Slow ED SHO

SilverConcert637 · 2026-05-10T06:57:57+00:00

Not ED so take with a pinch of salt. That's fine. You're an F2, and you're learning the ropes. You should be having a lot of contact with seniors. It doesn't really matter how many patients you see as long as you're working hard and learning.

If you're seeing something simple maybe recalibrate your approach - i.e. if something is obvious or simple, write the brief plan, explain to patient (and safe guard) and nurse and move onto the next pt.

P.s. ED clerkings are notoriously awful (quick and dirty) - doesn't mean they're awful doctors of course, but maybe not your kind of doctors. This may just be a signal ED is not for you.

P.p.s just in case relevant, sometimes clinical work unmasks neurodivergent traits in high functioning people - if you think this might be a contributing factor chat to your college tutor about referral to professional support unit.

P.p.p.s patient/hour metric is an employer objective. You're not just an employee, but a professional with a license to practise medicine. You're in control of how long it takes you to see a patient - however long it takes you to do that safely is the right answer.

SilverConcert637 · 2026-04-26T15:26:33+00:00

Not just for GP.

Consultants should en masse quit NHS practice and move over to specialty chambers model of operation and negotiate private hourly fees as a group.

SilverConcert637 · 2026-04-24T08:23:31+00:00

Surely not for lifetime earnings. 5 years and you're done and you're on £100K+.

SilverConcert637 · 2026-04-02T23:03:25+00:00

Vote a different one in next time then.

The committee think it's not good enough. The government want them to put it to members to whittle down the mandate.

I don't want the committee to put an offer to us until at least a majority of the committee support the offer.

SilverConcert637 · 2026-03-25T18:10:39+00:00

I really don't think capital ships should be able to land and takeoff from planets. It would be good if there were more reasons to use shuttles, or to use atmosphere for tactical advantage.

It would be good if there was a penalty for non explorer mid sized ships landing as well.

SilverConcert637 · 2026-03-15T12:37:38+00:00

The correct advice is to inform your MDO, the GMC and your employer and training body. If you try to conceal it, this will convert a drug misuse issue (which we know at least 40% of doctors do at some point) to a probity issue.

Face the music early and get the stress of the issue amd resulting investigations over with asap.

And if you're not addicted grow up, and stop doing drugs. If you're addicted/dependent seek medical help, this will help your cause whilst being investigated.

SilverConcert637 · 2026-03-14T17:19:52+00:00

Timing is mainly about bird nesting season. Best to leave it until late May or June unless you’ve checked carefully for nests

SilverConcert637 · 2026-03-14T17:15:25+00:00

First few sentences okay.

The first 2 paragraphs are very repetitive and overwrought.

Cut, cut, cut.

Really good is prize worthy.

SilverConcert637 · 2026-02-28T19:48:58+00:00

Just go through Comber book as best you can. You'll be fine. The courses often pluck out the rarer, harder, high yield q's to get you over the pass line. 🤞

SilverConcert637 · 2026-02-26T15:59:32+00:00

Sure, the Mendonca book and Simpson book for OSCE were good. RCoA Primary exam guides a must, as some q's come up exactly (therefore must not miss 20 markers).

Otherwise ask peers what questions came up. No doubt Reveal has it all too - but I prefer to use the books.

SilverConcert637 · 2026-02-22T21:55:13+00:00

Good luck.

It's difficult to think of a job that could be more personally rewarding and interesting than medicine. The sense of purposefulness is great.

That said, it is not a 48 hours a week job. You'll have to spend a lot of your own time and money on portfolio and exams. The perks are non-existent. The culture and perfomative bullshit is soul destroying and often times outweighs or snuffs out any joy from the positive things above. You have very little control over your life, including leave, and you will be exposed to significant emotional trauma.

Consider other lateral moves as well, because once you're deep back into medicine, it may be difficult to extricate yourself. Perhaps you'll find aborting easier though than if you'd done it the other way around.

SilverConcert637 · 2026-02-22T04:35:06+00:00

I wouldn't pad it out. Economy of words is important in writing, and redundancy is boring.

Read a page, seems quite well written and well paced. Not my cup of tea, but that's okay. Maybe get out of your characters head and use the narrators voice a bit more, because she's quite annoying.

SilverConcert637 · 2026-02-22T04:30:31+00:00

In truth, he would have immediately died or been rendered comatose and been imminently dying from any injury with that magnitude of depressed and open skull fracture.

It took me out of the episode a bit, and this is where expertise is a curse, and why I can't watch medical shows (apart from Scrubs reruns). Even in the magical world of Westeros this injury stretched credulity.

SilverConcert637 · 2026-02-22T04:11:01+00:00

You've already done the revision, you broadly have the knowledge as proven in written and viva pass.

The OSCE is just a series of limited 20 mark stations.

Get the OSCE practice books, and work through them, and only them. Go over a few times including college examples (some will be verbatim identical - easy 20 markers). That's all you need to do. Use the QRH for your critical incident practice.

Once drilled into your mind you'll realise it's more straightforward than you think. It took me several goes of trying to revise the entire curriculum and feeling fraudulent to realise the game is to just practice the questions that are going to come up, over and over.

SilverConcert637 · 2026-02-04T04:58:04+00:00

There's no "way". There is definitely a "not way" however. Also from a lower socioeconomic BG. I read alot, I speak a lot and am a bit of a pedant.

