Resident Medical Officer (RMO)

Resident Medical Officer (RMO) work is by far the biggest work opportunity for non consultant doctors who start work in the UK Independent Sector for the first time.

Most RMO’s are currently recruited directly from Eastern Europe. Doctors who engage in this role primarily use this opportunity

• As a stepping stone
• To earn money and
• Improve their English
• Under fixed term contracts - 3, 6, 12 months or longer
• Whilst retaining the ability to return and work in their Country of origin for at least every 2 of 4 weeks of RMO engagement or enhance their earnings in the UK as NHS locums, Private GP work or Health screening.

As an organisation we recognise various cultural differences, language barriers, levels of support required, equal opportunities and EU regulations. Our Medical Director has a close working relationship with all the RMO doctors to support them in their RMO role, act as mentor and assist with training and any clinical issues. See Why Choose Us below.

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Who we are and what we do

We have over 25 years of international healthcare experience. This includes 12 years in RMO (Resident Medical Officer) service provision in the United Kingdom and International Consultancy, Recruitment and Employment services. We have a global reach.

Why Choose Us

We suggest you compare us with other RMO providers in the UK. To avoid any pitfalls you should scrutinise any employment or agency contracts carefully before signing them. Rather than pointing out known pitfalls, we emphasise important do’s' and do not’s' that we adhere to. This is crucially important especially when considering that despite all the information made available, very few doctors in fact fully understand what RMO work is all about before they start working and that is normally after they have signed a contract!

• We do not have penalty clauses in your employment contract
• We do not withhold some of your pay with a promise to pay that at the end of your contract as a 'completion bonus'
• We specify resignation and termination clauses in your contract
• We do not force you to do extra and ‘compulsory standby weeks’ of RMO work
• Subsequently we allow, encourage and even assist you to perform non - RMO work in your weeks off duty, especially if you choose to work 1 week on 1 week off or 2 weeks on and 2 weeks off RMO rotations
• We make you aware that although you can opt out of the 48-hour working week under the WTR (Working time regulation) that you cannot opt-out of rest break requirements with the implication that the healthcare provider where you work should ensure that the workload on site is tolerable and sustainable
• We point out that RMO work is not a career or a training POST and that for career minded individuals the opportunity should ideally be used as a stepping stone into a NHS or other career post, to earn additional money and to gain clinical experience outside of your RMO duties
• We emphasise that RMO work has its frustrations and you will be required at times to do work which will make you feel like a nurse, phlebotomist or pharmacist
• We guarantee to pay you the most of all RMO providers by optimally matching your clinical experience and English speaking ability with the best available Client specification and capacity
• We remind you that even working for short periods of time you are entitled to Annual Leave for every hour worked and we roll that up in your pay as HOLIDAY PAY
• Finally we do not try to limit your registration to one organisation but, encourage you to register with as many organisations as you like

Take a moment to change your Life ^TM and register with HMS as well!. It is free of charge and carries no obligation.

The RMO Information section below is organised in categories that provide Doctors and Healthcare Providers (Clients) with all the information required to optimise RMO services in the United Kingdom.

Doctor, once you decide that RMO work is the right move for you, please register on-line or simply send your CV to recruitment@hippocrates.uk.com. Remember these posts are in high demand and very competitive. The better you sell yourself the higher your chances of securing a successful placement!

If you already understand RMO work and have the required information please ignore the following section and go straight to the registration page or email your CV. Clients and healthcare providers please refer to sections 10 and 11.

1. RMO Nature of Work

2. RMO Skills Required

3. RMO Code of Conduct

4. RMO Working Hours

5. RMO Salary and Benefits

6. RMO Annual Leave/Holiday Pay

7. RMO Accommodation

8. RMO GMC Revalidation

9. RMO Credentials

10. Healthcare Providers

11. Healthcare Provider service options

1. Nature of RMO work

There are approximately 190 Private Hospitals in the United Kingdom offering consultant led services, 95 Private Patient Units in NHS hospitals and 80 Treatment Centres (TC). Consultants working in Private Hospitals are primarily engaged in the NHS and their private hospital work can be seen as secondary, except where private hospitals function as Treatment Centres (TCs) for the NHS.

