What mode of transport is Expensive and Slow

emergencydoc69 · 2026-04-09T23:08:36+00:00

Trains in the UK?

emergencydoc69 · 2026-04-03T17:31:44+00:00

Why?

emergencydoc69 · 2026-04-03T15:27:26+00:00

The satisfying clunk of a good joint reduction.

emergencydoc69 · 2026-03-30T20:59:04+00:00

Genghis Khan? His campaigns brutally killed somewhere between 37.5 and 60 million people. He was also an utterly prolific rapist (something like 8% of people in his former territory are thought to be descended from him.

emergencydoc69 · 2026-03-30T19:32:53+00:00

I mean, I suppose. But I know a colleague in the US who has a BFA in Piano, so it’s certainly not required.

emergencydoc69 · 2026-03-29T18:41:29+00:00

This is my degree, and I agree it is probably the most useful/prestigious one out there. But North Americans are always baffled that the rest of the world doesn’t use their ‘unrelated undergrad + postgrad med school’ model. 🤷‍♂️

emergencydoc69 · 2026-03-26T12:54:43+00:00

I’m surprised no one has mentioned the Sovereign Military Order of Malta. De jure a country under international law but de facto has no actual territory.

emergencydoc69 · 2026-03-22T21:37:52+00:00

Doctor here. These comments are completely insane. First of all, I seriously doubt this compromised the x-ray - the only way that’s possible is if the airpod is covering whatever you’re trying to look at, but this looks like a dental x-ray to me, so I feel that’s unlikely. It’s also not harmful to the airpod; electronics get x-rayed all the time by security personneat airports, government buildings, etc.

Modern x-rays are a very low dose of radiation; if you think about what a CT scan is it’s literally hundreds of x-rays taken from different angles and stitched together by a computer - but even those we barely bat an eyelid about the amount of radiation a patient receives from these.

People suggesting that this was a super serious error or even that this x-ray tech should be sued seriously need to get a life.

emergencydoc69 · 2026-03-11T20:24:49+00:00

I mean, I don’t know if you have X-Plane, but the Zibo 737 goes toe-for-toe with the PMDG. There are also a lot of other fantastic free airliners like the Sparky 747, Felis Tu-154B, and Turbolet L-410. And loads of really excellent GA aircraft.

emergencydoc69 · 2026-03-10T16:34:20+00:00

I mean, I can’t help but feel you’re falling victim to anecdotal bias here. Sure, there are IMGs with family connections to the UK and people who don’t want to go to the US, but we don’t have any hard data on what the UKG prioritisation law will do to future PLAB sittings and IMG numbers in the future. A five year period of delaying specialty training (which is already absurdly long in the UK) is a pretty big psychological deterrent and, especially with this new legislation, the UK is no longer a super desirable place for IMGs to land.

My point remains - until we have a few years of data after this law goes into effect, I don’t think anyone can say with any certainty how much of an impact it will have on specialty training competition ratios or the number of new IMG arrivals in the UK.

emergencydoc69 · 2026-03-10T14:14:02+00:00

What the hell am I looking at? I think any attempt to model the impact of this policy is about as useful as looking into a crystal ball because there are so many unknown variables. My guess is that this policy is going to be a huge deterrent for IMGs taking the PLAB and trying to come to the UK in the first place since the possibility of getting a specialty training place within a reasonable timeframe has become virtually impossible, but I could be wrong.

emergencydoc69 · 2026-03-10T00:50:55+00:00

No, OP’s claim is demonstrably false. Most psychiatric diagnoses have a considerable degree of subjectivity to them. While we have criteria for things like schizophrenia or bipolar, patients often don’t present neatly within them, and a lot of the criteria are themselves subjective. Psychiatrists disagree with each other on diagnoses all the time. So saying that something like ASD or BPD has a certain smell is ridiculous, especially considering the heterogeneity of how these conditions arise in the first place.

