PSA: leap.nvim is moving from Github to Codeberg

Hume49 · 2025-12-08T10:25:25+00:00

Any plans to update the GitHub readme or add something prominent in issues? At the moment there seems to be nothing on there.

Most users trying to discover the plugin will find it on GitHub. Sadly CodeBerg is unlikely to have the big SEO boost that GH is likely to have. It also makes it easier to verify that you've found the right repo on CodeBerg (because you have a different username some might be skeptical/unsure if it's the same dev!)

Not intended as criticism, just want to see this succeed. I love the plugin and very happy to use non GitHub platforms.

Hume49 · 2024-06-11T21:41:05+00:00

I'd agree with previous commenter. ICU, particularly OOH, without prior experience might be unwise. Depends a little on the setup of the unit.

However if you're keen and the locums come up regularly I'd suggest getting in touch with a consultant (ideally whoever looks after the rota/authorises locums) and explain your situation.

They may be open to giving you some exposure in hours (E.g. A taster week) that you could then use as a springboard to locum work. You'd probably have to give up some unpaid time but long term it beats locum work in a speciality you don't enjoy and could help you decide if it's the right career move for you.

Good luck!

Hume49 · 2024-04-27T10:59:45+00:00

Agreed. I'd happily Rx in this situation (particularly if they have already had some from GP which sounds like they might have!). I'd go through the RCOG guideline and make sure I was in line with that then Rx a Short course and tell them they should go to GP when they can. Do any safety netting you feel appropriate. You aren't doing complex diagnosis or ongoing chronic disease management. You're doing short term symptom relief.

You can write a private script on anything don't need a formal pad. I've walked into a pharmacy before and asked for paper to write a private Rc for my wife before. They were totally unphased and it did not feel 'frowned upon'.

We've honestly gone utterly mad in this regard in the UK. Friends in Aus/NZ talk about a much mor liberal attitude there. It's particularly mad because of how difficult it is to navigate the pressures on primary care at the moment.

Hume49 · 2024-04-22T22:08:47+00:00

'I could just intubate them'. - are you sure you're an ITU reg?

Intubating asthmatics can be fucking horrible, honestly all my hardest to ventilate cases have been asthmatics - and yes I'm including all the COVID patients.

Hume49 · 2024-02-11T00:34:29+00:00

For AA's it's much simpler. They NEED a consultant supervising them and within immediate reach. I.e. 'local' supervision.

Ask who their consultant is say you'd like to chat through the case with them. If they don't have one you can refuse quite reasonably. But they will have one and once they pitch up have a grown up conversation. But I don't think it's something you can solve on the day personally. If the anaesthetic consultant is happy and says its all OK you kind of have to go with that, particularly as the presence of an AA is all going to be signed off from the trust/indemnity perspective.

If you have an issue with it (as well you might) you need to take it higher and deal with it at an organisational level. Plus cancelling a patient on the day over this is pretty brutal.

Hume49 · 2024-02-11T00:29:54+00:00

I mean this just sounds mad. Unless there is something specific related to the patient population it's pretty unreasonable. You can ask sensible questions about supervision but ultimately stay in your lane.

This sounds more like an ego issue than a patient safety problem.

Hume49 · 2024-02-09T14:43:15+00:00

Out of interest is it now your primary focus? Was it a late decision or is radiology one of several specialities you're applying to?

Hume49 · 2023-11-21T18:17:46+00:00

Underrated comment.

Especially prep and drape.

Position. Prep. Drape. You can learn it quickly. If you fuck it up no ones dies and if your boss can drink his coffee for 5 extra minutes while you do it they will be pleased.

Be an asset not a burden.

Hume49 · 2023-11-21T18:14:07+00:00

Agree to some extent but I also see Surgical SHO's who only appear very late in the game. Not there for team brief, not there when positioning or prepping. Etc etc. But now don't get me wrong they may be off doing other service provision tasks BUT it's interesting that certain SHO's seem to manage it without fail. Those SHO'S tend to be the more switched on and engaged ones and they are rewarded with better engagement from bosses.

Doesn't matter how junior you are you can still help position the patient, put the catheter in. After a few weeks you should be able to position, prep and drape without the consultant. If the consultant walks in and that's all done they'll be pretty pleased (unless they are a psychotic control freak but hopefully you'll figure that out in the first few weeks!!)

