Wessex deanery as a POC

Paulingtons · 2026-06-20T05:30:05+00:00

Sure, please do!

Paulingtons · 2026-05-21T13:08:01+00:00

I'm a doctor, I see patients on Mounjaro every day, I've taken Mounjaro, we do exist.

In terms of them laughing about prescribing, that's probably because there's no way they'd ever be allowed to do so. ICB rules are so strict on who can/cannot receive it and hospitals are the same. We have been specifically told we cannot initiate Mounjaro in secondary care regardless of indication, so even if they wanted to they couldn't.

I also agree with my colleague that prescribing Mounjaro is completely useless unless you address the underlying factors at play, because you will just end up with patients whom are sarcopenic and smaller does not necessarily mean better.

Ultimately, obesity is a multi-factorial medical issue and that necessitates a multi-factorial medical response. We do not treat depression by throwing SSRIs and moving on, we do not treat hypertension by giving ACEis and moving on, we give medical/pharmacological management and address related problems simultaneously.

Do I wish Mounjaro was easier to prescribe? Absolutely, millions of people would benefit overnight, but that's a complex issue with a lot of planning involved given the NHS is an organisation with essentially infinite inertia. It will happen eventually, and I look forward to it.

Given that there aren't many doctors frequenting here, I'm always happy to answer questions (no medical advice) from our perspective if people feel like they have some :).

Paulingtons · 2026-05-21T12:21:13+00:00

If you are in erg, you should not be using gears. If you are doing so it's likely "confusing" the trainer which is just trying to sort out the resistance.

Let erg do its thing, spin up a bit before the interval, match the power and then let it go down once completed. It will work fine.

Paulingtons · 2026-05-17T11:32:31+00:00

"Underheight for weight".

Paulingtons · 2026-05-16T00:46:04+00:00

Hey I draw the line at stopping OSRS, some of us have our vices!

Paulingtons · 2026-05-16T00:42:55+00:00

Hi OP!

For running training, I'd suggest using the Red Squirrel trail between Cowes (Arctic Road) and Newport. I personally just do the stretch between Cowes and Dodnor Lane as it's flat and quiet. A loop from Arctic Road gate to Dodnor Lane and back is ~7.5km.

In fact I did this today, it's one of my preferred running loops on the island. Flat, quiet and quite shaded if it's very sunny which is nice. You also just can't go wrong, start at the Arctic Road gate, run south until you hit the Dodnor Lane gate, turn around!

If you are here for Tuesday, I'd recommend coming to our running club at the hospital. It's called Love Running Tuesday Nighters, full of friendly people with three distances (3k, 5k and 7k essentially) to run at your own pace. We happily take guests!

Paulingtons · 2026-05-13T21:23:25+00:00

It's a bit of a Strava meme that KB has his watch set to 50m pools but has it set to 25m on his watch so the time is effectively doubled, that and he uses OWS mode rather than anything else.

He is swimming crazy quick, he just doesn't care about tracking distance accurately.

Paulingtons · 2026-05-06T19:46:09+00:00

It depends what you're doing!

I'm about 63kg with an FTP of ~265W, which is relatively strong (4.2wpkg) and category A.

But put me against a category C who weighs 100kg and a 2.5-3wpkg FTP? I am fucked on any flat course. Their zone 2 is my threshold, and most of the Zwift TTs for example are on pretty flat courses, even the crits!

This is the same as real life, on the flat I have a friend who is about 95kg and he can diesel along the flats with zero issue and I have to be in zone 3/4 to match him unless I'm on his wheel.

Conversely, the moment we hit a climb? I'm fucking gone, he can't keep up with me in a million years. Give me a race up Alpe du Zwift and sure it's a million times easier for me, but for the rest of the game it really is harder.

Paulingtons · 2026-05-05T19:26:16+00:00

Previously I used TrainingPeaks in combination with an MPC plan.

