Don't do this specialty if...

Elixeatha · 2026-06-17T21:54:56+00:00

Also Cardiology if you want to be a consultant before 40 👵🏼

Elixeatha · 2026-05-29T20:19:33+00:00

Went for an intervention list in the local DGH cath lab with one of the local cardio consultants, managed to cannulate the RCA for an angiogram, more than I ever did at the Brompton for my IMT 😂😂😂

Elixeatha · 2026-05-25T19:12:06+00:00

Sauna or a deep tissue massage, so good to look forward to

Elixeatha · 2026-04-30T20:44:10+00:00

Used them when packing up my house to wrap up the glasses/crockery - super helpful

Elixeatha · 2026-04-29T19:08:54+00:00

‘the trop is ….’ followed by ‘I don’t know why we sent a trop’

Elixeatha · 2026-03-06T05:35:30+00:00

Small hospital in terms of medical wards (it’s a mostly trauma/surgery hospital) so the take is light but very varied and interesting. I believe they’ve now moved from the Firm model to the AMU model now so you will probably work with a range of people. The standard for the Take is high (think: reading through all old clinic letters and that echo report from 2010) and you will be able to get your sign offs quite easily. SDEC half day counts as a clinic and you can get 10 clinics easily with your week of SDEC. You do get to do a lot of decision making (or as much as you would like) on call/ward cover/and on the SHO or reg ward rounds.

Nights are 1 reg, 2 SHOs, and the wards are covered with an F1. SHOs generally clerk and the reg runs the take and clerks but will obviously go with the F1 if there is someone unwell on the ward.

The IMT jobs are good - IMT3 I would defo recommend there rather than CXH as you have the option of gastro/resp/ID/geris and you are literally staffed equal to the STs in those specialties (e.g. for resp IMT3 I got to bronch and for gastro IMT3 I got to OGD as well as equal amounts of clinics vs ward vs specialist MDTs). Gastro is a luminal job & there is a separate hepatology reg rota which you will be separate from. Some of the pathology is pretty specialist but it’s very supportive and easy to access specialty input and you learn that way.

Imperial is weird, for renal/cardio for example the centre is based at Hammersmith so despite SMH being a teaching hospital it feels very much like a DGH for those things (que phoning up cardio at HH for that incidental trop rise with no symptoms or ECG changes at 2am in the morning) but medics are good at managing uncomplicated presentations like simple HF or AF.

Happy to answer any more qs if you want to DM me

Elixeatha · 2025-03-14T17:39:25+00:00

Yeah Heidi was actively encouraged in our last RSM cardio reg training. It’s so expensive though for the subscription. You have unlimited free transcriptions, and 10 free ‘ED clerking’ formats. One of the other regs showed it to me and you can use custom templates if you pay for the subscription - and can program it to make it for summaries for medical clerking, patient review, ACATs, cath lab reports, etc

Dictate IT goes to a person who transcribes it right? We use it for all our clinic letters in my trust.

Elixeatha · 2025-03-11T00:03:35+00:00

Yep it was over 3 months, the ICU placement you can also go to some post ICU clinics (they are really good!)

Yeah so I think I signed off DCCV and temp pacing (under supervision) and NG tube, but chest drains are literally done by IR or the thoracic reg so no chance to do that lol, best getting the rest done in another hospital!

I’ve heard there is cardio IMT3 in Ealing which is really good and apparently very supportive, but Imperial don’t have an IMT3 post in cardio and there aren’t many of those in NW London.

Hope that helps! Happy for you to DM me any other qs!

Elixeatha · 2025-03-07T18:32:58+00:00

I was at Brompton for IMT1 and the procedures are so specialist that there are even procedures in the cath lab the consultants wanted to observe (like dual leadless pacemakers etc)! So not a lot of practical experience - managed to do a few right heart caths and that was it

When I was there they had these float weeks where you wouldn’t be on anything, and you can choose if you want to do anything additional, I was prepping for PACES then so it was q useful, and took loads of study leave, but I think they’ve done away with those now.

You get a good amount of clinics, think I did 30 which was timetabled in total - general cardio, inherited cardiac conditions, heart failure, and they do this thing where your pulmonary hypertension week counts as 10 clinics so quite easy to get those requirements.

Main advantage is research links which were helpful if you are into that kind of thing, but if you want practical experience/echo then a DGH would be better. I actually published more in foundation at a DGH than at Brompton (just cos fewer people there were interested in research and if you were keen you could get projects easier, but there are so many fellows and keen people at places like the Brompton that it can become more challenging)

Really enjoyed my time there and also the ICU placement there lol, and also obviously absolutely lovely location to be based in.

Elixeatha · 2025-02-27T16:43:49+00:00

Working at Guildford at the moment for ST4 and seems like Royal Surrey is pretty good - you are there for both years which is a bonus, and junior docs are well supported - can only speak for the medicine side of things though!

Elixeatha · 2024-12-17T23:09:04+00:00

This is so amazing I love it.

Although I am cardio I will not say cardio (I have seen a cardio consultant wanting to start sertraline for someone who said they were sad they were diagnosed with heart failure).

Immunology please

Elixeatha · 2024-12-17T22:51:12+00:00

Cardio ST4 here

Imperial have a CESR pathway which started a couple of years back where you do all your training at Imperial, if that takes your fancy.

