In my opinion, this hospital should not have trainees. As evidenced by the GMC survey (who knows if PAH has been investigated based on its poor results), and by reviewers here, there is also a more general negative opinion of the hospital and it’s management (see nhs staff survey). Also via Reddit. Foundation trainees are not supported - if a trainee wishes to escalate something, there is no adjustment or empathy, the “gold guide” or whatever other rules are just regurgitated back at us. No wiggle room. No empathy. Just “oh we will refer you to PSW”. Lip service is given eg “my door is always open” but the actual support, advice, conversations are useless. This trust will not defend you if you make an error. You are on your own. The consultant or reg supervising you as a trainee will turn a blind eye and leave you out to dry. Escalation re surgery and urology supervision and staffing has been met with an increase in working hours from 9-5 to 8-8 for juniors, rather than seeking to employ appropriately trained seniors. Acute medicine consultants (in the most part) cannot and will not make decisions - most patients are admitted, beds filled, ED back up etc etc. Consultants who have clear, sensible plans, and who teach or explain their decisions are few and far between. The emergency department is inadequate as per the CQC. Protocols cannot be found. Consultants only care about timings and targets. They will chase you down to decide whether referral to medics or surgeons has been done yet will not ask if the patient has had the basics done/given or even enquire about how the patient is! The IT systems are truly atrocious. Paper notes for medics, one IT programme for surgeons’ notes, another for the emergency dept. Electronic prescribing programme. NEWS programme. OGD results programme. Radiology viewing programme. Bloods and image requesting programme. Vetting scans programme. Oh and now the trust made a completely non functional intranet where protocols are missing and names in the most idiotic way. Eg antibiotic guideline in the search bar doesn’t bring up anything but anti microbial is the phrase you need! You have to sign in to access a telephone directory! Poor OOH services. No ENT, no MAXFAX, no ophthalmology, no neurology/neurosurgery. If you have a ?cauda equina there’s no MRI overnight. The staff here are burnt out, undervalued and rota gaps don’t get filled because people don’t want to work here. Every morning juniors who are meant to be on rotation x are moved to a completely different ward. The care given is substandard and even incidents reported via datix are not investigated and there is no shared learning or feedback about mistakes. Even deaths which are looked at by people get brushed aside when questions are asked about the patients care. A personal bugbear is the generally poor communication of consultants with patients. No one seems to explain a diagnosis in ways patients can understand. End of life care or TEP discussions I have witnessed, and have had to remove myself from, have been harrowing and painful to listen to. There are a few fantastic medical consultants who stand out and who really want to improve the hospital. Also. Yes. Mice in the mess. Costa is great. Parking is average. No OOH hot food. Scrubs can’t be found anywhere. Quality of teaching is poor. I would not recommend training at PAH. It is not safe for trainees.

A rotation here is an exercise in service provision. Doctors in every discipline, except O&G and paeds oddly, have said that they have not worked in a hospital as poorly run. I have heard Medway and North Mid compared favourably. Training is poor. The standard of clinical care is... Substandard. The environment will either teach you to practice the most cautious medicine of your life, or break you. The junior doctors mess currently has at least 2 mice in residence. These mice will, on occasion, visit cardiology. Rota coordination... The positive is that as an F1, you don't have to do nights. Otherwise it is one of the more brutal rotas out there, with maxed out evenings and weekends, and huge rota gaps that are often foreseen but not dealt with in time. Burnout and short staffing is rife secondary to this. Last minute changes to which wards you will be working on. Minimal continuity of care. PAH has one of the most byzantine IT services known to man. Paper notes. Eprescribing on JAC. Blood results on a service that runs on Internet explorer. Another service for images. Another for observations, and handovers, but that the surgeons will write notes on as well. Another one for discharge summaries. Another login for checking whether scans are vetted. A login to get to the telephone directory, or to get to the directory where you can find the forms for referrals. Once you do find the referral form, it needs emailing, often the email itself is incorrect. Social life is less than ideal. Most of us commute in from London, and it's a short easy commute. But that is not amenable to drinks down the pub often. Make of this what you will. But, be warned, this is not a normally functioning hospital. And think carefully about whether you are up for a challenge.

Things to expect if you start work at PAH: 1. Generally friendly environment, pleasant staff 2. Rota is busy and doesn't allow for good work-life balance, both SHO and SpR level 3. Understaffed with rota gaps at every level, last minute locums advertised >1/week 4. Teaching feels poor at every level, both formal and informal 5. Lack of support from seniors in departments of Acute Medicine, Gastro, with a general lack of leadership and interest. 6. IMT3s are used as glorified SHOs in some specialties whilst in others they are expected to act as Specialty Trainees without appropriate support. 7. Canteen is decent; M&S and Costa on site 8. Parking off site in nearby linkway (2min away) decent 9. Rotations for IMTs have felt balanced overall on paper, giving a good exposure but lacks actual training

This SHOULD NEVER BE a training hospital. There is no support, no training, no teaching provided. Junior doctors are left alone, very often moved from one ward to another affecting continuity, supervision and safety. This hospital ruins doctors and sees them as merely service provision. The number of consultants willing to train is shockingly low and countable in just one hand. This should never be a training hospital and the Deanery should do something about it instead of believing in false promises. Nothing has changed in 3 years, things got actually worse and many juniors are opting out of training because of this place and how is managed.