Becoming a Locum Doctor in the UK

RIG Locums specialises in helping overseas doctors find their first and subsequent locum jobs in the UK. Locum placements are often a great way of getting your foot in the door, gaining relevant experience and building your CV. For international doctors, Locum work can offer an insight into what life is like living and working in the UK before a more permanent move.

This month we speak to Italian Trained Consultant Oncologist Dr Etta about his first experience as a locum doctor in the UK and Natasha Peets, the specialist medical recruitment consultant who helped him find the perfect placement.

What made you decide to become a doctor?

Dr Etta: “I always wanted to study medicine. I was born and went to school in Nigeria but my heritage is Cameroonian. The first time I took my A’levels I didn’t do very well, so I returned to Cameroon to re-sit. I did much better the second time around but my grades didn’t quite meet the requirements for medical school there. Medicine was a popular career choice and over 5000 applicants for just 60 places, so it was very competitive. At the time a friend of mine was planning to go to Italy to study Medicine so after consulting with the embassy I decided to go with him”.

Why did you decide to specialise in Clinical Oncology?

Dr Etta: “When I began my career I worked as an A&E locum doctor. It helped me develop almost a sixth sense, or gut feeling. If I had worked in the UK I would have been a A&E Consultant by then but in Italy A&E is not a formal specialization. My wife suggested I go into another area so that I could train to become a consultant and I wanted something ‘out in the field’ rather than based in operating theatres.

My neighbour at the time worked as a Clinical Oncologist, so I asked her what she found interesting about the role. She said, “Do you remember the old Motorola phones? Remember how long ago it came out…. and now we have the iPhone. We can see the evolution in such a short space of time. That’s what it’s like that in Oncology.” Methods are constantly being refined and it’s one of the fastest evolving specialisms.

Oncology has a lot of research behind it, especially physics. Although it would be more exciting to say I am a researcher in microbiology, Oncology is a specialism that is very dynamic and I am very happy in this field.

I feel lucky, I have an ability to think on my feet and trust my ‘sixth sense,’ but now doing Oncology I have the time to sit down, read, study, research – it is more of an evidence based medicine. I have learnt early in life that to survive you have to adapt, or risk getting left behind. I think that is why I am able to do both very contrasting types of medicine”.

Natasha Peets added: Oncology is such an intricate specialism. It has always and will always fascinate me. There are a myriad of malignancies and tumour sites to treat, within both the chemotherapy and radiotherapy branches. As Dr Etta explains, it is an ever changing, always evolving specialism and it’s impossible not get caught up in the excitement of those I work with”.

What unique attributes are needed to be a top Oncologist?

Dr Etta: “Patience and Courage. With Oncology, you never know how patients will respond to treatment because different people react in different ways. You have to be very, very patient and never tell the patients ‘I will cure you.’ That is why I also think courage is so important. You must have the courage not to tell patients what they want to hear and give them false hope. They often ask me, “Am I going to be alright? Am I going to be healed?” I respond that only God can guarantee that 100%. I am not God, I can only promise you a better quality of life, not a cure.

If there is no relapse in 5 years, you can say you have been cured – this is for statistical purposes. It doesn’t mean that in the 6th year, the patient won’t get cancer again though so we have to keep our fingers crossed.

Unfortunately, doctors being human beings sometimes feel the need to become a hero and say they can cure a patient. The truth is bitter but it’s for the best”.

What would you say are the key challenges compared to other specialisms?

Dr Etta: “It is not easy in A&E to deal with a patient with a trauma i.e. a brain trauma; something that happens unexpectedly and suddenly. Cancer is gradual and the process is slower. People have to deal with this in a very apprehensive way which is difficult. To be an Oncologist you need the ability to communicate, maybe more so than in other specialties. You need to explain things to patients in a language they can understand and try not to give false hopes. This is one of the best and worst parts about being an Oncologist”.

Why did you decide to come to the UK and why were you attracted to locum positions?

Dr Etta: “The main attraction for me is that in the UK you are rewarded on merit and of course the salary is also much better! A clinical Oncologist in Italy gets paid far less and often works longer shifts. The good thing about Italy though is the benefits, such as study leave and so on. If you are fully employed as a civil servant it’s worth it but as a freelancer it’s not”.