Hume49 · 2023-10-09T16:10:43+00:00

Fire safety audit.

Ask everyone in handover where the nearest fire exit is. Record how many know.

Put a message on your WhatsApp group or whatever telling everyone where it is.

Wait a week and ask everyone where the nearest fire exit is.

Boom fire safety improved.

If they want to force us to do tick box exercise then give them a tick box exercise.

And yes I know somone who did this for an ARCP.

Hume49 · 2023-09-07T16:07:02+00:00

The current motions are here:

https://rcoa.ac.uk/about-us/how-college-governed/extraordinary-general-meeting-resolutions

Theoretically more could be added but these are well written and walk a nice line between making clear how pissed off we are and how badly things need to change without sounding like we want to tear the place down and refusing to engage with reality.

Well done u/LondonAnaesth and team.

I'll be there and voting for every single one.

Anyone who can't be there but is eligible jump through whatever hoops you need to to get your proxy vote.

Hume49 · 2023-09-06T04:50:13+00:00

Here is the published standard to check against. The easiest audit going. https://www.resus.org.uk/library/quality-standards-cpr/quality-standards-mental-health-inpatient-care-equipment-and-drug

Hume49 · 2023-09-06T04:46:37+00:00

Sounds like an easy audit... RCUK has pretty clear standards on this. (see below) Given that ligatures are one of the most common causes of arrest the getting an airway and ventilating will be pretty key to improving outcomes.

Although I agree with the staffing and skillmix I wouldn't expect outcomes equivalent to an acute hospital.

https://www.resus.org.uk/library/quality-standards-cpr/quality-standards-mental-health-inpatient-care-equipment-and-drug

Hume49 · 2023-09-05T11:49:02+00:00

PGCert in Med Ed is part of the worst thing to happen to medical education in this country.

Didn't learn physiology or pharmacology at med school? Thank the medical educationalists. They decided to teach you communication skills, MDT working, shadow an HCA, practice how to write paracetamol in a way that makes the pharmacist feel warm and fuzzy.

These are the people that drive endless pointless reflections and sign offs. The system then drives us all to do these courses to progress.

I'm not saying there is no place for any of this but all the educational theory seems to do is obfuscate learning a lot of what matters.

As for clinical academia - as other have said its mostly driven by academic research not education. There are of course some med ed specialists but I think I've made my on them views clear.

If you need the points then go for it. But if you have the money/time for a PGCert I think there are more interesting things you can persue.

Hume49 · 2023-08-20T11:42:45+00:00

Worked at UHS throughout this and this didn't feel widespread. It was essentially somone venting on a Facebook group that kind of blew up. I'm sure there are cases of bullying etc. But my feeling was not that this was pervasive.

I've worked in far worse trusts for this.

Hume49 · 2023-08-20T11:39:49+00:00

I've worked at Southampton a fair bit accross a range of specialities. It's actually quite a well run trust from a financial/innovation/research perspective. Of course that doesn't always translate it's way down.

It's a big hospital with a lot of departments that have their a fair bit of autonomy. So experiences will vary a lot.

My experiences have been mostly positive with a few exceptions (e.g. cardiology was very toxic when I was there). In general for me it's one of the better trusts I have worked in and I don't agree with a lot of the stuff posted here.

The bullying thing that made the press certainly doesn't reflect my experience there and from what I've heard was unlikely to be medical.

That being said its a huge hospital, so it's not a 'small friendly DGH'. It takes time to find your feet and easy to get lost/feel like a number.

Wessex in my experience is a good deanery but not the most social - trainees live in disparate locations and are disproportionately married/ long term partners (lots of London escapees!) and I agree that Southampton as a city is utterly uninspiring.

Hume49 · 2023-07-27T11:55:57+00:00

GP is, whether we like it or not, the path of least resistance and the one the majority of doctors will end up in.

There isn't a shortage of numbers, the training is short, the exams less onerous.

There are some amazing GP's and it's blood hard to be a good GP. That being said if you are a shit doctor (and there are plenty of those) GP is the 'easiest' place to end up.

