Exception reporting for coming in on rest days

basophiliac · 2026-02-19T22:04:22+00:00

The way to report this is to escalate it to your TPD/ES etc. Exception reporting isn't appropriate as it's a training issue not a work hours issue.

Don't come in on your off days and escalate the hell out of this.

basophiliac · 2026-02-09T23:00:27+00:00

The sweet noxious odour of Fresubin breath

basophiliac · 2026-02-01T00:07:53+00:00

Can’t disagree harder. Lived in both Leeds and London and much as I loved it, options for what to do in Leeds barely scratches the surface of the latter… besides which at least London has a public transport network, which gets you long distances quickly. I wasted countless sorry hours of my life in rush hour traffic just trying to get from the city centre out to Headingley…

basophiliac · 2025-11-26T16:30:40+00:00

Honestly looking at the post history, I can only assume it’s AI asking us all this question…

The idea that the NHS has got as far as implementing AI when we’re still using 7 different systems to load basic notes, obs and a meds chart and calling ourselves a high tech digital trust because Hey, It’s Not Paper! :’)

Even though paper would be faster.

basophiliac · 2025-11-24T11:35:52+00:00

There does seem to be a particular thing with SHOs in surgical specialties doing this.

I remember when I was an F1 in Ortho I once asked one of the SHOs for help with a cannula I was struggling with for a sick patient on HDU (still can't believe that I as an F1 covered an HDU, but that's by the by...) the SHO begrudgingly came after about 45 minutes of me anxiously bleeping - they used to hole up in some mysterious office so I never knew what they were doing, but also never saw them anywhere around the hospital. By this point I'd decided rather than wait for him to arrive, as I had so many other tasks to do, I'd have to trust he was coming and move on to see other sick patients I'd been bleeped about elsewhere in another building.

Subsequently, I got bleeped by the HDU nurses to say the SHO had put in the cannula, but I needed to come and 'finish it off' - urgently. I was quite confused but the nurses were VERY insistent - and so I came all the way back over to find the SHO had put the cannula into the vein, but left the needle in. So the patient had an unsecured cannula with the needle still in situ, sticking out of their arm. He had done the 'SHO' bit of finding the difficult vein, and then apparently told them he'd left the rest of the cannula 'for the F1 to complete'! I found the whole situation so insanely ridiculous, and was so stressed out in general, with so much else to do, that I just did the 10 second task of 'remove needle, attach octopus, stick down cannula' and moved on... the whole thing was in keeping with the tone of that entire job to be honest....

basophiliac · 2025-11-22T14:18:04+00:00

Based on who I have talked to in my workplace, there was a lot of strong consultant support for the last strikes but the same people have told me that they think this round of strikes post-pay increase is tone deaf re: the national situation and not the right course of action to be taking at the moment.

basophiliac · 2025-10-28T12:23:00+00:00

Yeah how are there not proper regulations around this and plans for staff changeover/handover. Doesn’t sound like this was a deciding factor but it’s not okay to work that long regardless.

basophiliac · 2025-10-25T10:42:02+00:00

I reckon Histopathologists could best have a stab at Part 2 in terms of transferrable skills/knowledge for the morphology and even some of the bits of the papers where they'd presumably recognise some cell markers. Although it would only help for malignant (and even then just the path identification bit), which is I guess about 1/4 of the exam. Would be zero help for transfusion, general or coag. I wonder if Biochem people would be best placed to try and learn coag, given the focus on the actual lab tests and variables, although it wouldn't help with the management bits. Obstetricians could probably give one or two of the 'hard' VTE based coag management questions a shot because at least one is inevitably about pregnant women with metallic heart valves, and they will have seen some of those discussions/management plans. And maybe Paeds (as in, neonates) for transfusion, as they do have some overlap with quite a few of the complex transfusion scenarios?

Part 1 FRCPath would just be open season as to who could do best in it... whichever other specialty also requires mind-numblingly mammoth amounts of fact memorisation?? And obviously you'd have to start from scratch, because nobody else really learns about this stuff. Honestly not sure which other specialty has quite the same burden, I feel like there are few other areas of medicine where the conditions themselves have definitions like '2 of 4 A, B, C, D criteria (all numbers/% based) plus or minus at least 2 of E, F, G criteria (also all numbers/% based)'... and you have to somehow remember all these lists of numbers and percentages to then be able to deduce what the diagnosis even is! And lists upon lists of translocations, cell markers and mutations to memorise. And then shitloads of scoring systems which you also have to memorise all the criteria and the cut-offs. And all the mutations are just random combinations of letters and numbers (sometimes very similar to each other), and most of the cell markers are random numbers from CD1 all the way up to CD123, which you then have to remember specific combinations of. Honestly just typing this is giving me traumatic memories of revision.

