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Read all 3 good answers and adding few from personal experience. I worked in London NHS (National Health Service) Gastrointestinal Unit for 14 years before relocating to India.In U.K, coordinated care is a norm, electively individuals visit their G.P’s, who are the referral medium to specialists or super-specialists.Whereas in my country India, Coordination is literally non existent at first appointment. Referral system is weak, anybody can see any specialists. Therefore there is gap in patient treatment plan.NHS Consultants get weekend off, unless on-call. Saturday is a working day in India.Therefore the contracted hours is 40 per week and 48hours and more in India.Weekend break is very refreshing.Foreign doctors tend to have life beyond work, they travel or have a hobby. Whereas we are very extremely over committed about our work.In India, doctors are available 24/7, there is hardly any privacy. Unlike in U.K, doctors have a general number at work and personal number are personal.Foreign or UK trained doctors have to be very experienced to find a good package job opportunity, whereas Indian doctors have good demand overseas.The recent scheme launched is recruiting Indian doctors to plug gaps in NHS departments.Indian doctors have to undergo GMC (General Medical Council is a governing body)performance assessments within the NHS ,therefore most of them suffer from an inherent bias. In simple terms, Indian doctors more likely to face investigations.Patient consent is important issue within the NHS, Each and every detail of the procedure has to be explained to the patient.The consent form bears a lot of weight. But in India, consent form is just a paper and the doctor explains only top of iceberg.Indian doctors struggle to cope with cold weather, therefore working while ill is very common and most of the team is affected by the contagious bug. We hesitate to take leave, whereas foreign doctors understand spread of infection and take sick leave when required.Depending on the contract of employment, pay scales are decided on Bands no matter which speciality.For example, A Public Health Consultant is as same band as a Cardiac Surgeon.There is less room for competition. But a Consultant Cardiac Surgeon can have private clinics.Foreign doctors take Time seriously, it is like code, coming late is a sign of rude, I am not mentioning anything about Time concept amongst Indian doctors( too embarrassing!)In India, Doctors are pies but in NHS they are just slice of a pie.

We, as doctors, meet many people in day-today life. Basically I learnt two things-1.It doesn't require a person to be rich to take of their parents.I've seen some very poor cancer patients, whose sons & DIL take care of them very nicely.Once I had a cancer patient from a well to do family, old & in advanced stage; although he didn't have much symptoms like pain, breathlessness, but cancer had spread to all body parts. He was more than 80 & by his look (we assess by performance status), its risky to give them any cancer treatments & they won't get benefit also. So, we explained everything to the relatives & ask them to take home.After 1month, his son came to us complaining “U told he'll die soon, but he is still alive…….same like before & no sign of dying”2.Second thing………never guess anyone's relationship.I did this mistake twice……..Once I had a 10yr old patient of meningitis during my internship. She stayed in hospital for around 3weeks & a male person in 25–30s used to take care of her. I thought him to be her father, but he was her brother……Another once a Bangladeshi patient of lung cancer came to OPD aged >60years, & accompanying him a young girl of 16–18years was there. I asked her to bring his wife or some adult whom I can explain the treatment, but she told she is his wife & she had to sign the consent forms for treatment……….So, never guess anyone's relationship……… its none of our business.

How do we cope with a death in the OR? Listen it sucks. Only once has a patient of mine died on the operating table, dying in the OR is rare.As a surgeon you do everything in your power to save the person. Including, trying to get more help when appropriate, by getting other experts (surgeons, specialists) in the room to help solve the problem.When it becomes clear the battle is lost, you take responsibility. You are the captain of that ship and the buck stops with you for a reason. You feel terrible. You feel defeated. You feel sad. You feel like you failed. You feel angry. You feel human.Now, taking responsibility does not mean, saying you did something wrong, it means admitting that you tried to do your best and your best was not good enough in this case. Surgeons tend to be meticulous and so when our best is not good enough, we mull over the case in our mind over and over.During every surgery our job is to make the best possible decisions and execute those decisions to the best of our abilities.Surgeons don’t transport someone to the OR, unless we think they are stable enough to withstand the surgery. If they are stable enough to go to the OR, and you can’t fix it to the point of getting them off the table and into the intensive care unit to stabilize them further, then you’re stuck in a battle with the clock and eventually the time runs out.Life is full of unforeseen tragedies. No surgeon ever divides tissue knowing they will accidentally injure a major vein that is difficult to repair in even the best of circumstances.Sometimes a surgeon knows the odds are stacked against them and they do everything perfect and the patient still dies. That’s the worst.Technical errors in surgery do happen and they can cause death in the most rare circumstances. Patients sign consent forms prior to surgery where they affirm that they have been explained the risks and understand that the surgery has potential complications including death.That never displaces the guilt that surgeons feel when there is a death in the operating room.Telling Loved OnesYou take on the added responsibility of conveying that failure to the family and explaining the situation. Your loved one died during surgery. There were unanticipated complications. The bleeding could not be brought under control. We did everything we could. I’m so sorry for this outcome and for your loss. The words are real and the anguish is real. But it pales in comparison to what the family has to experience.Usually after a patient of mine dies (though only once in my career it happened on an OR table) I wake up in the middle of the night and replay everything I can remember that happened from the first time I met the patient until the time of their death, before the memory becomes too hazy. I try to be brutally honest and take maximal accountability, and internalize any lessons so that I won't make the same mistake twice.In nearly every instance, at some point after a patient of mine dies, whether it's in the peak of exhaustion after staying up all night with a crashing patient in the ICU and then getting a moment of privacy, or days later, when beating myself up over any detail I could have done differently, I eventually put my head into my hands and I cry.We cry.