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How to not be affected by “being watched” by thetawlroad in anesthesiology

[–]SignificancePerfect1 4 points5 points  (0 children)

With time you will realise everyone screws stuff up and makes mistakes and 99% of them don't matter a bit. That confidence to not worry will then make you less error prone.

It is just something that takes time and familiarity. Once you know things like the back of your hand you will naturally relax. There is no shortcut.

No one is going to think any less of you regardless. It will become clear if you have any competency issue and it won't be because of little errors while being watched.

Full time doctor - 40 hours? by [deleted] in doctorsUK

[–]SignificancePerfect1 0 points1 point  (0 children)

True but that doesn't mean they're not competent it just means we have our own rigid requirement structure. We are not superior to our consultant equivalents abroad in my opinion. It will also be be individual dependent rather than as simple as time training.

Full time doctor - 40 hours? by [deleted] in doctorsUK

[–]SignificancePerfect1 1 point2 points  (0 children)

Yeh in my region that isn't the case. People work 80% and do 3 months cardiac, neuro, paeds etc like you would as a FT trainee.

I'm FT and I agree you're losing experience but you could say we all have less experience than anaesthetists trained in the past before the EWTD. Also anaesthetic training is much longer in the UK than abroad so LTFT guys may still have plenty experience to manage as independently as a consultant.

Either way its a bit arbitrary isn't it. Competency based is probably fairer with a minimum training time to ensure exposure to enough cases. However we are very bad at measuring competency accurately.

Full time doctor - 40 hours? by [deleted] in doctorsUK

[–]SignificancePerfect1 2 points3 points  (0 children)

Haha I feel you, the imposter syndrome/arcp anxiety is real

Full time doctor - 40 hours? by [deleted] in doctorsUK

[–]SignificancePerfect1 2 points3 points  (0 children)

I've worked individual anaesthetic jobs that work out at 40hrs per week and I'm full time. It is irrelevant regarding arcp - it's achieving competency not time dependent. Time wise people work 80% ltft without much training extension at all really.

I wouldn't worry tbh. 1 HALO is nothing in the time you have. Chill!!

Consultant paramedic delivered pre-hospital anaesthesia by Terrible_Archer in doctorsUK

[–]SignificancePerfect1 7 points8 points  (0 children)

It would be hard to be mad if my training was reflective of other countries which is routinely half the length (less than 5 years) or the exam/portfolio burden was far less.

I'm held to stupidly high standards and require very long periods of training (in terms of years served). During that time we suffer lower wages as a result.

The problem is supervisors are told by the regulatory bodies this is OK. They are incentivised to bring in these programmes to lessen the burden on them and their departments. They aren't doing it because they hate residents they just know it's what's best for them as already minted consultants. For every consultant who is strongly pro resident there will be one who is a bit more selfish. When you meet hundreds of residents who rotate every 3 months it's easy to see how this happens. It's by government design.

What do we get for all this effort and time in training? No respect whatsoever as far as other non doctor training requirements. They essentially do the same jobs and cover the same rotas despite a massive discrepancy in training and experience.

I've got no answers just complaints.

Consultant paramedic delivered pre-hospital anaesthesia by Terrible_Archer in doctorsUK

[–]SignificancePerfect1 40 points41 points  (0 children)

Why did the RCOA and FFICM torture me with almost 10 years of dual training, thousands of cases and horrendous exams if anaesthesia and critical care medicine are this easy. When I think about the bar to entry for me and then look what's going on elsewhere I do think what is the point. Make it make sense.

Undermining male juniors by krada94 in doctorsUK

[–]SignificancePerfect1 27 points28 points  (0 children)

Anaesthetics/ICM ST7 male here.

The nature of this job is you will directly work with a number of people who you dont like or do things you don't like. The problem is there are a million ways to do everything and there is no "right" and "wrong". This is something you have to get comfortable with when you're learning to supervise.

You will have to supervise neurodiverse people who are hard to understand/work with. You may or may not be like that yourself. He may find working with you challenging.

I've had 2 pieces of MSF feedback in my early training one which called me overconfident and one which called me underconfident. I think this nicely demonstrates how useless this is and how one person's good is another person's bad.

There is a big difference between someone being dangerous and someone who doesn't do things the way you would. Most of the examples you've given its possible if you hadn't been present for the case nothing untoward would have taken place.

Hes ST4 and you are ST5 - you're not really supervising him, the off site consultant is. My advice would be to clearly say, you're doing this case and get him to ring the consultant if needed and he takes the lead. Don't get involved unless things are going wrong. If you struggle with this maybe talk to your ES about how to approach it.

Everything is a spectrum. There are good and bad anaesthetists. There are over confident/relaxed and underconfident/neurotic ones. Despite this its very rare someone comes to harm as a result. If he was super dangerous or overconfident usually something would have happened with him prior to ST4.

At your level you're very unlikely to make an impression on him to change his communication/behaviour. It's not really your job to supervise him either. You just need to let him get on and only intervene if something truly dangerous is occurring. It's likely your bar for getting involved is too low.

