FAQs  

1. What is a clinical attachment? 

A clinical attachment is an unpaid observership post aimed at newly qualified doctors or those new to the NHS system. It is especially beneficial for international medical graduates to gain an overview of the medical process and systems used in the NHS.  

2. What can I do in an attachment?  

Duties in an attachment can vary according to how regulated things are in  that particular trust; however general things you can do include: 

– Shadow junior doctors on wards, observe the daily tasks and chores

– Learn how to take patient histories, do physical examinations

– Learn how to document your findings, use the hospital IT systems 

– Learn how to make discharge letters  

– Observe consultants, partake in ward rounds and MDT meetings

– Perform basic clinical procedures (under supervision) – such as  cannulations, venepuncture, NGT insertion, and catheterizations (NOTE: each trust will have its regulations on this – please read  them carefully, ensure you gain approval from your consultant and  supervising doctor to do these and ensure you are supervised at all times)

– Undertake a clinical audit – very useful for future job applications 

– Partake in any teaching opportunities (if possible)  

– Attend teaching sessions for the junior doctors of that department 

It is important to note that this list is not comprehensive, and you may have more responsibilities or duties that you can take on. The best option is to write down the goals in the attachment. Then, once you begin, talk about them with your doctor, who supervises you to maximize the benefit from the assignment.

3. How long is a clinical attachment?  

The length of an attachment can vary based on each trust. However, they generally last between 2-6 weeks (with 4 weeks being the most common).  

4. Do I have to pay for an attachment?  

This depends on the trust and their policies. Some trusts offer attachments for free, and others require a payment (the amount depends on each Trust). I would not recommend paying excessive amounts for an attachment. Some trusts in London have been known to ask for £800 – £1000 for a 4-week  placement. You can easily find other places that charge less or even nothing. 

5. What are the eligibility criteria for an attachment?  

This may vary on the trust, and they will notify you regarding the particulars. However, some common requirements include: 

– Identity proof documents and proof of primary medical qualification 

– Up-to-date medical CV  

– IELTS/ OET certificate proving an appropriate level of English 

– Criminal records check/ Police clearance form 

– Occupational health clearance from the trust  

– Appropriate Visa (if applicable – click this link for more information) 

– Satisfactory references (not always necessary – Trust dependent)  

6. Which Trusts offer clinical attachments?  

Several Trusts all over the UK offer clinical attachments. Some trusts require you to contact consultants and gain acceptance to do an attachment personally; others have an established programme (detailed later).  

7. Which speciality shall I do my clinical attachment in?  

In short, any speciality is fine since the main aim is to gain experience in the  NHS system and the processes here. However, you can apply directly for those specialities if you have a specific preference. It may be more beneficial to apply for attachments in departments where you can see various cases, such as general medicine, acute internal medicine, emergency medicine, and general surgery.  

8. Will the hospital provide accommodation?  

Not necessarily. This depends on each trust, and you must inquire about this personally. You may have to book accommodation yourself.  

9. What are the benefits of a clinical attachment?  

– Gaining valuable NHS experience  

– Understanding the UK healthcare system and how it functions 

– Understanding the role of a junior doctor in the NHS  

– Practice and improve your clinical skills  

– Possibility to undertake a clinical audit or other clinical duties 

– Additional experience you can add to your medical CV  

– Gaining a reference for future job applications  

10. Is it necessary to do a clinical attachment to get a job?  

No, doing an attachment to get a job is not necessary or mandatory. It may open opportunities for you, and you can directly enquire about upcoming vacancies in the trust when doing an attachment. Rest assured that getting a job without an attachment is possible. 

HOW TO FIND A CLINICAL ATTACHMENT:  

There are a few different avenues you can explore to try and secure a clinical attachment. These are as follows:  

1. Contact the HR of respective departments:  

Call or email the HR/ Junior Doctor Admin (JDA) team for the department in which you want to do your attachment. Contact details can often be found on the respective Trust’s website.  

2. Apply directly to trusts that are known to offer clinical attachment programs:  

Some Trusts/ hospitals with established clinical attachment programs: 

• University Hospitals Coventry and Warwickshire
• East Sussex Healthcare NHS Trust
• Ashford and St Peter’s Hospitals
• Cardiff and Vale University Health Board  
• Leicestershire Partnership NHS Trust
• Dartford and Gravesham NHS Trust
• University Hospital Southampton 
• Rotherham NHS Foundation Trust 
• NHS Greater Glasgow and Clyde
• King’s College Hospital
• Guy’s and St Thomas’ NHS Foundation Trust
• Northern Lincolnshire and Goole NHS Foundation Trust
• Liverpool University Hospitals NHS Foundation Trust
• Torbay and South Devon NHS Foundation Trust

3. Google:  

Although it may not be straightforward to find the right links, you can always try searching “clinical attachments in the UK” or “clinical attachment <your desired trust name>”, and this may also yield you some results.    