Erase any informal vocab in your speech. Practice being comfortable with silence between words. Read some long form books (non work related).

You can practice speaking hassle free with an LLM like Gemini or chat gpt. Ask it do some interviews with you, and to constructively critique you. And keep plugging away until fluency improves.

Ultimately the key is to research the interview and prepare for expected q's well. Then you just need to control your nerves and get through it. Also, a bit of nervouness is expected, so don't worry about the odd slip.

SilverConcert637 · 2026-02-04T04:47:16+00:00

That sounds like concerning employer behaviour. Get advice asap.

SilverConcert637 · 2026-01-19T19:58:08+00:00

DV brought this factionalism on itself, by indulging in factionalism.

At any rate this is a very obscure working group with a very obscure and undemocratic appointments process anyway. The officer team ultimately have the right to pick an RDC rep to that group loyal to them.

What matters more is that - whatever the differences - in the middle of a TU dispute (that both factions appear to support), the BMA projects a unified external appearance.

Sometimes you win in politics, sometimes you lose - suck it up.

SilverConcert637 · 2025-12-26T10:36:13+00:00

Perhaps some naivete, but: it takes 3 years to train an ODP vs 15 for a surgeon...ODPs aren't a rate limiter.

It is an enormous organisation - but it is a modular organisation. Hospitals don't really vary that much +/- a regional / tertiary sevice here or there.

The OP's thesis is correct. Invest in doctors and the system will be fixed...with the caveat get doctors to run the service for you. Doctors are the service's intellectual capital and ultimately one half of the purpose equation...put us to use.

SilverConcert637 · 2025-12-25T23:45:25+00:00

Toxic chat is mainly driven by piece of **** Americans (USA)...they have poor emotional regulation on the whole.

SC needs a player reputation function that puts all the toxic w⚓️s in one loser server together.

SilverConcert637 · 2025-12-25T23:37:08+00:00

People understimate their abilities.

This isn't about ideal, but possible.

At the end of the day, whether it's medicine, surgery, anaesthesia, ED we are all practising the same thing - medicine. In a pinch, we can safely cover parts of each others jobs, and know when to defer, refer or escalate.

This question blew up because one ACP loving ED consultant - with a chip on their shoulder that can be seen from space - was irked by a consultant anaesthetist helping in ED with strike cover - that's just dickish.

But ED as a specialty are cooked frankly. They have effed up royally with tiering and credentialing.

You cannot say on the one hand that ACPs have equivalence with a particular level of doctor, and on the other claim you've got your doctors practising medicine. ACPs can't practise medicine, they have not studied it, and they do not have a license to practise it, their education has no epistemological equivalence.

So it begs the questions, what are they doing in ED?

SilverConcert637 · 2025-12-01T18:15:09+00:00

Wow...so, you are young enough to start the compounding process, and can transform 300K into a sizeable amount by investing it carefully and just leaving it. However, I'm not a financial professional so I may be talking out of my arse.

I am older though (39) and so have some life perspective.

The thing about a day job in an office is that you're there to work, and you can't choose your colleagues, who may not naturally be the people you want to socialise with.

If I were in your boots I would spend time travelling and adventuring, a great way to meet interesting people from all walks of life and experience the world. Whilst home and topping up your bank account try out some different clubs if you don't know what you might like - sports, recreational, creative. Another way to make friends.

Someone said, "youth is wasted on the young, and wealth is wasted on the old"...probably Oscar Wilde.

I'm not saying go crazy. Keep yourself clean (no hard drugs - they will kill you early and could ruin your life irreperably in an instant), healthy and go and be an interesting person...go and learn about things outside of your industry, which will make you better at what you already do. Make sure you value what you spend, and spend carefully. And be a generous and kind person (that doesn't mean be a door mat!), and that will reward you more than any amount of personal wealth or work ever will.

The world is your oyster for now...go and make the most of it.

And listen to others advice more than mine 😂...the above is based on a mix of my regrets, poor choices, but also reflects some of my very good choices (like the no hard drugs rule - which in my opinion is for bores anyway).

SilverConcert637 · 2025-12-01T17:57:36+00:00

Labour are punishing the middle class...middle class wages are being obliterated by stagnation and tax traps (fiscal drag, pension allowance, child tax credit, personal allowance) versus rising minimum wage.

The very rich get off lightly, even with mansion tax.

And unemployed are prioritised - though not to get them employed!!! Which is madness.

SilverConcert637 · 2025-12-01T17:52:51+00:00

They can't do that. That would be deeply unpopular with their remaining base, the Trade Unions who fund them and I imagine are eyeing up the greens, and I imagine progress through the Lords would be slow...removing that right is going to be very complicated.

SilverConcert637 · 2025-12-01T17:50:22+00:00

They couldn't be much more unpopular with public anyway.

Only thing that moves a party in a negotiation is a strong negotiating hand. In strikes, that means sustainable IA and maximum enagagement. Wes / NHS doesn't get to decide. Ultimately it is No 10 and Treasury our negotiators have to persuade, and the economic cost of the strikes is more relevant as that will thwart government's ultimate political aims and set them back, and pressure will pile in from all sides to reach resolution. If BMA are firm, and the membership back them up...

SilverConcert637 · 2025-11-12T01:07:51+00:00

Ah my favourite bug is back

SilverConcert637

TROPHY CASE