There is huge variance in the size, complexity and workload of these hospitals. This variance is clearly reflected in the pay rates, working hours/schedules and RMO qualifications required. The number of patient beds varies from 15 to 130. The larger hospitals have High Dependency Units (HDU) and the minority have Intensive Care Units (ICU).

Most private hospitals are predominantly engaged in relatively low-risk elective surgery, many on a day-case basis. The numbers of NHS patients undergoing surgery in private hospitals are increasing. Typically these hospitals do not have Accident and Emergency departments (A&E). Some private hospitals add sophisticated services to their surgical facilities in areas like diagnostics, infertility, chemo-therapy, well being and prevention, rehabilitation, medical admissions, geriatrics, psychiatry, physiotherapy, etc. A few hospitals engage in cardio-vascular and neurosurgery.

UK law stipulates that these private hospitals are required to have a Resident Medical Officer (RMO) on site 24 hours. The main RMO functions are to deal with any medical emergencies on the wards including cardio-respiratory arrests, adverse changes in patient condition and post-operative complications. This is the reason why all applicants are required to hold full adult and paediatric resuscitation qualifications (ACLS and APLS or equivalent).

Outside of this responsibility most of the clinical RMO workload entails consultant and nurse support, general ward work, admission clerking and treatment charts, ward rounds, pain relief (including epidural top-ups) cannulation and some IV administrations e.g. contrast required for MRI and CT, out-patients and pre-admission, phlebotomy, ECGs, prescriptions, discharge letters and prescriptions, hospital health and safety, infection control, audits and training, research, continuing professional development (CPD) and appraisal, etc.

The exact job descriptions vary hugely depending on the individual needs of the health providers and hospitals. In a nutshell, the main task for a RMO is patient risk management in a consultant led service with nurse's support. This entails the early recognition, assessment and management of an adverse change in a patient's condition with prompt communication of same with the consultant and in charge of the patient.

The emphasis is on TEAMWORK

You should realise that these RMO posts are non-career grade posts i.e. they are not "training posts" and that RMO work in the Private Sector is very unlike any typical NHS work in that RMO Doctors have a relative low level of responsibility in a consultant led service.

You should also be fully aware that as the requirement of continuity of RMO cover has been formally defined in law as a prerequisite for a private hospital to function, an RMO may not leave the hospital under any circumstances when on duty and is obliged to wait for the opposite doctor to arrive before a shift change can occur. Given the 24/7 nature of cover required, the majority of hospitals provide an on-call room that will usually have a bed, desk and satellite TV. Meals are often provided free of charge whilst on duty. Please note that hospitals are not obliged to offer an on-call room or free meals.

Some RMO posts are ideal for those doctors wishing to study whilst earning a reasonable salary. For some doctors it is an ideal way to enter the UK and later apply for NHS substantive posts while earning a salary. Many doctors enhance their earnings by doing additional NHS or RMO locum work at much higher hourly rates given the unpredictable and insecure nature of locum work.

2. Skills, certifications and criteria required

There are specific criteria you have to fully meet to become eligible for RMO work in the UK. Briefly, to work as a RMO in the UK you will need to meet a number of requirements as follows

• Full GMC registration and Licence to Practice
• Two satisfactory and recent work references
• Advanced Life Support (ALS) and European Paediatric Life Support (EPLS) certification both recent (within 6/12 from employment start date) and current
• Proficiency in English preferably with a passing score in IELTS (International English Language Testing System) or equivalent
• Health requirements: Hepatitis Variants Immunity Report; Tuberculosis certification (CXR, taken within the last months), Rubella and Varicella (chicken pox) immunity report
• A police clearance report from your country of origin or Enhanced Disclosure under the Criminal Records Bureau (CRB)
• The right to work in the United Kingdom. (Non EEA citizens can only work in the UK in areas where applicants within the EU are insufficient to fill these shortages). Access to the UK for non-EU citizens are by way of a work permit or working holiday visa.
• As general guide, on average, a minimum of two years of post-graduate experience is required. Good "all round" experience in the major disciplines of medicine is required, preferably surgical, internal medicine or anaesthesiology.
• Recent paediatric experience is a particular advantage and such experience should be clearly highlighted on your CV.
• Anaesthetic and or Critical Care experience is a particular advantage and such experience should be clearly highlighted on your CV.

