50 year old experiencing persisting chest pain despite medication and exercise

Ans: Hi, I understand that you pursued a medicine course in Russia (a non-European country) and, since you are from India, you have completed the FMGE. Now you want to practice or work in the UK as a doctor?

Based on your question, you are eligible to practice in India after completing your internship (which you haven't mentioned, but I assume you have completed it). The FMGE is essentially a licensure exam for Indian students who have completed their medical studies abroad, so you are eligible to practice in India only.

If you want to practice medicine in the UK, you need to complete the PLAB test, as you are from outside the UK/Switzerland/European countries (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland).

You also inquired about sponsorship. Here is the information related to sponsorship for practicing medicine in the UK.
(Extracted from general medical council, uk org. )Applying for registration using sponsorship
If you apply through sponsorship, you will have to satisfy the sponsor that you possess the knowledge, skills and experience required for practising as a fully registered medical practitioner in the UK. Each sponsor has their own scheme which we have pre-approved. If you can satisfy the requirements of their scheme, they will issue you with a Sponsorship Registration Certificate (SRC) which you will need for your application with us. Please ensure this is a Sponsorship Registration Certificate for GMC registration, as we can’t accept UK visa sponsorship certificates for your application for registration.
Please note that a core part of all sponsors' criteria is that a doctor applying for an offer of sponsorship must have been engaged in medical practice for three out of the last five years including the most recent 12 months. If you cannot meet these minimum criteria, it is unlikely that you'll be able to supply sufficient evidence to support your application for sponsorship.
Doctors applying through sponsorship are required to demonstrate their English language skills by achieving our current minimum scores in the academic version of the IELTS test or the OET (medicine version).
• Alder Hey International Fellowship Scheme (Anaesthetics)
• Betsi Cadwaladr University Health Board - BCUHB IMG Sponsorship Scheme
• BAPIO Training Academy Ltd – BTA International Fellowship Scheme
• BAPIO Training Academy Ltd – International Training Programme for Postgraduate Doctors
• BAPIO Training Academy Ltd - BTA International Fellowship Scheme – Internal Medicine with interest in Oncology with MSc in Oncology
• Barking Havering and Redbridge University Hospitals NHS Trust - BHRUT Sponsorship Scheme for Overseas Doctors in Clinical Radiology
• Birmingham and Solihull Mental Health NHS Foundation Trust - International Medical Fellowship Programme in Psychiatry (Birmingham)
• Birmingham Women’s and Children’s Hospital – Birmingham Women’s and Children’s International Medical Graduate sponsorship scheme
• Bradford District Care NHS Foundation Trust - International Medical Fellowship in Psychiatry
• Cambridge IVF, Cambridge University Hospitals NHS Trust – IVF Senior Clinical Fellowship Scheme
• Cambridge University Hospital – Senior Clinical Fellowship Scheme in Intensive Care Medicine/Anaesthesia
• Canterbury Christ Church University
• Cumbria Northumberland Tyne and Wear NHS Psychiatry Fellowship Programme
• Derbyshire Healthcare NHS Foundation Trust - International Medical Fellowship Programme in Psychiatry
• Dudley Group NHS Foundation Trust
• East Lancashire Hospitals NHS Trust - Clinical Fellowship in Urology or Ophthalmology
• East Lancashire Hospital NHS Trust - Specialist Clinical Fellowship in Pain Management
• East London NHS Foundation Trust (ELFT) – ELFT Advanced International Fellowship in Psychiatry
• East Suffolk and North Essex NHS Foundation Trust – ICENI Centre Fellowships Programme
