview for a job in primary care. When asked what the role involved, they said "seeing patients, general practice" 😬
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Your weekly reminder that NHS nurses graduate on £12.70 an hour
having paid tuition fees to work thousands of hours for free for the NHS during their degree.
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This was in 2017
I wonder what those numbers would be today 🤯
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In 10 days time
#JuniorDoctors
in England will be entitled to a 3rd paid break on a night shift! 🙌🏼
Tired doctors make mistakes. Safer doctors = safer patients.
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For F1s planning a family, be warned! If you conceive in the next couple of months then you won't yet qualify for NHS maternity pay.
I've seen foundation doctors miss out on this by only a few days and it's worth THOUSANDS of ££ so wanted to give you a heads up
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Feeling humbled to be elected to BMA Council.
I hope to justify the faith in me expressed by those who've voted.
Thankyou!
Time to smash the patriarchy 💪🏼
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This is the first year I've strongly recommended new F1 doctors flat/house share if they were considering living alone.
Cost of living is outstripping wages to a huge degree. A challenge for those allocated to work in cities like Bristol, London, Oxford
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It looks like Junior Doctors are going to have to schedule more strike dates to get this government talking about fair pay😩
Can you support a junior doctor to strike?
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Looks like there's a significant chance of more junior doctor strikes in April
Juniors, time to focus on your training and get your portfolios looking sharp.
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Junior Doctors
Opting out of paying your NHS pension is a TERRIBLE idea.
It should be a last resort if you are struggling financially.
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These strikes don't have to go ahead
@SteveBarclay
@RishiSunak
please talk to BMA doctors.
We'd rather be in the hospitals looking after patients
We won’t give up until junior doctors are fairly paid.
On 13 July, we will stage a 5 day strike, the longest single walkout by doctors in the NHS’s history.
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@dr_nigel_lane
Don't forget to pull that ladder up after yourself Nigel. How much do you repay a month for your student loan?
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So Category 3 LTFT (reducing hours just because you want to) is opening up to Foundation Trainees from August 22.
Who's applying?
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Junior doctors
Don't forget if you worked any part of a bank holiday (or had a zero day fall on a bank holiday) then you're owed a day off in lieu.
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Why yes...I did order this gift to myself for growing and pushing out a small human.
No its not my birthday, but it was recently his....💁🏽♀️
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From today the daylight lengthens by
> 1 min per day
3 weeks from now we'll have half an hour more daylight the we do today
Spring is on the way!
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UK doctors earn **£13.80 an hour** following graduation,
Having accrued tens of thousands of £££ student debt after 5/6 years of uni to get there.
They are worth more.
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This time in 6 weeks, Junior Doctors in England could be in the middle of a 72hr strike
Is your department prepared for 3 days without junior doctors?
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Why is it that messages from leadership are almost always:
•We need you to prioritise discharges
And not:
•What do you need in order to progress more discharges?
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Paediatric trainees feeling shaken going to work today:
Escalate everything. Document everything.
Take breaks. Leave on time.
Exception report/datix everything.
And look after each other.
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A massive thankyou to consultants, specialty doctors, and all other NHS staff caring for our patients and providing emergency care this week in lieu of junior doctors.
We could not do this without your support.
We are one NHS 💙
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Starting F2 in August? 👨⚕️👩⚕️
Self Development Time (paid rostered time for eportfolio, audit, QI etc) was recommended this year. From August it's a compulsory 2hrs a week for all Foundation Doctors in England.
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If any of the many junior doctors leaving the NHS could work on seting up an alternative provider for postgraduate examinations to Pearson Vue, that would be just fantastic.
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@SteveBarclay
@BMA_JuniorDocs
If you actually wanted to avert these strikes you'd have met with BMA doctors months ago and brought something to the table then.
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Junior doctors,
Next week may not be our only days of industrial action in the coming months
Plan your finances and your training appropriately.
Tough times ahead, but together we can do this.
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Junior doctor *annual leave* entitlement
Many rota co'ordinators assume that CT/ST1/2/3s have <5 yrs NHS service and are only entitled to 27 days AL per yr.
If you have >5 years service as a result of switching specialties, working LTFT....
