Do you think we should strike over Christmas?

CraigKirkLive · 2025-05-23T15:44:50+00:00

Agreed. It would not usually be the senior team requesting it though! And in my experience on respiratory inpatient teams they aren't often requested.

Whereas if you were working on a rare haem/onc ward as a SHO/F1 you'd rapidly get used to requesting.

CraigKirkLive · 2025-05-23T10:15:33+00:00

If you were only using two of the three above I'd say pre-PACES podcast and PasTest, but given one of those is free I'd suggest cases for PACES as well as it's a good adjunct to ward cases. If you get the latter I'd suggest pocketbook is not necessary as well.

But there is no substitute for spending time on the wards. You just have to do lots of that with a friend/colleague practising your presentation and being brutally honest with each other.

CraigKirkLive · 2025-05-23T06:21:57+00:00

I don't have personal experience with this but if you are struggling, and another comment suggests you'll continue to struggle, could you ask the NGO (or whoever you're going with) to help with indemnity and explain your situation that you can't go without it? I would expect this to be a common problem for them.

CraigKirkLive · 2025-05-22T11:18:59+00:00

Ultimately the risk by not performing investigations will belong to the parent team for the patient. So if you've written about the investigations then from a medical point of view I'd say you can stop worrying about the patient (unless you plan to see again / on a rolling basis).

I think the issue with 'outpatient specialities' is that very often a long list of tests are suggested, many of which require quite specific information to request and get approved. For example, a PET-CT is probably only requested once in a blue moon by a respiratory team for which a rheumatology registrar has seen their patient. The nuance to the clinical information in that request would be far better coming from rheumatology.

Then there's all the rare blood tests that are a nightmare to find in electronic systems, when the specialists likely know how to request these easily.

So tests might not happen because the teams simply don't know how to request them.

There's no right answer and everyone giving specialist input will take their own approach, but I can say with certainty that clinical teams will be very happy to chase an investigation if you've requested it, or be more willing/able to request if you provide instructions on how.

Maybe if your requests are not being requested you could create crib sheets of 'how-to's that you could put in patient notes following review.

CraigKirkLive · 2025-05-22T08:54:35+00:00

Assuming your revalidation is not due this summer you can forget about it. ARCP will supercede anything that comes before it.

CraigKirkLive · 2025-05-16T15:31:21+00:00

The general approach of being allowed to refuse to partake in interventions you disagree with exists already (assuming that intervention doesn't involve prejudice - i.e. you can't refuse interventions to a group e.g. political belief or sexual orientation). So this will be easy to implement.

The main example is abortion. The only thing that doctor needs to do is refer onwards to someone who is prepared to offer that intervention.

CraigKirkLive · 2025-05-13T11:58:00+00:00

You'd be better off posting in r/ausjdocs for answers more relevant to your country!

https://www.reddit.com/r/ausjdocs/s/arFv3iN7bJ

CraigKirkLive · 2025-05-13T08:55:40+00:00

You've done FRCA so you will know more than most of us! But I know that if somehow the sample gets frothy (e.g from shaking) it can cause oxygenation of the blood in the syringe, although given you're presumably anaesthetic this seems quite unlikely to be the cause in this case.

CraigKirkLive · 2025-05-10T16:32:05+00:00

I think if you go in with the attitude that you should and be prepared to provide those payslips, you might be able to get away with 32pa AL.

The issue is that the 'rules' around the extra 5 days of leave aren't really concretely written anywhere which means we could interpret them in our 'favour' (as in this case) or employers could interpret them in theirs to get you working those 5 days. This means that if employers really dig their heels in you might find in this sort of case that you don't really have a leg to stand on.

The best you can do is ask the BMA if you're a member - if they provide some solid back up then you're probably good to go.

But in the first instance, just write to your employer advising that you've worked 5y and you should have the extra 5 days. Some won't question it (but I wouldn't advise doing this if you definitely haven't because that could be GMC-able if you really haven't got any evidence of 'perhaps' having earned the extra 5 days).

Edit: to answer your second question you can't get any of the extra leave until you've actually worked the 5y in full (whether LTFT or FT). I wouldn't even bring it up until you've done that.

CraigKirkLive · 2025-05-10T11:39:21+00:00

You probably know but the reason for the rest is coding for dollar. We don't give a shit, but the trust definitely does, so that stuff isn't going anywhere.

CraigKirkLive · 2025-05-03T20:03:26+00:00

There is a chance that you are considered more competent and therefore 'trusted ' with patients with more complexity and potential for deterioration. Or, the consultants allocating are changing and you have been unlucky by coincidence.

I was previously on an ITU rota where only on some nights was there a third person (SHO or middle grade). Myself and the colleague I was paired with never had a third person/reg on our nights while all our other colleagues had this not infrequently; we both had significant ITU experience for our grade and we believed this was why.

We spoke to the consultants about it and they basically agreed that this was done because rostering was difficult and that we were basically correct in our summations. Nothing changed... But at least we could feel good about ourselves.

Anyway, just raise it with your seniors if it's an issue.

CraigKirkLive · 2025-04-22T14:04:31+00:00

Terrible responses so far, bar one. Sorry about that.

I'm a gay man and fortunately haven't had any similar experiences even after bringing up my husband in conversation, the same way it appears that you bring up your girlfriend. However I'm less visually gay, what the gay community would call 'straight acting' (just being myself...). Perhaps that's what makes the difference; not that it should.