• Edge Hill University and Wrightington, Wigan and Leigh NHS Trust – International Training Fellowships in MCh programmes
• ENT UK – Royal College of Surgeons
• Essex Partnership University NHS Foundation Trust – EPUT Advanced Fellowship in Psychiatry
• Frimley Health NHS Foundation Trust – International Fellowship in Regional Anaesthesia combined with MSc in Principles of Regional Anaesthesia at the University of East Anglia
• Great Ormond Street Hospital International Fellowship Programme
• Guy's and St Thomas' Hospitals NHS Foundation Trust – Critical Care
• Guy’s and St Thomas’ NHS Foundation Trust – International Clinical Fellowship Programme (ICFP)
• Guy's and St Thomas' Hospitals NHS Foundation Trust – Obstetrics and Gynaecology
• Guy’s and St Thomas’ NHS Hospitals Foundation Trust – Oncology Specialty Training
• Guy's and St Thomas' NHS Hospitals Foundation Trust – Specialty Training in Anaesthetics
• Harefield Hospital, Royal Brompton and Harefield NHS Trust – Anaesthesia and Critical Care
• Hertfordshire Partnership University NHS Foundation Trust
• Hull University Teaching Hospitals NHS Trust – International Fellows at Hull University Teaching Hospitals NHS Trust
• Humber Teaching NHS Foundation Trust - Sponsored International Fellowship Scheme in Psychiatry
• Imperial College Healthcare NHS Trust – Emergency Medicine
• Imperial College Healthcare NHS Trust – Haematology
• Imperial College Healthcare NHS Trust – International Anaesthesia Trainees
• Imperial College Healthcare NHS Trust – Intensive Care Medicine
• Imperial College, London - Clinical Research
• King’s College Hospital NHS Trusts – International Critical Care Fellowship
• King’s College Hospital NHS Trusts – Paediatric Critical Care Fellowship
• Lancashire & South Cumbria NHS Foundation Trust - Psychiatry specialty Fellowship Scheme
• Lancashire Teaching Hospitals NHS Trust - Overseas Registrar Development and Recruitment (ORDER)
• Leeds Teaching Hospitals NHS Trust – International Fellowship Programme
• Leicestershire Partnership NHS Trust – International Medical Fellowship Programme in Psychiatry
• Lincolnshire Partnership NHS Foundation Trust – CESR Fellowship in Psychiatry or Sponsored Fellowship in Psychiatry
• Lysholm Dept of Neuroradiology – National Hospital for Neurology and Neurosurgery, UCL
• Manchester University NHS Foundation Trust – International Fellowship Programme
• Midlands Partnership NHS Foundation Trust
• Ministry of Defence – International Military Clinical Fellowships
• Modality Partnership - Modality Primary Care International Fellowship Scheme
• NAViGO Health and Social Care CIC – International Medical Fellowship in Psychiatry
• NHS England, East of England - East of England International Office GMC Sponsorship
• NHS Fife – CESR Fellowship Programme in Psychiatry
• NHS Grampian – Psychiatry CESR Fellowship Programme
• NHS Grampian – Multi-specialty SAS Fellowship
• NHS Wales Shared Services Partnership (NWSSP) – All Wales International Medical Recruitment Programme
• Norfolk and Suffolk NHS Foundation Trust (NSFT) - Advanced Clinical Fellowship in Psychiatry
• North Lincolnshire and Goole NHS Foundation Trust (NLAG) Sponsorship Programme
• Northampton General Hospital – Clinical Fellowship in Regional Anaesthesia
• Northampton General Hospital NHS Trust - International Clinical Fellowship in Regional Anaesthesia, Vascular Anaesthesia, or Peri-operative Medicine
• Northamptonshire Healthcare NHS Foundation Trust – International Clinical Fellowship Scheme
• Northamptonshire Healthcare NHS Foundation Trust – International Clinical Fellowship Scheme (Psychiatry)
• Northern Care Alliance – NCA International Medical Fellowship Scheme
• Oxford University Hospitals NHS Foundation Trust – Oxford Eye Hospital
• Oxford University Hospitals NHS Foundation Trust – Oxford Intensive Care Medicine (OxICM) Sponsorship Scheme
• Oxford University Hospitals NHS Foundation Trust – Oxford University Hospitals Sponsorship Scheme
