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A clinical attachment, sometimes referred to as an observer-ship, involves shadowing a healthcare team within a hospital department of your future interest. It’s generally undertaken to gain insights into the functioning of that specific specialty or department while also familiarizing yourself with the broader NHS infrastructure.

Despite what you may have heard, taking up a period of observer-ship is not mandatory, although it helps to understand the system and works as a refresher for those who have been out of clinical practice for some time or just feel nervous about starting in the NHS.

Why should you participate in a Clinical Attachment – Pros and Cons

Pros

Insight into the NHS: Every healthcare system functions differently, and it is important to know for certain if you would be comfortable in an entirely new system before committing to your first NHS job contract.

Exploration of your chosen specialty: Perhaps you haven’t yet had the opportunity to work in your dream specialty back home, or you have but would still like to experience it in the NHS before working full time. A clinical attachment is the perfect opportunity to do that without the pressure of being expected to know everything.

Networking: The few weeks spent in the hospital are the best time to create meaningful relationships with fellow junior doctors and consultants. Remember, these people could be your future colleagues, and it’s great to have connections, especially when you are away from home. This is also a great time to make a good impression on your consultants, who may be able to help you secure any jobs for which vacancies open up.

Valuable NHS experience: When applying for your first NHS job, mentioning your clinical attachment can be beneficial. While it doesn’t officially count towards NHS experience, consultants screening applications still get the impression that you have some understanding of the workings of the NHS. You may also ask your consultant to be one of your references at the end of your attachment – having a consultant from the UK as one of your references also helps create a well-rounded picture for your job application.

Audit opportunities: Clinical audits are a valuable addition to your CV, and yet, these are not undertaken routinely outside the NHS. If you are looking for guidance and support to get involved in a clinical audit, your attachment is the best time to do it. Discuss your goals for the attachment with your consultant beforehand so that you can both work towards getting the most from your attachment.

PLAB 2 Preparation: In case you are completing your Clinical Attachment before your PLAB 2 attempt, I assure you it will give you an excellent idea of patient consultation styles, which, in turn, will improve your OSCE skills during the exam. This is particularly true for those who do Clinical Attachments in GP Practice – as most PLAB 2 situations are based in such a setting.

Cons

Unpaid opportunity: Clinical attachments are typically unpaid since you are only observing, which makes them slightly less appealing to some. Additionally, there are a few trusts that require applicants to pay for the opportunity. If finances are a concern, consider completing your attachment at trusts that offer it for free.

Extended stay in the UK: Most attachments last for around four weeks, which means extending your stay in the UK by that time period. This means having to cover the costs of an additional four weeks of rent, food, travel, and living expenses in the UK. It’s also important to ensure that your visa allows you to stay for that additional duration of time.

Limited Responsibility: As an observer or attachment participant, you may have limited responsibilities, which could limit your ability to actively participate in patient care. Most times, you are only allowed to observe consultations, surgeries, or procedures. Over time, you might be allowed to clerk patients and take histories independently under watchful supervision.

Competitive: Clinical attachments in popular specialties or locations can be highly competitive, making it difficult to secure a placement. Since there is no streamlined pathway for securing an attachment, this can add to the frustration of the whole process.

Time-Consuming: Clinical attachments can be time-consuming, which may be challenging for individuals with other commitments or obligations.

I hope this blog has helped you make a decision about whether a Clinical Attachment is right for you. Evaluating your goals and considering the pros and cons will help you decide if a clinical attachment is the right choice for your career development. Now it’s about how to secure a clinical attachment. We will discuss it in the next blog!