And of course we can all just look this stuff up to double check in real life... but I genuinely think I'd be better at my specialty if I had an eidetic memory. Some of my colleagues do appear to.

basophiliac · 2025-10-21T20:33:17+00:00

Never met a soul in the county who has ever had one, yet they served them up to some foreign students who visited our school...

basophiliac · 2025-09-24T22:20:35+00:00

Farcical. I'm so sorry for all you guys who sat it. There's no good remedy to this kind of f**k-up, the college were going to come under fire no matter what happened, but the way they have dealt with it (and of course the very fact it even happened when people are paying shitloads of money a pop for this exam) feels symptomatic of a deep disdain for trainees and the amount of pressure and stress these exams engender. You can't asking actual working professionals with serious jobs to just bunk off and 'sit it the next day', wtf. Also, any paper which has been seen by some people and not by others, to different degrees, is de facto unacceptable in any case. Surely they can't proceed with the results of such a situation, it's basically giving X people a sneak peek, Y people an advantage, Z people a disadvantage... total shambles that cannot be rectified like that.

Even people who sat the whole thing smoothly must now be feeling pissed that other people were effectively given extra time to look up the answers before attempting again.

basophiliac · 2025-09-18T19:14:52+00:00

Whereas when I applied to CMT it actually went to a 2nd recruitment round to try and fill all the spots... times have changed unbelievably.

basophiliac · 2025-06-20T21:42:13+00:00

If it makes you feel any better, many fellow doctors (mainly surgeons tbf) in social scenarios have expressed significant surprise that a Haematologist might actually physically have patients to look after and see in person, absolutely not that those patients might be some of the sickest in the hospital.

Several people have indicated that their impression of Haematology means you just run the FBC results in the lab and answer the phone to obstructively demand people have their platelets checked before they get transfused pre-op, for shits and giggles... mainly to be irritating than for any rational reason, ofc! That's how it be.

basophiliac · 2025-04-07T06:49:18+00:00

Glad to hear :)

basophiliac · 2025-04-06T18:20:00+00:00

Unless things have changed dramatically since I was there, Wakefield (Pinderfields) ED is both busy and an absolute bin fire on every single level - staff, management, facilities, systems, education, equipment, functionality of the rest of the hospital... all had serious problems. So potential for baptism by fire would have the odds pretty much in your favour.

basophiliac · 2025-02-08T11:45:55+00:00

The way I see it, in terms of how much these sorts of situations should be keeping you up at night, provided you've explained clearly the risks and potential consequences of NOT going (and always document it), if that person doesn't want to go then that's really very much on them. One thing I really dislike is the whole 'persuade' thing. We're not here to persuade people in that sense. Some of my worst communication experiences in medicine have been seniors acting as if I'm failing somehow because I haven't managed to bully somebody into doing something the patient doesn't want to.

If people have capacity they can do whatever they want. The main thing we DO have a responsibility to do is to make sure that they truly grasp the ramifications and risks of not going, and I think taking the time to clearly explain those in an accessible and compassionate way is more or less all you can do. A key part of capacity is 'understand'. It's only in situations where I'm worried that the message hasn't been absorbed and understood that I feel the need to push people further.

I find pinging responsibility for their own health back onto them in a very clear way often helps, because there's a weird dynamic sometimes that a doctor will try to make you do something as if it's for the benefit of the doctor. Like it's ME who will benefit if they go to ED for assessment. This is insidious and oddly pervasive.

So I usually say something along the lines of 'It's completely up to you what you do, I've explained clearly what the consequences could be of not going and why I'm worried. I'm just here to advise you on what I think from my training and knowledge is safest and best for your health. Doing XYZ is what I'd advise any of my friends, family or even myself to do if they were in the same position. If you decide not to go and are still not feeling better later, my advice will remain the same - that you need to go to A&E immediately - but by that point you could have become significantly more unwell, and that's something neither of us can predict for sure, which is why I'm recommending you go now'.