• Oxford University Hospitals NHS Foundation Trust – The Oxford International Neonatal and Paediatric Fellowship Programme
• Rotherham Doncaster and South Humber NHS Foundation Trust - Sponsored International Fellowship Scheme in Psychiatry
• Royal College of Anaesthetists – Global Fellowship Scheme (Anaesthesia or ICM)
• Royal College of Anaesthetists – MTI Scheme
• Royal College of Emergency Medicine
• Royal College of Obstetricians and Gynaecologists – MTI Scheme
• Royal College of Ophthalmologists
• Royal College of Paediatrics and Child Health – International Paediatric Sponsorship Scheme
• Royal College of Paediatrics and Child Health – MTI Scheme
• Royal College of Pathologists
• Royal College of Physicians of Edinburgh
• Royal College of Surgeons of England
• Royal College of Physicians of London
• Royal College of Physicians and Surgeons of Glasgow
• Royal College of Psychiatrists – MTI Scheme
• Royal College of Radiologists – Clinical Radiology
• Royal College of Radiologists – Clinical Oncology
• Royal College of Radiologists – RCR Specialty Training Sponsorship Scheme
• Royal College of Surgeons of Edinburgh
• Royal Devon and Exeter NHS Trust
• Royal Papworth Hospital NHS Foundation Trust – Senior Clinical Fellowship Programme in Anaesthesia and Critical Care
• Royal Wolverhampton Trust – Clinical Fellowship Programme
• Sheffield Children’s NHS Foundation Trust - Rotational Clinical Fellows in Paediatrics, Trauma and Orthopaedic International Fellows, and Subspeciality Fellows in Paediatrics
• Sheffield Health and Social Care NHS Foundation Trust - International Medical Fellowship in Psychiatry
• Somerset NHS Foundation Trust – Somerset Overseas Doctors Sponsorship Scheme
• Somerset NHS Foundation Trust – Psychiatry Overseas Doctors Sponsorship Scheme
• South Warwickshire University NHS Foundation Trust - GMC Multispecialty Sponsorship Scheme
• South West Yorkshire Partnership NHS Foundation Trust – International Fellowship in Psychiatry
• Southmead Hospital, North Bristol NHS Trust – International Obstetrics and Gynaecology Training Programme
• St Bartholomew’s Hospital, Barts Health NHS Trust – St Bartholomew’s Critical Care Fellowship
• St George’s University Hospitals NHS Foundation Trust – International Anaesthetics Fellowship Programme
• St George’s University Hospital NHS Foundation Trust (Dr Nirav Shah) – International Intensive Care Medicine Trainees
• St George’s University Hospitals NHS Foundation Trust – International Emergency Medicine Trainees
• Surrey and Borders Partnership (SABP) NHS Foundation Trust – International Psychiatric and Community Paediatrics Sponsorship Scheme
• Tees, Esk and Wear Valleys NHS Foundation Trust – International Psychiatric CESR or SAS Fellowship
• University College London Hospitals NHS Foundation Trust, Department of Critical Care – Clinical Fellowship Critical Care and Perioperative Medicine
• University Hospital Birmingham NHS Foundation Trust - International Training Fellowship Programme
• University Hospitals Birmingham NHS Foundation Trust - UHB LED Fellowship Programme
• University Hospitals Bristol and Weston NHS Foundation Trust – Bristol Children's Hospital International Fellowship Scheme
• University Hospitals Bristol and Weston NHS Foundation Trust - Department of General Internal Medicine at Weston General Hospital
• University Hospitals Coventry and Warwickshire NHS Trust
• University Hospitals of Leicester NHS Trust - Postgraduate Clinical Fellowship Programme
• University of Buckingham – Master of Medicine
• University of Buckingham – Master of Surgery
• University of Chester and Cheshire and Wirral Partnership NHS Trust – International Training Fellows Psychiatry
• University of Hertfordshire – Professional Doctorate in General Internal Medicine (Clinical MD) Programme
KINDLY NOTE: If your sponsor is not on this list then you cannot apply using sponsorship.
If you have any further questions, please visit the GMC website for more information.

