Few shows have generated as much buzz before launching in the UK as The Pitt. This American medical drama originally premiered in January 2025 and has since swept all major award ceremonies.
It’s also widely appreciated by medical professionals, who have written extensively about how accurately it portrays the realities of a hospital emergency room.
The show follows a single 15-hour day shift at Pittsburgh Trauma Medical Centre’s busy emergency room, known as ‘The Pitt’. Each of the 15 episodes unfolds in almost real time, giving viewers a fast-paced, realistic look at the challenges faced by the staff.
Noah Wyle plays Dr. Robinavitch, or Dr. Robby, the doctor in charge. The hospital team also includes Dr. Collins (Tracy Ifeachor), Dr. Langdon (Patrick Ball), and head nurse Dana Evans (Katherine LaNasa), alongside many other doctors and nurses with different levels of training and experience.
The show has always been known for realistically portraying the lives of doctors in the US, but does it accurately reflect what it’s like to be a medic in the UK?
After watching the first episode, Dr. David Kent, a pediatrician with experience in respiratory care, emergency rooms, and intensive care, shared his exclusive reactions with TopMob. He discussed how the show compares to the healthcare system in the UK, highlighting both similarities and differences.
Dr. Kent’s previous hospital experience was as an F2 doctor, which is similar in skill level to Dr. Mel King, a resident in their second year.
As a film nerd, I always find it fascinating how different countries approach filmmaking – and it’s the same with training. Apparently, the UK system is really distinct from the US one. Over here, people tend to pick a super specific role very early in their careers, while in the UK, it seems they get a broader base of skills first.
00:01
The episode opens with Dr. Robby beginning his shift in the emergency room. He quickly starts checking on patients, observing how the doctors are evaluating and caring for them.
This can be helpful for understanding the story, but Dr. Kent points out that in the UK, doctors in charge of a case (called attending physicians in the US) generally wouldn’t perform this action.
Here in the UK, doctors in the emergency room don’t always do a full check of every patient. A senior doctor wouldn’t typically see each one individually, but they would definitely know about all of them and their situations.
In the emergency rooms I’ve worked in, we regularly have team meetings – often every four to six hours – to discuss all the patients and make sure everyone is aware of who’s being cared for and where they are in the process.
Doctors and residents handle most patient cases, both routine and complex. Consultants are typically brought in for the more challenging cases – those where there are concerns about the patient’s condition or where the medical team and patient aren’t quite on the same page.
“And then the consultants are probably also picking up patients and seeing patients themselves.”
00:09
The first episode of The Pitt introduces four new trainee doctors who are joining the hospital’s emergency room team. Dr. Robby shows them around and explains how things work, emphasizing the importance of meeting Dana, the charge nurse – a sentiment Dr. Kent strongly supports.
According to one source, the charge nurse is usually the first to receive important alerts and has the most complete understanding of bed availability in both the emergency department and the general wards. They’re best positioned to coordinate patient flow and have a comprehensive overview of the entire hospital’s status.
These nurses are typically highly experienced, meaning they’re not only skilled at clinical care but also have a strong understanding of how things work within the healthcare system.
When a new doctor starts working in a specific area, they often have a strong understanding of the underlying disease processes – what’s happening at a cellular level. However, the experienced professionals already working there will have far more practical knowledge of how things actually work day-to-day in that environment.
It’s always a good idea to check with the charge nurses for their input, especially when it comes to how things are organized and structured.
00:11
The trainees quickly found themselves in a challenging situation after starting their rotation. Two patients arrived at the same time needing immediate trauma care – one had fallen onto the train tracks, and a second person was injured while trying to help.
A trauma specialist was brought in to assist with the cases. However, Dr. Kent pointed out that in the UK, a full trauma team would typically be dispatched for this kind of event.
He explains that it’s important to have a clear, organized plan for handling each new case. When multiple cases arrive simultaneously, it’s easy to get overwhelmed and simply focus on completing individual tasks. For example, one patient, who had suffered a head injury and was in worse condition, was having their temporary breathing tube replaced with a long-term one.
It’s easy to get extremely focused on details and lose track of the bigger picture. A consultant in this situation faces a challenge: they need to oversee everything happening while also allowing others to handle immediate problems at the same time. This requires delegating tasks to manage multiple urgent issues simultaneously.
In the UK, serious medical emergencies are handled by a specialized trauma team. One person typically leads the first evaluation, but there’s always a designated team leader overseeing everything and assigning tasks. That’s how it’s supposed to work. However, when multiple critical patients arrive simultaneously, things can quickly become chaotic.
I was really getting into trying to understand what was happening when Gloria Underwood, the head of medical operations, came up to me and asked if we could talk. It kind of pulled me away from everything else, but I figured it was important since she’s in charge of all the medical stuff.
