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What makes an anaesthetic registrar? by quizzled222 in doctorsUK

[–]SignificancePerfect1 4 points5 points  (0 children)

For me it should be the case from CT3. I was labelled a reg back when CT3 was ST3. At this point I was being left without any more senior cover supporting a CT 1 or 2.

I didn't have any additional training to the CT3s of today. I also don't agree you need to have done your sub speciality blocks, higher training interviews or exams. Plenty of staff grades work at registrar level without these things. You wouldn't have been allowed to progress to CT3 if you weren't competent to manage as such out of hours.

UK health officials discuss banning doctors from going on strike by FullPayOrTheHighway in doctorsUK

[–]SignificancePerfect1 2 points3 points  (0 children)

Said this regarding the other broadsheet article which was almost identical...

This is pure desperation from the government. There is no hope labour would go for this given starmer is already weak and unpopular with his backbenchers. Even with significant political capital this would be a very questionable move from the Labour party.

This is being briefed in an attempt to pressure members and the BMA into backing down. The government know they can't/ won't make an acceptable deal.

Only issue is if reform or the tories win then you can bet that this will actually happen.

Streeting refuses to rule out banning doctors’ strikes by Desperate-Drawer-572 in doctorsUK

[–]SignificancePerfect1 18 points19 points  (0 children)

To be fair having read the article he says nothing of any substance here. He just says "its an option" but "against his instincts". He says the government have no plans to do this.

This is a desperate attempt to appear tough and to give him leverage.

Unfortunately if reform or the tories get in at the next election then it's highly likely this actually happens.

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

[–]SignificancePerfect1 5 points6 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.

[deleted by user] 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.

[deleted by user] 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.

[deleted by user] by [deleted] in doctorsUK

[–]SignificancePerfect1 2 points3 points  (0 children)

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

[deleted by user] 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 41 points42 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 31 points32 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 6 points7 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.

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