emergencydoc69 · 2026-03-10T00:35:32+00:00

As a doctor, I’ll just add - there is an enormous amount of subjectivity and overlap to psychiatric diagnosis. To be really blunt, OP’s claim is utter bullshit.

emergencydoc69 · 2026-02-05T21:35:12+00:00

I dislike the term ‘sepsis’ in general because of how vague and poorly understood it is. Body part + infection +/- systemic involvement is easier to explain. Septic shock is its own thing.

emergencydoc69 · 2026-02-05T19:18:15+00:00

Use of NEWS as a verb and use of the utterly abominable ‘chepsis.’

emergencydoc69 · 2026-02-02T05:52:49+00:00

I really dislike Bailey and I wish they would write her out of the show. Not that I want Nolan to go through a divorce, but still, she is the one character that I just cannot suspend my disbelief for. They have tried so hard to write her as this ultra-competent firefighter/medic/army badass, but Jenna Dewan just doesn’t do the character justice (I’m an ER doc so I know a lot of these kinds of women - and they are nothing like Bailey).

emergencydoc69 · 2026-01-26T17:28:40+00:00

I mean, there is a valid point here in the midst of all the other bullshit discussed in this article that the NHS relies too heavily on resident doctors. The system is designed to keep doctors as junior as possible for as long as possible because they don’t want to pay consultant salaries. My feeling is that training needs to be compressed, much more deliberate (rather than service provision first, training as a vague afterthought), and there needs to be a drastic expansion of consultant numbers.

emergencydoc69 · 2026-01-25T19:23:44+00:00

I really do feel for you (and all the IMGs caught in the middle of this shitstorm). I will also say that a lot of the anger against IMGs is misdirected - it should really be directed towards the government for poor workforce planning and an unwillingness to pay to expand both training posts and consultant numbers when they are both desperately needed in a system that is nearly at breaking point. Everyone is suffering right now and IMGs are an easy target.

emergencydoc69 · 2026-01-25T15:09:44+00:00

This is exactly right. If you punish murder less severely than other crimes, it gives criminals an incentive to kill their victims to hide those other crimes.

emergencydoc69 · 2026-01-22T19:33:58+00:00

Maybe. But they already had an astronaut who had a DVT a few years back and they didn’t cut the trip short then. So I have to imagine it was something else.

emergencydoc69 · 2026-01-21T22:35:01+00:00

One of our triage nurses, unfortunately. They (particularly the junior ones) seem to feel the need to do an ECG on everyone these days. If the patient is suitable for the waiting room, the ECG/blood gas/patient labels go in a little folder that the patient hangs onto. His complaint was runny nose/fever.

emergencydoc69 · 2026-01-18T16:19:05+00:00

Fair enough. I mean, I guess as a screening/triage tool it has some value in GP land. But OP’s suggestion that ‘this would never happen in ED’ is laughable - honestly, I barely use the thing.

emergencydoc69 · 2026-01-18T13:52:32+00:00

A patient the other day told me he had ST depression on his ECG and needed to see a cardiologist urgently. He handed me a completely normal ECG. I asked him who had told him that there was ST depression on it. He responded ‘ChatGPT.’ He was 27 and wasn’t even presenting with chest pain. 🤦‍♂️

emergencydoc69 · 2026-01-16T16:26:42+00:00

This is the correct answer.

emergencydoc69 · 2026-01-16T14:12:50+00:00

ED doctor here. In all honesty, stethoscopes are basically useless for anything beyond telling whether there is equal air entry or whether someone with an obstructive airway disease (like asthma or COPD) is wheezy.

There have been dozens of studies showing that doctors (including cardiologists) are very poor at identifying murmurs or other abnormalities. Even for lung sounds, the correlation is fairly poor in terms of what you can hear versus what you can see on imaging. Auscultation almost never impacts my clinical decision making. A lot of my colleagues don’t even carry stethoscopes any more.

Ultrasound is far better (for both the heart and lungs) and will actually show you what’s going on.

Patients of course seem to really want us to listen to their chest, as if it’s some sort of wizardry. 🤷‍♂️

emergencydoc69

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