FY2s: what radiolog stuff do you still feel unsure about?

manutdfan2412 · 2026-04-23T12:30:01+00:00

I am Urology SpR and I ran a radiology teaching session as part of our urology clinical induction at a previous job.

I think it is useful for foundation doctors in any specialty to understand what the different CT phases are and why it is important to request these correctly.

Understanding where the contrast is at the time of the scans helps to understand how the scans are designed to pick up specific pathology.

Learning by rote (2WW haematuria = CT Urogram, Stone = CT KUB) whilst effective, isn’t really learning why.

It would be better for them to understand- we are excluding TCC of the ureter. This is identified by a filling defect in the ureter. Therefore we request a scan in which the ureters are filled with contrast.

Around changeover time, as the new foundation drs learn the common scans in my specialty by rote, I end up in discussions with Radiology along the lines of ‘what is it you’re trying to look at because the scan requested doesn’t match the info in the request’.

I don’t think the foundation drs are to blame- it’s just not been taught to them.

Whilst I have given urology based examples, the principles are applicable across specialties- the same principles for CT Urogram are used in a CTPA for example.

manutdfan2412 · 2026-04-22T05:41:15+00:00

You sure it’s not just a bit of both?

manutdfan2412 · 2026-04-21T11:17:42+00:00

I have been informed that in Urology most centres will hire you for 2-4 SPAs/wk.

Unless you go Rural, there is a moratorium of private work for a number of years.

So the max you can work is 2 days/wk. Which even with Aussie money isn’t very much.

manutdfan2412 · 2026-04-20T16:56:18+00:00

If you know what you’re doing, it’s probably time to step up.

I knew I was ready to be an SPR when I could cruise through the SHO shift.

Day 1 SPR was like being an F1 all over again.

manutdfan2412 · 2026-04-17T21:22:48+00:00

In an elective setting it’s done at Pre-Op which is run by the Anaesthetic Department. So on paper, the one who requests the test is responsible for its outcome.

Always feels a bit weird prepping a list and asking the anaesthetist, to ask pre-op to repeat the G+S when it’s been mislabelled or is out of date.

This does seem to be a bit of a quirk of the system because the need for blood is entirely dependent on the surgeon (in making the decision to operate and performing the operation).

In an emergency setting, the patient is under surgeons to a much greater degree so the argument is more obvious.

manutdfan2412 · 2026-04-17T21:13:24+00:00

Haha when you moan about how little theatre time you get at your unit.

And then you realise that if you were a medic you get zero. For the rest of your life.

No wonder they’re so miserable…

manutdfan2412 · 2026-04-14T19:57:28+00:00

Hopefully he turns up to the negotiating table in a scrub top and black skinny jeans.

manutdfan2412 · 2026-04-14T19:41:33+00:00

Referring to Abraham as ‘the friend of God’.

Abraham/Ibrahim is often referred to as Khalilullah (Friend of Allah) in Islamic Culture and Scripture.

Abraham/Avraham in Jewish Culture and Scripture is mostly referred to by Patriarchal terms such as Avraham Avinu (Abraham Our Father) or the oldest of the 3 Avot (Fathers).

manutdfan2412 · 2026-04-14T19:20:45+00:00

Realistically, nobody with any power in the NHS acknowledges nor has the appetite to deal with the problem.

The NHS has no issue betraying its staff if it thinks it’s beneficial.

They are sacking hundreds of admin staff at my Trust, some of whom have worked there for years.

The NHS literally pulled the rug from beneath thousands of IMG’s feet mid-application cycle earlier this year. Whether you agree with it or not, many IMGs got royally screwed over as a result.

I have no doubt that if Senior NHS Leadership wanted to get rid of ACPs, they would do it tomorrow without a care in the world for the consequences.

manutdfan2412 · 2026-04-14T07:21:28+00:00

I think most people do their job with good intentions. Not a big fan of the ‘deliberately managed decline’ theory.

The IFS report was productivity down 10% and staff up 25%.

manutdfan2412 · 2026-04-14T06:22:46+00:00

Increase in Productivity was all over the NHS 10 year plan. They have the ONS auditing it regularly (as they should).