As a film enthusiast, I’ve always been fascinated by stories about high-pressure situations, and this reminds me of one. From what Dr. Kent explains, it sounds incredibly tough being a doctor in charge of a seriously ill patient and running a whole unit at the same time. It’s like trying to focus on a critical scene while producers are constantly interrupting, wanting updates on how everything’s being handled behind the scenes. Apparently, this kind of interruption is actually pretty common, which just adds to the stress.
00:15
Dr. Robby spoke with Gloria about how happy patients are with their care. They found that the percentage of patients at Pitt who report being ‘very satisfied’ is significantly below the desired goal.
I was really struck by the conversation I overheard. Dr. Robby explained that so many patients are just stuck waiting for an open bed, and it seems like beds are available. His frustration was clear – he believes the hospital is hesitant to hire enough nurses and staff to actually care for those patients. But then Gloria pointed out something important: it’s not just this hospital, there’s a nationwide shortage of nurses, making the whole situation even more complicated.
Dr. Robby claims the hospital is cutting costs by housing patients in a less desirable area, which he refers to as a hidden practice. He also states that patients are receiving inadequate care while waiting in hallways for available ICU beds, sometimes for several days.
Dr. Kent points out that while the US hospital faces unique challenges, like constant financial troubles and the threat of closing, many of the problems Dr. Robby discussed with Gloria are also relevant in the UK.
The practice of leaving patients in hallway spaces, often called ‘corridor care,’ is a major problem throughout the UK and internationally. The issue isn’t usually a lack of beds, but a shortage of nurses. The UK is trying to address this by utilizing nursing associates and working to keep experienced nurses in the profession by offering opportunities for advancement.
Bed availability is consistently a challenge. We operate in a setting where resources are always limited, so unfortunately, patients sometimes get delayed in the emergency room—either in the major treatment areas or in resuscitation—because there isn’t space available upstairs.
If patients are delayed in major treatment areas or resuscitation, it indicates that other patients – those waiting or in less critical areas – aren’t being monitored as closely as they should be.
When patients aren’t closely monitored, it’s difficult to detect when their condition worsens. This can lead to poorer health outcomes because problems aren’t caught and addressed quickly enough.
While the circumstances aren’t identical, the UK faces comparable issues, and many individuals come forward to share these kinds of stories with the media.
00:17
One of the most shocking moments in the first episode of The Pitt features a patient with a severely injured foot. She has a broken and exposed bone in her lower leg, along with significant tissue damage.
The doctors were able to put it back in place, but she would still need surgery later. Dr. Kent explained that while the emergency room team could handle it, he’d prefer an orthopedic, trauma, or plastic surgeon to be present.
They can perform the procedure using a nerve block, which provides local pain relief. However, I’d strongly recommend also giving the patient some painkillers, as it’s likely to be a very challenging experience.
During a medical procedure, third-year resident Dr. Samira Mohan briefly lost consciousness while observing. This suggests the simulation was incredibly lifelike.
I’ve heard from Dr. Kent that it’s incredibly common for medical students to feel overwhelmed in the operating room – almost every doctor he knows has a story about a student fainting or nearly fainting at least once. It’s a really high-pressure environment, and I guess it’s just something many of them go through!
00:19
During an examination, a patient named Otis experienced a cardiac arrest. The medical team quickly applied defibrillator pads and administered a shock, though Dr. Kent notes this type of event is rare in actual practice.
He explains that if you can apply the defibrillator pads fast and quickly recognize a shockable heart rhythm, you can likely wait to analyze the rhythm after the pads are in place, and then deliver the shock.
If a patient stops having a heartbeat, shows no pulse, and isn’t responding, immediate action is needed. Someone should begin CPR, another person should retrieve the emergency equipment, and a call for help should be made right away.
When the buzzer sounds, it signals that a patient is in critical condition – essentially, they are at immediate risk of death. At that moment, they automatically become the most critically ill person in the entire department.
After Otis woke up, Dr. McKay explained that his kidneys were damaged because of muscle breakdown. This caused a dangerous buildup of potassium in his blood, which interfered with his heart’s electrical signals.
Dr. McKay explained to Otis that they’ve given him medication to reduce the potassium in his blood, and he’ll need dialysis to remove it completely. After a week or two of recovery, he should be alright.
This type of certainty in Dr McKay’s reassurance is perhaps unwise, Dr Kent notes.
I’ve seen patients experience a very short loss of heart function and recover completely. However, I believe it’s risky to tell a patient they’ll just need a little dialysis and then be okay, because it’s hard to predict their outcome. We can’t always know how well they’ll respond to the treatment.
It’s possible this is a sudden and severe situation, but there’s no way to know if the person was previously healthy and actually has underlying, long-term kidney problems that contributed to this event.
