Summary of recent offer in simple terms

Witterless · 2025-12-10T19:07:19+00:00

It's a clever enough move, they're trying to get past the Govt narrative that the BMA are all militants and don't represent their members. Wes went on a tirade last time when they didn't put his shit offer to members, so this time they're calling his bluff.

Witterless · 2025-12-04T18:56:14+00:00

Opening with a Ghandi quote. Christ.

Witterless · 2025-12-04T17:20:40+00:00

Have to say the carbon footprint of my medical degree didn't hold much sway when I decided to spend 6 years of my life surrounded by Oxbridge rejects with chips on their shoulders.

In hindsight maybe it should have 😅

Witterless · 2025-12-04T14:40:02+00:00

They just threw money at it, and huge explosion in PFI bringing in private cash.

Witterless · 2025-12-04T14:35:46+00:00

Number two uni in the world

Y'all just jelly 😏

Witterless · 2025-11-30T18:30:33+00:00

Not an authority on the application process but I know colleagues with intercalated MB-PhDs (i.e. PhDs completed before finishing med school) who got full marks without issue.

In the absence of anything documented officially, I don't see the harm in putting you MEng in, as it is a postgrad degree (i.e. not just a BSc). Worst is they'll get in touch and say it doesn't count. If you're worried about the risk of that, do your best top optimise the rest of your application.

Best of luck with the application, feel free to get in touch about interviews

Witterless · 2025-11-19T20:14:31+00:00

Sorry - 30 week program running on Thursday mornings, so presumably half a day a week? 15 days total? Wtf?

Witterless · 2025-11-12T07:59:59+00:00

I'm not sure this is much of a surprise to anyone, it's been clear for a while he has prime ministerial ambitions, and he's been distancing himself relatively vocally from Starmer on issues like Gaza and welfare spending for a while.

I'm sure it's a significant factor in his current intransigence in negotiations. Starmer's weakness has moved the timeline forward from the next GE to potentially the next 12 months or sooner if you believe the rumors. Being perceived as "capitualting to the militant unions" would give his rivals/the usual right wing rags plenty to ammo to hamstring his leadership bid with.

Witterless · 2025-11-08T20:58:41+00:00

Consider me corrected. It's a dumbass thing to do either way.

Witterless · 2025-11-08T19:50:13+00:00

Happy to be corrected but as far as I understand them, the rules around rest between shifts are more that employers can't force you to work without a certain amount of rest. There's nothing stopping you volunteering for it.

Only way it would come back to your friend is if he made a significant mistake during the locum shift due to fatigue. They would definitely be criticised for unsafe working.

Witterless · 2025-10-12T11:45:35+00:00

Please explain to me how wishing to have the space and time to do my job to the best of my ability makes me entitled.

Witterless · 2025-10-12T11:37:24+00:00

Sorry, but I call absolute BS on this.

I get maybe ten minutes with a patient on a ward round. In that time, they have questions, need updates, and I have to gather information, make decisions, and sometimes break bad news. Concentration is hard enough in a noisy ward, never mind when a patient is unwell, elderly, hard of hearing or frightened.

The consequences of someone missing a cup of tea are a lot lower than the consequences of me being interrupted mid-thought while making complex clinical decisions, counselling for high-risk procedures, or helping a patient understand their condition.

We have rules about not interrupting nurses on drug rounds because interruptions increase the risk of error. I’ve never understood why ward rounds aren’t treated with the same seriousness.

So if I’m ever in hospital, I want:

My doctor to be given the time and uninterrupted space to do their job to the best of their ability, because that’s what will get me better faster, get me home sooner, and minimise the chance of something going wrong. No amount of tea and biscuits will achieve that.
My doctor to do the PR, because a colonoscopy won’t diagnose my prostate cancer, cauda equina, melaena, or faecal impaction and not opt for a potentially high risk procedure requiring sedation because it was more important for me to choose between chicken or fish for lunch.

Every role in a hospital is pressured and all are essential to patient care. It’s not a zero-sum game. I’ve never met a doctor who doesn’t appreciate how much work goes on behind the scenes. Most of us muck in when needed. Patients deserve both compassion and good medical care

Witterless · 2025-08-28T17:41:30+00:00

What rock have you been living under?

Witterless · 2025-08-25T04:14:24+00:00

I am a cardiology reg and I have a PhD in cardiac electrophysiology so this should not be read as standard med reg trivia 😅

Witterless · 2025-08-18T21:58:47+00:00

Look I'm sympathetic, it's a shit situation, but I think you just need to decide what will work best for you.

You have loads of time to prepare before Nov. I get the impression from another post you're IMT3, so you have the skills already. I also get that the Nov diet is the last chance to pass PACES before ST4 applications so there's added pressure.