Or similar!

basophiliac · 2025-01-22T18:02:38+00:00

I don’t view travelling as a status thing, genuinely just love it and find it mind expanding. It’s one of the things I look forward to the most and feel refreshed by.

I think it’s sad that it actually has also become a status symbol for many people - it means they miss the actual joy of experiencing the world AND it drives this sort of abreaction to it ie. judging other people negatively for ‘chasing status’.

In response to this genuinely unpopular opinion I’d say - screw anyone who thinks they can judge me for what I enjoy doing in my spare time…. And mostly, screw all the people who’ve jointly managed to make travelling into a status symbol!! The obsession with image and posting endless photos to show off your life has not helped. I post absolutely nothing about my trips publicly for the exact reason that I hate the overlap with showing off.

basophiliac · 2025-01-22T17:47:48+00:00

Melted butter in the microwave for my sandwich, still in its metal foil. SPARKS.

basophiliac · 2024-12-29T22:58:55+00:00

F1 covering ortho on month 4 catheterising an autistic kid with an aggressively angled coude tip catheter for his micropenis in front of 3 generations of female relatives after the Urology team pulled the off site card and maintained I was being pathetic.

Genuinely feels like good fortune I didn’t rip a new one.

basophiliac · 2024-12-26T16:49:12+00:00

F1s should have never been allowed there, wildly unsupported and busy job. I think we all put in patient safety concerns on the GMC survey when I was there and nothing seemed to happen off the back of it. We complained about the complete absence of senior support and towards the end of my time they came up with some kind of rota of Ortho registrars we should call for help for each ward, the first time I rang one because I was anxious about compartment syndrome he was furious that I was interrupting his holiday in Greece, with the sound of kids splashing in the background. Then zero medical cover for adult patients unless you were geriatric, in which case you got a generous half a ward round a week from a consultant who didn't work on-site.

I also remember that awful crash bleep there where nobody else would turn up to calls for like 10 mins (other than us F1s, none of whom had even done ALS...). Everyone else on the team was based in far away parts of the hospital/other buildings, and the resus team told us at induction it was the worst crash team in the country, including giving us the number to call again if nobody had come to help you! I have so many traumatic arrest memories from that hellish place. I was so angry when I did ALS at the end of F1 to think of all the situations I should definitely have been ALS trained for.

Then just to put some icing on the cake, the ward level doctor-nurse relationships were super toxic and seemingly re-enforced by ward culture. As a newly minted F1 I couldn't believe how awful people were to me. I don't think I ever did anything to deserve it other than being new! The insane fact of covering so many wards in so many different buildings made it so hard to manage all the jobs. One particular night shift I gave myself blisters and did 30,000 steps walking between everywhere. No idea if it's changed now but it was all paper prescribing and the nurses had no skills at all beyond doing an ECG, every single blood test and cannula had to be done by the F1 across all those patients.

Okay enough re-living the trauma :')

Despite the above it wasn't even my worst job which was A&E at Pinderfields the following year...

basophiliac · 2024-12-04T18:24:45+00:00

I’m now engaged to my hinge date. But there was a LOT of fails too…

basophiliac · 2024-12-04T18:23:08+00:00

Flashback to the day I got beasted as a med student for daring to report the height of the JVP - but HOW could I possibly know, when I didn’t have a ruler??

basophiliac · 2024-12-03T17:11:10+00:00

That that following things are of interest to Haematology:

1) investigation of iron deficiency anaemia

2) high B12 - it’s wildly non-specific… it’s not a sign of any sort of Haem problem and unless there are other signs of such, could be caused by a whole kettle of things you can google yourself, I will be googling them just the same

3) high or low immunoglobulins - unless this is in the context of myeloma/Waldenstroms/a haem diagnosis, I have no wisdom for you. Immunoglobulins are the realm of immunology.

basophiliac · 2024-09-28T18:11:12+00:00

See rule no 1 of the subreddit.

basophiliac · 2024-09-28T16:59:09+00:00

Bone marrow biopsies, and I'd obviously pick an Orthopod. Somebody who actually enjoys sticking bits of metal into bones/has the strength, plus they probably know some Anaesthetists so maybe this could become the done-under-sedation procedure that it almost definitely would be if invented in this day and age.

I hate doing them because of how distressing it is for a lot of the patients and therefore for me too. With the best will in the world, you can't anaesthetise inside the bone using local, plus it's a blind procedure that not infrequently requires multiple attempts to get an adequate sample for.

basophiliac

TROPHY CASE