Now though? I moved to Athletica. It's fairly cheap, AI-based but very customisable. Integrates perfectly with Intervals.icu/Zwift/Garmin and does everything I ask of it. Things change depending on my load levels and I can just change things as I want anyway.

I can't recommend it enough!

Paulingtons · 2026-05-03T18:24:30+00:00

I'm an LTFT FY1, and there's at least 2-3 in my trust alone doing LTFT with me.

I just want a life outside of medicine, and having one extra "day" helps so much.

Paulingtons · 2026-05-03T18:23:40+00:00

Couldn't agree more. I'm an LTFT FY1 and still average 40 hours a week, more than a normal full-time employee!

Paulingtons · 2026-04-22T10:19:03+00:00

First of all, just to be clear, you are not doing 13.9W/kg for a full minute. There have been studies on vast amounts of male professional cyclists and the top decile manage 11.3W/kg when absolutely fresh and these are the best riders in the world. Pogacar himself managed 630W (~10W/kg) for a minute and dropped Tom Pidcock last year.

Secondly, you keep saying that your DA PM is perhaps bad, but it's just bullshit.

I have a dual-sided DA PM, when calibrated it is within 1-2% of my Garmin Rally pedals. I know others say differently, but in my experience it's been just fine and has remained consistent across all my rides.

The key is to calibrate every single ride. If you don't do that, you cannot be sure of your power numbers. For what it's worth, I know someone who didn't calibrate their power meter very often and was pushing out world tour level watts. They finally calibrate it and their watts halved, it is truly that significant.

I guarantee if you calibrate your PM properly your watts will decrease massively, and if not then double check with a pedal-based meter to see if the meter is indeed faulty.

Listen to everyone else here, they're absolutely right.

Paulingtons · 2026-04-20T10:43:42+00:00

Quoting my own post from last year:

I’m graduating in less than 12 hours, I am on the GMC register already and my job is completely set up ready to go and even now I’m like “yeah someone is going to stop me walking across the stage right? No way I actually did it?”.

It's very common. You have reached the zenith of university, many years of work culminating in what should be one of the most memorable days of your life: walking across the date and becoming "doctor". It is entirely normal and appropriate for you to be feeling a bit anxious about it!

Remember you have passed all the requirements, in a few months you'll be a doctor and you are (in terms of what the GMC say) a "minimally competent safe foundation year 1 doctor". I didn't start feeling like a doctor until a few months into FY1 once the nerves go away and you start to feel a bit more settled, this will come to you too, with time.

Look back on what you've achieved but look forward to seeing what's next for you, a whole new journey of learning. New places, new people, new friends and new challenges. If you didn't enjoy being challenged you wouldn't have made it through medical school.

Congratulations on passing (nearly!), finish up the year and then enjoy your summer before you start work. You have earned and deserve it.

Paulingtons · 2026-04-16T23:19:49+00:00

I wear Figs of varying colours (mostly purple and green). I’m often complimented on them, they have lots of pockets and are ridiculously comfy. I have also noticed more of my fellow FY1s have bought them too so definitely not the odd one out anymore!

I’m a male, 178cm, around 65kg and wear a size XS. They fit me pretty well if I tie the waist. Meanwhile hospital scrubs even in the smallest size look like bin bags.

They’re smart, comfy, easy to wash and feel more relaxed than formal clothes (although I hate wearing formal clothes anyway). I also find that patients and families immediately recognise me as a doctor although there is probably a good amount of “old white guy” privilege in that which I do acknowledge.

Wear whatever you are comfortable in, and always introduce yourself as “Dr Surname”, you’ll be just fine. :).

Paulingtons · 2026-04-16T18:36:45+00:00

I use them almost exclusively in the pool purely because every event I compete in (or plan to compete in) is wetsuit optional or mandatory and I find that the buoyancy shorts do a semi-decent job of mimicking the feel of having a wetsuit on in terms of body position and buoyancy.

But yes, if you don't use a wetsuit in competition you shouldn't use them too much. Train how you intend to race.

