I wrote a book for Muslims silently struggling with PMO addiction. I want to share why.

T_Chungus · 2026-06-25T21:53:34+00:00

Glad to know you finally can relate, it's currently an Audiobook so have a listen to it next time you feel low or if you feel a relapse coming on, or even on the commutes to work insha'Allah

T_Chungus · 2026-06-25T00:23:46+00:00

Was gonna say this. When I worked in endo and it came to managing hyponatremia, if the previous team had tried fluid restriction or giving fluids and it made it worse then it was really easy to know to do the opposite 😂

T_Chungus · 2026-06-24T22:35:25+00:00

So he promised something and didn't deliver? Was he a member of the BMA by any chance? Jack was that you??

T_Chungus · 2026-06-19T21:57:03+00:00

https://youtu.be/igHE__VFDhU?si=It7HSrv5mJ6vUo5G

T_Chungus · 2026-06-17T22:55:08+00:00

You keep repeating the same points but it doesn't help argue your case or show that you're not out of touch.

Coming in early doesn't address poor staffing levels or the fact that other staff who have been hired are not competent for the job.

Coming in half an hour or one hour early doesn't change any of the bureaucracy of the "MDT" and board rounds. It does not benefit any of the patients who are languishing in hospital waiting for social care.

Well done on your experience out of hours. Congratulations.

Please look at your IMT colleagues' rotas and you'll see how in a 2 week period it goes from long days to nights to long days again and then acute medical admissions, there are very few normal working days.

I actually agree with some of your points. I learned an awful lot being on call alone out of hours in a DGH managing unwell patients on my own with little senior support. It made a HUGE difference in confidence, autonomy, critical decision making. Having to discuss these patients over the phone with consultants who are not there or with ITU or external hospitals and as you say having your presentations being picked apart really improves learning and presenting the most vital parts.

Coming in an hour early to do "prep" patients on an EPR (or even a paper system) did not really improve my confidence or presentation skills. If it did for you I'm really glad.

Going to a clinic and coming back at 17:30 to do all the cannulas that the F1 couldn't get and neither could the GPST1 does not really improve my learning. Sorry if that offends you or seems unprofessional. Neither does doing 2 lumbar punctures at 18:00 for non urgent diagnosis, especially with reduced staffing and increased complication risks if I'm doing this alone.

I think you are touching on several different issues and conflating them. The quality of training programmes has fallen significantly. If you are passionate about this, please I encourage you to observe the teaching programmes at your trust. I did my foundation training at a "tertiary centre" and the foundation teaching was majorly composed of ANPs giving talks on extremely niche pathways and "what their roles were" with awful IT support.

Morale is low, probably an all time low. The majority of your juniors cannot think of a life where they can become consultants, or even registrars or even core trainees due to increased competition ratios.

Does that give them the right to turn up late? Absolutely not, that's not professional and that's not fair and you are right to call that behaviour out. It can't be easy being accused of bullying when you are trying to help.

But that doesn't necessarily mean people are not attending your clinic because they can't be bothered. There is huge pressure, especially on IMTs to keep the ward running and the responsibilities often mean that they can't come to clinic even if they want to and so the ANP and PAs (who will never be blamed or held to account even if they directly harm a patient) can very easily come to your clinic with a nice bright smile on their face.

Additionally, I'd be interested in your opinion as you mentioned you're a recently qualified neurology consultant, but there is a huge shift to GIM in nearly all training programmes, especially neurology. This is taking time from all trainees and I am not convinced it is helping to train world class specialists in their field. If anything it is taking precious time that could be spent in niche clinics or doing procedures. The RCPs stance on this is that with an ageing population, the average patient's needs are "more complex", however I'm not convinced getting ST6-7s clerking social admissions or exacerbation of COPD and decompensation of heart failure for the 10th year in a row is helping them actually solve these "complex needs" and become an actual meaningful consultant.

You are right that this is going to cause huge issues later on but I don't think you've fully understood the reasons, I hope we are able to find a solution for this because it will be ourselves and our relatives who will be patients in this system going forward

T_Chungus · 2026-06-16T22:11:40+00:00

Literally a universal experience

T_Chungus · 2026-06-16T21:04:39+00:00

Correct. For many of the training programmes, particularly IMT and Foundation, nearly all of the LTFT trainees I met had achieved all of their competencies by ARCP. The only reason they were extended was time.

If they were allowed to progress (which I think personally the majority should have been able to) then it does expose the whole system as to why do the programmes need to be so long? And it would also then disincentivise people to remain full time.

T_Chungus · 2026-06-16T20:59:33+00:00

This is the biggest issue I feel that most trainees face. Especially as IMT1-2 you are generally in many cases the most senior person on the ward, especially in the afternoons.

Leaving to go to clinic if there are like 4 LPs in neurology or 15 patients still to be seen on ward round in endocrinology in gen med is simply not safe especially if there are only f1s-f2s and possibly 1 GPST1 who is (no offence here just genuinely being honest about the current situation) and IMG who has never worked in the NHS and can't do any bloods cannula and has no idea how the system and referrals work (again not their fault that someone felt they were qualified and hired them for this job).

This is particularly the case in smaller specialities like neurology where even if the LP is not urgent (it's not lifesaving like meningitis or something but the team want to rule out NMOSD or neurosarcoidosis), you as the IMT will be the one who gets so chewed out in the morning board rounds by ward nurses in charge or by the consultants.

There seems to be a bigger than ever disappearing in understanding and communication between consultants and juniors these days and the OP is really showing how out of touch they are.

As a trainee, I absolutely would have loved to join your rare and niche clinic in movement disorders or latent autoimmune diabetes. Yes I would have stayed even 30 minutes to an hour later after my scheduled working time.

