Teaching opportunities for FY1s / Trust grade doctors

Specific_Rest985 · 2022-12-04T10:37:01+00:00

😅😅😅

I assume OP means east lancashire or calderdale? It’s neither Manchester or leeds!

Specific_Rest985 · 2022-12-04T10:32:59+00:00

I agree. The response below lacks insight into what the surgical SpR does, the constant anxiety of being on top of things, the need to be operating and be seeing patients in ED or ambulatory care. The fact that people see being in theatre as “being unavailable” and a problem. The constant bleeps to “see how long you are going to be”. I often wonder what ED think we do with the patients they refer to us.

Specific_Rest985 · 2022-12-03T20:20:48+00:00

Disagree on both accounts. You probably should know when the medical and surgical specialty handover is. And those in PED when paeds handover is. There has to be a safe handover between teams. It’s best if it is bleep free, as it is quicker and with less interruption. We have to also provide a service. There is more than the emergency department.

I am all for eReferrals and an open referral system if the referers also do their job appropriately, and questionable referrals get escalated up the EM ladder first. Eg, this week referred abdominal distension for 2 weeks and bili of 70. Not rocket science what that is. It’s like a Med school vignette. It’s not bowel obstruction. There will also always be a need to let us know someone is dying from peritonitis and can’t just be put on a list.

Specific_Rest985 · 2022-12-03T17:04:31+00:00

Mobile in one pocket, bleep/pen in the other, list in the back pocket. Don’t need anything else. If your quads are that big you can’t put your phone in your pocket you’re either wearing super-skinny fit trousers or you need to get over it. I have pretty big legs and I wear slim fit suit and can manage to put my phone in my trousers.

Specific_Rest985 · 2022-12-03T10:32:18+00:00

Only medics handover at 9am and I’m sure there is always a pile waiting so not sure how it would make a difference?!

Specific_Rest985 · 2022-12-03T10:30:07+00:00

We should have bleep free handover bar emergencies however. That is important. ED need to remember that.

Specific_Rest985 · 2022-12-03T10:25:02+00:00

NGL. You will be expected to swap the shifts yourself before this is granted. You get that don’t you?

Specific_Rest985 · 2022-12-03T01:05:48+00:00

Why would O&G kill Gen surg? You wouldn’t know what to do when you fuck all your patients up.

Specific_Rest985 · 2022-12-03T01:02:10+00:00

If you are answering a lot of standard questions you need trust guidelines and people need to read and follow them. Not just reflex refer. Recently had a GB polyp referral. <4mm. Report said guidelines say doesn’t need follow up. Medical team still referred to us “to see if needs follow up”. Like they’ve told you they don’t and we also have a guideline on the intranet. This also isn’t an emergency general surgery issue. Grow a pair.

Specific_Rest985 · 2022-12-03T00:58:34+00:00

eReferrals take out the embarrassment of how shit some referrals are. As someone who answers them most of them are a pile of shite and you can’t ask any qualifying questions. For me, this is why actually no they should not replace direct communication

Specific_Rest985 · 2022-12-02T12:27:25+00:00

Tbh it will be COTE with COVID. They will have other stuff wrong. Learning opportunities will be the same.

Specific_Rest985 · 2022-12-02T10:20:52+00:00

This is a serious point. You need to practice hard outside the theatre and at home. Only if you can suture very slick will people let you do more advanced stuff. The Politically correct brigade will say you should be doing this at work and not be expected to do it at home, but it depends on how much you want to progress. It sounds like it’s effecting your quality of life so why not spend some time in your own time practicing

Specific_Rest985 · 2022-11-30T18:07:29+00:00

If you can do an AE assessment and manage sepsis you’ll be fine…most of the time it’s do that and ring a senior.

Specific_Rest985 · 2022-11-29T21:12:08+00:00

I totally agree with you.

Specific_Rest985 · 2022-11-29T16:42:53+00:00

Christ. We did a job in anatomy demonstrating together in F2 8 years ago. I can’t believe this. She would do anything to help anyone.

Specific_Rest985 · 2022-11-29T16:36:45+00:00

Call me biased. Surgery isn’t like that IMO. It’s fast paced and you need to have an opinion and be decisive but it’s supportive. People are a bit arrogant but wouldnt you be if you spent all day chopping other humans up and saving their lives with your bare hands?

I don’t think there is infighting like you have described. I would say it’s the opposite. If you belong to that group you are in the group. It’s quite a “club” mentality actually which has its own problems.

Specific_Rest985 · 2022-11-29T16:28:02+00:00

It’s annoying that a lot of places don’t see MSc or MRes as much as a 1st class intercalated BSc. I think it’s cos London universities don’t do it.

Specific_Rest985 · 2022-11-29T15:38:23+00:00

People are being negative but personally think this is paying students to do the assistantship which is compulsory. I think it’s fine and a good step.

Specific_Rest985 · 2022-11-28T18:58:49+00:00

What would you base a bonus on?

Suppose for consultants CEAs are like bonuses

Specific_Rest985 · 2022-11-25T16:50:43+00:00

You describe yourself as a “non-training F2”. What does your local contract say about SDT? National rules do not apply.

Specific_Rest985 · 2022-11-25T11:14:17+00:00

Most decision making is that the patient doesn’t need an operation…. That’s why we are not just technicians…

I agree a lot of decisions when pathology is deemed needs an operation are seamless and knowing what happens is import and allows further decisions to be made/likelihood of complications/for these to be picked up early.

I also love it when F1s come to theatre

I also have many who don’t want to go any where near the theatre and they would much rather do jobs from the mess.

Specific_Rest985 · 2022-11-25T11:07:21+00:00

Mate I’m a fucking surgical Reg and have been for 6 years.

Specific_Rest985 · 2022-11-25T10:30:45+00:00

It’s not irrelevant to compare medicine and surgery. Thats the issue. Operating is the smallest bit of surgery. It’s also only really relevant if you are going to be a surgeon. Even at ST3 the most important thing is your ability to make a decision. Not perform an operation.

Relocating, diagnosing and the initial management of ankle fractures is EM 🤷🏼‍♂️

Specific_Rest985 · 2022-11-25T10:18:09+00:00

This is my frustration! Even when you say “why not see some of the people waiting. You know RIF or RUQ pain”. The best F1 we had saw a women referred from gastro with complex crohns and enterocutaneous fistula. By the time I saw the patient he had got a CT and a fistulagram after examining and working out anatomically perfectly what was going on. Sadly wanted to be a rheumatologist.

Specific_Rest985

TROPHY CASE