It’s a little presumptuous to confidently tell someone ‘You’ll be alright,’ but people do say things like that. It’s a common occurrence, even though it’s not always appropriate.
00:28
An elderly patient arrived from a nearby nursing home while still receiving chest compressions from a LUCAS device. The charge nurse quickly told the team to stop, explaining that a ‘do not resuscitate’ order had been located. After stopping compressions, the patient passed away. Dr. Robby observed that the team always pauses for a moment of silence to acknowledge a patient’s death.
Dr. Kent has observed that British emergency rooms often have well-established practices surrounding death and how it’s handled.
Once we’ve stabilized the patient, we’ll hold a quick team discussion, often called a ‘hot debrief.’ The goal is to quickly review what happened, identify what went well, and discuss any areas where we could improve.
It’s a space where people can discuss challenges, share successes, and simply express their feelings about their experiences.
In the UK, saying a prayer for the deceased is a long-standing custom. A moment of silence is also common, and when someone confirms a death and records it, people often add a phrase like ‘May they rest in peace’ or something along those lines.
00:38
Later in the show, Otis has another heart attack, and the medical team needs to perform a procedure to drain fluid that’s built up around his heart.
Dr. Kent states that he would prefer a bigger team assisting him if he were to perform this procedure now. He also thinks he’d be asked why he didn’t request additional help if he carried it out as depicted in The Pitt.
He explained they could have used a larger team. The patient had a short cardiac arrest, and they were about to perform a risky procedure to drain fluid around his heart. While the surgery was successful, the patient was in critical condition and the procedure itself was quite invasive.
He’s at serious risk of getting worse, so if you have the skills, start immediately. But we need to bring in more staff – people dedicated solely to managing his breathing and monitoring his pulse – in case his condition declines.
I’m not familiar with how things work in US emergency departments, but in the UK, if I had a patient with this condition, I’d definitely be asked why I hadn’t consulted with the intensive care team.
00:44
Dr. Kent found the speed of the toxicology screening for the child who accidentally ate cannabis gummies particularly unrealistic, especially considering the typical processes in the UK.
“That takes ages to come out,” he says. “That’s 72 hours at minimum, but it can be weeks.”
00:46
A major difference between medical practice in the UK and the US is the widespread availability and legal status of guns in the United States.
Okay, so this really unsettling scene unfolds at The Pitt. A woman is brought in because she’s been making herself throw up, and it quickly becomes clear it’s not a physical issue. She’s deliberately doing it just to get a doctor’s attention because she’s seriously worried about her son – she fears he might be a danger to others. Dr. Robby, thankfully, gets straight to the point and immediately asks if there are any guns in the house. It’s a tense moment, and you instantly understand the level of concern everyone has.
Dr. Kent admits he’s only considered that question once, when a depressed farmer was a patient. It’s not a typical concern he has to address.
He notes that he has never seen or treated a gunshot wound.
00:51
The episode ends with Dr. Robby remembering his time treating patients during the Covid-19 pandemic, shown in a flashback where everyone is wearing masks and protective suits.
Dr. Kent, having worked in respiratory care, the emergency department, and intensive care for a total of eight months each during the pandemic, recalls a sudden and unsettling end to that period. He remembers it vividly.
Wrap up
After reviewing the situation, Dr. Kent highlighted a key difference between the healthcare systems in the UK and the US: the mixing of children and adult patients. In the UK, children and adults are treated in completely separate facilities.
He noted that the A&E department seemed to handle a significantly larger workload on their own compared to what he’d typically seen in the UK. In just one shift, they dealt with two serious traumas, managing them almost entirely as a team with minimal involvement from a trauma surgeon.
In the UK, a complete trauma team would be assembled, including a general surgeon, an orthopedic surgeon, the core trauma team members, and an anesthesiologist – one of each for every critical patient. Additionally, in the case of cardiac arrest, a rapid response call should have been made. This would have alerted the anesthesiologist and the medical registrar, who, even if briefly involved, would be aware of the patient and available to help with care.
He noted that certain things progressed faster than anticipated, such as the toxicology screen results. He also mentioned the popliteal block was performed very quickly, and initial lab results were being received promptly.
He understands this level of drama is necessary for television, and generally, it reflects his experiences truthfully.
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The Pitt is available to watch now on HBO Max.
As a total cinema lover, I have to tell you about ‘The Pitt’! You can add it to your watchlist on the TopMob: What to Watch app – seriously, download it now. It gives you daily recommendations, cool features, and keeps you up-to-date on everything happening in the world of TV and film.
Authors
James Hibbs writes about TV dramas for TopMob, covering shows on streaming services and traditional channels. Before becoming a writer, he worked in public relations, first at a business-to-business agency and then at Fremantle, an international TV production company. He has a BA degree in English and Theatre Studies, as well as a Level 5 Diploma in Journalism.
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