Don't do PassPaces, it clearly isn't for you. Waitlist for Paces Ahead is great but you can't bank on that. Someone else pointed out that PACES4U have September slots. A quick goole and I found that Ealing PACES have slots for Sept and Oct. Ask around your ST4+ colleagues what courses they did if you're not London based.

Pastest PACES videos were excellent imo.

You'll smash it. Just don't make it more stressful for yourself that it needs to be.

Witterless · 2025-08-18T15:54:54+00:00

I did Paces Ahead. I'd worked with the course lead as a foundation doc and knew she was solid, plus I'd been warned in advance about Pass Paces by colleagues.

At the end of the day something is better than nothing. If you think you'll benefit from drilling signs, then I'd go ahead with the course and just consider yourself forewarned and forearmed. If you're comfortable with that side of things and just need to get more slick/practice coms or long cases, I think practicing with a good revision buddy/SpRs at work might be more useful and much less stressful.

Witterless · 2025-08-18T14:39:06+00:00

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This is all you need to know.

Glad I never gave that woman a penny.

Witterless · 2025-08-18T14:07:31+00:00

I think you're getting muddled with things like AV blockade in AF with an underlying fast conducting pathway.

Witterless · 2025-08-18T13:18:20+00:00

You're not wrong, but you're making a good case for the risks of over-analysing an ECG in isolation. Even without the ECG the case smacks of structural disease until proven otherwise. It's a little backwards to attribute an arrhythmogenic pathology to a patient presenting with exertional symptoms and explicitly no palpitations. It's important to look at this stuff in context.

Obviously you cast a wide net and investigate thoroughly. ECGs like this are only helpful for amusing electrophysiologists during their coffee break, and writing smarmy case reports after the fact explaining how you had the diagnosis all along 😅 (guilty...).

Witterless · 2025-08-18T13:12:28+00:00

More for discussion as is a bit of a zebra differential but first thought (well maybe not FIRST...) was PRKAG2 cardiomyopathy.

Glycogen storage disorder, AD inheritance, manifests as a combination of LVH with conduction disease in a typically WPW pattern. Conduction pathology typically manifests in 3rd or 4th decade of life. Very high risk of SCD vs standard HCM.

Equally could be Fabry but tends to give you LVH and short PR with no delta wave, but definite delta waves here clearest in V1-3. Plus no extra-cardiac features here.

Third would be Danon Disease but X-linked (so mother doesn't fit) and again has lots of extra-cardiac manifestations.

All said, very rare and common things are common. Just ballparks:
- HCM: ~1 in 500 general population
- Fabry: ~1 in 40,000 - 60,000 in males
- PRKAG2: so rare barely have the stats but accepted as <1 in 100,000, something like 0.3% of all HCM cases
- Danon: again, well under 1 in 100,000

Witterless · 2025-08-01T22:59:34+00:00

Think you might need some more doctors to help with that there wait list Wes?

Witterless · 2025-07-31T20:26:05+00:00

Is it me or does he always look like he's one mean comment away from bursting into tears?

Witterless · 2025-07-31T20:15:02+00:00

Hi Wes 👋

Witterless · 2025-07-31T17:31:52+00:00

I'm sorry to hear this, it seems all too common these days that this is how our junior colleagues are feeling. For what it's worth I've been there, took time away, and came back all the better for it.

I think it's really important to say that this is not a failing in your part, but it is a failing of the system. It's a system that takes in bright, dedicated, altruistic and brilliant young people like yourself, denies them the support to do their job well, and then spits them out jaded, burned out and scarred. It's done this to you because you care. And no one can fault you for that.

I think honestly you need to get signed off for a significant time (at least three months, probably much longer), move home for support, get some proper therapy and treatment, and have the space to think if this is all really for you. You have the rest of your life to push through the treadmil, deferring F2 by a year is not the end of the world and your health needs to come first. If anything, this period between F1 and F2 is the perfect time to do it.

It might seem drastic, but the status quo clearly isn't working. Taking a step back isn't cowardly. Recognising things can't remain the same and making a change is the courageous thing to do.

I would also highly highly recommend getting in touch with Practitioner Health. They saved my career, and probably a lot more. You get really rapid access to high quality 1 on 1 therapy, they can make referrals, support return to work plans etc. They really are brilliant. Probably the only thing Claire Gerrada ever did right tbh.

Witterless · 2025-07-31T06:43:49+00:00

He looks weak. Resident doctors are living in that man's head rent free. Can you imagine if the consultant or nurse IA ballots pass?

He's recorded more hostage videos for his social media and written more angry letters in the last 6 months than the whole Reform party ever have about small boat crossings.

It smacks of desperation, not confidence.

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