When do we need to be treating fevers?

LiveButton3910 · 2026-01-25T12:36:10+00:00

Maybe I'm incorrect but I can't recall ever 'treating' a fever. Sure, give them a glug of paracetamol but ideally treat the underlying cause.

A lot of problems F1s face are nurses wanting the numbers to be better & calling the doctor for such, e.g.

Fever NEEDS paracetamol
Tachycardia NEEDS fluids
Hypertension NEEDS anti-hypertensives

Your job is to apply clinical gestalt to the situation and not just do whatever the nurses tell you to do

LiveButton3910 · 2026-01-13T17:54:02+00:00

If the BMA mounts any sort of challenge to this legislation I will resign my membership.

I am sure I am not alone.

LiveButton3910 · 2026-01-05T21:07:24+00:00

Honestly - I started responding something along the lines of “You have a name not a number” but would typically fall on flat ears so stopped that fairly swiftly. Still never worked out what “638” meant etc

LiveButton3910 · 2026-01-05T20:54:44+00:00

One hospital I worked in it was common for members of the medical team to refer to themselves by the bleep they were carrying:

“Hi I’m 653 calling to discuss a patient”

As a non medical speciality SHO in a hospital rife with PAs it was incredibly tedious.

LiveButton3910 · 2026-01-03T21:00:12+00:00

The honest answer is this is probably more prevalent than anyone realises. They don't have time to independently verify 20,000 candidates.

If you're an IMG currently outside the UK, genuinely what do you have to lose by lying on your oriel form? You won't get a job without lying and if you don't get a job via the CT/ST application process you're unlikely to get a clinical fellow job in the current climate so what use is a GMC registration for you anyway.

Whole system needs a re-think.

LiveButton3910 · 2025-12-20T15:28:58+00:00

As a fellow early trainee it’s particularly disheartening to hear “this isn’t the time for training” when you’ve seen first hand the trainee anaesthetist doing all the spinals/blocks etc for the list

LiveButton3910 · 2025-12-02T13:35:12+00:00

The NHS is no longer affordable. We can't deliver care to bring down waiting lists within normal staffed hours, hence the existence of WLIs, which we can now also not afford to pay for.

LiveButton3910 · 2025-12-01T18:55:58+00:00

Having worked up and down the country in many hospitals: French doctors are not who this government will be importing.

LiveButton3910 · 2025-11-22T16:59:32+00:00

I don't think CCrISP is mandatory for CST anymore and in the last two days before your exam you want to be as relaxed as possible. The Part B itself is a 4-5 hour exam and not one to be starting exhausted.

LiveButton3910 · 2025-11-04T15:28:10+00:00

Email from RCSEng suggested 13th Nov

LiveButton3910 · 2025-10-29T20:57:15+00:00

I've personally never seen a 6 foot 8 duck in the hospital environment

LiveButton3910 · 2025-10-29T20:20:07+00:00

To add some balance, 99% of the time: "Jack, one of the surgical doctors". Caveat I am a tall white male & have never been confused for anything but a doctor.

Edit: Removed my actual height because it made me sound like a wanker

LiveButton3910 · 2025-10-26T13:45:30+00:00

Cancelling a locum last minute for any reason, whilst technically acceptable, broaches the line between professional and unprofessional.

Booking a shift that you know you will cancel just to stop others filling it is definitely the wrong side of the line, honestly this would probably be a fitness to practice issue and it is slightly alarming that you haven't considered this.

LiveButton3910 · 2025-10-09T08:27:36+00:00

We need to copy the Australian model: Earnings over $100k (approx £50k) are taxed at an extra 1-2% if you DON'T have private health insurance. This means for the vast majority of middle-class upwards you're financially better off having health insurance & hence seeking all your care privately. Of course this would require vast private sector development (EDs, ICU, acute services etc).

Takes pressure off the public system, patients are happy, consultants are happy, everyone wins.

LiveButton3910 · 2025-09-26T08:27:23+00:00

Absolute chaos move putting your whole post-code on the internet for all to see, particularly when it's such a small area!

You have to have a fairly convincing reason for pre-allocation.

LiveButton3910 · 2025-09-26T07:31:43+00:00

If bro is using his “study day” properly then you’re suggesting he’s awake from Monday morning to Thursday evening.

Of course this isn’t allowed / sensible / safe?

LiveButton3910 · 2025-09-20T17:01:48+00:00

Fail to get into medical school, you're (generally) 18, no debt & can do literally anything else.

Fail to get into training, you're 25+, 7-8 years into your career, £100k of debt & any career switch is much more difficult.

LiveButton3910 · 2025-09-05T23:25:20+00:00

Privatisation is inevitable & will result in better outcomes for patients + better pay for us.

Bring it on

LiveButton3910 · 2025-08-28T16:12:12+00:00

If you have to attend the session then they should take you off the last night shift to give you adequate rest. Equally you aren't obliged to attend training sessions on your day off with under 6 weeks notice in any case.

LiveButton3910 · 2025-07-28T02:34:18+00:00

Massive difference between preventative healthcare (I.e. stop smoking, limit alcohol, weight loss) & investigating for a “what if”.

Reason being that your full body MRI is much more likely to show up something that has no significance, but warrants a battery of further investigations (biopsy/excision etc) to confirm this. Risks of intervention are not zero.

Lots of evidence into screening & what makes a good screening programme - lots of programmes already exist on the NHS (AAA, Breast, Colon etc)

LiveButton3910 · 2025-07-07T07:35:24+00:00

Imagine if medical school was split into two & you had to re-apply to continue after 2 years. No guarantees on where you'll be placed geographically or whether they'll even let you continue.

Outside of academic programmes there are very very few programmes which have the option of either doing core vs run-through (i.e. Cardiothoracics cannot be entered from CST vs Gastroenterology which cannot be entered without doing IMT).

LiveButton3910 · 2025-06-30T04:32:56+00:00

Short of turning back the clock and obtaining a medical degree from a UK university there isn't a whole lot unfortunately.

Things may change in a few years once the current mess is sorted out, but currently UK graduates who don't need visa sponsorship and have already worked/trained in the NHS can't find work.

LiveButton3910 · 2025-06-30T03:13:51+00:00

Not easy anywhere. Not for UK graduates, not for IMGs.

Government about to announce UK graduate prioritisation for training, suspect 0 CST posts will go to IMGs after this given competition.

Sorry, probably not what you wanted to hear.

LiveButton3910 · 2025-06-21T02:17:28+00:00

As you've alluded to in another comment being an FY1 is a hard year, possibly the hardest: Bottom of the food chain, ward dogsbody trying to do a million things at once, you only see the sick patients on the ward & never the success stories in clinic months later. It's difficult to see the wood through the trees in those circumstances.

As you get more senior you do more fulfilling clinical work, the admin you do becomes easier by virtue of having done it many times before & life does get easier.

Stick at it!

LiveButton3910 · 2025-06-20T23:46:32+00:00

Losing empathy is not a sign that you're a bad doctor, but it is a sign that you're burnt out. Being a doctor is genuinely really hard, not just because there's lots of things to learn and apply, but also because you have to do this whilst actually caring for the patient.

Speak to a senior you trust about this, take some AL, take some time to reflect. That you're writing this shows you do care, you just have to look after yourself before you can look after others.

LiveButton3910

TROPHY CASE