4. Ask your contacts and colleagues:  

Having contacts is a huge bonus, especially in the healthcare field. If you know of any relatives, family friends, colleagues, etc., working in the NHS,  network with them and find out if they can help you in any way. Even if it is an email from a consultant or a phone number for the HR team, explore all opportunities, as you only need that one person to say yes! If they’re unsure, ask them if they can point you in the right direction. 

5. Email consultants: 

This is by far (in my opinion) one of the best ways to increase your chances of getting a reply and reaching out to a large number of consultants. The more emails you send, the better your chances of someone replying and accepting you for an attachment. This is the method that helped me gain an attachment, too.  

There are a few ways you can get consultant emails, and these are as follows:  

i) NHS jobs & Trac jobs websites:  

These sites are used to search and apply for non-training trust-grade positions within the NHS. If you haven’t done so already, I   recommend creating an account on both websites (click the links) since you will need it later if you apply for non-training jobs.  

Once you have created an account, you can search for jobs on these websites. Use the following links to understand how to use these sites to search for jobs (Link 1, Link 2, Link 3). Job adverts for different posts will have the email of the lead consultant or the JDA/ medical staffing department. You can use these and email them directly, requesting an attachment. This method may be more extended and tedious, but it is worth trying. 

ii) Consultant directory: 

Some trusts have dedicated consultant directories through which you can contact either their secretaries or consultants themselves (via email). These directories can sometimes be found on trust websites, or if you try to Google the trust name + consultant directory, you may get some results.  

iii) Using trust email endings to email consultants:  

This method was the most effective in my experience. Here’s  what to do:  

• Go to the Trust’s website/ NHS jobs/ Trac Jobs to look for senior  registrar or consultant vacancies in different departments  

• Find an advert for a post in the speciality of your choosing (usually  Acute, Emergency and General Medicine. There’s at least one post  advertised at SpR or consultant level) 

• Download that post’s Job Description (JD) and read through it quickly. The JDs for consultant posts almost always have a list of  consultants working in that department at that trust

• Copy these lists and save them somewhere so that you can start  emailing each one  

*Important tip*  

• Usually, the email addresses of NHS doctors follow a generic pattern  of: firstname.surname@trust-email-ending 

For example: if the consultant’s name is John Wick and he works at  University Hospitals of Coventry, the email would be 

john.wick@uhcw.nhs.uk  

Just like this, you can find the names of all the consultants working in a specific department at a Trust (using the JD from a job advert) →  , then find the email-ending for that trust → use the consultant list and apply the aforementioned tip to email individual consultants!  

This method will allow you to email a much larger proportion of consultants, and it is more likely to get you a response. All you  need is one person to say yes!  

HOW TO EMAIL CONSULTANTS FOR AN ATTACHMENT:  

After you have cured a list of consultants to start emailing, it is equally important to ensure the email you send is professional. I would recommend typing a draft email and saving it as a template when emailing many consultants. This will make the process more efficient, and you will be able to email a number of consultants in a short period of time.  

Here are a few tips on how to structure your email:  

1. Use a subject such as: Clinical attachment in <speciality name>  

2. Address them as Dr. + <their surname>  

3. Give a brief outline (1-2 sentences) on why you are emailing them 

4. Paragraph 1 (Introduction): provide a brief overview of your identity (name or grade, date, when you received your medical degree and the level of your experience when you are a holder of an official GMC registration as well as a licence to perform)

5. Paragraph 2 (Motivation): mention your reasons for wanting to complete an  attachment, why you are interested in this field particularly and what you  hope to gain from this attachment 

6. Attach a PDF version of your up-to-date medical CV  

7. Thank them for their time and consideration, sign the email with your title  and full name

Here is a template for what an email might look like requesting an attachment  in Acute Medicine:  

Dear Dr. <Consultant’s surname>, 

I hope this email finds you well. I am writing regarding an opportunity for a clinical attachment in the <insert department> department at <insert trust name>.  

My name is Dr. <your name>. I am a junior doctor and have completed my medical education from <your medical school and country>. As part of my primary medical qualification, I have completed a 1-year medical internship, where I rotated within several different specialities. The GMC approves this internship as the equivalent of Foundation Year 1. Furthermore, I recently gained full GMC registration and a license to practice.  