WISH YOU ALL THE VERY BEST.

Ans: You have provided very limited information. I understand that you are a student from Kathmandu University and wish to pursue higher education in medicine in the UAE. To provide a more accurate response, I need the following details:

What is your nationality? (Based on your nationality, I can check the relevant requirements from the health department regarding courses and internships).

Ans: Hi Sir,
You have provided very limited information to obtain the details. However, the percentile of the candidate will not solely determine the admission process. Other factors are also involved, including:

- Course
- Institution
- Caste
- Creamy layer
- Gender

But, there may be possibilities for admission to the following IIMs: IIM Visakhapatnam, Udaipur, Bodhgaya, Shillong, and Rohtak.

Ans: Asset Evaluation
Real Estate:
You own four houses worth Rs 10 crore, generating Rs 70,000 monthly rental income. This is a solid base for passive income. However, real estate can have fluctuating maintenance costs, tenant issues, and varying rental yields over time.

Stocks and Mutual Funds:
Your Rs 60 lakh investment in stocks and mutual funds is a commendable step. Active mutual funds offer professional fund management and can outperform index funds over time.

Foreign Stocks:
Your Rs 1.7 crore portfolio in foreign stocks adds geographical diversification. Monitor currency exchange fluctuations and global market trends.

Provident Fund (PF):
With Rs 1.3 crore in PF, this is a reliable retirement corpus. The fund provides fixed returns and tax benefits, adding stability.

Farm Lands:
Farm lands worth Rs 5 crore are an illiquid but valuable asset. They might not generate consistent income unless leased or developed.

Loans:
A loan liability of Rs 1.2 crore needs prioritised repayment. Focus on loans with higher interest rates first.

Insurance Coverage:
A Rs 5 crore term plan is robust. Your Rs 50 lakh health insurance is sufficient for unexpected medical emergencies.

Retirement Goals
You need Rs 3–4 lakh monthly for 27–28 years post-retirement.
The portfolio must generate steady, inflation-adjusted returns.
Action Plan for Retirement
Debt Management
Prepay High-Interest Loans:
Use a portion of your surplus income to prepay loans. This reduces interest outflow and increases your cash flow.

Avoid New Loans:
Focus on reducing existing liabilities instead of taking on new ones.

Portfolio Restructuring
Real Estate:
Retain essential properties. Sell underperforming or non-essential properties to reduce concentration in real estate. Invest proceeds in mutual funds or debt instruments for diversification.

Mutual Funds (MFs):
Increase SIPs in actively managed funds. They outperform direct funds due to guidance from Certified Financial Planners and MFDs. Regular funds offer better tracking and professional assistance.

Stocks:
Monitor direct equity investments closely. Consider reallocating underperforming stocks to mutual funds for better management.

Debt Instruments:
Invest in high-quality debt funds or fixed-income securities for stability. These instruments balance equity volatility and ensure steady returns.

SIP Strategy
Increase SIPs from Rs 70,000 to Rs 1 lakh/month.
Allocate 70% to equity funds for long-term growth.
Invest 30% in debt funds for stability and liquidity.
Emergency Fund
Maintain a 12-month expense reserve in liquid funds or fixed deposits.
This covers unexpected expenses without disturbing investments.
Income During Retirement
Systematic Withdrawal Plan (SWP)
Use SWPs in mutual funds to generate regular income.
Withdraw 6–8% annually from your mutual fund portfolio for a steady income stream.
Rental Income Optimisation
Review property rents regularly.
Invest part of rental income in equity or debt mutual funds for compounding.
Dividend Stocks
Retain high-dividend-yield stocks for regular income.
Reinvest surplus dividends for long-term growth.
Tax Efficiency
Equity Funds Taxation:
Long-term gains above Rs 1.25 lakh are taxed at 12.5%. Short-term gains are taxed at 20%.

Debt Funds Taxation:
Both short- and long-term gains are taxed per your income slab.