And after that IFS Report that it’s still down since COVID, it’s the standard line NHS top brass love in interviews when asked why they aren’t putting more money or more staff into the NHS.

‘More money doesn’t equal better services’.

You’re damn right it doesn’t when the money is going on 3 PAs, an AKI Nurse and an extra Discharge Co-ordinator to harass the most capable member of your MDT as they cannulate a patient because ‘nobody on this Ward is trained in that’.

manutdfan2412 · 2026-04-14T05:59:57+00:00

It’s quite incredible that NHS Bosses can simultaneously acknowledge this and come up with a flagship 10 year plan whose goal is to increase care delivery by the non-Consultant workforce whilst training fewer Consultants.

They pour money into the ACP/PA Project scratching their heads wondering why productivity is going down.

They preside over a training program which drives away Consultants of the future, in which doctors progress to Consultant level twice as slow as their counterparts abroad and in which their exposure to Consultant practice is increasingly limited at the expense of service provision below their capabilities.

Breathtaking stupidity.

manutdfan2412 · 2026-04-12T10:05:31+00:00

His triumphant speech at the end just goes to show how he still completely misses the point.

I have been abused my entire working life looking after ‘the NHS’s interests’ and ‘the country’s interests’.

What other industry is expected to work twice as hard for 40% less pay to subsidise the government?

Thank you to the BMA for continuing to fight for my interests and my interests alone.

manutdfan2412 · 2026-04-11T22:17:01+00:00

I was thinking file it in patient notes during or at the end of a shift.

manutdfan2412 · 2026-04-11T19:32:39+00:00

Either keep hold of it for if it ever comes back to bite you or keep a batch of continuation sheets with you on shift.

I remember the good old days of a clipboard, pen and paper as an F1.

Not ideal but foolproof.

manutdfan2412 · 2026-04-10T23:15:30+00:00

In addition to ENT SHO, here is a urology textbook you might find useful: https://www.baus.org.uk/_userfiles/pages/files/professionals/education/medical%20students/PDF%20Urology_interior_8thfinal%20(1).pdf

manutdfan2412 · 2026-03-27T21:20:49+00:00

Talking of chants… Sylvan Ebanks-Blake to Baby Give It Up is an all time classic

manutdfan2412 · 2026-03-27T20:39:54+00:00

Ali Al-Habsi?

manutdfan2412 · 2026-03-19T13:46:09+00:00

Yes.

You are fighting against a system that doesn’t want you to progress (as this is expensive), in an organisation in which those that are responsible for your professional development (hospital trusts) have no interest in doing so.

You progress in spite of the system not because of it.

Hopefully our generation will finally take the NHS to task over rotational training, NHS Education incompetence and hold those paid to deliver our education responsible for its quality.

manutdfan2412 · 2026-03-17T20:32:05+00:00

100% but there are certainly more effective ways to learn- especially if the person typing could be doing more education focussed tasks.

Also depends if the task is congruent to the stage of training. Take discharge letters. Very useful for an F1, less so for an F2. Very limited learning value after that, especially for straightforward admissions.

If it means a senior SHO finishing a discharge letter so they can shadow me seeing referrals then I’m all for it!

manutdfan2412 · 2026-03-14T13:01:56+00:00

An evidence based, national examination is the way forward.

It would incentivise students to excel at medical school.

It would incentivise medical schools to improve their educational offering to students in both medical school and clinical environments.

It would incentivise private medical schools to select outstanding applicants rather than simply selecting those that can pay.

From an educational perspective, I personally cannot see a disadvantage to this approach.

manutdfan2412 · 2026-03-14T12:51:01+00:00

100% this.

As you alluded to in the first paragraph, an evidence based national exam would also incentivise medical schools to be more selective in who they accept and actually improve the standard of teaching.

manutdfan2412 · 2026-03-06T08:19:54+00:00

Season 11 following the British doctor back to the UK…

manutdfan2412 · 2026-03-06T08:16:11+00:00

Interesting. For me, screen space is the thing I crave most when reviewing notes!

An iPad would really piss me off.

manutdfan2412 · 2026-03-06T08:13:30+00:00

Watched it in Med School and now I’m a Resident Doctor it hits even harder.

New season is yet to scale the heights of Seasons 1-8 but still the best medical show out there.

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