Acute Medicine is a speciality that has always fascinated me as a medical student and as a junior doctor. I relish the opportunity to gain exposure to a variety of different clinical cases and learn in a fast-paced environment. Moreover, the ability to have a significant impact on a patient’s health and welfare by providing the appropriate care is something that appeals to me greatly.  

Undertaking my clinical attachment at this trust would be an incredible opportunity to learn the intricacies of clinical diagnosis and treatment from leading physicians in the country, such as yourself. It will familiarise me with working in the NHS environment, helping broaden my knowledge of the organisation’s functioning and strengthening my position as a potential candidate for an FY2 level job.  

I would be very grateful for the opportunity to undertake a clinical attachment under your supervision at <trust name>. Please kindly find attached to this email a copy of my CV. If you’re looking for more details, don’t hesitate to contact me.  

Thanks for your consideration and time. I’m looking forward to a response from you as soon as I can at your earliest convenience.

Yours sincerely,  

Dr. <Your full name>  

Note: If you haven’t done so already, I would highly recommend updating/  making an up-to-date medical CV. This will be useful when sending emails for attachments and help when sending job applications later on. Links for help on medical CV making: Link no 1, Link no 2, Link no 3, Link no 4, Link no 5. 

MAKING THE MOST OF YOUR CLINICAL ATTACHMENT

The following are some tips that might be useful when completing your  attachment to ensure you gain the most out of it:  

1. Make a list of your objectives and what you hope to achieve:

You can discuss these with your supervisor/ doctor whom you will shadow.  This will allow you to achieve the most out of your placement and show a proactive approach.  

2. Learn the system and the job: 

– Shadow doctors of a similar grade to what you will be (FY1s, FY2s, CTs) – Take part in ward rounds, MDTs and any educational opportunities such  as teaching sessions offered to the junior doctors  

– Learn what the role is of a junior doctor and observe the daily jobs  – Familiarise yourself with patient clerking, examinations and procedures  – Once you feel comfortable, gain approval and ask to do clerking,  

examinations and basic clinical procedures yourself (with supervision)  – Learn how to use the IT systems, requesting investigations and scans  – Practice making discharge letters and doing phone referrals  – Practice presenting patients in rounds/ meetings  

– Observe patient consultations, how to break bad news and how to deal  with difficult patients  

– Take time to understand how the department works, all the way from  patient admission, inpatient procedures and discharge planning  

3. Ask questions, be inquisitive and proactive:  

– Show a genuine interest in the role, ask questions from your seniors  whenever you are not sure or want clarification and explanations – Volunteer to do jobs, this will not only show your willingness to be part of  the team but also show you are actively there to learn  

4. Note down everything you do, learn and observe:  

– Keep a personal notebook with you in which you note each day  everything you did, interesting cases you saw, and procedures you observed  and completed → this will help immensely when updating your CV  

– Optional – keep a logbook of procedures you have witnessed and any  procedures you have completed under supervision  

5. Try to participate in a variety of different shifts:  

– Ask the HR/ staffing department or the consultants if you can shadow a variety of different shifts, such as day on-calls, weekends, nights and twilight shifts. This will give you a more broad experience of the rota. 

6. Try to do an audit:  

– Ask the junior doctors you shadow if you can do a joint audit with one of  them (pursue this early on) → this can help add some substance to your  portfolio later when applying for jobs  

7. Network as much as possible:  

– Talk to the junior doctors, consultants and the HR department, and tell them  your intentions of wanting to work as a junior doctor in that trust – Enquire about upcoming vacancies in the department by asking  consultants, other colleagues and the staffing team for that department  – Try to get the contacts of other JDAs (junior doctor admins) within the  trust → you can then send them emails about your interest in applying for  any upcoming vacancies and send your medical CV 

8. Throughout your attachment:  

– Introduce yourself to the members of staff 

– Let other members of staff (e.g. nurses) know your role and how you’d  like to help in any way possible  

– Always make sure any procedures you do are approved by your  consultant/ senior, and you are supervised at all times when doing these  – Always be polite and respectful, smile and show enthusiasm  

9. At the end of your attachment:  

– Personally thank the consultant who accepted you for the attachment  and send a follow up email regarding the same, and enquire about any  upcoming vacancies (show your interest that you’d like to be considered)  

– Visit the JDA/ HR office and ask them about any vacancies, leave a copy of  your CV with them and email them as a follow-up as well  

– Perhaps bring in a card and some chocolates as a thank you for the staff  in the department  

This is not by any means a definitive guide to getting an attachment, things to do and what not to do, but an overview written from my own personal experience.  

The information provided is useful and may help you in gaining a clinical attachment (and hopefully a subsequent job) within the NHS! 

Wishing you all the best for the future and in your journey as a junior doctor