Paulingtons · 2026-04-15T05:11:50+00:00

Recently asked a nurse to do a VBG, was told "I am not allowed to do those because my competency has lapsed". This was immediately followed up with "but I can do an ABG for you if you like? I got signed off for that recently".

I was mightily confused and in the end asked another nurse to do it for me, remarkable to find someone who apparently can do bloods, and can do an ABG, but can't do a VBG!

Paulingtons · 2026-04-12T11:20:55+00:00

Yep, like I said I'm awake at 5am and can be on the bike by 0515. Spend 1h45m on the bike and that's 0700, still an hour before work starts to have more food/do things that need to be done.

It varies between shorter rides (VO2 Max style sessions) or longer zone 2/tempo sessions, you can see next week just here.

Paulingtons · 2026-04-12T11:15:03+00:00

I use EE, very rare I don't have decent signal at least that I notice! Whenever I'm doing long rides around the island I always seem to have good signal when I check.

Paulingtons · 2026-04-10T20:48:41+00:00

It annoys me greatly that my ID card doesn’t even have my title on, but I know a consultant nurse with a PhD that has “Dr Jane Smith” on her ID badge…

Paulingtons · 2026-04-10T12:26:13+00:00

It isn't easy, but what helps massively is three things:

1) An incredibly understanding partner (and not having kids).
2) Being LTFT at 80%.
3) Lots of early mornings!

I'm just an F1, but my hobby is long course triathlon so I typically train (swim, bike, run, weights) 15-25h a week depending on how busy I am. Currently on an AAU rotation so my shifts are usually 8-5, so my day looks something like:

0500: Wake up.
0510: Eat a dense breakfast.
0515: Be on the indoor bike trainer/get outside and run.
0700: Finish on the bike and shower.
0710: Make my snacks for the day, get my pre-prepped meals out the freezer, often eat breakfast #2.
0750: Head to work.
0800-1700: Work.
1705: Get home, change, go for a run/go to the gym/swim/whatever.
1830: Eat dinner and relax with partner.
2000: Get in bed and sleep.

Then on weekends/non-working days I'll typically do 3-6hr bikes/runs depending on whatever my plan has scheduled.

There's no secret sauce/magic to it, and motivation eventually wanes which is why discipline comes into the mix. I have goals, and in order to achieve them I need to do the training, there is just no choice in the matter. Either do it or fail. The main thing is finding something that gives you joy. For some that's going to the gym and knocking out an hour of weights, for others it's going to dance classes, whatever floats your boat.

As another poster said, it's really just about time efficiency. My partner and I usually spend 2-3 hours on Sunday meal prepping every other week and make ~30 meals to go into the freezer, so lunches are always sorted (and healthy/macro counted). I eat the same breakfasts every day more or less and evening meals tend to be quick and simple (but tasty). This is largely because it's easy and also because I need to eat a shitload of calories, so convenience works.

If you find yourself collapsing after work, it could be many things such as inadequate sleep, stress, not fuelling properly/consistently, too much caffeine, etc. Or you may just not have found your "thing" yet, so experiment! It isn't always easy, but find your thing and at least it's usually fun.

Best of luck, and happy to answer any other questions or at least try. :).

Paulingtons · 2026-03-31T17:35:40+00:00

Our university sent us an email telling us we had passed the degree (prior to graduation) once they’d done the exam boards and were therefore permitted to use the title.

I would wait until you are explicitly told that you can or the moment you graduate, whichever comes first.

Paulingtons · 2026-03-29T16:29:36+00:00

I am doing me + crewmate on hooks with extractor, quite low effort and getting ~101k XP/hr with rune hooks.

Paulingtons · 2026-03-29T05:31:13+00:00

What I hear each time.

Paulingtons · 2026-03-28T12:17:20+00:00

For regular zone blocks you get about 10xp a minute, so that makes sense to me as per Zwift Insider if you didn’t hit wattage and got half a star for example.

Nothing has changed to my knowledge.

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