1/3
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Calling all JUNIOR DOCTORS who've recently worked at
Kingston
Croydon
Royal Free & Barnet
Hillingdon
You may have been underpaid during your rotation
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Junior doctor *annual leave* entitlement
Many rota co'ordinators assume that CT/ST1/2/3s have <5 years NHS service and are only entitled to 27 days AL per yr.
If you have >5 years service as a result of switching specialties, working LTFT....
1/3
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Yesterday I hear my obstetric appointment is postponed due to staff sickness.
Today the trust I'm due to deliver at declares critical incident.
It's a hard time to be a member of NHS staff.
It's a hard time to be a patient 😞
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A reminder for Junior Docs
Annual leave entitlement goes up after 5 calendar years service.
It doesn't have to be service as a doctor, full time, or continuous.
Maternity/parental leave also counts.
Make sure you book and take your extra AL!
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F1 doctors planning on starting a family?
You won't yet qualify for occupational maternity/shared parental/adoption pay if you conceive this month.
FYI, don't get caught out
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Junior doctor *annual leave* entitlement
Many rota co'ordinators assume that CT/ST1/2/3s have <5 years NHS service and so are only entitled to 27 days annual leave per yr.
If you have >5 years service as a result of switching specialties, working LTFT......
1/3
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If you're soon to graduate as an F1 then please know your F1 salary likely won't be enough to get you the standard of living you're expecting if you want to live alone
especially if you're going to live anywhere in the South of England. My advice would be to look for a flatshare
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I can't help but feel this is a decision that will cost NHS England more in the long term secondary to staff sickness.
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From next week 🌻Paediatric trainees🌻 will be able to apply to work LTFT without needing a "reason".
🎉🎉Hooray!🎉🎉
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Your mortgage goes up £300 a month due to catastrophic government mismanagement
Tories cut your national insurance payments by £50 a month
And pat themselves on the back?
No.
#GeneralElectionNow
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@AlanGrinch
@CaffCast
@StopFundingHate
@AutoTrader_UK
@DailyMailUK
As a daughter of 2 dad's, it's perfectly normal to me 😊 a much happier childhood than one raised by an unhappy man with an unhappy woman.
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A reminder you have NO obligation to tell your department if you intend to strike or not.
Your rota coordinators know this
Your bosses know this
They shouldn't be asking repeatedly or putting you under pressure.
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If you as an individual are happy to work for 25% less than your counterparts were 14 years ago were then that's on you,
But please don't stand in the way of those of us that are not.
Thankfully the majority of consultants I encounter are supportive.
We are one profession.
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It's a yes from me
Because I'm worth more than a massive real-terms pay cut
#BMADoctorsVoteYes
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Thanks to lobbying by RCPCH and BMA, Category 3 LTFT (i.e. LTFT without needing a specific reason) is coming soon to 🌻 Paediatrics! 🌻
Happy to chat on DM for anyone wanting to know more about my experience working 80%
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Trusts, pay for junior doctors may not be within your gift, but this is.
It's possible to do better.
Booked a family holiday for Mar 24 in Jul 23. Spent months trying to contact the rota coord at the Trust I start at in Feb to organise leave. Told I needed to find swaps but not given contact details of other drs. It’s all become so stressful that we’ve cancelled the holiday.
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Gave my baby who's weaning some mashed avo on toast today,
Quickly realised the error of my ways and took it away before he was resigned to a life of never owning his own home
#GenerationRent
#HousingCosts
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Pension contributions are dropping for LTFT doctors
in England, Wales and NI (Scotland yet TBC) from October as contributions will be taken from actual LTFT pay rather than WTE pay,
a massive win for
@BMA_Pensions
Committee!
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Junior doctor *annual leave* entitlement
Many rota co'ordinators assume that CT/ST1/2/3s have <5 years NHS service and are only entitled to 27 days AL per yr.
If you have >5 years service as a result of switching specialties, working LTFT....
1/3
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From today the daylight lengthens by
> 2 min per day
3 weeks from now we'll have an *hour* more daylight the we do today
Spring is coming 🌻
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Not doctors though 🙃
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Eportfolio, QI, audit are work and should be rostered and paid.