How easy have you found it to adjust to the NHS system and what was your greatest worry before starting your role here?

Dr Etta: “Initially I wanted to start with A&E in the UK because I was concerned about perhaps not being able to communicate well with oncology patients. The British mentality is to be very direct they don’t ‘beat around the bush’. I was afraid of making a mistake. The Italian approach is very laid back, it is easier to say what patients wants to hear.

I was worried that having worked in such a different culture for so long, it would be difficult for me to adapt to the UK system but it’s been three weeks already working in an oncology placement and I am practically independent. I know what to do and more importantly if I have any problems I know who to ask for help. Other consultants have been available and they welcome my questions”.

What are the main differences you have noticed between the NHS and the Italian hospital system?

Dr Etta: “Working patterns are more or less the same. In terms of interaction, patients here ask more questions, they want to know more. They have a stake in their therapy and participate more in the discussions. It’s a good thing. In Italy the general attitude is, “you’re the doctor… you tell me what to do’. I think ‘It is your body, your treatment… you tell me your thoughts.’ Colleagues in the UK are also very supportive and respectful, regardless of grade. I think this is due to a British respect for hierarchy that doesn’t exist in some other countries”.

What advice would you give to new doctors who would like to specialize in Oncology?

Dr Etta: “Patience, patience, patience, but firstly communication. Knowing how to choose the right words, the tone of voice, your presentation and composure is essential. I was lucky, in my medical degree I learnt a lot about patient communication but if you have the opportunity to do a communication course, I would recommend it.  It’s important to be open and communicative so that patients know what they can and can’t do, allowing them to live their lives. Simple things, like not being scared to go on holiday and knowing what to eat. Information is power and freedom.

If you are thinking about doing locum work in the UK, I would also recommend that you find somebody who has already gone through the process to talk to. I have a friend in the UK who has given me advice on things like getting an ALS certificate. My friends in Italy are now using me as a point of reference!

I recommend watching a lot of UK films and TV to help you get used to the accents here and there are books that help with ‘Medical English’ which are useful.

Finally, it is a good idea to start preparing your documents as early as possible, I recommend you start even if you are still undecided about coming to the UK because the whole process took me almost a year. Once I had all of the supporting documents for my GMC registration, the application process was simple and really quite fast but obtaining them in the first place took a while”. 

What changes do you predict within Oncology, over the next 5 years? When do you think we will have a cure for cancer?

Dr Etta: “That’s impossible to answer. Whenever there is a new discovery in the lab, it’s often years and years before it even reaches animals. I don’t think we will find a cure soon. Right now, our aim is to guarantee a better quality of life”.

And finally… Natasha, what do you enjoy about being a specialist medical recruiter and helping international doctors like Dr.Etta?

Natasha Peets: “It’s my role to understand the Oncology market and treatments so that I can place those I work with into suitable roles for their skills. I understand the differences between various specialist radiotherapy treatments such as Brachytherapy, Cyberknife or SABR. This allows me to find roles that challenge the locum oncologist I work with, opportunities that help them to develop their skills and research, whilst supporting cancer departments. Patient care is also always at the core of what I do. My knowledge and experience as an oncology recruiter means that I can match the required skills with the oncologists I represent and place the most suitable candidates for the role.

I have recently relocated, from Wales to London, so I understand how difficult it can be relocating away from friends, family and all the little comforts that may seem silly to others are important to us. I have a ‘my mobile is always on’ policy and my role isn’t to just place Oncologists like Dr Etta but to make sure they are happy in their roles.

I began working with Dr Etta in October, before he had applied for GMC registration, and there is no better job satisfaction or reward than seeing him now, settled and happy in his first UK locum role”.

As we’ve read from Dr.Etta’s story, locum uk work can actually become a fruitful long term career move. Dr.Etta’s story is truly inspirational and we hope it serves as an example for those of you who are contemplating making a temporary, or more permanent career move, to locum doctor work. Becoming a full-time locum is particularly well suited to doctors that enjoy variety and change and the financial benefits are huge, with higher than average pay rates guaranteed. Although the idea of swapping the security of a full-time role may sound daunting, it is possible and Dr.Etta’s success stories is the living proof.

Article published by Samantha Elgie, Marketing Manager, RIG Locums Limited