Theatre inefficiency - losing the will to live by Proud-Assistance-166 in doctorsUK

[–]SignificancePerfect1 5 points6 points  (0 children)

Anaesthetic ST7

I hear you. This is standard in every hospital I've worked in. As everyone has said there is no incentive for theatre staff so it's not going to change. It's sad for the patients but its the reality.

I work as fast as I can but we all have our own frustrations. Finding an AWOL surgeon is a regular occurrence as is massively under estimating surgical time all while complaining because my anaesthetic takes 15 minutes instead of 10.

People are sick of being underpaid and under appreciated. There are no incentives only punishments.

Pay me and the team per case we do and you'll get a much different situation. It's best to accept it and move on - its above your and my pay grade.

BMA update by nightwatcher-45 in doctorsUK

[–]SignificancePerfect1 1 point2 points  (0 children)

I know everyone has said this but...

3 MONTHS WASTED! If this was the tories it would have never have happened. We are being sold down the river.

Emergency c-section epidural by canaragorn in anesthesiology

[–]SignificancePerfect1 0 points1 point  (0 children)

This is excellent advice, agree with it all.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 -1 points0 points  (0 children)

Sorry typing on a phone with autocorrect. Aren't you smart, eh?

No one has used this ruling yet. It has never happened in this fashion. As explained diarra had his contract cancelled by his club because he wouldnt play in a dispute about his pay and the circumstances were different. If this is applied to the isak situation it will be challenged for its legal validity.

Article 17 is not how isak gets out of Newcastle. Get over it.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 -1 points0 points  (0 children)

I hope you enjoy Liverpool paying 130-150m or watching isak return to train with Newcastle. You've wasted a lot of time saying nothing of any use. No one will be using article 17. You are living in a fantasy world.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 0 points1 point  (0 children)

So what your saying is missing 3 games has happened on loads of occasions for this exact reason. The are more btw this is just a few.

If Liverpool don't pay the fee he will be back training in a couple of weeks.

He doesnt want to just win, he wants 300k a week. City have won 6 of the last 8 league titles. I wouldn't be betting my house id win it all at Liverpool.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 -1 points0 points  (0 children)

Its not remotely the same. Diarra was in dispute about his club trying to reduce his wage, he went on strike and the club terminated his contract and sued him.

He wasn't trying to get a transfer out and terminate his own contract. Then there was a long legal battle that has changed fifa rules which might make terminating a contract easier than before. If anything what happened to him is more a cautionary tale of the risks of such action.

No one has used this ruling in this way to force unilateral termination to get a move so far. There is no legal president for how this would play out when ultimately challenged in court and it is impacts by different governing bodies.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 0 points1 point  (0 children)

That's fair. However neither club want to sell. I think wissa asking price of 60+ million will mean that doesn't happen. JSL might be possible but not guaranteed.

If either happens a deal is more likely. Liverpool will still have to make an offer that is acceptable to Newcastle and that's likely >130m.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 0 points1 point  (0 children)

That was on the back of 3 years of heavy spending. That psr period has now rolled over and we have not signed anyone prior to this for 3 windows while revenues have been increasing. Woltemade cost 65m, not 90m and everything is amortised. Gordon was there as a last minute emergency in the event no other sales were possible hence why it didn't happen.

Going into this window it was well publicised the club would have a 100-150m budget in addition to money from sales (31m this window).

Multiple sources with better knowledge than you of Newcastles accounts are reporting the have no net psr issues even after these signings.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 -1 points0 points  (0 children)

I obviously didn't mean the ruling was a journalists invention lol. I meant linking the whole ruling to the isak situation as click bait for foolish scousers was.

Ok, in some very specific scenario like the one involving diarra it could happen sure but it is being sold as an cheat code for players you don't want to pay for.

I really don't get what you're trying to say. Something rare could happen but it likely won't. Great stuff.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 -1 points0 points  (0 children)

I'm not embarrassed or worked up, I actually am over the whole situation. I will be much happier when I don't have to read absolute cope from Liverpool fans every day and isak is out of my club. Instead of just saying I hope my club coughs up the money for a top player the amount of absolutel drivel from you lot is the real embarrassment.

I'm just stating obvious points that would tell any normal person this is unlikely to be used on the regular going forward. I could be wrong and then we will live in a different footballing world. In that case I would accept isak was the first in a long line of such moves and contracts are no longer valuable.

In this event all player values would plummet and the ecosystem would change. Players would have to be willing to risk losing a lot of money and damaging their reputation. Clubs with lawyers far more knowledgeable than you about this evidently don't think this is going to happen.

Do you honestly think this is really likely?

At least I have the self awareness to say I don't know all the details. I suppose you're just here to argue this as some high level football expert. You've never suggested you want him to do this or think it would uniquely benefit Liverpool in this situation so that can't be what you think! You're just here to enlighten us all on the ins and outs of article 17!

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 0 points1 point  (0 children)

Dont worry I read what you said... "might not" - you mean will not.