3. Code of Conduct

Generally you would be expected to perform your profession to the best of your ability and to adopt and follow the code of conduct as in your employment contract and as prescribed by the hospital client. You would be expected to wear a white coat or 'scrubs' in the hospital with a RMO name tag and display professional conduct at all times towards all patients, visitors and hospital staff. You will maintain patient confidentiality at all times and make the hospital management immediately aware of any complaints or grievances by patients that come to your attention.

Specifically, you would follow the guidelines as published by the GMC (General Medical Council) which is your UK professional registration and licensing authority, titled 'Good Medical Practice'

4. Working Hours

The big variance in the nature of private hospitals discussed under Nature of Work, offer a wide variety of work schedules and rotas. The variance in intensity of and workload itself offers a choice of placements from being very demanding to verging on boredom.

This variance offer unique and unparalleled working opportunities depending on your preferences, whether it be challenging clinical experience in ICU, or on-duty available study time for your examinations in small, quiet hospital, or perhaps commute from your normal country of residence to work 50% of your available time in the UK and 50% of your time in your home country.

You should be aware that RMO posts are covered by the EWDT and WTR 1998 that allows workers to opt-out of the 48 hour working week (although not the rest break requirements) with a contractual employment clause offering you the option to opt back "in" after a period by giving written notice.

5. Salary, Currency, Tax and Other Benefits

The hourly rates of pay you can expect depend on various factors, e.g. your qualifications and experience and the particular hospital and its profile that you are allocated to. Doctors in quiet small hospitals earn less, those with recent Paediatric experience and Anaesthesiology skills earn significantly more, RMO locum rates are higher than contracted rates, etc.

Average Annual Income - Guideline only

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Typically by HMS matching your skills and interests with a particular hospital, its profile and requirements would result in optimum earnings for your skill set and areas of interest.

Please note that as UK employee all UK salary earned, holiday pay and any bonuses are subject to compulsory tax and National Insurance deductions unless you join as an associated independent contractor led by our Medical Director.

For applicable rates updated year on year please visit http://www.hmrc.gov.uk/rates/it.htm

Other Benefits:

Please ask your recruitment consultant for any special offers announced from time to time that might reimburse e.g. some of the following expenses, GMC registration or renewal (where doctor is already registered), MPS or MDU medical indemnity costs, ACLS and APLS resuscitation courses (or update where already held), flights, etc. Please note these are not available all the time.

6. Annual Leave/Holiday Pay

 You have a statutory entitlement of 4 weeks paid annual leave under any UK employment, and are entitled to claim holiday pay "in lieu" in the event that you did not take you paid annual leave for any reason.

7. Accommodation

Some hospitals provide limited accommodation "on-duty" accommodation, although they have no obligation. Generally no off-duty accommodation options are available. This implies that for doctors that require accommodation in the UK, they should establish an accommodation base either by purchasing or renting.

8. GMC Revalidation and Appraisals

You should stay up to date with registration and licensing requirements as published by the General Medical Council (GMC).

HMS in-house appraisals are required for future employment references when you move to a new job and will be referred to in the event of any complaints made by or received in relation to you as part of the "complaints procedure" as published or stipulated in your employment contract.

9. Credentials

The minimum obligations you have working as an RMO are

• Your annual GMC registration and Revalidation, Licence to Practice (where applicable) must be maintained.
• You must attend, pass and maintain ALS and EPLS certification. Refresher courses are required before your current certification expires
• You must keep your clinical skills, pharmaceutical and theoretical knowledge up to date.
• GMC Registration and Licence to Practice
• You require full GMC registration and a Licence to Practice to work as RMO, which is an unsupervised post.

Curriculum Vitae

Your Curriculum Vitae is the best document to "sell" yourself.

Although a bit tedious our RMO template can be downloaded which is specifically designed for RMO work.

References

At least 2 open, satisfactory, recent/current or previous employment references are required.The names and contact information of 2 further referees are recommended.