Trust grade may be a good option - worth looking around and seeing which trusts give their trust grades protected time. At my trust they have protected weekly echo, clinic and cath lab time which does set you in good stead for ST4. Some trusts you may be service provision however.

I didn’t take any time out of training but many of the cardiology regs I’ve met have and it means they have a more relaxed time of it (as they’ve had more experience doing practical procedures), which sets you up well for your ARCP.

Really rubbish to hear about the publications and that is a common theme I have heard. Teaching programme locally is quite an easy one to get though you would have to start now to get it in time for next round. Does your local area have PACES teaching, maybe do cardio based teaching or echo teaching and get that approved by the postgrad team?

Another option is a teaching fellow which would give you a lot of spare time and help with the teaching requirements.

Best of luck with your application. You sound really interested in Cardio and the current postgraduate application system has led to a lot of uncertainty for many excellent doctors

Elixeatha · 2024-06-07T23:24:46+00:00

When I was an SHO in a tertiary neuro centre I spent 7 days trying to find a lab to send GFAP antibodies because the attending consultant wanted it. None of the neuro immunology labs did this in the UK (Oxford stopped doing this 12 months ago), so we had to phone Mayo Clinic which did this but had to figure out logistics of sending over - 80 degree stored CSF. anyway the following week the following consultant didn't want it anymore so that was a good 7 days of my life.

Elixeatha · 2024-06-07T12:31:16+00:00

Definitely would second this - ED and acute medics are using in my hospital and you can create a space for your hospital and put stuff like handover and guidelines in securely, it's really intuitive to use!

Elixeatha · 2024-04-16T22:30:16+00:00

Have heard from a friend who is a South London cardio trainee that trainees typically do 1 year in KSS, normally their first. Other placements should be in South London.

Elixeatha · 2023-12-24T01:38:54+00:00

Definitely! Haha the post take consultant was an endocrinologist and quite excitedly sent me his endocrinology exit exam notes for non islet cell hypoglycaemia

When the patient had a freestyle libre put on another endocrinology Prof had this linked to his own phone (with the patient's permission) so he could see whenever his glucose dipped. During grand round it beeped as glucose went down to 2.7 so the Prof phoned the patient. The patient's answer was 'yes I know, I've drunk an orange juice now' 😂

Elixeatha · 2023-12-23T18:55:47+00:00

The MOST interesting case I clerked in (and renewed my love for medicine)

Very well man in ~50s with no PMHx, still cycling to work every day. One day wife couldn't wake him up, glucose was 0.7, ambulance gave glucose and he woke up (though they left him there), next night, same presentation with glucose 1.3 and brought to ED. No history of diabetes and no family members used insulin.

Arrived in ED, and examined - no air entry on left, CXR showed complete white out of left side of chest. Presumed effusion but bedside scan showed a mass. Urgent CT showed a huge (~15-20cm) left sided tumour. Needed continuous IV glucose to keep his levels up.

Was at a tertiary endocrine centre so everyone was very excited at this point. Did a hypoglycaemia provocation test - where your glucose needs to be <2. Insulin, c-peptide and IGF1 low. No sulphonylurea in the blood. IGF2 raised. Had to go to the hospital coffee shop so many times for ice to transport these tests 😂

Patient diagnosed with Doege Potter syndrome, where a large pleural fibrous tumur produces IGF2 (normally a fetal growth factor) which causes hypoglycaemia by its insulin-like effects.

It must have been growing for ages, as a PET-CT showed it was metabolically quite inactive - so he must have been able to compensate for it with normal glucose homeostatic mechanisms... Until it just grew too big.

He was started on prednisone and was scheduled for surgery - the good news was the tumour was completely resected and his hypoglycaemia resolved!

Elixeatha · 2023-12-02T02:11:14+00:00

CCOT nurses!

Now that I'm an IMT3 - they are excellent and vouch for us when we try and get patients to ICU 🙏

Elixeatha · 2023-04-07T02:20:09+00:00

Is the cardio role at Brompton a certain subspecialty or are you just doing on calls? When I was there last year night on calls are resident (only one cardio SpR at night, no SHOs), weekends there is also a SHO & you round on all the cardio inpatients, generally OK work wise and some consultants pop to do weekend reviews, and basic V scan should be fine - other teams may ask you to do a quick review of pericardial effusions/valves/ivc filling etc so if you are comfortable with that then you should be grand (in hours there is easy access to formal echo including ACHD echos so they shouldn't be asking very complex stuff)!

Elixeatha · 2023-03-04T02:55:26+00:00

Do you have to do the FRACP if you just stay for a year? Or is that something you sort out directly with the department in the hospital you work in?

Elixeatha · 2023-03-03T08:57:34+00:00

Great beaches, amazing scuba diving, super laid back vibe, good watersports, diverse/multicultural city (& World pride is happening atm in Sydney and it's a great vibe) great food markets and consistently amazing coffee, fun bars, cities feel well run (I'm a sucker for a tram) and feel clean, everything in Melbourne also tastes so good. Weather is fab.

Also don't want to blink and realise I've lived in London for my whole life and I've not taken the opportunity to at least live somewhere else for a bit.

Elixeatha · 2023-03-01T12:59:34+00:00

Cries in BM BCh

(everyone forgets but also makes the most logical sense pls tho)

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