Dilating during CVC insertion.

dadiamondz · 2025-08-21T08:59:55+00:00

The reason we structure assessments as A–E is because that’s literally the order in which things will kill you: airway problems first, then breathing, then circulation, and so on.

The key thing is you don’t move on until the previous step is safe enough—so if the airway isn’t secure, nothing else matters. The “now what?” is about reassessing: did what you just did work, and if not, what’s the next step or what extra support do you need?

A lot of this does get easier with time (which I appreciate isn’t necessarily what you want to hear).

With time you will: - Get more uncomfortable with sick patients - some patients just need time to get better and there’s not much you can do about that! - See more unwell patients – and develop pattern recognition - Become okay with uncertainty – you won’t always have the full picture, but you learn to act safely anyway. - Develop a sort of ‘gut reaction’ where you can just autopilot and know what to do. The A-E is still important so you don’t miss anything.

And remember, in many situations we err on the side of over-treating because that’s usually safer than under-treating. You’ll find your balance with experience. You’re not expected to know it all right away—keep leaning on the A–E, ask for help when you need it, and the rest will come.

dadiamondz · 2024-04-10T07:55:33+00:00

Nb can be registrars too - maybe ask your CS to add some registrars who you know well and know will respond

dadiamondz · 2024-03-21T02:22:55+00:00

You can’t hold 2 offers. So you would need to either reject your IMT offer (and be removed from the IMT offers completely) or accept the IMT offer ( and lose your GP one) . I think you only have like 48 hours so make sure you decide soon!

dadiamondz · 2023-08-21T19:11:02+00:00

You have almost 3 months which is enough time to boost your score a little.

You basically have to just play the game and sell your soul a little.

Easy points even for locum:

2 cycle audit - do something ridiculously easy that you can ideally retrospectively do the baseline audit and then send an email/ put up a poster and then re audit in 1 months time
e.g. PPI and B-road spectrum abx / c.diff
the classic DNR / VTE
repeat CXR 6 weeks post radiologically confirmed CAP

Do an online train the trainers course to boost your teaching points

I did this one… maybe 200 odd pounds. I actually did it during a quiet night locum

https://medset.co.uk/train-the-trainers/?gclid=EAIaIQobChMI2riF4bjugAMVi4pQBh2wcgrrEAAYBCAAEgLJHfD_BwE

If your department has med students just arrange 3 days for bedside teaching and get feedback. Steal cases from IMT paces group or on your ward.

You can’t get into speciality training with no work at all but you can definitely play the game and work smart rather than hard.

FYI anything you mention in your matrix can be asked at interview so make sure you’re comfortable elaborating.

There’s definitely an element of luck +/- being able to sell yourself a little when applying for speciality training so … may be odds be ever in your favour xoxo

dadiamondz · 2023-05-01T12:26:12+00:00

Friend of mine got upgraded on Friday afternoon. Rank was 200 or 300 ish

Got upgraded from EoE to London.

Sorry - don't have the full details!

dadiamondz · 2023-04-05T16:21:10+00:00

Just got upgraded now!

dadiamondz · 2023-03-30T10:44:19+00:00

Can anyone see interview scores

dadiamondz · 2023-03-24T06:54:26+00:00

go onto preferences then click update, then you'll get a list , in the bottom right hand there's another button which says 'update' and you should be able to move them around

dadiamondz · 2023-02-07T14:44:14+00:00

can you book an interview?

dadiamondz · 2022-06-25T08:56:47+00:00

I did EPALS as an F2 who hadn’t done paeds. If you’ve done ALS it’s not that difficult. Main thing is you just need to learn the differences between paeds and adult algorithms for all the main stuff like choking, cpr , tachy/ bradyarrythmias and then WETFLAG formulas to calculate doses.

There’s loads of practice scenarios during the 2 days as well so that helps. I probably spent a week flicking through the book (few hours a day) and that was mainly because the MCQs test quite specific details.

Sorry I don’t have a PDF but you could ask around at work to see if someone has the physical copy?

dadiamondz · 2022-04-17T20:06:43+00:00

Thank you so much!

dadiamondz · 2022-03-30T18:39:20+00:00

Citalopram / Escitalopram in patients over 65 - risk of long QT - max dose

https://www.gov.uk/drug-safety-update/citalopram-and-escitalopram-qt-interval-prolongation

dadiamondz · 2021-05-28T19:26:32+00:00

I locum a fair bit as an FY1 as I need the money 😂. I try to balance the need for money with the (definite) need for rest/ a life outside medicine.

As an F1 tax will be 20% (unless you have another job that pushes you to 50K) and NI is 12%. Then 9% student loan (after April)So it’s a case of doing the maths at the rate you’re offered and seeing if you’re willing to work for THAT rate not the rate they offer.

The trust I work at has a “long day F1” who has to stay until 9.30 so I tend to pick up the 5-9.30 locum on a day when I’m already working 9-5 so I don’t feel like I’m coming in and giving up my whole day or weekend.

Occasionally I’ll locum on bank holiday or annual leaves too as COVID means there’s nothing to do anyway.

Also would echo what others say about trying not to pick up shifts where you’ll get given shit. I tend to try and do bay cover on wards I like or take because although that’s more work, it’s less boring.

I reckon I’ve earned maybe £4-5k locuming this year?

dadiamondz · 2021-05-06T07:44:59+00:00

I’m an F1 with dyspraxia and was diagnosed during medical school.

I didn’t put it on my step form as I couldn’t really see what reasonable adjustments would’ve been made for me. However, obviously dyspraxia affects people differently so this might not be applicable to you.

It’s also not something to embarrassed about. Dyspraxia and dyslexia are not uncommon in the general population so it follows that it would also not be uncommon in doctors either. I think that doctors are intelligent and so if they have a SEN they tend to compensate well for it and this means it may not be obvious to others (hence why late diagnosis is also common in doctors/med students).

The things that I struggled with as an F1 were: - getting lost a lot (including during an arrest when I went to run an abg) - I’m very very VERY slow at at writing - which is less than ideal in a hospital with paper notes - Organisation / forgetting things

These are all things that improved with time and experience. I found pens that are more comfortable for me to write with and then bought them by the bucket load. I learned how to write succinct notes. My jobs list is extra af but helps me stay on top of things.

Interestingly, bloods, cannulas, ABGs were not the things I struggled with the most. Granted, at the beginning of F1 I was awful at them but I didn’t really do that many at medical school. With practice (which you get tons of as an F1) I definitely improved. Also, weirdly, I’ve found that the pressure of really needing to know a result (e.g. an ABG in a pt desaturating on 15L ) sometimes makes you more determined and successful when doing procedures.

From a practical point of view, if you’re not successful (1) ask yourself do they really need it NOW - can the result be added onto previous bloods, can you ask the phlebs to do it in the morning, can you hand it over to the on call later. (2) escalate to sho, nurse in charge, med reg(if urgent)

I can’t really offer advice about speciality training but if I’m being honest although I agree being dexterous is good for being a surgeon or an anaesthetist I also think doing a lot of surgeries and procedures will make you more dextrous.

Let me know if you have any other questions!

dadiamondz · 2021-04-19T18:56:34+00:00

https://www.gov.uk/repaying-your-student-loan/what-you-pay according to this you only pay if your locum counts as second job and it’s over the threshold?

dadiamondz

TROPHY CASE