English Language

Communication with patients, nurses, colleagues and consultants require competence in English. HMS has no discretion in making any allowances for doctors with poor English language skills, as that would compromise patient care.

The standard of English required for doctors had originally been set as a minimum score of 7 (seven) in each of the categories of the IELTS (International English Language Testing System) test.

All doctors working for HMS in the UK who provide successful IELTS test scores or equivalent will rank higher in the selection process of applicant doctors.

Advanced life support courses ALS and PALS

UK Private Hospitals use ALS and PALS resuscitation protocols. As RMO you will be expected to be team-leader in the event of a cardio-respiratory arrest.

Recent (within six months) ALS and PALS courses followed by refresher course are mandatory. Securing a slot on these courses might be difficult due to the high demand and you should reserve your place well in advance.

Health Clearance

Police Clearance/Enhanced CRB

Full disclosure of any previous convictions under the Criminal Records Bureau is mandatory. If you have not been working or living in the UK you are required to provide a Police Clearance Report from your local police station in your country of residence. Once you have been working in the UK for a period of time, CRB disclosure will be requested.

Right to work in the UK

EU citizens do not require work permits and can work anywhere in the EEA. If you are eligible and it is required, HMS will assist you with a UK work permit. For more information please visit Work Permits.

A convenient way to work for a temporary period in the UK is to start under a Working Holiday Visa. This might later be converted to a work permit. For more information please visit Working Holiday Visa.

Employment Contract

Before you can be awarded and sign an employment contract you must successfully meet the criteria above.

10. CLIENTS (Health Care Providers).

We understand how most private hospitals operate in the UK and that as a minimum a client requires service provision to meet at least the following criteria

• Guaranteed quality including RMO English speaking ability
• Continuity
• Cost effective
• Seamless operations
• Maximum flexibility
• Integrity, honesty and professionalism
• Partnership
• HMS Medical Director’s support and mentorship.

In providing RMO services to you HMS will need to clearly understand your Client Profile that will broadly fall under the following categories

• Nature of cover required
• Specification of cover and work description
• Critical care levels
• Resources and Core facilities
• Specialist capabilities
• Ten most frequent operations/procedures
• Quality standards

For RMO STANDARDS we follow current guidelines for example regarding RMO work the gold standard is the IHC National Minimum Standards Regulations (ISBN 0 11 322572 5) - Resident Medical Officers.

STANDARD A6

A 6.1

Where the establishment provides in-patient care there is a resident medical officer available on immediate call at all times to manage urgent patient care in the absence of the consultant under whom the patient is admitted.

A 6.2

Resident medical officers have post-registration clinical experience relevant to the clinical work undertaken in the hospital.

A 6.3

Resident medical officers undertake a formal induction programme, the content of which is documented.

A 6.4

Resident medical officers undertake resuscitation training to Advanced Life Support level, including defibrillation and intubation skills, on appointment which is updated annually.

A 6.5

Where the hospital admits children the resident medical officer is trained in Paediatric Advanced Life Support, which is up dated annually.

A 6.6

There is written job description for the resident medical officer, which includes the line management arrangements for the post and the hour's on-call and shift patterns.

A 6.7

Resident medical officers have access to advice and support at all times from medical consultants with practising privileges and the communication arrangements are documented.

A 6.8

The accommodation for resident medical officers, while on-call, is sited within easy reach of the areas in which patients are cared for.

A 6.9

The resident medical officer's on-call accommodation has a telephone connected to the hospital's internal telephone system.

OUTCOME

Patients have an appropriately skilled and trained doctor available to them at all times within the hospital. This desired outcome forms the basis of the HMS pre-employment "RMO Matching Programme"

Example 24/7 hour RMO cover has two broad options available:

1. HMS Employment business division offers elective corporate and individual hospital service contracts at selected future target dates, or emergency service agreements where a hospital experiences a breakdown or difficulties with its current provider. Individual hospitals are allowed to opt-in and out of any corporate contracts by giving no less than three months notice.

2. HMS Agency division offers for the hospital to employ the doctor after a successful HMS introduction and placement from our matching programme database.

To request medical cover please contact us directly by email or register with us.