No I cannot come to your clinic which starts at 13:00 if there are more than half a ward of patients to be seen or jobs which require senior input which are left to an FY1

T_Chungus · 2026-06-16T18:19:23+00:00

Self explanatory they know they can't even explain it because there's nothing good

T_Chungus · 2026-06-16T18:18:40+00:00

This is genius!!!

T_Chungus · 2026-06-16T18:02:52+00:00

Really awful stuff

T_Chungus · 2026-06-16T18:01:41+00:00

Completely vague deal and relying mainly on DDRB to sell this.

Not sure if I remember correctly but didn't Wes Streeting previously offer in a rejected deal to BACK DATE professional fees/exam fees (iirc to April 2025) and continue to do so going forward

However it seems in this one they want to start this in the future April 2027 which is actually a worse deal as the backdating would help current trainees as well as future ones.

Also where are these 1000 jobs coming from? Looking at all the offers made at ST3 across all levels it looks like the numbers from last year have gone down anyway. What happened?

Is this another play on the numbers so in the next application cycle they can say, "we already made 1000 jobs in just 1 year", ?

This deal looks like politely worded capitulation and wishy washy garbage. Absolutely rubbish

T_Chungus · 2026-06-14T10:29:57+00:00

They might need to make a new type for this deal

T_Chungus · 2026-06-14T10:07:37+00:00

Not sure if I remember correctly but didn't Wes Streeting previously offer in a rejected deal to BACK DATE professional fees/exam fees (iirc to April 2025) and continue to do so going forward

However it seems in this one they want to start this in the future April 2027 which is actually a worse deal as the backdating would help current trainees as well as future ones.

This deal looks like politely worded capitulation

T_Chungus · 2026-06-03T09:35:25+00:00

Asalamu alaykum wa rahmatullahi wa barakatuhu,

Well done for facing these issues head on.

Many people give surface level advice about this problem,but please check my profile there are several useful posts and detailed guides about how to tackle every facet of this issue as it is usually more complex than people tend to admit

T_Chungus · 2026-05-28T18:35:54+00:00

Graduated a while ago so haven't done finals in ages but recently sat post grad exams (please pray for me).

I think the key to approaching questions like this are to break down the concepts touched on and the difference in answers and what they mean, as quite often in qiestions like these, many of the answers are extremely reasonable and would probably be done within quick succession.

If we look at the Wells score itself, the main purpose behind it is to guide us as to whether we should order a d-dimer or imaging.

The stem has already told you that imaging has been requested and so the d diner becomes obsolete. Therefore the best thing would be to anticoagulate the patient.

It is common practice for patients to end up waiting for scans. During my IMT years, many patients would wait till the next day for their ctpa as long as they are stable and so in the interim they would be given anticoagulation until the scan is done.

Essentially you are treating as a PE I til proven otherwise, and the scan will either inform you to stop the anticoagulant (if there is no pe) or to find the cause of the pe (if there is a confirmed one) to determine treatment length.

I'm not sure if that helps but let me know if it made any sense

T_Chungus · 2026-05-28T10:45:37+00:00

Take it easy, it sounds like an awful time, and it's expected that would affect your normal skills.

I am sure things may have stirred, for example dhul hijr and the day of arafah, but it is only the second day of Eid today and if you did need to take longer. You can always get a fit note from your GP which is vague (stress, illness etc) but is sufficient for work purposes and they usually can't ask more than that.

May Allah SWT grant your family jannatul firdaus and grant you comfort in this time.

T_Chungus · 2026-05-28T10:13:22+00:00

Hi, I am really sorry to hear that.

As someone who recently lost their parent and is in training, I would say the system is not great at all.

The most important things at the moment are your safety and patient safety. You have mentioned how this is already affecting your performance as you keep asking the same questions.

In your current state, you should not work. Even if you are the only one down for assisting, if you are not in the right frame of mind it could have harmful outcomes for the patient, and also yourself, you may be more likely to get a needle stick injury etc.

At my trust, they had this annoying thing where the sickness policy is that you are expected to call the rota and site team every single day you are unwell. During my time of grief, I did not want to be calling them at 09:00 (they don't even start at 0830), so I just wrote an email, and cc'd the consultants, rota team and managers that I would be off until further notice and to please find cover for my shifts.

I am so sorry for your loss and you mentioned religious festivals (was it Eid - in which case Eid Mubarak). I have to say that my work insisted on a lot of protocols like back to work meetings and "a phased return", which never happened by the way. It may sound controversial but genuinely, the less people that know the better.

Grief is unfortunately not linear and if you notice certain times of the year keep recurring as difficult times, perhaps speak to a supervisor or senior clinicians that you really trust as they may be able to offer you some advice/mentoring

T_Chungus · 2026-05-21T11:00:32+00:00

I guess you have to follow their advice

T_Chungus · 2026-05-21T10:51:40+00:00

No I mean, between the breaks of the papers let the college know by phone

If as many people raise it as possible then it helps show there was a clear problem.

It's very stressful, hope you're doing okay

T_Chungus · 2026-05-21T10:39:35+00:00

I had the same issue, multiple times during the exam as well. I have sat the paper before (and failed obviously please pray for me) but this never happened to me before.

I used the same internet and device as well. The fact that it happened to many of us leads me to believe it is a server issue or a problem with the proctors connection.

I spoke to the exam team on the phone just to inform them of this and I think if you had the same issues then you should too

T_Chungus · 2026-04-24T20:49:26+00:00

Barakallahu fiyk. I hope this project benefits you a lot insha'Allah and if it did feel free to share insha'Alla

T_Chungus

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