I refused to basically run a 40 patient geriatrics unit alone when I had zero experience. I confronted my superior, told him that I felt incompetent for the job and he ended up consulting me every day, like he should have in the first place. That was an easy call, I was scared shitless.

I've never had a problem with saying no and don't understand at all why other people do. I consider myself much less compassionate/symphathetic than average, i.e. don't feel other peoples emotions. My empathy is pretty intact though.

Just begin with sorry...

• but I don't think it's fair to the patients if some zero experience know-nothing just wings it there because a senior doctor is jaded in his job.
• but my hands are full at the moment.
• but I already have other plans, maybe some other time?
• but I'm really not that ambitious.
• but X really isn't my thing.

If those don't work, I come up with a white lie. If they keep pushing it, I have no problem with being blunt.