To accept or not to accept?

EDITOR—I agree that, in general, you should not opt out of a job after accepting it.¹ However, in some circumstances it may be unavoidable.

Because of the difficult job situation, after passing the Professional and Linguistic Assessments Board (PLAB) test overseas doctors may settle to start work in the NHS as a preregistration house officer (PRHO), despite their work experience. If they are subsequently offered a senior house officer post by another trust because of a last minute drop out, having been declined earlier, would you expect them turn it down and take up the PRHO appointment?

Sometimes, the opportunities for working in your desired specialty arise late and you may have to make difficult decisions, such as to be or not to be happy.

However, I fully agree with the damage control measures outlined in the main article. I would also like to add that although you do not have to give the reason for opting out of a job you previously accepted, it may go down well if you give a valid and appropriate reason.