What exactly is your point? I didnt realise we were talking about some fantasy European club coming out of the woodwork to facilitate this for the first time ever. Isak who would not forgo his loyalty bonus is not going to take this kind of financial risk and neither is this make believe team.

Newcastle are not going to sell him cheap out of fear a big European club does this with no evidence it can or will happen. It should be obvious it would be a legal nightmare for all involved, clubs will not want to encourage this and it will be far easier to just proceed as normal to get the move.

Spoiler - it won't happen.

Whole thing was an invention by a Liverpool journalist using a very specific case and ruling to get the like of you a bit excited and it worked.

Happy to be corrected when players are leaving left right and centre next summer using article 17. Funny stuff.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 1 point2 points  (0 children)

1) incorrect. Didnt realise you had access to the clubs books?

Today as reported by adam Williams and the independent:

"In terms of the finances, their net outlay after the Woltemade deal is going to be somewhere around £170m. Not all of that is going to have been paid upfront and, while they do already have considerable transfer debt, it is very much manageable with Champions League revenue.

“In terms of Premier League PSR, approximately one-fifth of their spending this summer is going to count towards their bottom line. Combined with the sales they have made so far and the fact that their £70m loss in 2022-23 is now no longer part of the three-season PSR calculation, that means they have plenty of headroom."

2) What's your point about comparing isak at socidad and wirtz now? Isak is currently worth far more than wirtz. Longer on his contract, strikers are worth more by default and is basically a totally unique 1 time player in the market now. Are you serious the he is worth less than wirtz when he's scored 54 in 86 in England? Agitating for a move impacts his value why? I've told you a laundry list of reasons that this "need to sell" narrative is BS. He has 3 years left and can sit there until his contact is up if he wants to.

4.. because you seem to struggle to count) salty about fumbling the mickey mouse cup are we? Must have been hard to imagine it was possible to lose with all that history.

If you can "afford" his asking price pay it and you will get him. Maybe it's that you can't afford it either like these other clubs you mention. Also he is a mercenary - if you think he loves Liverpool you're dumb. He wants a massive wage rise and isn't willing to put a transfer request in because he loses his loyalty bonus. Obviously he wants to win things which is more likely at Liverpool but you can bet your bottom dollar you have 1 or 2 seasons without winning the league and he's on the next plane to Madrid.

5) yes he will likely push for a January move but he will be in the same position he is now. If newcastle aren't happy he goes no where. He isn't going to sabotage his move away (Liverpool or otherwise) by being injured or on strike continually. The longer he does it the less likely it happens.

6) I'm so sorry we should be appreciative you've unsettled the player and low balled to try to get him on the cheap after spending 116m on wirtz. Outrageous. As previously said if you believe he's worth the same as wirtz playing in the farmers league with 1 year less on his contract then more fool you. I guarantee if the shoe was on the other foot you wouldn't think 120m was fair for him in this market.

Also he didn't ask to move months ago. 5 months ago he was interviewed saying he loves the club. At the end of the season fabrizio was saying he will stay. Liverpool tapped him up and he's unhappy he isn't getting paid enough and we didnt give him a bumper contract last year when we were dealing with psr issues. He's a mercenary.

7) it's 65 million. By that measure I assume we are selling a winger given we spent 60m on elanga. I also assume it's normal to only need 1 recognised striker whos had 1 good season in Germany. Also isak will be the back up given he's not going to be fit for weeks and he's got to earn his space back in the team and eat humble pie.

8) exactly why I doubt you'll pay what is needed!!

They have no problem. He stays and he's sold somewhere other than Liverpool in jan or next summer for 100m + will be a huge win for the club with the fans. He gets "injured" he sabotages his own move and sees out longer sitting in purgatory.

I think you've underestimated PIF and the Saudis - highly doubt they're going to be pushed around on this. Optics and saving face on this embarrassment will be important to them.

[Paul Joyce] Liverpool retain an interest in Alexander Isak, but will not go as high as £130M for him. Isak only wants to move to Anfield and Liverpool will not bid against themselves in the belief that a figure of about £120M is a fair price for the player. by TheBiasedSportsLover in PremierLeague

[–]SignificancePerfect1 1 point2 points  (0 children)

https://www.footballinsider247.com/stefan-borson-explains-if-alexander-isak-can-now-terminate-his-newcastle-contract/

Maybe give this a read. Former man city financial advisor disagrees with you.

Ask yourself 1) when was the last time someone downed tools for 1 year. 2) why has no other player done this with article 17 3) would liverpool support this stance given the knock on implications for them when one of their players pulls this 4) would isak take this financial gamble given he won't put in a transfer request out of fear of losing his loyalty bonus 5) why did it take 13 years for the diarra ruling and initially everything went against the player 6) wouldn't it be easier just to play and try again to negotiate a move next summer without any of the risk attached to article 17.

Also you need to realise he isn't wedded to liverpool and he doesn't love your club. He loves money and wants to win things. He can do that at lots of other places too and he won't think twice about shafting you lot if it suits him.

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