Real Estate Capital Gains:
Use exemptions under Sections 54 or 54F to save tax on property sales.

Inflation Protection
Allocate 60–70% of your portfolio to equity investments.

Equity provides inflation-adjusted returns over time.

Debt funds and fixed instruments safeguard against equity market volatility.

Estate Planning
Draft a will to allocate assets transparently among family members.
Use nomination and joint ownership to avoid legal complications.
Consider a family trust for farm lands to avoid disputes.
Periodic Review
Review your financial plan every six months.
Adjust investments based on market conditions, goals, and needs.
Consult a Certified Financial Planner regularly for updates.
Finally
A well-diversified portfolio ensures financial independence post-retirement. Focus on debt repayment, portfolio balance, and tax-efficient withdrawals. Your assets can comfortably generate Rs 3–4 lakh monthly income, adjusted for inflation.

Best Regards,
K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

Ans: Dear Kevin,
Starting small can be helpful. Consider connecting with people through shared interests or hobbies, either online or in person, where the pressure to immediately open up is minimal. Online communities, local meetups, or volunteer activities can create low-stakes opportunities to connect with like-minded individuals. The goal isn’t to instantly find someone to confide in but to slowly build a sense of belonging and companionship.

Your relationship with your wife appears to be another significant source of emotional distance. While her lack of interest in deep conversations may seem like a barrier, it’s worth exploring other ways to reconnect—perhaps by spending time together in shared activities or revisiting moments that once brought you closer. Sometimes, relationships stuck in routines benefit from new experiences or even professional counseling to navigate the underlying dynamics.

Regarding your daughter, while it’s clear she cannot shoulder your emotional burdens, she can still be a source of joy and connection. Investing time in activities with her can provide a sense of fulfillment and grounding that counters loneliness.

Above all, remember that reaching out for professional support, such as therapy, is not a sign of weakness but an act of self-care. A therapist can provide a safe space to express your feelings and help you develop strategies to foster deeper connections and manage emotional isolation.

You deserve to feel supported and connected, and even if the journey to finding that seems long, every step you take toward opening up or seeking out others is a move toward a more fulfilling and less lonely existence.

Ans: 01. Considering your Income of Rs.9.00 lakhs as business income & Rs.1.00 lakh as STCG on securities, without any tax savings, your tax liability would be around Rs.62,400.00 in New tax regime. If we opt for the old tax regime, your tax liability would be much more than this.
Most welcome for any further clarifications. Thanks.

Ans: 01. In this case, you would be subjected to LTCG (Long Term Capital Gain) tax.
02. To work out LTCG, you should reduce its Cost from the Sale proceeds (Rs.165.00 lakhs).
of property, which was costed to your mother.
03. However, following details may help you to assess your tax liability.
Under present provisions of Income Tax Act, you may opt any of the options (Long Term
Capital Gains), as under :
(a). Tax Rate 12.50% without indexation or
(b). Tax Rate of 20% with Indexation.
04. You may calculate your tax liability under both options & may opt for the tax regime, where tax liability is minimum.
05. To avoid tax, you may invest in purchase of some house property. Exemption available would be minimum of Cost of new house property or the LTCG, which ever is less.
06. You have the option to purchase Capital Gain Bonds of NHAI etc., for tax saving.
07. Most welcome for any further clarifications. Thanks.

Ans: Kindly keep in touch with your previous employer (present owner of the company), in this connection. There should not be any problem in getting your PF amount, except certain formalities/ forms to be submitted.
Most welcome for any further clarifications. Thanks.

Ans: 01. In absence of exact figures, it is not possible to calculate your Capital Gains Tax. However, following details may help you to assess your tax liability.
02. Under present provisions of Income Tax Act, you may opt any of the options (Long Term
Capital Gains), as under :
(a). Tax Rate 12.50% without indexation or
(b). Tax Rate of 20% with Indexation.
03. You may calculate your tax liability under both options & may opt for the tax regime, where tax liability is minimum.
04. Most welcome for any further clarifications. Thanks.