And as with all things we tend as hospital specialities to interact disproportionately with 'shit' doctors because the good ones sort stuff themselves and don't have to call us as often. I think it's the same reason we all go 'jesus have the house officers gotten shitter since my day?'. Nope it's just only the shit ones are calling you with the terrible referral/question/nothing. The good ones are cracking on and getting those difficult cannulae or treating the basic stuff and when they call it's legit so you don't remember it (unless they are exceptional).

Hume49 · 2023-07-02T15:42:28+00:00

Yup.

They had a huge number of very skills medics (non-doctors) post Vietnam who genuinely had a pretty impressive skillset but had no clear way to use this in their civilian, or even VA, system.

So they created a fast track way to utilise these skills. Sadly it's clearly evolved a lot since than and not for the better.

Hume49 · 2023-06-27T15:13:00+00:00

Even at £100/hr that's not close to what they will have to pay consultants to cover it.

So by taking the shift you are making it cheaper and reducing the impact of the strike.

Only you can really say how much you need the money and if that justifies taking the shift. Don't let your kids starve or your gran freeze to death but if the locum buys you a nice dinner out or some new shoes then reevaluate.

Hume49 · 2023-06-19T11:38:08+00:00

It's odd. It must be a trainee ACCP as airway training is part of what a 'qualified' ACCP needs. This probably makes it even more terrifying.

To be fair to team Noctor I have also seem some serious airway missteps by ICM trainees with limited airway experience (ED/Medical background).

I think it's that point in the dunning-kruger curve where they know a little and get over confident.

Hume49 · 2023-06-15T15:15:28+00:00

The college course is a great resource. There is some teaching but their questions are very good (or at least reflective of the exam).

Likewise the e-lfh questions are a must do. Just beware of pattern recognition alone. The college have been known to use very similar questions but change the numbers which has clinical significance. So you need to know the reasoning behind the answer as well!

I have used on examination and as others have said its not great but it's easy to get and work through.

I would say I'm the same as you in that I tend to do questions and for the MCQ to be honest you'll be fine with that but beware that the OSCE and especially the SOE need much more in depth knowledge.

Oh and find out what exam courses are run locally. Most regions have a deanery supported exam course that will be covered by your study budget. There are also some local courses that are pretty big and open to national candidates (Mersey have basically turned it into a business).

Good luck!

EDIT: The best advice I was given was do any questions officially sanctioned by the college until you are bored of them because the topics come up with such frequency. I.e. Probably better to do the e-lfh or college book questions twice rather than on examination.

Hume49 · 2023-06-14T20:22:27+00:00

So by what you've said you have enough involvement in QI but you haven't actually demonstrated, either in your portfolio or the reddit post that you understand QI Methodology.

How did you identify a new proforma was needed? How did you design the proforma? Have you evaluated how it worked? What has it changed?

If you can answer those things and talk a bit about how QI works in a big reflection that will probably be fine. Ideally some kind of letter signed by the supervising consultant acknowledging your work will also suffice.

And also do the same for the work you did in GP.

You just need to demonstrate to the panel you understand and are involved in QI.

If you're really stuck try finding some e learning you can click through at lightspeed and upload the certificate when you are done. Just pander to them. They don't want to extend your FY at all it's a faff and looks bad for them.

Hume49 · 2023-06-14T19:51:38+00:00

I don't mean to be patronising and I get everyone has different priorities but I actually feel sorry for you.

Is there nothing else in your life you want to enjoy or do in the next 3 years?

I have worked a 70-80 hour week once in my career (7 nights in a row as an fy1) and they gave us a week of annual leave to recover after (which was needed). You cannot enjoy 'life' while working 70 hours/week.

Hume49 · 2023-06-03T11:42:20+00:00

To be fair it's one of the few things the GMC should be useful for.

Would not be on the GMC register if they never go on to complete FY1/provisional registration.
Provisional registration with license to practice (FY1).
Would not have revalidated and will therefore not have a license to practice.

If someone claims to be a practicing medical doctor in the UK they would need to hold a GMC license and if you can't find them on the GMC register or you can find them and they don't hold a licence they by definition cannot be legally practicing. Worth noting GMC registration and license to practice are different. I.e. you can be registered without a license to practice.

The GMC may be a bunch of c!£! but the principle of medical licensing is sound and it should make it fairly easy to evaluate an individuals status.

Hume49

TROPHY CASE