If you don't have rostered SDT/SPA time and are therefor doing it in your own time? You need to exception report the overtime. This is how we drive positive change.
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A reminder for new F1s:
If you're rostered to work any part of the bank holiday on 29th August
Or have a zero day fall that day,
Then you're entitled to an additional day off in lieu. Book it ASAP as you would AL
#KnowYourRights
#BMAJDC
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Sat next to a medical student on the coach who is telling her study partner to "Add on a D dimer just in case..."
Nooooooooooooo
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It's February
In less than 4 weeks the daylight hours will already be over 1.5hrs longer each day
Spring is coming 🌷🌸🌤
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@Keir_Starmer
Retain existing clinicians with fair pay, postgraduate training places and fair pensions rules
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Thoughts are with colleagues working at Derriford Hospital tonight and all other emergency services colleagues.
Please seek help and support after your shift, take care of yourselves x x
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Senior doctors are cutting their working hours to avoid losing access to tax-free childcare
The NHS has thousands of doctor vacancies, we can't afford to lose these doctor hours
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Honestly if you are a junior doctor at a grade below ST3, and you're planning on having kids, do your maths and check you'd be able to afford to return to work after
If this government want to help people back to work, they need to fix the childcare system first
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Waking up in a world where you can take your child to Primark but not Primary School.
We've got our priorities wrong.
Children and Young People need us to speak up for them
#BacktoSchool
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Saw a 13yr old in ED this week, has grown up in South West England
And has NEVER seen a dentist in her life
Is this just the "new normal" we are expecting now?
#ToryBritain
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@DrRosena
Rosena, Wes and the shadow health team are not inspiring confidence amongst NHS colleagues.
We need to hear more about retention of clinicians from Labour, and that clinicians deserve pay that keeps pace with living costs.
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@darrengrimes_
Astounding that junior doctor pay has fallen such that a 35% rise is what's needed to correct it.
Astounding that doctors have put up with this for so long.
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NHS junior doctors graduate on £13.50 having spent 5 or 6 years at uni, often accruing debts in the range of £70k.
They then must self fund their own postgraduate exams to progress in their careers.
1% is not enough.
#FundOurNHS
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If you're F1/F2 and thinking of having kids, you may not be able to afford to return to work.
If you're ST1-3 and returning then unlikely to be worth returning more than 50 or 60% LTFT in the South
Childcare costs for junior doctors are significantly higher than other groups due to shift work and nights/long days. We had a nanny but required my wife’s entire post tax income.
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First nightshift back at
@MusgrovePark
done, and look at how they're taking care of their staff! 👏🏼👏🏼👏🏼 A great place to be a Junior Doctor
@BMA_JuniorDocs
#FatigueandFacilities
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@NurseDanaRose
@BenefitUK
Tens of thousands of NHS staff taking their business elsewhere.
Big mistake Benefit, huge!
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@lottieflying
Stay at home, as much as possible, and encourage friends and family to do the same.
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Junior Doctors- remember to tell HMRC about your "professional expenses"
GMC fees, BMA and indemnity (MDU/MPS) are all tax deductible.
HMRC can adjust your personal allowance for the rest of your paychecks this year.
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So I've thrown my hat in the ring for BMA council.
I'm hoping to see a diverse array of candidates on the ballot paper this year 🙏🏻
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My tips for Paediatric Specialty Training Interviews
A Thead
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RIP the social life of anyone who wants to apply for core surgical training 😵
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Pregnancy insomnia in late 3rd trimester when you're about to deliver a sleep thief into your life is just cruel isn't it? 😴
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Christmas gift from my ward and a ton of food.
If you have to be in hospital at Christmas, the paeds ward is the place to be
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Want to take action on Junior Doctor pay?
Know your trade union law:
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@WhitHealth
The medical profession needs to ask itself why we think this is OK.
The pressure to sit this exam didn't come from nowhere.
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Junior doctor *annual leave* entitlement
Many rota co'ordinators assume that CT/ST1/2/3s have <5 years NHS service and so are only entitled to 27 days annual leave per yr.
If you have >5 years service as a result of switching specialties, working LTFT......
1/3
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