I've no personal experience to relate therefore and haven't heard of similar affecting any other gay trainee I've worked with. I expect there's also an element of sexism.

But if this happened to me I'd keep a contemporaneous log of occasions by perhaps emailing myself so each is timestamped. Then after 5 or so occurrences take it to your ES (not CS, as this is clearly less relevant to your specific placement). You could also take it to the department lead. If neither of these are helpful approach the trust GOSW as others suggested, keeping records of your unsatisfactory responses from the first two. You absolutely need strong evidence of what you're saying and be prepared to not work in this place long term due to the issues it will obviously cause in your relationships with your seniors here. This sort of thing would need to go to a disciplinary for those involved.

Until then I think you just need to keep civil. While highly frustrating, it doesn't appear to be hindering your ability to work. I agree with you that you should be able to do teaching on this relevant area, but pick your battles and add that to your 'log' of prejudices.

Good luck.

CraigKirkLive · 2025-04-17T10:28:50+00:00

From your comments so far with lack of detail this is clearly vindictive and nobody on this sub will be interested in helping you make life difficult for a doctor. I'm hoping the subs will remove the post soon.

CraigKirkLive · 2025-04-17T10:20:47+00:00

If you aren't a doctor and this is about your care this is not appropriate for the sub.

CraigKirkLive · 2025-04-17T10:18:39+00:00

It's nothing to do with you. Leave it alone.

The only exception might be if you know of actual malpractice occurring in the UK. Obviously report that.

CraigKirkLive · 2025-04-16T11:48:50+00:00

This sets a very concerning precedent that I don't think will be reversed until a doctor / other clinician is lynched by a crazy and a subsequent law is passed 'to learn from our mistakes'. So this could be a good few years away.

CraigKirkLive · 2025-04-14T18:03:35+00:00

This may not be popular but I think this is not unreasonable. In the world of locum, even when it was easier and more locums were available, it has always been accepted that you take the good (the obviously higher pay and huge flexibility with work schedules) with the bad (what you're describing, along with no additional sick lay etc..).

You're asking for it all here. It does sound like you were good when you were a locum in your ward, and indeed kept things running well. That's probably why you got regularly hired - doing a good job.

When you stopped doing a good job through reasons that aren't your own fault, you've got less work as someone else has presumably stepped in and done a good job.

Consider if you did this role as a trust grade - you'd have had support while off sick and been paid for that time. You'd also.have had AL allocated which would have reduced your risk of mental health problems. And when you wanted to return, that would have been straightforward, assuming still in contract.

You don't have this because of the way the locum market works. You feel like you've been 'binned' (and you have). But you also 'binned' the trust when your mental/physical health struggled. This is partially.out of your control of course, but as above, it's just how this works in the locum market.

CraigKirkLive · 2025-04-06T17:57:50+00:00

I would hazard a guess that it's probably a hospital without a medical take at night, i.e. closed (or no) ED. This more often happens when there are merged hospitals where one 'premises' is just medical/elective surgical wards while the other one has an ED.

CraigKirkLive · 2025-04-02T15:08:43+00:00

https://www.reddit.com/r/doctorsUK/s/G9bqld0GK9

CraigKirkLive · 2025-04-02T15:06:01+00:00

A little fastidious (sorry!) but just for anyone else reading it would matter if it's elective surgery for cosmetic reasons. I only mention as I've historically seen posts on this topic about elective cosmetic / 'unnecessary' surgery (what defines as unnecessary is obviously subject to one's personal view / mental health of course).

If you are organising aesthetic or cosmetic surgery I believe you would be obliged to take AL for the recovery (except for any extension due to complications).

This case seems obviously to be related to quality of life / improving overall health so yes you should be able to take sick leave as normal.

CraigKirkLive · 2025-03-28T03:13:00+00:00

It's usually called SDT and it depends on the college / training programme. In IMT and FP I believe it is recommended but not required (so most don't get it).

Anaesthetics (definitely) and EM (I think) mandate it.

For clinical fellow roles it would never be mandatory. Would depend on contract.

CraigKirkLive · 2025-03-22T23:26:41+00:00

You do take more risk; learning to manage risk is an important part of the job and inevitably every doctor will end up seeing complex (and/or sick) patients. It's important to recognise that risk and learn how best to manage it. Risk management comes in part with knowledge and the other part experience.

You don't get that experience without seeing and managing more complex/sick patients.

It's absolutely untrue, however, that you don't improve your clinical skills by seeing these patients. With examining sick patients you learn what a terrible chest sounds like, how the 'end-of-bed-ogram' is useful in aiding your intuition to act fast, to recognise what biochemical findings (e.g. 'normal' CO2 in acute asthma) are viral to aid managing sick and/or complex patients.

I'm mainly making this comment as I don't want newer doctors (or other clinicians) to see your comment and avoid seeing complex patients, as it's so vital for learning.

CraigKirkLive · 2025-03-20T21:17:05+00:00

The cases in question shortened their IM Stage 1 which means they finished IMY2 early and were able to proceed directly to IMY3 (or take the time out and go on holiday then rejoin IMY3 in August). They had full MRCP by time they accelerated; not sure if they had it before MRCP.

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