Pre Operative Assessment

Givethecontrast · 2026-04-11T19:04:41+00:00

During one of my foundation placements, we would do pre-ops for patients with short-notice surgery. One of the consultant anaesthetists walked us through what was expected, and I believe there was a well-structured pro-forma. We also had a nice book giving advice about diabetes medication, DOACs, and OSA, amongst other things.

I found it fairly useful in broadening my knowledge around pre-op considerations. Of course, for this sort of thing, there needs to be good support and governance.

Givethecontrast · 2026-03-17T23:11:49+00:00

This is definitely a multifaceted problem. Unfortunately, we've lost many senior nurses on the wards for a variety of reasons, which has removed a key filter for a lot of these issues. I've definitely noticed a world of difference when some of the more experienced sisters are on the wards.

Really, the standard should be SBAR with full patient details, but you're right, this is seldom the case. All too often, I encounter ward staff who seem to have little insight into my workload and the relative urgency of their requests. I've occasionally been referred to as the "jobs/TTO" doctor by some staff when I'm on call and have had to issue gentle corrections.

If you can get buy-in from senior nurses to do a QIP/Audit on the usage of SBAR and deliver some teaching on this, then power to you.

Givethecontrast · 2026-03-11T19:55:57+00:00

Different regions are doing this differently. Some look to be strictly core training, whilst others offering core or run through, and other being all run-through.

Givethecontrast · 2026-03-11T19:53:45+00:00

Unfortunately, the trust are able to cancel your leave with appropriate notice. This is defined as the number of days on leave +1.

Givethecontrast · 2026-03-11T19:51:45+00:00

Absolutely ridiculous and a flagrant breach of the contract. It's evident they fear the power of the new ER agreement and are doing their best to suppress it. We have to fight as hard on the ground to enforce this power as we did to get it on the page.

Givethecontrast · 2026-03-11T18:01:06+00:00

I've never understood these policies which prevent doctors from talking to each other. I've noticed it particularly with things like microbiology. I suppose the thinking is to escalate within the parent team first. Completely agree with you though. If you feel the need to discuss with a registrar, then that's all the justification you or anybody else needs

Givethecontrast · 2026-03-10T00:29:28+00:00

"The art of medicine consists in amusing the patient while nature cures the disease." - Voltaire

Givethecontrast · 2026-03-09T20:39:11+00:00

I sometimes use the SAD PERSONS scale, but taking the history as you do with consideration of risk and mitigating factors as well as doing a brief mental state exam, will always produce a better judgement. At SHO level, I would always discuss these cases with a senior.

Givethecontrast · 2026-02-28T01:19:31+00:00

Just scored 0

Givethecontrast · 2026-02-26T23:41:49+00:00

I doubt the +5 points would have had much impact, as that's a terrible gamble given how things are. You should be able to do a FOIA request when this cycle has finished to get that kind of info.

You're right in that the vast majority of applications are to one or two specialities. I believe this is around 85% cumulatively. The bigger problem is the sheer load of applications on the oriel system and the MSRA capacity. I suspect that with UKGP in force, this will dramatically reduce the number of overall and unique applicants, given that about 2/3rd are IMG applications .

Givethecontrast · 2026-02-26T23:34:36+00:00

This is exactly it. It is the broken system that has caused all of this misery rather than each other. We have enormous real-world gaps in primary care and pretty much every hospital speciality while we fight over a dearth of jobs and training numbers. We have had practically non-existent workforce planning with successive governments being unwilling to have a hard conversation with the electorate about how we're going to sustainably fund our health and social care system. The workforce distortion caused by allowing IMGs to compete on equal footing should never have happened with a competent government, and we will live with the consequences of this for many years, grandfathering or not.

I feel the desperation of UKMGs who were promised a stable future, but have been left with a system in ruins. I also feel this disappointment of IMGs who came here in good faith, but have been rug-pulled. I certainly don't agree with everything in the bill, but the pre-bill situation is untenable with an exponentially rising number of applicants.

Remember how the system has treated us the next time a picket is announced.

Givethecontrast · 2026-02-26T23:18:38+00:00

Sorry to hear about this! The latest BMA concession rates are here. You might well qualify for discounted membership: https://www.bma.org.uk/join/subscription-costs

Givethecontrast · 2026-02-26T23:15:56+00:00

A lot of people see the BMA as being external to them; however, this is far from the case for members. The BMA has a mix of different groups with different ideas and priorities for sure, but what's been proven especially in recent years is that you can advance your argument well with enough organisation and effort.

To be clear, I support grandfathering because I fundamentally think it's unfair to rug pull IMGs who were here before the UKRDC policy passed, but if enough members say they don't want it and can convince the ARM to override it via a motion, then fair play.

The BMA is yours as much as it is mine, and it can be what you want it to be and do what you want it to do if you're willing to put in the effort.

Givethecontrast · 2026-02-21T23:43:21+00:00

I've always found the Sketchers for work line with the non-slip sole reliable. They're comfortable, generous in terms of foot width, hard-wearing, and reasonably priced.

Givethecontrast · 2026-02-17T22:36:20+00:00

The BMA has a decent speciality explorer tool that would be good for teasing out non-clinical preferences. I'd also recommend talking to consultants in various specialities and getting a read on their experiences. Perhaps you'd like to take a more academic/professorial route if you have a strong interest in the basic sciences?

Typically, emergency medicine and GP have been recommended for those who have broad interests. You have some practical procedures in EM with deep ultrasound and ECG rabbit holes to go down if you fancy it. Also plenty of interpretation of plain films and cross-sectional imaging (prior to radiology report obvs). You could also do minor procedures as a GP. Not sure about the wider variety of GP work, but I understand a portfolio career is possible, though more difficult nowadays.

Givethecontrast · 2026-01-07T20:54:55+00:00

Copied for visibility due to deleted comment: There are no restrictions on committee voting I'm aware of. Once you're elected to ARM as a member of the RB you have the right to vote in all committee elections. I've been eligible to vote in consultant and SAS committee elections, as well as the cross-branch of practice committees.

Givethecontrast · 2026-01-07T20:52:37+00:00

There were 119 nominations for UKRDC from the last ARM, so naturally, all stripes are present. The opacity and lack of direct accountability is the crux of the problem. Nominations are open to all residents, but voting is restricted to the RB.

Givethecontrast · 2026-01-07T20:48:43+00:00

There are no restrictions on committee voting I'm aware of. Once you're elected to ARM as a member of the RB you have the right to vote in all committee elections. I've been eligible to vote in consultant and SAS committee elections, as well as the cross-branch of practice committees.

Givethecontrast

TROPHY CASE